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Biomedical subjects

K Harish

Publications and source records attributed to K Harish.

At least 19 recordsLinked to original sources
PubMed2006

Recurrent renal cell carcinoma presenting as gastrointestinal bleed. A case report.

Recurrence in renal carcinoma after primary therapy is a rare but known event. The recurrences are often asymptomatic, but could manifest in varied forms depending on the organ involved. In this report, we present a case wherein the recurrent tumor had ulcerated into the duodenal lumen manifesting as an upper gastrointestinal bleed. A 58-year-old male patient underwent radical nephrectomy on the right side for renal cell carcinoma (T2, N0, M0). Three years and 5 months later, the patient presented with an acute episode of upper gastrointestinal bleed. The recurrence was diagnosed by biopsy through endoscopy and evaluated by computed tomography (CT) scan. The patient was managed with an en bloc pancreatico-duodenectomy after metastatic evaluation and is disease free for 2 years. Recurrences in renal cell carcinoma can show varied presentation. Only 2 cases of gastrointestinal bleed of recurrent renal cell carcinoma are reported. High index of suspicion and long term follow-up are required. Aggressive surgical management for recurrence of renal cell carcinoma is warranted as good prognosis could be expected in the absence of metastasis.

Carcinoma, Renal Cell↗
PubMed2006

Thyroglobulin: current status in differentiated thyroid carcinoma (review).

Thyroglobulin (Tg) measurements in tissue and serum play an important role in the management of differentiated thyroid cancers. In the post thyroid ablation scenario, Tg estimation plays a very important role for detection of recurrence and metastasis. Although there could be Tg autoantibody interference in some patients, Tg is a highly specific and sensitive tumor marker for differentiated thyroid cancer in those where the autoantibody is absent. The clinical sensitivity of Tg is greatest when endogenous TSH is elevated before radioiodine imaging. Tg assays and radioiodine scans are independent indicators of residual or metastatic thyroid cancer, indicating that both these tests are complimentary. Immunohistochemical detection of Tg in surgical specimens is useful in the differential diagnosis of tumors of unknown origin. In future, measurement of Tg mRNA to detect circulating tumor cells may help to overcome some of the current limitations. Key words: Thyroglobulin Serum estimation -Antibodies mRNA testing - Differentiated thyroid cancer Radioiodine Thyroxine TSH Diagnostic use.

Autoantibodies↗
PubMed2005

Giant cell tumor of the temporal bone--a case report.

BACKGROUND: Giant cell tumor is a benign but locally aggressive bone neoplasm which uncommonly involves the skull. The petrous portion of the temporal bone forms a rare location for this tumor. CASE PRESENTATION: The authors report a case of a large giant cell tumor involving the petrous and squamous portions of the temporal bone in a 26 year old male patient. He presented with right side severe hearing loss and facial paresis. Radical excision of the tumor was achieved but facial palsy could not be avoided. CONCLUSION: Radical excision of skull base giant cell tumor may be hazardous but if achieved is the optimal treatment and may be curative.

Journal Article↗
PubMed2005

Sentinel node biopsy: concepts and current status.

One of the major routes for spread of cancer is via lymphatic vessels to local lymph nodes. For this reason, local lymph nodes are removed to prevent further spread of tumors. Over the years, surgery has evolved from therapeutic lymphadenectomy for involved nodes to elective lymphadenectomy when the risk of harboring metastasis was high. Two major problems encountered with such an approach included the morbidity of the procedure and a high proportion of nodes being negative on pathologic examination. For these reasons, a new approach has been developed -- Sentinel node biopsy (SNB). SNB is an in vivo assessment of the nodal involvement in early disease. During surgery, the sentinel node is identified by the injection of a blue dye, a radio-colloid substance or both which has been show to have fewer false negatives. This procedure is now standardized during surgery of breast carcinoma or melanoma. However, its use in other types of tumors is still considered investigational at present.

Animals↗
PubMed2005

Neck dissections: radical to conservative.

BACKGROUND: Neck dissection is an important surgical procedure for the management of metastatic nodal disease in the neck. The gold standard of neck nodal management has been the radical neck dissection. Any modification in the neck dissection is always compared with this standard. Over the last few decades, in order to alleviate the morbidity of radical neck dissection, several modifications and conservative procedures have been advocated. These procedures retain certain lymphatic or non-lymphatic structures and have been shown not to compromise oncological safety. METHODS: A literature search of the Medline was carried out for all articles on neck dissections. The articles were systematically reviewed to analyze and trace the evolution of neck dissection. These were then categorized to address the nomenclature, management of node positive and node negative neck including those who had received chemoradiation. RESULTS: The present article discusses the neck nodal nomenclature, the radical neck dissection, its modifications and migration to more conservative procedures and possible advances in the near future. CONCLUSION: Radical neck dissection is now replaced with modified radical neck dissections in most situations. Attempts are being made to replace modified radical neck dissections with selective neck dissections for early node positivity. Sentinel node biopsy is being studied to address the issue of node negative neck. More conservative surgeries are likely to replace the 'radical' surgeries of bygone era. This process is facilitated by earlier detection of the disease and better understanding of cancer biology.

Journal Article↗
PubMed2005

Ethmoidal osteoid osteoma with orbital and intracranial extension - a case report.

BACKGROUND: Osteoid osteoma is a benign bone neoplasm which is seen in the long bones of appendicular skeleton. It is rarely seen in the cranium. Skull base osteoid osteoma is extremely rare and has been anecdotally reported. CASE PRESENTATION: The authors report a case of a large osteoid osteoma of the ethmoid with intraorbital and intracranial extension in a 33 year old male patient. He presented with loss of vision in the left eye. The intra-cranial extension was excised through a single burr-hole fronto-orbitotomy. The ethmoid and orbital portions were approached and excised through a Weber-Ferguson incision and inferior orbitotomy. Radical excision of the tumor could thus be achieved through a craniofacial approach. CONCLUSION: Although benign and rare, skull base osteoid osteoma can present with neurological deficit due to its mass effect and involvement of vital structures. A multispeciality team approach is advisable in such cases if radical excision is to be achieved. A craniofacial approach made radical single stage excision of this multicompartmental osteoid osteoma possible with an uneventful postoperative period.

Journal Article↗
PubMed2005

Isolated pure lipoma of the uterus--a case report.

Lipoma primary to uterus is a rare entity among uterine fatty tumors. These create preoperative diagnostic confusion and their histogenesis is still unclear. Only a few cases of pure lipoma of uterus have been reported in the last few decades. A case of isolated pure lipoma primary to uterus diagnosed postoperatively by pathological examination is presented.

Female↗
PubMed2004

Treatment outcomes in locally advanced colorectal carcinoma.

BACKGROUND: Locally advanced colorectal cancers form a distinct subgroup where contiguous organs could be involved without distant metastases and so may be amenable to curative surgical resection. It was our objective to report our experience in treating six such patients with operable locally advanced colorectal carcinomas. METHODS: We retrospectively reviewed the case notes of 47 patients who were diagnosed with colorectal cancers at M S Ramaiah Medical Teaching Hospital between the years 1996 - 2001. Six patients were identified with T4 lesions, adjacent organ involvement and with no nodal involvement. The treatments and outcomes for these patients were then reviewed. RESULTS: Two of three patients with rectal malignancies who underwent pelvic exenteration succumbed to disease recurrence within the first 18 months. One of the three patients with colonic cancers died of non malignant causes. The other two are disease free till date. CONCLUSIONS: Aggressive multivisceral resections for locally advanced colonic cancers might be appropriate. Rectal cancers when locally advanced may be considered for pelvic exenteration, but a more guarded prognosis may apply.

Journal Article↗
PubMed2004

Adenoid cystic carcinoma of the parotid metastasizing to liver: case report.

BACKGROUND: Adenoid cystic carcinoma is a rare malignant parotid tumor. Metastasis can occur even a decade or more after initial treatment of the primary. CASE PRESENTATION: We report a 60 year old female patient who presented with adenoid cystic carcinoma of the parotid gland. She underwent a total conservative parotidectomy followed by adjuvant radiotherapy. While on follow up, patient developed multiple liver metastases which manifested three years later. Patient lived for another two years before she died of her disease. CONCLUSIONS: Although distant metastases of adenoid cystic carcinoma develop frequently, isolated metastasis to liver is unusual. Even after manifestation of distant metastasis, patients can be expected to live for a number of years. Palliative chemotherapy can be considered in symptomatic cases while the usefulness of metastasectomy is controversial.

Carcinoma, Adenoid Cystic↗
PubMed2004

"Primary" aggressive chondroblastoma of the humerus: a case report.

BACKGROUND: Chondroblastomas are rare epiphyseal bone tumors. Very few cases with extra-cortical aggressive soft tissue invasion or metastasis are reported. CASE PRESENTATION: We report a 28 year-old adult male who presented with a large swelling over the left shoulder region. Pre-operative imaging revealed a large tumor arising from upper end of humerus with extensive soft tissue involvement necessitating a fore-quarter amputation. Patient received adjuvant radiation. CONCLUSIONS: This patient is one of the largest chondroblastomas to be reported. Although chondroblastomas are typically benign, rarely they can be locally aggressive or metastatic. Early diagnosis and institution of proper primary therapy would prevent mutilating surgeries and recurrences.

Adult↗
PubMed2004

Management of primary malignant epithelial parotid tumors.

Parotid cancers are infrequently encountered. These tumors carry a prolonged risk of recurrence and metastasis. Controversies surrounding pre-treatment evaluation by imaging and fine needle aspiration, utility of operative frozen section are partly resolved. Though surgery remains the mainstay of treatment, radiation is being recognized as a useful adjuvant. Facial nerve preservation is one of the important goals at surgery. The role of chemotherapy is still investigational. The prognosis and necessity of elective neck treatment are mainly guided by the tumor grade and stage.

Humans↗
PubMed2003

Low grade fibromyxoid sarcoma of the falciform ligament: a case report.

BACKGROUND: Low grade fibromyxoid sarcomas (LGFMS) are very rarely seen. They commonly arise from deep soft tissues of the lower extremities. Very few cases of intra-abdominal location have been reported. CASE PRESENTATION: We report a 37 year old man who presented with an abdominal mass and dragging pain. Pre-operative imaging suggested the possibility of a subcapsular hemangioma of liver. CONCLUSIONS: Laparoscopy was useful to locate the tumor as arising from falciform ligament and made the subsequent surgery simpler. This is one of the large fibromyxoid sarcomas to be reported.

Abdominal Neoplasms↗
PubMed2003

Sternalis muscle: importance in surgery of the breast.

Mastectomy is a commonly performed surgery for carcinoma of breast. During surgery, pectoral fascia is removed and pectoralis major muscle is laid bare. Sternalis is a rare muscle encountered in the subcutaneous plane. We examined the operative records of 1,152 patients who underwent modified radical mastectomies between 1990 and 2000. Patients who underwent conservative breast surgery or radical mastectomy were excluded. Among 1,152 patients who underwent modified radical mastectomy, eight were identified as having sternalis, a subcutaneously placed muscle oriented craniocaudally. The thickness of the muscle varied. The muscle was spared in all patients. Sternalis is a rare muscle in the subcutaneous plane. It should not be mistaken for a mass on mammography. During surgery it is important to be aware of this rare entity and identify the muscle early so that the dissection plane is appropriate. The depth at which internal mammary nodes are irradiated may also vary in the presence of the muscle. In addition, it should not be mistaken for recurrence on follow-up.

Breast Neoplasms↗
PubMed2003

Cytological diagnosis of nonulcerative penile neoplasms: report of two cases.

Nonulcerative penile mass lesions are rare. Pathological diagnosis of these lesions would traditionally be a biopsy. We report two such primary penile lesions which were diagnosed by fine-needle aspiration cytology (FNAC). Both lesions were present in the shaft and were diagnosed as squamous cell carcinoma (SCC). The first patient had a recurrence on the penile stump of partial amputation without any ulceration. The second had a primary urethral carcinoma on the terminal penile shaft infiltrating the corpora cavernosa dorsally. Open biopsies were avoided in both cases. FNAC was associated with very little and tolerable discomfort. There were no complications. The aspirate yield was sufficient for cytological diagnosis. FNAC of nonulcerated penile lesions is safe, well tolerated, and capable of providing a cytological diagnosis. Hence, it is a very useful outpatient procedure and could be the procedure of choice for diagnosis.

Aged↗
PubMed1995

The role of tobacco in penile carcinoma.

OBJECTIVE: To study the role of tobacco in squamous cell carcinoma of the penis. SUBJECTS AND METHODS: The use of tobacco in the form of cigarettes, chewing tobacco and snuff was studied in a total of 503 patients and age-matched controls. RESULTS: By multivariate analysis, a significant association was found between smoking (P = 0.002) or chewing tobacco (P < 0.001) and the use of snuff (P = 0.004) in patients with penile carcinoma as compared with controls. A dose-response relationship was observed for both smoking and chewing. CONCLUSIONS: The use of tobacco is a significant risk factor for penile carcinoma, and the use of more than one form of tobacco increases this risk.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

C-reactive protein in childhood meningitides.

Utility of C-reactive protein (CRP) latex agglutination test in meningitis was evaluated. Serum CRP test was positive in 100% cases of meningitic groups and 53% cases of "no meningitis (NM)" group. Cerebrospinal fluid (CSF) CRP test was positive in 100% cases of pyogenic meningitis, whereas it was negative in 95% cases of tuberculous meningitis and 100% cases of NM group. CSF CRP test showed 100% sensitivity and negative predictive values, 95-100% specificity and 94-100% positive predictive values for various inter-group differentiations. This study concluded that CSF CRP positive cases should be considered as pyogenic meningitis unless proved otherwise. Routine use of this simple, reliable and inexpensive test is recommended for rapid diagnosis and differential diagnosis f meningitis.

Biomarkers↗