Uterine choriocarcinoma developing in patients beyond reproductive age is a rare occurrence. We report a case of choriocarcinoma of uterine corpus in a 54-yr-old woman after 7 yr of menopause and 25 yr after last child birth. She presented with pain in the abdomen, and on radiological investigation a left uterine adnexal mass of 3.4 x 2.8 cm size was detected. Her serum CA125 level was 40 mIU/mL (normal up to 35 mIU/mL). Hysterectomy revealed an intramural growth in left uterine cornu measuring 3.5 x 3.0 x 2.5 cm. Histological features of the tumor were consistent with choriocarcinoma, and immunohistochemistry detected strong reactivity for beta-hCG in the tumor cells. Serum beta-hCG level 4 wk after surgery was 1345 mIU/mL. The patient was put on combination chemotherapy (EMACO). She achieved serological remission but showed a rise in serum beta-hCG level 4 wk after completion of chemotherapy. We conclude that a high level of suspicion may help in preoperative diagnosis of uterine choriocarcinoma in the postmenopausal age group. However, the response to chemotherapy in these cases may not be as encouraging as in choriocarcinoma of reproductive age.

No abstract

Gemcitabine is used in various carcinomas like lung cancer, pancreatic cancer, bladder cancer and breast cancer in adults. It is considered to be a well-tolerated drug with little known side effects [1]. The reported toxic effects of gemcitabine include myelosuppression, altered liver function tests, flu-like syndrome, bronchospasm, rash, itching, and fever [2]. Skin reactions are rarely reported [1-4], the reported incidence being 7%-30% [4].

No abstract

18580 Background: MBD is common complication in many malignancies. Pain is common presentation of MBD. It is major cause of morbidity, major determinant of quality of life and an important reason for emergency medical referral. Acute pain necessitates emergency pain relief measures. Besides conventional radiation and pain killers, bisphosphonates are indicated in MBD. They contribute towards pain relief. Literature suggests that ibandronate may be effective in acute pain relief. The aim of this study was to study the efficacy of ibandronate in acute pain relief. This should obviate the need for local radiation and or increase in dose of pain killers. Methods: Patients with severe pain were given inj. ibandronate 6 mg iv over 2 hrs for 3 consecutive days. Pain was assessed by direct questioning the patient . Pain was assessed on first four days and after four weeks. Patients were continued with single dose ibandronate once in a month there after. Response was assessed as excellent-more than 90% disappearance of pain, good -more than 50% but less than 90%, satisfactory -between 25– 50% and no response-if less than 25%. Results: A total 9 patients were treated using loading dose ibandronate. There were 4 patients of carcinoma prostate, 3- carcinoma lung, 2- multiple myeloma. All had intolerable bone pain and this was the main reason for this particular admission to hospital. All patients had shown satisfactory response on day 2. On day three 6/9 patients shown a good response. On day four, 4/9 patients shown an excellent response, 4/9 -good response and 1/9 satisfactory response. At the end of four weeks 6/9 patients shown an excellent response, 2/9 good response and 1/9 satisfactory response. The pain response improved over four weeks. On questioning, all patients communicated there strong willingness to continue the same treatment. Conclusion: Loading dose, consecutive three day administration of ibandronate appears to be the ideal strategy for rapid pain relief in patients with MBD. There is an excellent response to such an intervention. In compromised patients with reduced bone marrow reserves this may form the standard of care. Broader data acquisition is warranted. No significant financial relationships to disclose.