Groin dissection is an effective treatment for nodal metastasis from carcinoma of the penis. However, innovative approaches are needed for the subset of patients with dismal outlook.

In the hospitalized children who underwent VCUGs within a week after diagnosis of UTI, the presence of reflux is not significantly different from those studied later. Furthermore, late scheduling of VCUGs resulted in failure to perform the procedure in more than half of the patients. Some of the patients who were not evaluated would be expected to have vesicoureteral reflux and thus be at risk for chronic renal disease. Therefore, the traditional recommendation to perform the VCUG at 3 to 6 weeks after the diagnosis of UTI should be reconsidered, especially for hospitalized children.

BackgroundIgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that can affect nearly any organ (1). No detailed clinical and laboratory assessments have been reported in large numbers of patients with IgG4-RD diagnoses established by strict clinicopathological correlation (2-4).ObjectivesTo describe a single center cohort of 125 patients with biopsy-proven disease.MethodsWe reviewed the baseline features of 125 patients with biopsy-proven disease. The diagnosis was confirmed by pathology review according to consensus diagnostic criteria (5). Disease activity and damage were assessed by the IgG4-RD Responder Index (RI) (6). Flow cytometry was used to assess levels of circulating plasmablasts (7, 8).ResultsOf the 125 patients, 103 had active disease and 86 were on no treatment. Only 51% of the patients with active disease had elevated serum IgG4 concentrations. However, patients with active disease and elevated serum IgG4 concentrations were older, had a higher RI, a greater number of organs involved, lower complement levels, a higher absolute eosinophil count, and higher IgE levels compared to those with active disease but normal serum IgG4 (P<0.01 for all comparisons). The correlation between IgG4+ plasmablast level and RI (R=0.45, P=0.003) was stronger than that of total plasmablasts and RI. Seventy-six (61%) of the patients were male, but no significant differences according to gender were observed with regard to disease severity, organ involvement, or serum IgG4 concentrations. Glucocorticoids failed to produce sustained remission in the majority of patients.ConclusionsNearly 50% of this patient cohort with biopsy-proven, clinically-active IgG4-RD had normal serum IgG4 concentrations. Serum IgG4 elevation identify a subset with more inflammatory features. IgG4+ plasmablasts correlate well with disease activity.ReferencesStone JH, Zen Y, Deshpande V. IgG4-related disease. NEJM 2012; Feb 9;366(6):539-51.Zen Y, Nakanuma Y. IgG4-related disease: a cross-sectional study of 114 cases. Am J Surg Pathol 2010; Dec;34(12):1812-9.Ebbo M, Daniel L, Pavic M, Seve P, Hamidou M, Andres E, et al. IgG4-related systemic disease: features and treatment response in a French cohort: results of a multicenter registry. Medicine (Baltimore) 2012; Jan;91(1):49-56.Chen H, Lin W, Wang Q, Wu Q, Wang L, Fei Y, et al. IgG4-related disease in a Chinese cohort: a prospective study. Scand J Rheumatol 2014;43(1):70-4.Deshpande V. Consensus Statement on IgG4-RD Diagnosis. Modern Pathology 2012; 25(9):1181.Carruthers MN, Stone JH, Deshpande V, Khosroshahi A. Development of an IgG4-RD Responder Index. Int J Rheumatol 2012;2012:259408.Wallace ZS, Mattoo H, Carruthers M, Mahajan VS, Della Torre E, Lee H, et al. Plasmablasts as a biomarker for IgG4-related disease, independent of serum IgG4 concentrations. Ann Rheum Dis 2015; 74(1):190.Mattoo H, Mahajan VS, Della-Torre E, Sekigami Y, Carruthers M, Wallace ZS, et al. De novo oligoclonal expansions of circulating plasmablasts in active and relapsing IgG-related disease. J A...

13of anorectal melanoma were evaluated in our institution. These patients were identified from the computer data base in our tumor registry using the ICD-O (third edition) site codes for anus and rectum (C21.0, C44.5 and C20.9) and the morphology code for melanoma (M-8720/3). The case records of these patients were retrospectively reviewed in detail to obtain information regarding clinical features (symptoms, duration, investigations and stage), pathological features (size, depth of invasion and immunohistochemical studies), treatment and follow-up details. Depth of the lesion was assessed either by histopathological examination of the surgical specimen or by clinical examination in patients who did not undergo surgery.Immunohistochemistry (IHC), performed by the streptavidin-biotin-peroxidase method was used to further categorize anorectal tumors labelled on routine Optimizing local control in anorectal melanomaRamakrishnan AS, Mahajan V, Kannan R Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai -600 036, Tamil Nadu, IndiaCorrespondence to: Dr. Ramakrishnan AS, E-mail: ram_a_s@yahoo.com Abstract BACKGROUND: Wide local excision (WLE) of anorectal melanoma is associated with a high incidence of local recurrence.

Availability of biosimilar rituximab has increased access and survival of patients with DLBCL in India. Radiotherapy improved outcomes in early stages.