Breast carcinoma with metastasis to the gallbladder:an unusual case report with a short review of literature

Gallbladder metastases are very rare and usually arise from malignant melanoma, renal cell carcinoma and cervical carcinoma. Breast carcinoma tnetastatic to the gallbladder is extremely rare and only 4 cases have been reported in the English literature. We hereby report a 54-year-old lady who was diagnosed as having breast carcinoma and underwent modified radical mastectomy. One month after the operation, she developed acute abdomenal pain and underwent cholecystectomy after clinical investigation. Histopathological examination revealed metastasis to the gallbladder. Being considered a patient with tnetastatic breast carcinoma she was subjected to taxane and anthracycline-based palliative chemotherapy. Later she had CNS involvement and died of the progressive disease soon after few months.     

A case of colouterine fistula managed laparoscopically

Fistulas between the uterus and bowel are rarely reported. We report successful laparoscopic management of a colouterine fistula caused by a foreign body in the uterus. Fistulas between the gastrointestinal tract and the female genital tract are usually found between the vagina and rectum as a result of complications of childbirth or iatrogenic trauma. Communication between the uterus and bowel is rarely reported. We report successful laparoscopic management of an unusual case of colouterine fistula caused by a foreign body in the uterus.     

Tooth in a cyst — Is it always a dentigerous cyst?

We present the case report of an 18-year-old female patient who presented with unilateral nasal obstruction. Computed tomography scanning revealed an unerupted molar in the posterior wall of the right maxillary sinus with a cystic swelling in the sinus. The preoperative diagnosis was a dentigerous cyst. The patient underwent endoscopic removal of the cyst and tooth. The operative findings and histopathology showed that it was an odontogenic keratocyst. This paper stresses the importance of diagnosing this condition and that a tooth in a cyst is not always dentigerous.     

Mucormycosis: A retrospective study

A retrospective study has been carried out in a hospital over the past 5 years on 13 patients of mucormycosis. The study included evaluating the etiology, pathology, clinical features, management, and complications of mucormycosis. The results and conclusions have been studied and summarised in our paper. Dept of E. N. T. K. E. M. H.     

Necrotising fasciitis of the neck

Necrotising fasciitis is a fulminant soft tissue infection that causes necrosis of fascia and subcutaneous tissue while sparing skin and muscle initially. It is most commonly seen in adults involving the perineum, extremities and and minal wall. Immunncompromised patients are at an increased risk of developing this infection. These infections require early diagnosis, aggressive surgical debridaient and appropriate antibiotic therapy. Mortality rates have been reported to be as high as 52 and 73% in general surgery literature.(Freuschtag et al, 1985., Rouse et at 1982). Necrotising fasciitis of the head and neck is rare. The commonest cause is secondary to denial infections. We report a case of necrotising fasciitis of the neck secondary to a peritonsillar abscess in a previously healthy individual. The pathogenesis and treatment of this fulminant infection are also discussed.     

MRI diagnosis of suspected atlanto-occipital dissociation in childhood

Objective. To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Materials and methods. Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Results. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1–2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. Conclusion. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors. Received: 11 February 1998 Accepted: 20 November 1998