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Purpose: A comparison of simultaneous integrated boost (SIB) with sequential boost (SEQ) using intensity-modulated radiotherapy along with concurrent cisplatin in locally advanced head and neck cancer (HNC) was made with regard to their survival outcomes and toxicity profile. Materials and Methods: A total of 34 patients were enrolled between October 2016 and March 2019. They were randomized into two arms, SIB and SEQB. All patients were treated with 6 MV photon beam on Linear Accelerator with weekly concurrent cisplatin at 35 mg/m2. Overall survival (OS) and disease-free survival (DFS) were the primary end points and acute and late toxicities were the secondary end points. Results: The median follow-up period was 40.6 and 37.3 months for SIB and SEQB, respectively. At the end of 5 years, the median OS was 40.6 and 37.3 months (P = 0.947) and the median DFS was 35.1 and 37.3 months in the SIB and SEQB arms, respectively (P = 0.991). Complete response at 3 months was 64.7% and 76.5% and partial response was 23.5% and 17.6%, whereas progressive disease was 11.8% and 5.9% in SIB and SEQB arms, respectively. Acute dermatitis, mucositis, dysphagia, and salivary gland toxicities were higher in the SIB arm compared to the SEQB arm. Conclusion: SIB and SEQ arms were comparable in terms of OS and DFS. However, the acute toxicities were higher in the SIB arm, although the difference was not significant, compared to the SEQB arm. [ABSTRACT FROM AUTHOR]

Aneurysm in the extracranial segment of the internal carotid artery is extremely rare in children. Traumatic aneurysms of the internal carotid artery are generally "false aneurysms" (pseudoaneurysms) with at least part of the aneurysm wall composed only of the adventitial layer, or even just by the hematoma. There are few reports in the world medical literature about its etiology, presenting features, and catastrophic consequences. The natural history of the disease has not been well-defined yet. However, the potential risk of embolism originating from the aneurysm or even its rupture indicates a need for early diagnosis and intervention. We present a 12-year-old previously healthy child with recurrent oropharyngeal hemorrhage leading to massive hematemesis and hypovolemic shock due to right-sided internal carotid artery pseudoaneurysm with hemorrhage and right middle cerebral artery territory infarct. The child required urgent endovascular stenting with decompressive craniectomy for life-threatening intracranial bleeding with herniation with near-complete recovery. [ABSTRACT FROM AUTHOR]

Introduction: The role of hypofractionated radiotherapy (HFRT) in postmastectomy breast cancer patients is not well established. This study was done to establish the role of two different HFRT schedules in the treatment of chest wall and regional lymph nodes after mastectomy. Materials and Methods: Between 2012 and 2016, consecutively registered patients of locally advanced breast cancer patients having undergone mastectomy and adjuvant radiotherapy (RT) at a tertiary cancer center were analyzed. Locoregional recurrence (LRR) was the primary endpoint, whereas overall survival (OS), disease-free survival (DFS), and both acute and late adverse events were secondary endpoints. Results: A total of 34 patients who were treated with 39 Gy in 13 fractions over 2½ weeks and 35 patients who were treated with 40 Gy in 15 fractions over 3 weeks were identified. The median follow-up period was 47 months and 63.5 months in the 39 Gy and 40 Gy arms, respectively. LRR was seen in 11.8% and 8.6% of patients in the 39 Gy and 40 Gy arms, respectively. OS at 4 years was 66% and 71.5% in the 39 Gy and 40 Gy arms, respectively. The mean DFS for 39 Gy and 40 Gy arms was 43.6 months and 66.4 months, respectively (P = 0.822). Acute skin toxicity was similar in the two groups. Arm edema was significantly more in the 40 Gy arm. Conclusion: The two HFRT schedules are equivalent to each other in terms of survival outcomes. Arm edema is higher with 40 Gy arm as compared to 39 Gy arm. [ABSTRACT FROM AUTHOR]

Introduction: Anatomic disfigurement caused by zygomatic fracture warrants intervention tore establish facial symmetry. It is most predictably restored to pre morbid condition by ORIF. Aim: To evaluate the efficacy of 2 point fixation in Zygomaticomaxillary complex fractures. Material and Method: 20 patients with established ZMC fractures were operated using two point fixation method and followed up for upto 3 months. Results: 2 point fixation revealed satisfactory functional and esthetic results. Conclusion: 2 point fixation offers efficient outcome as compared to other modalities of management of ZMC. [ABSTRACT FROM AUTHOR]

Sir, Microsurgical gross total resection of cerebellar hemangioblastoma is considered the gold standard of treatment with long term risk-free survival. The Magnetic Resonance Imaging (MRI) Plain and contrast revealed heterogenous signal intensity lesion with few cystic areas and flow voids in the right cerebellar hemisphere with significant enhancement of the solid component. The cyst capsule had been removed with the rest of the tumor and a vessel abutting the tumor capsule was purportedly left assuming it to be one of perforators. [Extracted from the article]

Tubercular abscess of the pituitary fossa is rare and may lead to diagnostic uncertainty in a patient with absence of tuberculosis elsewhere in the body. We present a rare case report of a young lady who presented with sellar and suprasellar cystic mass. She was diagnosed as a case of pituitary macroadenoma and was intraoperatively found to harbor pus in the lesion. She did not have any symptoms of infection. The case underlines the importance of considering such a possibility in the differential diagnosis of cystic sellar lesions and further diagnostic tests should be done for confirmation and treatment of this rare and potential life threatening illness. [ABSTRACT FROM AUTHOR]

The common sites of metastasis from a urinary bladder carcinoma include lymph nodes, bones, lung, liver, and peritoneum. Only a few cases of small bowel metastasis from urinary bladder malignancy have been reported in the English literature. Only one of these cases presented with bowel intussusception. We report a case of an adult small bowel intussusception due to metastasis from a urinary bladder carcinoma which is extremely rare as small bowel metastasis occur mostly from breast, lungs or melanomas. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding a case study of a 53-year-old immunocompetent woman who has vertebral osteomyelitis due to Aspergillus fumigatus infection.

Clear cell meningioma is a rare subtype of meningioma seen mainly in pediatric patients. Supratentorial location is an unusual site of occurrence and its natural history and prognosis are not well described in the literature. We present a unique case of a left-sided frontoparietal tumor in a 15-year-old child who was managed successfully with gross total surgical excision and is recurrence-free at 18 months follow-up. A favorable clinical behavior and a longer symptom-free interval can be expected after gross total removal. The patients should be followed after successful surgery and other modalities of therapy should be used for recurrence. [ABSTRACT FROM AUTHOR]