Background: As most of the studies in HIV patients with diarrhea were cross sectional, focusing on the etiological agents, we are reporting data on the rate of diarrhea, associations between diarrhea and CD4 counts and variation in frequency of identifying a pathogen with consistency of diarrhea and duration in a prospective hospital based study.

IMT is a rare neoplasm of uncertain biological potential. Complete surgical resection remains the mainstay of the treatment.

Non-pulmonary metastases in osteosarcoma are increasingly recognized because of improved longevity in patients receiving modern treatment. One rare site of metastasis is the orbit, with only three cases reported so far. This report describes a 16-year-old male patient, who underwent above-knee amputation for right tibial osteosarcoma and later presented with a painful protrusion of the right eyeball and near-normal vision. The uncommon features in the present case are the site of metastasis and near-normal vision.

20026 Background: Infantile malignancies are peculiar in the way they present with lot of diversity and had poor prognosis compared to other pediatric malignancies. The spectrum of malignancies had a great regional variability owing to the environmental and genetic differences (both aquired, maternal and paternal). Methods: It is a retrospective data analysis conducted at a tertiary care cancer center, Bangalore, India. The institute has an annual attendance of 16,000 new cases with reasonably good follow-up. The contribution of pediatric malignancies is 18%. The details were collected from the case records and percentages were calculated for the variables. Results: Between 2003–2006 we diagnosed 1,798 pediatric tumors. Of them 198 (11%) are infantile malignancies. The commonest diagnosis at our center is leukemia (30% of all infantile malignancies). The main types of leukemia are ALL-80%, AML-13%, and CML-7%. Other hematological malignancies are lymphomas- 2%, myelo proliferative disorders and Langerhan Cell histiocytosis-3% each. The next common diagnosis is benign neoplasms, wrongly diagnosed as malignant at the secondary referral center which contributed 16% of all cases. The reminder 46% is solid malignancies. In the decreasing frequency the incidences are Wilm’s tumor-12%, neuroblastoma-10%, germ cell tumors-8%, retinoblastoma- 6% CNS malignancies and 3% hepatoblastoma -2%. The reminders are other rare malignancies. Conclusion: The contribution of infantile malignancies at our center is relatively higher compared to the west. Similarly Relative contribution of AML to the all hematological malignancies and neurblastoma & CNS tumors to solid malignancies is less compared to the existing literature. Wilm’s tumor and ALL diagnosed more frequently than expected in our population. All these findings together suggest that south Indian population had a different spectrum of infantile malignancies compared to rest of the world and their genetic and environmental risk factors need further exploration. No significant financial relationships to disclose.

20531 Background: There have been major advances in understanding the behavioral pattern, pharmacological intervention, and clinical response of GIST; yet Indian data in this regard is sparse. This study analyses the clinico-pathologic features in 36 patients (21 male, 15 female) of GIST seen at our institution. Methods: GIST was defined as a mesenchymal spindle or epithelioid cell lesion arising in the GI tract with CD117 immuno-reactivity. Retrospective data from January 03 to March 06 was analyzed for age, tumor site, morphology, immuno- reactivity, prognostic factors, response to treatment (by RECIST), and recurrence or metastasis. All patients had surgery; those with residual, recurrent, or metastatic disease got imatinib till tumor progression. Results: GIST presented at a mean age of 48.2 yrs (SD 6.4, range 34–65). The mean tumor size was 13.9 cm (range 2–42). The most common site was the small intestine (ileum 8, jejunum 7, duodenum 4). 24 patients (66.7%) had localized disease at baseline. Of these, 14 had local recurrence after surgery, and were given imatinib. 5 of them are in complete remission, 4 had partial response (PR), 3 patients died, and 2 had stable disease. Most patients with recurrent GIST had a mitotic rate of >10/50hpf. 8 patients developed metastasis, and received imatinib. Of these, 2 got a PR, 3 had progressive disease and died, and 3 had stable disease. 12 patients (33.3%) had metastasis at baseline (to liver and abdominal cavity), and underwent debulking. Of these, 6 patients with stable disease are on treatment with imatinib, 3 died and 3 were lost to follow-up. Conclusions: Average age of presentation was less than in Western reports. The commonest site was the small intestine as opposed to stomach in western literature. Mitotic rate was a better prognostic factor than gross tumor size. GIST with a mixed cell morphology showed aggressive behavior. Imatinib mesylate is useful in the post-operative management of GIST. [Table: see text] No significant financial relationships to disclose.