Post COVID 19- mucormycosis and osteomyelitis of the mandible- A rare case report

Corona virus disease was declared as pandemic in 2020. The second wave of covid 19 in India was completely influenced by the fatal complication of covid 19 called Mucormycosis. It was declared as an epidemic in India after 2 wave. The use of Corticosteroids in the management of covid 19 and uncontrolled diabetes mellitus with other systemic illness has shown tremendous immunosuppression which has ultimately caused Mucormycosis. Mucormycosis is rare in mandible. We are presenting a case report with brief discussion of 9 patients having post covid Mucormycosis along with osteomyelitis of the mandible, the rarest form of the post covid infection, which was managed surgically as well as with adjuvant antibacterial and antifungal drugs followed by post-operative prosthetic rehabilitation. This fatal infection has to be kept in mind in covid 19 active cases as well as in recovered patients, especially in those having comorbidities and judicious use of cortico-steroids should be recommended.

Urachal yolk sac tumor penetrating the bladder as a diagnostic challenge: a case report and review of the literature

Background Yolk sac tumor (YST) is a germ cell tumor. It is primarily located in the gonads but can also occur extragonadally (extragonadal yolk sac tumor - EGYST), most commonly in the pelvis, retroperitoneum or mediastinum. Only a few YSTs of the urachus have been described. Case report We present a rare case report of a 37-year-old male with episodes of macroscopic hematuria. The histological specimen obtained by transurethral resection showed a solid, and in some parts papillary infiltrative, high-grade tumor with numerous areas of marked nuclear atypia and clear invasion between the detrusor bundles. Glandular pattern has been observed in only minority of the tumor. Immunohistochemistry showed significant positivity for GPC3, SALL4 and cytokeratins AE1/AE3, while KRT7 and GATA3 were negative. We concluded that the biopsy findings were consistent with urothelial carcinoma with infrequent YST differentiation. In definitive surgical specimens we found a malignant epithelial, glandular and cystically arranged tumor of germinal appearance arising from urachus. The surrounding urothelium was free of invasive or in situ tumor changes. We reclassified the tumor as a urachal YST. Conclusion EGYST was suspected because glandular and hepatoid structures were found, but the presence of these structures should be verified by immunohistochemistry.

Unilateral absence of internal carotid artery: A rare case report

Unilateral absence of internal carotid artery (ICA) is a rare congenital anomaly. We present the case of a 35-year-old man with episodes of recurrent strokes in the past and now presenting with right-sided upper limb weakness. Radiological diagnostic workup revealed a thin left ICA in the neck with non-visualization beyond petrous bone in the intracranial course. The ipsilateral brain parenchyma is supplied by vessels from the contralateral side of the Circle of Willis. As the patient had no evidence of a cerebrovascular accident on radiological evaluation and no neurological signs and symptoms, he was discharged with anticoagulant medications with the advice of follow-up. This is the first report to describe a case of ICA agenesis with a pattern of collateral circulation that doesn’t fit any of the six types described by Lie.