Tumour thrombosis of the left axillary vein due to infiltrative ductal carcinoma causing superior vena cava obstruction.

Invasive ductal carcinoma is the most common type of breast cancer and can affect any age group, predominantly females older than 55 years of age. We present a case of a female in her mid-30s complaining of a fungating mass in the upper outer quadrant of the left anterior chest wall. On workup of the patient, it was histopathologically found that the patient was affected by infiltrating ductal carcinoma of the left breast, which was causing tumoral thrombosis of the left axillary vein. Also, thrombosis of the right axillary vein, bilateral brachiocephalic veins, and superior vena cava with a focal hepatic hotspot sign were appreciated on contrast-enhanced computed tomography scan. No such case of tumoral thrombosis of the axillary vein causing superior vena cava obstruction has been reported in recent literature.

Bladder Carcinoma With Solitary Skull Metastasis: A Rare Presentation in a Middle-Aged Female.

Bladder carcinoma is a common malignant tumor of the urinary system, with the leading cause of death being the metastasis of cancer. It, however, is a rare malignancy in the Indian population with the incidence being higher in males compared to females. The most common sites of metastasis for bladder carcinoma are the peritoneum, liver, lung, pleura, lymph nodes, adrenals, intestine, and kidney. Metastasis to the heart and brain are rare. Only a few cases of bladder cancer metastasizing to the skull have been reported to date. Here in this article, we describe a female patient who presented with metastasis to the calvarium from bladder cancer before the identification of the original tumor.

Chronic Lower Limb Pain Unveiling a Rare Case of Spindle Cell Soft Tissue Sarcoma: A Diagnostic Odyssey.

Spindle cell soft tissue sarcomas are rare and challenging malignancies that tend to masquerade as benign conditions. This case report presents a 70-year-old female who sought medical attention due to persistent right lower limb pain and swelling over one year. Despite prior consultations at private clinics, her symptoms continued to progress. A tender, palpable swelling was noted upon examination, prompting further diagnostic investigations. Initial X-ray results yielded inconclusive findings, necessitating an MRI study with contrast. The MRI unveiled a substantial multi-lobulated spindle-shaped mass lesion exhibiting heterogeneous enhancement and altered signal intensity, measuring 7.3 x 2.5 x 2.2 centimeters. Additional nodular lesions in the periarticular region posterior to the ankle joint confirmed the diagnostic suspicion of spindle cell sarcoma, supported by orthopedic evaluation. Symptomatic management was initiated with analgesics and antibiotics, alongside a recommendation for biopsy. Histopathological examination of the biopsy specimen confirmed the presence of spindle cell soft tissue sarcoma under high magnification. This case underscores the diagnostic challenges of spindle cell sarcomas and the imperative role of a multidisciplinary approach in their accurate diagnosis and management.

The Early Presentation of a Classic Case of Tuberous Sclerosis: A Case Report.

Tuberous sclerosis (TS) is a potentially severe medical disorder that poses a life-threatening risk and can lead to drastic lifestyle changes. In infants and young children, the typical diagnostic criteria for this condition encompass cutaneous manifestations and seizures, and the development of cellular growths termed hamartomas, astrocytomas, myolipomas, and even carcinomas observed within the cardiac, cerebral, renal, and retinal tissues. The usual age of presentation varies widely, which affects the prognosis. We report a case of a four-month-old male patient who presented with early signs of TS. The patient showed signs of infantile spasms and seizures. On further examination, he had neurological, cutaneous, cardiac, and retinal manifestations, which pointed toward the diagnosis of TS. This case report emphasizes the importance of screening for TS at an early age due to the possibility of patients presenting earlier than the usual age of presentation. To the best of our knowledge, there is scarce data on this kind of early-onset signs of TS; therefore, we feel that it is imperative to start screening infants earlier to improve the prognosis and decrease the complications of this disease. The screening tests and the incidence of screening will vary based on the cost and availability of proper diagnostic and screening tests and the accessibility of efficient treatments.

Wandering Fibroid in a Post Menopausal Woman From Rural India: A Case Report.

Fibroids, also known as uterine leiomyomas, are the most common solid benign lesions of the uterus. Fibroids are responsive to hormones and are stimulated by estrogens and commonly grow during pregnancy and involute as menopause progresses. The treatment is mostly conservative. When symptomatic, the treatment requires surgical intervention. We present a case of a 72-year-old post-menopausal female with a large, calcified parasitic fibroid, an extremely rare variant of uterine leiomyoma occurring outside the uterus. The number of cases reported about this pathology is minimal.

World Health Organization (WHO) Grade 1 Astrocytoma in a Female From Rural India: A Case Report.

Astrocytomas are rare in adults and less common in the parietal and temporal regions of the brain parenchyma. The current case is of a 26-year-old female patient who presented with a four-month history of headaches and a two-month history of vomiting. The patient's MRI brain showed an ill-defined, thick-walled lesion in the right parietal and temporal region with mass effect, which on histopathology confirmed to be a case of WHO Grade 1 astrocytoma. This manuscript describes the imaging and histopathological appearance of WHO Grade 1 astrocytoma in an adult female.

Clinico-radiological evaluation and management of type II radial ray defect in a young female from rural India: case report.

Radial Ray Defect (RRD) is a rare disorder, and the etiology of this disorder is still under discussion. RRD is associated with many medical conditions for which prenatal counselling is of paramount importance. Any association with the family history is still unknown. The patient is a 16-year-old female who came to the orthopaedic clinic complaining of tingling and weakness in the right forearm. On examination, there was a gross deformity in the right forearm with radial deviation of the hand. An X-ray revealed radial ray defect type-2. She previously had a history of perinatal infection during early childhood. Surgery was successfully achieved, and positive results were accomplished. Radial Ray Defect can be focal or associated with other clinical manifestations. The timing of antenatal ultrasound for detecting this musculoskeletal anomaly is crucial. When RRD is associated with other syndromes, counselling to the parents about the quality of life and morbidity comes into play. Treatment is primarily surgical.

Anaerobic infections in patients admitted in various surgical units of a tertiary care hospital of north India: neglected but important.

BACKGROUND AND OBJECTIVES: Anaerobic infections are usually caused by the host's endogenous flora due to a breach in the anatomical barriers and Bacteroides spp. are the most notorious organisms associated with anaerobic infections. The identification of anaerobes has been a challenge since times. MALDI-TOF-MS is a boon for aiding the rapid detection of anaerobic organisms and has helped us to enlist the distribution of various anaerobic pathogens. MATERIALS AND METHODS: This retrospective analysis (January 2018 to December 2019) was carried out in a tertiary care hospital in North India, in which the anaerobic microbiological profile of all patients admitted to surgical wards, ICU, and OPD of various departments (Orthopedics, Surgery, Gynecology, and Obstetrics) was reviewed. Samples received were immediately processed aerobically (5% sheep blood agar and Mac Conkeyagar) as well as anaerobically (RCM and freshly prepared sheep blood agar) as per the laboratory protocols. RESULTS: Bacteroides fragilis (19.12%) was the most common anaerobe whereas among aerobes Escherichia coli (30.2%) followed by Klebsiella pneumoniae (10.34%) were most commonly isolated. The majority of patients were males (56%) and the most common presentation was with abscesses (21.4%). Polymicrobial infections (69.51%) outnumbered monomicrobial ones (30.48%). CONCLUSION: There is a paucity of literature on anaerobe isolation from surgical infections from our country which motivated us to study anaerobic infections and the high sample size in our institute enabled us to study surgical infections from an anaerobic perspective. This will add to the knowledge of microbiologists and clinicians. MALDI-TOF MS helped in rapid and accurate identification and hence we could report a wider spectrum of organisms in our study.