Chondroid syringoma (CS) is a rare benign tumor of the sweat gland. It generally presents as a painless, slowly growing, subcutaneous swelling, typically located on the head and neck region. The majority of the cases develop in middle aged and elderly males. We present a case of CS located over the right thumb of a 25-year-old male. The diagnosis was made initially by cytological evaluation and later confirmed by histopathological examination. There was no recurrence on two year follow up after the complete surgical excision of the tumor.
BACKGROUNDSitus inversus totalis is rare with incidence of one in ten thousand. It is usually associated with dextrocardia (true mirror image) with only 3% -5% incidence of congenital heart disease, the most common being transposition of the great vessels. However, surgeons, radiologists and general practitioners should be aware of this condition as it may lead to wrong diagnosis and surgical mishaps.
MATERIALS AND METHODSIn this study, we have included the patients who were diagnosed with dextrocardia on routine chest x-ray over a 5-year period from March 2012 to February 2017. We studied the imaging findings using routine screening imaging modalities like transabdominal ultrasound together with computed tomography, barium studies where applicable in the diagnosis of this relatively rare condition. The electrocardiogram findings were also assessed.
RESULTSWe encountered 45 cases of dextrocardia during the 5-year period. Transabdominal ultrasound revealed transposition of liver, gall bladder, spleen, stomach and abdominal blood vessels. Computed tomography and barium studies reinforced the diagnosis. Electrocardiogram showed dextrocardia with right axis deviation.
CONCLUSIONSitus inversus totalis with dextrocardia being a rare clinical entity should be interrogated with routing imaging modalities like chest x-ray, transabdominal ultrasound, computed tomography and barium studies to make the patient and clinician aware of this condition, thereby preventing wrong diagnosis and surgical mishaps.
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