Paraneoplastic cushing syndrome due To Wilm's tumor

Paraneoplastic syndromes are rare disorders that are triggered by an altered immune system response to neoplasm. Paraneoplastic syndromes may be the first or the most prominent manifestations of cancer. Wilm's tumor is the most frequent pediatric renal malignancy and usually presents with abdominal mass. Unusual presentations like acquired von Willebrand disease, sudden death due to pulmonary embolism and Cushing syndrome have been described in the literature. Cushing syndrome, as the presenting symptom of a malignant renal tumor in children, is a very rare entity. Few case reports are available in the literature exploring the option of preoperative chemotherapy as well as upfront nephrectomy. We report a rare case of paraneoplastic Cushing syndrome due to a Wilm's tumor. Based on gradual decrease of postoperative weight, blood pressure, serum adrenocorticotropic hormone, and plasma cortisol levels, along with histological confirmation of Wilm's tumor, paraneoplastic Cushing syndrome due to Wilm's tumor was confirmed

study of renal tumours in tertiary care hospitals

Renal cell carcinomas [RCC] comprise 90% of all renal tumours and are presage of poor outcome. Very little data has been published in Pakistan regarding the clinical and pathological manifestations of the disease. A total 0/50 cases presenting with different subtypes of RCC were selected from Allied Hospital Faisalabad and Sheikh Zayed Hospital, Lahore. Clinical details were obtained from the hospital records. The fresh nephrectomy specimens were further processed according to College of American Pathologists guidelines. Mean age of the study population was 50.16 +/- 11.982 years. Male to female ratio was 2.57:1. Left to right ratio was 1:1. Most tumours [n = 36, 72%] were located in the upper pole. Most common symptom was heamaturia [n = 38, 76%]. Mean of the greatest dimension was 10.41 +/- 4.22 cm. The most common stage of presentation was stage II [n = 21, 42%] and histological subtype was clear cell carcinoma [n = 37, 74%]. Renal cell carcinoma, including its chromophobe variant, is a growing malignancy in Pakistan. Delay in seeking medical care on the part of patient and inadequate facilities account for the tumour growing to a larger size and more advanced stage of malignancy in our country

Role of fine needle aspiration cytology for neoplastic evaluation of nodular goitre

To see the accuracy of fine needle aspiration cytology [FNAC] for neoplastic lesions in nodular goitre. A prospective comparative analytic study. The study was conducted in Pathology Department, Punjab Medical College Faisalabad in association with the Department of surgery, Allied Hospital Faisalabad from September 1[st], 2008 to May 31[st], 2010. With an informed and explained consent, the study was conducted on 117 patients of primary euthyroid nodular goitre who underwent thyroid surgery. Preoperative diagnosis in all the patients was established by fine needle aspiration cytology and thyroid function tests. After thyroid surgery, excised tissue was sent for histopathology to confirm the diagnosis. Cytological diagnosis was compared with histological diagnosis to see the accuracy of fine needle aspiration cytology for neoplastic lesions. Among the 117 patients, FNAC showed neoplastic and non-neoplastic lesions in 27 and 90 patients respectively. While, histological diagnosis revealed neoplastic lesions in 24 patients and non-neoplastic lesions in 93 patients. Sensitivity, specificity and accuracy of FNAC for neoplastic lesions in nodular goitre remained 79.17%, 91.4% and 88.89% respectively. Fine needle aspiration cytology plays a pivotal role in pre-operative differentiation between the neoplastic and non-neoplastic lesions of nodular goiter

Ocular Malignancies; lactate dehydrogenase levels in aqueous humour and serum of patients

A total of 50 cases with clinical diagnosis of ocular malignancy were studied for lactate dehydrogenase [LDH] levels in aqueous humour and serum. On histological examination, 40 cases were those of retinoblastoma, 7 had other types of ocular malignancies [squamous cell carcinoma 5, one each of malignant melanoma and sebaceous carcinoma]., whereas three turned out to be non-malignant. Aqueous LDH levels were significantly raised [P< 0.001] in cases of retinoblastoma when compared to other malignancies as well as controls. Mean aqueous humour to serum LDH ratios were also significantly raised [P<0.001] in cases of retinoblastoma