Aneurysmal bone cysts (ABCs) are benign bone lesions arising mostly in the pediatric population t... more Aneurysmal bone cysts (ABCs) are benign bone lesions arising mostly in the pediatric population that can cause local pain, swelling, and pathologic fracture. It is occasionally an aggressive benign lesion whose treatment of choice is complete resection, even though the risk of profuse intraoperative bleeding exists. We here report a case of spinal aneurysmal bone cyst treated by surgery and adjuvant radiotherapy.
Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor pr... more Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor prognosis in view of its aggressive nature. We here report a case of small cell carcinoma GB 55-year old lady presented with features of obstructive jaundice with significant weight loss. Examination revealed hard lump in right upper abdomen with multiple scratch marks all over the body. Clinically she had jaundice. Blood investigations revealed hyperbilirubinemia. Tumour markers showed raised CA 19-9. Staging CECT thorax and Abdomen reported polypoidal enhancing wall thickening of gall bladder with multiple metastatic deposits close to pancreatic head encasing main portal vein and common bile duct. Histopathology was suggestive of small cell carcinoma. Patient was referred to Oncology department and is receiving palliative cisplatin-etoposide chemotherapy
Background: Patients with cancer are more susceptible to acquire SARS-Cov-2 infection due to thei... more Background: Patients with cancer are more susceptible to acquire SARS-Cov-2 infection due to their immunocompromised state related to the disease and anticancer treatment. There is a lack of literature assessing the patient’s perspective of the present crisis and its impact on their treatment. Aims and Objective: The present study aimed to address the challenges and sufferings faced by patients with cancer during their treatment in the current COVID-19 pandemic era. Materials and Methods: A single-institute, cross-sectional questionnaire-based observational study was conducted in a tertiary care teaching hospital. Patients attending the Oncology outpatient department were enrolled in the study. Results: One hundred patients (64 males, 36 females) with a mean age of 47.17 years (range-24-71) participated in the study. The majority of patients (89%) were aware of the COVID 19 symptoms and did not confuse them with cancer symptoms. Most of them were aware of preventive measures like fr...
Peritoneal inclusion cysts have been described in females of reproductive age. It is a rare cause... more Peritoneal inclusion cysts have been described in females of reproductive age. It is a rare cause of intestinal obstruction. Causes include pelvic inflammatory disease and prior abdominal surgery. We here present a case of young female of peritoneal inclusion cyst who presented with intestinal obstruction.
International Journal of Otorhinolaryngology and Head and Neck Surgery
We are reporting an uncommon case of second primary chondrosarcoma of the maxilla in a 52-year-ol... more We are reporting an uncommon case of second primary chondrosarcoma of the maxilla in a 52-year-old male patient. Patient had first been diagnosed in 2004 with chondrosarcoma of the right maxilla. He had undergone right partial maxillectomy for the same. Since 2016 he had started noticing a swelling over the left side of the maxilla. Repeated biopsies from the growth showed no evidence of any malignancy. Hence, he was kept on routine follow up. However, in 2018, during follow up the growth had increased in size - hard swelling present in remnant post partial maxillectomy cavity, non-tender -and a punch biopsy was taken, revealing a well differentiated chondrosarcoma. A diagnosis of second primary chondrosarcoma of the maxilla was made based on Warren and Gates criteria. A brief discussion on the radiologic and histologic presentation of the tumor and the treatment modalities of this unusual tumor is discussed.
International Journal Of Community Medicine And Public Health
Background: Delayed presentation of patients of cancer is associated with poorer survival. Early ... more Background: Delayed presentation of patients of cancer is associated with poorer survival. Early presentation, timely diagnosis and treatment are critical factors in improving long-term survival for patients with cancer. Thus, reducing delays in diagnosis of cancer should be a priority. Against this backdrop this study was conducted to identify factors leading to delayed presentation of patients in advanced stages of cancer at our institute. Methods: Newly diagnosed patients of cancer coming to radiation oncology, surgery and medical oncology outpatient departments were included in this study. Data was collected in a pre-validated questionnaire format.Results: 360 patients were included. Majority of patients 212 (58.9%) were male. 66.7% patients were from rural areas. Most of the patient’s educational level was upto primary schooling 178 (49.4%) and caregiver educational level was upto primary schooling 153 (42.5%). Reason for alternative treatment correlated significantly with pat...
Coronaviruses are enveloped, single-stranded, positive-strand RNA viruses and are classified unde... more Coronaviruses are enveloped, single-stranded, positive-strand RNA viruses and are classified under Nidovirales. The 2019-novel coronavirus (2019-nCoV) is classified as a novel betacoronavirus belonging to the sarbecovirus subgenus of Coronaviridae family [1-3]. The 2019-nCoV is the third coronavirus to exhibit cross species infection from animals to humans. The previous two being 2002 outbreak caused by the severe acute respiratory syndrome coronavirus (SARS-CoV) and the 2012 outbreak caused by the Middle East respiratory syndrome coronavirus (MERS-CoV) [4,5]. Coronaviruses are known to cause common colds in human adults and children. It typically causes common cold like symptoms in immunocompetent individuals. Coronavirus disease 2019 (COVID-19) has a unique pathogenicity with its ability to cause both upper as well as lower respiratory tract infection Purpose: Due to COVID 19 pandemic, the treatment of cancer patients has become a dilemma for every oncologist. Cancer patients are at an increased risk of immunosuppression and have a higher risk to acquire any infection. There are individual experiences from some centers regarding the management of cancer patients during such a crisis. So we have developed our institutional strategy to balance between COVID and cancer management. Materials and Methods: Radiation Oncology departmental meeting was held to prepare a consensus document on Radiotherapy schedules and department functioning during this pandemic. Results: Strategies were taken in form of following areas were steps need to be taken to decrease risk of infection, categorise treatment on the basis of priority, radiotherapy schedules modification, academic meetings and management of COVID positive patient/personnel in Radiation Oncology department. Conclusion: We hope to strike the balance in overcoming both the battles and emerge as winners. Stringent long term follow up will be done for assessing the response or any unforeseen treatment related sequelae.
International Journal of Research in Medical Sciences
Disseminated blood-borne metastases from carcinoma of the gall bladder are uncommon and usually o... more Disseminated blood-borne metastases from carcinoma of the gall bladder are uncommon and usually occur late. The most common site of extra-abdominal metastasis is lung followed by brain. Skeletal metastases in carcinoma gall bladder are very rare. To date there have only been a few case reports of bone metastasis in carcinoma gall bladder at the time of presentation. Authors here present a rare case of carcinoma gall bladder that progressed to isolated sacrum metastasis.
Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bl... more Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bladder stone disease infrequently seen in surgical practice due to early diagnosis of gall stone disease by imaging and appropriate and prompt antibiotic and surgical treatment . We report our experience with a 40 year old lady who presented with yellowish discharge through the umbilicus. Abdominal examination revealed a sinus opening at umbilicus with yellowish discharge and vague mass in the right hypochondrium . CT Fistulogram shows tract extending form umbilicus to gall bladder .Open cholecystectomy with excision of fistulous tract was done. Histopathological examination showed chronic inflammation of gall bladder with fistulous tract lined by inflammatory granulation tissue. Post operative recovery was normal and uneventful .Patient was normal in follow up period . Cholecystocutaneous fistula is a rare clinical entity. Diagnosis is established by CT scan and MRCP. Surgery remains the...
Brunner’s gland hamartoma (or Brunneroma) is an uncommon tumour with an incidence of <0.01%, a... more Brunner’s gland hamartoma (or Brunneroma) is an uncommon tumour with an incidence of <0.01%, accounting for approximately 5–10% of benign duodenal tumours. Usually asymptomatic, it may manifest occasionally with duodenal obstruction or upper gastrointestinal haemorrhage and rarely with biliary fistulation, cholestatic jaundice and intussusception. It may be associated with uraemia and chronic pancreatitis. The diagnosis is usually confirmed by imaging studies and upper gastrointestinal endoscopy. Surgical excision or endoscopic resection is preferred for symptomatic large hamartomas. Here we report a case of 45-year-old man presenting with features of pancreatitis and gastric outlet obstruction due to a large Brunner’s gland hamartoma, on his endoscopic, radiologic, surgical and pathologic findings.
e17553 Background: Latest AJCC staging has included extranodal extension (ENE) in nodal staging o... more e17553 Background: Latest AJCC staging has included extranodal extension (ENE) in nodal staging of head and neck cancers (HNC) in view of its prognostic significance. Presence of clinical ENE makes the disease N3b and the stage grouping will be stage IVB. This retrospective analysis was done with an objective to find out the percentage of patients with HNC getting upstaged because of ENE and their treatment outcome. Methods: A retrospective analysis of all HNC patients registered in our department from January 2018 to January 2019 were done to identify the presence of ENE and their staging. AJCC criteria was used for defining clinical and radiological ENE. The site, subsite, stage and presence of ENE were documented. Results: A total of 562 patients were registered with HNC. Among them 40 patients were identified to have ENE (7.1%). There were 35 males and 5 females. There were 17 cases with ca oropharynx, 13 oral cavity, four hypopharynx, three supraglottis, two glottis, and one ma...
Aneurysmal bone cysts (ABCs) are benign bone lesions arising mostly in the pediatric population t... more Aneurysmal bone cysts (ABCs) are benign bone lesions arising mostly in the pediatric population that can cause local pain, swelling, and pathologic fracture. It is occasionally an aggressive benign lesion whose treatment of choice is complete resection, even though the risk of profuse intraoperative bleeding exists. We here report a case of spinal aneurysmal bone cyst treated by surgery and adjuvant radiotherapy.
Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor pr... more Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor prognosis in view of its aggressive nature. We here report a case of small cell carcinoma GB 55-year old lady presented with features of obstructive jaundice with significant weight loss. Examination revealed hard lump in right upper abdomen with multiple scratch marks all over the body. Clinically she had jaundice. Blood investigations revealed hyperbilirubinemia. Tumour markers showed raised CA 19-9. Staging CECT thorax and Abdomen reported polypoidal enhancing wall thickening of gall bladder with multiple metastatic deposits close to pancreatic head encasing main portal vein and common bile duct. Histopathology was suggestive of small cell carcinoma. Patient was referred to Oncology department and is receiving palliative cisplatin-etoposide chemotherapy
Background: Patients with cancer are more susceptible to acquire SARS-Cov-2 infection due to thei... more Background: Patients with cancer are more susceptible to acquire SARS-Cov-2 infection due to their immunocompromised state related to the disease and anticancer treatment. There is a lack of literature assessing the patient’s perspective of the present crisis and its impact on their treatment. Aims and Objective: The present study aimed to address the challenges and sufferings faced by patients with cancer during their treatment in the current COVID-19 pandemic era. Materials and Methods: A single-institute, cross-sectional questionnaire-based observational study was conducted in a tertiary care teaching hospital. Patients attending the Oncology outpatient department were enrolled in the study. Results: One hundred patients (64 males, 36 females) with a mean age of 47.17 years (range-24-71) participated in the study. The majority of patients (89%) were aware of the COVID 19 symptoms and did not confuse them with cancer symptoms. Most of them were aware of preventive measures like fr...
Peritoneal inclusion cysts have been described in females of reproductive age. It is a rare cause... more Peritoneal inclusion cysts have been described in females of reproductive age. It is a rare cause of intestinal obstruction. Causes include pelvic inflammatory disease and prior abdominal surgery. We here present a case of young female of peritoneal inclusion cyst who presented with intestinal obstruction.
International Journal of Otorhinolaryngology and Head and Neck Surgery
We are reporting an uncommon case of second primary chondrosarcoma of the maxilla in a 52-year-ol... more We are reporting an uncommon case of second primary chondrosarcoma of the maxilla in a 52-year-old male patient. Patient had first been diagnosed in 2004 with chondrosarcoma of the right maxilla. He had undergone right partial maxillectomy for the same. Since 2016 he had started noticing a swelling over the left side of the maxilla. Repeated biopsies from the growth showed no evidence of any malignancy. Hence, he was kept on routine follow up. However, in 2018, during follow up the growth had increased in size - hard swelling present in remnant post partial maxillectomy cavity, non-tender -and a punch biopsy was taken, revealing a well differentiated chondrosarcoma. A diagnosis of second primary chondrosarcoma of the maxilla was made based on Warren and Gates criteria. A brief discussion on the radiologic and histologic presentation of the tumor and the treatment modalities of this unusual tumor is discussed.
International Journal Of Community Medicine And Public Health
Background: Delayed presentation of patients of cancer is associated with poorer survival. Early ... more Background: Delayed presentation of patients of cancer is associated with poorer survival. Early presentation, timely diagnosis and treatment are critical factors in improving long-term survival for patients with cancer. Thus, reducing delays in diagnosis of cancer should be a priority. Against this backdrop this study was conducted to identify factors leading to delayed presentation of patients in advanced stages of cancer at our institute. Methods: Newly diagnosed patients of cancer coming to radiation oncology, surgery and medical oncology outpatient departments were included in this study. Data was collected in a pre-validated questionnaire format.Results: 360 patients were included. Majority of patients 212 (58.9%) were male. 66.7% patients were from rural areas. Most of the patient’s educational level was upto primary schooling 178 (49.4%) and caregiver educational level was upto primary schooling 153 (42.5%). Reason for alternative treatment correlated significantly with pat...
Coronaviruses are enveloped, single-stranded, positive-strand RNA viruses and are classified unde... more Coronaviruses are enveloped, single-stranded, positive-strand RNA viruses and are classified under Nidovirales. The 2019-novel coronavirus (2019-nCoV) is classified as a novel betacoronavirus belonging to the sarbecovirus subgenus of Coronaviridae family [1-3]. The 2019-nCoV is the third coronavirus to exhibit cross species infection from animals to humans. The previous two being 2002 outbreak caused by the severe acute respiratory syndrome coronavirus (SARS-CoV) and the 2012 outbreak caused by the Middle East respiratory syndrome coronavirus (MERS-CoV) [4,5]. Coronaviruses are known to cause common colds in human adults and children. It typically causes common cold like symptoms in immunocompetent individuals. Coronavirus disease 2019 (COVID-19) has a unique pathogenicity with its ability to cause both upper as well as lower respiratory tract infection Purpose: Due to COVID 19 pandemic, the treatment of cancer patients has become a dilemma for every oncologist. Cancer patients are at an increased risk of immunosuppression and have a higher risk to acquire any infection. There are individual experiences from some centers regarding the management of cancer patients during such a crisis. So we have developed our institutional strategy to balance between COVID and cancer management. Materials and Methods: Radiation Oncology departmental meeting was held to prepare a consensus document on Radiotherapy schedules and department functioning during this pandemic. Results: Strategies were taken in form of following areas were steps need to be taken to decrease risk of infection, categorise treatment on the basis of priority, radiotherapy schedules modification, academic meetings and management of COVID positive patient/personnel in Radiation Oncology department. Conclusion: We hope to strike the balance in overcoming both the battles and emerge as winners. Stringent long term follow up will be done for assessing the response or any unforeseen treatment related sequelae.
International Journal of Research in Medical Sciences
Disseminated blood-borne metastases from carcinoma of the gall bladder are uncommon and usually o... more Disseminated blood-borne metastases from carcinoma of the gall bladder are uncommon and usually occur late. The most common site of extra-abdominal metastasis is lung followed by brain. Skeletal metastases in carcinoma gall bladder are very rare. To date there have only been a few case reports of bone metastasis in carcinoma gall bladder at the time of presentation. Authors here present a rare case of carcinoma gall bladder that progressed to isolated sacrum metastasis.
Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bl... more Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bladder stone disease infrequently seen in surgical practice due to early diagnosis of gall stone disease by imaging and appropriate and prompt antibiotic and surgical treatment . We report our experience with a 40 year old lady who presented with yellowish discharge through the umbilicus. Abdominal examination revealed a sinus opening at umbilicus with yellowish discharge and vague mass in the right hypochondrium . CT Fistulogram shows tract extending form umbilicus to gall bladder .Open cholecystectomy with excision of fistulous tract was done. Histopathological examination showed chronic inflammation of gall bladder with fistulous tract lined by inflammatory granulation tissue. Post operative recovery was normal and uneventful .Patient was normal in follow up period . Cholecystocutaneous fistula is a rare clinical entity. Diagnosis is established by CT scan and MRCP. Surgery remains the...
Brunner’s gland hamartoma (or Brunneroma) is an uncommon tumour with an incidence of <0.01%, a... more Brunner’s gland hamartoma (or Brunneroma) is an uncommon tumour with an incidence of <0.01%, accounting for approximately 5–10% of benign duodenal tumours. Usually asymptomatic, it may manifest occasionally with duodenal obstruction or upper gastrointestinal haemorrhage and rarely with biliary fistulation, cholestatic jaundice and intussusception. It may be associated with uraemia and chronic pancreatitis. The diagnosis is usually confirmed by imaging studies and upper gastrointestinal endoscopy. Surgical excision or endoscopic resection is preferred for symptomatic large hamartomas. Here we report a case of 45-year-old man presenting with features of pancreatitis and gastric outlet obstruction due to a large Brunner’s gland hamartoma, on his endoscopic, radiologic, surgical and pathologic findings.
e17553 Background: Latest AJCC staging has included extranodal extension (ENE) in nodal staging o... more e17553 Background: Latest AJCC staging has included extranodal extension (ENE) in nodal staging of head and neck cancers (HNC) in view of its prognostic significance. Presence of clinical ENE makes the disease N3b and the stage grouping will be stage IVB. This retrospective analysis was done with an objective to find out the percentage of patients with HNC getting upstaged because of ENE and their treatment outcome. Methods: A retrospective analysis of all HNC patients registered in our department from January 2018 to January 2019 were done to identify the presence of ENE and their staging. AJCC criteria was used for defining clinical and radiological ENE. The site, subsite, stage and presence of ENE were documented. Results: A total of 562 patients were registered with HNC. Among them 40 patients were identified to have ENE (7.1%). There were 35 males and 5 females. There were 17 cases with ca oropharynx, 13 oral cavity, four hypopharynx, three supraglottis, two glottis, and one ma...
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Papers by Sweety Gupta