Radiological tumor thickness as a clinical predictor of pathological depth of invasion in oral squamous cell carcinoma: a retrospective analysis.

PURPOSE: Inclusion of depth of invasion (DOI) in the recent AJCC/UICC TNM staging for oral cancer has incorporated the concept of tumor third dimension and its prognostic importance. However, there is no uniform consensus about measuring DOI at clinical setting at present. For more practical reasons, radiological tumor thickness (rTT) is a simple and practical measurement which can be used as a clinical predictor of pDOI. METHODS: We compared rTT and pathological DOI (pDOI) of 179 patients with OSCC who underwent curative surgery from April 2018 to April 2020 at AIIMS Rishikesh, India. Spearman correlation was used to determine correlation between rTT and pDOI. ROC curve was used to determine inter-group cutoff values. RESULTS: Overall, rTT showed a strong correlation with pDOI (rho = 0.74; 95% CI 0.667-0.8; p < 0.001). The inter-group cutoff value for rTT were 8 mm (Sn 89.1%; Sp 53.2%) between Group A (pDOI ≤ 5 mm) and B (pDOI > 5 mm, ≤ 10 mm), and 14 mm (Sn 89.5%; Sp 78.3%) between Group B and C (pDOI > 10 mm), respectively. CONCLUSIONS: rTT is a clinical predictor of pDOI in OSCC, and may be considered as a surrogate of DOI in the clinical setting.

Gastric dysplasia causing gastric outlet obstruction.

Gastric dysplasia signifies the presence of atypical cells in the gastric mucosa, which have not invaded beyond the lamina propria, and it rarely leads to tissue growth large enough to cause gastric outlet obstruction (GOO) to the gastric contents. However, GOO is commonly observed as a first clinical manifestation of advanced invasive gastric cancer in developing countries where patients seek medical care late. The present case highlights the treatment journey of a young woman who presented to us with features of GOO. Her endoscopic and radiological findings revealed a nodular gastric antral thickening causing GOO. An endoscopic biopsy showed features of dysplasia. She underwent distal gastrectomy following discussion in a multidisciplinary tumour board. Histopathological examination of the gastrectomy specimen confirmed dysplasia without any invasion beyond lamina. To the best of our knowledge, this is perhaps the first report of dysplasia of the stomach presenting as GOO.

A Rare Case of Primary Pleural Neurofibroma.

Metastatic deposits are the most common cause of pleural masses, solitary or multiple. Primary pleural neoplasms are rare entities that are occasionally encountered. Of these, the tumors of neurogenic origin are exceedingly rare with only a few cases reported in the literature. We describe a case of an isolated neurofibroma involving the pleura in a 23-year-old male patient, who underwent CT and MRI scans of the thorax as part of the initial investigations. The final diagnosis was clinched by a CT-guided biopsy of the lesion.