Browsing by Author "Ekanayaka, S.P.N."

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    Characteristics and survival of advanced untreated hepatocellular carcinoma of non-viral etiology
    (Indian Society of Gastroenterology, 2024) Ekanayaka, S.P.N.; Luke, N.; Thilakarathne, S.B.; Dassanayake, A.; Gunetilleke, M.B.; Niriella, M.A.; Siriwardana, R.C.
    INTRODUCTION AND OBJECTIVES Hepatocellular carcinoma (HCC) is an aggressive tumor and presents late. The underlying etiology of HCC is changing rapidly. HCC in Sri Lanka is unique due to its predominant non-viral etiology (nvHCC) but lacks survival data.METHOD Data was collected from patients who presented with HCC from 2011 to 2018. There were 560/568 (98.6%) nvHCC. The patients who were not candidates for tumor-specific treatment (149/560 [26.7%]) were selected. Population characteristics, demographic data, tumor characteristics, survival and factors affecting survival were analyzed.RESULTS The median age was 64 years (range 30-88) and 86% (n = 129) were males. As many as 124 (83%) were cirrhotic. The overall performance score was 80%. Nearly 21/124 tumors were detected in cirrhotic screening. Tumors were single nodular in 32 (21%), up to three nodules in 28 (18%), more than three nodules in 33 (22%) and diffusely infiltrating in 56 (37%). The major venous invasions were present in 78 (52.3%). Extra-hepatic tumor spread was seen in 19 (12.7%) (lungs 13 [72.2%], bones 2 [11.1%]). The median survival of patients receiving palliative care was three months (1-43 months). Tumor size and cirrhotic status were significant predictors in univariate analysis.CONCLUSION A quarter of nvHCCs were not amenable to treatment at presentation as they had dismal survival.
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    Unusual presentation of jejunal gastrointestinal stromal tumour with large metastatic deposits in the liver and peritoneum: Advantageous surgical exploration
    (University of Kelaniya, Sri Lanka, 2021) Ekanayaka, S.P.N.; Nishshanka, N.M.P.S.
    Gastrointestinal stromal tumour (GIST) is a relatively rare neoplasm accounting for less than 3% of all malignant gastrointestinal tumours. The diagnosis of GIST is often delayed due to its indolent symptoms. Patients present in advanced stages with metastatic deposits and at times unresectable stage. This report presents a case of a jejunal GIST with subsequent metastasis to the liver and multiple peritoneal deposits in a 59-year-old female patient managed surgically.