Sudden death of an egg donor during oocyte retrieval due to ovarian hyperstimulation syndrome

Ovarian Hyperstimulation Syndrome (OHSS) is uncommon among oocyte donors during in vitro fertilization (IVF) procedure and is rarely associated with death. We report a case of a 23-year-old oocyte donor who suddenly died on the operation table during oocyte retrieval. She had no risk factors in her menstrual history, laboratory, or clinical parameters. The antagonist cycle, triggered with the GnRH agonist protocol, was carried out. The cause of death at autopsy was attributed to respiratory failure due to acute massive pulmonary edema, which developed due to the complication of OHSS. Only a few autopsy cases associated with OHSS have been published, but, as far as we know, no clinical or autopsy cases of sudden death caused by OHSS have been reported

Alveolar soft part sarcoma of orbit: A rare diagnosis

Objective: Alveolar soft part sarcoma (ASPS) is an aggressive, rare tumour with unique morphological and histopathological features. Methods: We report a rare case of orbital ASPS and its management in a young male who presented with painless proptosis and progressive loss of vision. Result: Twenty-two year male presented with a history of gradually increasing proptosis with loss of vision since 12 months. He underwent radical re-excision of mass with right orbital exenteration and reconstruction using temporalis muscle flap. Adjuvant radiotherapy to a dose of 64 Gy in 32 fractions over 6.5 weeks was planned in view of positive surgical margins. Patient is free of disease and currently under follow up in multidisciplinary clinic. Conclusion: Function preserving surgery remains the standard treatment approach in localised disease however the complex anatomy and locally aggressive nature makes it difficult to achieve clear surgical margin. Adjuvant radiotherapy has shown to improve local control in patients with positive surgical margins

Large lipid-rich mammary analogue secretory carcinoma of parotid gland: An unusual case

Mammary analogue secretory carcinoma (MASC) of the salivary gland is a malignant tumor which bears morphologic, immunohistochemical and molecular features similar to those of mammary secretory carcinoma. The tumor is considered as a low-grade malignancy perhaps slightly more aggressive than acinic cell carcinoma. High-grade transformation with recurrences, regional nodal involvement, metastases, and cancer-related death has been reported in a few cases. We report an unusual case of large MASC of the parotid gland in a young patient without regional lymph node involvement. To the best of our knowledge till date such a large MASC of the salivary gland has not been reported in the English literature

Solid pseudopapillary neoplasm of the ovary with metastases to the omentum and regional lymph nodes

Extrapancreatic solid pseudopapillary neoplasms (SPNs) are rare tumors, which bear morphological, immunohistochemical, and molecular features similar to those of pancreatic counterparts. SPN occurs primarily in adolescent girls and young women. It is considered to be a malignant neoplasm with low-grade biology. Ovarian SPNs are uncommon, have benign morphology, usually limited to the ovary and local surgical excision is curative. We report an unusual case of SPN of right ovary with extraovarian spread and metastases to lymph nodes. To the best of our knowledge, this is the second documented case of extragonadal spread of ovarian SPN

Mesothelial/monocytic incidental cardiac excrescences (MICE) with tubercular aortitis: report of the first case with brief review of the literature

Mesothelial/monocytic incidental cardiac excrescence (MICE) is a rare and distinctive cardiac lesion composed of mesothelial and monocytic cells with other inflammatory cells and fibrin. Though the first case of MICE was reported about three decades earlier, to date fewer than 50 cases have been recorded in the available literature. We describe the case of a 40-year-old male who was admitted in the Department of Cardiothoracic and Vascular Surgery with complaints of dyspnoea (NYHA Class III) of 1 year's duration. There was no history of pedal oedema, chest pain, palpitations, syncope, neurological or embolic manifestations or signs of infective endocarditis and rheumatic fever. Clinical examination revealed absence of pallor, jaundice, cyanosis, pedal oedema, lymphadenopathy or Marfanoid features. His general condition was fair. His pulse was 88/min and regular with all peripheral pulses palpable. His blood pressure was 140/80 mmHg. There were peripheral signs of aortic regurgitation. Respiratory system examination did not reveal any abnormality. Cardiovascular examination showed apex beat in the left sixth intercostal space. The heart sounds S1 and S2 were audible with an ejection systolic murmur at the aortic area. Electrocardiogram revealed normal sinus rhythm, left axis deviation and left ventricular hypertrophy. Echocardiography revealed severe aortic regurgitation without any stenosis. The other valves were normal. There was no clot, vegetation or pericardial effusion. With a clinical diagnosis of aortic regurgitation, the patient underwent aortic valve replacement

Impact of prophylactic hydroxychloroquine on ultrastructural impairment and cellular SARS-CoV-2 infection in different cells of bronchoalveolar lavage fluids of COVID-19 patients

Abstract Many drugs were recommended as antiviral agents for infection control and effective therapy to reduce the mortality rate for COVID-19 patients. Hydroxychloroquine (HCQ), an antimalarial drug, has been controversially recommended for prophylactic use in many countries, including India, to control SARS-CoV-2 infections. We have explored the effect of prophylactic HCQ from the cells of bronchoalveolar lavage fluids from COVID-19-induced acute respiratory distress syndrome patients to determine the level of infection and ultrastructural alterations in the ciliated epithelium, type II pneumocytes, alveolar macrophages, neutrophils, and enucleated granulocytes. Ultrastructural investigation of ciliated epithelium and type II pneumocytes showed lesser infections and cellular impairment in the prophylactic HCQ+ group than HCQ− group. However, macrophages and neutrophils displayed similar infection and ultrastructural alterations in both patient groups. The enucleated fragments of granulocytes showed phagocytosis of the matured virus in HCQ+ groups. The present report unveils the ultrastructural proof to complement the paradox regarding the role of prophylactic HCQ in COVID-19 patients