Dr. Pavan Kumar
@shri ram murti smarak institute of medical sceinces
SGPGI
Scopus Publications
Scopus Publications
Pavan Kumar, Piyush Kumar, Shalini Singh, Niraj Kumari, and NR Datta
Medknow
The article deals with a rare case of chordoma with increased prolactin levels. It could often result in a diagnostic dilemma and problems in differentiating it from a pituitary adenoma.
Pavan Kumar, Shalini Singh, NR Datta, and Ashwani Tandon
Medknow
Metastasis to an epitrochlear lymph node from a primary invasive breast cancer has not been reported earlier. We report a case of epitrochlear lymph node metastasis that presented 10 years after the primary breast malignancy had been treated with radiotherapy, chemotherapy, and hormonal therapy. The patient was successfully treated and continues to remain asymptomatic more than 2 years after she presented with the metastasis.
Shalini Singh, Piyush Kumar, Pavan Kumar, Narendra Krishnani, and NiloyR Datta
Medknow
BACKGROUND
Gliosarcomas (GS) are biphasic brain tumors composed of glioblastoma multiforme (GBM) and sarcomatous component. Therapeutic approaches include maximum surgical decompression with postoperative radiotherapy. Outcomes in gliosarcoma are poor despite multimodality management.
AIMS
To analyze the outcome in patients of GS treated in our institute over a period of 15 years and compare it with GBM treated during the same period.
SETTINGS AND DESIGN
Clinical records of the post-irradiated GS patients and GBM patients seen between 1990 and 2004 were retrieved.
MATERIALS AND METHODS
Demographic and treatment variables were evaluated for their influence on overall survival (OS). The survival outcomes of GBM and GS treated during the same period were also compared.
STATISTICAL ANALYSIS
Univariate analysis was carried out using the Kaplan-Meier method and tested using log-rank test for significance.
RESULTS
During these 15 years, 24 evaluable GS patients were treated as compared to 251 evaluable patients of GBM. There was a slight male preponderance in GS (14 males vs.10 females) with a median age of 50 years. All patients underwent surgery followed by post-operative radiotherapy (median dose of 60 Gy). None of the patient or treatment related factors were found to be significantly influencing their OS. Median OS in GS was 7.3 months compared to 7.5 months in GBM patients (P = 0.790).
CONCLUSIONS
The OS appears to be similar for GS and GBM. None of the demographic variables appeared to prognosticate the survivals of GS.
Neeraj Rastogi, Pavan Kumar, Manoj Jain, and Poonam Chhabra
Medknow
Ependymoma are rare glial neoplasm, it rarely metastasize outside the central nervous system. We present a case of anaplastic ependymoma with extraneural metastases with review of literature. A ten-year-old male child presented with anaplastic ependymoma of choroid plexus and treated with craniospinal radiotherapy in 1998. He had intracranial recurrence in 2004, confirmed by biopsy. He was given adjuvant chemotherapy in form of PCV. At 10 months after completion of chemotherapy, he developed extracranial scalp metastasis and so was treated with palliative local radiation therapy to the scalp metastasis and systemic chemotherapy with oral Etoposide. Scalp metastasis completely disappeared and ataxia improved. After five cycles of chemotherapy, the patient had progression of disease in form of scalp and cervical lymph node metastasis confirmed by fine needle aspiration cytology, biopsy and immunohistochemistry. He was given salvage chemotherapy (carboplatin + ifosfamide + etoposide) at 3-weekly. He had partial response and was still on chemotherapy till May 2007.