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Anil K D'Cruz

Publications and source records attributed to Anil K D'Cruz.

17 recordsLinked to original sources
PubMed2006

Collision tumor of the thyroid: follicular variant of papillary carcinoma and squamous carcinoma.

BACKGROUND: Collision tumors of the thyroid gland are a rare entity. We present a case of a follicular variant of papillary carcinoma and squamous carcinoma in the thyroid. To the best of our knowledge, this is the first documentation of a collision tumor with a papillary carcinoma and a squamous carcinoma within the thyroid gland. The clinicopathological features and immunohistochemical profile are reported. The theories of origin, epidemiology and management are discussed with a literature review. CASE PRESENTATION: A 65 year old woman presented with a large thyroid swelling of 10 years duration and with swellings on the back and scalp which were diagnosed to be a follicular variant of papillary thyroid carcinoma with metastasis. Clinical examination, radiology and endoscopy ruled out any other abnormality of the upper aerodigestive tract. The patient was treated surgically with a total thyroidectomy with central compartment clearance and bilateral selective neck dissections. The histopathology revealed a collision tumor with components of both a follicular variant of papillary carcinoma and a squamous carcinoma. Immunohistochemical analysis confirmed the independent origin of these two primary tumors. Adjuvant radio iodine therapy directed toward the follicular derived component of the thyroid tumor and external beam radiotherapy for the squamous component was planned. CONCLUSION: Collision tumors of the thyroid gland pose a diagnostic as well as therapeutic challenge. Metastasis from distant organs and contiguous primary tumors should be excluded. The origins of squamous cancer in the thyroid gland must be established to support the true evolution of a collision tumor and to plan treatment. Treatment for collision tumors depends upon the combination of primary tumors involved and each component of the combination should be treated like an independent primary. The reporting of similar cases with longer follow-up will help define the epidemiology, biology and establish standardized protocols for treatment of these extremely rare tumors.

Journal Article↗
PubMed2006

Buccal plate excision for buccal paramandibular spread.

Cancer of buccal gingival sulcus lie in close proximity to mandible but tend to invade bone late in the course of disease. Segmental mandibulectomy advocated for these tumors results in cosmetic disfigurement and functional impairment. We, for the first time, describe a mandibular preservation alternative, in form of buccal cortical plate excision, for these tumors.

Cheek↗
PubMed2006

Urinary bladder metastasis--an unusual presentation of distant spread from a primary pyriform sinus cancer: a case report.

Hypopharyngeal cancers have a high propensity to distant metastasis. However, metastasis to the urinary bladder as an initial presentation of distant spread has not been reported in literature. We present a report of a patient with a treated and controlled pyriform sinus cancer who presented with complaints of dysuria, 8 months after completion of treatment. Cystoscopy revealed a bladder mass and biopsy confirmed it to be a metastatic squamous cell carcinoma. On further investigation, the patient was found to have disseminated disease for which chemotherapy was instituted. A relevant review of literature is also presented.

Adult↗
PubMed2006

Metastasis of squamous cell carcinoma of the oral tongue is associated with down-regulation of epidermal fatty acid binding protein (E-FABP).

Squamous cell carcinoma (SCC) of the tongue is one of the most common cancers encountered in India, due to the prevalent habits of tobacco chewing and smoking. Up to 40% of the early stage tumours (clinical N0 M0) presenting at the Tata Memorial Hospital have occult cervical lymph node metastasis. Therefore, features in the primary tumour that would predict metastasis would be very useful for designing therapeutic approaches. Hence, we aimed at detecting genotypic markers of the metastatic sub-clones within the heterogeneous primary tumour population. We studied the differential expression of mRNAs between the primary tumour samples of SCC of the oral tongue and their metastasis by differential display analysis and identified a gene, FABP5, coding for Epidermal fatty acid binding protein (E-FABP-GenBank Accession ). Its expression was up to 4-fold higher in the primary tumours (67%) as compared to the corresponding metastatic lymph nodes by northern blot analysis.

Adult↗
PubMed2006

Selective neck dissection (I-III) for node negative and node positive necks.

Selective neck dissection (I-III) for oral cancers offers similar regional control rates with less morbidity as compared with modified radical neck dissection. Charts of 414 patients with oral cancer, who underwent selective neck dissection (I-III) during 1994-2001, were analysed retrospectively. Seventy nine percent of the patients had a primary tumour in the gingivo-buccal complex. Cancer of tongue showed a trend towards higher regional failure (12.3%) as compared to gingivo-buccal cancers (6.5%). Primary tumour was staged as T1-8%, T2-47%, T3-19% and T4-26%. Sixty five percent of the patients were clinically node negative. Isolated neck failure was observed in 4.8% of patients at 2 years and in 5.8% at 5 years. De-differentiation of primary tumour and perineural spread were associated with regional failures. Eighty three percent of the neck recurrences were in the ipsilateral neck and only 16% of these were at levels IV or V. In all, 30% of all regional failures were outside the field of dissection.

Adult↗
PubMed2005

Advanced squamous cell carcinoma of lower gingivobuccal complex: patterns of spread and failure.

BACKGROUND: Carcinoma of the gingivobuccal complex is commonly associated with the use of smokeless tobacco known as "quid." METHODS: We conducted a retrospective chart review of 511 patients with advanced cancer of gingivobuccal complex surgically treated during 1994 to 1995. We evaluated patterns of disease failure in these patients and correlated disease-free survival with various prognostic factors. RESULTS: During a median follow-up of 46 months, 159 locoregional recurrences and 11 distant metastases were detected in 148 patients. Seventy-nine percent of the recurrences appeared within 18 months of surgery, and the median survival for patients with recurrent disease was less than 4 months. Two-year and 5-year disease-free survival rates were 64% and 57%, respectively. On multivariate analysis, disease-free survival showed significant correlation with skin involvement and extracapsular spread. CONCLUSIONS: Gingivobuccal cancers usually fail locoregionally. Soft tissue infiltration and extracapsular spread of nodal disease influence disease-free survival.

Adult↗
PubMed2004

A novel technique of raising a pectoralis major myocutaneous flap through the skin paddle incision alone.

A good reconstruction should not only be functionally and aesthetically sound at the recipient site but also cause least possible cosmetic aberration of the donor site. The pectoralis major myocutaneous (PMMC) flap continues to be one of the most commonly used flap for head and neck reconstruction in this part of the world. Conventionally, once the skin paddle over the pectoralis major muscle is marked, a line is drawn joining the outer edge of the skin flap extending to the apex of the anterior axillary skin fold or midclavicular point to expose the underlying pectoralis major muscle and harvest the flap. We intend to suggest a novel technique, in which the pectoralis major muscle is exposed by raising the skin around the skin paddle incision alone without making any further extension.

Dermatologic Surgical Procedures↗
PubMed2004

Reconstruction of early lower gingivo buccal complex lesions using floor of mouth advancement augmented with hyoglossus release.

The surgical treatment in early cancers of the lower gingivobuccal (GB) complex involves wide resection of the buccal mucosa and GB sulcus with or without marginal mandibulectomy. To reconstruct this defect we endeavour to describe a method of advancement of the lateral floor of mouth and tongue to provide pliable, vascularised tissue to bridge the mucosal defect and achieve tension free, primary closure whilst preserving maximum tongue mobility and maintaining adequate mouth opening, thus offering an elegant and simple solution to the problems of reconstruction in early lesions of the lower gingivo buccal complex.

Cheek↗
PubMed2004

mTHPC-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: a multicenter study of 128 patients.

BACKGROUND: The aim of this multicenter study was to assess tumor response, clinical quality-of-life benefit, survival, and safety after treatment with mTHPC in patients with recurrent/refractory squamous cell carcinoma of the head and neck unsuccessfully treated or unsuitable for treatment with conventional modalities. METHODS: One hundred twenty-eight patients were treated with mTHPC followed, 96 hours later, by illumination of the tumor surface with 652-nm laser light. Tumor response was assessed with WHO criteria and tumor mass reduction from baseline. Clinical quality-of-life benefit was based on the University of Washington Quality-of-Life questionnaire. RESULTS: By use of WHO criteria, 38% of evaluable patients achieved an overall tumor response, and 16% achieved a complete tumor response. Forty-three percent of assessable lesions achieved 100% tumor mass reduction, and 58% achieved 50% or greater tumor mass reduction. Fifty-three percent of evaluable patients experienced significant clinical quality-of-life benefit. Subset analyses revealed two subgroups in which significantly better responses were seen in patients with tumors 10 mm or less in depth and patients with fully illuminated lesions. In patients fulfilling both categories, overall tumor response was 54%, complete tumor response was 30%, and 61% demonstrated significant clinical quality-of-life benefit. Median survival was significantly better in responders. No major toxicities were detected. CONCLUSIONS: Patients with advanced cancer of the head and neck, who have exhausted other treatment options, can achieve significant clinical benefit and improvement in quality of life with mTHPC.

Adult↗
PubMed2003

A multicenter Phase I safety study of intratumoral photoactivation of talaporfin sodium in patients with refractory solid tumors.

BACKGROUND: Photodynamic therapy (PDT) currently is approved for the palliative treatment of malignancies of the aerodigestive tract using laser-activated porfimer sodium. A new approach has been developed, based on intratumoral placement of a nonlaser light device that activates talaporfin sodium, that may expand the use of PDT to include a broader range of treatment-resistant malignancies. The safety of this approach was assessed in a Phase I study in patients with locally advanced, refractory tumors. METHODS: Twenty-one patients with radiation-resistant or chemotherapy-resistant or inoperable malignancies were enrolled in four cohorts representing four light doses. Patients were treated with a single intratumoral light device and a fixed photosensitizer dose. Safety assessments were based on review of adverse events (AEs) and serious adverse events (SAEs), and independent evaluation of computed tomography (CT) images. RESULTS: The observed occurrence of treatment-related AEs and SAEs was minimal. No cutaneous phototoxicity was observed in any patient. The overall observed tumor response rate was 33%. CONCLUSIONS: Photoactivation of talaporfin sodium using intratumoral nonlaser light was found to be safe in the patient population of the current study at all light dose levels tested.

Aged↗
PubMed2003

Transoral laser surgery for early glottic cancers.

OBJECTIVE: To demonstrate the oncologic safety of transoral endoscopic laser surgery in early glottic cancers. PATIENTS: The study included 107 patients with early glottic cancers. The disease was in situ in 21 (19.6%) and infiltrative in 86 (80.4%), of which 52 (48.6%) were stage T1a, 17 (15.9%) were T1b, 13 (12.1%) were T2, and 4 (3.7%) were TX lesions. One hundred three patients (96.3%) were treated primarily, whereas 4 patients (3.7%) were operated on after radiotherapy failure. Anatomically, 77 lesions (72.0%) involved the anterior or middle third of the vocal cord; 14 lesions (13.1%) involved a single cord and the anterior commissure; 4 "horseshoe" lesions (3.7%) involved both cords and the anterior commissure; 7 lesions (6.5%) involved the posterior third of the cord reaching the vocal process of the arytenoid; and 5 cases (4.7%) involved both cords separately. RESULTS: There were 17 (15.9%) local recurrences (10 among patients with single cord lesions, 5 among patients with cord and anterior commissure lesions, and 2 among patients with lesions involving both cords), and 1 regional recurrence. One hundred one patients (94.4%) were alive and disease free at a median of 40.7 months. Three patients (2.8%) were alive with disease. One patient (0.9%) died of other causes. Two patients (1.9%) died of a second primary cancer. The overall larynx preservation rate was 92.5%. Recurrence-free survival was 86.6% at 2 years, 84.1% at 5 years, and 78.1% at 10 years. CONCLUSION: Transoral laser surgery is an oncologically safe, function-preserving modality for treatment of early glottic cancers.

Carcinoma, Squamous Cell↗
PubMed2002

Near-total laryngectomy in advanced laryngeal and pyriform cancers.

OBJECTIVE: To demonstrate the oncologic and physiological safety of near-total laryngectomy (NTL), its success in voice conservation, and its versatility for use in extensive resections that necessitate pharyngoplasty, and even in post-radiation recurrences. STUDY: In this study of 137 cases of NTL for cancer of the larynx (45 cases) and pyriform (92 cases), 86.9% were stage T3/T4 and 60.6% were N+. A total of 8.8% had extended pharyngeal resections necessitating patch pharyngoplasty (ENTLP). In 10.9% cases, NTL was used as salvage of post-radiation failures. Concurrent neck dissection was performed in 99 cases. RESULTS: A total of 70.1% was alive and disease-free at the last follow-up ranging from 12 months to 104 months (median, 35 mo). A total of 7.3% had local/locoregional recurrences and 11.7% had purely regional recurrences. The local control rate for post-radiation salvage with NTL was 93.3%. A total of 88.6% developed communicable speech, and the speech success rate was 100% in 12 cases of ENTLP. Complications included major wound dehiscence with total shunt breakdown in 2 cases (1.5%), pharyngeal leak requiring surgical intervention in 7 cases (3.6%), significant aspiration through the shunt necessitating completion laryngectomy in 1 case (0.7%), and complete shunt stenosis in 9 cases (6.6%). CONCLUSION: The study shows that NTL is an oncologically safe voice conservation procedure in advanced, lateralized laryngeal and pyriform cancers treated not only per primum, but also in carefully selected post-radiation failures. It has a high success rate of speech development even in those cases requiring extensive pharyngeal resections. Major complications were acceptably low.

Adult↗
PubMedDate not supplied

Squamous cell carcinoma of the maxillary sinus: a Tata Memorial Hospital experience.

BACKGROUND: The optimal treatment of maxillary sinus carcinoma remains to be defined and there is a paucity of Indian studies on the subject. AIMS: To present experience of management of squamous cell carcinoma of the maxillary sinus treated with curative intent at a single institution. SETTINGS AND DESIGN: Retrospective study of patients with squamous cell carcinoma of the maxillary sinus who presented between 1994 to 1999. MATERIALS AND METHODS: The records of 73 patients with squamous cell carcinoma of the maxillary sinus were analyzed. Sixty-two patients were evaluable. Forty patients (65%) were treated with surgery followed by postoperative radiotherapy, five patients (8%) were treated with radiotherapy alone, five patients (8%) were treated with surgery alone; 12 patients (19%) received chemotherapy. STATISTICAL ANALYSIS USED: Statistical analysis was done using Kaplan-Meier method. RESULTS: The majority of patients presented with locally advanced disease (52, 84%); nodal involvement was observed in five patients (8%). The most common site of recurrence was at the primary site, which was observed in 28 patients (45%) and regional failures occurred in 10 (16%). The 3 and 5-year overall survival was 38% and 35% and the disease free survival was 29% and 26% respectively. The 5-year overall survival after surgery and postoperative radiotherapy was 42%. CONCLUSIONS: The majority of patients present with advanced disease resulting in poor outcomes to conventional treatment modalities. Locoregional tumor progression remains a significant pattern of failure. New approaches such as neoadjuvant or concomitant chemoradiotherapy with aggressive surgery need to be considered and evaluated in prospective studies.

Adolescent↗