Caesarean scar pregnancy with scar dehiscence - successful laparoscopic management and the review of literature

Caesarean scar ectopic pregnancy is a rare but potentially life threatening entity. The diagnosis and treatment of caesarean scar pregnancy is challenging. The true incidence has not been determined as there are only few cases reported in the literature. The optimal management of this condition is individualized based on various factors. Here we report a case of caesarean scar pregnancy with scar dehiscence which was successfully managed laparoscopically. Patient underwent laparoscopy with complete removal of trophoblastic tissue, repair of scar defect following prophylactic bilateral ligation of anterior division of internal iliac artery without need for blood transfusion. Laparoscopy is an effective and minimally invasive approach in dealing with scar pregnancy

Primary neuroendocrine carcinoma of the breast: A rare entity

Neuroendocrine carcinomas of the breast are a rare and distinct entity that is not routinely encountered in clinical practice. The diagnosis of primary neuroendocrine breast carcinoma is mainly a diagnosis of exclusion as the metastatic disease is more common a possibility. The algorithmic approach in the evaluation of such tumors includes the clinical and radiological examination of the breast lumps followed by correlation with Histopathological study and Immunohistochemistry tests. We report a case of primary neuroendocrine carcinoma of the breast in a 64-year-old female who presented with breast lump for one month duration

Case series of rare ovarian malignancy: granulosa cell tumor

Granulosa cell tumors are rare ovarian sex cord stromal tumors characterized by indolent course and favorable prognosis. The treatment of granulosa cell tumor is individualized based on many factors like age, desire for future fertility and stage of the disease. Here, we report three cases out of which two were acute presentation and one was diagnosed incidentally when she got evaluated for menstrual irregularity. Fertility sparing surgery with proper staging is offered to young patients presenting in early stage. In patients who have completed family, comprehensive surgical staging including hysterectomy with bilateral salpingo oophorectomy is the standard treatment. Lymph node metastasis in granulosa cell tumor is very rare, hence pelvic and para aortic lymphadenectomy can be safely avoided if preoperative findings and frozen section favour granulosa cell tumor

Laparoscopic-assisted resection of jejunal GIST with Acute Gastrointestinal Bleed

Small intestinal bleeding accounts for about 5-10% of gastrointestinal bleed. Jejunal GIST’s though can be a cause but rarely present with acute bleed. The diagnosis of such cases can be quite challenging and requires a multidisciplinary approach. We present a case of acute bleed from jejunal GIST that was managed by laparoscopic-assisted resection. The postoperative period was uneventful and the patient was discharged on day four. Histopathological examination of the specimen was suggestive of GIST that was confirmed further with immunohistochemical staining

Laparoscopic repair of high rectovaginal fistula: Is it technically feasible?

BACKGROUND: Rectovaginal fistula (RVF) is an epithelium-lined communication between the rectum and vagina. Most RVFs are acquired, the most common cause being obstetric trauma. Most of the high RVFs are repaired by conventional open surgery. Laparoscopic repair of RVF is rare and so far only one report is available in the literature. METHODS: We present a case of high RVF repaired by laparoscopy. 56-year-old female who had a high RVF following laparoscopic assisted vaginal hysterectomy was successfully operated laparoscopically. Here we describe the operative technique and briefly review the literature. RESULTS: The postoperative period of the patient was uneventful and after a follow up of 6 months no recurrence was found. CONCLUSION: Laparoscopic repair of high RVF is feasible in selected patients but would require proper identification of tissue planes and good laparoscopic suturing technique

Mucosal prolapse polyp masquerading as malignancy: A rare case report

Mucosal prolapse polyp is a variant of mucosal prolapse syndrome which comprises of various clinical and histopathological entities, with mucosal prolapse as the underlying pathogenic mechanism. We present the case of a 17-year-old male with a history of mucous discharge per rectum. Colonoscopy revealed ulceroproliferative polypoid growth in distal rectum at 18cm from the anal verge. Polypectomy was done which showed polypoid rectal mucosa with branching and distortion of crypts. Splaying of muscle fibers into lamina propria, mixed inflammatory cell infiltrate and fibrosis was noted. After review of clinical history and histopathology, the patient was diagnosed to have mucosal prolapse polyp, a variant of mucosal prolapse syndrome. Here, we present this rare case to enlighten the importance of identifying mucosal prolapse syndrome as the treatment plan completely changes