Glioma Presenting as an Isolated Facial Nerve Palsy: A Case Report.

A peripheral palsy of the facial nerve that results in muscle weakness on one side of the face usually manifests as Bell's palsy. Glioma in the left half of the pons and middle cerebellar peduncle is a rare cause of isolated infranuclear facial paralysis. We report a case of 12- year-old female patient who came to our hospital with isolated unilateral facial palsy but turned out to have a low grade glioma.

Laparoscopic Morcellation of Fibroid and Uterus In-Bag.

OBJECTIVES: Uterine morcellation of presumed leiomyomas inadvertently results in an increase in morcellated uterine leiomyosarcoma (ULMS). Morcellation alters the natural course of ULMS, leading to an increased incidence and earlier recurrences. Recurrences following tumor morcellation are significantly more likely to occur in the peritoneum. Since there is no reliable method for predicting whether a woman with fibroids may have a uterine sarcoma, the US FDA (Food and Drug Administration) discourages the use of laparoscopic power morcellation during hysterectomy or myomectomy (US Food and Drug Administration, http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm393576.htm in 2014). In the wake of recent ban on usage of power morcellation by US FDA, we introduce a technique of in-bag morcellation, thus avoiding spillage of tissues in the peritoneal cavity and spread of an undiagnosed disease or cancer or sarcoma. METHODS: We present a study of twenty-one cases of laparoscopic in-bag morcellation of fibroid and uteri done by Total Health Care method. RESULTS: The in-bag morcellation technique handles the issue of ULMS and makes laparoscopic myomectomy and hysterectomy possible with fair safety. CONCLUSIONS: Further studies should be directed toward identifying patients at high risk of ULMS prior to presumed leiomyoma resection in order to reduce the risk of inadvertent tumor morcellation.

A rare presentation of cervical fibroid in pregnancy.

Pregnancy in a fibroid uterus is not rare. However cervical fibroid is rare in pregnancy and has unique management challenges. We report a case of cervical fibroid in a Gravida2 Para1 patient that was found incidentally in a routine ultrasound in the second trimester. The fibroid grew in pregnancy till term, caused obstructed labour, a Cesarean section was required for the baby. Post surgery the fibroid prolapsed out of the introitus. Conservative management was decided to prevent surgical complications, delayed consequences of surgery and to preserve future child bearing. The case shows that conservative management over surgery is sometimes the appropriate choice.