Medicine and Health Sciences Commons^™

Testicular Choriocarcinoma With Small Bowel Metastasis And Active Gastrointestinal Bleeding, Asad Saulat Fatimi, Khizer Masroor Anns, Faheemullah Khan, Wasim Ahmed Memon, Junaid Iqbal, Muhammad Aman, Izaz Ahmad, Sahar Fatima

Medical College Documents

Testicular choriocarcinomas make up less than 1% of all germ-cell tumors and are highly malignant, attributable to hematogenous spread. While the most common sites of metastasis are the lungs and liver, metastatic spread to the gastrointestinal tract is rare wherein patients may present with GI distress or even an upper GI bleed. In this report, we present a case of known testicular choriocarcinoma in a 40-year-old male who presented to the emergency room with severe anemia and a suspected upper GI bleed.

Our Experience Of Treating Adult Bone Lymphoma, A Retrospective Cross-Sectional Study In A Tertiary Care Center, Aga Khan University Hospital, Karachi, Masood Umer, Muhammad Younus Khan Durrani, Javeria Saeed, Nasir Ud Din

Section of Orthopaedic Surgery

Objective: To determine the experience at the Aga Khan University Hospital in diagnosing and treating adult patients with primary lymphoma of bone.
Methodology: All patients with Primary lymphoma of bone (PLB) that were diagnosed and/or treated at Aga Khan University Hospital, Karachi from 2005 to 2019 were included as part of this study.
Results: There were 17 patients with PLB including 13 (76.5%) males and 4 (23.5%) females with a mean age of 44 ± 16.5 years. Nine patients were between 30-59 years of age at diagnosis. The mean follow-up time of patients was 80±46.7 months. Six patients had tumours …

Metastatic Renal Cell Carcinoma To Pancreas And Gastrointestinal Tract: A Clinicopathological Study Of 3 Cases And Review Of Literature, Jamshid Abdul Ghafar, Nasir Ud Din, Ramin Saadaat, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Background: Renal Cell Carcinoma (RCC) metastasizes in approximately 20-30% cases. The most common sites for metastases are the lungs, bones, liver, and brain. Metastases of RCC in the gastrointestinal tract (GIT) are very rare. Metastatic RCC has a poor prognosis. We herein present a case series of three patients with metastatic disease in the colon, duodenum, and pancreas following complete resection of RCC.
Methods: Hematoxylin and Eosin and immunohistochemical slides of 3 cases of RCC metastatic to GIT were reviewed. These cases were diagnosed between 2002 and 2019 at French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan, and …

Role Of Contrast Enhanced Computed Tomography In Assessing Cervical Lymph Node Metastases In Oral Cavity Squamous Cell Carcinoma, Talha Ahmed Qureshi, Muhammad Wasif, Mohammad Sohail Awan, Adnan Yar Muhammad, Ainulakbar Mughal, Abdullah Ameen

Section of Otolaryngology, Head & Neck Surgery

Objective: To evaluate the diagnostic accuracy of contrast-enhanced computed tomography scan in detecting cervical nodal metastasis in oral cavity squamous cell carcinoma.
Methods: The retrospective cross-sectional study was conducted at Aga Khan University Hospital, Karachi, Pakistan. and comprised records from January 1, 2015, to October 31, 2016, of patients diagnosed with oral cavity squamous cell carcinoma and who underwent surgical resection of primary tumour along with neck dissection after having a contrast-enhanced computed tomography scan of head and neck. Diagnostic accuracy of the scans was calculated using final histopathology as the gold standard. All scans were reviewed by a consultant …

Utility Of Ultrasound And Mammography In Detection Of Negative Axillary Nodal Metastasis In Breast Cancer, Anam Khan, Imrana Masroor, Kumail Khandwala, Summar Un-Nisa Abbasi, Muhammad Usman Tariq

Department of Radiology

Objective: The status of axillary lymph nodes is one of the most important prognostic factors in patients with breast cancer. A precise noninvasive evaluation of axillary lymph node status preoperatively, although challenging, is vital for optimization of the treatment plan for patients. The objective of our study was to assess the utility of ultrasound and mammography in detecting the absence of axillary lymph nodal metastasis in patients of breast cancer, taking histopathology as gold standard.
Methods: A cross-sectional study was conducted in the Department of Radiology, Aga Khan University Hospital, Karachi. All female patients between 20 and 95 years of …

Challenges Of Diagnosis And Management Of Postpartum Choriocarcinoma In Resource Limited Settings: A Case Report From A Tertiary Hospital Of Western Kenya, Amubuomombe Philippe, Benjamin Elly, Andrew Cheruiyot, Sahara Shurie, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Choriocarcinoma is a rare occurrence in pregnancy. It is a highly curable malignant tumour that arises from trophoblastic cells within the uterus. However, the timely diagnosis of choriocarcinoma following birth is challenging, especially in low resource settings because most clinicians are not aware about the existence of the disease following uneventful pregnancy and birth. This report discusses the case of a 28 years old patient, para 2, diagnosed with choriocarcinoma two months after uneventful vaginal delivery at term. She underwent a total abdominal hysterectomy, followed by chemotherapy treatment; and succumbed to her disease. It highlights difficulties encountered on diagnosis and …

Incidentally Found Metastatic Prostatic Carcinoma In A Therapeutic Orchiectomy Specimen, Zeeshan Uddin, Muhammad Bilal, Mohammad Ayaz Khan

Department of Pathology and Laboratory Medicine

Metastatic tumour involving the testis is a rare event. Incidental discovery of metastatic cancer in a therapeutic orchiectomy is even rarer. We report a case of metastatic adenocarcinoma prostate found incidentally in one of the bilateral therapeutic orchiectomy specimens. The patient was a 55-year-old man presenting with back ache and generalized body aches. Clinical examination showed malignant feel of prostate. Bone scan revealed metastatic disease and a serum PSA level of >100 ng/ml. Clinical diagnosis of carcinoma prostate was established and subsequent bilateral orchiectomy for hormonal deprivation was performed. On gross examination of left testis, there was a small 0.7 …

Clinicopathological Prognostic Factors Of Oral Squamous Cell Carcinoma: An Experience Of A Tertiary Care Hospital, Muhammad Usman Shaikh, Ahmed Raheem Baksh, Sayed Akbar Abbas, Javeria Saeed, Salman Hashmi

Department of Pathology and Laboratory Medicine

Locoregional recurrence accounts for majority of the treatment failures in oral cancer patients. Current study aimed to determine the predictors of recurrence and survival in patients with biopsy proven Squamous Cell Carcinoma (SCC) of the oral cavity. This study included 88 patients of squamous cell carcinoma treated at our institution from 2007 till 2013. Primary intervention was surgery in all patients with radiation and chemotherapy in selected patients. Primary end point was locoregional recurrence, distant metastasis and death. Out of 88 patients, 23 (26.1%) patients developed locoregional recurrence and 6 (6.8%) patients developed distant metastasis. Overall survival rate was 77.3%. …

Skeletal Metastasis In Renal Cell Carcinoma: A Review, Masood Umer, Yasir Mohib, Muhammed Atif, Muhammad Nazim

Section of Orthopaedic Surgery

Background: Renal cell carcinoma account for 3% of all cancers, with peak incidence between 60 and 70 years of age predominantly affecting male population. Renal carcinoma is the most common malignancy of kidney constitutes for 80-90% of renal neoplasm with an overall 45% five years survival rate. Majority are diagnosed incidentally during investigation for other disease process of abdomen. Classical triad of gross hematuria, pain and palpable mass in abdomen is rare accounting to only 6-10%. Treatment of early stages of disease i.e. localized disease is partial or radical nephrectomy. Most common metastasis in RCC occurs to lung, followed by …

The Role Of Mucin-Educated Platelet Activation In Tumor Invasiveness: An Unfolding Concern In The Realm Of Cancer Biology, Akbar Shoukat Ali, Arzoo Ajaz

Department of Obstetrics & Gynaecology

Metastasis is a complex and well-coordinated phenotypic transformation of cancer cells governed by aberrant genetic and molecular pathways. It has been approved as the most consistent cause of cancer death. With emerging insight into the genomics, transcriptomics and proteomics, progress has been made and reasonably large number of molecular pathways of metastasis has been forwarded, but our understanding of precise underlying molecular mechanisms remains largely scarce. It has been well-known for around a decade and more that platelets are intriguingly contributing to the cancer metastasis. However, it is only recently that cancer cells can activate platelets have started to become …

Relationship Of Tumor Thickness With Neck Node Metastasis In Buccal Squamous Cell Carcinoma: An Experience At A Tertiary Care Hospital, Sadaf Qadeer Ahmed, Montasir Junaid, Sohail Awan, Moaz M. Choudhary, Maliha Kazi, Aria Masoom, Hareem Usman Khan

Department of Surgery

Introduction Squamous cell carcinoma is the most common malignancy of the head and neck, with the buccal mucosa being the most common site involved. Early locoregional metastasis is a hallmark of this disease, and early stage tumors may harbor metastatic nodes that are occult. Certain parameters can help identify high-risk patients for whom the pattern of occult nodal metastasis can be predicted. Tumor thickness is one such objective parameter. Objective To determine the relationship of tumor thickness with neck node metastasis in squamous cell carcinoma of the buccal mucosa. Methods A retrospective chart review of 102 patients with biopsy-proven squamous …

An Unusual Case Of Cauda Equina Secondary To Spinal Metastasis Of Thyroid Cancer, Shabbir Akhtar, Mohammad Adeel

Department of Surgery

Abstract

INTRODUCTION:

Cauda equina secondary to metastatic follicular thyroid cancer of the lumbosacral area is a rare entity.

CASE REPORT:

We report an unusual case of a 52-year-old male who presented with backache, lower limb weakness, and perianal numbness. A CT-scan of the lumbosacral area showed an enhancing mass at the L4, L5 and S1 vertebrae. Histopathology after excision revealed a metastatic thyroid cancer. Hence, a CT scan of the neck and chest was performed which showed a nodule in the left lobe of the thyroid and a mass in the left chest wall. A total thyroidectomy and excision of …

Malignant Ectopic Thyroid Tissue With Distant Metastasis: A Case Report, Shehla Tabassum, Najmul Islam, Saulat H. Fatimi, Mubasher Ikram, Arsalan Ahmed, Maseehuz Zaman

Department of Medicine

Introduction: Ectopic thyroid tissue is the most common form of thyroid dysgenesis. But primary malignant transformation in ectopic thyroid tissue is quite a rare entity, with follicular malignancy being the dominant form at ectopic sites. Very infrequently, malignant ectopic thyroid tissue can present with metastasis to lymph nodes. But we report a case of malignant ectopic thyroid tissue over manubrium sterni with distant metastasis.
Case presentation: A 42-year-old Pakistani female presented with gradually increasing swelling on anterior aspect of manubrium sterni for last 6 months. She had no goitre and was clinically and biochemically euthyroid. Rest of systemic exam …

Is Surgical Spinal Decompression For Supratentorial Gbm Symptomatic Drop Down Metastasis Warranted? A Case Report And Review Of Literature, Muhammad Babar Khan, Muhammad Riaz, Muhammad Ehsan Bari

Medical College Documents

Background: Symptomatic spinal metastasis from an intracranial primary
glioblastoma multiforme (GBM) is very rare. Our literature search identified a total
of 42 such patients of which 11 were treated with surgical decompression for spinal metastasis with only one such report from the pediatric age group. Previous studies have reported variable outcomes after surgical management.

Case Description: We report the case of a 16‑year‑old boy who underwent
surgical spinal decompression for spinal metastasis after intracranial GBM. The
patient regained motor and autonomic function following surgery and reported
improvement in pain. We also present findings from a literature review using …

Accuracy Of Magnetic Resonance Imaging In Pretreatment Lymph Node Assessment For Gynecological Malignancies, Saira Naz Sufian, Imrana Masroor, Waseem Mirza, Zainab Hussain, Saima Hafeez, Zafar Sajjad

Department of Radiology

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis in pelvic and para-aortic lymph nodes from different gynecological malignancies.MATERIALS AND Methods: This retrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, age range between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically proven gynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to our radiology department.Results: MRI was 100% sensitive and had a 100% positive predictive …

Threshold Primary Tumour Sizes For Nodal And Distant Metastases In Papillary And Follicular Thyroid Cancers., Maseeh Uz Zaman, Nosheen Fatima, Zafar Sajjad, Jaweed Akhter, Najmul Islam, Qamar Masood, Asma Ahmed

Department of Radiology

Abstract

BACKGROUND:

In papillary and follicular thyroid cancers (PTC, FTC), nodal and distant metastasis are generally considered important determinants of recurrence and survival, respectively. However, there is no consensus about the threshold primarytumour size (PTS) for these determinants. The aim of this study was to assess size relationships for developing nodal, pulmonary, bone and overall distant metastases.

METHODS:

This prospective study covered 139 (93 females and 46 males) consecutive biopsy proven patients with PTC (114/139, mean age 41.0 ± 15.7 years, M: F, 35%:65%) and FTC (25/139, mean age 39.2 ± 14.3 years, M: F: 24%:76%).

RESULTS:

Average primary tumor …