A 65-year-old man with hydatid disease of the liver presented with a spontaneous cutaneous rupture draining about 10 L of fluid with daughter cysts. Contrast-enhanced CT showed multiple hypodense areas in the residual right lobe of the liver and abdominal wall with compensatory hypertrophy of the left lobe, confirming the diagnosis of a hydatid cyst presenting as external fistulisation which represents a very advanced stage of hydatid disease. Once the patient's nutritional status improved he was taken for surgery. On laparotomy there were multiple cysts seen in the residual right lobe of the liver and inflammatory changes in the abdominal wall with an external fistulous opening. Right-lobe hepatectomy was carried out along with excision of the fistulous tract. The specimen showed multiple degenerated contents of the cyst with numerous daughter cysts along the fistulous tract and examination of cyst fluid demonstrated protoscolices. The postoperative period was uneventful. He was regularly followed and was doing well.
We present a very rare case of breast gangrene in a 26-year-old woman, lactating primipara, referred to the emergency department of our hospital with a 1-day history of difficulty in breathing, high-grade fever associated with chills and rigor and failure to pass urine. After initial resuscitation, stabilisation and thorough examination her right breast was found to be gangrenous, with satellite lesions at the periphery. Later, under local anaesthesia and appropriate antibiotic coverage, the patient was taken for emergency debridement. She gradually recovered and as the wound developed healthy granulation tissue and wound culture became sterile, grafting of the affected area was carried out. The graft took well following which she was discharged.
Extraosseous Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) is an uncommon, aggressive, and malignant tumor of poor prognosis. Pancreas in one of the very rare extraosseous location for this tumor thus very minimal information regarding this disorder is present in literature. The present case was clinically and radiologically misdiagnosed as a pancreatic tumor. Histopathology of the tumor tissue revealed "small round cells" that were positive for CD99 (MIC-2), confirming the diagnosis of ES/PNET. In young adults with intraabdominal, extraintestinal mass, Ewing's sarcoma must be kept as a differential diagnosis is our aim in presenting this case report.
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