Publications by authors named "Anand Raja"

24 Publications

  • Page 1 of 1

Primary Renal Synovial Sarcoma Case Series: Clinical Profile and Management of a Rare Entity.

Urol Int 2021 Nov 29:1-3. Epub 2021 Nov 29.

Department of Surgical Oncology, Cancer Institute (WIA), Chennai, India.

Synovial sarcomas occur predominantly in the extremities. Primary renal synovial sarcoma is a rare entity. Very few cases have been reported in the literature. Clinical and radiological features are similar to renal cell carcinoma with the diagnosis being established after surgery based on histopathology, immunohistochemistry, and chromosome studies. There are no established guidelines on the role of adjuvant treatment in the management of this disease. We herein present a series of 3 cases managed at 2 institutions. In the current series, all patients had venous thrombus, and surgery was the mainstay of treatment. One patient received neoadjuvant chemotherapy after a preoperative biopsy which was done as she did not respond to chemotherapy for a presumptive diagnosis of Wilm's tumor.
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http://dx.doi.org/10.1159/000520223DOI Listing
November 2021

Factors Predicting Nodal Metastasis in Penile Cancer: Analysis from a Tertiary Center.

Urol Int 2021 Nov 24:1-6. Epub 2021 Nov 24.

Department of Surgical Oncology, Cancer Institute (WIA), Chennai, India.

Introduction: Lymph node metastasis is an important prognostic marker in penile cancer. Identification of occult metastasis is by lymphadenectomy based on the histological features of primary tumor; however, this leads to unnecessary surgical morbidity in node negative patients.

Methods: A retrospective analysis of all surgically treated penile cancer patients managed at our institute from January 2011 to March 2014 was performed. Patient characteristics, histological factors, and lymph node involvement were identified. Logistic regression analysis was used to compute odds ratio (OR) in univariate and multivariate analysis.

Results: Ninety seven patients underwent surgical management at our institute during the abovementioned period. Grade III tumor, presence of lymphovascular invasion, tumor thickness >10 mm, perineural invasion (PNI) and Ki67 >50% were significantly associated with nodal metastasis. On multivariate analysis, only presence of PNI was found to be significant (OR: 6.82) (95% confidence interval: 1.72-27.03) (p = 0.006).

Conclusion: PNI is a strong independent predictor of occult lymph node metastasis in penile cancers. Its inclusion in stratification of clinically node negative patients will identify high-risk patients who will benefit from prophylactic lymphadenectomy.
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http://dx.doi.org/10.1159/000519918DOI Listing
November 2021

In Situ Preparation for Nerve Preservation in Extremity Soft Tissue Sarcoma. Point of Surgical Technique.

Indian J Surg Oncol 2021 Sep 11;12(3):641-646. Epub 2021 Jul 11.

Department of Surgical Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Guindy, Chennai, 600036 Tamilnadu India.

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http://dx.doi.org/10.1007/s13193-021-01376-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490571PMC
September 2021

Clipping inguinal lymphatics decreases lymphorrhoea after lymphadenectomy following cancer treatment: results from a randomized clinical trial.

Scand J Urol 2021 Sep 23:1-6. Epub 2021 Sep 23.

Apollo Cancer Hospital, Chennai, India.

Background: Post-operative lymphorrhea is a well-known complication of inguinal lymph node dissection. However, the interventions to reduce the duration of drain have not been sufficiently elaborated.

Objectives: We evaluated the potential role of intra-operative mapping of lymphatic leakage with peri-incisional methylene blue injection and clipping of lymphatics after inguinal block dissection in reducing postoperative lymphorrhea.

Methods: We randomized 39 inguinal dissections done for various malignancies such as for carcinoma penis, urethra, malignant melanoma, rectum into 19 dissections (Interventional group) and 20 dissections (Control group). In the interventional group, after the completion of inguinal dissection, two ml of methylene blue dye was injected 4-8cm from the incision to identify the leaking lymphatics and they were clipped.

Results: The primary outcome was the decrease in duration of days of drain and was found to have significant reduction of 3.07 days in the interventional arm. (p value-0.02). The secondary outcome was the reduction of 21 ml of mean drain output in the interventional group ( = 0.09). The number of lymphatics clipped was not found to have statistical correlation with the duration of drain and the mean drain output.

Conclusion: The intraoperative mapping of lymphatic channels using methylene blue after inguinal dissection reduces the number of days of drain .
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http://dx.doi.org/10.1080/21681805.2021.1980096DOI Listing
September 2021

Nerve-Sparing Postchemotherapy Retroperitoneal Lymph Node Dissection (PC RPLND) for Nonseminomatous Germ Cell Tumour: Experience from a Tertiary Cancer Centre.

Indian J Surg Oncol 2021 Jun 25;12(2):374-377. Epub 2021 Mar 25.

Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, India.

Postchemotherapy RPLND remains an integral part of management of testicular tumours. Nerve-sparing techniques can minimize the ejaculatory dysfunction due to the procedure. We report our functional and oncological outcomes for nerve-sparing RPLND in postchemotherapy settings. We analysed data from all patients undergoing nerve-sparing PC RPLND from January 1990 to December 2013 at our institute. Antegrade ejaculation and fertility issues were determined by patient history. Nerve sparing was achieved in 30% of patients undergoing PC RPLND. Of the 33 patients who underwent nerve-sparing PC RPLND, 19 (57.8%) had antegrade ejaculation. The mean time to antegrade ejaculation was 6.8 months. After a median follow-up of 75.61 months, 5-year disease-free survival was 98%. Nerve-sparing RPLND can improve functional outcomes without increasing recurrence rates in post chemotherapy setting.
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http://dx.doi.org/10.1007/s13193-021-01313-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272781PMC
June 2021

Utility and Safety of Repeat Transurethral Resection of Bladder Tumor Performed at a Tertiary Center.

South Asian J Cancer 2020 Jun 14;9(2):86-89. Epub 2020 Dec 14.

Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.

 Repeat transurethral resection of bladder tumor (ReTURBT) has become an integral part of the management of superficial bladder cancers at various urological centers around the world. Early detection of residual disease, leading to upstaging in some cases, leads to decrease in recurrence rates. Our study aimed to analyze the impact of ReTURBT in detecting residual tumor and tumor recurrences, hence validating the benefits of procedure as a routine.  A total of 152 patients with superficial bladder cancer who were treated at Cancer Institute (WIA) between January 2005 and December 2013 were analyzed and followed up for 3 years.  Of the 152 cases who underwent ReTURBT, 47 patients had residue in the final histopathology of the resected specimen (31%). The overall rate of upstaging to muscle-invasive disease following ReTURBT was 3.3%. The mean follow-up period was 47.13 months, during which 25 (17%) out of 147 patients who underwent ReTURBT had disease recurrence. There was no additional morbidity due to ReTURBT as compared with the primary procedure.  ReTURBT is an effective procedure in treating recurrent tumors also as long as they remain superficial. The procedure when performed with utmost care in experienced hands remains a very safe procedure to be followed as a routine and standard.
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http://dx.doi.org/10.1055/s-0040-1721213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745745PMC
June 2020

Sarcoma Care Practice in India During COVID Pandemic: A Nationwide Survey.

Indian J Orthop 2020 Jul 31:1-8. Epub 2020 Jul 31.

Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, India.

Background: Amidst the COVID-19 pandemic, management of cancer has been one of the most intensely debated topics across the globe. We conducted an online survey to determine the consistency/or the lack of it, in the management of sarcoma patients between centres and the changes in policies.

Methods: A twenty-five question online survey was conducted among practicing physicians over a period of 10 days using online portal (surveymonkey.com). It was followed by a critical analysis based on responses to each question.

Results: Of 194 medical professionals who participated, 80% were surgeons and 53% were working in government institutes. Most respondents (81%) continued their practice with some modifications. In OP majority (67%) relied only on symptom, contact enquiry and temperature recording for screening. COVID-19 testing was done more (43%) in IP patients. Most of institutes (83%) followed rotational policy to reduce the number of staff at risk while 57% offered an alternate accommodation. 52.3% continued chemotherapy for all patients while radiotherapy for all was offered by 45%. In metastatic cases, majority preferred either no treatment or non-surgical intervention (71%).84.5% believed in adapting changes (42%-avoid supra major surgeries, 27%-Operating only emergency cases and 15.5%-High grade sarcomas with curative intent) in surgical management of sarcomas. For benign bone tumors, majority (71%) agreed on adapting changes while 25% agreed on deferring all cases. 69% preferred teleconsultations for follow-up. Complete PPE were being used for all aerosol generating procedures by 44%. Only two thirds agreed with their institutes policy of PPE usage and COVID-19 testing.

Conclusion: This survey has highlighted disparity on COVID-19 screening and management in various institutes across the country. This will act as a reference point for tracking future trends in bone and soft tissue tumor management guidelines, as the COVID-19 scenario unfolds globally and particularly in India.
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http://dx.doi.org/10.1007/s43465-020-00206-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393016PMC
July 2020

Adapting Management of Sarcomas in COVID-19: An Evidence-Based Review.

Indian J Orthop 2020 May 30:1-13. Epub 2020 May 30.

Department of Radiology, Tata Memorial Hospital, and Homi Bhabha National Institure (HBNI), Mumbai, India.

With the novel coronavirus disease (COVID-19) being declared a global pandemic by the World Health Organization, the Indian healthcare sector is at the forefront to deliver optimal care. Patients with cancer especially are at serious risk for increased chances of morbidity and mortality due to their immunocompromised state. Currently there is a paucity of definitive guidelines for the management of sarcomas during the pandemic in a resource-constrained and diverse population setting like India. Health care professionals from various specialties involved in the management of sarcomas have collaborated to discuss various aspects of evidence-based sarcoma management during the COVID-19 pandemic. This article provides structured recommendations for HCP to adapt to the situation, optimize treatment protocols with judicious use of all resources while providing evidence-based treatment for sarcoma patients.
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http://dx.doi.org/10.1007/s43465-020-00143-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261215PMC
May 2020

A retrospective analysis of patients undergoing postchemotherapy retroperitoneal lymph node dissection and metastasectomy in advanced nonseminomatous germ cell tumors.

Indian J Urol 2020 Apr-Jun;36(2):112-116. Epub 2020 Apr 7.

Department of Surgical Oncology, Apollo Specialty Hospital, Chennai, Tamil Nadu, India.

Introduction: Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) and metastasectomy play an important role in the management of advanced-stage nonseminomatous germ cell tumors (NSGCT). We aimed to analyze preoperative parameters that could predict postoperative histology.

Materials And Methods: We analyzed the data of 72 patients who underwent PC-RPLND and 14 patients who underwent metastasectomy after receiving cisplatin- or carboplatin-based chemotherapy for advanced stage NSGCT at our institute from 1994 to 2015. Clinical and pathological parameters such as the histology of orchidectomy, RPLND and metastasectomy, serum tumor markers, and the pre and post chemotherapy retroperitoneal lymph node size were recorded.

Results: Seventy-two patients with a mean age of 28 years underwent PC-RPLND. Of the various variables evaluated, only percentage change in nodal size was found to be statistically significant in predicting necrosis ( = 0.004). A decrease of 75% was found to predict the necrosis with a specificity of 100%. There was 84.6% concordance between the histology of RPLND and that of metastasectomy.

Conclusion: A 75% reduction in tumor size is highly predictive of absence of viable tumor or teratoma, however larger series are required to confirm these findings. RPLND histopathologies have a high concordance with metastasectomy histology and thus can be used as a guide to tailor further management.
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http://dx.doi.org/10.4103/iju.IJU_301_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279107PMC
April 2020

Paediatric Renal Synovial Sarcoma: Another Diagnostic Pathological Dilemma.

Indian J Surg Oncol 2020 Mar 27;11(1):138-141. Epub 2019 Oct 27.

3Department of Pathology, Christian Medical College, Vellore, India.

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http://dx.doi.org/10.1007/s13193-019-00989-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064649PMC
March 2020

Isolated regional nodal metastasis in giant cell tumor of the bone: Case report and review of literature.

South Asian J Cancer 2020 Jan-Mar;9(1):58

Department of Pathology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.

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http://dx.doi.org/10.4103/sajc.sajc_244_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956574PMC
January 2020

Usefulness of narrow-band imaging in transurethral resection of bladder tumor: Early experience from a tertiary center in India.

South Asian J Cancer 2019 Oct-Dec;8(4):226-228

Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.

Background: The current standard for diagnosis and treatment of urinary bladder cancer is transurethral resection of bladder tumor (TURBT) using white light guidance. Narrow band imaging (NBI) has emerged as a promising method for identifying additional bladder lesions. Various studies have been published to evaluate its sensitivity in identifying new lesions and its impact on decreasing recurrences. In this study, we evaluated our early experience using NBI in TURBTs.

Aims And Objective: The aim of the study is to determine the accuracy of NBI in identifying additional malignant lesions during TURBT.

Materials And Methods: We retrospectively collected data for all patients who underwent either TURBT or repeat TURBT with white light and NBI from November 2016 to July 2017 at Cancer Institute (WIA). The number of additional lesions identified using NBI was evaluated along with its correlation with the final histopathology.

Results: Forty patients were analysed of which 20 underwent TURBT and 20 underwent repeat TURBT. Of these, 36 patients had complete resection of tumour. Additional lesions were detected in 6 patients (14%) by NBI of which 2 (33%) were malignant histology. The additional lesions detected were carcinoma in situ and no patient was upstaged.

Conclusion: The inclusion of NBI to conventional white light TURBT increases the sensitivity for identifying additional lesions. The limitation of NBI is high false positivity and its availability. Long term follow up studies with larger subset of patients are required to evaluate its role in decreasing recurrences and justification in routine clinical practice.
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http://dx.doi.org/10.4103/sajc.sajc_367_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852624PMC
December 2019

The Challenge in the Management of Extremity Fibromatoses: Our Experience.

Indian J Surg Oncol 2019 Jun 13;10(2):329-334. Epub 2018 Dec 13.

2Division of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, India.

Desmoid tumours are known for their varied clinical behaviour. Hence, choosing an ideal treatment protocol remains challenging. This is further complicated by the rarity of these neoplasms and high recurrence rates following treatment. In our study, we tried to answer these questions in the background of Indian scenario. This is a retrospective study of 41 patients with extremity fibromatoses who were operated between June 2002 and November 2012. The mean age for all patients was 29.2 years with 30 females and 11 males. The mean duration of follow-up was 4.37 years. Eight patients were margin-positive on final histopathology. Seventeen developed recurrences (41.4%). Ten of these 17 patients underwent repeat surgery. The remaining 7 patients with inoperable recurrence were put on metronomic chemotherapy. The DFS for patients treated with surgical management was 62.6% at 3 years, 54.4% at 5 years and 44% at 10 years. The enigmacy on the tumour biology, natural history and optimal management of fibromatoses continue. Surgery remains the standard treatment and should be attempted only if R0 resection is possible without much morbidity to the patient. Non-surgical modalities also have their role to play in the management of these neoplasms.
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http://dx.doi.org/10.1007/s13193-018-0857-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527625PMC
June 2019

Multiple adenoid basal cell carcinoma: An uncommon presentation.

Indian J Dermatol Venereol Leprol 2019 Jul-Aug;85(4):393-396

Department of Pathology, Cancer Institute, Adyar (W.I.A.), Chennai, Tamil Nadu, India.

Basal cell carcinoma (BCC) is the most common malignant skin tumor which occurs more frequently over the sun exposed parts of body. Its adenoid variant is a rare histological subtype. We report a case of multiple adenoid basal cell carcinomas at unusual sites in a middle-aged male patient.
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http://dx.doi.org/10.4103/ijdvl.IJDVL_803_16DOI Listing
December 2019

Real World Experience of Treating Neuroblastoma: Experience from a Tertiary Cancer Centre in India.

Indian J Pediatr 2019 05 18;86(5):417-426. Epub 2019 Feb 18.

Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamilnadu, India.

Objectives: Management of neuroblastoma, especially high-risk (HR) disease is difficult in a resource-limited setting. There is a paucity of literature on outcomes of patients treated in India. The present study was conducted to analyse the clinical profile, treatment, and outcomes of patients with neuroblastoma treated at authors' centre.

Methods: The study was a retrospective analysis of newly diagnosed patients with neuroblastoma treated at authors' centre between 2000 to 2017. The International Neuroblastoma Staging System and risk grouping were used to classify patients as low-risk (LR), intermediate-risk (IR) and high-risk (HR). Treatment was individualised and risk-adapted. Kaplan-Meier method was used to calculate the event-free survival (EFS) and overall survival (OS).

Results: The study included 85 patients with a median age of 4 y and 67% were males. Malnutrition was observed in 55% of patients. Adrenal gland was the most common site in 75% patients followed by mediastinum in 12%. LR was observed in 7/85 (8%) patients, IR 20/85 (24%) and HR in 58/85 (68%) patients. The CCG-3891 protocol was used to treat 80% of the patients. Autologous stem cell transplantation (ASCT) was performed in 32% of HR patients. The median follow-up was 16.6 mo. The median EFS and OS for all patients were 19.2 mo and 26.9 mo respectively and the 3 y EFS and OS was 36% and 47% respectively. The 3y EFS for LR, IR and HR patients was 100%, 54%, and 18.9% respectively (P < 0.001) and for OS was 100%, 77%, and 34% respectively (P = 0.002). On multivariate analysis, a hemoglobin less than 10 g% predicted inferior EFS (P = 0.002) and OS (p = 0.005) for all patients. For patients with high-risk disease, on multivariate analysis, hemoglobin (P = 0.002) and 13-Cis Retinoic acid maintenance (P = 0.002) predicted EFS and only radiotherapy to the primary (P = 0.01) predicted OS. Only 4/19 (21%) are alive and in remission post ASCT.

Conclusions: Majority of patients with neuroblastoma presented to authors' centre with advanced disease. Survival outcomes of patients with LR disease are excellent. However, patients with HR disease have poor outcomes despite multimodality management. Non-availability of N-MYC testing in few patients could have falsely down-staged them to IR from HR. A low hemoglobin at diagnosis is a poor predictor of outcome.
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http://dx.doi.org/10.1007/s12098-018-2834-6DOI Listing
May 2019

Factors that impact the outcomes in testicular germ cell tumors in low-middle-income countries.

Med Oncol 2019 Feb 6;36(3):28. Epub 2019 Feb 6.

Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, 600020, India.

Germ cell tumors (GCTs) are one of the most common tumors in adolescents and young adults. There is paucity of data on GCT from low-middle-income countries (LMIC). The present study was conducted to assess the demographic features, clinical manifestations, pathology, and outcomes of GCT patients treated at our center. Patients with testicular GCT above the age of 18 years, treated at our center from 2001 to 2015 were included in the study. Data were extracted retrospectively from the case records. Event-free survival (EFS) and overall survival (OS) were calculated using the Kaplan-Meier method and the variables were compared using the log-rank test. The study included 421 patients among whom 128 (30%) had a histological diagnosis of seminoma and 293 (70%) had non-seminomatous germ cell tumor (NSGCT). Metastatic disease at presentation was observed in 83/128 (65%) with seminoma and 254/293 (87%) with NSGCT. According to the International Germ Cell Cancer Collaborative Group (IGCCCG) risk stratification for metastatic disease, good- and intermediate-risk seminoma were observed in 55/83 (66%) and 28/83 (34%) patients, respectively, and good-, intermediate-, and poor-risk NSGCT were observed in 82/254 (32%), 76/254 (30%), and 96/254 (38%) patients, respectively. The median follow-up was 32.3 months (range 0.03-200 months). The 3-year OS for the entire cohort was 80.3%. The 3-year OS for seminoma was 91.4%, and for NSGCT was 75.3%. Factors significantly associated with inferior EFS and OS on multivariate analysis included poor performance status, scrotal orchidectomy, carboplatin-based regimen, NSGCT histology, and treatment default. Patients with testicular GCT in India present in an advanced stage and higher IGCCCG risk compared to Western data. Factors unique to LMIC like treatment default, bulky disease, dose compromise, and scrotal orchidectomy have a negative impact on the outcome.
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http://dx.doi.org/10.1007/s12032-019-1252-6DOI Listing
February 2019

A mini review: garlic extract and vascular diseases.

Neurol Res 2018 Jun 20;40(6):421-425. Epub 2018 Mar 20.

a China-America Institute of Neuroscience, Beijing Luhe Hospital , Capital Medical University , Beijing , China.

Vascular diseases refer to medical conditions that narrow blood vessels. Narrowed cardiac or cerebral arteries can lead to myocardial infarction or ischemic stroke. Risk factors including atherosclerosis, hypertension, and diabetes may induce either cardiovascular or cerebral complications. Based on current research, garlic favorably affects atherosclerosis, hypertension and diabetes, and helps decrease the risk of myocardial infarction and ischemic stroke. Garlic has been utilized for hundreds of years as a natural health remedy. New research is emerging regarding its effectiveness in treating common diseases, including atherosclerosis, hypertension, and diabetes. The underlying mechanisms by which garlic, and its byproducts, can alter pathophysiology have begun to be elucidated by these studies. Garlic is a prominent topic for future research regarding its potential as an adjuvant to conventional pharmacotherapy for these common health conditions. In this mini-review, we discuss the current state of the literature regarding garlic and its effects in patients with vascular disease. Specifically, we decided to briefly discuss the key points regarding the mechanisms underlying garlic's anti-hypertensive, anti-hyperlipidemic, and hypoglycemic effects. This allows the readers to understand each process while keeping the paper concise. These mechanisms can be further explored in the original articles, at the reader's discretion.
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http://dx.doi.org/10.1080/01616412.2018.1451269DOI Listing
June 2018

Sporadic Meningioangiomatosis: A Series of Three Pediatric Cases.

Cureus 2017 Sep 1;9(9):e1640. Epub 2017 Sep 1.

Neurosurgery, Wayne State University School of Medicine.

Meningioangiomatosis (MA) is a rare benign, hamartomatous lesion within the leptomeninges and cerebral cortex. Three percent of intractable epileptic patients with tumor develop MA. It may be accompanied with neurofibromatosis type II, or it may occur sporadically. Three patients, age range of 2-16 years old, presented with episodes of seizure. The patients demonstrated no family history or stigmata of neurofibromatosis type II. Electroencephalogram (EEG) was unremarkable for epileptiform activity. Magnetic resonance imaging (MRI) revealed enhancing lesions within the frontal gyrus, the anterior cingulate gyrus, and the parietal lobe. Incomplete resection led to recurrence in one patient, and later, intraoperative ultrasound was used to achieve total resection in another patient. Each patient was seizure free on follow-up, and managed with anti-epileptic medication. Resection is the only curative treatment in 85% of MA cases. Complete resection is necessary for symptomatic treatment in cases of MA, as recurrence has been documented in this lesion. Intraoperative ultrasound is an effective imaging modality to ensure gross total resection of MA.
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http://dx.doi.org/10.7759/cureus.1640DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665690PMC
September 2017

Primary Synovial Sarcoma of the Kidney with Inferior Vena Caval Thrombus.

Indian J Surg Oncol 2016 Sep 22;7(3):345-8. Epub 2016 Jan 22.

Department of Surgical Oncology and Department of Oncopathology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036 India.

Synovial sarcomas occurs primarily in the soft tissues, mostly in para-articular regions of the extremities. These tumors have been described in other unusual locations like the pleura, lungs, mediastinum, and kidneys. Primary synovial sarcoma of the kidney is a recently described entity; to date, a total of approximately 35 cases have been reported. Only three cases of primary synovial sarcoma of kidney with IVC thrombus have been reported so far. Here we present the case of a 44 year old gentleman, with primary synovial sarcoma of the left kidney with caval thrombus.
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http://dx.doi.org/10.1007/s13193-015-0438-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016319PMC
September 2016

Synovial Sarcoma in a Neonate.

Indian Pediatr 2016 Apr;53(4):345-6

Departments of Medical Oncology, *Pathology and #Surgical Oncology, Cancer Institute, Adyar, Chennai, India. Correspondence to: Dr Venkatraman Radhakrishnan, Associate Professor, Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai 600 020, India.

Background: Malignant tumors in neonates are rare.

Case Characteristics: A tumor was detected in the left biceps of a 3-day old neonate. Tumor biopsy and molecular study confirmed the diagnosis of synovial sarcoma. The child received multi-modality treatment with surgery and chemotherapy.

Outcome: The child is disease-free on follow-up period of 12 months.

Message: Synovial sarcoma can rarely occur in a neonate.
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http://dx.doi.org/10.1007/s13312-016-0850-zDOI Listing
April 2016

Chikungunya Fever With Seizures, Myocarditis, and Severe Thrombocytopenia in a Child With Osteosarcoma.

Pediatr Blood Cancer 2016 09 29;63(9):1687. Epub 2016 Apr 29.

Division of Pediatric Oncology, Department of Medical Oncology, Cancer Institute (WIA), Chennai, India.

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http://dx.doi.org/10.1002/pbc.26040DOI Listing
September 2016

Synovial sarcoma of kidney in a child: A rare presentation.

J Indian Assoc Pediatr Surg 2016 Apr-Jun;21(2):75-7

Department of Medical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.

There are no reported cases in the literature of primary renal synovial sarcoma in pediatric patients. The management of renal synovial sarcoma has been extrapolated from the management of soft tissue sarcomas at other sites. We present a 4-year-old female who was suspected to have Wilms' tumor. The patient underwent guided biopsy as she did not respond to neoadjuvant chemotherapy for Wilms' tumor. The biopsy was consistent with primary renal synovial sarcoma. The child was treated with change in her neoadjuvant chemotherapy regimen and surgery. The diagnosis of synovial sarcoma was confirmed by demonstrating the t (X, 18) translocation using polymerase chain reaction.
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http://dx.doi.org/10.4103/0971-9261.172502DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790133PMC
April 2016

Role of dynamic sentinel node biopsy in carcinoma penis with or without palpable nodes.

Indian J Urol 2016 Jan-Mar;32(1):57-60

Department of Pathology, Cancer Institute (WIA), Adyar, Chennai, India.

Introduction: We aimed to evaluate the role of dynamic sentinel node biopsy (DSLNB) in patients diagnosed with carcinoma penis and clinically N0 disease using superficial inguinal dissection as the standard staging modality.

Materials And Methods: Twenty consecutive men (40 groins) with carcinoma penis having clinically N0 status were enrolled in the study. Patients underwent DSLNB if fine needle aspiration cytology from the groin nodes was negative, followed by injection of radiocolloid and blue dye. The sentinel lymph node(s) were harvested. The inguinal incision was then extended and a modified superficial inguinal dissection was performed and all nodes were labeled separately and sent for frozen section. A completion deep inguinal with pelvic dissection was performed if any of the nodes were reported positive for malignancy.

Results: The median age of the patients was 52.5 years. Ten patients were smokers. Phimosis was present in five patients. Lesions were present over the glans penis and shaft in 18 and two patients, respectively. Wide local excision, partial penectomy and total penectomy were performed in one, 15 and four patients, respectively. Clinically palpable nodes were found in 19 groins. Median follow-up was 26 months. Nodes were positive in 10 groins. DSLNB missed the sentinel node in one groin. The accuracy and false-negative rate of DSLNB was 97.5% and 10%, respectively.

Conclusion: DSLNB is a useful and reliable technique to identify the involved node(s) in patients diagnosed as having carcinoma penis with clinical N0 status (with or without palpable nodes). It helps to avoid the morbidity associated with a staging inguinal dissection in these patients.
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http://dx.doi.org/10.4103/0970-1591.173111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756552PMC
March 2016
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