Adult Solid Hepatic Mesenchymal Hamartoma Masquerading as Malignancy

Solid Hepatic Mesenchymal Hamartoma (HMH) rarely occurs in adults. We report two cases of solid adult HMH. A 62-year-old female with right upper abdominal pain on Computed Tomography (CT) scan revealed a well defined heterogeneously enhancing solid mass lesion in segment VII of liver along with non-enhancing central necrotic areas. Percutaneous biopsy and intraoperative frozen section were inconclusive and conventional right hepatectomy was done. Final histopathology was solid HMH. Another 63-year-old female with right upper abdominal pain had cirrhotic liver, choledocholithiases, cholelithiases, mild ascites and a right lobe lesion with calcifications on CT scan. Ultrasound guided biopsy showed fibrocollagenous tissue. She was operated for a right hepatectomy and choledochoduodenostomy. Final histopathology revealed solid HMH. Though solid adult HMH is rare, it should be considered in differential diagnosis of solid/cystic/focal or multifocal liver lesions and surgical resection to negative margins is the treatment of choice

SPLEEN PRESERVING DISTAL PANCREATECTOMY FOR AN UNCOMMON LARGE PANCREATIC MASS: A CASE REPORT

Solid pseudo papillary tumour is a rare primary neoplasm of the pancreas with low malignant potential that typically affects young Asian women. We herein report a case of a teen aged girl who presented with a large painless progressively increasing asymptomatic abdominal lump. On radiological investigation, there was a solitary large heterogenous mass arising from the tail of pancreas. An ultrasound guided fine needle aspiration cytology revealed a solid pseudopapillary epithelial neoplasm. The patient underwent spleen preserving distal pancreatectomy. The histopathology confirmed the diagnosis of solid pseudopapillary neoplasm of pancreas. The patient had an uneventful recovery and is under follow up

A comparative analysis of upper airway space with lateral cephalogram and cone beam computed tomography in north Gujarat population

Objective : The Aim and objective of this study is to evaluate the accuracy of upper airway measurement using with lateral cephalogram , CBCT lateral reconstruction and CBCT axial planes as well as to correlates these finding with area measurements acquired with the latter imaging methods. Methods : In this study , 44 subject (22 males & 22 females) included from north Gujarat adults . Landmark were defined for measurement of naso and Oropharynx , for different planes , using linear antero-posterior measurement and the corresponding area. Result : Analysis of variance shows linear measurement in nasopharynx and oropharynx area wise distribution and Inter Group Wise Distribution in Nasopharynx , all three group have significant different value. In inter Group Wise Distribution in Oropharynx, there is statistically no significant difference between Lateral Reconstruction Group and Lateral Cephalogram Manual Tracing Group. Statistically, no significant difference between Lateral Reconstruction Group and Axial Slice Group & also Statistically, no significant difference between Lateral Cephalogram Manual Tracing Group and Axial Slice Group. Conclusion : The linear measurements of the airway space obtained using the different techniques correlated positively with the respective area measurements, which demonstrate the reliability of the investigated techniques

Small bowel obstruction due to an endometriotic ileal stricture with associated appendiceal endometriosis: A case report and systematic review of the literature

Introduction: Endometriosis is defined as the presence of functional ectopic endometrial tissue outside the uterine cavity. It rarely involves the small bowel and obstruction due to the same is highly uncommon. Preoperative diagnosis is difficult based on clinical and radiological studies. Diagnosis can be confirmed only on histopathological examination of the surgically resected specimen. Presentation of case: A 44 years old lady presented with repeated episodes of abdominal pain, non bilious vomiting and diarrhea. She also gave history of abdominal pain during every menstruation. She had diffuse abdominal tenderness and the computed tomography showed a concentric infective/inflammatory thickening of the distal ileum. Colonoscopy confirmed a tight distal ileal stricture After a failed trial of conservative management, she underwent a laparoscopic right hemicolectomy. The histopathological examination revealed multiple endometriotic foci in the ileum and the appendix. Discussion: Ileal endometriosis presenting as obstruction is uncommon and very few cases have been reported thus far. The symptoms are usually cyclical but may later become continuous with the progression of the disease. Preoperative diagnostic dilemma is due to the clinical and the radiological similarities to inflammatory, infective and irritable bowel diseases. Conclusion: Ours is probably the first case of small bowel obstruction due to ileal and appendiceal endometriosis that was managed with laparoscopic right hemicolectomy. We highlight the preoperative diagnostic dilemma and the progression of the cyclical symptoms. Thus, endometriosis must be considered in cases of small bowel obstruction in women in the reproductive age group as a rare cause