An unusual testicular mass in a young male: Metastasis from occult gastric carcinoma

Metastases to the testis are uncommon. Signet-ring cell carcinomas from the gastrointestinal tract (GIT) can rarely disseminate to the testicles, mimicking primary testicular malignancies with signet-ring cells. We hereby describe a case of a 26-year-old male who presented with left testicular swelling, multiple lymphadenopathies, and normal serum tumor markers. Lymph node biopsy revealed clusters and singly lying signet-ring cells. Judicious use of immunohistochemistry confirmed the tumor to be GIT primary. Further investigations confirmed a gastric tumor extending to the duodenum. Although rare, metastatic tumors to the testis should be considered in differential diagnoses of testicular masses in a young patient, particularly when serum germ cell tumor markers are normal or mildly deranged.

Management of venous thromboembolism.

INTRODUCTION: Venous Thromboembolism is an important healthcare problem the world over, resulting in significant morbidity, mortality and resource expenditure. The rationale for use of thromboprophylaxis is based on solid principles and scientific evidence. Indian perspective on this topic is lacking due to the non-availability of published Indian data. This document reviews the available International and Indian data and discusses the relevance of recommendations for prevention and management of Venous Thromboembolism (VTE) in the Indian context. MATERIALS AND METHODS : Meetings of various specialists from different Indian hospitals in the field of Gastrointestinal Surgery, General and Vascular Surgery, Hematology, Intensive Care, Obstetrics and Gynecology, Oncology and Orthopedics were held in the months of August 2005 to January 2006. The guidelines published by American College of Chest Physicians (ACCP), the International Union of Angiology (IUA), and the Royal College of Obstetricians and Gynecologists (RCOG), were discussed during these meetings. The relevance of these guidelines and the practical implications of following these in a developing country like India were also discussed. Any published data from India was collected from data base searches and the results, along with personal experiences of the participating specialists were discussed. The experiences and impressions of the experts during these meetings have been included in this document. Data from recent sources (International Union of Angiology and the National Comprehensive Cancer Network (NCCN) Practice guidelines in Oncology on Venous thromboembolic disease) was subsequently also included in this document. RESULTS: The suggestions formulated in this document are practical, and would intend to serve as a useful practical reference. CONCLUSIONS: A number of unanswered questions remain in the field of thromboprophylaxis, and carefully designed research protocols may help answer some of these. Implementation of the suggestions outlined in the document remains to be studied in the Indian context.

Papillary cystic neoplasm of the pancreas, diagnosed by fine needle aspiration cytology--a case report.

A case of papillary cystic neoplasm of the pancreas diagnosed by fine needle aspiration cytology is presented surgical removal of the pancreatic tumour and histological study confirmed the cytologic diagnosis. A brief review of the literature and emphasis on cytological and histological features are discussed.

Computed tomography evaluation of esophageal carcinoma.

Forty patients of histologically proven esophageal carcinoma were subjected to computed tomography (CT) with the objective to assess its reliability in preoperative evaluation of these patients. The findings were confirmed on surgery in twenty five of these patients, thought to be resectable. Bronchoscopy was performed to evaluate bronchial tree in cases of tumor of upper and middle third of esophagus. CT was found to be sensitive in predicting the location and size of tumor, in assessing invasion of tracheo-bronchial tree, spread to liver, celiac and left gastric nodes. However, it was not successful in picking up metastatic spread to local periesophageal nodes in five cases and celiac in one case. The study concluded CT should be carried out for preoperative evaluation of esophageal carcinoma to select operable cases and avoid unnecessary radicle surgery in advanced cases.

HIV infection in Asian Indian patients with haemophilia & those who had multiple transfusions.

A total of 124 Indian patients with haemophilia and 185 multiple transfused patients with thalassaemia, haemoglobinopathies, patients on chronic haemodialysis and others were screened for HIV-1 infection by a commercially available competitive ELISA test and supplementary Western Blot (WB) test. The results showed that HIV-1 infection was mostly confined to the haemophiliacs where 15 (12.1%) were confirmed to be positive for HIV infection. All except one had received both foreign and Indian cryoprecipitate. However, one haemophilic seroconverted within 4 months of receiving a cryoprecipitate manufactured in India.