Extended Level IV Neck Dissection for Limited Prophylactic Clearance of Level V in Node-Positive Papillary Thyroid Carcinoma: a Homogenous Study Population.

There is near consensus that prophylactic lateral neck dissection has no role in the management of differentiated thyroid cancer, but the extent of lateral neck dissection in differentiated thyroid cancer remains controversial, especially whether level V should be addressed or not. There is lot of heterogeneity in reporting of the management of level V in papillary thyroid cancer. We at our Institute address the lateral neck positive papillary thyroid cancer with selective neck dissection involving levels II-IV, performing extended level IV dissection with inclusion of the triangular area delineated by the sternocleidomastoid muscle, the clavicle, and the perpendicular line drawn to the clavicle from the point where the horizontal line at the level of cricoid cuts the posterior border of sternocleidomastoid muscle.

Perivascular Epithelioid Cell Tumor (PEComa) of Vulva: a Rare Occurrence.

Perivascular epithelioid cell tumor (PEComa) is a tumor of mesenchymal origin, with features of perivascular epithelioid cells. The primary sites of PEComa reported are the uterus, vulva, rectum, heart, breast, urinary bladder, abdominal wall, pancreas, retroperitoneum, liver, and uterus. But what is unique is that PEComa of the gynecological tract is very rare.

Patterns of Failure After Trimodal Treatment in Esophageal Squamous Cell Carcinoma: Initial Experiences from a High-Risk Endemic Area.

Recurrence is a significant problem faced in patients with esophageal cancer even after treatment with trimodal approach. We report patterns of failure in our patients of esophageal squamous cell cancer (ESCC) treated with trimodal approach. This is a single-institution retrospective analysis of 46 patients of locally advanced ESCC (treated between 2013 and 2017) managed by trimodal treatment approach.

Minimal impact of COVID-19 outbreak on the postoperative morbidity and mortality following emergency general surgery procedures: results from a 3-month observational period.

Aim The outbreak of the COVID-19 pandemic has had a major impact on the delivery of elective, as well as emergency surgery on a world-wide scale. Up to date few studies have actually assessed the impact of COVID-19 on the postoperative morbidity and mortality following emergency gastrointestinal surgery. Herein, we present our relevant experience over a 3-month period of uninterrupted provision of emergency general surgery services in George Eliot Hospital NHS Trust, the United Kingdom.

Emergency Laryngectomy Feasibility and Indications Beyond Airway Obstruction in the Era of Concurrent Chemoradiotherapy.

Background: It is believed that carrying out laryngectomy in tracheotomized patients leads to higher postoperative complications and stomal recurrence compared to carrying out the procedure upfront without prior tracheotomy. We believe that emergency laryngectomy is a feasible procedure in most cancer centers and can be carried out for indications beyond acute airway obstruction as well and complex reconstruction procedures can be also carried out simultaneously. We hereby describe our experience with emergency laryngectomy with or without pharyngectomy.

Level V Clearance in Neck Dissection for Papillary Thyroid Carcinoma: A Need for Homogeneous Studies.

 Papillary thyroid carcinoma has a very high rate of lateral neck node metastases, and there is almost unanimity concerning the fact that some sort of formal neck dissection must be performed to address the clinical neck disease in these cases. Although there is an agreement that levels II to IV need to be cleared in these patients, the clearance of level V is debatable.  We herein have tried to analyze various papers that have documented a structured approach to neck dissection in these patients.

Efficacy of Drainless Total Thyroidectomy in Intrathyroidal Lesions of Thyroid.

 There is difference of opinion about the placement of the drain in thyroid surgeries, and, to the best of our knowledge, the efficacy of drainless total thyroidectomy regarding various parameters of thyroid lesions has not been well-established.  To report our experience with drainless total thyroidectomy, and to define an appropriate patient population for its performance.  This is a retrospective case analysis of the patients who underwent total thyroidectomy for intrathyroidal lesions with or without central neck dissection in a tertiary referral hospital (number = 74).

Sentinel Lymph Node Biopsy in Breast Cancer: A Clinical Review and Update.

Sentinel lymph node biopsy has become a standard staging tool in the surgical management of breast cancer. The positive impact of sentinel lymph node biopsy on postoperative negative outcomes in breast cancer patients, without compromising the oncological outcomes, is its major advantage. It has evolved over the last few decades and has proven its utility beyond early breast cancer.

Bulbar conjunctival metastasis from mucoepidermoid carcinoma of parotid-a case report and review of literature.

Background: Mucoepidermoid carcinoma of salivary glands usually metastasizes to the lungs, liver, bone, brain, and skin. We report a rare case of distant metastasis of high-grade mucoepidermoid carcinoma of the parotid to the ipsilateral bulbar conjunctiva of the eye.

Case Presentation: Sixty-year-old male of Kashmiri origin presented to our tertiary care referral cancer institute with exophytic lesion of the left bulbar conjunctiva following his treatment for mucoepidermoid cancer of ipsilateral parotid gland, 9 months back.

Follicular thyroid carcinoma presenting as solitary liver metastasis: a case report.

Background: Distant metastasis from differentiated thyroid carcinoma at presentation is rare and isolated liver metastasis on presentation is almost unknown. We report a case of primary follicular carcinoma of the thyroid with isolated liver metastasis at presentation.

Case Presentation: A 65-year-old man of Kashmiri origin presented to our tertiary referral center with obstructive jaundice; he was evaluated with magnetic resonance cholangiopancreatography and positron emission tomography-computed tomography.

Primary transitional cell carcinoma of the fallopian tube in a premenopausal woman: A case report and review of literature.

Transitional carcinomas are extremely rare in the fallopian tube. A 41-year-old premenopausal lady presented with colicky abdominal pain and was found to have a left-sided pelvic mass on examination. In view of the elevated CA-125 and imaging findings suggestive of ovarian mass, she underwent staging laparotomy.

Primary mammary small-cell carcinoma: A case report and review of the literature.

Only a few cases of primary small-cell carcinoma of the breast have been documented in the current medical literature. A confident diagnosis can only be made if a nonmammary site is excluded or if an in-situ component can be demonstrated histologically. These criteria have been met only in a very few of the published cases, including this case report.

Primary pancreatic lymphoma: Report of three cases with review of literature.

Background: Primary pancreatic lymphoma (PPL) is an extremely rare neoplasm, which may be confused with pancreatic adenocarcinoma. So far only about 150 cases of PPL have been reported.

Materials And Methods: We present our experience of 3 cases of PPL over a 4-year period.

Transfusion related acute lung injury presenting with acute dyspnoea: a case report.

Introduction: Transfusion-related acute lung injury is emerging as a common cause of transfusion-related adverse events. However, awareness about this entity in the medical fraternity is low and it, consequently, remains a very under-reported and often an under-diagnosed complication of transfusion therapy.

Case Presentation: We report a case of a 46-year old woman who developed acute respiratory and hemodynamic instability following a single unit blood transfusion in the postoperative period.

A phase II pilot study to evaluate use of intravenous lidocaine for opioid-refractory pain in cancer patients.

Opioid-refractory pain is distressing because it is notoriously difficult to treat. Relief from adjuvant therapies often occurs after a lag time. Retrospective evidence points to a role for intravenous (IV) lidocaine in this setting for pain relief.

Irrigation-coupled bipolar cautery unit: A practical, economical, and simple version.

Hemostasis is a fundamental principle of surgery for which electrocoagulation is universally used. Bipolar electrocautery has an advantage over monopolar electrocautery in terms of the precision of the extent of tissue coagulation and the lateral extent of thermal tissue injury. However, secondary to the thermal changes induced in the tissue due to electric current passage, there is charring of tissue, which adheres to the cautery tip.

Androgen secreting steroid cell tumor of the ovary in a young lactating women with acute onset of severe hyperandrogenism: a case report and review of literature.

Introduction: Steroid cell tumors of the ovary account for less than 0.1% of all ovarian tumors 1 and these tumours may present at any age in association with interesting presentations related to the hormonal activity and virilizing properties of tumor. Hayes and Scully 2 reported 63 cases in patients ranging from 2 to 80 years of age.