Objective  To evaluate the accuracy of clinical examination and fine‐needle aspiration cytology (FNAC) in detecting groin metastases in patients with carcinoma of the penis, and to assess the positive and negative predictive value (PPV, NPV) of a preliminary sentinel lymph‐node biopsy (SNB) and biopsy of the most medial of the horizontal group of inguinal lymph nodes (MIN) in selecting patients for an ilio‐inguinal block dissection. Patients and methods  The study comprised 28 patients (56 groins) with Stage I (one), Stage II (11) and Stage III (16) carcinoma of the penis. All patients underwent a detailed clinical examination followed by FNAC of the palpable inguinal nodes, and were subsequently submitted for block dissection. The MIN, the SN and the rest of the inguinal and iliac nodes were histologically examined separately for metastases. Results  The clinical evaluation had a sensitivity of 74%, a specificity of 61%, a PPV of 57% and a NPV of 77%. The corresponding values for FNAC were all 100%, and the specificity and PPV for both MIN and SN were 100%. The sensitivity and NPV of MIN were higher than for SN, although not significantly so. Conclusion  Clinical examination alone is inaccurate in selecting patients with carcinoma of the penis for block dissection. FNAC is accurate and specific when nodes are palpable; in those with impalpable nodes a preliminary MIN biopsy followed by SNB if the MIN biopsy is negative will accurately select all patients with metastases in the groin nodes. This can be performed by examining frozen sections of the lymph nodes; if positive, block dissection can be carried out at the same time.

Background and Aim Prior knowledge of axillary node status can spare a lot of patients with early breast cancer morbidity due to an unnecessary axillary dissection. Our study compared various metabolic and pathological features that can predict the sentinel lymph node biopsy (SLNB) status in patients with positron emission tomography/computed tomography (PET/CT) negative axilla. Patients and Methods All consecutive patients with early breast cancers (< 5 cm) with PET/CT negative axilla who underwent breast surgery and SLNB from November 2016 to February 2020 were included. Various primary tumor (PT) pathological variables and metabolic variables on PET/CT such as maximum standardized uptake value (PT-SUVmax), metabolic tumor volume (PT-MTV), and total lesion glycolysis (PT-TLG) were compared using univariate and multivariate analyses for prediction of SLNB status. Results Overall 70 patients, all female, with mean age 55.6 years (range: 33–77) and mean tumor size 2.2 cm (range: 0.7–4.5), were included. SLNB was positive in 20% of patients (n = 14) with nonsentinel nodes positive in 4% (n = 3) patients. Comparing SLNB positive and negative groups, univariate analysis showed significant association of SLNB with low tumor grade, positive lymphovascular invasion (LVI), positive estrogen receptor (ER) status with lower mean Ki-67 index (34.41 vs. 52.02%; p = 0.02), PT-SUVmax (5.40 vs. 8.68; p = 0.036), PT-MTV (4.71 cc vs. 7.46 cc; p = 0.05), and PT-TLG (15.12 g/mL.cc vs. 37.10 g/mL.cc; p = 0.006). On multivariate analysis, only LVI status was a significant independent predictor of SLNB status (odds ratio = 6.23; 95% confidence interval: 1.15–33.6; p = 0.033). Conclusion SLNB is positive in approximately 20% of early breast cancers with PET/CT negative axilla and SLNB status appears to be independent of PT size. SLNB+ PTs were more likely to be LVI+ and ER + ve, with lower grade/Ki-67/metabolic activity (SUVmax/MTV/TLG) compared with SLNB–ve tumors. Logistic regression analysis revealed LVI status as the only significant independent predictor of sentinel lymph node status.

Numerous studies over past four decades have implicated a strong association of Streptoccus bovis infection with colorectal carcinomas. Strong is this association that a screening colonoscopy for identifying malignancy is considered mandatory in patients whose blood/fecal cultures show growth of this particular pathogen. Here, we report an interesting case of a 61-year-old female patient who presented with pyrexia of unknown origin for 3 weeks. Positron emission tomography/computed tomography, in addition to helping diagnose mitral valve endocarditis, also identified a clinically occult T2N0 rectal carcinoma.

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A 42 year old male fisherman presented with a tender mass in the right side groin/root of the thigh. The entire episode followed a trauma. A biopsy specimen revealed a chondroma like lesion with necrosis. The final diagnosis made was Necrosis of Tendon.