Clear Cell Hidradenoma of the Breast Diagnosed on a Core Needle Biopsy: A case report and review of the literature

Clear cell hidradenoma (CCH) is a tumour originating from the eccrine sweat glands. It usually presents in the limbs, axilla or trunk. CCH of the breast is rare and can present as a cystic lesion in the breast that can be easily misdiagnosed as malignancy. We report a 36-year-old female patient who presented at the Sultan Qaboos University Hospital Breast Clinic, Muscat, Oman, in 2018 with a lump in her left breast. Ultrasound examination reported a complex cystic lesion with a solid, vascular component. An ultrasound-guided core needle biopsy was suggestive of clear cell hidradenoma. Surgical excision was performed and histopathology confirmed the diagnosis of CCH of the breast. This is the first ever case of a diagnosis of CCH made using core needle biopsy. CCH can be challenging to diagnose; therefore, awareness of its histopathological and ultrasonographic features are essential to avoid misdiagnosis and over treatment.Keywords: Eccrine Glands; Breast; Acrospiroma; Sweat Gland Adenoma; Sweat Gland Neoplasms; Case Report; Oman

Laparoscopic Repair of Traumatic Intraperitoneal Bladder Rupture

Intraperitoneal rupture of the bladder is an uncommon condition that is usually caused by pelvic fractures. This is a true surgical emergency managed conventionally by open laparotomy with single or double layer repair. We present a case of successful laparoscopic repair of an intraperitoneal bladder rupture secondary to blunt abdominal trauma and pelvic fracture in a 37 year-old man. The repair was done using single layer repair, with successful results

Breast One Stop Clinic – Follow up Experience at Sultan Qaboos University Hospital in the Sultanate of Oman

Background: The role of the breast clinics is to diagnose breast cancer and reassure patients with benign disorders. One stop clinics - same day reporting - further reduce anxiety caused by the delay in the results. The first one stop clinic was introduced in SQUH–Oman in September 2011. Methods: This retrospective analysis of 395 consecutive cases presented to Breast One Stop Clinic at SQUH was done between September 2011 and December 2013. All patients underwent triple assessment conducted by consultants. Mammography was performed for patients above 35 years with no contraindications. Ultrasound was done for all patients with palpable lesions. The reports were assigned a score (BIRADS 0-6). Fine Needle Aspiration Cytology (FNAC) was done for all patients with palpable abnormality or nipple discharge. An immediate report was given using the standard reporting categories: acellular/inadequate, benign, atypical, suspicious, and malignant (C1-C5). Results: Out of 395 patients, 210 were found to have palpable lesions with a mean age of 36 years (12-84 years). All patients were female. The FNAC sensitivity and specificity was 95.7% and 92.2%, respectively. Out of 210 patients, 15.3% were diagnosed with breast cancer on FNAC who were subsequently staged and discussed in the Breast Multidisciplinary Team Meeting (MDT), and 84.7% were diagnosed to have benign breast disorders who were reassured and advised to be followed up after 6 months. Conclusions: Immediate relief and reassurance to the majority of patients with benign disease obviate the need for review appointments. A reliable diagnosis can be obtained with triple assessment which can be used to avoid unnecessary core biopsy of benign lesions, if correctly done