Primitive neuroectodermal tumor of the kidney is a rare tumor. A total of approximately 79 primary renal cases have been reported to date. Primitive neuroectodermal tumors occur preferentially in the soft-tissues of the paravertebral region and chest wall, less frequently in extremities, with a slight male predominance. We report a case of primitive neuroectodermal tumor of the kidney in a 17-year-old male with a pre-operative diagnosis of renal cell carcinoma-stage 4. The patient underwent radical nephrectomy and histopathological examination revealed a highly aggressive tumor of monotonous sheets of round cells with focal areas of rosette formations and high mitotic rate with Ki67 index of 25-30%. Tumor cells were positive for CD 99 confirming the diagnosis of primitive neuroectodermal tumor. Primitive neuroectodermal tumor of the kidney needs to be kept in mind as a differential diagnosis in young adults presenting with a large kidney mass.

Background: The role of apoptosis is not clear in leprosy and lepra reactions. Objectives: To evaluate frequency of apoptosis in skin lesions of borderline leprosy and Type 1 lepra reaction. Methods: Sixty patients with borderline leprosy (30 with clinically diagnosed Type 1 reaction (T1R) (Group I) and 30 without clinical evidence of reaction (Group II)) were analyzed in this prospective study. Apoptosis was detected by two different methods for comparison, that is, histopathologic examination (HPE) and deoxyribonucleic acid (DNA) fragmentation and electrophoresis. Quantification of apoptotic bodies/10 high power fields (HPF) was also done. Results: Out of 30 cases, apoptosis was detected in 29 cases in Group I and 24 cases in Group II by HPE (P = 0.103), whereas, with the use of DNA electrophoresis it was detected in 24 cases in Group I and 18 cases in Group II (P = 0.091). On quantitative estimation it was found that number of apoptotic bodies are higher in Group I in comparison to Group II (2.77 vs 1.99), which is statistically significant. Conclusions: There was moderate agreement (κ = 0.47) between the two methods of apoptosis detection. Apoptosis was seen more in patients with T1R both qualitatively (statistically nonsignificant) and quantitatively (statistically significant). Clinical significance of this novel finding is that apoptosis can be used as one of the variables for diagnosis of T1R to increase detection rate.

Background Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy with limited effective systemic therapies. Modified FOLFIRINOX (mFOLFIRINOX) and gemcitabine plus nab-paclitaxel (GN) are commonly used first-line regimens. The purpose of this study is to evaluate real-world efficacy (response rates, progression-free survival (PFS) and overall survival (OS)) and toxicity (grade 3/4 hematologic and non-hematologic toxicities) of first-line mFOLFIRINOX and gemcitabine plus nab-paclitaxel in patients with advanced pancreatic ductal adenocarcinoma. Methods We conducted a retrospective analysis of 64 patients with advanced PDAC treated between May 2023 and May 2025. Thirty patients received GN, and 34 received mFOLFIRINOX. Efficacy outcomes included overall response rate (ORR), clinical benefit rate (CBR), PFS, and OS. Toxicities were graded using Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Statistical analyses included Kaplan-Meier survival estimates and Cox regression modeling. Results The median age was 59 years (range: 32-75), with a predominance of male patients (68.2%). Most had Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1 (89.1%). Patients receiving mFOLFIRINOX were younger and more likely to have tumors in the pancreatic head, whereas elevated CA19-9 levels were more common in the GN group. ORR was 57% in the GN arm and 52.9% with mFOLFIRINOX (P=0.179), while CBR was comparable (77% vs. 76.5%, P=0.985). The median progression-free survival of patients receiving GN was 6.97 months and 8.5 months with FOLFIRINOX (HR: 1.14; 95% CI: 0.58 - 2.22; P=0.713). mFOLFIRINOX had a median overall survival benefit (HR: 1.352; 95% CI 0.63 - 2.90; P=0.428), but this did not reach statistical significance. One-year OS was higher with mFOLFIRINOX (91.6% vs. 82.4%), as was 1.5-year OS (76.3% vs. 55.0%). Paradoxically, one-year PFS favored GN (32.5% vs. 20.3%). Grade 3/4 hematologic toxicities were more frequent with mFOLFIRINOX (e.g., neutropenia: 20% vs. 8.8%, anemia: 20% vs. 5.9%). GN was associated with more grade 3/4 vomiting (38.2% vs. 10%, P=0.009), diarrhea (26.5% vs. 3.3%, P=0.011), and neuropathy (29.4% vs. 6.7%, P=0.02). Dose modifications and treatment delays were similar, though delays were more frequent in the mFOLFIRINOX arm. Conclusions Both mFOLFIRINOX and GN demonstrated comparable efficacy in real-world treatment of advanced PDAC. mFOLFIRINOX offered better long-term OS but carried a higher risk of hematologic toxicity, while GN was associated with greater gastrointestinal and neurological adverse effects. Treatment selection should be guided by patient-specific factors such as comorbidities and tolerance to toxicity. Sequential treatment planning, including access to second-line therapy, significantly impacts survival and should be integral to care strategies.

Purpose: Gallbladder cancer is highly prevalent in North India and associated with poor survival in advanced disease. Although chemoimmunotherapy improves outcomes in biliary tract cancers, prospective data specific to gallbladder cancer remain limited. We compared gemcitabine-cisplatin (GemCis) with or without durvalumab in patients with advanced gallbladder cancer. Methods: In this ambispective observational cohort study at a North Indian tertiary cancer center (Jan 2023–June 2025), 98 patients with unresectable/metastatic gallbladder cancer received GemCis alone (n=48) or GemCis+durvalumab (n=50) based on drug availability and patient preference after counseling. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), and safety. Results: Baseline characteristics were balanced. ORR was 30.0% with durvalumab vs 18.8% with GemCis alone; DCR was 56.0% vs 39.6%. Median PFS was 6.1 vs 4.1 months (HR 0.62, 95% CI 0.45–0.88; P=0.007). Median OS was 14.2 vs 9.7 months (HR 0.69, 95% CI 0.52–0.91; P=0.012). Grade ≥3 adverse events were similar between arms. Immune-related adverse events occurred in 20% receiving durvalumab (grade ≥3: 2%), all manageable. Conclusions: In this gallbladder cancer-specific cohort, durvalumab added to GemCis was associated with improved PFS and OS without increased toxicity. These findings support further evaluation of chemoimmunotherapy for advanced gallbladder cancer in high-incidence regions.