EPIDERMAL INCLUSION CYST OF THE PERIANAL REGION: REPORT OF A RARE CASE

Epidermal cysts are congenital lesions that originate from embryonal tissue remnants. It requires histopathology for its diagnosis. In this case, we report a young male with no comorbidities presenting with perianal swelling. He was evaluated and taken up for surgery. Post operative period was uneventful and he was discharged on 2nd post operative day. He is doing well at 4 months of follow up.

The Story of Separate Yet Connected Cholesteatomas

Significance Statement Petrous cholesteatoma is rare but frequently leads to complications. A thorough radiological evaluation helps in identifying the pathology and the extent of disease. Sound anatomical knowledge is vital for the planning of surgical approach to get adequate access without damaging important structures. Presentations in congenital lesions are varied due to the uneven growth model of the temporal bone. To the best of our knowledge, the pattern of involvement in this case has never been reported earlier.

Cervicofacial Actinomycosis in the Pediatric Population: Presentation and Management

Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and prolonged antibiotic therapy. Thirty-four pediatric cases of cervicofacial actinomycosis are reviewed, 2 presented herein, and 32 from the published literature. There was equal gender distribution and the median age was 7.5 years. The most common site for infection was the submandibular area. Four (12%) of cases arose in pre-existing congenital lesions. Most patients were treated with penicillin-based antibiotics for a median duration of 6 months following surgical excision or debridement. Conclusions: Actinomycosis is a rare infection of the cervicofacial region; secondary infections arising from congenital lesions of the head and neck are even more rare. A previously excised pre-auricular sinus and a sublingual dermoid cyst are not previously reported sites of infection. Actinomycosis should be suspected in chronically draining sinuses of the head and neck region and confirmed through anaerobic culture. Osteomyelitis is a potential complication and magnetic resonance (MR) imaging is warranted. Long-term antibiotic therapy with a penicillin-based antibiotic and surgical excision should be considered.

Role of Neurosonography in evaluation of brain abnormalities in neonates

Background: Brain damage in preterm infants may result from a series of eventsrather than one specific insult. Maturational characteristics with a failingadaptation capacity may predispose the brain to harmful events during bothintrauterine and extrauterine life. The study aimed to detect anomalies in the brain of neonates with neurosonography. Methods : the studywas conducted on patients with clinically suspected lesions in the brain, undergoing NSG for evaluation of brain abnormalities in Prathima Institute ofmedical sciences, Karimnagar.Neurosonographic examinations were performed through anteriorfontanelle in both the coronal and sagittal planes.The examination started in the coronal plane along the coronal suture, with a transducer angled towards the frontal region. Then brain was examined invarious coronal planes by sweeping the transducer from anterior to posterior. Results : The most common abnormality found on neurosonogram in 3 – 5 days was germinal- matrix haemorrahge comprising n=13 (31%) followed by PVL n=12 (28.6%), cyst n=5 (11.9%), flaring n=5 (11.9%), cerebral edema n=4 (9.5%), congenital lesions n=2 (4.8%) and infections n=1 (2.4%). Follow up scan was performed around 2nd week of life, n=24 (57.1%) neonates were showing normal neurosonogram findings, remaining 18 (43%) showing abnormal findings, which are PVL n=6 (14.3%), GMH n=9 (21.4%), cyst n=1(2.4%), cerebral edema n=1 (2.4%) and congenital lesions n=1 (2.4%). Conclusion: High incidence of brain injuries was detected in babies born less than 32 weeks of gestation, weighing less than 1500 gm. The commonest clinical presentation was seizures followed by absent suckling and lethargy. The abnormalities found on the neurosonogram in our study were germinal matrix hemorrhage, periventricular leukomalacia, cystic PVL, corpus callosum agenesis, and TORCH infection.The mortality rate was high in grade III and grade IV GMH.10-14 days followup scan detected new cases of cystic PVL which were not diagnosed in the initial scan

Giant dorsal sacral meningocele in a child

Sacral meningoceles are uncommon congenital lesions, usually described in the anterior or lateral position, and they typically are asymptomatic [1,7]. A nine-years male child presented with a progressively increasing swelling over the lumbosacral region since birth.

Intracranial Neurenteric Cyst in a Patient with Acute Unilateral Thalamic Infarction

Intracranial neurenteric cysts are rare congenital lesions that can be mistaken for other lesions. They may contain mucous or serous glands, smooth muscle, lymphoid tissue and components of connective tissue. We report a case of neurenteric cyst which was detected accidentally by diagnostic imaging in the context of a thalamus infarct in a 45-year-old woman. We also discuss the results of a brief literature review and the pathological findings, imaging spectrum, evaluation and management of neurenteric cysts and thalamic infarctions.

“The Innate Tail”: An Unusual Cause of Rectal Bleeding in an Adult Male

Retrorectal cystic hamartomas or tailgut cysts are infrequent congenital lesions presenting as presacral masses originating from the embryonic hindgut. They are commonly diagnosed in middle-aged women. Physicians must have a high index of suspicion to diagnose this rare tumor. We report a case of retrorectal hamartoma in a 70-year-old male presenting as rectal bleeding instead of the usual compressive symptoms. The utility of imaging modalities and the paramount importance of histopathology has been described. The treatment modality is surgical excision to prevent the potential malignant transformation.

Incomplete diprosopia with ventral cerebellum inversion in one bovine calf

The objective of this case report is to relate a malformation in a newborn male girolando breed bovine calf. The bovine presented craniofacial duplication and was sent to the Animal Diagnosis Center (CDA) at the Federal University of Rondônia (UNIR). The descriptive study of the main anatomical changes observed during the desiccation of the facial muscles and removal of the brain was performed. The anatomical parts were exposed on a board for photo documentation and description of the malformations. The diagnosis of incomplete diprosopia was made by observing the congenital lesions on the face and brain characterized through the craniofacial junction without total head separation; the animal presented triophthalmia, duplication of nasal and oral structures with lateral deviance of the right jaw side. The animal’s cerebellum was found in the opposite position and was united with the two brains through the cerebral peduncles in a caudal cranial orientation. In this case report, it was not possible to determine the malformation etiology, however, it emphasizes the importance of diprosopia in bovine and it suggests the need of further studies about the mechanism that produce cranial alterations.