Primary Mucinous Eccrine Carcinoma in Nasomaxillary Region: a Rare Case Report and Management Insights.

Primary Mucinous eccrine carcinoma (MEC) is a rare malignant neoplasm of skin believed to arise from eccrine sweat gland commonly with periocular involvement. Here we report a case of 60-year male with a recurrence of unilateral nasomaxillary mass and epiphora. Imaging suggested nasolacrimal duct as probable site of origin. Histopathology and immunochemistry confirmed the diagnosis and managed surgically. This case report emphasizes the significance of including primary MEC in the differential diagnosis of nasomaxillary mass for its recurrence nature and histological similarity with metastasis from other viscera.

A Prospective Study to Evaluate the Role of Narrow Band Imaging and Toludine Blue in the Screening of Premalignant and Malignant Lesions of the Oral Cavity in a Tertiary Referral Centre.

In India cancer patients come at a very advanced stage with many of them being crossed the stage of resection. A wide range of non invasive techniques like toludine blue staining, methylene blue staining, Narrow band imaging have been developed for the early detection of malignant and premalignant lesions in the mucosa including oral cavity and gastrointestinal tract. However it is difficult for the clinicians to decide which diagnostic tool is most appropriate and useful for screening, resulting in failure to pick up the lesions at an early stage. Various online journals have been reviewed and no journal was found to support this point. This study here by describes Toludine blue and narrow-band imaging (NBI), diagnostic tools already proven independently as a useful screening method in many fields, and demonstrate its usefulness in the early detection of premalignant and malignant lesions of the oral cavity, as reported by previous studies in the otolaryngologic literature and compare both screening tools which has not been done till now. This study was done in a tertiary referral centre in middle India from March 2018 to August 2019 in order to evaluate the role of different screening tools (NBI and Toludine blue).44 patients with suspicious oral cavity lesions (premalignant and malignant) who had given consent for both NBI and toludine blue screening techniques were selected from the suspected (premalignant and malignant lesions) who had visited the OPD during the study period. Patients with proven malignancy were excluded from the study. A detailed history of the patient taken and standard Ear, nose, throat, oral cavity and neck examination of patient carried out. After subjecting the patients to screening tools like NBI and toludine blue, the efficacy of these techniques in helping us to take a representative biopsy was evaluated. In present study the sensitivity (to correctly identify all patients with disease), specificity (to correctly reject healthy patients without disease) of older technique toludine blue in detecting premalignant lesion was 66.6%, 87.8% while for NBI was 66.6%, 95%. For malignant lesion sensitivity and specificity of toludine blue was 94.3%, 100%, while the same for NBI was 100%, 88.8% respectively. Both NBI and toludine blue staining can be adopted for screening and the accurate detection of biopsy site and in the follow up of premalignant lesions to look for malignant transformation. Time tested is Toludine blue which is cheap and easily available. But being a better tool and having an upper hand in evaluating the lesions, NBI should be made available in all the secondary and tertiary care centres as a screening method.

Role of Video Laryngostroboscopy in Benign Disease of Larynx.

Benign disease of larynx frequently present with voice disorder. Observing the larynx with high resolution stroboscope and its mucosal wave pattern with greater precision aids in the better understanding of normal/abnormal anatomy and function, which forms the basis of designing treatment strategies.Videolaryngostroboscopy now a days is considered routinely used method of vocal fold examination and evaluation of patients with voice disorders. This valuable imaging tool can also be used to assess the outcomes of therapy of laryngeal diseases or functional result of phonosurgical procedures. Present study, videostroboscopic assessment of 81 cases of different benign vocal cord pathologies was done. Stroboscopic parameters like glottic closure, amplitude, vocal fold edge, symmetry, periodicity and mucosal wave pattern were studied and statistically significant relationship with different vocal pathologies were obtained.

Immunohistochemistry and morphometric analysis of pelviureteric junction complexes in children with hydronephrosis.

AIM: The study aimed to analyze the musculature and innervations of pelviureteric junction (PUJ) complex and upper ureter by morphometry and immunohistochemistry in surgically resected specimens of PUJ obstruction and compares the findings with normal controls. MATERIALS AND METHODS: Specimens of the PUJ were obtained from twenty patients with hydronephrosis due to PUJ obstruction undergoing surgical treatment in this unit from 2013 to 2015. In the control group, seven PUJ complexes were taken from patients who had nephrectomy due to trauma and Wilms tumor. The sections were stained with H and E stain and elastic von Gieson stain. For immunohistochemistry, the tissue sections were immunostained by an indirect immunoperoxidase method for S-100 and neuron-specific enolase. RESULTS: Histopathologically, the predominant arrangement of muscle fibers was layered, i.e., a thick circular layer surrounded by two longitudinal layers on either side in PUJ of obstruction patients. S-100 immunoreactivity in the muscle layer showed dense neural innervation in PUJ complex of obstructed patients. CONCLUSIONS: Circular enhanced musculature may cause a sphincter-like activity with holding up of urine. The higher density of neuronal expression in PUJ might be responsible for causing constant contraction and intrinsic obstruction.

Taenia Solium: A Rare Expression in Oral Cavity.

Cysticercosis is a helminthic infection caused by the larval stage of pork tapeworm, Taenia solium. The worm requires different hosts during its different stages of development. Humans are the definitive hosts and harbor the adult worms, while pigs harbor the larval stage and act as the intermediate hosts. This disease is endemic in developing countries of the world where poor sanitary conditions are prevalent. It manifests mostly in form of lesions in the subcutaneous tissues, brain and skeletal muscles. It is interesting to note that the oral cavity is a rare site for its occurence and pose as a diagnostic challenge for the clinicians. Here, we report one such rare case of an isolated lesion of the oral cavity involving the buccinator muscle.

Myxoid Chondrosarcoma of Nasomaxilloethmoid Region with Intracranial Extension.

Chondrosarcoma of the faciomaxillary area constitute only 4 % of non-epithelial tumours of the nasal cavity, paranasal sinuses and nasopharynx, making it one of the rare malignancy (Indian J Otolaryngol Head Neck Surg 60(3):284-286, [1]), with its myxoid variety still rarest. It is a slow-growing tumour, occurring mostly in middle-aged men. Primary chondrosarcoma of the nasal and paranasal sinus region, including the nasal septum, rarely extends into the cranial or intracranial areas unless there is recurrence (Indian J Ophthalmol 41(4):189-191, [2]. When it does occur, early diagnosis is difficult because patients generally present with common, nonspecific sinonasal complaints. A 45 year male patient came to ENT OPD with complaints of epistaxis, diplopia, facial swelling and loosening of teeth. On examination extensive swelling was present involving right maxilla, palate and ethmoid with shifting of Rt eye laterally. FNAC of swelling was non specific infected cystic lesion. On endoscopic examination there was erosion of Rt lateral wall of nose with mucoid material filling maxilla. Its wall was expanded & lined with velvety red mucosa. Maxillary antral biopsy report was myxoid chondrosarcoma. CT scan revealed extensive lesion of maxilla, ethmoid going up to optic nerve and brain. This case of myxoid chondrosarcoma is presented as it is a rare diagnosis. It presented with advanced disease involving nasomaxilloethmoid region and extended up to optic canal and middle cranial fossa. In a thorough review of Indian literature this was a rarely diagnosed tumour.