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.
We present a unique case of a colonic lithobezoar in a relatively healthy, young male with no history of psychological or psychiatric disorders. Furthermore, unlike previously reported cases, this patient had no history of gastric surgery. The mode of presentation and the rariety of disease pose difficulties in diagnosis of lithobezoar. The different modalities of treatment, both surgical and nonsurgical, were thought of and discussed. The diagnosis of a lithobezoar in a healthy patient requires a high index of suspicion, as it presents with nonspecific symptoms. The standard treatment for bezoars is discussed but lithobezoar needs special mention due to its rariety and no specific surgery guidelines.
Lipomas, also known as "universal tumours" are benign soft tissue tumour of mesenchymal origin occurring in approximately 1% of the population, 13% of all the lipomas are reported to be in the head and neck region. Knowing the universal nature of the tumour, in most cases there is no diagnostic dilemma and an accurate clinical diagnosis can be made. However, large swelling, especially of the head and neck region arise the suspicion of malignancy. The primary diagnostic challenge is to differentiate a lipoma from other malignant lesions, specially a well-circumscribed liposarcoma. Diagnostic imaging like X-ray, Ultrasound, CT Scan and MRI are helpful in evaluating these swellings and confirming the diagnosis and deciding the course of further management. In this case series we have reported three cases of giant lipoma of head and neck region.
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