A Rare Location of Pseudoaneurysm in Subaortic Ring after Bentall Operation

Bentall operation is considered a gold standard of surgery in the treatment of ascending aortic aneurysm. This operation with en-bloc resection of ascending aorta and aortic valve requires aortic valve with two coronary bottoms re-replacements in a prepared composite graft. The four important locations for the pseudoaneurysm include proximal and distal composite graft anastomosis and two coronary bottom sites. However, many complications have been reported with this technique but the most serious complication associated with this operation is defined as pseudoaneurysm. We report an exceedingly rare case of subaortic ring pseudoaneurysm in retro composite graft position enclosed by infected surgical that was used to control bleeding in this location. Dehiscence occurred between the aortic ring and the underlying left ventricular muscle. The aortic ring was separated from the underlying muscle by the high tensile strength of sewing ring sutures. The pseudoaneurysm compressing the left atrium without communicating with any cardiac chamber and presenting with high fever (39°C), chills, a few months after Bentall operation. The patient underwent redo operation and repair of the dehiscence’s site. The 6-month follow-up revealed no recurrence of a pseudoaneurysm. The uniqueness of this case report is related to the site of pseudoaneurysm between the aortic ring and underlying left ventricular muscle that have not been reported in the medical literature so far.

Osteochondritis Dissecans Lesion of the Trochlear Groove: A Case of Nonsurgical Management for a Rare Lesion

Osteochondritis dissecans (OCD) lesions are potential causes of knee pain in pediatric patients, with lesions most frequently found on the lateral and medial femoral condyles. This case discusses an OCD lesion of the trochlear groove, a rare location for OCD lesions, in an 11-year-old female athlete. The patient presents after several years of knee pain that had acutely worsened, and both X-ray and MRI demonstrated the lesion, with MRI confirming a stable lesion. While previous literature has leaned towards surgical management, this patient was successfully managed nonoperatively in a locked knee brace for 12 weeks. She then went through 4 weeks of physical therapy and a 4 week progression back into soccer activity with return to full activity in 5 months.

Alveolar soft part sarcoma of the retroperitoneum: A case report

Alveolar soft part sarcoma is a rare soft tissue tumor with uncertain histogenesis. It is a slow growing tumor with a high rate of metastasis. The tumor is not easily identified as clinical symptoms are not pronounced. The retroperitoneum is a rare location of tumor, with a few cases published in literature. Surgical excision is the mainstay of treatment. Here we describe a rare case of a large retroperitoneal Alveolar soft part sarcoma in a young female with radiological and histopathological findings.

Odontogenic Keratocyst in Anterior Mandible: A Case Report

Odontogenic Keratocyst (OKC) is a non-inflammatory developmental odontogenic cyst arises from cell rest of the dental lamina and most commonly occurs in the posterior of the mandible. OKC may be detected in patients of various age groups, from infants to seniors, and usually occurs in the third and fourth decades of the patient’s life. Female to male prevalence is 2:1 respectively. Mandible makes up 60% to 80% of cases and shows a specific tendency to involve the ramus and posterior area. Detection of OKC through clinical exams and radiography is to be suspected, and thus, confirmation via histopathology is needed. This study describes the occurrence of this lesion in a rare location in a 36 years old female patient.

Rare location of Universal tumor

Lipomas are one of the most common benign mesenchymal tumor in human. Lipoma occurring in the tongue is rare as tongue has paucity of normal adipose tissue. Here we present an unusual case of lipoma presented in the tongue, and removal of which comforted patient by regaining of the functional task of tongue. Fifty two year’s old Muslim women presented with painless swelling on right lateral border of tongue for 5 years for which excision was done and histopathology evaluation was performed. The histopathology was consistent with the diagnosis of Lingual Lipoma. Existence of lipoma in the tongue is very rare, which can be managed by simple excision. Histopathology is the gold standard in the diagnosis.

Endodermal cyst: rare intraaxial brainstem location. Illustrative cases

BACKGROUND This report detailed an extremely rare location of an endodermal cyst. Such location of the tumor can pose radiological confusion and a therapeutic dilemma. However, when identified, it can be a pleasant surprise for the surgeon and provide the possibility of a symptom-free long life for the patient. OBSERVATIONS This report discussed two young patients who presented with relatively short-duration reports of ataxia and diplopia. Investigations revealed intraaxial brainstem lesion. During surgery, thick, pus-like fluid was evacuated and part of a wall was resected. Histology revealed that the lesion was an endodermal cyst. Both patients are well and are lesion- and symptom-free for 24 and 72 months. LESSONS Endodermal cysts are some of the few long-standing and benign intraaxial brainstem lesions.