Evaluation of Ultrasonography and CT for Imaging of Head and Neck Pilomatricoma in Children and Adolescents

Background and Objectives Pilomatricoma is a frequently diagnosed skin lesion of the head and neck that may often be misdiagnosed as other skin lesions. This study evaluated whether ultrasonography (USG) or computed tomography (CT) is the most helpful imaging modality for the accurate preoperative diagnosis of pilomatricoma in head and neck regions of children and adolescents.Subjects and Method A retrospective review was conducted for 59 patients with pilomatricoma under the age of 19 years. All cases were pathologically confirmed with pilomatricoma in the head or neck.Results Preoperative imaging examinations were performed with USG in six cases and with CT in nine cases. The accuracy of preoperative diagnosis was compared between three groups: 1) with clinical findings only, 2) with USG, and 3) with CT. The correct preoperative diagnosis was made in 18 (30.5%) of the total of 59 cases. Using only clinical findings, 10 (22.7%) out of 44 patients were diagnosed as pilomatricoma. With the addition of USG, pilomatricoma was diagnosed in 1 (16.7%) out of six cases, whereas with the addition of CT, 7 (77.8%) out of 9 cases (77.8%) were diagnosed correctly. Preoperative diagnosis of pilomatricoma with CT imaging was more accurate than clinical findings only (vs. CT; odds ratio [OR]=11.900, 95% confidence interval [CI] 2.126-66.615; p=0.001) or USG (vs. CT; OR=17.500, 95% CI 1.223-250.357; p=0.020).Conclusion In the preoperative diagnosis of pilomatricoma, imaging modalities such as CT and USG are helpful, with CT offering higher diagnostic accuracy and USG procedural benefits in younger children.

Colonic Lipoma Causing Bowel Intussusception: An Up-to-Date Systematic Review

Background: Colonic lipomas are rare and can sometimes cause intussusception. The aim of this review was to define the presentation and possible management for colocolic intussusception caused by colonic lipomas. Methods: A systematic search for patients with colocolic intussusception caused by colonic lipoma, including all available reports up to 2021. Epidemiological, clinical, laboratory, and instrumental data and details about the treatments performed were gathered. Results: Colocolic intussusception caused by lipoma is more frequent in women (57%), occurring between 40 and 70 years of age. Up to 83% of patients report abdominal pain, followed by constipation (18%), rectal bleeding (16%), and diarrhea (12%), with abdominal tenderness (37%), and distension in 16%, whereas 24% have a negative exploration. CT (72%) and colonoscopy (62%) are more commonly able to diagnose the entity. The most common location of intussusception is the transverse colon (28%). The surgical operation varies according to the site. The average dimensions of the lipoma are 59.81 × 47.84 × 38.9 mm3. Conclusions: A correct preoperative diagnosis of colonic lipoma causing intussusception might not be easy. Despite nonspecific clinical and laboratory presentation, cross-sectional imaging can help differential diagnosis. Surgical treatment depends on the localization.

Amyand's hernia complicated with appendicitis

Introduction: The finding of a vermiform appendix within the peritoneal sac of an indirect inguinal hernia occurs in approximately 1% of cases. However, the presence of appendicitis within an inguinal hernial sac is found only in 0.08% of the general population.Case report: We present the case of a 58-year-old male patient that was admitted with abdominal pain associated with a small non-reducible right groin mass.Discussion: To establish the correct diagnosis preoperatively, an abdominal and pelvic CT scan is mandatory.Conclusion: Acute appendicitis in an Amyand's hernia is a very rare entity that can be easily misdiagnosed preoperatively. CT is extremely useful in reaching the correct preoperative diagnosis.

Primary Synovial Chondromatosis of Elbow: A Bowl Full of Tumors

Synovial osteochondromatosis is a disease of the synovium characterized by the formation of multiple cartilaginous bodies. The disease is characteristically monarticular, most commonly involving the knee. Despite frequent mention of elbow involvement in various texts and articles, we wish to review the clinical, radiologic, and histologic features of synovial osteochondromatosis of the elbow by presenting a case in an elderly male. By correct preoperative diagnosis and complete excision, full range of motion can be achieved in an relatively unforgivable elbow joint even with a delayed presentation. Keywords: Loose bodies, Elbow, Synovial

Results of diagnosis and surgery of small bowel cancer at Bach Mai Hospital

Tóm tắt Đặt vấn đề: Ung thư ruột non là khối u hiếm gặp, thường được chẩn đoán và phẫu thuật ở giai đoạn muộn khi biến chứng đã xảy ra. Nghiên cứu nhằm mô tả đặc điểm lâm sàng, cận lâm sàng, đánh giá kết quả phẫu thuật ung thư ruột non. Phương pháp nghiên cứu: Nghiên cứu mô tả, hồi cứu 45 người bệnh (NB) ung thư ruột non nguyên phát được phẫu thuật tại Bệnh viện Bạch Mai từ 2012 đến 2016. Thu thập các đặc điểm lâm sàng, cận lâm sàng, chẩn đoán trước mổ, mô bệnh học, kết quả điều trị và thời gian sống thêm. Kết quả: 45 NB gồm 23 nam, 22 nữ, hay gặp ở nhóm 41 đến 60 tuổi. Triệu chứng đa dạng, không đặc hiệu và thay đổi theo thể giải phẫu bệnh, có 64,4% chẩn đoán được trước mổ là u ruột non. Chụp cắt lớp vi tính chẩn đoán chính xác 56,7%. Thể saccom cơ trơn gặp nhiều nhất (51,1%), carcinoid gặp ít nhất (4,4%). Kết quả điều trị không có tử vong, 8,9% nhiễm trùng vết mổ. Thời gian sống thêm sau mổ trung bình là 71,1 ± 1,98 tháng, thể ung thư biểu mô tuyến ngắn nhất 22,1 ± 9,5 tháng, thể u carcinoid dài nhất 54,7 ± 12,2 tháng, tuổi >30 tiên lượng tốt hơn nhóm < 30. Kết luận: Ung thư ruột non vẫn còn khó chẩn đoán đúng trước mổ. Điều trị phẫu thuật có hiệu quả tốt và tiên lượng phụ thuộc lứa tuổi và thể mô bệnh học. Abstract Introduction: Small intestine cancer is a rare tumor that is usually diagnosed and operated at a later stage when complications have occurred. Objectives: Describe clinical, subclinical characteristics and surgical results of small intestine cancer. Tạp chí Phẫu thuật nội soi và Nội soi Việt Nam (2020) Số 5 - Tập 10; 27 - 32 27 Kết quả chẩn đoán và điều trị phẫu thuật ung thư ruột non tại Bệnh viện Bạch Mai Trần Hiếu Học và cộng sự Materials and Methods: Descriptive and longitudinal study on 45 patients of primary small bowel cancer operated at Bach Mai Hospital from 2012 to 2016. Data included clinical, subclinical characteristics, diagnosis, histopathology, results of treatment and survival time. Results: The study has 45 patients (23 males and 22 females), most of them aged 41 - 60. Symptoms are diverse, nonspecific and vary according to disease anatomy, correct preoperative diagnosis of small bowel tumor was 64.4% and sensitivity of CT was 56.7%. Frequency of Sarcoma was highest (51.1%) and of carcinoid was least (4.4%). There was no postoperative mortality, 8.9% incision infection. The survival time is 71.1 ± 1.98 months, shortest belongs to carcinoma (22,1 ± 9,5 months) and longest belongs to carcinoid (54,7 ± 12,2 months), prognosis is better in the age group over 30. Conclusions: Proper preoperative diagnosis of small bowel cancer is still difficult. Surgical treatment is effective and prognosis depends on age and histopathology. Keywords: Small bowel cancer, surgery, survival time.

Morphological Variations in Human Liver: A Cadaveric Study

The variations of liver like the accessory fissures and lobes are a potential source of diagnostic errors. The knowledge in the variations may help in diagnosis, treatment planning and minimize the risk of post operative complications. The present study was aimed to observe the morphological variations of livers. The study was done in 70 formalin fixed human livers and was observed for morphological variations. The present study concluded the normal morphology of liver was in 54.28% and anomalies in 45.71% of liver. The most common anomalies were accessory fissures which were found in 32.86% of livers. The second common anomalies were absence or incomplete fissure for ligamentum teres in 15.71% of livers. Then the enlarged papillary process was found in 11.43%, short gall bladder was in 10% and elongated left lobe was in 7.14%. The knowledge of normal and variant liver may contribute to the understanding of the liver disease and to achieve correct preoperative diagnosis; and to avoid intra-operative complications.

Extraorgan retroperitoneal mature teratoma in a 12-year-old child

Teratomas are germ cell tumors consisting of derivatives of 3 germ layers and havingvarious malignant potential – from benign mature forms to immature embryonic and forms with somatic type of malignancy.This article describes the clinical caseof rare localization of mature teratoma – retroperitoneal space, aswell asan example of multidisciplinary interaction of clinicians, radiation diagnosticians and pathomorphologists in correct preoperative diagnosis using computed tomography, successful surgical treatment and histological verification of extraorgan teratoma of the retroperitoneal space.

Isolated liver tuberculosis

Isolated liver tuberculosis is still considered a rare condition and its atypical clinical presentation challenges the clinical acumen of the treating physician. There is difficulty in reaching the correct preoperative diagnosis of nodular hepatic tuberculosis that presents as a space-occupying lesion. It is usually unsuspected and confused with primary or metastatic carcinoma of the liver. In this report, we describe a rare case of isolated liver tuberculosis.

Tuberculosis of Gal-Blader Mimicking Malignancy – A Case Report

A correct preoperative diagnosis of gall-bladder tuberculosis is exceptionally unusual in the absence of pathognomic features both on clinical presentation and on imaging. Herein we present a case of 50 year female who was operated with a provisional diagnosis of gall-bladder malignancy and was found to have tuberculosis of gall-bladder on histopathology.