Pediatric Granular Cell Tumor of the Breast: An uncommon neoplasm in an uncommon site and age group

Granular cell tumor (GCT) is a rare soft tissue neoplasm of Schwann cell origin. Most cases occur in adults; however, the precise incidence is unknown in children. GCT is usually a slow-growing, painless tumor involving the skin and soft tissues that is mostly located in the head and neck region, especially the tongue. The breast is one of the least common sites involved by GCT. This paper presents a 3-year-old girl who presented with a soft to firm, ill-defined swelling on the right breast with painful ulceration of the overlying skin. Fine needle aspiration rendered an initial diagnosis of fibrocystic change accompanied by apocrine metaplasia. Histologic evaluation of the excised breast mass revealed a benign granular cell tumor. Although rare, GCT of the breast should be included in the differential diagnosis for breast masses in pediatric patients. Proper diagnosis and timely management of this tumor are essential because of its malignant potential (<2% of cases) and high rate of local recurrence if not properly excised

Antenatal and postnatal sonographic imaging findings of a single ventricle presenting as double outlet right ventricle with rudimentary left ventricle and single atrium

Congenital heart disease is a major cause of morbidity and mortality. Single ventricle is a rare finding and usually of left ventricular morphology. We present here interesting antenatal and postnatal echocardiographic findings of a baby having a rare single ventricle of right ventricular morphology with double outlet. Antenatally we saw a large ventricular septal defect indistinguishable from a single ventricle with left to right ventricular ratio of 1:1. Postnatally we saw a single ventricle having the outlets for both the main pulmonary artery and aortic root. The left ventricle is collapse with a rudimentary morphology possibly due to changes in hemodynamics after birth and absent of outlet from it

Comparison of ultrasonography and Intravenous urography in predicting the outcome of Extracorporeal Shockwave lithotripsy in nephrolithiasis

Introduction: ultrasound has a well established role in evaluating the kidney. Calculus is readily picked up on ultrasound. Normal sonographic features with doppler detection of ureteric jets indicate presence of normal renal function. Using these advantages we undertook this present study to determine whether ultrasound (USG) can replace intravenous urography (IVU) in the pre-operative evaluation of extracorporeal shockwave lithotripsy (ESWL) patients. Methods and Material: This study was a prospective observational study conducted in the Department of Radiodiagnosis, Regional Institute of Medical Sciences (RIMS), Imphal, during a period of 2 years. 50 patients with confirmed renal stones referred for ESWL treatment in the Department of Urology, RIMS, Hospital, Imphal were included. USG and IVU were independently interpreted. Cases were grouped as excellent, good, borderline or poor cases. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of USG and IVU are compared. Results: The sensitivity and specificity of ultrasound in predicting the outcome after ESWL for solitary renal calculus is 95.8% and 50% respectively with a PPV and NPV of 97.8% and 33.33% respectively and the sensitivity and specificity of IVU in predicting the outcome after ESWL are 97.9% and 50% respectively with a PPV and NPV of 97.8% and 50% respectively. Conclusions: USG can be the alternative radiological examination in the pre-operative evaluation of ESWL patients as the USG and IVU have comparable predictive values

Papillary cystadenocarcinoma of the parotid gland: a rare sub-variant of salivary gland adenocarcinoma

Papillary cystadenocarcinoma of the salivary gland is a very rare malignant neoplasm accounting for only 2% of all salivary gland lesions. In 1991 it was first included as a separate entity in the World Health Organization (WHO) classification of salivary gland tumors and in 2017 WHO Classification, the tumor was clubbed as a sub-variant of adenocarcinoma, not otherwise specified. It most commonly occurs in the major salivary glands. Herein we report a case of salivary papillary cystadenocarcinoma in a 54-year-old female, who presented with rapid enlargement of the right parotid swelling. Based on radiology and fine-needle aspiration cytology, a working diagnosis of the malignant tumor involving the superficial lobe of the right parotid gland was made. In view of the malignant nature of the swelling, superficial parotidectomy was done. The histopathology and immunohistochemistry of the mass confirmed the diagnosis of papillary cystadenocarcinoma of the right parotid. With the revised 2017 WHO classification of salivary gland tumors, it is important to report all rare subtypes in order to understand their biology and behavior

Rectovaginal Fistula Complicated by Retained Vaginal Foreign Body: A Case Report

Foreign bodies in the genital tract are rare but can be found in females of all ages. Objects inserted vaginally may be for therapeutic purposes, accidental placement, and sometimes even for sexual gratification. Non therapeutic objects commonly seen include tampons, bottle caps, sex toys, and, rarely, metallic objects of various shapes and sizes. The authors report a case of a 40-year-old widowed woman, with no living children, presenting with foul-smelling vaginal discharge and passage of stool per vagina. Upon examination, a retained vaginal foreign body was noted intravaginally, complicating as a rectovaginal fistula, necessitating emergency laparotomy and requiring a colostomy. Long-retained objects are known to cause excessive foul-smelling discharge and can lead to serious complications such as lacerations, pelvic inflammatory disease, fistulas, fibrosis, and even death. Therefore, patients should seek medical attention and be treated promptly to prevent any complications