Giant scrotal lymphoedema – A case report

AbstractIntroductionGiant Scrotal Lymphoedema is a rare disease. Such Scrotal elephantiasis presents multiple problems both to the patient as well as the treating clinician obstruction, aplasia, or hypoplasia of the lymphatic vessels. The most common cause world wide is lymphatic Filariasis.Presentation of caseWe present a particularly grotesque where the resected scrotal tissue weighed 32kg which is one of the largest so far mentioned in literature. The lymphoedema was progressive over 8 years duration and the testes were not palpable with the penis deeply buried.DiscussionScrotum was explored and penis was recovered deep within the pit of lymphoedema. Careful dissection done with cautery to delineate penis circumferentially from the root of scrotal lymphoedema. Foleys catheterisation was done. After the separation of penis scrotal skin flaps were raised on either side by extending the incision horizontally. De bulking of lymphoedema was done and the remaining scrotal skin was closed in Y shaped manner with root of penis in centre. Meticulous technique of dissection, cautery and ligasure use of Ligasure enabled excision with minimal blood loss.ConclusionOnce fibrosis sets in resectional therapy will be needed in most cases. Successful reduction scrotoplasty with acceptable cosmetic results can be obtained in giant scrotal lymphoedemas weighing as large as 32kg as in our case

Benign idiopathic stricture of the duodenum

Benign strictures of the distal duodenum are rare. While idiopathic benign strictures of the ileum and jejunum have been described in the literature, those of the distal duodenum have not been described. We describe a case of benign stricture of the proximal portion of the third part of the duodenum presenting with high intestinal obstruction. An approach to the diagnosis of the underlying conditions causing distal duodenal strictures is outlined

Cutaneous metastases from gastric carcinoma

Cutaneous metastases are uncommon. Breast, lungs and abdominal viscera are the common sites of primary tumour in patients presenting with cutaneous metastases. Prognosis for such patients is poor though chemotherapy may offer some benefit. The role of surgery is palliative. We report a 25-year-old man with adenocarcinoma of the stomach who developed tumour deposit in the skin of the face

Aggressive angiomyxoma of the epididymis - a case report

Aggressive angiomvxoma is a distinctive, locally aggressive but non-metastasizing soft tissue tumour of the pelvic region and perineum. This is seen more commonly in premenopausal women. We report a case that occurred in a man who presented with swelling in the inguino-scrotal region for which the patient underwent herniorraphv for hernia with excision of the mass at the upper pole of the testis, in the region of the epididymis

Mesothelial cyst of epididymis - a rare presentation

Mesothelial cysts of epididymis are very rare. Their clinical significance lies in their presentation as discrete testicular masses often diagnosed as hydroceles prior to removal. We report our experience of a cyst lined by mesothelial cells lying at the upper pole of the testes, from the epidi-dyinis

Effects of Exercise based Prehabilitation in Children Undergoing Elective Surgeries:A Systematic Review

This systematic review is to find out the effects of exercise-based prehabilitation seen in children that under go elective surgeries

Penile metastasis from carcinoma of the rectum: A case report

Penile metastases are extremely uncommon. When they do occur the primary lesion is most often in one of the pelvic organs. Patient may present with a painful nodule, priapisfn and urinary obstruction. Treatment is usually pal-liative. Aggressive surgical approach may benefit care-fully selected patients who have no other clinical metastatic lesions