Intussusception in adults: the case report of a rare cause of intestinal obstruction

Intussusception of the bowel is defined as the telescoping of a proximal segment of the bowel within the lumen of an adjacent segment. This condition is a common cause of intestinal obstruction in children below two years of age. It is considered a rare cause of intestinal obstruction in the adult. It accounts for 5% of all cases of intussusception and 1-2% of all cases of intestinal obstructions in the adult population. Almost up to 20% of cases are idiopathic and they are not having any lead point pathology. The rest of the cases are caused by organic lesions like Meckel’s diverticulum, benign and malignant lesions, metastatic neoplasm, intestinal polyp, etc. In adults’ preoperative diagnosis is difficult and a definitive diagnosis is made at laparotomy. Computerized tomography is the most sensitive diagnostic modality for this condition.

FNAC: A Simple & Cost-Effective Diagnostic Tool for Benign & Malignant Pathologies Associated with Cervical Lymphadenopathy

Introduction: Cervical lymphadenopathy is very common as the presenting complaint in our outpatient departments. Its etiology may either be benign or malignant. Fine needle aspiration cytology (FNAC) is a comparatively cheap, easy to perform minimally invasive test. It has become the go to test to determine the cause of lymphadenopathy Aims & Objectives: To determine whether FNAC is a cost-effective diagnostic tool in evaluation of various benign and malignant Pathologies associated with cervical lymphadenopathy. Place and duration of study: It is a retrospective study conducted at Gulab Devi Hospital from April 2019 to April 2021. Material & Methods: The cyto-morphologic features seen in the aspirates were critically analyzed and correlated with their etiology. SPSS version 24.0 was analyzed for data analysis. A p-value of <0.05 was considered significant. Results: Among the 100 patients 56 were females and 44 were males with a female to male ratio of 1.3:1. The age range of the patients was from 3 to 75 years. 37% were reactive lymphadenitis, 32% were tuberculosis, 12% were suppurative, 11% were lymphoproliferative disorders, 8% cases were metastatic neoplasm. Conclusion: FNAC is a reliable and cost effective to diagnose the etiologies of cervical lymphadenopathy.

RADI-05. Metastatic Neoplasm Volume Kinetics Following Two-Staged Stereotactic Radiosurgery

Introduction Multisession staged stereotactic radiosurgery (2-SSRS) represents an alternative approach for management of large brain metastases (LBMs), with potential theoretical advantages over fractionated SRS and represents an alternative to surgery in poor surgical candidates. We aimed to investigate the clinical efficacy and safety of 2-SSRS in patients with LBMs. Methods LBMs of patients treated with 2-SSRS between 2014 and 2020 were evaluated. Demographic, clinical, and radiologic information was obtained. Volumetric measurements at first SSRS, second SSRS, and follow-up imaging studies were obtained. Results Twenty-six patients with 28 LBMs were included in the study. Fifteen patients (58%) were male. Median age at 2-SSRS was 61 years (range: 31–84). Median marginal doses for first and second SSRS were 15 Gy (range: 12–18 Gy) and 15 Gy (range: 12–16 Gy), respectively. Median duration between sessions was 32 days. Two patients (8%) failed to receive their second SSRS due to local progression. Median tumor volumes at first SSRS, second SSRS, 3-month follow-up, and 6-month follow-up were 8.7 cm3 (range: 1.5–34.7 cm3), 3.3 cm3 (range: 0.8–26.1 cm3), 1.7 cm3 (range: 0.2–10.1 cm3), and 1.4 cm3 (range: .04–20.7 cm3), respectively. The median absolute and relative decrement between S-SRS sessions was 3.7 cm3 (range: 2.8–16.5 cm3) and 49.5% (range: 17.1- 87.1%), respectively. Overall, 26 of the 28 lesions (93%) demonstrated early local control following the first SSRS with 18 lesions (69%) demonstrating a decrease in volume of &gt;30% and 3 lesions (12%) remaining stable. Six lesions (23%) showed disease progression. There were no grade 3 adverse events. Conclusions Our study supports the effectiveness and safety of 2-SSRS as a treatment modality for patients with large, symptomatic brain metastases, especially in non-surgical candidates. The local failure rate and low occurrence of adverse effects are comparable to other staged radiosurgery series.

Malignant adnexal cutaneous tumor of the scalp: a case report of difficult differential diagnosis between metastatic breast cancer and primary sweat gland tumor

The authors describe the case of a 71-year-old female patient who initially went to the dermatologist to assess a scalp skin tumor. This lesion was submitted to an incisional biopsy, performed by dermatologist herself, and the result of the anatomopathological examination and immunohistochemical study showed a preliminary diagnosis of metastasis of breast carcinoma. The patient had no history of breast cancer and, in view of this result, she was referred to consult with the mastologist, who carried out an investigation of breast nodules in search of the possible primary focus of the carcinoma, through imaging exams, biopsies and mammotomy, without finding any possible primary focus on the breasts. Finally, the lesion on the scalp was removed in its entirety by the plastic surgeon and a new exam of pathological anatomy and an immunohistochemical study confirmed the diagnosis of metastasis of breast carcinoma. In view of these results, the authors discuss the difficulty in diagnosing differentiation from primary or metastatic neoplasm of the scalp, with the resources currently available, until the conclusion that it was a primary carcinoma of the sweat gland.

EVALUATING THE UTILITY OF FINE-NEEDLE ASPIRATION CYTOLOGY(FNAC) IN LYMPH NODE PATHOLOGIES- A FOLLOW-UP STUDY

Background: Lymphadenopathy or adenopathy is an often encountered clinical problem with many causes ranging from inammatory to malignant process. The present study was conducted to assess the cases of lymphadenopathy using FNAC. Materials & Methods: This study comprised of 140 patients of male and female with neck masses. All patients underwent to FNA and subsequently surgical excision of their neck masses. Smears were then prepared and marked with Pap method. Results: Out of 140 cases, males were 80 and females were 60. The difference was non- remarkable (P- 0.1). Out of 140 cases, 105 were benign and 35 were malignant. In begin lesions, 70 were in males and 40 were in females and in malignant cases, 15 were in males and 15 were in females. The difference was signicant (P- 0.01). Metastatic neoplasm was seen in 11 males and 9 females, hodgkin's lymphoma in 5 males and 4 females, and non- hodgkin's lymphoma in 4 males and 2 females. The difference was nonsignicant (P> 0.05). Conclusion: FNAC is the simple, safe, reliable, and cost-effective procedure for initial screening of various lymph node pathologies.

Long-Term Survival and Glycemic Control with Toceranib Phosphate and Prednisone for a Metastatic Canine Insulinoma

ABSTRACT Canine insulinoma is a highly metastatic neoplasm that is associated with a guarded to poor prognosis in dogs with distant metastases. A median survival of 6 mo has been reported for dogs with metastatic insulinoma. The dog in this report, diagnosed with stage III pancreatic insulinoma, had long-term glycemic control with survival of over 24 mo while receiving prednisone and toceranib phosphate after partial pancreatectomy. Toceranib phosphate has been shown to be an efficacious therapy for canine mast cell tumors with increasing evidence that it may be beneficial in the medical management of neuroendocrine tumors.