Search

Background: Multiple myeloma (MM) evolves from Monoclonal gammopathy of unknown significance (MGUS), a premalignant clinical condition. Second to non-Hodgkin’s lymphoma, MM is the most common haematological malignancy. The aim of the study was to review the clinical profile and response of individuals treated for MM from this part of country.Methods: We evaluated data of patients with MM managed between 2013 and 2019 at a tertiary care cancer hospital in Rajamahenderi, India. Data regarding demographic variables, clinical features, disease characteristics and treatment details were collected and analysed.Results: Total of 54 patients with MM were managed. Mean age was 59.4 years. Males accounted for 63%. Bone pain (90%) was the most common symptom. Elevated serum creatinine was noted in 16.7% and M band in 42 (77.8%). X-ray of skull showed lytic lesions in 41 (75.9%). Mean haemoglobin value was 8.8±1.9 g/dl and serum calcium was 9.12 mg/dl. Majority of subjects, 44 (81.48%) belong to stage IIIA, 9 (16.67%) to stage IIIB, and 1.85% to stage IIA of Durie Salmon staging system. No response was noted in 17 (31.5%), 4 (7.4%) subjects had a progressive disease even on treatment, and 8 (14.8%) subjects had a very good partial response. Median survival of subjects belonging to DSS stage II was 17 months, IIIA was 11.037 months and stage IIIB was 17.463 months.Conclusions: MM has an early onset in India. Though MM is an incurable disease, many promising treatment options are there which lead to increase in survival. Early treatment helps in improving mortality rates, better quality of life and decreases disease burden.

Background: Colon cancer is a leading cause of increase in cancer incidence and now becoming a major cause of cancer related mortality.Methods: We evaluated data of patients diagnosed with colon cancer and managed under Aarogyasri program between 2013 and 2019 at a tertiary care cancer hospital in Rajamahenderi, Andhra Pradesh, India. We collected data regarding demography, clinical presentation, subsite, histology, stage and treatment.Results: A total of 142 patients with colon cancer were managed. The mean age was 53.6 years with males accounting for 57%. Most common clinical presentation was abdominal pain followed by vomiting. Most common histology was well differentiated adenocarcinoma. Left sided colon tumors accounted for 47%. Most common stage at presentation was stage III.Conclusions: Our data of colon cancer was different from that described in the western countries. Young age presentation, higher mucinous and signet ring carcinomas and advanced stage presentation were reported in our study. Socioeconomic factors, inadequate health care access might account for some of these differences.

Gardners syndrome (GS) is a variant of familial adenomatous polyposis (FAP) and presents with both colonic and extra colonic manifestations. It is an autosomal dominant disorder and results from mutations in adenomatous polyposis coli (APC) gene. Patients with GS if not treated early will invariably develop colonic cancers at a much younger age than those with sporadic colonic carcinoma. These patients also develop other malignant tumours like duodenal cancers, gastric cancer, hepatoblastoma, papillary carcinoma of the thyroid and multifocal cholangiocarcinomas. With early diagnosis and treatment of colonic polyposis, adenocarcinoma of the duodenum has become the leading cause of death in FAP patients. The mean age at which duodenal carcinoma is diagnosed in FAP is 45-52 years. We report the rare occurrence of duodenal carcinoma as the presenting feature of Gardner’s syndrome in a young 25-year-old male with no obvious malignant changes in the colonic adenomas.

Turcot’s syndrome is a rare genetic disorder clinically characterised by concomitant occurrence of primary brain tumour and colorectal polyposis. It is commonly seen in association with two other syndromes, namely, hereditary nonpolyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP). It is characterized by an increased risk for early onset of other tumours including of endometrium, stomach, small intestine, hepatobiliary system, kidney, ureter, brain and ovary. We report the rare occurrence of Turcot syndrome in a 13-year-old girl who presented with focal seizure.

Primary splenic lymphoma (PSL) is a rare entity accounting for less than 1% of lymphoid malignancies. Follicular lymphoma primarily involving the spleen is still rare and constitutes only 10% of the PSLs. PSLs constitute a heterogeneous group of diseases with wide variations in clinical presentation as well as lymphoid populations from which they originate. Here we are reporting a case of a 43-year-old female presenting with massive splenomegaly and hypersplenism with anemia, leucopenia, and thrombocytopenia. Other investigations revealed no abnormality. When the patient underwent splenectomy for hypersplenism and the specimen was subjected to histopathological examination and immunohistochemistry the diagnosis of follicular lymphoma was made. As splenomegaly and hypersplenism are common in clinical practice, other common causes of splenomegaly and hypersplenism should be excluded. High level of suspicion and thorough investigation are required to establish the diagnosis. In the present case, the diagnosis was made retrospectively after splenectomy.