Sangram Keshari Panda - Academia.edu (original) (raw)

Uploads

Papers by Sangram Keshari Panda

Introduction: The incidence of internal hernias is 0.2% to 2%. It is a rare cause of intestinal o... more Introduction: The incidence of internal hernias is 0.2% to 2%. It is a rare cause of intestinal obstruction and leads from 0.5 to 4.1% of acute obstruction cases caused by hernia. Presentation of Case: We report a case of internal hernia traversing the lesser sac with a primary defect in the greater omentum and a second defect in the lesser omentum, causing small bowel obstruction which is extremely rare. Discussion: The most common causes of small bowel obstruction in adults are adhesions bands, malignancy and hernias. Internal Hernia (IH) is defined as herniation of viscera through a normal or abnormal aperture within the peritoneal cavity. Internal hernias are infrequent, accounting for 0.2 to 0.9% of the cases of intestinal obstruction. Transomental hernias through the greater or lesser omentum are even rarer, representing 1 to 4% of all internal hernias, with hernias occurring through both the omentum being extremely rare as in our case. Conclusion: When a case of acute intesti...

Indian Journal of Surgical Oncology, 2021

The oncological necessity of submandibular gland removal during neck dissection for oral cavity s... more The oncological necessity of submandibular gland removal during neck dissection for oral cavity squamous cell carcinoma surgery has remained controversial. This study was aimed to determine the rate of SMG involvement and assess the feasibility of submandibular gland (SMG) preservation. We present a prospective study conducted at a tertiary cancer center from June 2017 to May 2019. All patients of oral squamous cell carcinoma who underwent primary surgery with neck dissection were included and analyzed for incidence and predictive factors for incidence of level IB nodal and SMG involvement as per CAP guidelines. A total of 60 patients were inducted in the study, wherein 63 neck dissections were performed including bilateral dissection in three cases. There was involvement of SMG in 6 patients with two cases each in floor of mouth cancer, gingivo-buccal, and alveolar lesions. The SMG was involved by direct contiguous spread from the primary lesion in two cases, extra-capsular extensi...

International Surgery Journal, 2022

Solitary fibrous tumour (SFT) occurs rarely in extrapleural sites such as head and neck region. H... more Solitary fibrous tumour (SFT) occurs rarely in extrapleural sites such as head and neck region. Head and neck region is affected in 16% cases occurring usually in orbit and paranasal region and are benign variants. Though usually benign, Malignant SFT in buccal space is extremely rare and comes with challenges in diagnosis and management. We report a rare case of Malignant SFT in the buccal space in a 70-year-old- gentleman who presented with slow growing mass in left cheek. Patient was treated with surgical excision and adjuvant radiotherapy and is on regular follow up. Malignant SFTs are difficult to diagnose due to lack of specific histological pattern but certain IHC and genomic markers can help. Buccal space malignant SFT can be managed by wide local excision and adjuvant radiotherapy in cases of large tumour size and margin positive resection.

Background: Pectoralis Major MyoCutaneous (PMMC) flap has been commonly used since decades for pl... more Background: Pectoralis Major MyoCutaneous (PMMC) flap has been commonly used since decades for plastic reconstruction in oral cavity cancer surgery. However, rarely the PMMC donor site develops tumor recurrence. Management includes surgical resection in unifocal lesion or salvage radical chemoradiotherapy in clinico-radiologically nonmetastatic unresectable disease which results in satisfactory tumor related outcomes.Case presentation: A 46 year gentleman known case of Squamous Cell Carcinoma left Retromolar Trigone after surgery and adjuvant radiotherapy presented with isolated recurrence at PMMC flap donor vascular pedicle site which was abutting left subclavian vein and so was managed with concurrent chemo-radiotherapy with curative intent and is on follow up since 2 years with no evidence of recurrence.Conclusions: Isolated PMMC flap donor site recurrence in oral cavity squamous cell carcinoma management is complex, with surgical intervention with excision of such lesions in abs...

International Journal of Surgery Case Reports, 2014

INTRODUCTION: Follicular carcinoma of thyroid usually behaves in an indolent manner with low meta... more INTRODUCTION: Follicular carcinoma of thyroid usually behaves in an indolent manner with low metastatic potential. Distant metastases as initial presentation is rare in follicular carcinoma; especially in young patients. PRESENTATION OF CASE: We report the clinical, pathological features and the management of three different cases of follicular carcinoma of the thyroid with unusual presentations at the time of diagnosis. First case presented as thyroid abscess, second case with a large skull swelling in a pre-exiting goiter and the third case with a swelling in the sternum. DISCUSSION: Follicular carcinoma of thyroid is the second category of well-differentiated thyroid cancer that constitutes about 10% of all thyroid malignancies. Blood borne metastasis is common with spread to lung, bone and other solid organs. In less than 10% cases of follicular carcinoma, there is evidence of lymphatic involvement. The patients' presentations above are highly unusual. CONCLUSION: Recognizing these cases has a significant impact on clinical decision-making and prognosis of the patients. Treatment in these patients should be individualized and an alternative therapeutic approach should be considered.

Global Surgery, 2015

Aim: Gastric cancer is the fourth common cancer and is the second leading cause of cancer-related... more Aim: Gastric cancer is the fourth common cancer and is the second leading cause of cancer-related mortality worldwide. Majority of the patients are diagnosed when the cancer is at an inoperable or metastatic stage. Median survival of patients with advanced tumors remains poor. Only 7-10 months. The best promise to improve this poor survival is provided by new agents acting against specific molecular targets.Of these, HER-2 is currently in the spotlight. Frequency of HER2 expression in gastric cancer has been reported from different geographic zones with a range of 6% to 35%. The purpose of this study was to evaluate the frequency of HER2 expression in gastric adenocarcinoma and its association with various clinicopathological characteristics and survival in Odisha. Methods: A total of 150 patients undergoing gastric resection surgery (radical/palliative) for gastric adenocarcinoma at S.C.B. Medical College and hospital, Cuttack were included in this study. They were prospectively evaluated using Immunohistochemistry (IHC). HER2 overexpression was confirmed in 28 of 150 (18.7%) patients. Significantly different HER2 positivity rates were observed when comparing intestinal-type gastric cancers with diffuse/mixed-type cancers (28.6% vs12.8%, P=0.01), and moderate-differentiated cases with poorly differentiated cases (38.7% vs16.7%, P=0.01). Positive reactivity with anti cerbB-2 antibody was significantly more frequent in UICC stage-III (40%, p=0.005). No relationship was observed between the HER2 positivity rate and sex, age, tumor site. The HER2 positive gastric cancer patients did not show statistically significant reductions in mean survival times,1-year or 2-year survival rates. The well differentiated HER2 positive patient group exhibited shorter mean survival time (18.5 mo vs 27.5 mo) and lower 1-year and 2-year survival rates compared to the HER2 negative group (84.42% vs 96.00%; 50.65% vs 86.89%; P=0.0123). Conclusion: HER-2/neu overexpression is common in gastric carcinoma and more prevalent in intestinal and moderate differentiated subtypes. HER2 status has a mild impact on gastric cancer patient survival and may not constitute an independent prognostic factor in gastric cancer patients.

International Journal of Surgery Case Reports, 2014

INTRODUCTION: Fibroadenomas are among the most common tumours of the female breast, occurring mos... more INTRODUCTION: Fibroadenomas are among the most common tumours of the female breast, occurring most frequently in women of child-bearing age, especially those under 30 years. PRESENTATION OF CASE: We report a case with a total of 27 fibroadenomas presenting bilaterally of a 46-year-old woman. The histopathologic and immunophenotypic features of the fibroadenomata are described. DISCUSSION: Most fibroadenomas are present as single mass, however the presence of multiple fibroadenomata can be seen in 15-20% of the patients. It has been reported that the average number of masses in cases of multiple fibroadenomas is 3-4 in a single breast but occurrence of more than five fibroadenomas in an individual patient is much less common. CONCLUSION: There are few reports of multiple fibroadenomas. We report this case hoping to expand the literature and to provide insight to aetiology of multiple fibroadenoma formation and advice on management.

International journal of surgery case reports, Jan 2, 2014

Appendix duplication is an extremely rare congenital anomaly that is seen in 0.004-0.009% of appe... more Appendix duplication is an extremely rare congenital anomaly that is seen in 0.004-0.009% of appendectomy specimens. Duplicated appendix may be associated with number of congenital anomalies. In this case report, we are presenting a rare case of duplicated vermiform appendix with a co-existing Meckel's diverticulum. Anomalies of appendix are rare and duplication of vermiform appendix is extremely rare. In 1936, Cave classified appendiceal duplication for the first time which was modified by Wallbridge in 1963 into three types. Concomitant malformations or duplications of the large intestine or the genitourinary system may be present, especially in types B1 and C probably due to their similar embryological origin. Here we are presenting a very rare case report of type B1 appendix anomaly associated with Meckel's diverticulum. Surgeons should be aware of these conditions because of the possible clinical implications.

International Journal of Surgery Case Reports, 2015

INTRODUCTION: Mucormycosis caused by order mucorales, an ubiquitous saprophytic mold found in soi... more INTRODUCTION: Mucormycosis caused by order mucorales, an ubiquitous saprophytic mold found in soil and organic matter worldwide, is a rare but invasive opportunistic fungal infection. Gastrointestinal mucormycosis is the most uncommon clinical presentation being particularly rare, accounted for 4-7% of all cases. PRESENTATION OF CASE: We report an unusual presentation of mucormycosis of ascending colon that was simulating carcinoma colon. DISCUSSION: GI mucormycosis most commonly involves the stomach (57.5%), followed by the colon (32.3%) and the ileum (6.9%). Initial presentations may be abdominal pain and distension, fever, and diarrhoea. Colonic mucormycosis presenting as a mass with altered bowel habit, melena and abdominal pain in our case is extremely difficult to differentiate it from carcinoma colon. A definitive diagnosis of mucormycosis is almost always ascertained by histopathological evidence of fungal invasion of tissue. CONCLUSION: Knowing these unusual presentations of this disease, surgeon need to maintain a high index of suspicion and perform timely and appropriate diagnostic evaluation to improve patient outcome. Prompt diagnosis, reversal of predisposing conditions, and aggressive surgical debridement remain cornerstones of therapy for this deadly disease.