Highlights
Synchronous presentation of mixed germ cell tumor of testis and renal cell carcinoma is a rare presentation and has not been reported in literature.
During the metastatic work up to mixed germ cell tumor we found the mass in the left kidney which was diagnosed to be renal cell carcinoma.
Treatment strategies for both malignancies depend on accurate clinical staging and should be integrated to provide best results.
The management of both the malignancies depend on their merit and is a real challenge for a surgeon.
Background: Varicose veins is a common clinical condition affecting the lower limbs. Usually patient comes for a cosmetic problem, it can cause complications giving rise to significant morbidity if not treated in time. Different options are available for surgical management. The present study has been carried out to study demographic factors, evaluate clinical presentation and outcome of various modalities of management of varicose veins of lower limb.Methods: The present study was carried out in a tertiary care academic hospital from October 2016 to October 2018 and 54 cases were enrolled. The clinical presentation of varicose veins were studied. Mean age and gender preponderance were calculated. All patients underwent clinical tests and venous doppler and accordingly appropriate treatment in the form of conservative, surgical or endovenous laser ablation was given. Complications following the procedures were studied.Results: A total of 39 (72%) patients out of 54 were below the age of 50 years. Prominent veins over lower limb was most common presentation. Sapheno-femoral junction was most commonly involved vein. Male preponderance was observed with a male to female ratio of 12.5:1. Venous Doppler had accuracy of 92.59% in detecting sapheno-femoral and perforator incompetence. Results of endovenous laser ablation are similar to surgery but with less morbidity.Conclusions: This study revealed the disease is prevalence in active phase of life with male preponderance. Majority of the patients had great saphenous vein incompetency and the complications are more when both great saphenous and perforator systems are involved. Venous Doppler is the investigation of choice as it has high accuracy.
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