Publications (26) View all
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Article: Primary renal osteosarcoma with systemic dissemination.
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ABSTRACT: Primary renal osteosarcoma is an uncommon disease, which, unlike its skeletal counterpart, presents mostly in adults, and is generally diagnosed late due to its non-specific features and intra-abdominal location. Even if the disease is localized at diagnosis, it follows an aggressive course despite radical surgery and adjuvant treatment. We report a case of renal osteosarcoma in a 65-year-old female, who developed regional recurrence, and lung and bone metastases soon after radical nephrectomy for localized disease. Chemotherapy was ineffective in controlling systemic disease.Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 01/2012; 23(1):114-6. -
Article: MGMT gene promoter methylation in pediatric glioblastomas.
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ABSTRACT: Relatively few studies have been performed on molecular properties of pediatric glioblastoma multiforme (GBM). Methylation of DNA repair gene O(6)-methylguanine-DNA methyltransferase (MGMT) promoter region has been associated with favorable prognosis and prolonged survival in adult GBM patients treated with temozolomide (TMZ). We explored the frequency of MGMT gene promoter methylation in pediatric glioblastomas and compared it with the known molecular alterations in p53. Twenty pediatric GBM cases were selected. MGMT promoter methylation was assessed by methylation specific PCR. p53 expression was determined by immunohistochemistry. MGMT gene promoter methylation was observed in 50% of pediatric glioblastomas. p53 protein expression was detected in 60% of cases. Seventy percent of cases with methylated MGMT promoter were p53 immunopositive. The frequency of MGMT gene promoter methylation in pediatric GBMs was similar to adult GBM patients. The pediatric GBMs should also be investigated for MGMT promoter methylation to identify a subset of patients likely to benefit from TMZ therapy. p53 protein overexpression was more common in pediatric primary GBMs. To the best of our knowledge this is only the second study on MGMT gene promoter methylation status in pediatric GBMs.Child s Nervous System 11/2010; 26(11):1613-8. · 1.54 Impact Factor -
Article: A clinicopathological and molecular analysis of glioblastoma multiforme with long-term survival.
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ABSTRACT: The median survival time of patients with glioblastoma multiforme (GBM) is 12 months, and only 3-5% of patients survive longer than 3 years. We performed histomorphological and detailed molecular analyses of seven long-term survivors of GBM to identify any prognostic factors that potentially contribute to survival. Morphology and immunohistochemistry for p53, phosphatase and tensin homologue (PTEN) and epidermal growth factor receptor (EGFR) protein expression were investigated. EGFR amplification and 1p/19q deletion were assessed by fluorescent in situ hybridization. The O6-methylguanine-DNA methyltransferase (MGMT) gene methylation status was evaluated by performing methylation-specific polymerase chain reaction assays. All tumors were classical GBMs and no significant oligodendroglial differentiation was noted. The majority showed EGFR amplification (4/7), PTEN protein expression (6/7) and MGMT promoter methylation (5/6). Immunopositivity for p53 was noted in three of seven patients. Deletion of chromosome 1p/19q, either isolated or combined, was not identified in any of the se patients. All patients were treated by gross total resection followed by radiotherapy; six patients received additional temozolomide treatment. A relatively young age of onset (48 years), with a high MGMT promoter methylation and PTEN protein expression were favorable factors for long-term survival. The presence of EGFR amplification indicates that more than a single factor determines survival in GBM.Journal of Clinical Neuroscience 09/2010; 18(1):66-70. · 1.25 Impact Factor -
Article: Tibial involvement in breast cancer: issues in diagnosis and management.
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ABSTRACT: Skeletal metastases below elbow and knee are uncommon, those to tibia are even rarer. Diagnosis may be delayed, and often confused with primary bone tumors (in solitary metastases) or with osteomyelitis or arthritis. Management depends on extent of disease and severity of symptoms. In most cases, treatment is essentially directed towards symptom relief. We describe a case of metastases to the tibia and foot in a case of breast cancer after a long disease-free period. Roentgenogram appearance mimicked osteomyelitis, which was ruled out by absence of fever, sterile cultures and no response to antibiotics. Diagnosis was established by a bone biopsy, with immunohistochemistry demonstrating a carcinoma with estrogen and progesterone receptor positivity. The patient was managed with multiagent chemotherapy, hormone therapy, bisphosphonates and palliative radiotherapy. She remained stable for 1 year after which her disease progressed with cutaneous metastases, and she was given symptomatic treatment only. Management of acrometastases from breast cancer involves a multimodality approach. Both systemic therapy and local therapy (in the form of surgery or radiation therapy) may help. Treatment needs to be individualized depending on prognosis and extent of disease.The Foot 03/2010; 20(1):35-8. -
Article: Lycopene in treatment of high-grade gliomas: A pilot study
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ABSTRACT: Background : The therapeutic benefit of lycopene is well established for carcinoma prostate in various clinical trials and has been proposed for other malignancies including high-grade gliomas. Setting and Design : Randomized placebo control study in the Department of Radiation Oncology of a teaching hospital. Materials and Methods : Fifty patients with high-grade gliomas were treated with surgery followed by adjuvant radiotherapy and concomitant paclitaxel. Patients were randomized to receive either oral lycopene (Group A) 8 mg daily with radiotherapy or placebo (Group B). Pre-and post-radiotherapy plasma lycopene levels were measured using high-precision liquid chromatography. McDonald′s criteria were used for response assessment. Magnetic resonance imaging (MRI) of brain and Single Photon Emission Computed Tomograph (SPECT) were done three-monthly for two visits and six-monthly thereafter. Primary endpoint was response at six months post radiotherapy. Statistical Analysis Used : The data was analyzed using SPSS Software v10.0 (SPSS corporation Chicago IL) by applying Student′s t-test, ANOVA F test, Chi-square test and Karl Pearson Correlation Coefficient. Results : Median age was 38 years. The commonest histology was glioblastoma multiforme (n = 32). Pre- and post-treatment plasma lycopene levels in the patients in Gropu A were 152 ng/ml and 316 ng/ml and in the patients in Group B were 93 ng/ml and 98 ng/ml (P = 0.009). There was non-significant differences in favor of lycopene between Group A and Group B with higher overall response at six months (P = 0.100), response at last follow-up (P = 0.171) and time to progression (40.83 vs. 26.74 weeks, P = 0.089)., The follow-up duration was significantly higher for Group A than Group B (66.29 vs. 38.71 weeks, P = 0.05). Conclusions : Addition of nutrition supplements such as lycopene may have potential therapeutic benefit in the adjuvant management of high-grade gliomas.Neurology India. 01/2010;
