Oncology Journal of India

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Background: Sellar and parasellar/juxtasellar regions are complex areas of the brain, and different varieties of tumors can occur in this area. Preoperative noninvasive diagnosis with magnetic resonance imaging (MRI) is essential for treatment planning. Aim of the Study: The aim of this study is to characterize MRI features of the sellar and juxtasellar tumors and to correlate MRI diagnosis with histopathological diagnosis in order to evaluate the efficiency of MRI. Materials and Methods: Patients with sellar and juxtasellar lesions who were operated during September 2015–August 2017 and the pathological reports were compared with the MRI findings retrospectively. Results: A total of 50 patients were enrolled in the study, and the mean age of presentation was 34.6 years. MRI-based radiological diagnosis showed 21 cases of pituitary macroadenoma, 15 cases of craniopharyngioma, 9 cases of meningioma, 2 cases of germinoma, 1 case of glioma, and 2 cases of epidermoid cysts. Histopathological correlation revealed MRI accuracy of 94.12%, 94%, 100%, 98%, 100%, and 100% for the diagnosis of pituitary macroadenoma, craniopharyngioma, meningioma, germinoma, glioma, and epidermoid cyst, respectively. One case each of pituitary macroadenoma and germinoma diagnosed on MRI comes out to be as craniopharyngioma after final histopathological correlation, whereas one case of craniopharyngioma turned out to be macroadenoma after final histopathological examination. Conclusions: The present study revealed a strong correlation between MRI and histopathological diagnosis for sellar and juxtasellar tumors. MRI is the modality of choice for characterizing sellar and suprasellar lesions.

Osteosarcoma is an aggressive primary bone tumor arising from primitive bone-forming cells. The most frequent site of metastasis is the lung followed by bone. However, osteosarcoma presenting as malignant pleural effusion during the initial presentation is extremely rare. Involvement of more than one bone at the time of initial presentation is rare and it is confusing whether these multiple lesions represent multiple primaries or metastasis. We report the case of a 17-year-old male who presented with fever and breathlessness of 1-month duration. Examination revealed massive pleural effusion. Pleural fluid cytology showed malignant cells. On examination, a scalp swelling was also noted. Radiological evaluation revealed multiple bony lesions involving the skull, femur, humerus, and vertebrae. Biopsy of the lesion in the humerus confirmed the diagnosis of osteosarcoma.

Fibro-osseous lesions are bony lesions where the bone is replaced by fibrous connective tissue and include fibrous dysplasia (FD), cemento-osseous dysplasia, and ossifying fibroma (OF). OF is a benign osteogenic mesenchymal tumor and clinicopathologically divided into juvenile and conventional subtypes. Juvenile OF (JOF) is a rare rapidly growing tumor of the craniofacial bones having aggressive clinical behavior with high recurrence rate. Pathologically, JOF is classified into juvenile trabecular OF (JTOF) and juvenile psammomatoid OF. JTOF microscopically shows proliferation of fibrocellular connective tissue stroma along with immature and woven bony trabeculae with varied histologic features. We report a case of JTOF of the mandible in a 12-year-old male with the initial presentation of painless swelling on the right side lower jaw. Clinicoradiologically, the case was suspected as central giant cell granuloma and odontogenic tumors. He was successfully treated with wide local excision and reconstruction and was on follow-up for 8 months without any recurrence of the disease.

Congenital mesoblastic nephroma (CMN) is a rare tumor of infancy and consists of 3%–10% of cases among all the pediatric renal tumors. Histologically, it can be classic, cellular, and mixed subtypes, with the cellular variant being difficult to differentiate from Wilms tumors and more aggressive. In this report, macroscopic hematuria was noticed first, and a right renal mass was detected in a 32-week-old premature female neonate, who was born to a 30-year-old woman by emergency cesarean section. Nephrectomy was performed, and histopathological examination of the operated specimen revealed features of cellular variant of CMN.

Mature cystic teratoma (MCT) is the most common germ cell tumor of the ovary. Malignant transformation is found in only 1%–2% of MCTs, with squamous cell carcinoma (SCC) being the most common type, and is extremely difficult to predict early detection for clinicians. We report a case of MCT with malignant transformation to SCC in a 59-year-old postmenopausal female with the initial complaint of pain in the lower abdomen. The case was suspected as MCT based on the magnetic resonance imaging findings and normal range of serum markers. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done with intraoperative spillage of the tumor occurred. The patient delayed 2 months for the planned adjuvant chemotherapy followed by completion of surgery in view of suboptimal cytoreduction and intraoperative spillage. She developed recurrent disease as bilateral adnexal deposits. She was on chemotherapy with paclitaxel and carboplatin-based combination regimen, and contrast-enhanced computed tomography scan after three cycles of chemotherapy showed decrease in size of metastatic deposits.

Online since 19^th May, 2017