Filariasis of the Axilla in a Patient Returning from Travel Abroad: A Case Report

Background: The term filariasis comprises a group of parasitic infections caused by helminths belonging to different genera in the superfamily Filaroidea. The human parasites occur mainly in tropical and subtropical regions, but filariae are also found in temperate climates, where they can infect wild and domestic animals. Humans are rarely infected by these zoonotic parasites. Patients and Methods: A 55-year-old patient presented with a new-onset, subcutaneous, non-tender palpable mass in the right axilla. Ultrasonography showed a 1.3-cm, solid, singular encapsulated node. Sonography of the breast on both sides, axilla and lymphatic drainage on the left side, lymphatic drainage on the right side, and mammography on both sides were without pathological findings. The node was excised under local anesthesia as the patient refused minimal invasive biopsy. Results: On histopathological examination, the tail of a parasite of the group of filariae was found. The patient revealed that she had stayed in Africa and Malaysia for professional reasons. 6 months before the time of diagnosis, she had also suffered from a fever and poor general condition after a trip abroad. The patient was referred for further treatment to the Institute for Tropical Medicine at the University of Dusseldorf, where a treatment with ivermectin was conducted on the basis of positive staining with antibodies against filariae. Conclusion: Our case demonstrates the importance of interdisciplinary collaboration between breast center, pathology, and other specialties such as microbiology and tropical medicine

A study of biopsy confirmed skin adnexal tumours: experience at a tertiary care teaching hospital

Background and objectives: Skin adnexal tumours are a heterogeneous group of tumours with considerable clinical and histopathological overlap. Methods: Retrospective study of skin adnexal turmours (n=35) diagnosed on histopathological examination over a period of 11 years (January 1993 to December 2003) Results: Majority of the patients were in the third decade; females outnumbered males. Twenty seven tumours were benign and 8 were malignant. The most common benign and malignant tumours were nodular hidradenoma (n=5) and sweat gland carcinoma (n=4). Only 4 out of 35 cases showed clinical correlation with histopathologic diagnosis. Conclusions: Skin adnexal tumours are relatively rare. Benign adnexal tumours are more common than malignant lesions. Histopathology is essential to confirm the diagnosis

Hepatic mucormycosis in a renal transplant recipient: A rare presentation

Fungal infections account for 5% of all infections in renal transplant recipients. Mucormycosis has emerged as an important invasive fungal infection in transplant recipients associated with aggressive clinical course and substantial rates of death. A 28-year-old male with chronic kidney disease underwent renal transplantation from a deceased brain-dead donor. Implantation kidney biopsy showed features of acute tubular necrosis. On follow-up, the patient had progressive renal failure. The patient expired 3 months after transplantation due to sepsis with refractory shock. Postmortem needle biopsy done on the liver showed areas of necrosis with broad, aseptate filamentous fungal hyphae stained positive with Gomori methenamine silver stain favoring mucormycosis. Mucormycosis is a fatal mycosis in transplant recipient due to its angiophilic and thrombosis/hemorrhage-oriented characteristics. The overall mortality rate among solid-organ transplant recipients with mucormycosis is 38%–48%. Early detection and appropriate timely management of fungal infections play a decisive role in improving the survival and reducing the mortality

Cerebellar liponeurocytoma: a case-report

Cerebellar liponeurocytoma is a rare cerebellar neoplasm of adults with advanced neuronal / neurocytic and focal lipomatous differentiation, a low proliferative potential and a favorable clinical prognosis corresponding to World Health Organization grade I or II. Only a few cases have been described in the literature (approximately 20 cases) by different names. A 48-years old female, presented with history of headache and dizziness associated with neck pain; restricted neck movements, drop attacks and occasional regurgitation of food since one year. Magnetic resonance imaging disclosed a right cerebellar mass lesion. Gross total resec- tion of the tumour was accomplished through a suboccipital craniotomy. The excised tissue was diagnosed as cerebellar liponeurocytoma, a rare entity, based on histopathological examination and immunohistochemistry. The morphological appearance of this neoplasm can be confused with that of oligodendroglioma, neurocytoma, ependymoma, medulloblastoma, solid hemangioblastoma and metastatic carcinomas etc., with unpredictable prognosis, which require postoperative radiotherapy, hence the importance of accurately diagnosing this rare neoplasm. This tumour should be added to the differential diagnosis of mass lesions of the posterior fossa

Accuracy of preoperative ultrasonography in measuring tumor thickness and predicting the incidence of cervical lymph node metastasis in oral cancer

Context: A major determinant of the prognosis of oral cancer is the risk of cervical lymph node metastasis. Several factors have been assessed preoperatively to predict the risk of lymph node metastasis; among them, tumor thickness is proved to be a significant predictor of lymph node metastasis. Ultrasonography (US) is a noninvasive, rapid, easily repeatable, and economical examination to measure tumor thickness. This study is undertaken for evaluating the usefulness of US to predict neck metastasis. Aim: To measure tumor thickness in oral cancer with preoperative US and to predict occult cervical lymph node metastasis. Materials and Methods: In all, 43 patients with biopsy-proven squamous cell carcinoma of tongue/buccal mucosa underwent preoperative US to measure tumor thickness. Statistical Analysis: Tumor thickness from histolopathology and US was analyzed using Pearson's product moment correlation. Fisher's exact test was used to assess the relationship between tumor thickness and the risk of cervical lymph node metastasis. Results: There was a significant correlation between preoperative US and histological measures of tumor thickness (correlation coefficient 0.961, P 0.05. Conclusion: Preoperative US is an accurate measure of maximal tumor thickness. Tumor thickness ≥5 mm can be considered as a risk factor for cervical lymph nodal metastasis

Primary synovial sarcoma of the brain in a 35-year-old patient: A rare clinical experience

Synovial sarcoma is an aggressive soft-tissue sarcoma with a poor prognosis and has an origin of uncertain histology. It frequently presents as a localised disease, especially near large joints around the knee and thigh. Intracranial disease, which is rare, has been reported as a metastasis from synovial sarcoma. We report the case of a patient with no obvious primary extracranial pathology, suggesting primary intracranial synovial sarcoma. A 35-year-old male presented with altered sensorium for 1 week. Imaging was suggestive of a left frontal high-grade tumour, for which he underwent decompression. Histology showed biphasic synovial sarcoma. Positron emission tomography–computed tomography did not show lesions elsewhere. He underwent radiotherapy adjuvantly

Reactive Actinomycotic tonsillar lesion

Actinomycosis, because of its varied presentation mimics many other common diseases. We report the rare occurrence of reactive actinomycotic tonsillar lesion in a 17-year-old boy. Accurate histopathological diagnosis facilitated early institution of appropriate treatment

Retained intrauterine foetal bones: a rare cause of secondary infertility leading to diagnostic dilemma

The presence of intrauterine bone fragments is rare. These patients may present with pelvic pain, dysmenorrhoea, abnormal uterine bleeding and secondary infertility. We present a case of a 36-year old woman complaining of dysfunctional uterine bleeding with secondary infertility of six years duration.Detailed history, pelvic ultrasonography, hysteroscopy and histopathological examination of the hysteroscopically evacuated uterine cavity fragments were performed. Morphological examination revealed interesting presence of some tiny bony chips along with endometrial tissue. Intrauterine retained foetal bony chips due to previous medical termination of pregnancy was identified to be the cause of secondary infertility in the present case. Our case reiterates the importance of analyzing detailed clinical history in the evaluation of patients with secondary infertilit

Metastasis in central nervous system: Clinicopathological study with review of literature in a tertiary care center in South India

Background: Secondary central nervous system (CNS) tumors are common in Western countries, but in Indian literature, scant data are available. With the advent of newer imaging techniques, the confirmatory histopathological diagnosis has become comparatively easier. Hereby, we have analyzed our data from a single tertiary care center in south India. Materials and Methods: In this retrospective study from January 2000 to December 2010, histopathologically diagnosed secondary CNS tumors were reviewed along with clinical, imaging, and relevant immunohistochemical findings. Meningeal, lymphoproliferative, and myeloproliferative tumors and autopsy data were not included in the study group. Results: There were 40 secondary CNS tumors. Male to female ratio was 2.3:1. Age range was wide (28-75 years). Majority of cases were seen in the fourth and fifth decade. Imaging-wise, (computed tomography and magnetic resonance imaging) majority were single lesions ( n = 34, 85%). Most commonly, these single lesions were present in the cerebral hemisphere ( n = 20, 50%) followed by cerebellum ( n = 10, 25%). Adenocarcinoma accounted for maximum number of cases ( n = 25, 62.5%) with lungs being the most common primary. Conclusion: We have noted 25% metastatic adenocarcinomas in cerebellar location, which is higher when compared with available world literature. However, we also encountered a good number of cases (30%) due to unknown primary. Though histopathological examination with use of immunohistochemical markers can reliably distinguish primary from secondary CNS tumors in addition to available clinical and imaging data, particularly in developing countries, still a better work-up with an array of immunohistochemical markers and newer imaging modalities is desirable