Successful Intra-peritoneal Antibiotic Therapy for Primary Abdominal Nocardiosis in an Immunocompetent Young Female Masquerading as Carcinoma Ovary

Nocardiosis is a common opportunistic infection in the immunocompromised and in patients with chronic debilitating diseases,e.g continuous ambulatory peritoneal dialysis (CAPD) patients. Primary abdominal nocardiosis is rare and is indeed a very rare infection in immunocompetent persons. Only two cases have been reported in immunocompetent patients so far and this may be third case to the best of our knowledge and first in India. About 11 cases have been reported in CAPD patients and AIDS patients.We report a case of Nocardiosis in an immunocompetent young female who presented with an abdomino-pelvic mass masquerading as carcinoma ovary.After initial resistance to various antibiotics, she responded to intraperitoneal and oral linezolid and oral ciprofloxacin

A Rare Primary Pelvic Hydatid Cyst Presenting as Sciatica

Primary hydatid cyst in the pelvis is rare, and usually presents with pressure symptoms affecting the adjacent abdominal organs. We describe a rare hydatid cyst which was eroding the sacral hallow, protruding into the right sciatic foramen and presenting as a radiating pain and weakness of right lower limb due to compression of the lumbosacral nerve roots. Laparotomy with removal of cyst and postoperative treatment with albendazole is effective in controlling the disease and preventing recurrence

Ovarian Fibroma with Meigs Syndrome associated with Elevated CA125 - A Rare Case

Postmenopausal women with solid adnexal masses, ascites and pleural effusion with elevated CA 125 are highly suggestive for malignant ovarian tumor. However in literature 28 cases Meigs syndrome (Benign ovarian tumor, ascites and right pleural effusion) with raised CA 125 have been reported. We report a case of Meigs syndrome caused by right ovarian fibroma with elevated serum CA125 level in a postmenopausal woma

Morbidity following Surgical Management of Vulval Cancer.

The objective of this study was to know the complications following vulvectomy and inguinofemoral lymphadenectomy including the time taken to complete wound healing. 42 patients who were subjected to either radical or modified radical vulvectomy for primary and inguinofemoral lymphadenectomy (80 groins) for groin metastases were analysed retrospectively. The complications analysed were wound breakdown, wound cellulitis or infection, lymphocyst, limb edema and the time to wound healing. In a total of 80 inguinofemoral lymphadenectomies 55% had wound breakdown, 17.5% had wound infection/cellulitis, lymphocyst in 31%, limb edema in 36% and time taken for complete wound healing ranged from 10-134 (average 46 days). Overall post operative morbidity was 85%

Primary Fallopian Tube Carcinoma

Primary Fallopian Tube Carcinoma (PFTC) is rare and accounts for about 0.3% of all gynecologic cancers. Less than 1500 cases have been reported in the literature. It arises in postmenopausal women and typically presents with abdominal pelvic pain, vaginal bleeding and watery discharge. However, a correct diagnosis is rarely achieved preoperative, and in many cases, the diagnosis is made after incidental surgery for unrelated conditions commonly being ovarian carcinoma . Compared with ovarian carcinoma, PFTC more often presents at early stages, but it has a worse prognosis. PFTC is usually managed in the same manner as ovarian cancer. We report a case of Left PFTC that presented as Left ovarian mass, and we briefly review the literature

A Rare Xanthogranulomatous Oophoritis Presenting as Ovarian Cancer

Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to affected organs; it is characterized by the presence of lipid-filled macrophages with admixed lymphocytes, plasma cells, and neutrophils. Only a few cases of xanthogranulomatous oophoritis have been reported to date. We describe a rare case of xanthogranulomatous oophoritis with involvement of omentum

Metastatic Leiomyosarcoma of Small Intestine

This is the report of a case of primary leiomyosarcoma of the small intestine, an uncommon primary malignancy of the small intestine

Spontaneous Evisceration of an Incisional Hernia Presenting One Year After Primary Surgery

Spontaneous evisceration is a rare complication associated with incisional hernia which demands an emergency surgery. A few cases have been reported on this. We report a spontaneous evisceration of bowel with strangulation which was managed by bowel resection and anastomosis and anatomical repair of incisional hernia

Preoperative Surprise of a Mass per Abdomen Mimicking Ovarian Neoplasm in a 50 Years Old Woman

We report a large cystic tumour of about 40cms size in a perimenopusal woman mimicking ovarian tumour, with peroperative surprise of finding it as degenerated fibroid arising from fundus of the uterus

Borderline Ovarian Malignancies : A Single Institute Retrospective Study.

Background: Borderline ovarian tumors are histologically characterized as epithelial tumors with a stratified growth pattern but without destructive stromal invasion. Little is known about the histological subtypes and outcome, role of fertility sparing surgery and role of postoperative therapy in advanced stage in Indian scenario. While there is ample data in the world literature about this disease, prognosis in Indian patients is largely unknown due to dearth of studies in our setting. Objective: To study the demographic profile, clinical features, imaging, treatment and outcome of borderline ovarian tumors. Methods: This is a retrospective study of eighty seven patients with pathologically proven diagnosis of borderline ovarian tumor, diagnosed and treated from January 2006 to October 2011 at our institution. Most patients underwent surgical staging which incuded total abdominal hysterectomy and bilateral salphingo-oophorectomy, infracolic omentectomy, bilateral pelvic and para aortic lymphadenectomy. Young patients who had not completed their family underwent fertility sparing surgery. Patients with invasive metastatic implants received adjuvant chemotherapy. The outcome of these patients was correlated with stage, type of peritoneal implant, type of surgical procedure and with histological subtype. Results: At a median follow-up of 48 months, 100 percent survival was noted. One patient with stage III disease had recurrence. Conclusions: Borderline ovarian tumors occur at a younger age compared to invasive tumors. In patients with early stage disease who wish to preserve fertility, hysterectomy and contralateral oophorectomy are not necessary. Serous tumors occur at a younger age. They can be associated with invasive peritoneal implants and raised CA125 values. Majority of the serous tumors are bilateral and smaller in size compared to mucinous and endometroid tumors. Raised CA125 values did not correlate with the stage of disease. These patients have an excellent prognosis even in Indian scenario where majority of patients present with big ovarian masses