Clinical Challenges in the Management of Malignant Ovarian Germ Cell Tumours.

Nonepithelial ovarian cancers (NEOC) are a group of rare malignancies, including germ cell tumours (GCT) and sex cord-stromal tumours (SCST), along with small-cell carcinomas and sarcomas. GCTs represent 2-5% of ovarian cancers, with a yearly incidence of 4:100,000, and they usually affect young women and adolescents. Precursory germ cells of the ovary form the basis of GCT. They are histologically classified into primitive GCT, teratomas, and monodermal and somatic-type tumours associated with dermoid cysts. A primitive GCT can be either a yolk sac tumour (YST), dysgerminoma, or mixed germ cell neoplasm. Teratomas are either mature (benign) or immature (malignant). Given that malignant GCTs occur rarely compared to epithelial ovarian tumours (EOC), greater focus is required in their diagnosis and treatment. In this article, we review the epidemiology, clinical manifestations, diagnosis, and molecular biology, along with the management and therapeutic challenges.

Amyand's Hernia: A Radiological Solution of a Surgical Dilemma.

Amyand's hernia is a rare condition whereby the appendix lies within the sac of an inguinal hernia; rarer still, the appendix can become inflamed (acute appendicitis) and is frequently misdiagnosed as a strangulated inguinal hernia. We report a case of Amyand's hernia complicated with acute appendicitis. In this case an accurate preoperative diagnosis was provided by a preoperative Computerised Tomography (CT) scan, permitting planning of treatment by a laparoscopic approach.

A Case Report on an Adult Presentation of Henoch-Schönlein Purpura.

Henoch-Schönlein purpura (HSP) is an immunoglobulin A (IgA)-mediated multisystem vasculitis commonly affecting children under 10 years of age. Although diagnostic criteria exist, making a diagnosis is often difficult as this condition can present atypically in adults. We discuss a 22-year-old female with a delayed diagnosis of HSP, resulting in significant anxiety and distress. Our patient's symptoms improved with analgesia and corticosteroids, which were initiated upon diagnosis and she experienced two mild, self-limiting relapses over two years following symptom resolution. Our case illustrates that an integrated multidisciplinary approach is needed to effectively diagnose, safely manage and monitor patients presenting with HSP. Although self-limiting in nature, HSP has the potential to manifest into life-threatening conditions such as end-stage renal failure, which stresses the importance of early diagnosis and management.