Retroperitoneal Mass-lymphangiomyoma.

We report a case of retroperitoneal mass, in a postmenopausal lady,about a size 10-8 cm in left side of abdomen. This turned out pathologically lymphangio-myoma. Retrospectively when we searched in literature we found that, commonly lymphangiomyoma seen in premenopausal women and is associated with ascites or renal angiomyolipoma or plural effusion. But in our case CxR -PA was normal and abdominal USG was not showing renal or ovarian involvement. It was a rare case and presentation was rare than the literature.

Gastro-intestinal stromal tumour--a case report.

Gastro-intestinal stromal tumours are rare tumours of the gastro-intestinal tract. Among non-epithelial tumours of gastro-intestinal tract, gastro-intestinal stromal tumours are the commonest but as they are not extensively documented, they are underestimated, poorly understood and inadequately treated for various reasons, particularly at peripheral centres in India. The gravity of the problem increases further as these tumours respond poorly to conventional cytotoxic chemotherapy and radiation therapy. Here a case of gastro-intestinal stromal tumour is reported. The patient was a 35-year-old male who was admitted with evidence of subacute intestinal obstruction. The haematological and biochemical tests showed moderate anaemia, raised serum aminotransferase aspartate (AST, SGOT) and mild hypoproteinaemia. Laparatomy revealed a jejunal tumour which was resected. The routine histopathological examination revealed a spindle cell tumour suggestive of gastro-intestinal stromal tumour -intermediate risk group. Immunohistochemical study showed strong positivity for c-kit confirming the diagnosis of gastro-intestinal stromal tumour. The patient was then referred to oncology centre for further management.

Evaluation of importance of cystoscopy in staging carcinoma of the uterine cervix.

Four hundred cases with carcinoma of the uterine cervix were evaluated by cystoscopy regarding involvement of urinary bladder. In stages I and II there was not a single case of bladder involvement; in stage III, 3 out of 39 cases and in stage IV, 2 out of 10 patients were found to have bladder involvement. Thus cystoscopy resulted in elevating the clinical stage in 3 of these patients but was unchanged in 2 cases. These findings indicate that cystoscopy is mandatory only for clinical stages III and IV.

Simple closure of perforated duodenal ulcer.

A study was undertaken to evaluate the efficacy of simple closure followed by drug therapy in cases of perforated duodenal ulcer and to identify the risk factors in relation to the mortality. The male to female ratio was 5:1. Of the patients 59.2% were up to 50 years of age, while 40.8% were above the age of 50 years. Of the patients 47% were admitted 24 hours after the onset of peritonitis. All these patients were surgically treated with simple closure of the perforation with omental patch. Nine patients expired leading to 7.5% mortality. The risk factors identified for mortality were age 60 years and above, presence of shock on admission and delayed presentation. The mortality is directly related to the number of risk factors present in a given patient. At the time of discharge the patients were advised to take orally famotidine 40 mg at bed time for a period of 8 weeks. Eighty-one patients could be followed up and Visick grading was done. Sixty-two patients were in grade I, 11 in grade II, 3 in grade III and 5 in grade IV. The results indicate that simple closure followed by drug therapy is acceptable treatment for perforated duodenal ulcer.

Pseudomyxoma peritonei presenting as sub-acute large bowel obstruction.

A case of pseudomyxoma peritonei, a rare mucin-secreting tumour in the peritoneum, in a 30-year-old male and presenting as sub-acute large bowel obstruction, is reported here with review of the literature.