Publications by authors named "Renu Madan"

Primitive myxoid mesenchymal tumor of infancy (PMMTI) is a low to intermediate-grade, poorly differentiated myofibroblastic tumor and is characterized by its tendency to recur locally. It commonly occurs in the 1 year of life and is predominantly seen in the axial skeleton and rarely in the retroperitoneum. We report one such case of PMMTI, which is the second case reported in English literature.

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In recent years, 68Ga-FAP inhibitor has emerged as a possible substitute radiotracer to FDG for imaging of most of the tumors. Here, we report a 7-year-old girl diagnosed with recurrent papillary tumor of the pineal gland, presenting with complaints of headache and vomiting. 18F-FDG PET/CT revealed an FDG-avid enhancing lesion in the posterior part of the third ventricle.

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Background: Gamma Knife Radiosurgery (GKRS) has established a role in treating various benign brain pathologies. The radiosurgery planning necessitates a proper understanding of radiation dose distribution in relation to the target lesion and surrounding eloquent area. The quality of a radiosurgery plan is determined by various planning parameters.

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Purpose: Radiotherapy (RT) is a well-established modality for treating malignancies, but its role in treatment of benign lesions has not been well explored. Herein, we present a retrospective analysis of a 7-year data regarding the benefit and the safety profile of RT for treating benign tumors in our institute.

Materials And Methods: Data of 23 patients who received RT for benign tumors from January 2015 to April 2022 were retrieved, and a retrospective analysis was conducted.

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Article Synopsis
  • - Retinoblastoma (RB) is the most common eye cancer in children, and its advanced stages are often seen in low and middle-income countries (LMICs) due to factors like lack of awareness and limited healthcare access.
  • - Significant advancements in treating extraocular retinoblastoma (EORB) have been made, focusing on reducing treatment toxicity through the use of chemotherapy, surgery, and radiotherapy.
  • - The article discusses ICMR consensus guidelines for managing EORB and metastatic RB, highlighting ongoing challenges and the generally poor prognosis in LMICs.
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Extragonadal germ cell tumors (GCTs) are challenging to diagnose. We present a case of suprarenal GCT, with hepatic infiltration where differential diagnosis included neuroblastoma and hepatoblastoma. The positive positron emission tomography scan further obfuscated the situation.

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Article Synopsis
  • Retinoblastoma (RB) is the most common eye cancer in children, but many cases are diagnosed late in low-middle income countries due to a lack of awareness.
  • Recent treatment advancements, like systemic and targeted chemotherapy, have improved outcomes, but their use remains limited in LMICs due to cost and accessibility issues.
  • The article discusses the ICMR consensus guidelines for managing advanced intraocular RB, emphasizing the importance of considering treatment costs, risks, and parental discussions in decision-making.
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Article Synopsis
  • - Retinoblastoma (RB) is the leading eye cancer in children, primarily caused by mutations in the RB1 gene and affecting about 8,000 children worldwide each year, with 1,500 cases in India.
  • - The survival rate for RB exceeds 90% in developed countries, with typical symptoms in Indian children being leukocoria (white pupil) and proptosis (bulging eye), diagnosed mainly through fundus exams and ultrasounds.
  • - The review outlines the International Classification of Retinoblastoma for staging, emphasizes the significance of genetic testing for high-risk families, and discusses histopathologic factors that influence treatment decisions and metastasis prediction.
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Background: Target selection during Gamma Knife radiosurgery (GKRS) in cases of tumor-related trigeminal neuralgia is always debatable. We analyzed the correlation of regression of tumor size and degree of release of the nerve with long-term pain control.

Methods: Between March 2012 and March 2023, 50 cases of tumor-related trigeminal neuralgia were treated with GKRS (tumor was targeted).

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Purpose: The aim of this study was to evaluate the diagnostic potential of 68 Ga-pentixafor PET/CT for in vivo CXCR4 receptors imaging in glioma and its possible role in response assessment to radiochemotherapy (R-CT).

Methods: Nineteen (12 men, 7 women) patients with glioblastoma multiforme (GBM) underwent 68 Ga-pentixafor PET/CT, contrast-enhanced MR, and MR spectroscopy. Patients were divided in to 2 groups, that is, group I was the presurgical (n = 9) group in which the scanning was done before surgery, and PET findings were correlated with CXCR4 receptors' density.

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Article Synopsis
  • Septic or aseptic loosening around artificial prostheses can cause bone loss and potential failure, with rare cases linked to metastatic cancer.
  • An elderly woman experienced swelling and pain at her previous hip surgery site, leading to the discovery of a lytic femur lesion suggestive of metastatic cancer, although no primary kidney tumor was found.
  • Following her diagnosis, she underwent palliative treatments including radiotherapy and systemic therapy (sunitinib), but now she receives zoledronate and supportive care for better management.
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Purpose: Concurrent chemoradiation is the standard of care for the treatment of anal cancer. Radiation can be delivered by sequential or simultaneous integrated boost (SIB) approach. The present study was conducted to compare the treatment outcomes and toxicity profile of patients with anal cancer treated with sequential boost and SIB approach.

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Background And Objectives: There is conflicting evidence on the significance of adrenocorticotrophic hormone (ACTH) staining in the prognosis of nonfunctioning pituitary neuroendocrine tumors (NFpitNETs). The objective of this study was to define the effect of ACTH immunostaining on clinical and radiographic outcomes of stereotactic radiosurgery (SRS) for NFpitNETs.

Methods: This retrospective, multicenter study included patients managed with SRS for NFpitNET residuals.

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Solitary fibrous tumors (SFTs) are mesenchymal neoplasms with variable clinical behavior depending on age, tumor site, and size, and pathologic factors such as mitoses and necrosis. Imaging features on computed tomography (CT) or magnetic resonance imaging (MRI) are not specific, and the diagnosis relies on histopathology with immunohistochemistry. SFTs arising from seminal vesicles is rare and reported in only eight earlier cases.

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Background: Cystic vestibular schwannoma (CVS) traditionally considered as poor responder to gammaknife radiosurgery (GKRS). Their longterm radiobiological behavior is less known. Here we discuss 38 cases with intra tumoral cyst CVS primarily treated with GKRS.

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Background: The WHO classification of central nervous system neoplasms (2016) recognized 4 histologic variants and genetically defined molecular subgroups within medulloblastoma (MB). Further, in the 2021 classification, new subtypes have been provisionally added within the existing subgroups reflecting the biological diversity. YAP1, GAB1, and β-catenin were conventionally accepted as surrogate markers to identify these genetic subgroups.

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Background: Series on radiotherapy (RT) practice in pediatric malignancies are limited in India as only a few centers practice pediatric RT, particularly under anesthesia. We aimed to study the clinical profile of pediatric cancer patients treated with RT and to analyze various challenges in pediatric RT under anesthesia.

Materials And Methods: The data were prospectively maintained in Microsoft Excel spreadsheets.

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Purpose: We undertook a prospective planning study to describe the delineation of ileal conduit (IC) loop on radiotherapy planning computed tomography (RTP CT) scan as an organ at risk (OAR) and its sparing using volumetric modulated arc therapy (VMAT) during adjuvant irradiation of bladder malignancies.

Materials And Methods: Fifteen patients with bladder malignancy needing adjuvant radiotherapy postoperatively and having normal renal function underwent delayed phase RTP CT from June 2020 to March 2021, with certain modifications (Foley's catheter through stoma, additional delayed scans). We identified the course of ureters, external stoma, IC, and uretero-ileal (right and left) anastomotic sites.

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Purpose: The purpose of this study was to estimate and incorporate rotational error to translational error for clinical target volume (CTV) to planning target volume (PTV) margin calculations for non-6D couch.

Materials And Methods: The study involved cone-beam computed tomography (CBCT) images of the patients who already had treatment in Varian Trilogy Clinac. The different sites studied were brain (70 patients, 406 CBCT images), head and neck (72 patients, 356 CBCT images), pelvis (83 patients, 606 CBCT images), and breast (45 patients, 163 CBCT images).

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Background: Clival chordomas are challenging because of their proximity to critical neurovascular structures. Stereotactic radiosurgery (SRS) has been proven effective with minimal adverse effects.

Objective: To compare the outcomes of histologically confirmed primary clival chordomas in adults who underwent SRS alone (SRS group) vs SRS after fractionated radiotherapy (FRT+SRS group).

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Background: The inadequate awareness in the general population is a primary concern for the management of various neurosurgical ailments treated with gamma knife radiosurgery (GKRS).

Objective: Our study aimed to assess the written patient information by focusing on readability, recall, communication, compliance, and patient satisfaction.

Methodology: The senior author formulated disease-specific patient information booklets.

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Background: Gamma-knife radiosurgery (GKRS) has emerged as one of the mainstream modalities in the treatment of many neurosurgical conditions. The indications for Gamma knife are ever-increasing and presently more than 1.2 million patients have been treated with Gamma knife worldwide.

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Radiation-induced sarcoma (RIS) of the central nervous system is an uncommon late complication of radiation therapy. We report a case of a 47-year-old male patient who underwent surgery followed by irradiation and chemotherapy with temozolomide for a frontal lobe gliosarcoma and presented 43 months later with a recurrent tumor in the same location with interval growth in the size of the lesion. Histology from surgical resection of the recurrent tumor revealed embryonal rhabdomyosarcoma (RMS).

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Purpose: Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignant neoplasm, usually diagnosed in advanced stage. Role and efficacy of adjuvant radiotherapy has not been well defined. The objective of this study is to describe the various clinical characteristics and prognostic factors affecting the survival of ACC along with the role radiotherapy on overall survival and relapse free survival.

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