Role of FNAC in Hepatic lesions: Risk of track metastases.

BACKGROUND: Liver is one of the most common site of metastases in patients with malignancy and the evaluation of space occupying lesions (SOL) of liver in patients with malignancy is important. Its important to differentiate benign from malignant to take necessary decisions. MATERIALS AND METHODS: We have performed a retrospective analysis of liver SOLs for which fine needle aspiration cytology (FNAC) was done in the year 2011. Risks and benefits associated with FNAC were evaluated. RESULTS: We analyzed 755 patients who underwent FNAC of which 524 patients had secondary metastases to liver, 148 patients had primary hepatocellular carcinoma, 14 cases were benign neoplasms and 53 were nonneoplastic conditions. Histological correlation with FNAC was available in 112 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93%, 90.9%, 98.9%, 58.8%, and 92.8%, respectively. Though there were no incidence of bleeding, two patients developed track metastases following FNAC. One was a case of Hepatocellular carcinoma and the other a case of metastatic breast cancer. CONCLUSION: FNAC was very much useful in our setup where most of the patients could not afford for Computer tomography (CT) scan and was useful in counseling them especially in patients with advanced malignancy where no active cancer directed therapy is required.

"Ovarian Metastases from Colorectal Cancer: Our Experience".

Ovarian metastases from colorectal cancer are uncommon and can present synchronously and metachronoulsy. Role of prophylactic oophorectomy for colorectal cancer is controversial and there is no definitive evidence to support it. A retrospective analysis of all the patients with colorectal cancer who had attended a single unit at our center have been analysed. Clinical presentation, Pathological features and image findings were analyzed. We had 7 patients with ovarian metastases who had presented synchronously or metachronously at our institute. Five patients presented synchronously at the time of primary surgery and 2 patients had presented metachronously after the treatment of primary. Three patients had malignancy in ascending colon and 2 had in sigmoid colon , one in rectosigmoid junction and one case in rectum. The mean overall survival rate was 12.4 months (range 6-20 months). All the patients received adjuvant chemotherapy. Ovarian metastases is rare in colorectal and occurs in younger patients.

Triple negative breast cancer - our experience and review.

Triple negative breast cancer (TNBC) constitutes 10-25% of patients with breast cancer. TNBC is an aggressive phenotype affecting younger age groups and has poor prognosis. We retrospectively analysed 50 triple negative breast cancer patients attending our outpatient department among 270 breast cancer patients. The incidence of TNBC was 18.5%, and most of them were premenopausal 56% (28/50) with mean age was 46.66 ± 13.87 (Range 28-72 years). Most of them had Invasive ductal cancer 94% (47/50) and were high grade (Grade 3-96%)(48/50). Five patients presented with metastatic disease (2 patients only Skeletal, 1 patient with Skeletal and Lung, 1 patient with Lung and 1 patient with Liver) and 7 patients developed recurrence (all 7 had chest wall recurrence, 3 had supraclavicular lymph node recurrence, 2 had skeletal metastases and 1 had developed brain metastases) during follow up. The mean disease free survival was 15 months (Range 3-58 months) and overall survival was 20.14 months (Range 5-70 months). Fifty six percent (28/50) of patients were premenopausal and mean age of presentation was 46.66 ± 13.87 years (Range 28-72 years). Ten percent (5/50) presented with metastatic disease and 15% (7/45) developed metastases during follow up. Five patients (10%) died during follow up. Hence, Triple negative breast cancer is aggressive, with rapid progression leading to mortality in younger patients.