ABSTRACT:Gastrointestinal stromal tumours are relatively common tumours of gastrointestinal tract, most commonly found in the stomach. GISTs are generally asymptomatic but may present with epigastric pain, bleeding and features of gastric outlet obstruction. Adult intussusception is rare and the diagnosis can be delayed because it occurs infrequently, and its symptoms are long standing, intermittent, and nonspecific. Here we present a rare case of gastroduodenal intussusception with gastric stromal tumour as a lead point. Preoperative diagnosis was made on abdominal CT and confirmed by laparotomy and histopathology.
BACKGROUND Nutrient foramina are cavities that conduct nutrient arteries and peripheral nerves on the shaft of long bones. Long bones receive most of the interosseous blood supply from nutrient arteries and sometimes through the periosteal vessels. The aim of this study was to determine the common location, direction & number of nutrient foramina of upper limb long bones. MATERIALS & METHODS This is descriptive study of a total 150 human upper limb long bones {50 humeri, 50 radii & 50 ulnae} taken from Department of Anatomy, Guntur Medical College, Guntur and each was studied for location, direction & number of nutrient foramina. RESULTS In humerus, a single nutrient foramen was found in 78% and double in 22% of bones, of them 62% foramina were on antero-medial surface, 25% on medial border, 5% on anterior border, 5% on posterior surface & 3% on lateral border. 87% of nutrient foramina were in middle third of shaft of humerus. All radii had single nutrient foramen, of them 70% were on anterior surface & 30% on interosseous border. 74% of nutrient foramina were in middle third & 26% were in upper third of shaft of radius. 98% of ulnae had single nutrient foramen & 2% had double nutrient foramina, of them 78.4% were on anterior surface, 11.8% on posterior surface, 5.9% on interosseous border & 3.9% on anterior border. 88.2% of nutrient foramina were in middle third & 11.8% in upper third of bone. All nutrient foramina were directed away from the growing end i.e., towards the elbow. CONCLUSION The study of nutrient foramina is of clinical importance in surgical procedures like orthopedic transplant techniques & microvascular bone transfer procedures.
ABSTRACT:Bone metastases are common but serious complication of aggressive thyroid carcinoma, but calvarial metastasis is relatively uncommon complication of the primary tumor of thyroid gland. We are presenting an unusual case report of large calvarial metastasis which had both intracranial and extra cranial components of a previously diagnosed and operated case of follicular carcinoma of thyroid. KEY WORDS: Calvarial metastasis, primary follicular carcinoma of thyroid, skeletal metastasis in thyroid carcinoma. INTRODUCTION:Metastases to the skeletal system from thyroid carcinoma are a well-known event, constituting the second most common systemic site of involvement after lungs. The poor prognosis associated with bone metastases of differentiated thyroid cancer might partly be due to the fact that they are rarely detected at an early stage. Carcinoma of the thyroid gland is one of the possibly curable cancers. At the time of initial diagnosis, 1%-3% of patients with thyroid cancer may have distant metastases, whereas another 7%-23% will develop distant metastases during the disease course 2, 12, 16 .The distant metastases, especially those involving bone, increase mortality rate, compromise quality of life and shorten patient survival.After lung, bone is the most common site of systemic metastasis from thyroid carcinoma 1, 2 , the overall reported incidence ranging from 1% 3 to more than 40% 4 . This incidence varies according to the primary tumour type, with follicular carcinoma showing a much higher frequency than the papillary or anaplastic subtypes in most reported series 1,2,[5][6][7][8] .Approximately 90% of non-medullary thyroid malignancies are well differentiated and are classified as papillary or follicular. Patients with differentiated thyroid carcinoma (DTC) have a high 10-year survival rate (80%-95%), except in the presence of metastatic disease (40% 10-year survival). Incidence of bone metastases is Vertebrae (54%), Pelvis (50%), Ribs (31%), Femur (21%), Skull (13%) and Humérus (11%).Among the different histologic subtypes, follicular carcinoma is most likely to show bone metastases, with reported incidences ranging from 7% to approximately 28%. The poor prognosis associated with bone metastases of differentiated thyroid cancer might partly be due to the fact that they are rarely detected at an early stage. The influence of the microscopic tumor type and tumor differentiation on survival after bone metastasis primarily appears to be due to the much worse prognosis among anaplastic and medullary carcinomas. Age at diagnosis of bone metastases does not influence survivals.
ABSTRACT:Pigmented villonodularsynovitis (PVNS) is a benign proliferative disorder primarily occurring in the large joints of the appendicular skeleton such as the knee and hip joints.PVNS is a slow-growing lesion of uncertain aetiology arising from the synovial membrane. It is characterized by villous and nodular overgrowths of the synovial membrane of the bursa or the tendon sheath.Though magnetic resonance imaging (MRI) is considered to be most sensitive in revealing findings consistent with PVNS, these findings are to be correlated with clinical and histopathological findings for precise diagnosis.Here we present a case with painless, non-traumatic swelling of left knee since 2 years, diagnosed as PVNS on plain radiograph, CT and MRI,underwent total synovectomy andwas later on confirmed histopathologically.
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