Solitary Masseter Metastasis from Renal Cell Carcinoma: A Rare Case Report.

Background: Renal cell carcinoma (RCC) frequently presents with metastatic spread, sometimes many years after treatment. However, masseter muscle metastasis is extremely rare, with just six reported cases in literature, and none in the United Kingdom (UK). Given its rarity, we hope our case will add to the body of knowledge on the subject and encourage clinicians to maintain a high index of suspicion when reviewing patients with previous RCC and an unexplained mass. Case Summary: Here presented is a 62-year-old man who previously underwent left radical nephrectomy in 2014 for an 11 cm clear cell renal carcinoma (ccRCC). He had subsequent right adrenalectomy in 2020 for a 19 mm recurrence, which was excised with clear margins. He then presented in 2022 with a three-month history of enlarging painless mass in the left side of his face. Imaging was inconclusive, but biopsy showed a singular ccRCC metastatic deposit in the masseter. Surgical resection was not possible due to extension into the infratemporal fossa, and he was referred for radiotherapy. Conclusions: Masseter muscle, whilst rare, can be a site of distant metastases for renal cell carcinoma. Diagnosis relies on a high index of clinical suspicion in patients with prior RCC, combined with cross-sectional imaging and biopsy. Early detection gives the best chance for cure with metastasectomy.

Vesical Endometriosis in a male patient on treatment for papillary urothelial carcinoma.

Endometriosis denotes the abnormal growth of tissue resembling endometrium in ectopic sites and has largely been studied in women of reproductive age. It is an extremely rare phenomenon in men. We came across an exceptional clinical scenario of histologically proven bladder endometriosis in a 66-year-old man in relook bladder biopsy following completion of adjuvant intravesical Bacillus Calmette-Guerin induction course for G3pTa bladder cancer. We have pencilled down pathophysiology and commonly seen predisposing factors for "endometriosis in male patients" from available case reports and applied those findings to hypothesise the disease profile of our patient in this case report.

Internist's tumour into thyroid: A case report.

Renal cell carcinoma (RCC) is well known for its unpredictable and diverse behaviour, with tendency to cause synchronous or metachronous metastasis to unusual site, which is why it is called the "internist's tumour."Although thyroid gland is an infrequent site for metastasis of different primary malignancies, metastatic RCC is one of the most common secondary thyroid malignancies. Diagnosis relies on a high index of suspicion in patients with prior RCC, combined with cross-sectional imaging and biopsy. A case of secondary thyroid neoplasm from RCC after 13 years of radical nephrectomy is described with clinicopathological features and literature review.

Massive Small Bowel Enterolith in Post Cystoprostatectomy Ileal Cul-de-sac : A Unique Presentation of a Rare Clinical Condition.

Enterolithiasis or formation of gastrointestinal concretions is an unusual medical entity that typically occurs in patients suffering from persistent intestinal stasis. We present a rare case of non-obstructive enterolith wedged in the blind end of bowel reconstruction following cystoprostatectomy and ileal conduit formation due to muscle-invasive bladder cancer. Although we watched it grow over the years, radiological characterisation was made possible when it grew to a significant size. We, herein, will discuss the aetiology and complexities associated with the diagnosis and management of such orphan cases given their non-specific clinical presentations in an already hostile abdomen due to multiple laparotomies.

Performance Analysis of Linearly Arranged Concentric Circular Antenna Array with Low Sidelobe Level and Beamwidth Using Robust Tapering Technique.

In this research, a novel antenna array named Linearly arranged Concentric Circular Antenna Array (LCCAA) is proposed, concerning lower beamwidth, lower sidelobe level, sharp ability to detect false signals, and impressive SINR performance. The performance of the proposed LCCAA beamformer is compared with geometrically identical existing beamformers using the conventional technique where the LCCAA beamformer shows the lowest beamwidth and sidelobe level (SLL) of 12.50° and -15.17 dB with equal elements accordingly. However, the performance is degraded due to look direction error, for which robust techniques, fixed diagonal loading (FDL), optimal diagonal loading (ODL), and variable diagonal loading (VDL), are applied to all the potential arrays to minimize this problem. Furthermore, the LCCAA beamformer is further simulated to reduce the sidelobe applying tapering techniques where the Hamming window shows the best performance having 17.097 dB less sidelobe level compared to the uniform window. The proposed structure is also analyzed under a robust tapered (VDL-Hamming) method which reduces around 69.92 dB and 48.39 dB more sidelobe level compared to conventional and robust techniques. Analyzing all the performances, it is clear that the proposed LCCAA beamformer is superior and provides the best performance with the proposed robust tapered (VDL-Hamming) technique.

Challenges faced by female radiation oncologists (FRO) in South Asia.

AIM: This study was designed to evaluate the personal challenges, work environment, and financial satisfaction of female radiation oncologists (FRO) in South Asia. MATERIAL AND METHOD: A 28-point online survey was answered by 296 FRO from south Asia. The study comprised of seven sections: personal, professional, family, economic, workplace burnout, research/academic components, and challenges exclusive to being a working woman. RESULTS: The distribution of the participants was 73.4%, 14.8%, 7.9%, and 3.9% from India, Bangladesh, Nepal, and Pakistan, respectively. Age distribution was>50 y 12.1%, 30-50 y 61.1%, and<30 y 26.8%. Out of 296 respondents 206 (69.6%) and 176 (59.5%) were married and mothers respectively. 43.8% (77) of all mothers were denied maternity leave partially.45.9% (136) of all respondents and 68.7% (121) of all mothers found motherhood the principal obstacle to career growth. Total 60.1% encounter a gender bias in the department, and 34.8% reported they were either gained or lost a job/training because of their gender. 43.3%, 36.9%, 30.6%, and 25.5% of responders felt they could have done well in professional, financial, social, and academic perspectives, respectively, had they been of the opposite gender. 28.5%, 31%, and 16.4% FRO have income ½, equal and>1.5 times than their partners. 58.9% of FRO have a similar income to male colleagues in the city, and 43% of participants are financially satisfied. CONCLUSION: This study shows a fraction of FRO in south Asia faces a substantial gender disparity in the workplace. They are partially satisfied as a woman, as RO, as mother, and as lone-earner in the family. FROs need well deserved support for optimum delivery in their professional and personal lives.

T11 target structure exerts effector function by activating immune cells in CNS against glioma where cytokine modulation provide favorable microenvironment.

Glycoprotein T 11 target structure (T11TS), derived from sheep erythrocyte membrane, directly interacts with T cells to activate them to enter in the brain. When untreated, glioma exerts an immune-suppressive environment in its vicinity by secreting prostaglandin E2 (PGE2), IL-10, tumor growth factor beta, gangliosides etc. to dampen the immune attack. But exogenous administration of T11TS reverses the situation to pro-inflammatory immune active state by expressing enhanced IL-12 and tumor necrosis factor alpha (TNF-alpha) production and suppression of IL-4 and IL-10 levels. The T11TS activated lymphocytic accumulation along the capillary endothelium in brain and their penetration in the matrix was evident from histological sections. IL-6 with TNF-alpha facilitates leukocyte migration to glioma site to exert cytotoxic effector function. Brain infiltrated lymphocytes offer cytotoxic proximity to neoplastic glial cells, which lead them to apoptosis. In the Th1 dominated microenvironment microglial cells was found with enhanced phagocytic functions. Initially infiltrated lymphocytes with microglia showed increased production of TNF-alpha, interferon gamma (IFN-gamma) to facilitate their effector actions. Repeated dosing of T11TS shows glioma abrogation in rat model, but also a resurgence of anti-inflammatory cytokine environment found with increased IL-4, IL-10 and decreased IL-12, IL-6, TNF-alpha. This is a unique homeostatic regulation of total immune system after T11TS mediated carnage of glioma. The resultant balance of cytokines between interacting glioma cells, T cells and microglia in T11TS induced condition determines the success of its immunotherapeutic effect in glioma.

Immunotherapy with T11TS / S-LFA-3 specifically induces apoptosis of brain tumor cells by augmenting intracranial immune status.

BACKGROUND: Immunopotentiating agents are the best options in cancer therapeutics because they can specifically destroy tumor cells via immunocytes, which are mostly apoptotic in nature. Previously, immunotherapy with T11TS / SLFA-3 in a ethyl-nitrosourea (ENU)-induced animal model (Druckrey rats) of neural neoplasm showed a significant tumor mass destruction by augmenting the cellular immune status. MATERIALS AND METHODS: The modulations of the peripheral as well as neural immune systems after T11TS administration were monitored by assessing the CD4+ and CD8+ lymphocytes, along with the cytotoxic activity of splenic and brain infiltrating lymphocytes (BIL). The rate of apoptosis of the tumor cells, microglial cells (Mg) and BIL were measured by flow cytometry-based propidium iodide analysis and TUNEL assay. RESULTS: Cell cycle phase distribution analysis by propidium iodide -FACS and TUNEL assay revealed that T11TS administration gradually increased the number of apoptotic brain tumor cells and, at the same time, decreased the number of dividing cells. Up-regulation of the CD4+ and CD8+ lymphocytes were observed after T11TS administration in ENU - induced immunosuppressed animals. A gradual increment of cytotoxicity of splenic and BIL was also demonstrated after successive administration of T11TS. CONCLUSION: These data strongly support the specific apoptosis-inducing role of T11TS in experimental brain tumor cells. Apoptosis of BIL and Mg, that occurred to a much lower level, can be explained in terms of changes in the neural immune system before and after T11TS application.

T11TS/S-LFA3 induces apoptosis of the brain tumor cells: a new approach to characterise the apoptosis associated genetic changes by arbitrarily primed-PCR.

Genetic alterations in ethyl nitrosourea (ENU) induced brain tumor model were analysed by simple PCR based technique with arbitrary primers. T11TS/SLFA3 was established previously as a potent immune stimulator with antineoplastic property in experimental glioma model. The goal of this study was to reveal whether T11TS induces apoptosis of the neural neoplastic cell and to decipher the DNA polymorphism level of the cells undergoing apoptosis. The results clearly establish the apoptogenic role of T11TS/S-LFA3 and along with the detection of cancer associated genomic instability, AP-PCR analysis is useful for the detection of DNA level fragmentation, a unique feature of apoptosis.

The first cross sectional survey on intracranial malignancy in Kolkata, India: reflection of the state of the art in southern West Bengal.

Recent increase in the occurrence of intracranial malignancies and poor performance of therapeutic measures have established the disease as an important concern of medical sciences. The lack of information about the disease pattern throughout India creates problems for maintaining community health for prevention. The present study on the hospital population of Kolkata was conducted to determine the incidence pattern of the disease in the population of southern West Bengal, focusing on distribution with age, sex, occupation and religion in different districts of the region, and characterizing diagnostic and therapeutic measures. Among a total of 39,509 cancer patients from 21 health centers of Kolkata, 2.4% had brain cancers and among these more than 60% are gliomas. A cross-sectional study for a period of 3 years reported the occurrence of 15 types of intracranial malignancy, which demonstrated astrocytomas (36.8%), glioblastoma multiforme (GBM) (7.9%) and meningiomas (11.6%) to be predominant. Brain tumors occur more frequently in males with few exceptions and the incidence was found to be highest among the 40-49 year old group (20.2%). No specific trend for religion and occupation was apparent. However, the district wise distribution showed maximum incidences among industrial areas, namely, Kolkata (33.1%), North 24-Parganas (18.2%), Howrah (9.3%) and Hoogly (7.6%). Diagnosis of the disease was by CT scan, MRI and histological identification (pre and post operative). Therapeutic procedures rely mainly on surgery and radiotherapy, whereas chemotherapy was used as an adjuvant for about 10% of the cases. Evaluation of the scenario regarding intracranial malignancy in this region was a long awaited requirement which should ultimately serve an important function in pointing to risk zones within the population and allow better control measures to be introduced for the disease.