Thyromegaly: Not The Usual Cause.

Non-Hodgkin lymphoma (NHL) of the thyroid is a very rare condition. Swelling of the neck is the usual presentation among patients. Of all thyroid malignancies, only a very small portion accounts for NHL of the thyroid. Here, we present two cases of diffuse large B-cell NHL of the thyroid. Preoperative diagnosis helps in the management of patients with chemotherapy, but in rare cases, surgical removal of the thyroid is done to reduce obstructive symptoms. The diagnosis is usually made based on fine-needle aspiration cytology and biopsy with immunohistochemistry. In these two cases, the patients presented with a history of a rapidly growing mass in the neck for three to four months, but the treatment modalities differed. In one of the cases, the patient received six cycles of chemotherapy, and in the other case, the patient underwent a total thyroidectomy, followed by six cycles of chemotherapy, though chemotherapy is the standard treatment option over surgical removal of the thyroid.

Endometriosis of para-aortic node masquerading a malignancy: a rare occurrence.

Endometriosis is a benign estrogen-dependent disorder affecting women in their reproductive age group. Endometriosis means 'abnormal growth of endometrial glands' outside the uterus. Multiple theories on aetiopathogenesis of endometriosis have been postulated, Halban's theory on 'Benign Metastasis' which proposed the presence of endometriotic cells in lymphatic vessels and lymph nodes provides the basis of this case report. Here, we report a case of 26-year-old nulliparous woman who presented with grossly elevated CA 125 with endometriosis in her para-aortic nodes mimicking as ovarian cancer.

Chest wall resection in locally advanced or recurrent breast cancer - series of three cases.

BACKGROUND: The usefulness of chest wall resection in breast cancer is poorly defined as extensive surgical resection is seen inappropriate, as it is regarded as harbinger of systemic disease. We report our experience of chest wall resection in recurrent or locally advanced breast cancers Case Presentation: We reviewed our institute records for chest wall resection in locally advanced or locally recurrent breast cancers from 2016 - 2018. There were 3 cases of chest wall resection for carcinoma breast. 1 for recurrent breast cancer and 2 for locally advanced breast cancer after neoadjuvant chemotherapy. Preoperative symptoms were ulceration in recurrent tumor, pain and mass in other. One patient needed Lattismus dorsi (LD) myocutaneous flap and one required a free flap. One underwent LD muscle flap. Mean postop stay were 8 days. One patient required redo flap surgery for partial flap necrosis Conclusions: Full thickness chest wall resection is relatively safe procedure with acceptable morbidity and can be considered in carefully selected patients Key Words: Breast carcinoma-Chest wall recurrence- Chest wall resection-chest wall reconstruction.

Thoracoscopic (hybrid) complex chest wall resection in pediatric Ewing sarcoma.

Askin tumor (a Ewing sarcoma variant) is the most common tumor of the chest wall in the pediatric age group. Multimodal treatment is required, with complete resection being the cornerstone of effective management. We describe the case of a 13-year boy with a left paraspinal Ewing sarcoma with intraspinal extension and spinal cord compression with neurological weakness. He underwent complex surgical resection using thoracoscopic resection of multiple ribs along with vertebral resection and reconstruction, after neoadjuvant therapy.

Solitary recurrence at intercostal drain site in oesophageal adenocarcinoma.

56 year old gentleman was evaluated for dysphagia and diagnosed with oesophageal adenocarcinoma and had undergone Transhiatal Oesophagectomy elsewhere, pT3N0, but had defaulted adjuvant treatment. He presented 15 months later to us with nodule at left intercostal drain (ICD) drain site. Positron Emission Tomography (PET) scan showed it to be single site metastasis and he underwent wide excision, followed by six cycles of chemotherapy. He is symptom free and on regular follow up for a period of ten months. Oesophageal cancer although with poor prognosis can be considered for metastatectomy after considering the disease free interval, site of recurrence and histological factors in carefully selected patient.

Role of Pelvic Lymphadenectomy in Intermediate-Risk Endometrial Cancer and Predictors of Nodal Positivity in Indian Patients.

One of the most intense controversies in endometrial cancer revolves around the need for lymphadenectomy at the time staging. The study carried out to analyze the role of staging with pelvic lymphadenectomy in intermediate-risk stage I endometrial cancer-stage IA grade III and stage IB grades I and II. Review analysis of all the patients with stage I carcinoma endometrium intermediate risk treated at our institution between January 2006 and December 2014. All demographic data, tumor factors, adjuvant treatment, follow-up, and recurrence were recorded. Sixty-five were in intermediate-risk group, of which 21 were in low intermediate- and 44 in high intermediate-risk group, with 4 patients with positive pelvic node in each group. In patients with low intermediate-risk stage IA, grade III tumors, the nodal involvement was substantial even when the myometrial invasion was less than 50%. All grade 1 tumors did not have pelvic nodal metastasis. Overall percentage of pelvic nodal metastasis in our review of intermediate-risk carcinoma endometrium was 12%, with 19% in stage IA, grade III tumors, and 9% with stage IB, grade I and II tumors. A systematic lymphadenectomy should be done in patients with endometrial cancer who are at intermediate to high risk of lymph node metastases. The grade III histology is more likely to predict for nodal metastasis more than depth of myometrial invasion. It is recommended to stratify patients into risk groups to formulate guidelines for therapeutic lymphadenectomy.