Biomedical subjects
Publications and source records attributed to J N Kulkarni.
Polyorchidism is a rare anomaly and neoplasia arising in a supernumerary testis is even rarer. We herein describe a case of tumor in a supernumerary abdominal testis in an adult male with unrecognized persistent müllerian structure syndrome.
An unusual case of bilateral synchronous parotid metastases from renal cell carcinoma presenting seven years after nephrectomy is reported. The patient underwent bilateral superficial parotidectomy and is alive free of disease three and half years after the metastatectomy.
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We herein report our experience in the management of 21 patients with tumors in undescended testis. The primary tumor was in the abdominal testis in six patients and in the inguinal testis in 15 patients. Seventeen patients had unilateral involvement and four had bilateral. Prior orchiopexy was reported in six (30%) patients, unilateral in three and bilateral in the other three, although tumors occurred in one side of three bilateral orchiopexy patients. Clinical staging showed five as stage I, six at stage IIb, two as stage IIc, seven as stage III, and in one no stage was possible. Microscopy showed seminoma, non-seminoma, and mixed tumors in 12, six, and three patients, respectively. As per protocol, stages I and IIb had either radiotherapy or retroperitoneal node dissection, giving three and five year survival of 11/11 (100%) and 7/7 (100%). All nine patients with stage IIc and stage III received induction chemotherapy (VAB-6) first and showed complete response (CR) in four (45%) and partial response (PR) in five (55%). Three and 5 year survival was 45% and 33%, respectively. Overall, 3 and 5 year survival was 70% and 69% respectively in all patients. Early stage disease (stages I, IIb) had excellent survivals, showing the adequacy of treatment, while patients with advanced tumor can still be salvaged with a combination of surgery, chemotherapy, and radiotherapy.
Fifteen children, 14 males and 1 female with a mean age of 4.9 years, were treated for rhabdomyosarcoma of the bladder and the prostate, between 1976 and 1985. In 14 patients, the disease was limited to the pelvis, while one had pulmonary metastases. The lesions were trigonal in 12 patients and involved the prostate in the other three. Eleven patients received vincristine-Adriamycin-cyclophosphamide (VAC) chemotherapy, followed by radiation therapy. Four of these 11 patients required cystoprostatectomy for residual or persistent disease. Of the remaining four patients, two underwent radical cystoprostatectomy, one partial cystectomy and the patient with pulmonary metastases received only chemotherapy. Six patients were alive at 5 years (40% 5-year survival). Six patients died of local relapse within 18 months, one patient died of an unknown cause, while two patients were lost to follow-up free of disease after 2 years.
Fourteen patients with adenocarcinoma of the bladder have been seen over a 14-year period; 6 tumours were of urachal origin and the remaining 8 were primary. All tumours were muscle-infiltrating. The 6 patients with urachal tumours were subjected to surgery; 3 underwent partial cystectomy and 3 radical total cystectomy. All patients who underwent partial cystectomy are alive and free of disease at 60 months, 12 months and 12 months respectively. The other 3 patients who underwent radical cystectomy suffered recurrence and 2 succumbed to their disease within 1 year. All patients with primary adenocarcinoma of the bladder underwent radical cystectomy, 5 of them after planned pre-operative radiotherapy. There were 3 post-operative deaths. One patient died of an unrelated cause 30 months after surgery and 2 died of disseminated disease 8 and 16 months after surgery. One patient developed inguinal lymph node metastases 4 months after surgery and is controlled at 12 months with radiotherapy. Only 1 of the 8 patients with primary adenocarcinoma of the bladder is alive and free of disease at 6 months.
Eight patients of histologically proven penis carcinoma treated by Iridium-192 implant are reported. The tumours were T1 in 2 patients, T2 in 5 patients and T3 in 1 patient. Groin status was N0 in 4 patients and N1-2A in 4 patients (fine needle aspiration cytology was negative in the latter 4 patients). Six patients achieved complete local control with excellent cosmetic result with follow-up ranging from 6 to 24 months. One patient who had local failure was salvaged by partial penis amputation, and one patient was lost to follow-up (LTFU). None of the patients developed groin nodes.
We report two cases of primary extranodal lymphoma of the prostate, an unusual site for extranodal presentation. The clinical presentation and treatment is discussed.
Extra-adrenal non-functioning retroperitoneal paragangliomas are rare tumors. We herein report a case of retroperitoneal tumor which posed a diagnostic and management problem. Review of the literature shows only 16 previously reported cases of extra-adrenal paraganglioma which underwent complete surgical excision.
The case of a young woman with primary aldosteronism originating extraadrenally--ovarian tumor--is reported. Clinically she presented with uncontrolled hypertension. Biochemical and hormonal profiles showed features of aldosteronism. The primary was found in the left ovary. Following excision of the tumor, aldosteronism regressed completely. Microscopically, the tumor was of the lipid cell type. Nine months after surgery she is asymptomatic and well. Review of the literature uncovered three previous reports of aldosterone-secreting ovarian tumors.
A case of germ cell tumor occurring simultaneously in the descended and undescended testes of an infertile phenotypic man is reported. Cytogenetic studies revealed a 46XY pattern. Exploration of the abdomen showed a left testicular mass in close proximity to a rudimentary uterus, a fallopian tube and a right testicular mass in the scrotum. Complete excision of both testicular masses and the uterus with the adnexa was done. Histologically, both tumors were seminoma. The patient was well 2 years after treatment.
Thirty bladder tumours of various stages and grades were examined for the presence of A.B.O. (H) cell surface antigen using specific red cell adherence (SCRA) technique. Ten patients with stage A disease and low grade tumour (grade I) retained the antigens, whereas all patients with high stage disease (B,C,D) and high grade tumours showed absence of antigen. When these data were correlated with recurrence pattern and metastasis or invasion rate, patients who did not show the antigen at the initial visit developed metastases and had poor prognoses. The patient who had expressed the antigen by positive SCRA had fewer recurrences and a longer tumour-free interval. Hence if SCRA is done in all bladder tumours at the initial visit and at subsequent follow-up, it can be used as a biological marker.
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Twenty patients of primary urethral carcinoma in females are presented. Age group affected was between 40 and 60 years. Vague symptoms in early stage delayed the diagnosis in most patients. Surgery is the treatment of choice for meatal or anterior urethral lesions while combined Radiotherapy and surgery has been suggested as treatment for entire urethral lesions. In the present series 33% three years and 21% five years survivals were noted.
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Twelve patients with lingual thyroid are reviewed. Two of these patients had a follicular carcinoma in the ectopic gland and both are well 5 and 16 years after treatment. The diagnosis is essentially clinical but confirmation may be made with a thyroid scan. Six patients were treated conservatively with thyroxine with good results. Six patients were treated by surgical excision, 2 undergoing autotransplantation of the excised gland into the anterior abdominal wall.
Primary carcinoma of fallopian tube is a rare entity. We report an interesting case of primary carcinoma of fallopian tube with contralateral lymph node involvement. The clinicopathological findings and its management is presented.