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Background: Phyllodes tumour is a rare breast neoplasm having three histological types i. e benign, borderline and malignant. Surgical excision is the mainstay of treatment, but quantification of adequate margin required during excision is still a matter of debate. Role of adjuvant radiotherapy also remains controversial. Aims: Study of prognostic factors in patients with phyllodes tumour of breast and their effect on survival. Setting and design: A retrospective analysis. Material and methods: From the year 2016 to 2019 we included 54 patients in this study and assessment of clinical and histopathological features, requirement of adjuvant radiotherapy and their effect on DFS (disease free survival) and OS (overall survival) was done. Log-rank test was used for univariate analysis and multivariate analysis was done by using Cox propotion hazard ratio method. Statistical analysis: Descriptive statistics was used for calculating proportion and median value. Survival analysis was done by using Kaplan Meier method. P value of

Medullary thyroid carcinoma is a rare tumour that is anatomically located in the thyroid gland but is functionally a neuroendocrine tumour. It is usually a disease of older age group but manifests in a young patient in familial form. It is derived from parafollicular c cells and has a predilection for lymph node metastasis. It is associated with slow growth in thyroid gland with early nodal metastasis. Serum calcitonin is useful as a preoperative marker of disease burden and prognosis. In the preoperative period serum levels of calcitonin can guide regarding the need for compartment wise lymph node dissection and the possibility of distant metastasis. It is used as a tool of surveillance in the postoperative period. The levels of serum CEA and calcitonin and their doubling time is a useful guide in the detection of early recurrence or distant metastasis. Imaging modality useful for diagnosis is USG in a majority of patients. Thus, the initial diagnosis and preoperative assessment of medullary thyroid carcinoma is similar to other forms of thyroid cancer but further management of disease differs significantly form other forms of differentiated thyroid carcinoma or even anaplastic carcinoma. Prognosis however differs according to age, gender, presence or absence of lymph node metastasis at presentation, metastatic disease at presentation and levels of biochemical markers., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Mammary analogue of secretory carcinoma is a recently described entity in WHO 2017 classification of head and neck tumours. It resembles secretory carcinoma of breast. It usually affects the salivary glands and has an indolent behaviour. We reviewed five cases of Mammary analogue of secretory carcinoma in our institute and compared our results with existing literature. All the patients underwent surgical resections and appropriate adjuvant treatment. Immunohistochemistry is an alternative cost effective tool as compared to genetic testing to differentiate secretory carcinoma from its mimickers. Surgery with adequate margins followed by adjuvant therapy is the treatment of choice., Competing Interests: Conflict of interestThe authors have no relevant financial or non-financial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Iatrogenic chyle leak is commonly seen when dissection happens very low in neck. Management of chyle leak is conservative with compression dressing, fat restricted diet, somatostatin analogues. Surgery is required in extreme cases with failure of conservative treatment. This is a retrospective observational study carried out from a prospectively maintained database. A total of 6482 head and neck surgeries with neck dissections were carried out between January 2015 till July 2020 at our tertiary cancer center. Out of which there were 52 cases of chyle leak reported post neck dissection. All details regarding age, sex, primary tumor location, surgery performed, level of nodal dissection performed, details related to chyle leak from beginning day and its progression and management offered. The median age in the study group was 42 years (24-70 years). Chyle leak was most commonly seen on left side (88.5%). Low output leaks( n  = 43) resolved within a median period of 9 days (5-13 days) period of conservative management. High output leak ( n  = 9) had leak resolution within a median period of 12 days (7-19 days). Patients who had received preoperative radiotherapy and who had extra nodal extension in lymph nodes had significantly higher incidence of high output leaks. Chyle leak is a rare but serious complication in head and neck surgery. Timely identification and management is crucial. Conservative management is mainstay. Surgical management is instituted in cases of failure of conservative management., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Association of Otolaryngologists of India 2021.)

Chemoports are routinely used for administering chemotherapeutic agents, drugs, blood, and blood products. Chemoport insertion is associated with inherent complications. Fracture of chemoport due to pinch off syndrome is a rare life-threatening complication. We report our experience of fracture chemoport in patients with carcinoma breast and its management. We also present a detailed review of literature about this complication, clinical features, warning signs, diagnostic workup, management, and prevention. From a prospectively maintained database of chemoport insertion patients, a retrospective analysis was done from 2017 to 2020. During this period, the incidence of fracture chemoport was evaluated and their management. Out of 560 chemoport insertions, there were 3 patients with chemoport fracture, with an incidence of 0.5%. All the three patients were hemodynamically stable, with no clinical signs of pulmonary embolism. The chemoports were non-functional and on radiologic evaluation fracture of chemoport with embolization of distal segment was demonstrated. All the patients were managed by retrieval of the embolized catheters by a snare and removal of port chambers under local anesthesia. Choose internal jugular vein over subclavian vein for placing central venous access devices. When subclavian vein is chosen, point of entry should be lateral part of costochondral space. The incidence of chemoport fractures is 0.5% which present as non-functioning chemoports. Identify pinch off sign, especially with an upright check X-ray after chemoport placement. Consider repositioning of chemoport if pinch off sign is present., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© Indian Association of Surgical Oncology 2021.)

Introduction: Anorectal malignant melanoma (ARMM) is an aggressive malignancy with dismal prognosis and a 5-year survival rate less than 20% in most of the previous studies. The ideal surgical treatment has still remained controversial. This retrospective study aims at analysing the outcome in patients with ARMM treated with curative surgical resection., Patients and Methods: This is a retrospective study of 38 patients of stage I anorectal malignant melanoma treated with curative surgical resection at our tertiary cancer institute., Results: WLE (Wide Local Excision) was carried out in 12 patients and APR (abdominoperineal resection) was done in 26 patients. The median overall survival of the entire group in this study was 20 months. Although the median overall survival of WLE patients was higher than those with APR (37 months versus 16 months, respectively), this was not a statistically significant event (P=0.317). The 1-, 2-, 3-, 5-year survival rates were similar with both APR and WLE with no significant difference in the 5-year survival rate (P=0.816); overall 5-year survival rate of just 13%. There were 3 long-term survivors in this study group who survived for more than 10 years., Conclusion: Most patients ultimately succumb to the disease regardless of the management. Both APR and WLE have significant roles in the management depending on the subset of patients selected. Local treatment should be preferred wherever possible. Abdominoperineal resection should be offered in nodal disease or in a recurrent setting., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Primary chest wall sarcoma is a rare entity. It can be classified based on its origin, as bone sarcomas or soft tissue sarcomas. Various prognostic factors have been studied in different case series like age, sex, tumor histology, grade, resection margin status, adjuvant treatment, and others. The present study aimed to analyze common histological types, their management by resection and reconstruction and prognosis, in cases presenting at a regional cancer center in western India., Material and Method: This was an observational study from a prospectively maintained database. 57 patients with chest wall sarcoma treated with curative intent between January 2016 till January 2019 with a minimum follow-up of 3 months were included in the study. The goals of surgical treatment were to obtain a wide resection margin of 3-4 cm, preserve the function of the chest wall and provide stability and rigidity to protect intrathoracic organs., Results: The median follow-up of the present patient's cohort was for 20.2 months. Overall two-year survival was 74.7%. Two-year OS and DFS of bone sarcoma were 62.3% and 35% and soft tissue sarcomas were 91% and 71.3%. Ewing's sarcoma had the worst two-year overall survival of 50.6% and chondrosarcoma and fibromatosis had 100% two-year overall survival., Conclusion: Chest wall sarcoma forms a heterogeneous group of tumors. In the present study, Ewing's sarcoma was the most common histology with the worst survival, since they presented in advanced stages. Management should be multidisciplinary and surgical resection should be aggressive to achieve an R0 resection. Reconstruction of chest wall should aim to provide structural and functional stability with minimal morbidity. Frozen section assessment should be utilized whenever in doubt., (Copyright © 2021. Published by Elsevier Ltd.)