Urinary bladder carcinoma

Painless hematuria is hallmark for clinical presentation.
Male to female ratio 3:1
Smoking is important risk factor.
Worker of dye factory,leather factory,patroliem product,solvant risk for urinary bladder carcinoma.
Transitional cell carcinoma is most common tumor.
TURBT is treatment fo choice early stage tumor(T-1)
Post TURBT BCG irrigation is adjuvent therpy of choice.
Radical cystoprostatectomy in male and radical cystectomy with hystrectomy and b/l salpingoophrectomy with excision of ant wall of vagina is option of choice for T2 and above tumor.

Testicular tumor

Seminoma is most common testicular tumor.
Undescended testis is important risk factor.
Most common presentation is painlesss lump in testes.
USG of testes to diffrentiate it from solid and cystic lesion.
Preop tumor marker- AFP,betaHCG,LDH.
High Inguinal orchidectomy- send specimen for HPE .
Further treatment depend on stage and HPE.http://http://en.wikipedia.org/wiki/Testicular_cancer

GIST

Most Common site-Stomach
Origin-C Kit Receptor of Tyrosin Kinase
C/f- Asymptomatic and incidental finding
-obstruction
-perforation
-bleeding
inv- EUS AND GUIDED biopsy
t/t- D1 gasterectomy
Adjuvent t/t- Imatinib

Risk factor for breast cancer

Germline mutation-BRCA 1
Personal history of breast cancer
Radiation exposure
Family history -first degree family in premenopausal
Age at first child birth-older than 30yr
Hormonal replacement thrapy
Early menarche -Younger than 12yr
late menopause-older than 55yr

Role of Sentinel lymph node biopsy in gyne ca

Only in Valval malignency

Gandhi jayanti

Gift to nation

Evaluation of patient with breast lump

Tripple assesment for breast lump-
C/E---------Radiological inv(MMG/USG)--------FNAC/TRU cut biopsy
Tripple assesment diagnose 99% breast cancer
C/E suggestive of breast cancer- Firm to hard lump fixed to breast tissue, nipple retraction,dimpling,peu'd orange, axillary adenopathy.
RI- Lump with distorted architecture,spiculated margin, brnching Microcalcification.
FNA/TRU- most common HPE infiltrating intraductal typeCA.

OT List of 19th July 2010 in NRDH, Delhi

1.Undescended Testes with Rt indirect inguinal hernia- Diagnostic laproscopy with lap orchidectomy and TAPP.
2.Lap cholecystectomy

Surgery perfomed by Dr B.N.Tiwary at Delhi Divisional Hospital
Thyroidectomy
Modified Radical Mastectomy
Lap Chole
Lap Hernia
Lap Appendicectomy
Lap and Open Rectopexy
Open and Stapler Hemmoroidectomy