Clinico-Demographic Profile Of Soft Tissue Sarcoma- 5 Year Experience From A Tertiary Care Centre Of Eastern India.

Soft tissue sarcomas (STS) are a diverse group of malignant mesenchymal neoplasm.But, due to their low prevalence, very little data is available worldwide as well as in India regarding their clinico-epidemiological pattern.In this study we analysed the clinico-demographic profile of STS patients attending a tertiary care centre of Eastern India over the last 5 years. We analyzed the prospectively maintained database of a tertiary care centre of West Bengal in Eastern India, and collected the data regarding the demography, clinical profile, pathology and treatment of STS patients who attended our OPD between 2017-2021. The objective was to assess the demographic and clinical data of STS patients of Eastern India and compare it with those of the reported literature from rest of the country as well as outside world. Most of the cases (27%) were between 41-50 years of age group with a slight male predominance (Male: Female = 1.01:1). Spindle cell sarcoma was the most common (24.3%) histology followed by undifferentiated pleomorphic sarcoma (15%) and extremities were the most common site of involvement (47.7%). 71% patients presented with stage III and advanced disease.81% patients underwent radical surgery,14% patient received neo-adjuvant and 60% received adjuvant radiotherapy.91% patients received systemic chemotherapy. To conclude, this study is one of its first from Eastern India and will act as a stepping stone for future studies concentrating on clinico-epidemiological profile, early diagnosis and treatment of STS.

A case of akathisia induced by escitalopram: case report & review of literature.

Although cases of Selective Serotonin Reuptake Inhibitor (SSRI) induced akathisia have often been reported in literature, this adverse effect has not adequately been mentioned in major pharmacology textbooks. As a result, SSRIinduced akathisia is very frequently under-recognized. A review of literature showed that almost all frequently used SSRIs such as Fluvoxamine, Fluoxetine, Sertraline, Citalopram have been reported to be causing akathisia. SSRI-induced restless legs syndrome and movement disorders have also been reported. However, Escitalopram-induced akathisia is rare. In our review of literature, we could find only one single case of Escitalopram-induced severe akathisia. And this specific SSRI drug has rarely been implicated with occurrence of restless legs syndrome and extra-pyramidal side-effects like dytonia etc. Here, we present a case of Escitalopram-induced severe akathisia - a 53year old female, who had developed severe akathisia after taking Escitalopram for a few days. According to the Barnes Akathisia Rating Scale (BARS), her Global Clinical Assessment of Akathisia Score was 5 i.e. severe akathisia. As per Naronjo Adverse Drug Reaction Scale the probability of association of this adverse reaction with Escitalopram was 7 (i.e. probable). Her symptoms continued in spite of prompt discontinuation of the drug. But, she improved rapidly with the use of Propranolol and Clonazepam. On the last follow-up, she was free from any symptoms. As new generation antidepressants are rarely associated with extra-pyramidal symptoms, the recognition of such adverse effects requires a high index of suspicion. Early recognition of the symptoms and discontinuation of the offending agent along with supportive therapy like a short course of benzodiazepines, beta-adrenergic antagonists or anticholinergics may rapidly relieve the patient from this distressing symptom.

Osteosarcoma of the mandible--second cancer in a case of Hodgkin's lymphoma post-chemotherapy.

Osteosarcoma as a second cancer occurring in an adolescent male previously treated with only chemotherapy for Hodgkin's lymphoma is rare. A 14 year old male presented with gradual swelling of right jaw and numbness of lip and chin for last three months. He was treated with only chemotherapy for Hodgkin's lymphoma four years back. Incisional biopsy was taken from mandibular swelling, histopathology suggesting osteosarcoma. Right hemimandibulectomy and reconstruction with metallic implant were done along with excision of right parotid lymph node. Chemotherapy was started with cisplatin and doxorubicin regimen. Absence of radiation as a risk factor and very young age of the patient presenting with a second cancer made this case a rarity and hence the case is being reported.

Carcinoma in situ of true vocal cord in a nonsmoker adolescent female.

Carcinoma in situ (precancerous lesion) of true vocal cord in a nonsmoker adolescent female without any history of prior neck irradiation is rare. A 16-year-old female patient without any of the known risk factors presented with history of gradual-onset hoarseness of voice unrelieved by symptomatic treatments for 1 year. Contrast-enhanced CT scan of neck and laryngoscopy and histopathology of the tissue from irregular lesions along the medial margin of the left vocal cord diagnosed it as a case of carcinoma in situ of vocal cord. Absence of known risk factors and very young age of the patient made this case a rarity and hence the case is being reported.