Aim:This study was designed to retrospectively review our experience with the multimodality management of hepatoblastomas (HB).Materials and Methods:Thirteen patients were treated for HB between 2000 and 2007. The clinical presentations, chemotherapy tolerance and response, surgical procedure undertaken, and complications were analysed.Results:Median age of the population was 12 months (3-60 months), with a male-to-female ratio of 3.3:1. Nine patients were treated with neoadjuvant chemotherapy incorporating cisplatin and adriamycin. Primary surgery was done in four patients. Extent of hepatic resection in the operated patients varied. Mixed type was the predominant histopathological diagnosis. Adjuvant chemotherapy was well tolerated with no morbidity or mortality. Five-year event-free survival (EFS) and overall survival (OS) of all the 13 patients is 76.9%. All the nine patients who could complete multimodality treatment are alive with no evidence of disease or complications with median follow-up of 63 months (46-122 months).Conclusions:Treatment of HB with multidisciplinary approach was well tolerated. OS and EFS of patients were comparable with published studies.

We present the case of a 32-year-old healthy male who presented with a three-month history of insidious onset pain and swelling over the right tibia. Initial radiographs and imaging pointed to a diagnosis of subacute osteomyelitis, as there was no cortical destruction, periosteal reaction, or soft tissue involvement. The patient underwent surgery for osteomyelitis. However, the histopathology and immunohistochemistry (IHC) findings pointed to a possible B-cell lymphoma diagnosis. The patient was referred to a tertiary-level oncology centre, where a repeat biopsy and positron emission tomography (PET) scan confirmed a diagnosis of primary bone lymphoma (PBL). Treatment was initiated immediately in the form of a combination of chemotherapy and radiotherapy, and the progress was followed up with further scans at four-month intervals. The patient achieved remission nine months after the initiation of treatment.

A case of orbital rhabdomyosarcoma had a localised recurrence 13 years after being treated with chemo radiotherapy. Late recurrences are rare in orbital RMS. Only two cases have been reported to have recurred after five years of follow up. Pathological similarity of both the lesions and occurrence outside the irradiated field excluded a radiation-induced second neoplasm. Immunohistochemistry staining with p 53 was positive. Patient had good response to chemotherapy and radiotherapy. Surgical resection of residue showed complete necrosis. Retreatment with combined modality therapy resulted in complete remission and the patient is on follow up.

Human epidermal growth factor receptor 2 (HER2)-positive is an aggressive subtype of breast cancer and has historically been associated with poor outcomes. The availability of various anti-HER2 therapies, including trastuzumab, lapatinib, pertuzumab, and trastuzumab emtansine (TDM-1), has remarkably improved the clinical outcomes in patients with HER2-positive metastatic breast cancer (mBC). However, there is a need to optimize treatment within this population, given the wide variability in clinical presentation. Additionally, geographical and socio-economic considerations too need to be taken into account. To clarify and collate evidence pertaining to HER2-positive metastatic breast cancer, a panel of medical and clinical oncologists from across India developed representative clinical scenarios commonly encountered in clinical practice in the country. This was followed by two meetings wherein each clinical scenario was discussed in detail and relevant evidence appraised. The result of this process is presented in this manuscript as evidence followed by therapeutic recommendations of this panel for management of HER2-positive mBC in the Indian population.

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