Mucormycosis, caused by saprophytic fungi of the order Mucorales of the class Zygomycetes, is a rare opportunistic fungal infection, which has a rapidly progressive and fulminant course with fatal outcome. These fungi are ubiquitous, found in soil, bread molds, decaying fruits and vegetables. The most common form of mucormycosis is rhinocerebral and is usually seen in uncontrolled diabetes mellitus or in immunocompromised patients. This fungus invades the arteries, leading to thrombosis that subsequently causes necrosis of hard and soft tissues. We report a case of palatal perforation by rhino-maxillary mucormycosis in an immunocompromised patient. The aim of this article is to draw attention to the clinical presentation and pathogenesis of mucormycosis and to emphasize the need for high degree of suspicion in its diagnosis and management.
Congenital cystic adenomatoid malformation (CCAM) of the lung, Stocker's type III is a rare anomaly characterized by replacement of normal pulmonary tissue with cysts of variable size and distribution. We report here a 16-week stillborn fetus with Stocker's type III bilateral CCAM involving the entire lungs. The additional associated malformations included collapsed nasal bridge, low set ears, malformed ears, absence of neck folds, absence of nipples and areolas, tracheal stenosis, fetal hydrops and small heart. The pathogenesis, radiological findings, pathological findings and prognosis of CCAM are discussed along with review of literature.
Persistent Mullerian Duct Syndrome (PMDS) is a rare form of internal male pseudohermaphroditism, characterised by presence of Mullerian duct derivatives in a genotypic and phenotypic male. It is caused by absence of anti- Mullerian hormone or defective functioning of its receptors. We report a case of 19-year-old cryptorchid male with history of orchideopexy who was clinically and radiologically diagnosed as left sided chylocele. A definitive diagnosis of PMDS with ovarian endometriosis was made on histopathological examination which is important for genetic counselling and to reduce complications like infertility and neoplastic transformation. We report this case of PMDS with ovary showing evidence of endometriosis for its rarity.
A 37-year-old female presented with swelling over right elbow since 2 years, which was gradually increasing in size and was associated with pain since 8 months. There was no history of trauma. On examination, a diffuse swelling was noted over the lateral aspect of elbow extending from lateral epicondyle to proximal part of forearm. On palpation swelling was tender and firm in consistency. Supination and pronation movements were restricted.Radiographs of right elbow revealed an expansile lytic lesion involving the radial head and proximal shaft of radius with breach in the cortex with soft tissue extension and sclerosis of distal margin suggestive of benign bone tumour [Table/ Fig-1]. MRI of right elbow revealed T2W hyperintense and T1W hypointense expansile lytic lesion with multiple thick septations involving the meta-epiphyseal region of radius, extending to the articular surface with its breach and elevation of cortex and presence of Codman's triangle features suggestive of neoplastic lesion-giant cell tumour [Table/ Fig-2]. Complete blood count showed HB of 13.5 gm/dl, total leucocyte count of 8400 cells/cumm and platelet count was 2.4 lacs/cumm. Routine biochemical investigations showed RBS of 110 mg/dl, serum alkaline phosphatase was 90 IU/L, HIV and HBsAg test were negative. Wide local excision of proximal radius along with radial head was done and the specimen was sent for histopathological examination.On gross examination the specimen showed multiple firm irregular reddish white tissue bits all together weighing 50 gm along with 3 ml of mucoid gelatinous material. Also, received was radial head measuring 3x2x1 cm with glistening white external surface. A cavity was noted on radial head measuring 1.5x1.5 cm with reddish friable material inside the cavity. Multiple sections were given and slides were stained with H&E stain. Chondromyxoid fibroma (CMF) is a rare benign cartilaginous tumour accounting to less than 1% of bone tumours. It is most commonly seen in lower extremity involving tibia. CMF of radius is rare. We report a rare case of CMF of proximal radius in a 37-year-old female who presented with swelling and pain over right elbow. Wide local excision of proximal radius along with radial head was done and above elbow POP slab was applied for one month. Elbow range of movement exercises started after one month. Keywords: Bone tumour, Cartilage, TibiaOn microscopic examination, multiple sections were studied which showed tumour tissue arranged in varying sized lobules. Centre of the lobule was hypocellular with peripheral hypercellular areas [ Elbow range of movement exercises were started after one month and patient was followed up for 3 months.Patient had a good range of painless functional movements and was able to carry out her day today activity without any assistance.
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