Germline mutations affecting the Krebs cycle enzyme, succinate dehydrogenase (SDH), can also cause an inherited tumour susceptibility syndrome. Thus, inherited mutations in SDHB, SDHC, and SDHD genes (encoding subunits of SDH) are associated with a high risk of head and neck paragangliomas and/or adrenal and extra-adrenal pheochromocytomas. Very rarely, germline mutations in SDHB have been found in patients with RCC and a personal or family history of pheochromocytoma and/or paraganglioma.
In developing countries like India, there exists a gaping breach in the percentage of terminally-ill populace as opposed to the percentage of resources available to fight the diseases. It is, therefore, no surprise that several Indians choose to explore other lesser known forms of medicine like Ayurveda, alongside the conventional allopathic medicine; the reasons governing this choice being accessibility, affordability, social coaxing between peers, among other reasons. Vaidya et al, stated that Ayurvedic formulations have effectively controlled the side effects of chemotherapy.
Ayurveda literally means the “science of life” and it is a science that aims foremost at preserving health and if required, at treating disease.
In aphorism 207, Dr. Hahnemann guides us to procure detailed history of the treatment taken till date, regarding perturbing medicines most frequently used, external applications, baths, pernicious artificial operations the patient has undergone. This is to enable the physician to avoid the employment of medicines that have already been improperly used.
The differential diagnosis for hepatoblastoma is impacted by the age of the patient. In infants, hemangiomas, hemangioendotheliomas and hamartomas are common liver tumors. However, a liver tumor in an adolescent is more likely to be a hepatocellular carcinoma (HCC)
Histologic classification of Ewing’s sarcoma includes three major subtypes: classic or conventional type, primitive neuroectodermal tumor, and a typical Ewing’s sarcoma. These tumors share the same immunohistochemical and molecular features, differing only in the extent of neural differentiation.
Classic Ewing’s sarcoma is composed of small round uniform cells. The nuclei are round, and the nucleoli are inconspicuous. The cytoplasmic boundaries are indistinct, such that, the cytoplasm of several cells seems to form a syncytium with nuclei are embedded in it. Mitotic activity is usually not prominent.
PNET: the diagnosis requires the presence of Homer Wright rosettes with central core of neuropil, the background contains monotonous fields of conventional Ewing’s Sarcoma.
A typical Ewing’s sarcoma difficult to recognize because these tumors have a greater degree of cytologic variability or growths patterns bringing a broad variety of primary or metastatic small round cell tumors in differential diagnosis.
Based on the International Neuroblastoma Pathology Classification (INPC), the tumour cells show a spectrum of differentiation from primitive neuroblasts to ganglion cells and their classification depends on the relative amounts of these components. This classification applies to untreated neuroblastomas, chemotherapy often induces maturation and/or nuclear anaplasia, therefore, post-chemotherapy neuroblastoma should be diagnosed only as neuroblastoma with chemotherapy effect.