No abstract

Rhabdomyosarcoma (RMS) is a highly malignant soft tissue sarcoma that typically affects children and adolescents. Histologic appearance of RMS is similar to that of other small round blue cell tumors of childhood. Thus, RMS can mimic acute leukemia, both clinically and histologically. We report a case of a 42-year-old female patient who presented with pancytopenia. She was referred to our centre with a diagnosis of acute leukemia after bone marrow studies. Bone marrow sample was reviewed at our centre, which showed atypical cells resembling blasts. However, myogenin positivity by immunohistohemistry in bone marrow specimen confirmed the diagnosis of RMS infiltrating bone marrow.

Contrary to primary malignant cardiac tumors, metastatic tumors of the heart are relatively common. Cardiac metastases are usually the immediate cause of death in about one-third of such cases. They may cause cardiac failure, pericardial effusion and arrhythmia, with cardiac failure being the most common cause of death as a result of restrictive ventricular inflow and outflow tract obstruction, myocardial disease and pericardial constrictive disease. According to autopsy reports, cardiac metastases have been found in about 25% of patients with soft-tissue sarcoma. The incidence of cardiac metastasis has increased during recent years in view of better diagnostic tools and aggressive treatment of malignant tumors have led to longer survival of patients. Despite their increasing frequency, cardiac metastases are rarely diagnosed in living patients because other metastatic symptoms co-exist. We report a case of relapsed malignant peripheral nerve sheath tumor with symptomatic metastases to the heart. She was planned for surgery but in view of poor general condition, she was managed with palliative chemotherapy.

Introduction: Burkitt's lymphoma (BL) is a highly aggressive B cell non-Hodgkin lymphoma (NHL) having three distinct subtypes: endemic, sporadic, and immunodeficiency-associated BL. Sporadic BL accounts for only 1 to 2% of adult NHL. Objectives: The objective of this article was to study the clinical profile and treatment outcome of patients with BL. Materials and Methods: This was a retrospective study of 60 patients with BL conducted in the department of medical oncology at a tertiary cancer center in India during a 10-year period. Patients with BL/leukemia above 14 years of age diagnosed during the study period were included and their clinical presentation, treatment details, and outcome were studied. Results: Among 60 cases with BL, there were 41 males and 19 females. The median age at presentation was 42 years (range: 14–81 years). The main symptoms were lymphadenopathy, abdominal pain, and abdominal distension. Two patients each had paraparesis, breast lump, and jaw swelling and one patient had involvement of the cervix. Thirteen patients had features of tumor lysis at presentation. The Ann Arbor stage was I in 17, II in 16, III in 5, and IV in 22. Fifty-five patients received combination chemotherapy that included hyper-cyclophosphamide, vincristine, adriamycin, dexamethasone ± rituximab (hyper-CVAD ± R; 35), cyclophosphamide, adriamycin, vincristine, prednisolone/ cyclophosphamide, vincristine, prednisolone ± rituximab CHOP ± R (13), Berlin-Frankfurt-Munich protocol (4), and others (3). Thirty-four patients attained remission, 13 patients had progressive disease, and 8 patients died during chemotherapy. At a median follow-up of 113 months, 58% patients were alive. Conclusions: BL accounts for 1.57% of NHL above the age of 14 years with male preponderance. Intensive, short-duration chemotherapy is the standard treatment. Treatment with hyper-CVAD ± R gives 8-year progression-free survival and overall survival (OS) of 60%. Treatment with CHOP ± R is an alternative option in elderly frail patients with an 8-year OS of 46%.

Case:Multifocal synchronous primary skeletal chondrosarcomas of an extremity are rarely reported. In this study, we report 2 such cases. The first case is a 32-year-old woman who presented with extensive right femoral and tibial diaphysis lesions. The second case is a 36-year-old woman with lesions in the left proximal humerus, the coracoid process of scapula and sternum. Both patients underwent limb salvage surgery and were disease-free at the 38- and 20-month follow-up.Conclusion:Athough rare, the possibility of multifocal chondrosarcoma should be kept in mind during the workup of a patient with chondrosarcoma.