Cerebrospinal fluid (CSF) within the cerebral ventricular system is secreted by a neuroepithelial tissue which is called as the choroid plexus. Tumors arising from these tissues are rare. Choroid plexus papillomas (CPPs) have been denoted as WHO grade I of the choroid plexus tumors. Among the intracranial tumors, neoplasms of the choroid plexus constitute around 0.36-0.6%. CPPs are mostly slow growing and cause symptoms due to mass effect and obstructive hydrocephalus, resulting in increased intracranial pressure. We report a case of CPP arising from the temporal horn in a 7-year-old girl presenting with progressive head enlargement since birth due to bilateral massive hydrocephalus without any obstruction, making it purely a hypersecretory hydrocephalus. A drainage procedure followed by complete tumor resection was carried out in our case and the patient showed marked relief from her symptoms.
Background
Liposuction is the most accepted technique for treatment of gynecomastia at present with or without residual gland tissue excision. Conventional liposuction uses incisions for introduction of cannula, made usually at the inframammary crease or axilla resulting in consequent scars. Cross-chest liposuction technique was introduced to avoid these additional scars and improve the aesthetic outcome. This study aimed to evaluate the difference between aesthetic outcome of conventional liposuction and cross-chest liposuction in treatment of gynecomastia.
Method
A prospective comparative study between 2 groups with 15 patients in each was conducted, one with conventional and the other cross-chest liposuction. Excision of residual gland tissue was performed through circum-areolar incision in both the groups. Aesthetic outcome was evaluated in both the groups using Likert scale and compared.
Result
The mean age of the patients was 22.6 years and the mean duration of presentation was 8.13 years. Satisfaction rate with conventional and cross-chest liposuction was 80% and 86%, respectively, as assessed by the patients. The rate was 80% and 77%, respectively, in both the groups as assessed by independent observer. The complication rate was 13.3% in conventional and 20% in cross-chest group. The difference in outcome was not statistically significant between two groups. Difference between the mean Likert scores of pre-operative and post-operative satisfaction was statistically significant for both the techniques.
Conclusion
The conventional and the cross-chest liposuction, both yield comparable results when used for treatment of gynecomastia in terms of aesthetic outcome.
Level of Evidence III
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Desmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen. History of trauma or surgery to the site of tumor origin is elicited in up to one in four cases and they most commonly develop in the anterior abdominal wall and shoulder girdle but they can arise in any skeletal muscle. The clinical behavior and natural history of desmoid tumors are unpredictable and management is difficult with many issues remaining controversial, mainly regarding early detection, the role, type and timing of surgery and the value of non-operative therapies. We report a case of anterior abdominal wall desmoid tumor in a 40-year-old male with a previous history of surgery.
Background: Kuttner’s tumour is a condition of the submandibular gland which is underreported as a distinct entity. Also called as the chronic sclerosing sialadenitis it resembles a plasmocytic and lymphocytic inflammatory process and presents as a hard and painful mass which clinically mimics a malignancy and raises significant concerns. The objective of the present study was to evaluate cases of Kuttner’s tumor and discuss its clinical and pathological aspects to distinguish it from a definite malignancy and create a grown acceptance of the presence of such an entity in our setting.Methods: We collected 170 cases of submandibular swellings and evaluated in detail the clinical and pathological aspects of eight cases out of them which were later diagnosed to as Kuttner’s tumour.Results: The age of the patients varied between 23 to 61 years (mean age 42.5 years) with 3 males and 5 females. 6 patients reported with a firm to hard painless submandibular mass (5 left sided; 3 right sided) while 2 patients experienced intermittent discomfort. The mean duration of presentation of symptoms was 5.3 months. Fine needle aspiration cytology was done in 6 cases preoperatively. Following submandibular sialadenectomy histopathology showed salivary gland tissue with preserved lobular architecture, but with marked fibrosis, acinar atrophy, and a dense lymphoplasmacytic infiltrates.Conclusions: Kuttner’s tumor may be pre operatively distinguished from a malignancy with improved imaging and a good image guided FNA Cytology saving the clinician and the patient from a lot of dilemma. However, histopathology and immunohistochemistry would be the key in establishing the diagnosis.
Pleomorphic adenoma is the most common tumor arising from the parotid salivary gland. In most instances, it involves the superficial part of the gland rarely affecting the deep part, which often presents as a swelling on the lateral pharyngeal wall. The neoplastic process involving the superficial and the deep part of the same gland is extremely unusual. We had a patient who presented to our clinic with a recurrent swelling of his left parotid gland with a diagnosis of pleomorphic adenoma. On a computed tomographic scan, it was found to involve both the superficial and deep parts of the gland. The gland was excised completely, preserving the facial nerve and all its branches. A histopathologic study of the specimen confirmed the diagnosis and extent of the disease.
Littré’s hernia is caused by the protrusion of Meckel’s diverticulum through an orifice in the abdominal wall. Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract that is generally asymptomatic and only manifests in a specific way when complications exist. An unusual complication of Meckel’s diverticulum is known as Littre’s hernia. It comprises less than 1% of all Meckel’s diverticulum. Usual sites of Littre hernia are right inguinal (50% of cases), umbilical hernia (20%), and femoral hernia (20%). We present a case of Littré’s hernia where we found a strangulated Meckel’s diverticulum in an inguinal hernia sac.
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