A case of BCC - Dr Hasan Khalaf
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An 87-year-old man with multiple medical comorbidities presented with a 15-year history of a neglected facial ulcer. A biopsy found it to be a high-risk subtype of basal cell carcinoma. Surgery was performed but margins were positive. Given the patient's poor surgical candidacy, vismodegib was ordered as the next treatment step.
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3. Management is discussed including laparoscopic versus open appendectomy, non-operative versus operative treatment, and considerations for delayed presentation and normal appearing appendices.
Carcinoma pancreas management
This document discusses the management of periampullary cancers. It covers the role of fine needle aspiration in diagnosis and pre-operative biliary decompression. Staging laparoscopy and clinicopathological staging are discussed. The document outlines curative surgeries like pancreaticoduodenectomy and distal pancreatectomy. It also discusses operative and non-operative palliative options. Adjuvant therapies including chemo-radiation are mentioned. Emerging novel agents for treatment are noted.
Document 20211230150725
This case report describes the treatment of a 55-year-old male patient diagnosed with gastric diffuse large B-cell lymphoma (DLBCL) at the Portsudan Oncology Center in Sudan from August 2018 to July 2021. The patient received 8 cycles of CHOP chemotherapy, followed by 8 cycles of rituximab and 30GY radiotherapy to the gastric region and lymph nodes. The treatment resulted in regression of lesions. However, the patient later experienced a relapse and was treated with 8 cycles of ICE chemotherapy, with regression of lesions observed again. The report discusses DLBCL and the challenges of treating it at a small oncology center with limited resources and capabilities.
Core Needle Biopsy of Breast : Updates
Core needle biopsy is a commonly used and reliable method for sampling breast lesions, allowing diagnosis in over 90% of cases. However, certain lesion types like fibroepithelial lesions, spindle cell lesions, papillary lesions, and radial scars can be difficult to diagnose with certainty on core biopsy alone. Immunohistochemistry and excisional biopsy are often needed in these problematic cases to arrive at a definitive diagnosis. Standardizing the reporting of core biopsies and following international guidelines helps ensure consistent and optimal patient care.
cnbbreast-Core needle biopsy of breast : practical issues and updates
This document discusses core needle biopsy of the breast, including:
- CNB is more reliable than cytology but also more expensive and invasive. It allows diagnosis and treatment planning.
- CNB is indicated for clearly malignant lesions, microcalcifications, or when cytology is inconclusive. Devices include stereotactic, ultrasound, or MRI-guided spring-loaded needles ranging from 14G to 18G.
- Processing involves sectioning at 50um intervals and staining a minimum of three levels. Special stains may be needed.
- Reporting includes basic information, histological findings, and prognostic factors like grade. Repeat HER2 testing may be needed if initial CNB results are equivocal or suboptimal.
Dr Anil:AIIMS Patna, Primary leiomyosarcoma of IVC.
- A 60-year-old female presented with vague right loin pain, weight loss, and weakness. Imaging revealed a 6-7 cm retroperitoneal mass adjacent to the renal portion of the IVC, which was compressing the luminal space.
- The patient underwent surgery involving a right nephrectomy and resection of the tumor along with the involved portion of the IVC. A Dacron graft was implanted to reconstruct the IVC.
- Pathology identified the tumor as a leiomyosarcoma arising from the smooth muscle of the IVC, which is an extremely rare malignancy. Complete surgical resection offers the best chance of survival when the tumor is resectable.
primary leiomyosarcoma of IVC: CCR Presented by Dr Anil Kumar.Senior Resident...
Clinical Combined Round presentation By Dr Anil on rare Case :Primary Leiomyosarcoma of Juxtarenal IVC:
departmental presentation ,gynaecological oncology department,NICRH
a presentation on few patients with gynaecological malignancy. presented on September 2022. This presentation contains with diagnosis ,investigation, management (both surgical & medical ).
Oral cancers
1. A 35-year-old male presented with a non-healing ulcerative growth on his right tongue. Biopsy revealed grade II squamous cell carcinoma. He underwent right hemi-glossectomy with neck dissection and reconstruction. Pathology showed pT3pN2b disease. Adjuvant chemoradiation was proposed.
2. A 55-year-old male presented with a large left neck mass. Biopsy showed metastatic squamous cell carcinoma of unknown primary. He underwent resection of the neck mass with bilateral neck dissection and reconstruction. Pathology showed a 14cm poorly differentiated carcinoma with sarcomatoid features and nodal metastases. Adjuvant chemorad
fertililty sparing surgeries in gynecological cancers
- Fertility preservation is important for cancer patients of childbearing age to maintain their quality of life. Advances in cancer treatment like chemotherapy and radiation can impact fertility.
- For early stage cervical cancers like stage 1A1, 1A2, and 1B1, fertility sparing surgeries like conization or radical trachelectomy combined with lymph node dissection may be options to preserve fertility while treating the cancer.
- For early stage ovarian and endometrial cancers, fertility sparing surgeries like cystectomy or tumor resection with lymph node sampling can be considered to treat the cancer and spare fertility in select cases.
Peritoneal Carcinomatosis : Dr Amit Dangi
Here are the key steps:
1. The left subphrenic space is entered by incising the peritoneum overlying the left hemidiaphragm.
2. The peritoneum is dissected off the left hemidiaphragm in a cephalad direction towards the diaphragmatic crus.
3. The peritoneum is then stripped down the left paracolic gutter towards the pelvis, removing all peritoneal surfaces.
4. The left subphrenic peritonectomy is then completed, exposing the left hemidiaphragm and removing all peritoneal surfaces in the left subphrenic space.
Management of Squamous cell carcinoma
A 65-year-old male presented with a painful ulcerative lesion on the left side of his face that had been gradually increasing in size over the past year. Examination revealed an ulcerated tumor measuring 5cm by 3cm involving the upper lip, right angle of the mouth, and lower half of the nose. The lesion was excised and found to be squamous cell carcinoma on histopathological examination. Treatment for the patient would depend on accurate staging of the cancer including its size, involvement of lymph nodes or distant organs, the patient's overall health, and whether combination therapies like surgery and radiation are appropriate. The goal of treatment is complete removal of the cancer while preserving function and minimizing long-term side effects.
Collision Tumor of the Thorax
Cutaneous squamous cell carcinoma (SCC) is the second most common cancer in the United States, and high-risk SCC is associated with more aggressive tumor behavior and correlated with poorer outcomes. This case study illustrates a patient who was found to have a large, fungating mass that had been neglected for 20 years. An excisional biopsy was completed, and the mass was identified histologically with two distinct patterns of invasive carcinoma: SCC and adenoid basal cell carcinoma, thus a collision tumor. This case report discusses risk factors and possible treatment options for this rare presentation.
cancer papilar prezentare.pptx
This document describes a rare case of a 72-year-old man with papillary thyroid cancer that has metastasized to his lungs. Papillary thyroid cancer typically grows slowly and rarely spreads, but this patient presented with an enlarged thyroid gland and numerous lung nodules. A biopsy confirmed the diagnosis of papillary thyroid cancer. He underwent surgery to remove his thyroid gland and neck lymph nodes. While the long-term prognosis is generally favorable for differentiated thyroid cancer that has metastasized, this case represented an advanced stage of the disease.
Ca Papillary(Thyroid Gland)
1. The patient presented with a swelling in his neck for 2 years that had been gradually increasing in size and causing pain for the past 2 months.
2. Examination and investigations including lymph node biopsy, ultrasound neck, and CT neck revealed metastatic papillary carcinoma of the thyroid.
3. The patient underwent a total thyroidectomy with modified radical neck dissection. Post-operative recovery was unremarkable.
Gallbladder carcinoma (D1)
1. Carcinoma of the gallbladder is a rare but aggressive cancer, usually diagnosed at an advanced stage with poor median survival. Risk factors include gallstones, chronic infection, and obesity.
2. Surgical resection offers the only potential for cure, but most patients are not candidates due to advanced disease at presentation. Neoadjuvant chemotherapy may help some locally advanced tumors become resectable.
3. For unresectable or metastatic disease, palliative chemotherapy with gemcitabine and cisplatin provides modest survival benefits. Supportive care focuses on relieving biliary obstruction and other symptoms.
Kavya_Award paper.pptx
Three cases of cutaneous malignancies are presented that were referred to a dermatologist. Case 1 involved a 58-year-old woman with vulvar carcinoma in situ that was treated with wide local excision and lymph node resection. Case 2 was a 56-year-old woman with pigmented basal cell carcinoma below her right eye, treated with Mohs micrographic surgery. Case 3 was a 65-year-old woman with multiple actinic keratotic lesions and squamous cell carcinomas on her skin from sun exposure, treated with wide local excision and radiation therapy. Early diagnosis and multidisciplinary treatment approaches were important for good patient outcomes in these cases of skin malignancies.
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opening the door of palliative care for breast cancer patient
opening the door of palliative care for breast cancer patient
cnbbreast-Core needle biopsy of breast : practical issues and updates
cnbbreast-Core needle biopsy of breast : practical issues and updates
Dr Anil:AIIMS Patna, Primary leiomyosarcoma of IVC.
Dr Anil:AIIMS Patna, Primary leiomyosarcoma of IVC.
primary leiomyosarcoma of IVC: CCR Presented by Dr Anil Kumar.Senior Resident...
primary leiomyosarcoma of IVC: CCR Presented by Dr Anil Kumar.Senior Resident...
departmental presentation ,gynaecological oncology department,NICRH
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A case of BCC - Dr Hasan Khalaf
- 1. A case of BCC Presented By: Dr Hasan Khalaf
- 2. 87 year old male DM HTN IHD Mild renal impairment Hypertension Presented with a 15 years history of a neglected facial ulcer. He was referred several times to dermatology but missed his appointments.
- 5. A 4 mm punch biopsy biopsy was taken from the ulcer under local anesthesia
- 9. Immunohistochemistry was positive for BCL2 BerEP4 CK 5 and 6 P63
- 10. Histopathologic diagnosis: Basosquamous BCC (high risk subtype)
- 11. CT scan for neck, chest, abdomen and pelvis showed no lymphedenopathy
- 12. Case was referred to Plastic Surgery. The defect was reconstructed with a cheek rotation flap for the lower eyelid area and a nasolabial VY advancement flap for the medial canthal area.
- 14. Histopathology report • Histopatholigical subtype: Basosquamous BCC • Level of invasion: Extradermal, muscle • Margins: Lateral and superior margins are • involved, medial and inferior margins are more • Than 5 mm away from the tumor. • TNM: T2
- 16. Tumor was removed but still has positive margins. Patient is a poor candidate for surgery.
- 17. Case was discussed with oncology depatment and the most appropriate next step was to order Vismodegib for the patient.
- 19. Could it have been possible to minimize size of tumor before surgery?
- 20. Thank You! Dr Hasan Khalaf