Dual malignancy in adolescence: A rare case report of metachronous papillary carcinoma of thyroid following dysgerminoma of ovary.

Dual malignancy is rare in adolescents. Dual malignancy with the second malignancy of thyroid is rare. No association has been reported between dysgerminoma of ovary and carcinoma thyroid in medical literature. Despite a thorough PubMed search (key words - Papillary carcinoma of thyroid, metachronous, dysgerminoma ovary), we were unable to find a previous reported case of metachronous papillary carcinoma of thyroid (PTC) following dysgerminoma of the ovary. After surgery, the patient is being regularly followed up for recurrence/development of new primary. We report this unusual and rare case in a 17-year-old female patient.

Can the Right Kidney be Salvaged in the Surgical Management of Leiomyosarcoma of the Inferior Vena Cava-a Rare Case Report.

Primary leiomyosarcoma is rare malignant tumour arising from the smooth muscles and can appear at any site where smooth muscle is present. It is more common in the peripheral vessels and has predilection for the female sex. We here report a rare case of leiomyosarcoma involving the segment I & II of inferior vena cava with extension into the renal veins in a 70 year old male patient. Midline transperitoneal approach was taken to excise the tumour along with the vessel wall with anastomosis between the right renal vein and the infrarenal inferior vena cava with a reversed great saphenous vein graft thereby salvaging the right kidney.

Reconstruction in oral malignancy: Factors affecting morbidity of various procedures.

AIMS AND OBJECTIVE: (1) To study the age and sex distribution of patient with oral malignancies. (2) To analyze various types of surgery performed. (3) Evaluation of reconstruction and factors affecting complications and its relation to the type of reconstruction. MATERIALS AND METHODS: Cases of oral malignancies, undergoing surgery for the same in Sri Aurobindo Medical College and PG Institute, Indore from the period from October 1, 2012, to March 31, 2015. RESULTS: Out of analysis of 111 cases of oral malignancy, 31 (27.9%) cases were in the fifth decade of life with male to female ratio 1.9:1. The commonest site of cancer was buccal mucosa. Forty-seven cases (43.2%) were in stage IVa. Diabetes was the most common co-morbidity reported, accounting for 53.9% of cases with reported morbidity. Tobacco chewing was the common entity in personal habits. All the cases underwent neck dissection along with resection of the primary. Hemimandibulectomy was the most preferred form of primary resection accounting for 53.15% (59 cases), followed by wide resection of primary 27% (30 cases). Pectoralis major myocutaneous (PMMC) flap only was the most common reconstruction across the study population. PMMC alone accounted for 38.7% (43 cases). The infection rate was 16.21%. PMMC alone accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population. PMMC + deltopectoral accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population. CONCLUSION: PMMC is a major workhorse for reconstruction with better functional outcome and acceptance among operated patients.

Spectrum of second primary malignant neoplasms in central india: case series from a tertiary care centre.

BACKGROUND: Cancer survivors are at an increased risk for developing second cancers than the general population. In recent times detection of a new second primary following the index primary has increased due to refinement of existing diagnostic tools and development of newer modalities of diagnosis combined with better understanding of patterns of inheritance, risk factors and environmental influences. Today with improvement in Cancer management the average lifespan of cancer survivors have increased along with the increase in detection of both synchronous and metachronous malignancy with increase in disease free survival. With the improved cancer survival, second primary malignancy has become an important issue among cancer survivors and an increased burden on the treating oncologists and health care system. AIMS AND OBJECTIVE: To report the trends of second malignancy in a tertiary care centre in Central India with review of relevant literature. METHODS: A hospital based retrospective collection of data of patients diagnosed with second primary malignancy based on Warren and Gates Criteria (1932) over 2 years in the Department of Surgical Oncology of a tertiary care centre in Central India. CONCLUSION: Secondary primary malignancy needs to be separated from metastasis as the latter implies progression in disease and portends poor survival. Operable synchronous secondary primary malignancy can be tackled in the same sitting thereby reducing the load on the overburdened healthcare system in India. Increase in awareness of secondary primary malignancy leads to better chances of detection management and hence chances of improved survival.

"Huge axillary mass - neurofibroma brachial plexus".

Axillary swelling arising from soft tissue is not uncommon. Lipoma, Lymphadenopathy due to Kochs or Lymphoma are commonest swellings seen but firm to hard non tender mass arising from maninges of Brachial plexus is not so common. Usually these masses are benign but one may come across malignant tumour. Twenty-three year male presented with mass in anterior chest wall & arm pit having no other specific complaints, was diagnosed as Spindle cell tumour on FNAC & excision biopsy turned out to be Neurofibroma of Brachial plexus.

Pigmented villonodular synovitis great toe.

A young boy of 14 years. presented with swelling over dorsal aspect of right great toe, which was slightly tender, non fluctuant. It was excised under subarachnoid block. The mass was golden brown in colour encircling the extensor tendon (Extensor Hallucis Longus Tendon). Histopathology reported to be Pigmented Villonodular Synovitis.

Rare cause of intestinal obstruction - Vaginal enterocele.

In surgical emergency admissions, acute abdomen with intestinal obstruction is very common problem. Many causes of intestinal obstruction are there but most common once are postoperative bands and adhesions, hernias, tumors and congenital bands. Here we report very rare and unusual cause of acute abdomen with intestinal obstruction in a non hysterectomized 78-year-old female having pelvic herniation i.e. anterior and posterior vaginal enterocele, in which loop of intestine got entrapped, strangulated and became gangrenous. Exploratory laparotomy was performed and resection anastomosis of small bowel was done with obliteration of pouch of Douglas (Rectouterine space) and utero-vesicle space.