Congenital anomalies of the male urogenital tract are common. Some lesions like posterior urethral valve or anterior urethral diverticulum tend to present early in infancy and are often easily diagnosed on conventional contrast voiding cystourethrograms. Other conditions like posterior urethral diverticulum or utricle can be relatively asymptomatic and therefore present late in childhood. We present the spectrum of imaging findings of common and uncommon anomalies involving the male urethra. Since the pediatric radiologist is often the first to make the diagnosis, he or she should be well aware of these conditions.

Rupture of hepatocellular carcinoma (HCC) is a catastrophic complication, which carries high mortality. We report a case of spontaneous rupture of HCC, diagnosis of which was considered on clinical presentation and confirmed on computed tomographic (CT) scan. On CT scan, characteristic 'enucleation sign' was observed on arterial phase imaging, where a hypervascular peripheral mass showing central necrosis was seen protruding from liver surface with discontinuity of hepatic parenchyma associated with high attenuation ascites. ( J CLIN EXP HEPATOL 2016;6:335-336)

Introduction: Canalicular injury is commonly encountered in lid trauma. A multitude of techniques and stents are available to manage canalicular lacerations. Monocanalicular stents offer a simple, technically easy and cost-effective solution for managing such cases. Objective: This is a retrospective review of the patients presenting with canalicular lacerations to a tertiary eye hospital from January 2014 to September 2017. We evaluated factors like time of surgery, cause of injury, time of stent removal and their association with the surgical outcome. Additionally, we also reviewed the current data available in literature on the exclusive use of monocanalicular stents for the management of all types of canalicular injuries. Methods: Retrospective patient file review. Results: We evaluated 30 cases of canalicular injuries in 30 patients. The majority of our patients were males (24, 80%), and the mean age was 32.11±15.09 (4-59) years. The mode of injury was road traffic accidents (RTA) in 20 (66.7%), assault with sharp edged weapons in 8 (26.7%) and dog bite in 2 (6.6%) cases. The mean time of repair was 17.2±9.37 (6-36) hours after injury and the mean time of stent removal/ extrusion was 3.5±0.99 (0.5-5) months. The cases were divided based on time of repair i.e., within 24 hours (21 cases) or after 24 hours (9 cases) from the onset of injury. The extrusion rates were 14.3% (3) and 44.4% (4) respectively in the two groups. Our overall anatomical success rate was 86.7% and functional success rate of 76.7%. Conclusions: Overall failure rate was 23.3% (7 out of 30). Delay in surgery (>24 hours) and dog bites were associated with a poorer prognosis of canalicular repair using monocanalicular stents. Abbreviations: FDDT = Fluorescein dye disappearance test, SPSS = Statistical Package for Social Sciences, RTA = Road Traffic Accident

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A 48-year-old lady presented with a palpable lump in left breast for the last two years. On examination, there was a large nontender, hard lump occupying almost entire breast with edema of the overlying skin and ulceration of the nipple-areola complex (Figure 1). An enlarged, mobile, hard lymph node was palpable in the ipsilateral axilla. Examination of the opposite breast and axilla was unremarkable.Bilateral mammography showed a large, lobulated, isodense mass with indistinct margins involving the entire left breast. The mass showed large, lobulated heterogeneous calcification with areas of dense calcification resembling bone ( Figure 2). Thus, the imaging differential of sarcoma was considered. Ultrasonographic examination revealed a 14 × 12 × 9 cm solid cystic mass with increased vascularity in the solid areas. Left axilla showed multiple enlarged lymph nodes with loss of fatty hilum. Left breast lesion was classified BIRADS 5 according to ACR BIRADS lexicon. The histopathologic examination of the mass showed malignant cells with numerous osteoclast type of giant cells, and chondro-osseous and rhabdoid differentiation and diagnosis was made of heterologous type of metaplastic carcinoma ( Figure 3A and B). Immunohistochemistry (IHC) was negative for ER, PR, and HER-2/Neu and showed moderate positivity for CK5/6 and strong positivity for vimentin consistent with metaplastic carcinoma ( Figure 3C and D).Metaplastic carcinoma of breast is a rare, aggressive breast tumor accounting for less than 1% of all invasive breast cancer. It is called "metaplastic" as there is differentiation of glandular epithelium into various nonglandular, epithelial (like squamous cell and spindle cell) and mesenchymal (like bone and cartilage) components.It usually presents as a rapidly growing palpable mass in women older than 50 years. There are no specific imaging features, and it can show imaging appearances similar to malignant as well as probably benign masses. On mammogram, they usually appear as high density, round to irregular mass with circumscribed to noncircumscribed (obscured, indistinct, or spiculated) margin. They are often noncalcified with the incidence of calcification being <25%. Calcifications are frequent in rare, matrix-producing subtype of metaplastic carcinoma which demonstrates calcifications due to mineralization of cartilaginous and osteoid matrix. The common patterns of calcification, if present, are amorphous, coarse, punctate, or pleomorphic, and none of the previous studies have demonstrated large dense calcifications in metaplastic breast carcinoma. Mammogram in our case demonstrated a mass with a large, lobulated heterogeneous calcification showing patchy areas of dense calcifications resembling bone, due to mineralized osteoid matrix. This pattern of large dense calcification has been described in breast sarcomas. Metaplastic breast carcinoma needs to be differentiated from breast sarcomas as these vary in their management approach and patient outcome. It is, however, challenging to differentiate them ...

IntroductionPlantar fasciitis is a degenerative condition of the plantar fascia that leads to heel and sole pain. Physical modalities, physiotherapy, medication, and orthoses have been tried before as treatments. Extracorporeal shockwave therapy (ESWT) and the injection of autologous platelet-rich plasma (PRP) are generally effective in the treatment of plantar fasciitis, which might be resistant to other conservative measures. The present study compares the efficacy of ESWT and PRP injection in respect of symptomatic relief, functional improvement, and change in plantar fascia thickness (PFT). MethodsSeventy-two patients were enrolled and randomized into two groups. Patients in the first group received ESWT, whereas patients in the second group received PRP injections. Patients were evaluated using the Visual Analog Scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) score, along with PFT measurement (using ultrasonography) before the treatment and at days 15, 30, and 90 after the treatment. The X 2 test was used to compare qualitative variables, and the paired T-test was used to evaluate quantitative data. Quantitative variables had a normal distribution with a standard deviation, and the significance level was set at P-value=0.05. ResultsOn day 0, the mean VAS of the ESWT and PRP groups were 6.44±1.11 and 6.78±1.17, respectively (p=0.237). On day 15, the mean VAS of the ESWT and PRP groups were 4.67±1.45 and 6.67±1.35, respectively (p<0.001). At day 30, the mean VAS of the ESWT and PRP groups were 4. 97±1.46 and 4.69±1.39, respectively (p=0.391). On day 90, the mean VAS of the ESWT and PRP groups were 5.47±1.63 and 3.36±0.96 (p<0.001). On day 0, the mean PFTs of the ESWT and PRP groups were 4. 73±0.40 and 5.19±0.51, respectively (p<0.001). At day 15, the mean PFT of the ESWT and PRP groups were 4.64±0.46 and 5.11±0.62, respectively (p<0.001) which changed to 4.52±0.53 and 4.40±0.58 at day 30 (p<0.001), and to 4.40±0.50 and 3.82±0.45 at day 90 (p<0.001).