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Biomedical subjects

Hemant B Tongaonkar

Publications and source records attributed to Hemant B Tongaonkar.

14 recordsLinked to original sources
PubMed2006

Diagnostic dilemma in a case of malignant mixed mullerian tumor of the cervix.

BACKGROUND: Malignant mixed mullerian tumors (MMMT) are rare biphasic malignant neoplasm. The commonest site of their occurrence in female genital tract is body of the uterus. MMMT of the cervix is extremely rare. CASE PRESENTATION: We report the clinical, pathological and immunohistochemical profile and diagnostic difficulties in a case of giant MMMT of the cervix in a postmenopausal woman who presented with a large cervical mass. On microscopic examination, initially tumor appeared to be endometrial stromal sarcoma, however, immunohistochemical examination revealed the biphasic nature of the tumor. The malignant epithelial component was basaloid squamous carcinoma with homologous sarcomatous component. The patient was treated with surgery. However, she experienced vaginal vault recurrence four months after the initial treatment, which was successfully treated with pelvic radiotherapy. CONCLUSION: Accurate diagnosis of cervical MMMT is important for appropriate treatment of the patient.

Journal Article↗
PubMed2006

Indigenous and austere technique of self-retaining abdominal retraction for facilitating surgical exposure.

Adequate exposure is of paramount importance in major abdominal surgeries. This is achieved by appropriately placed incision, proper position of the patients, and judicious use of retractors. A third assistant is usually required for retaining the retractors. Self-retaining retractors have also been utilized for assisting in adequate exposure of the operative field. However, these retractors are complex and unwieldy, causing hindrance in the movement of the surgeon. We describe a technique of self-retaining abdominal retraction that is simple and also obviates the need for an additional assistant.

Adult↗
PubMed2006

Accuracy of intraoperative frozen section in the diagnosis of ovarian neoplasms: experience at a tertiary oncology center.

BACKGROUND: Epithelial ovarian neoplasms are an important cause of morbidity and mortality in women. The surgical management of ovarian neoplasms depends on their correct categorization as benign, borderline or malignant. This study was undertaken to evaluate the accuracy of intra-operative frozen section in the diagnosis of various categories of ovarian neoplasms. METHODS: Intraoperative frozen section diagnosis was retrospectively evaluated in 217 patients with suspected ovarian neoplasms who underwent surgery as primary line of therapy at our institution. This was compared with the final histopathologic diagnosis on paraffin sections. RESULTS: In 7 patients (3.2%) no opinion on frozen section was possible. In the remaining 210 patients frozen section report had a sensitivity of 100%, 93.5% and 45.5% for benign, malignant and borderline tumors. The corresponding specificities were 93.2%, 98.3% and 98.5% respectively. The overall accuracy of frozen section diagnosis was 91.2%. The majority of cases of disagreement were in the mucinous and borderline tumors. CONCLUSION: Intraoperative frozen section has high accuracy in the diagnosis of suspected ovarian neoplasms. It is a valuable tool to guide the surgical management of these patients and should be routinely used in all major oncology centers.

Journal Article↗
PubMed2006

Clinical outcome of 36 male patients with primary urethral carcinoma: a single center experience.

AIM: Retrospective analysis of male urethral carcinoma to assess the best therapeutic approach to the management of this tumor. METHODS: A review of 36 cases of male urethral carcinoma diagnosed and treated at our center was performed. Clinical features, treatment modality and outcomes were analysed. RESULTS: The overall median survival time was 55.16 months. The 5-year overall and disease-free survival rate for the cohort was 49% and 23%, respectively. The 5-year survival is 67% for low-stage versus 33% for high-stage tumors and is significantly different (P = 0.001). The survival was 72% for tumors of the distal urethra versus 36% for tumors of the proximal, with a P-value of 0.02. CONCLUSION: The tumor location and clinicopathological stage were the most important predictors of the disease-free and overall survival. Multimodal approach is necessary for achieving local control especially for proximal and higher stage tumors.

Aged↗
PubMed2005

Benign mixed epithelial stromal tumor of the renal pelvis with exophytic growth: case report.

BACKGROUND: Mixed epithelial and stromal tumor (MEST) is a distinctive benign composite neoplasm of the kidney predominantly seen in females mostly in the perimenopausal period. Although these tumors are known to arise from renal pelvis, our case was distinct in that it had no intrapelvic component growing in exophytic fashion. CASE REPORT: A 35 year old female patient presented to us with vague abdominal pain. She had undergone excision of bilateral ovarian cystic masses for cystic teratoma twelve years earlier. A computed tomography scan of abdomen and pelvis showed a 9 x 7 cm uniformly solid mass with poor contrast enhancement situated in the inferomedial aspect of the left kidney. On exploration, the mass was arising from the inferior and anterior aspect of left renal pelvis, and was attached to it with a narrow pedicle. There was no adherence or attachment to the renal parenchyma. The mass was excised preserving the kidney. Microscopically, the tumor was composed of large collagenized areas containing bundles of spindle cells and several 'microcysts' lined by cuboidal epithelium suggestive of a benign mixed epithelial stromal tumor. DISCUSSION: Mixed epithelial tumors usually present in perimenopausal women as a partially cystic mass. Tumors are composed of irregular mixtures of cystic and solid areas, glands with variable complexity and distribution and the stromal component is characterized by a spindle cell proliferation. Commonly, it arises from the renal parenchyma and pelvis and nephrectomy is advocated to manage these tumors. CONCLUSION: MEST is a distinctive benign tumor of the kidney that should be distinguished from other renal neoplasms. MEST arising from the renal pelvis and growing exophytically is a rare entity. The overall prognosis is favorable.

Journal Article↗
PubMed2005

Management of renal cell carcinoma with solitary metastasis.

BACKGROUND: Distant metastasis are common in Renal cell carcinoma (RCC) nearly one forth of the patients have metastasis at presentation while another 50% develop metastasis during the follow-up. A small percentage of these are solitary metastasis. We describe survival after surgical excision or radiotherapy of solitary metastatic lesion from renal cell carcinoma. PATIENTS AND METHODS: Between 1988-2001, 43 patients with solitary metastasis to different sites from renal cell carcinoma underwent either surgical excision or radiotherapy were analyzed. The solitary nature of the lesions was confirmed by investigations. All patients have had radical nephrectomy for the primary lesion. Survival analysis was carried out by Kaplan Meier Method. RESULTS: All solitary metastatic lesions were treated with intent of cure either by excision or radiotherapy. Of these, 13 patients had solitary metastasis at the time of presentation in whom 3-year overall median survival was 26 months. The survival of those who developed solitary metastases during follow-up after nephrectomy for primary was 45 months. The patients with long interval between diagnosis and development of metastasis, early stage and low grade of the primary tumor had better prognosis. CONCLUSION: Complete resection of either synchronous or metachronous solitary metastases from renal cell carcinoma is justified and can contribute to a long-term survival in this select group of patients.

Journal Article↗
PubMed2005

Primary carcinoma of the female urethra: single center experience of 18 cases.

BACKGROUND: Primary carcinoma of the urethra is more common in women than in men. Vague symptoms in the early stages delay the diagnosis in most patients. Surgery and radiotherapy are used as treatment modalities for these tumors, either alone or in combination. METHODS: We retrospectively analyzed the records of 18 female patients with urethral cancer presented to our institution. Secondary tumors involving the urethra from adjacent organs like bladder carcinoma and gynecological cancer were excluded. RESULTS: In our review, the overall survival was 74% at 3 years and 33% at 5 years with median overall survival of 51 months. There was a statistically better overall survival in patients with early stage tumors compared with later stage disease (P = 0.03) and patients with distally located tumors had better survival compared with proximal and whole urethral involvement. CONCLUSIONS: The prognosis is poor in advanced stages and in those with proximal or whole urethral involvement, requiring extensive surgical procedures. The aim of treatment in distal urethral carcinomas should be local excision and radiotherapy, thereby preserving the bladder.

Combined Modality Therapy↗
PubMed2005

Renal angiomyolipomas--a study of 18 cases.

Angiomyolipoma is a distinctive neoplasm composed of an intimate admixture of three components, viz. mature adipocytes, smooth muscle cells and blood vessels. This study was undertaken to better define the various morphological patterns of angiomyolipoma and their immunohistochemical profile. The paraffin blocks and slides of 18 cases of renal angiomyolipoma, accessioned over a period of 8 years from Tata Memorial Hospital, were reviewed. There were 2 men and 16 women in the age range of 17 to 68 years. Pre-operative fine needle aspiration cytology (FNAC) was performed in 6 cases, of which 5 were erroneously diagnosed as renal cell carcinomal sarcoma. Histologically, 14 cases revealed conventional histology. The remaining 4 cases were particularly misleading posing diagnostic problems due to variant patterns (leiomyomatous variant-3 cases and epithelioid variant- 1 case). Apart from the usual histology, necrosis, giant cells, and varying degrees of nuclear pleomorphism were present in three of the cases. Immunohistochemistry performed in 16 cases revealed immunoreactivity for HMB45 in all the 16 tumors (100%), estrogen receptor (ER) and progesterone receptor ((PR) in 2 cases (12.5%) and 6 cases (37.5%) respectively.

Adolescent↗
PubMedDate not supplied

Isolated gall bladder metastasis from renal cell carcinoma.

Gall bladder metastasis from renal cell carcinoma is rare. We report a 46-year-old man with isolated gall bladder metastasis from renal cell carcinoma 11 months after radical nephrectomy. He underwent cholecystectomy and frozen section revealed the metastatic tumor. Sixteen months later, the patient is free of disease.

Carcinoma, Renal Cell↗