Primary non Hodgkin's lymphoma of talus in a child—A rare presentation

We report a rare case of primary non-Hodgkin's lymphoma of bone which presented with an osteolytic lesion of the head of the right talus which to the best of our knowledge is the first case to be reported in the paediatric age group. Early and accurate identification is necessary as it has a good prognosis.     

Emphysematous Pyelonephritis—A Case Report

A 46 year old woman with complaints of high grade fever with chills and rigor and abdominal pains for 1 week presented with shock and acute renal failure and her blood sugar was found to be highly elevated. CT scan showed extensive destruction of right renal parenchyma with gas collection within the parenchyma and in the perinephric region thus confirming the diagnosis of emphysematous pyelonephritis. The clinical presentation and radiological findings of EPN are discussed.     

Asymptomatic dedifferentiated liposarcoma mimicking renal cell carcinoma—A rare case report and review of literature

Introduction

Soft tissue sarcomas are rare and account for one percent of all cancers globally. Approximately 15% of these tumours are found in the retroperitoneum and have a peak incidence at around 40 to 60 years of age.

Intestinal Obstruction due to Meckel’s Diverticulum: A rare presentation

Meckel’s diverticulum occurs in about 1–3% of general population. The majority of them are asymptomatic and incidentally found at laparotomy. The most common complication due to Meckel’s diverticulum in adults is intestinal obstruction. The frequency of symptoms decreases with age. Enteroliths are rarely formed in a Meckel’s diverticu-lum and are known to cause intestinal obstruction. These should be considered in the differential diagnosis of radio-opaque shadows in the plain abdominal films. We describe a rare presentation of Meckel’s diverticulum in an elderly woman.     

Isolated retroperitoneal hydatid cyst in a child: a rare cause of acute scrotal swelling?

Hydatidosis affects almost every region of the body. Although adults are mostly affected, children also suffer from the disease especially in endemic areas. The usual affected location is the liver, lung, spleen, brain, and kidney. We report a hydatid cyst located in a retroperitoneal location presenting with a sudden scrotal extension in a 7-year-old child. The finding presented a diagnostic dilemma vis-à-vis obstructed inguinal hernia.     

Herniography: a reliable investigation avoiding needless groin exploration—a retrospective study

Introduction  Herniography has been shown to be useful in the detection of occult groin hernias in patients with a history of groin pain. We performed a retrospective review to assess our experience of this investigation. Methods  The notes of 170 patients who underwent herniography between 1995 and 2004 were reviewed. The results of herniography and subsequent treatment and follow-up were investigated. Results  Of the 170 patients who underwent herniography, 84 patients (49%) had positive herniograms, indicating the presence of hernia. Twelve of these were patients with chronic groin pain post hernia repair. All patients reported as having a positive herniogram underwent surgical exploration, which confirmed the presence of herniae, which were repaired and patients reported symptomatic benefit on further follow-up. The remaining 86 patients (51%) had a normal herniogram; 20 patients presented with groin pain after hernia repair and were referred to a pain management team. There were two minor complications of the procedure and no major complications. Twenty patients were prevented from undergoing needless surgical re-exploration by the use of this technique. Conclusion  Herniography has great value in excluding inguinal hernia in patients with chronic symptoms in the groin. It is a useful diagnostic tool for the identification of clinically occult herniae and this investigation can prevent needless surgery and re-exploration in those cases with previous hernia repair.     

Ectopic hamartomatous thymoma — A truly rare neoplasm: Report of a case

An ectopic hamartomatous thymoma is an extremely rare benign neoplasm that commonly occurs in the lower neck region. It has distinctive pathological features that include haphazardly arranged spindle cells, epithelial cells, and mature fat tissue. Its histogenesis is still controversial. This report presents a case of a 26-year-old man with ectopic hamartomatous thymoma in the left supraclavicular region, and discusses the current knowledge regarding this type of lesion. Clinicians as well as pathologists should be aware of the existence of this disease so that it can be identified correctly.     

Garré's chronic diffuse sclerosing osteomyelitis of the sacrum: a rare condition mimicking malignancy

Garré's chronic diffuse sclerosing osteomyelitis (DSOM) is a rare disease that occurs most commonly in the mandible. We present a case of sacral DSOM that simulated an expanding destructive sacral tumour. Treatment was conducted on the basis of the available experience with the mandibular form of the disease, with partial symptomatic relief, but progressive sclerosis of the sacral lesion. To the best of our knowledge, this is the first case initially presenting in the sacrum. As an osteolytic expanding lesion simulating malignancy, it is important to recognize this entity in the sacrum.     

Parosteal lipoma of humerus—A rare case

INTRODUCTIONParosteal lipoma is an extremely rare benign tumor composed mainly of mature adipose tissue with a bony component.PRESENTATION OF CASEThis study reports the case of a 65-year old woman with a big mass on the posteromedial aspect of the right upper arm since 1 year. The swelling was a slow growing, painless, nontender, immobile mass which was not fixed to skin. She had no complaints of painful or restricted movements of the shoulder joint. She had no history of trauma to the upper limb.MRI revealed a large 13 cm × 5 cm × 8 cm well defined, nonenhancing, lobulated, heterointense, predominantly fat intensity lesion with a small area of chondroid component measuring 2 cm × 1.6 cm in posteromedial aspect of proximal right humerus, seen completely separate from the adjacent muscles.DISCUSSIONThe patient underwent surgery under general anesthesia. Vertical elliptical incision was taken over the posterior border of the upper arm over the mass. The tumor was below the lower part of deltoid near the upper end of humerus, which formed the roof, and between the long and medial heads of triceps muscles. A part of tumor, measuring 6 cm × 5 cm × 5 cm, was under the long head of triceps displacing it along with radial nerve and vessels medially while the other part, measuring 7 cm × 6 cm × 3 cm, was under the medial head of triceps displacing it laterally. The tumor was excised undocking its periosteal attachment. The specimen weighed 250 g. On histopathology, the lesion was composed of mature lipocytes that had an intimate relationship with the periosteum. No cellular atypia or lipoblasts were seen.CONCLUSIONParosteal lipomas are rare neoplasias with no proven malignant potential. These tumors can be resected without much damage to the adjacent structures, thus preserving the function of the upper limb.     

Hysterectomy in a male? A rare case report

INTRODUCTION

Persistent Mullerian duct syndrome is a rare form of male pseudo-hermaphroditism characterized by the presence of Mullerian duct structures in an otherwise phenotypically, as well as genotypically, normal man; only a few cases have been reported in the worldwide literature. A great variety of organs have been found in indirect inguinal hernial sacs.

PRESENTATION OF CASE

We report a case of 70 year old man, father of 4 children with unilateral cryptorchidism on the right side and left-sided obstructed inguinal hernia containing uterus and fallopian tube (that is, hernia uteri inguinalis; type I male form of persistent Mullerian duct syndrome) coincidentally detected during an operation for an obstructed left inguinal hernia.

DISCUSSION

PMDS is usually coincidently detected during surgical operation, as was in our case. However pre-operative ultrasonography, computerized tomography and MRI allow possible pre-operative diagnosis.³

CONCLUSION

In cases of unilateral or bilateral cryptorchidism associated with hernia, as in our patient''s case, the possibility of PMDS should be kept in mind.