Solid-pseudopapillary carcinoma: a case study and literature review.

Solid-pseudopapillary tumour (SPT) is a rare exocrine tumour of the pancreas and is considered to have low malignant potential. Few morphological criteria are used to predict malignant behaviour such as equivocal perineural invasion, angioinvasion and invasion to surrounding tissue, and should be designated as solid-pseudopapillary carcinoma (SPC). We report a case of SPC. Clinical and radiological findings are typical for SPT with no metastatic disease. There is no tumour recurrence after 4 months postresection. Clinical history and radiological findings were retrieved from the patient's record sheet and Viarad system. H&E staining and few immunoproxidase staining were reviewed by several pathologists. The histological findings are typical for SPT, with additional perineural invasion. There is no angioinvasion or capsular invasion identified. This is our first experience in diagnosing and managing SPC. We look forward to seeing the patient's disease status during her next routine follow-up. We expect good disease-free survival and very low risk of tumour recurrence, in view of only one risk factor (perineural invasion) and uninvolved surgical margins by the tumour.

Reliability and accuracy of the tape measurement method with a nearest reading of 5 mm in the assessment of leg length discrepancy.

INTRODUCTION: The aim of this study was to determine the reliability and accuracy of the tape measurement method (TMM) with a nearest reading of 5 mm in assessing leg length discrepancy (LLD). METHODS: This was a cross-sectional study conducted on 35 patients with LLD and 13 patients without LLD. Two blinded surgeons measured the lower limbs from the anterior superior iliac spine to the medial malleolus using TMM with a nearest reading of 5 mm. Computed tomography (CT) scanograms of the lower limbs of 22 patients were conducted by two blinded radiologists. Intraclass correlation coefficient (ICC) with 95 percent confidence interval was calculated to assess the interobserver reliability of TMM. The accuracy of TMM was assessed by comparison with CT as the gold standard. RESULTS: The interobserver reliability of LLD measurement using both TMM and CT scanogram was high, with ICCs of 0.924 and 0.971, respectively. No significant mean difference on paired sample t-test was observed for both TMM and CT scanogram. Compared to CT scanogram, TMM had good accuracy, with an ICC of 0.805. When the mean TMM readings by two observers were compared to those derived from CT scanogram, the ICC was found to be 0.847, with a mean difference of 1.95 (range -3.17 to 7.07) mm. CONCLUSION: There was excellent agreement in the LLD measurements between the two surgeons using TMM, between the two radiologists using CT sonogram, and between the TMM and CT measurements. This study showed that one TMM with the nearest reading of 5 mm was reliable and accurate in measuring LLD.