Intra-osseous glomus tumour: a case report.

A rare case of intra-osseous glomus tumour is described, together with a review of eight other reported cases. Electron microscopic studies suggest that glomus cells, the histogenesis of which has not been completely resolved, originate from smooth muscle. Studies in this case support that hypothesis: they showed the important role of contraction of the glomus cells in eliciting the peculiar type of pain.     

Synchronous bilateral renal tumour: a case report

We report a case of synchronous bilateral renal carcinoma treated by partial nephrectomy on the right and total nephrectomy on the left. Follow-up at 42 months after surgery showed no recurrence of the disease. The increasing use of diagnostic imaging techniques such as ultrasound tomography, computerised tomography and nuclear magnetic resonance now allows even small-sized renal formations to be identified. Synchronous bilateral renal tumour has a favourable prognosis, especially when compared with single or asynchronous renal tumours. The recommended intervention is total monolateral nephrectomy combined with partial nephrectomy. The treatment of neoplasms at a more advanced stage, of such a nature as to necessitate bilateral nephrectomy or chemotherapy, results in a significant increase in mortality. Recently, biological therapy has been proposed as a more promising short-term option using interferon-alpha (IFN-alpha) and gamma.     

Phyllodes tumour in pregnancy: a case report

Phyllodes tumour (cystosarcoma phyllodes) is a rare breast tumour that grows rapidly and to a relatively large size, especially during pregnancy. These tumours may be classified as benign, borderline or malignant. They have a high incidence of local recurrence but little tendency to metastasize to distant organs. The question of whether the tumour is hormone dependent remains unresolved. This report describes the case of a patient who had a phyllodes tumour that first became apparent in her 31st week of pregnancy. After enucleation and subsequent wide excision she remained tumour free through a second pregnancy. Although the follow-up period is short, it appears that subsequent pregnancy is not necessarily associated with recurrent or new disease for patients who have had their initial tumour completely excised. The goal for the management of these tumours is complete surgical excision.     

Gigantic recurrent abdominal desmoid tumour: a case report

Deeply seated fibromatosis or desmoid tumour (DT) is a rare entity characterized by benign proliferation of fibroblasts. Although non-malignant, this tumour can be life-threatening due to its invasive property and high recurrence rate. We report a unique case of a huge recurrent abdominal DT (36 cm in diameter, 25 kg in weight) that caused pressure necrosis and sloughing of the overlying anterior abdominal wall, and produced a large fungating mass protruding outside the abdomen. Although preoperative neoadjuvant therapies were all ineffective, radical surgical removal of the tumour was successful. The procedure was followed by an excellent clinical recovery and the patient is still alive with no evidence of recurrent disease after a 6-year follow-up. We recommend surgical removal of DT regardless of its size and in particular in cases where there is no or inadequate response to neoadjuvant therapy.     

Giant-cell tumour in the cervical spine: a case report

A forty-six-year-old man presented with a two-month history of increasing neck pain of insidious onset. He received treatment from his familty doctor and chiropractor consisting of analgesics and manipulation respectively, both of which did not offer relief. The patient presented to University Hospital where plain radiographs and CT showed a pathological fracture of the C4 vertebral body. A neoplasm was suspected and surgical excision revealed a giant-cell tumour of bone. This type of neoplasm is rare in the spine and difficult to manage in this site. This case highlights some of the problems encountered in the treatment of giant-cell tumour of the spine.     

Ectopic thyroid masquerading as submandibular tumour: a case report

An ectopic thyroid gland may be present in any location along the path of migration from the foramen caecum to the mediastinum. The most common locations for an ectopic thyroid are the lingual thyroid followed by median cervical cysts. An ectopic thyroid in the submandibular region is extremely rare. We present the case of a 44-year-old patient with ectopic thyroid tissue in submandibular space and a review of the literature related to it.     

Hepatoma presenting as a bone tumour: a case report.

Osseous metastases from hepatoma are rare. One patient who had a lesion in the upper humerus is presented.     

Atypical presentation of a glomus tumour: A case report

A 46-year-old man presented with an extremely painful, 1 cm, mobile, nodular mass located on the medial side of his right elbow. Symptoms failed to respond to conservative treatment. Ultrasound and Doppler flow imaging revealed a well-defined, round hypoechoic mass. Under local anesthesia, the mass was resected and the wound closed without complication. Final pathology diagnosed the lesion as a glomus tumour, solid type. Histology staining showed the tumour cells were positive for antibodies to vimentin and muscle actin. It is unusual for a glomus tumour to be located anterior to the medial epicondyle of the right arm. Hand surgeons most commonly encounter glomus tumours in the nailbeds of the fingers.     

Cerebellar haemorrhage and tension pneumocephalus after resection of a Pancoast tumour

Summary We present an unusual case of cerebellar haemorrhage followed by tension pneumocephalus several days after thoracotomy for resection of a Pancoast tumour. The postoperative course of the 32-year-old patient was complicated by a cerebellar haemorrhage and hydrocephalus caused by compression of the fourth ventricle. Immediate surgical evacuation of the haemorrhage and placement of an external ventricular drain was performed. Respirator ventilation maintaining a continuous positive airway pressure was required. Following weaning and extubation the patient rapidly deteriorated and became comatose. A cranial CT scan revealed a dilated ventricular system filled with air, and air in the subarachnoid space. Recovery of consciousness was observed after aspiration of intracranial air through the ventricular drainage. Recurrent deterioration of consciousness after repeated air aspiration indicated rapid refilling of the ventricles with air.The patient underwent emergency surgical re-exploration of the thoracic resection cavity: dural lacerations of the cervico-thoracic nerve roots C8 and Th1 were identified. Subarachnoid-pleural fistula, cerebellar haemorrhage and tension pneumocephalus after discontinuation of continuous positive airway pressure respiration are unusual complications of thoracic surgery. We discuss the putative pathomechanisms and present a brief review of the literature.     

A rare submucosal tumour of stomach-glomus tumour: A case report

IntroductionGlomus tumour (GT) of the stomach is a rare submucosal mesenchymal tumour. Gastric glomus tumours are clinically recognized as benign. Nevertheless, some show biological behaviour similar to that of malignant lesions and presurgical confirmation is often impossible.Presentation of caseA 32 year old female who presented with epigastric pain and was subsequently investigated for a antral tumour of the stomach and Wedge resection of tumour was done. Immunohistochemistry demonstrated strong positivity of smooth muscle actin and vimentin with low rate of mitosis studied by ki-67.DiscussionWe discuss the preoperative investigation, the diagnostic problems and the surgical treatment of the patient with gastric glomus tumour.ConclusionGlomus tumours should be considered as differential diagnosis for submucosal tumours of stomach.     

Gastrointestinal stromal tumour presenting with duodenal-jejunal intussusception: a case report

Duodenal-jejunal intussusception is an extremely rare occurrence and has never been reported in the context of a gastrointestinal stromal tumour (GIST). We present the case of a duodenal GIST which presented with major intestinal haemorrhage in addition to duodenal-jejunal intussusception.     

Melanotic neuroectodermal tumour of infancy: report of a case.

A case of melanotic neuroectodermal tumour occurring in a seven-month-old male infant is reported. The aetiopathogenesis, clinical features, treatment and prognosis of the condition are discussed. Tumours of the jaw in infancy are extremely rare, and pigmented tumours still rarer. One such case of pigmented tumour of the maxilla is the subject of this report.     

Giant cell tumour of the first metatarsal: a case report

The classical giant cell tumour (GCT) is a solitary lesion characterised by benign-appearing osteoclast-like giant cells and stromal cells that originate within the epiphysis of adults. Long tubular bones (75–90%) are frequent sites of involvement and make up 5% of all primary bone tumours. The foot is a rare site for GCT; less than 50 cases of GCT in foot bones have been reported in the literature. It is easy to misdiagnose a lytic lesion in the foot for commoner disorders. We report a case of GCT of the first metatarsal and highlight the importance of early and proper diagnosis.