Eccrine Angiomatous Hamartoma: A Rare Presentation in Late Adulthood

Eccrine angiomatous hamartoma is a tumor characterized by benign malformation of eccrine and vascular elements, occurring generally at birth or during early infancy and childhood. The rarity with which it is encountered in adults and the elderly makes it a diagnostic challenge in such age brackets. We report an interesting case of eccrine angiomatous hamartoma presenting in late adulthood confirmed by histopathology. Keywords: Cisplatin, concurrent chemotherapy, daily, weekly, three weekly, carcinoma cervix

Comparison of Response to the Concurrent Low Dose Daily Cisplatin Vs Weekly Cisplatin Vs Three Weekly Cisplatin with External Beam Radiotherapy in Carcinoma Cervix Patients of Stage IIB, IIIA & IIIB: A Prospective Study from Single Institution

Introduction: Cervical cancer continues to be a major public health problem affecting middle-aged women, particularly in less-resourced countries. External beam radiation therapy along with intra cavitary insertion has long been the treatment of choice for locally advanced (IIB-IVA) cervical cancer, but long-term successes are limited in terms of pelvic recurrence or distant metastasis. Outcome of low dose daily versus weekly versus three weekly Cisplatin concurrent with External beam radiotherapy in locally advanced cervical carcinoma was compared in this study. Methods: A prospective cross sectional study was carried out in J K cancer institute, Kanpur. Total 60 patients of cervical cancer were randomized into 3 arms. Arm I, Arm II and Arm III received External beam radiotherapy concurrent with either daily (8mg/m2), weekly (40 mg/m2) or three weekly (100 mg/m2) Cisplatin respectively. External beam radiotherapy was given with a dose of 50 Gy / 25 # / 5 week / 2 field or 4 field. Patients were evaluated weekly during treatment and afterwards up to 1year. Results: Most of the patients were from fourth and fifth decade, low socioeconomic strata and illiterate. Majority of the cases belong to squamous cell carcinoma (96.6%) and stage III B (55%). Objective response in arm I was 80.0%, in arm II was 75.0% and in arm III was 60.0% respectively. Statistically significant difference was noted between arm III and Arm I (80%Vs60% p<0.05). Results were better in arm I as compare to arm II but not statistically significant. (80%Vs75% P>0.05) Conclusions: This study showed that response was better in ARM I as compared to ARM III and best results was seen with Cisplatin concurrent daily with radiation. Keywords: Cisplatin, concurrent chemotherapy, daily, weekly, three weekly, carcinoma cervix

ANALYSIS OF TREATMENT OUTCOMES IN LOCALLY ADVANCED CERVICAL CARCINOMA - AN INSTITUTIONAL STUDY

Introduction:Carcinoma cervix is the second most common cancer among women in India. Carcinoma cervix is associated with many risk factors such as multi parity, early age at marriage, early age at coitus and the most important basic cause is poor socioeconomic status, illiteracy, lack of proper self-hygiene, lack of awareness of screening programs and treatment modalities. The main objective of this study is to analyze various outcomes following treatment of locally advanced carcinoma cervix and also to determine the causes of treatment failure so as to improve disease free survival, progression free survival and overall survival. Materials And Methods: A retrospective study was conducted among 191 locally advanced cervical carcinoma patients treated in the Department of Radiotherapy, Stanley Medical College and Hospital, Chennai during the period between 2015 and 2019. Various parameters of our study included age distribution, chief complaints at presentation, histopathological types and grades, staging, type of treatment, details of brachytherapy, response assessment and follow up. Results: Majority of them belong to stage II(50%) followed by stage III (41%). 14 patients belong to stage IV and only 4 patients belong to stage I. Among them 102 patients (53.4%) showed complete response and 34 patients (17.8%) showed partial response. Discussion: Most of the patients were in 4th and 5th decade which is very close to TNCRPregistry. Stage grouping of patients is considered most signicant in assessing the outcome of the treatment wherein it was found necessary to identify and present the symptoms at early stage to fasten the treatment and aim at complete cure. Conclusion: This study brings a clear picture of the possible reasons for treatment failure in locally advanced cervical carcinoma and highlights necessary steps to be implemented in improving infrastructure facilities in Government hospitals that would result in better treatment for poor patients with maximum benets.

Prognostic Significance of Pre-treatment Serum Inflammatory Biomarkers on Survival in Patients with Carcinoma Cervix Treated by Radical Radiotherapy or Chemo-radiation

Background: Inflammation has an important role in the initiation and progression of carcinoma cervix. The measurement of inflammatory biomarkers is a cost-effective method of identifying patients at high risk of recurrence after treatment. This study was done to identify the influence of pre-treatment inflammatory biomarkers on survival in patients treated with radical chemo-radiation or radiation. Methods: Patients with biopsy proven carcinoma cervix treated with Radiotherapy or Chemo-radiation from January 1st, 2016 to September 30th, 2017 were included. Pre-treatment complete blood counts, differential counts, serum albumin and C-reactive protein (CRP) were obtained. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and CRP Albumin ratio (CAR) were calculated. The best cut off values for NLR, PLR, serum albumin, CRP and CAR were found out from receiver operating characteristic (ROC) curves. OS (Overall Survival) and DFS (Disease Free Survival) were estimated using Kaplan -Meier method. The prognostic value of inflammatory biomarkers on survival was assessed by cox regression model. Results: Sixty-three patients were included. The median follow up was 42.5 months. The best cut off values for NLR, PLR, albumin, CRP and CAR from the ROC curve were 2.36, 122.725, 3.95, 0.65 and 0.8 respectively. The three-year OS and DFS probability were 68.3% and 63.5% respectively. Patients with CAR >0.8 had 5.7 times more risk of death and 6.01 times risk of relapse or progression compared to patients with CAR ≤0.8. Conclusion: Patients with a CRP-Albumin ratio of more than 0.8 are at significant risk of relapse and death after chemoradiation or radiation.