Carotid body tumors are rare neoplasms, which typically present as a slow growing, painless neck mass found along the anterior border of the sternocleidomastoid muscle. All borders were well-defined. It was non pulsatile, had no cranial nerve involvement. Neck glands were not enlarged. Her haematological and biochemical investigations did not reveal any abnormality. These tumors are generally benign but possess aggressive local growth potential. A 50 year female patient presented with a large (70 × 50 × 45 mm) sized swelling on the left side of the neck in the anterior triangle. CT with contrast revealed a hyper vascular lesion 5x4 cm at the carotid fork and not attached to the vessel (Shamblin type II).The operation was performed under general anaesthesia with endotracheal intubation. There were a lot of feeding vessels between the tumour mass and external and common carotid artery. The tumour was excised along the subadventitial plane. Histological examination of the tumor mass was done and it revealed typical features of nonsecreting paraganglioma. The patient recovered well from the effect of anaesthesia and there were no neurological deficit. Therefore, definitive treatment requires surgical resection. Paragangliomas (PGLs) are extra-adrenally located in 10% of cases. The authors describe a case of a patient with a carotid body tumor and review the most recent literature on this unusual topic.
BACKGROUND: Repair of Inguinal Hernia is one of the most common elective surgeries performed worldwide. Our objective in this study is to compare results after hernioplasty using a Laparoscopic (TAPP) Technique to that using Open (Lichtenstein) Technique, in an effort to determine if the advantages could be reproduced in practice. Methodology: This was a prospective clinical study comparing Open Lichtenstein Mesh Repair and Laparoscopic Trans Abdominal Preperitoneal Mesh Repair (TAPP) consisting of 40 patients with inguinal hernia, who were randomly assigned to TAPP Repair Group (n=20) or Open Repair Group (n=20). Patients were then operated, followed up in the early postoperative period as well as the later post-operative period until 6 months after surgery. Results: The Primary endpoints were length of post operative pain, complications, hospital stay, and patient satisfaction. There were 7 patients (17.5%) patients who had minor complications. In Lichtenstein Group, there were minor complication in 6 patients (30%) and in TAPP Group there was 1 patient (5%). Hence patients in Lichtenstein group had significantly more complications as compared to TAPP Group. Recovery period is fast for laparoscopic hernia repair with a mean post operative hospital stay of 2.80 days compared to 5.35 days for open repair, and were able to resume their normal work earlier with 6.65 days compared to 12.20 days. Post operative pain for laparoscopic TAPP repair was of lower score than that of open mesh repair by visual analogue scale assessment. Patient's operated by laparoscopic technique responded with good to excellent grading in terms of results, post operative pain and recovery and in terms of cosmesis. CONCLUSION: This study supports the view that laparoscopic pre-peritoneal mesh repair is safe and efficient when compared to open mesh repair of inguinal hernia.
Virilizing or masculinizing features in a female can be an alarm for the doctor and a source of embarrassment for the patient. These features appear as a result of hyperandrogenism, the source being ovary or adrenal gland. Here is a case of Virilizing ovarian tumour in a 51 year old diabetic female. This patient presented with a 14 year history of appearance of hair all over the body with loss of scalp hair. She also had complaints of pain in lower abdomen with excessive micturition for 3 months. Examination showed hirsutism and features of virilisation. Suprapubic mass was present on abdominal examination. Per vaginal exam revealed a soft mass? Ovarian. Radiological tests showed features suggestive of ovarian malignancy with possible uterine involvement and mild ascites. Most routine hematological investigations were normal. Total testosterone was grossly elevated (>1500 ng/dl); CA-125 was also raised (103.7 U/ml). FSH & LH values were low, TSH was normal while estradiol& progesterone were raised. Urine microscopy had features of urinary tract infection; hence treatment was started for the same. Patient underwent panhysterectomy. Histopathological studies confirmed steroid cell left ovarian tumour (T1aN0Mx), which was the source of virility in the patient. Patient improved dramatically after the surgery with reversal of androgenic features (partial).key words: steroid cell tumor, hirsutism, and panhysterectomy. INTRODUCTION:Steroid cell tumors are tumors composed entirely or predominantly of cells resembling steroid hormone secreting cells. They are classified under sex cord-stromal tumors which account for approximately 8% of all ovarian tumors. These tumours can be a source of testosterone and other steroids, hence can cause hirsutism and virilisation in a female adults and precocious puberty in children. [1][2][3][4] Approximately one-third of the steroid cell tumours have been reported to be malignant. 1 Since Virilizing tumours of the ovary account for only 0.1% of all ovarian tumours, not much has been studied on the modalities of treatment for the same. Although surgery has been the mainstay, a recent report showed that gonadotropin releasing hormone agonist was effective in treating steroid cell tumors. [5][6] Here, we present a case of a 51year old lady who presented with hirsutism, virilisation of 14 year duration and was found to have steroid cell tumour of the left ovary measuring 12x12x9 cm. She showed drastic reversal of symptoms following panhysterectomy and was declared free of tumour.
Nerve sheath tumors arising from the cervical vagus nerve are extremely rare, and are of diagnostic challenge. We report A 14-year old male presented with swelling in the left side of neck for the past 6 months. FNAC revealed a vascular lesion, MRI scan showed a well circumscribed mass, 4 × 4 cm located in the lateral part of neck and was suggestive of a Glomus tumor. At surgery the swelling was found to be in close proximity with the internal jugular vein and common carotid artery and the vagus nerve on the left side. The encapsulated tumor was completely resected through a J-incision and it was found to be a benign schwannoma in pathology. Schwannoma are relatively rare tumor and even rarer in children. The incidence of such tumors and the management of our patients are discussed.
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