Peripherally inserted central catheter (PICC) is a modern drug delivery system utilised in oncology practice. The purpose of this study was to determine the complications associated with PICCs within a one year study period. PICCs inserted in patients registered at Dharamshila Cancer Hospital and research centre from 1st July 2012 to 30th June 2013 were studied. Data was retrieved from the procedure room records, medical records department, department of radiology and department of microbiology. Data was collected by oncology residents and procedure team. A total of 246 PICCs were inserted during the one year period. Complete data was not available in 23 patients. 223 results were included in the final analysis. USG guidance was required in 14 patients (6.3%). Optimal PICC duration was achieved in 151 patients (67.7%). 28 patient developed culture positive infective complications (12.5%). 44 patients developed mechanical complications (19.7%). Our study shows a relatively higher rate of infective complications. PICC is an acceptable means of drug delivery system.

Carcinoma of esophagus encompasses mainly two different histopathologic subtypes, squamous cell carcinoma and adenocarcinoma. Adenocarcinoma is the most common cancer seen. It usually arises in association with Barrett's esophagus and is localised in the distal third of the esophagus while squamous cell carcinoma predominates in the middle third. Carcinoma arising in the proximal third (cervical) of the esophagus is almost always squamous in origin. We report a case of adenocarcinoma arising in the cervical esophagus.

Squamous cell carcinoma (SCC) of rectum is an uncommonly seen malignancy. It has been difficult to establish the precise etio-pathogenesis due to paucity of cases. For the same reason, the rigorous treatment protocol has not been defined. The available compendium of knowledge about this pathology is based on isolated case reports and case series. We report a case of SCC of rectum who was treated with chemo-radiotherapy.

Waldenstrom's macroglobulinaemia (WM) is a rare lymphoproliferative disorder. It is mostly seen in the elderly population with a median age of 65 years at the time of diagnosis. The clinical presentation is variable and the patient may be entirely asymptomatic. The slow progressive nature of the disease allows many patients to survive for more than 5 years. At times it may be difficult for a clinician to determine the timing of therapy. We present an interesting case of WM that highlights the typical course of the disease and timing of its management.

During 2012-13, we diagnosed 4 patients with extensive skeletal tuberculosis (TB) who were referred to us as cases of bony metastasis with unknown primary. Radiological investigations done outside favoured a diagnosis of disseminated malignancy. Positron emission tomography/computed tomography (PET/CT) scan performed in our institute for localization of primary lesion also suggested metastatic disease. There was no evidence of malignancy on histo-pathological examination (HPE) of the involved sites. The diagnosis of TB was established on characteristics HPE. This article highlights the diagnostic dilemma of PET/CT in cases of TB versus malignancy and the importance of HPE for reaching an accurate diagnosis.