HighlightsMassive ovarian tumour weighing 56.95 kgs or 125.29 lbs removed in toto – HPE : mucinous cyst adenomaPost operatively - had a parietal wall bleed - re-explored and hemostasis achieved
Schwannomas are usually benign, slow growing tumors, that originate from any nerve that has a Schwann cell sheath. Here, we report the case of a 40 year-old female patient with an incidentally noted submucosal gastric tumor while being evaluated for cervical lymphadenopathy as a part of workup for lymphoma. She underwent sleeve resection of the stomach under suspicion of a gastrointestinal stromal tumor, but postoperative histopathological and immunohistochemical findings confirmed the diagnosis of shwannoma. Although schwannomas are mostly benign, they are often indistinguishable preoperatively from malignant tumors such as gastrointestinal stromal tumors. Therefore, resection is the treatment of choice for all such tumors.Keywords Gastric schwannoma . GIST . Immunohistochemistry . Sleeve resection Case ReportA 48 year old lady with cervical lymphadenopathy was subjected to ultrasound of the abdomen for ruling out splenomegaly as a part of work up for lymphoma. Ultrasound of the abdomen (Fig. 1) revealed a well defined lobulated hypoechoic mass lesion in the epigastric region located between the left lobe of liver and gastric wall. It was 4.2 × 4.1 cm in size. Computed tomography scan showed well defined uniformly enhancing gastric fundal wall mass, (Fig. 2) most likely to be GIST (gastrointestinal stromal tumour) with celiac axis and periportal nodal enlargement. The mass was partly exophytic and partly projecting into the lumen causing smooth indentation. The patient then underwent upper GI endoscopy which showed a sub mucosal bulge on the anterior wall of the fundus of the stomach. An endosonography was done using a linear scope which showed a large submucosal mixed echoic mass with few areas of necrosis in body of stomach mainly on greater curvature measurng 5 × 4 cm arising from muscularis propria. Two celiac nodes, hypoechoic round with uniform echotexture were also seen. FDG pet scan showed metabolically active tumor mostly representing GIST (Gastrointestinal stromal tumour) from body of the stomach (Fig. 3).A provisional diagnosis of submucosal mass, which could be most likely GIST, was made and fine needle aspiration cytology was done from both the lesion and the nodes with endosonoguidance. The FNA from gastric submucosal lesion showed features suggestive of spindle cell tumor while the celiac nodes showed reactive hyperplasia. A preoperative diagnosis of GIST arising from anterior wall of proximal stomach was made. The patient was subjected to laparoscopic examination which revealed an exophytic solid tumor measuring 6 × 7 cm arising from the anterior wall of the junction of body and fundus. The medial margin was at the lesser curvature and lateral margin was just short of greater curvature. In order to get a good tumor negative margin laparoscopy was converted to minilaparotomy and sleeve resection of the tumor was done using linear staplers. Histopathology revealed a submucosal tumor with features suggestive of spindle cell tumor (Fig. 4). IHC done showed positivity
Background: Recent studies highlight a role for vitamin D (VD) in the growth and differentiation of various cell types. The biologically active form of vitamin D3 is 1,25-dihydroxyvitamin D3. Most cells of the body including prostate cells have vitamin D receptor (VDR) and VD metabolizing enzymes, and can respond to 1,25-VD. Literature supports multipronged effects of 1,25-VD in the prevention of prostate carcinoma development and progression. However, the relationship between prostate carcinoma and VD is still not entirely understood. There are no studies conducted on the association of VD and prostate carcinoma among the Asian population and our study is the first of its kind in literature and hence the need for the same.
Primary Ewings sarcoma (EWS) of the kidney is a very rare tumor and very few cases have been reported till date. We present a case of a young girl presenting to us with flank pain. On evaluation, she was found to have a renal mass. She was explored and a nephrectomy was done. Histopathology was reported as EWS. She was then planned for adjuvant chemotherapy. Primary EWS of the kidney is characterized by an aggressive course and poor prognosis. Hence, while dealing with renal masses in young patients, this entity should always be kept in mind.
In this era of laparoscopic surgery, laparoscopic repair of ventral hernia is gaining popularity due to faster recovery, shorter hospital stay and lower recurrence rates. In obese patients it is a technically easier procedure than open repair. However, this new method requires advanced technologies. Transfacial sutures and tacks are the usual methods to fix the mesh to the anterior abdominal wall. These methods, however, have their own complications. This article is to report an unusual complication of tacks migrating and trying to extrude out of anterior abdominal wall, forming chronic sinuses.
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