Marjolin Ulcer

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Q) True about Marjolin's ulcer

a) lymphatic spread is common

b) They are painful

c) Aggressive and fast growing tumors

d) Squamous cell carcinoma is the most common type

d. squamous cell carcinoma

When a SCC or BCC occurs in a long standing scar, it is called marjolin's ulcer.

Marjolin's type of ulcer is a malignant change that can occur in any long standing ulcer (ie venous ulcer)

Scar tissue is devoid of lymphatics, so no lymphatic spread. Lymphatic spread can still occur when it invades normal tissue. also nerve endings are not in scar tissue, so pain is a late feature

They are slow growing tumors, and squamous cell carcinoma is the most common type. Slow growth is again due to avascular characterstic

Contrast hazards in radiology

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Q1. Not true about hazards of contrast medium use in radiological interventions?

a) Use of newer agents have improved the risk of sudden death

b) Low osmolar contrast agents are better than previously used high contrast medium

c) After contrast injections, patients should be observed for 30 mins

d) Metformin can be continued in patients with normal renal function
Answer 1

Squamous cell cancer of upper esophagus

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Q ) Old 65 years male with SCC upper Esophagus and Grade IV Dysphagia. Next treatment

a) Definitive CRT

b) Preop Chemo then THE

c) Chemotherapy

d) Neoadjuvant crt followed by three field esophagectomy


Radical Cholecystectomy

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 Q) Radical cholecystectomy includes all except

a) Segment IVb and Va

b) 2cm wedge resection

c) Rt Extended Hepatectomy

d) Paraaortic lymphnodes

Answer and Explanation here

History of Radical Cholecystectomy

  1. Early 20th century removal of gall bladder and wedge of liver ( No lymphadenectomy) 
  2. In 1954, Glenn et al - radical resection procedure with intended regional lymphadenectomy (portal lymph node dissection), designated as “radical cholecystectomy” (Glenn operation)
  3.  Fahim et al in 1962 advocated radical resection consisting of hepatectomy and portal lymph node dissection

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Borderline resectable pancreatic malignancy

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Q)False in Borderline resectable Pancreatic malignancy

a) Solid tumor contact with the IVC <180

b) Solid tumor contact with the SMA of ≤180 degree

c) Solid tumor with CHA involvement of 2.5 CM

d) Solid tumor contact with the SMV or PV of >180 degrees