Visual Corner
 
A Case of Tropic Ulcer
 
 

Dr. Rajneesh Kumar Sharma, BHMS
NH 74, Moradabad Road, Kashipur
Uttaranchal, India, Pin:244713
Phone- 05947- 275535 / 260327
Mobile :98 976 21896
Email:drrajneeshhom@hotmail.com


Introduction

        Dr. Rajneesh Kumar Sharma, a research scholar, social worker, dedicated him self for the development of Homoeopathy. He has presented many articles in scientific journals with evidence-based documents. Here the author shares his experience with adenocarcinoma of oesophagus with histopatholgical evidence.

        Adenocarcinoma of oesophagus also known as Barrett’s carcinoma is common among causian males. The incidence is more past the age of forty. The location is usually the lower part of the oesophagus affecting the columnar mucosa above the gastro oesophageal junction

         Most oesophageal adenocarcinomas arise in Barrett’s oesophagus. Many adenocarcinomas presumed to be originating from the gastric cardia, may actually be arising in a short-segment Barrett’s oesophagus. Only about half of patients relate symptoms of chronic gastro oesophageal reflux. The radiological appearance is highly variable. May present as stricture, ulcer or polypoid mass.

         In histopathology morphological range as adenocarcinoma of the stomach, from well-differentiated adenocarcinoma with relatively uniform gland formation to poorly differentiated tumors with only focal gland formation and/or mucin formation. Signet ring cell carcinoma may also occur. Major prognostic factor is clinical stage. The majority of tumors are known in late stage, hence poor overall survival.

Case History
         A female aged 50 years with the habit of beetle chewing and tobacco habit complained regurgitation of food and dysphagia. She was much debilitated and scared about her disease. She stays alone in the house.Past history revealed Herpes zoster in the past few years back. She had three abortions. Earlier she had spicy food and desires for sweets and hot food always. Family history is nothing relevant.

The Histopathogical Report 12-12-2003

         The oesophageal specimen shows hyper cellular epithelium and loss of nuclear polarity. Pleomorphic nuclei, predominantly enlarged, with marked hyperchromasia, chromatin clearing and clumping, mitoses, and prominent nucleoli are also marked. Crowded irregular glands, possibly with luminal infoldings and possibly villiform surface are evident.

Impression- Barrett’s esophagus with high-grade dysplasia.

* See the slide with report printed at the visual corner-Before treatment

 
First prescription
21-01-2004

Based on the mental symptoms and desires aversions.

Lycopodium 200 Alternate day
Hydrastis Q TDS
Follow Up 1
06-02-2004

Regurgitation+++
General improvement better

Phosphorus 1 M one dose.
SL TDS
Follow Up 2
16-03-2004

Marked improvement.

SL continued.
Follow Up 3
29-04-2004

Asymptomatic

No medicine
Histopathological Report
06-05-2004

         The specimen sent as oesophageal piece shows features of necrosed tissue with shriveled cells. Some cells show hypercellularity to mild degree. No pleomorphism seen in different neucli except hyperchromatism in some.

         Impression- faint to mild degree of dysplasia showing necrosis and hypocellular epithelium.

Result

The regression of the carcinoma with necrosis of the cancer cells.
*See the slide with report printed at the visual corner-After treatment
The patient keeps good health now and being monitored