Bilateral optic neuropathy with central diabetes insipidus in a child

Central nervous system germ cell tumors are rare and they occur in the first two decades of life. Optic nerve germinomas can sometimes mimic optic nerve inflammation. In this case report, we discuss an 11-year-old girl who presented with features of presumed bilateral optic neuritis and developed polyuria and polydipsia, subsequently she was diagnosed to have infiltrative etiology. Her clinical and radiological presentations were initially consistent with inflammatory optic neuropathy. Poor visual recovery to steroid therapy and progressive visual loss warranted the need for optic nerve biopsy which revealed germinoma.

Idiopathic intracranial hypertension associated with anaemia, secondary to antiretroviral drug in a human immunodeficiency virus positive patient

Papilledema in a patient with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome is an alarming finding. Any condition giving rise to raised intracranial tension (ICT) can cause papilledema, and in these patients, it could be secondary to opportunistic infections like meningitis to neoplasm. We report a case of a 28-year old female with HIV on antiretroviral therapy, who presented to us, with papilledema. Her fundus examination revealed superficial hemorrhages and Roth's spots along with papilledema. Patient was diagnosed with idiopathic intracranial hypertension (IIH), and all other possible systemic associations were ruled out. Her blood tests showed severe anemia. The papilledema and retinal changes resolved with treatment of anemia. This is a rare presentation of IIH in HIV positive patient due to anemia, secondary to zidovudine adverse effect.

A rare variant of carcinoma of the cervix: neuroendocrine tumour.

Neuroendocrine neoplasm that occurs in the uterine cervix is rare. It accounts for 0.5-1% of all malignant tumours of the uterine cervix. A 55 years old female patient complained of postmenopausal bleeding and history of foul smelling discharge per vagina since 1 month. On examination cervix appeared bulky, both lips indurated, bleeds on touch, both parametrium involved but not up to pelvic wall with bulky uterus. Vagina and per rectal mucosa was free. Clinical diagnosis of carcinoma cervix, stage 2B was made. Cervix biopsy with HPE revealed squamous epithelium of cervix showing neoplastic cells arranged in nests and prominent perivascular pattern, small round cells with minimal cytoplasm and hyperchromatic nucleus, abundant mitosis, cells showed rosette pattern and isolated foci of cell debris and necrosis. Diagnosis of neuroendocrine tumour of cervix was considered. Immunohistochemistry for cytokeratin, neuron specific enolase, chromogranin and synaptophysin was positive, confirming the final diagnosis of neuroendocrine carcinoma cervix (High grade of small cell type). Recognition of Neuroendocrine carcinoma cervix is important for appropriate therapy & management since these patients have worse clinical outcomes when compared with conventional squamous /adeno carcinoma of cervix. Immunohistochemistry should be supplemented with ultrastructural studies for confirmation and correct categorisation of carcinoma cervix for appropriate management.

Synthesis and Cell Line Activity of Angular Benzofuro Fused Naphthyridines.

The present work describes the preparation of novel compounds based on the structure of 2- substituted benzo[b]-furo[2,3-h][1,6]napthyridin-5[4H]-one (10). Their methyl and methoxy derivatives were synthesized and their cytotoxicity evaluated against a cancer cell line HeLa. The analogue bearing methyl group on the system is three times more potent than the methoxy group. One could suggest that the methyl group activates the inhibitor’s site. These results provide new information on the structure activity relationship of these naphthyridine based systems.