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Rojesara M, Sattavan S, Sharma M, Rathod P, Puj K, Pandya S, Bande V, Pawar A, Ghosh N, Bhat S S, Kumar M S. Wide Composite Resection of Sternal Metastasis & Reconstruction Using Titanium Mesh Implant and Myocutaneous Flap in Differentiated Thyroid Carcinoma: Case Report of Two Cases. Indian J Otolaryngol Head Neck Surg 2024; 76:1347-1350. [PMID: 38440601 PMCID: PMC10908690 DOI: 10.1007/s12070-023-04326-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 03/06/2024] Open
Abstract
Differentiated Thyroid carcinoma (DTC) with distant skeletal metastases is associated with a very poor prognosis and are unfortunately resistant to radioiodine therapy (RIT). Surgical removal of the metastases in such selected cases is a beneficial adjunct to RIT. We report two cases of DTC with sternal metastases whom we successfully managed with surgical resection of the sternal lesion with reconstruction of the chest wall defect using titanium mesh implant and myocutaneous flap.
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Affiliation(s)
- Mit Rojesara
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Swati Sattavan
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Mohit Sharma
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Priyank Rathod
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Ketul Puj
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shashank Pandya
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vivek Bande
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Ajinkya Pawar
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Nilanjan Ghosh
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Sankhya Bhat S
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Senthil Kumar M
- Department of Surgical Oncology, Gujrat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
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Pawar A, Rathod P, Warikoo V, Sharma M, Salunke A, Pandya S, Pandya S, Aaron J, Thottiyen S, Trivedi S, Kapur K, Bande V, Patel N, Yalla P, Joshi G. 'AJ's Orbicularis Oris Stitch: A Novel and Simple Technique of Reconstructing Central Arch Mandibular Defects in Resource-Constrained Set Up'. Indian J Otolaryngol Head Neck Surg 2023; 75:3703-3710. [PMID: 37974779 PMCID: PMC10645984 DOI: 10.1007/s12070-023-04044-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/26/2023] [Indexed: 11/19/2023] Open
Abstract
Lip and oral cavity SCC account for 2nd highest incidence of cancers and 3rd most common cause of mortality from cancer in India. Reconstruction of defects of central arch invading cancers results in poor cosmetic and functional outcomes if free flaps are not used. 30 patients with Oral SCC in the age group 20-75 years requiring central arch segmental mandibulectomy were included. Reconstruction was done with pedicled bipaddled PMMC flap with 'AJ's orbicularis oris stitch' using Fiber wire. Patients were divided into 4 groups according to extent of lip and skin loss post excision of primary tumour. Patients were evaluated with subjective scores for drooling, oral competence and cosmesis. There were 4, 12, 9 and 5 patients in Group A, B, C and D respectively. Mean subjective scores using our technique for drooling, oral competence and cosmesis were 3.75/4,3.75/4 and 3.5/4 for group A, 3.45/4, 3.36/4 and 3.09/4 for group B, 2.8/4, 2.6/4 and 2.3/4 for group C defects and 2.5/4, 3/4 and 2.5/4 for group D defects respectively. Over all scores for all patients were 3.2/4, 3.14/4 and 2.84/4 for drooling, oral competence and cosmesis. This simple, quick and inexpensive technique of reconstruction of central mandibular arch defects can drastically improve cosmetic and functional outcomes in a resource restrained set up. However, long term results and comparison studies are required for standardisation of the technique.
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Affiliation(s)
| | - Priyank Rathod
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Vikas Warikoo
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Mohit Sharma
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | | | - Shashank Pandya
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Shivam Pandya
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Jebin Aaron
- MCh Surgical Oncology, GCRI, Ahmedabad, India
| | | | | | | | - Vivek Bande
- MCh Surgical Oncology, GCRI, Ahmedabad, India
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Pawar A, Rathod P, Aaron J, Bande V, Kapur K. Large Brown Tumour of Mandible with Bleeding as Initial Presentation: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:3988-3992. [PMID: 37974669 PMCID: PMC10646025 DOI: 10.1007/s12070-023-04003-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 11/19/2023] Open
Abstract
Brown Tumour or Osteitis fibrous cystic or Von-Recklinghausen disease of bone is a non-malignant condition due to abnormal metabolism of bones in hyperparathyroidism. Although pathognomonic of hyperparathyroidism, brown tumours are rare and only case reports are found in literature. We report a case of brown tumour of mandible with recurrent episodes of bleeding. A 46 year old male patient presented in emergency with bleeding from ulceroproliferative mass from left floor of mouth. After control of bleeding, radiological, laboratory and histopathological investigations were done that led to the diagnosis of brown tumour of mandible in the presence of parathyroid adenoma of left lower parathyroid gland. Left upper and lower parthyroidectomy was done with segmental resection of mandible with mass and titanium plating. Brown tumour of facial bones is a rare entity. Very rarely it can reach enormous sizes to cause bleeding. Although parathyroidectomy and correction of parathormone levels cause regression of small tumours, large brown tumours with complications should be managed with surgical resection and reconstruction.
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Affiliation(s)
- Ajinkya Pawar
- Mch Surgical oncology, GCRI hospital, Ahmedabad, MS General surgery, DNB General surgery, 80B/42, Brindavan Society, Thane West, Maharashtra, 400601 India
| | - Priyank Rathod
- Surgical oncology, GCRI hospital, Ahmedabad, MS Mch Head and Neck oncosurgery, 1, Krushnapark Society, Karelibaig,, Vadodara, Gujarat 390018 India
| | - Jebin Aaron
- Mch Surgical oncology, GCRI hospital, Ahmedabad, MS General surgery, No 67 Moses St iyappa nagar pammal, Chennai, Tamil nadu 600075 India
| | - Vivek Bande
- Mch Surgical oncology, GCRI hospital, Ahmedabad, DNB General surgery, E 502, Neelkanth Park 1, Ghoda camp road, Shahibaug, Ahmedabad, Gujarat 380004 India
| | - Kanika Kapur
- Mch Surgical oncology, GCRI hospital, Ahmedabad, MS General surgery, House no 301, Aulyam-3, Meghaninagar, Ahmedabad, Gujarat 380016 India
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Kapur K, Sharma M, Puj K, Bande V, Pandya S. Solitary endobronchial plasmacytoma-a rare differential of an endobronchial mass. Indian J Thorac Cardiovasc Surg 2023; 39:629-631. [PMID: 37885935 PMCID: PMC10597973 DOI: 10.1007/s12055-023-01557-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/21/2023] [Accepted: 06/02/2023] [Indexed: 10/28/2023] Open
Abstract
Diagnostic dilemma, owing to the inconclusiveness of biopsy results, often leaves us with limited options to offer to the patients upfront, amongst the various armamentarium available. We hereby report a rare case of extramedullary plasmacytoma, whose diagnosis was established only on the final histopathology report with the aid of immunohistochemistry. A 50-year-old gentleman presented to our outpatient setup with computed tomography suggestive of a well-defined endobronchial mass occupying the left lower lobe bronchus. However, bronchoscopy and computed tomography-guided biopsies were inconclusive. After a routine metastatic workup, the patient underwent a left lower lobectomy following a provisional diagnosis of carcinoid on the frozen section. The final histopathology was solitary endobronchial plasmacytoma. Postoperative myeloma workup was within normal limits and the patient is doing well and disease free at 8 months of follow-up. This rare differential needs to be kept in mind while evaluating a case of well-defined endobronchial growth.
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Affiliation(s)
- Kanika Kapur
- Department of Surgical Oncology, GCRI Hospital, Ahmedabad, India
| | - Mohit Sharma
- Department of Surgical Oncology, GCRI Hospital, Ahmedabad, India
| | - Ketul Puj
- Department of Surgical Oncology, GCRI Hospital, Ahmedabad, India
| | - Vivek Bande
- Department of Surgical Oncology, GCRI Hospital, Ahmedabad, India
| | - Shashank Pandya
- Department of Surgical Oncology, GCRI Hospital, Ahmedabad, India
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Mokhasanavisu VJP, Mithi MT, Rathod P, Bande V, Pandya SJ. Oral Carcinoma Cuniculatum: A Variant of Squamous cell Carcinoma with Unique Histological Characteristics and a Diagnostic Challenge. Indian J Otolaryngol Head Neck Surg 2023; 75:2591-2594. [PMID: 37636602 PMCID: PMC10447828 DOI: 10.1007/s12070-023-03812-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 04/13/2023] [Indexed: 08/29/2023] Open
Abstract
Oral carcinoma cuniculatum (OCC) is a rare squamous cell carcinoma (SCC) variant with low incidence often due to misdiagnosis. This report aims to highlight this unique variant of SCC which is suggested to have a better prognosis with a focus on its histopathological features in comparison with similar clinical entities.
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Affiliation(s)
| | - Mohamed Taher Mithi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Priyank Rathod
- The Gujarat Cancer & Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, 380016 India
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vivek Bande
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shashank J Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
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