Category Archives: Case Reports

SCC Cervix_Diwan A

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Cutaneous metastases after radical chemoradiotherapy in carcinoma cervix: an unusual manifestation
Diwan AK,1 Subeera Khan S,2 Mahobia VK1
Assistant Professor,1,3 Resident2

1-3Department of Radiation Therapy & Oncology, Government Medical College & Hospital, Nagpur, Maharashtra, India.

ABSTRACT
Cervical cancer is one of the most common malignancy affecting women in India, however cutaneous metastasis arising from cervical cancer is particularly rare. Skin metastases are unusual even in the terminal stages of the disease with incidence ranging from 0.1% to 4.4%.Mostly they occur as a sign of recurrent disease and are associated with poor prognosis. We report a case of carcinoma of the uterine cervix with cytology proven unusual extensive metastasis to the vulva, anterior abdominal wall and thigh developing within one month of external beam radiation therapy. Cutaneous metastasis usually presents in the form of nodule, plaque and inflammatory telangiectasia. However in our case presenting symptom was an ulcer which spread to completely destroy the vulva. Adenocarcinomas of the cervix have a higher propensity for cutaneous metastasis. Skin metastases from cervical carcinoma occur predominantly in cases of tumor recurrences, with metastases developing up to 10 years after initial diagnosis. No effective treatment has been identified till date. Palliation is the aim using chemotherapy, radiation and surgery alone or in combination.
KEY WORDS
Carcinoma cervix, cutaneous metastasis radical chemoradiotherapy.

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Renal SCC_Diwan A

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Primary squamous cell carcinoma of kidney: a rare case report

Diwan AK,1 Santosh KR2

Assistant Professor,1 Junior resident2

1-2Department of Radiation Therapy & Oncology, Government Medical College & Hospital, Nagpur, Maharashtra, India.  

ABSTRACT
Neoplasms of the kidney are most commonly adenocarcinomas. Carcinomas of the renal pelvis and ureter are rare, accounting for only 4% of all urothelial cancers. Squamous cell carcinoma of renal pelvis and ureter are very rare and account for 6-15% of all renal tumours of which transitional carcinomas constitute the majority followed by adenocarcinoma and squamous cell carcinoma. Renal squamous cell carcinoma (RSCC) is a rare malignancy of the upper urinary tract characteristically presenting with advanced stage, the reported incidence being 1.4% of all renal malignancies. Very few cases have been reported in literature. Most patients have a history of chronic urolithiasis, renal infection or abuse of analgesics. This tumor is aggressive in nature and usually has a poor prognosis. We report two cases of renal squamous cell carcinoma one with characteristic history of chronic pyelonephritis and one without characteristic etiologic factors. These cases have been reported due to their extreme rarity and also highlight the silent presentation of these tumors and the need to keep it as a differential diagnosis while evaluating cases of nephrolithiasis and chronic inflammations.
KEY WORDS
Chronic pyelonephritis, renal pelvis, squamous cell carcinoma.

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Giant Lipoma_Gaur Rajesh

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Giant Lipoma In Front Of Neck Presenting As Thyroid Neoplasm – A Rare Case 

Gaur R,1 Sharma RL,2 Rai S,3 Jain D4

Professor & Head,1 Associate Professor,2 Demonstrator,3 Resident4

1-4Department of Pathology, G R Medical College, Gwalior, Madhya Pradesh, India.

ABSTRACT
Lipoma is the most common benign soft tissue mesenchymal tumor of adipose tissue. Their occurance in head and neck is relatively rare and is most frequently located in posterior subcutaneous neck region. In this article we report the giant mass in front of neck in 65 year old woman measuring 32cm x 30cm which was increasing slowly since 18 years causing pressure symptoms like dysphagia, dyspnea. It was clinically diagnosed as thyroid neoplasm and confirmed by histopathological examination.
KEY WORDS
Giant lipoma, Head and neck,  Lesions in neck,  Lipoma.

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Treachers collins syndrome_Sarella LK

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Treacher -Collins syndrome

Sarella LK1 Kumar PD,2 Kumari CK3

Professor & Head,1,2 Resident3

Department of Obstetrics & Gynecology,1,3 Department of Orthopedics2

1-3Rangaraya Medical College, Kakinada, Andhra Pradesh, India.

ABSTRACT
INTRODUCTION Treacher Collins syndrome (TCS) is a rare syndrome inherited as autosomal dominant. The affected children may vary in severity ranging from minimal features as slanting of palpebral fissures to major features of craniofacial development such as hypertelorism, micrognathia, maxillary hypoplasia, high arched palate, conductive hearing loss, external ear abnormalities and narrow nostrils. We report a case of Treacher Collins syndrome with term gestation with polyhydramnios and fetus with micrognathia on ultrasound examination with previous two babies and father having the same disorder.

Case Report

A 30year old ,unbooked G3 P2 L1D1, postcesaerean pregnancy, term gestation with polyhydramnios with breech presentation with features of TCS admitted for institutional delivery at Government General Hospital, Kakinada, Andhra Pradesh, India. Her scan on admission revealed single fetus in breech presentation with micrognathia and AFI 25cm. she delivered a live male baby weighing 2.2kg with features of TCS through ceserean section and inspite of airway support the baby died on first postnatal day.

Conclusion

This case report confirms the need to identify the antenatal women with physical malformations and early ultrasound scan in women with previous H/O anomalous children, and polyhydramnios so that termination can be planned early. 

KEY WORDS
Polyhydramnios , Treacher Collins Syndrome, Micrognathia, Anti mongoloid slant of eyes

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Recurrent Infections_Goyal S

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Recurrent infections in a five year old boy

Goyal S,1 Goyal V2

Assistant Professor1,2

1Department of Pediatrics, Chirayu Medical College & Hospital, Bhopal, M P, India

2Department of Medicine, Chirayu Medical College & Hospital, Bhopal, M P, India

ABSTRACT
Children are prone to develop recurrent illness in the form of upper respiratory tract infections, gastroenteritis, pustulosis and otitis media owing to developing immunity and environmental exposures. Majority of such children improve on symptomatic treatment. However, few of them might develop severe life threatening infections affecting vital organs. Primary immunodeficiency is an entity in which children develop recurrent infection due to defect in the development of immune system. This may affect plasma cells, T lymphocytes, natural killer cells or peripherally circulating leucocytes. We present a 5 year old male child with such diagnosis. A five year old boy was admitted with history of repeated infections since one year of age. His serum IgA, IgG and IgM levels were markedly decreased. Flow cytometry showed absence of B cells. He was started on intravenous immunoglobulin 10 gm every four weeks following which there was marked reduction in intercurrent infections. Primary immunodeficiency should always be suspected in differential diagnosis if history of repeated infections exist.
KEY WORDS
Primary immunodeficiency, recurrent infections.

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AdenoCA of Duodenojejunal junction_Dubepuria

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Adenocarcinoma of Duodenojejunal junction: A case report
Dubepuria R,1 Gupta AK,2 Gupta A,3 Gupta A,4 Gupta AK5

PG Resident,1,5 Assistant Professor,2 Professor and Head,3 Associate Professor,PG Resident5

1,2,3,5Department of Surgery, G.R. Medical College, Gwalior,  M.P, India

4Department of Radio-Diagnosis G.R. Medical College, Gwalior, M P, India

ABSTRACT
Adenocarcinoma of duodenum contributes only 0.3-0.4% among all Gastrointestinal malignancies though 75% of all duodenal malignancies are adenocarcinoma.The reported incidence has been increasing due to the widespread use of endoscopy. Adenocarcinomas are the most common of small bowel malignancies, followed by carcinoid tumours, lymphomas, and leiomyosarcomas. We have reported adenocarcinoma in 60 years male. Surgery is the only means of cure. More evidence is needed to help define the role of segmental duodenectomy and chemotherapy in the management of this disease.
KEY WORDS
Adenocarcinoma, duodenum, duodeno-jejunal junction.

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Shamsudden_cushingsyndrome

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CUSHING’S SYNDROME AND ADRENAL SUPPRESSION FOLLOWING TOPICAL CORTICOSTEROID USE

Shamsudden A,1 Remorino R,2

Paediatric Registrar,1 Consultant Paediatrician2

1Department of Pediatrics, Leeds general Infirmary, United Kingdom

2Department of Pediatrics, St Richards Hospital, Chichester ,United Kingdom

ABSTRACT
The extended use of topical corticosteroids, particularly in young children, may cause suppression of the hypothalamo-pituitary-adrenal axis. Here, three cases of iatrogenic adrenal suppression resulting from topical corticosteroids are presented.
KEY WORDS
Adrenal insufficiency, Corticosteroid, Iatrogenic cushing’s syndrome.

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aggrawal_cystichygroma

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Cystic Hygroma in a Newborn

Aggrwal R,1 Naik T,2 Ambey R,3 Gaur A4

Post Graduate Student,1 Assistant Professor,2,3 Associate Professor4

1,3,4Department of Pediatrics, G R Medical College, Gwalior-474001, M P, India

2Department of Pediatrics, Pt. Jawahar Lal Nehru Memorial Medical College & Dr.B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India

ABSTRACT
A newborn presented with cystic hygroma in axilla. In view of rarity of condition, presentation at birth at unusual site and classical features of clinical condition, we are reporting the case.
KEY WORDS
Axillary swelling, cystic hygroma, newborn.

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sharma_renalangiomyolipoma

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Renal angiomyolipoma:  a case report
Sharma M1, Nema SK2, Singh A3, Khanam B4, Julka K5
Resident1, Professor and Head2, Associate Professor3, Assistant Professor4,5

1,2,3 Department of Pathology, 4 Department of Medicine, 5 Department of Radio diagnosis,

1-5Index Medical College Hospital and Research Centre, Indore, M P, India

ABSTRACT
Angiomyolipoma (AML) is a rare benign tumor composed of adipose tissue, smooth muscles and blood vessels with an incidence is 0.3-3% which is predominantly found in females. These tumors have a strong association with tuberous sclerosis but can occur sporadically. Clinical importance lies in their susceptibility to spontaneous haemorrhage. They can be unilateral or bilateral. Interestingly these tumors occur more in right kidney. We present a case of sporadic unilateral angiomyolipoma of left kidney in a 55 yrs old female who had complaints of off and on left lumbar pain. She was subjected to left nephrectomy and diagnosis was confirmed on histopathology.
KEY WORDS
Angiomyolipoma(AML), kidney tumour, renal angiomyolipoma.

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garg_granuloma

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EXTENSIVE PATCH TYPE GRANULOMAS ANNULARE: A RARE CASE REPORT
Garg Anubhav1, Garg Sushma2, Gupta L K3, Khare A K4, Mittal Asit3
Assistant Professor1, Consultant Physician2, Associate Professor3, Professor and Head4

1Department of Dermatology, Venereology and Leprosy , G R Medical College, Gwalior, M P, India

2 Gwalior, MP, India

3,4Department of Dermatology, Venereology and Leprosy , RNT Medical College, Udaipur, Rajasthan, India

ABSTRACT
A 16-year-old girl presented with multiple, asymptomatic, progressive, hyperpigmented patches of 6 months duration over trunk and thighs. Histopathology showed features of interstitial granuloma annulare. The clinical diagnosis was consistent with patch type granuloma annulare.
KEY WORDS
Granuloma annulare, patch type granuloma annulare, interstitial pattern, palisading granuloma, necrobiosis

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