Hepatic haemangioma causing isolated right-sided pleural effusion and bilateral pedal oedema

Hepatic haemangioma (HH) is a common benign tumour of the liver and is usually asymptomatic. HH causing isolated right-sided pleural effusion and bilateral pedal oedema due to inferior vena cava (IVC) compression have never been reported in the literature. We report a 35-year-old male patient who presented with breathlessness and mass per abdomen. On examination, the patient was found to have right-sided pleural effusion, bilateral pedal oedema, hepatomegaly. Contrast-enhanced CT showed compression of the IVC by the HH. The patient was managed with right-sided intercostal drain insertion for pleural effusion and hepatic artery embolisation. The patient improved gradually with reduced pleural effusion and resolving pedal oedema.

First comprehensive report on distribution of histologically confirmed oral and maxillofacial pathologies; a nine year retrospective study

Objective: To report the distribution of oral and maxillofacial pathologies diagnosed histologically in laboratory. Methods: The retrospective descriptive cross-sectional study was conducted at Rehman Medical Institute, Peshawar, Pakistan, and comprised biopsied lesions submitted to the institutional laboratory from 2010 to 2019. Data on gender, age, site of the lesion and histopathological diagnosis was retrieved from the records. Data was analysed using Microsoft Excel. Results: Of the 986 histologically confirmed cases, 545(55.27%) related to males and 441(44.72%) to females. The overall mean age of the patients was 43.20+19.85. Tongue was the most affected site 159(16.1%). The most common diagnostic category was malignant tumours 338(34%), followed by salivary gland pathology 162(16%), and cysts and odontogenic tumours 138(14%). The most common histopathological finding was oral squamous cell carcinoma 249(25.2%), and pleomorphic adenoma was the most common benign tumour 103(10.4%). Conclusion: Oral squamous cell carcinoma was the most common malignancy, while pleomorphic adenoma was the most common benign tumour. Key Words: Oral and maxillofacial lesions, Prevalence, Histopathology, Benign lesions, Malignant lesions.

PLEXIFORM NEUROFIBROMA OF THE BRACHIAL PLEXUS – A RARE CASE REPORT

Neurobroma is a common benign tumour occurring as part of an autosomal dominant disorder, neurobromatosis type 1, leading to the formation of benign tumours or neurobromas of the peripheral nervous system. Large neurobromas of the brachial plexus are rare and present a difcult challenge for surgeon due to the anatomical complexity of the brachial plexus. Dermal neurobromas usually present with swelling and occasional pain, but neurobromas associated with the brachial plexus present with pain and neurological symptoms. These plexiform neurobromas of the brachial plexus are known to undergo malignant transformation. Here, we present a case of a large plexiform neurobroma affecting the left brachial plexus and extending till the elbow, conrmed with MRI and surgical debulking was done.

CLINICOPATHOLOGICAL AUDIT OF SUBMANDIBULAR GLAND SURGERY

Aim:- Aim of this study is to evaluate clinical profile and histopathological findings in patient undergoing submandibular gland excision (due to sialadenitis and primary tumors of submandibular gland benign or malignant). Method:-we carried out retrospective analysis of submandibular gland excisions performed in our hospital over five year period and analysed clinical data and postoperative histopathological findings of excised glands. Results:- In 43 cases of submandibular gland excision main presenting symptom was swelling of submandibular gland (100%). Patients presented with pain 26 (60%), swelling 43 (100%), recurrent swelling 30 (70%), persistent swelling 13 (30%). On palpation, firm consistency was seen in 42 cases (97.67%) and hard consistency in 1 case (2.3%). Swelling was tender in 20 Cases (46.5%) and non tender in 23 cases (53.4%). Most frequent indication of submandibular gland excision was sialadenitis with sialolithiasis (37 patients, 86%). Neoplastic pathology was present in 6 patients (14%). Benign pathology (4 patients, 9.3%) was more common than malignancy (2 patients, 4.7%). Most common benign tumour was pleomorphic adenoma of submandibular gland. Among the malignant tumour 2 cases were identified in histopathogy, one of adenoid cystic carcinoma and 1 of acinic cell carcinoma of submandibular gland. Overall benign/malignant ratio was 2:1.Conclusion:- Inflammatory submandibular gland swelling are mainly enlarged and tender while neolastic swellings are non tender. The most common pathology of the patients undergoing submandibular gland excision was chronic sialadenitis followed by neoplastic Pathology. In neoplastic pathologies benign tumors were more common than malignancy

Anal excision of perianal fibroadenoma: Expect the unexpected

Breast fibroadenomas are a common benign tumour in women that may need to be surgically excised. A mammary-like fibroadenoma can exceptionally be found in the pathological report after an anal polyp removal. A 60-year-old woman presented with huge anal polyp of 25 mm. It was surgically removed transanally. Histologic examination revealed a breast fibroadenoma pattern with glandular structures. Proctologist specialists must be aware that mammary-like tumours are a possible differential diagnosis for anal masses despite their rarity in the literature.

Treatment of Infantile Hemangioma

Infantile hemangioma represents the most common benign tumour arising ininfancy. The natural history of infantile hemangioma is characterized by aproliferative phase during the first few months of life, followed by slower involutionover the years. Evolution of infantile hemangioma has four stages, contain nascent,proliferation, involution, and involuted. Most infantile hemangioma do not requireactive treatment and involute without leaving significant residual. However, someinfantile hemangioma is problematic due to complications such as ulceration,interference with a vital function, or potential disfigurement. The managementapproach for IH contains active non-intervention and active intervention. Thedecision of treatment is based on many factors, including size and location,psychosocial implication, risks and benefits of the proposed therapy. Earlyrecognition of infantile hemangioma is essential for optimal management andpreventing complication.

Ameloblastoma of the mandible: analysis of radiographic and histopathological features

Introduction: Ameloblastoma is the most common benign tumour of odontogenic origin in Africa and presents five times more in the mandible than the maxilla. The presentation of ameloblastoma in the mandible is unique due to its anatomical variation and hence the aim of this study was to analyse the radiographic and histopathological features of ameloblastoma involving the mandible. Materials and methods: This was a retrospective, descriptive study of all histopathologically diagnosed ameloblastoma of the mandible over a period of 45 years. Patient demographics, radiographic and histopathological features were recorded and compared to previous studies. Results: A total of 148 lesions were included. The male to female ratio was nearly equal (1.05:1). The majority of patients were below 50 years of age (83.77%) and were black African (58.8%). The posterior region was the most affected site with majority of lesions presenting with multilocular appearance (68.24%) and root resorption (66.38%). Histologically, conventional ameloblastoma was the most common variant (48.65%). Conclusions: Mandibular ameloblastoma had a higher predilection for black African patients with higher prevalence of mixed density lesions when compared to previous studies. The size of lesions in this sample was considerably larger than those reported in previous studies. In addition, lesions in this sample also exhibited marked cortical expansion as well as root resorption.

Giant Uterine Leiomyoma in a Young Woman as an Accidental Finding Due to an Ultrasound for Digestive Symptoms Caused by Acute Exacerbation of Chronic Gastritis – A Case Report

Uterine leiomyoma is the most common benign tumour encountered in female genital pathology. It originates from the level of the smooth muscle tissue, and from the morphological point of view, the tumour is well delimited, being surrounded by a pseudocapsule. We report a case of a 46-year old woman who, following a CT scan performed for epigastric abdominal pain and nausea, showed a dense bulky tumour formation, with multiple hyperdense inclusions inside and well-defined areas of necrosis, with maximum axial diameters of 133/168/249 mm (LL / AP / CC), having as a starting point most likely the uterine upper pole. A total hysterectomy is performed, with bilateral anexectomy, and the histopathological examination describes a giant subserosal leiomyofibroma of the uterus with signs of hyaline degeneration, left hydrosalpinx with strong stasis of the left tube, follicular hemorrhagic cysts of the left ovary.

Rare case of combination of warthin tumour with tuberculosis in parotid gland.

We are reporting a case of tuberculosis within warthin tumour of left parotid area in a 72 years old male with findings of benign tumour with acute and chronic inflammation on FNA (Fine Needle Aspiration). Warthin tumour is a benign tumours of the salivary gland particularly parotid region. It is the second most common benign tumour. In addition the tuberculosis in a parotid gland is very rare. Further having tuberculosis within warthin tumour is quite rare.1 To best of our knowledge there is the only few cases which are being reported.

Giant Intermuscular Thenar Lipoma: A Case Report and Literature Review

Lipoma is the most common benign tumour in hand. Lipoma in hand of size more than 5 cm is classified as Giant Lipoma. Lipoma of larger sizes is rare in hand because of accessibility and lesser subcutaneous tissues. Large lipoma interferes in the hand functions. Lipoma in dominant hand is usually noted early and gets operated. This case is of 65 year old female patient who reported with the swelling in right hand for past 25 years. The size of the lipoma was big and asymptomatic till the presentation. The swelling was investigated and surgically removed which was diagnosed histopatholoically as Intermuscular Thenar Lipoma .