Open Access Case Report

Mixed Type Mucinous Breast Carcinoma in an Old Female: A Rare Case Report and Review of Literature

Diptajit Paul, Rakesh Dhankhar, Vivek Kaushal

Asian Oncology Research Journal, Page 22-26

Aims: Mucinous carcinomas of breast are rare malignant tumors characterized by mucin-producing cancer cells. Primarily based on cellularity these are divided into two different variants: pure and mixed. The reported incidence of mixed type mucinous breast carcinoma is very less. We present a case of mixed type mucinous breast carcinoma in an old female.

Presentation of Case: A 60-year-old previously healthy, post-menopausal female presented with painless, right breast lump of 4-months duration. Other history of the patient was unremarkable. Local examination revealed a 3.0 × 2.5 cm size mobile, non-tender lump in upper outer quadrant of right breast without any axillary lymph node. Patient underwent right modified radical mastectomy, histopathology and immunohistochemistry markers confirmed the mass as stage II (pT2N0) mixed (AB) type mucinous carcinoma of breast with neuroendocrine differentiation. Patient was given 6-courses of adjuvant anthracycline-based chemotherapy and after 1–year of follow up patient is completely disease free.

Discussion: Although, mucinous carcinoma has praising prognosis than other invasive breast malignancy, mixed type has comparatively less favorable outcome. Surgery is the primary mode of treatment; decision of adjuvant therapy whether chemo-, radiation or hormonal therapy depends on different prognostic markers. Regional nodal metastasis is the most significant and adverse prognostic marker; tumor size, hormone-receptor-positivity and amount of mucin production being the other prognostic indicators. Anthracycline-based chemotherapy is mostly explored with encouraging outcome, radiation and hormone-therapy are given as per indication. ‘

Conclusion: Here, radical surgery followed by adjuvant chemotherapy yielded complete response in a mixed type mucinous breast carcinoma.

Open Access Case Study

Open Access Case Study

Versatile, Bi-paddle Pectoralis Major Myocutaneous Flap in a High Risk Geriatric Male with Multiple Co-Morbidities, Presented with Advanced, Complex Oro-mandibular Cancer: A Case Report

Sachin S. Kadam, Tejaswini Kadam

Asian Oncology Research Journal, Page 16-21

The study reporting a case of a 78 year old elderly male patient with multiple co-morbidities  with poor performance status with advanced oro-mandibular cancer who underwent oncological resection followed by reconstruction with bi-paddle PMMC flap as an alternative to micro-vascular free flap. Composite resection of the advanced or-mandibular cancer results in extensive defects which poses a challenge to the treating team as it will be difficult to restore mastication, speech and swallowing function. In head and neck cancers, free flaps have been used increasingly to cover the defect with the help of experienced and trained surgeons with fine skills of micro-vascular procedures. However , free flaps are not easily available at all centers in developing countries because of resource constraint, cost and expertise of surgeon. PMMC flap is the robust flap and it has been described and established since long in covering the both, intra and extra oral defects . With the help of random flap and multiple perforators, PMMC flap can mould into bi-lobed / bi-paddle / folded version which can cover intra-oral defect with covering of external lining. Bi-paddle PMMC flap is highly vascularized, versatile flap with short and easy learning curve and produces satisfactory aesthetic and functional results and should be considered as a first option in a geriatric patient with multiple co-morbidities.

Open Access Case Study

Urothelial Carcinoma in Bladder Diverticulum: The First Case Report from Nepal

Anil Kumar Sah, Mahesh Bahadur Adhikari, Bipin Maharjan, Reena Rana, Sunila Basnet, Rajesh Panth, Gopi Aryal

Asian Oncology Research Journal, Page 27-32

Herniation of bladder mucosa through the bladder wall muscle layer is known as bladder diverticulum. The incidence of bladder diverticulum is 1 to 7% of the urinary bladder. About 0.8 to 10% of the urinary bladder diverticula develop carcinoma. Transitional cell carcinoma is the most common one. Painless haematuria is the most common clinical presentation. Different imaging modalities along with cystoscopy are the key for accurate diagnosis and staging. High grade multifocal urothelial carcinoma in bladder diverticulum is better managed by radical cystectomy and standard pelvic lymph node dissection with ileal conduit. Here, we report a case of a 66-year-old man with high grade multifocal urothelial carcinoma in bladder diverticulum managed with radical cystectomy and standard pelvic lymph node dissection with ileal conduit. Urologists in Nepal deal with adequate number of urinary bladder cancers. Such cases have been addressed adequately in the literature, but we did not find any case report from Nepal.

Open Access Original Research Article

The Protective Effect of 9-Diaminoacridine against Ehrlich Ascites Carcinoma (EAC) Induced Spleen Injury in Female Mice

Ehab Tousson, Afaf El-Atrash, Ibrahim El Tantawy El Sayed, Ezar Hafez, Hebat Allah El Basyouny, Ramadan M. Kandyel

Asian Oncology Research Journal, Page 4-15

Background and Objective: The study aims to evaluate the protective activity of 9-Diaminoacridine (N1-(acridin-9-yl) propane-1, 3-diamine hydrochloride; 9-DAAD) against Ehrlich Ascites Carcinoma (EAC) bearing mice.

Materials and Methods: A total forty mice were randomly divided into four groups (1st group, control mice were injected with 0.1% DMSO 15 ml/ Kg bw subcutaneously; 2nd group, mice were administered with 9-DAAD (30 mmol/ kg bw every 3 day) subcutaneously for 2 weeks; 3rd group, mice were injected interaperitonealy with 2.5×106 EAC cells/mouse; 4th group, were injected with EAC as the 3rd group then administered with 9-DAAD for another 2 weeks).

Results: The results showed that; EAC exhibit a significant reduction in RBCs, Hb, HCT, MCV, MCH, MCHC levels. Moreover, EAC exhibit a significant elevation in WBCs and PLT levels when compared to the control group.

Many histopathological alterations were observed within the splenic tissue of the EAC group as cellular degeneration of red and white pulps, several necrotic cells, vacuolar degeneration, and notable amyloid deposition. In addition, there is a significant increase in the activity of caspase-3 and vascular endothelial growth factor (VEGF) expressions. On the other hand; treatment of EAC mice with 9-DAAD regularized serum levels of the above-mentioned parameters and also restore the splenic tissue normal histological architecture.

Conclusion: The results indicated that the 9-DAAD possesses a protective activity against EAC induced changes in blood, biochemical parameters and splenic injury. Further studies are warranted to explore its mode of action and safety for medicinal use in cancer therapy.