ONCOLOGY POSTINGS KHL( MARCH 2022)

 KHL postings :

DAY 1 :Presented a case of 56 /F P3L2D1 with c/of lump of right breast since 6 months .. on examination 5 *3*3 cm lump present in right upper outer quadrant .. with no other findings like nipple discharge, distruction, paued orange or lymphnodes . FNAC done outside shows ? invasive carcinoma advised true cut biopsy and mammography .

Other follow up cases of carcinoma of breast and cervix  

DAY 2: Approch to thrombocytosis 

DAY 3: carcinoma of pancreas 

DAY 4: Carcinoma of stomach 

DAY 5: Carcinoma of rectum 

DAY 6 : Carcinoma of cervix 

DAY 7 : Recurrent carcinoma of breast 

DAY 8: 26/F P2L1 missed abortion done D and C outside twice but due to uncomfortable bleeding during 2 nd D and C emergency TAH + BSO done and HPE of the specimen of uterus showing invasive mole ( outside hospital ) ..so referred here to our hospital for further management .. on presentation patient was stable , only one beta hcg values available which was done after hystrectomy as HPE showing in invasive mole . Value of beta - HCG is 194 .. so patient as been started on Inj methotrexate 80mg in 250 ml NS over 30 mins weekly regimen .. after 1 st session her beta HCG values dropped to 26 .. which showed positive response to methotrexate 

DAY 9 : Approach to inoperable breast lump ( metastatic to bone )

DAY 10 : Hepatocellular carcinoma 

DAY 11: urinary bladder cancer 

DAY 12 : carcinoma of floor of mouth 

DAY 13 : Squameous cell carcinoma of lung 

DAY 14 : Cholangiocarcinoma

DAY 15: Approach to Pancytopenia 

13/ boy 3 rd child of non consangenous marriage ,pure vegetarian came with complaints of sob on exertion since month, fever since 15 days , yellowish discoloration of sclera since 3 days 

On admission : vitals stable , clinically pallor , icterus +, facial puffiness + , jvp increased, hyperpigmented knuckles +, platynachia + , bony tenderness +

P/A :mild spleenomegaly +

Hb -3.7, wbc- 3800, platelets 75,000 

TB -3.0 , enzymes:  normal 

LDH elevated, sr iron and B12 decreased, sr ferritin within normal limits 

Retic count : 30 ,index 3.7 

P . Smear: NCNC, macrovalucytes, fragmented cells 

DCT - negative, MP, dengue, weils test - negative 

Pancytopenia secondary to B12 deficiency ( acutely trigged by infection ) 

Plan : 1 blood transfusion done , inj B12 IM given alternate day along with folic acid 5mg and orofer xt 


DAY 16 : Approach to moderate spleenomegaly 

50/M came with complaints of pain abdomen, weight loss, early satiety since 6 months , chronic smoker and alocholic 

O/examination: pallor +, tremors + no icterus , bony tenderness 

P/A : soft, no tenderness, moderate spleenomegaly + 

Infectious: bacterial : TB, Kala azar, malaria , typhoid 

Viral: HPE 

Infiltrative: Gaucher's , glycogen storage disease, 

Malignant causes : CML, myelofibrosis, hairy cell leukaemia

Differences between CML, myelofibrosis, hairy cell leukaemia


Day 17 : Hepatocellular carcinoma 

Day 18 : carcinoma of tongue

Day 19: 

Day 20 : sunday

Day 21 : Ewings sarcoma 

Day 22 : Multiple myeloma 

Day 23: 






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