Background: Fiberoptic bronchoscopy is the most important diagnostic tool for lung cancer. Early tissue diagnosis and proper staging remains the key to the management of the lung cancer patient. Endobronchial forceps biopsy has high diagnostic yield from the visible lesions. The aim of the study was to evaluate diagnostic yield of endobronchial biopsy. Methods: A retrospective cross-sectional study was conducted at B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal. Bronchoscopy reports of 1074 patients from January 2000 to December 2009 were included. Endobronchial biopsy was the main procedure performed. Results: A total of 1074 patients underwent bronchoscopy for suspected lung cancer. Majority of the patients (N=340) had lesion in lobar bronchus. Squamous cell carcinoma was the most common histological diagnosis. The diagnostic yield of endobronchial biopsy was 75%. The diagnostic yield for central tumor was 82.3% which was statistically significant (p<0.001) compared to peripheral tumor and extrinsic compression. Conclusion: Endobronchial biopsy provides good diagnostic yield especially in central tumors. Fiberoptic bronchoscopy is a safe procedure.

Primary malignant sternal tumors are rare clinical entities. We came across two such patients with primary sternal tumors. One was a chondroblastic osteosarcoma while the other was a chondrosarcoma. One patient received neoadjuvant chemotherapy followed by surgery. The second patient underwent upfront surgery. Both cases received wide excision of the tumor (sternum along with part of medial ends of bilateral clavicles and upper ribs). Reconstruction was done using autologous bone graft with prolene mesh in one case and titanium reconstruction plates in the other case. Both cases received coverage with pectoralis major muscle flaps.

Pancreatic Adenosquamous Carcinoma is a rare subtype of pancreatic cancer. Here we present a 51 year old man who presented with features of obstructive jaundice. Radiological imaging studies revealed the presence of solid pancreatic mass. He underwent pancreaticoduodenectomy – superior mesenteric artery (SMA) first approach. Postoperative period was complicated with prolonged ascitic drainage. Histological analysis suggested adenosquamous carcinoma with 30% squamous components, pT2N0M0. Patient is being planned for adjuvant chemotherapy.