An unusually long electric wire in a urethra and bladder.

Foreign bodies in the urethra and bladder are mostly due to self-insertion, iatrogenic insertion, migration from surrounding organs or through penetrating injuries. Self-insertion of a foreign body through the urethra is mostly related to sexual gratification, psychiatric conditions or to get relief from the intractable voiding symptoms. We present a case of a 17-year-old male who self-introduced an extremely long 120 cm electrical wire into his bladder for sexual gratification. The wire was removed by supra-pubic cystotomy to avoid urethral injuries.

Ewing's Sarcoma of the Adrenal Gland.

Ewing's sarcoma (ES) or primitive neuro-ectodermal tumor (PNET) typically occurs in long or flat bones, the chest wall, extra-skeletal soft tissue, and rarely in solid organs. Incidence of adrenal Ewing's sarcoma is very rare. Here we report a case of Ewing's sarcoma of the right adrenal gland in an 8-year-old girl who presented with an abdominal mass. The huge tumor was managed by preoperative neo-adjuvant chemotherapy followed by surgical resection. She died due to metastasis after five months of surgery.

Renal Agenesis with Full Length Ipsilateral Refluxing Ureter.

Unilateral renal agenesis with vesicoureteral reflux in the ipsilateral full length ureter is a rare phenomenon. Herein we report a case of 10-year old boy who presented with recurrent urinary tract infections. No renal tissue was identified on left side in various imaging studies. Micturating cystourethrogram (MCUG) showed left sided refluxing and blind ending ureter. Left ureterectomy was done because of recurrent UTI in the refluxing system.

Ectopic ureter draining into the uterus.

We report a rare case of a 13-year-old female child with a right-sided duplex system with the upper moiety draining into the uterus. Only one such case has been reported in scientific literature in English, of ectopic ureter draining into the uterus has been reported in literature. The patient was managed with laparoscopic end-to-side ureteroureterostomy into the normal ureter of the lower moiety.

Breast carcinoma in a prepubertal girl.

Breast carcinoma is a very rare disease in children. We present a rare case of breast cancer in an 11-year-old prepubertal girl. Clinically, it was a case of locally advanced breast cancer (T4bN1M0). The core biopsy report showed adenocarcinoma of the not otherwise specified (NOS) variety (oestrogen receptor-negative, progesterone receptor-negative and human epidermal growth factor receptor 2-negative). Diagnosis was late in this case due to lack of suspicion. A modified radical mastectomy was considered to be adequate treatment. Histologically, it was adenocarcinoma NOS, which is rare in young girls (the secretory type being more common). Incidence, differential diagnoses, investigation and management of breast carcinoma in young girls are discussed. The purpose of reporting this case is to highlight that prevention and early detection of breast carcinoma in children is very important.

Epidemiological factors in gall bladder cancer in eastern India-a single centre study.

India has high incidence of Gallbladder carcinoma with regional variation in incidence possibly due to environmental factors. Prospective study of all the gall bladder cancer in our hospital over 18 months analysing how the epidemiological factors are influencing the disease. Incidence-Four cases per 100,000 populations per year. The peak incidence was in 41 to 50 years group (49.20 %). Male to female ratio was 1:3.8. Majority (69.84 %) were in lower socio-economic group. 61 out of 63 patients (96.62 %) were non-vegetarians. 60.34 % and 19.04 % patients weighed between 50 and 55 kg and 55and 60 kg respectively (p = 0.003). Male smokers had significantly higher risk (p = 0.000 1). Gall stones were present in 45 out of 63 cases(71.42 %).45 out of 63 patients were typhoid carriers (p < 0.05). Pain abdomen was the commonest complaint (87.30 %), followed by pallor, lump in right upper quadrant, nausea & vomiting and jaundice in 71.42 %, 69.84 %, 66.66 %, 31.74 % patients respectively. This data highlights high prevalence of gall bladder carcinoma in Eastern India. Better hygiene and water supply to prevent typhoid carriers, prevention of malnutrition, early intervention for cholelithiasis, importance of balanced diet, increase in awareness about risk of tobacco and alcohol consumption-all are highlighted as significant modifiable factors.

Lymphangioma circumscriptum of the scrotum following vasectomy.

Lymphangioma circumscriptum is a congenital lymphatic hamartoma and rarely occurs in the male genital organs. Here we report a case of acquired lymphangioma circumscriptum of scrotum following vasectomy, which has not been reported till date. High clinical suspicion index is the clue to the clinician for diagnosis; histopathological confirmation and adequate surgical excision with deep lymphatic cisterns give the best result.

Mature teratoma of the mesentery.

Teratoma of the mesentery is an extremely rare tumour of the germ cells and imposes diagnostic dilemma in clinical practice and is reported because of its very uncommon occurrence. With the advent of modern imaging modalities like ultrasonography, computerised tomography (CT) and magnetic resonance imaging (MRI), it is now confidently diagnosed and rarely requires diagnostic laparotomy. CT shows characteristic appearance (Rokitansky sign).