Unmasking the Silent Threat: Meleney's Synergistic Gangrene in a Healthy Young Woman Without Predisposing Factors.

A rare rapidly-spreading necrotizing infection of the skin and soft tissues, Meleney's synergistic gangrene is characterized by a synergistic infection with both staphylococci and microaerophilic streptococci. This report presents a case of Meleney's synergistic gangrene in a young female patient with no comorbidities and no surgical history who was initially misdiagnosed as a case of perineal abscess and later after the culture report and course of the spread of infection, it was diagnosed as a case of Meleney's synergistic gangrene. The patient underwent serial debridements with a combination of broad-spectrum antibiotic cover followed by secondary closure of the wound and the patient was followed up after three months post-discharge and showed full recovery with no recurrence of infection.

Presacral Tailgut Cyst.

A tailgut cyst is a rare benign polycystic congenital lesion in presacral or retrorectal space, when there is failure of involution of tailgut. Clinical presentation may be with or without symptoms of different types related to obstruction, infection, or rarely malignancy. Symptoms may be misleading and atypical, so understanding of characteristics of tailgut cysts is important for precise and early diagnosis to be made for proper treatment and to avoid complications and malignant transformation. Magnetic resonance imaging pelvis was used as diagnostic imaging investigation, but the final confirmation was only done by histopathology. Definitive treatment is surgery, though various surgical approaches are described, surgery is tailored which will suit the individual patient's anatomy and suspected diagnosis of mass. This case review used PubMed and Web of Science databases to search for the studies. We found around 176 articles and selected 77 articles in our survey, with 8 reviews, 31 case reports, and 31 case reports and reviews.

RésuméUn kyste intestinal est une lésion congénitale polykystique bénigne rare dans l'espace présacré ou rétrorectal, en cas d'échec de l'involution de l'intestin grêle. La présentation clinique peut être accompagnée ou non de symptômes de différents types liés à une obstruction, une infection ou, plus rarement, une tumeur maligne. Les symptômes peuvent être trompeurs et atypiques, c'est pourquoi il est important de comprendre les caractéristiques des kystes de l'intestin grêle pour établir un diagnostic précis et précoce afin d'établir un traitement approprié et d'éviter les complications et la transformation maligne. L'imagerie par résonance magnétique du bassin a été utilisée comme examen d'imagerie diagnostique, mais la confirmation finale n'a été faite que par histopathologie. Le traitement définitif est la chirurgie, bien que diverses approches chirurgicales soient décrites, la chirurgie est adaptée à l'anatomie de chaque patient et au diagnostic suspecté de masse. Cette revue de cas a utilisé les bases de données PubMed et Web of Science pour rechercher les études. Nous avons trouvé environ 176 articles et sélectionné 77 articles dans notre enquête, avec 8 revues, 31 rapports de cas et 31 rapports de cas et critiques.

Schwannoma as Extraspinal Swelling Over the Thoracolumbar Region: A Tumor at a Rare Site.

This case report describes an unusual presentation of schwannoma, a typically benign and solitary tumor originating from Schwann cells in peripheral nerves. While the literature on extraspinal schwannomas is limited, this report discusses the case of a 21-year-old female with complaint of a back swelling persisting for two years, causing discomfort during sleep. The oval-shaped swelling, measuring 7x6 cm, was located over the T11-T12-L1 vertebrae, with normal overlying skin, pinchable hardness, and fixation to the vertebrae. The patient had no history of pain or weakness in the lower limbs. Fine-needle aspiration cytology (FNAC) yielded inconclusive results. X-ray imaging of the thoracolumbar spine revealed a soft tissue shadow over the T11-T12-L1 vertebrae. The patient underwent complete surgical excision through a vertical incision, emphasizing the importance of preoperative imaging for accurate diagnosis, optimal surgical planning, and ensuring procedural safety.

Giant Cell Tumor of the Anterior Arc of the Rib: A Case Report.

Tumors that develop on the chest wall are usually rare. This case report highlights a rare occurrence of a giant cell tumor originating from the anterior arch of the fourth rib. The patient, a 21-year-old male, presented with a bulging mass that had been gradually increasing in size over an eight-month period, reaching dimensions of 12 x 8 cm. Despite the noticeable swelling, the patient reported no associated pain or discomfort and denied any history of weight loss or trauma. The absence of chest pain or cardiovascular symptoms distinguished this case from other chest wall pathologies. This report underscores the importance of considering rare entities such as giant cell tumors in the differential diagnosis of chest wall masses, especially in cases where clinical presentation and patient history do not align with more common conditions.

Gastrointestinal Stromal Tumor: A Clinicopathological Study and Management.

Background and aim Gastrointestinal stromal tumors (GISTs) account for a major portion of gastrointestinal mesenchymal tumors. The purpose of the current study is to examine the clinicopathological features, management, and therapeutic outcomes of primary GIST in a tertiary care hospital.  Materials and methods This is a prospective observational analysis. Seventeen patients with GIST have been detected and treated in the Department of Surgery of a tertiary care hospital with an attached medical institution over the last seven years. The clinical presentation, diagnosis method, tumor locations, histopathological results, surgical treatment, and postoperative results were analyzed.  Results There were six females and 11 males with ages ranging between 35 to 72 years. All the patients had symptoms, with abdominal pain the most prevalent. The most frequent primary site for GIST was the stomach (60-70%), followed by the small intestine (25-30%), the rectum, the esophagus, and the colon (2%). Preoperative diagnosis was made through endoscopy and a contrast-enhanced CT scan. Ninety-two percent of the cases tested positive for CD117. Surgery has been conducted for all 17 patients, with the liver being the most common site of metastasis. Imatinib and sunitinib increased the survival as well as postoperative recurrence rate while decreasing metastasis.  Conclusions The most general symptom of GIST was abdominal pain. In most instances, it was treated with surgery as well as adjuvant imatinib and sunitinib, and had a favorable prognosis. With increasing size and mitotic activity, the five-year survival rate falls, and the prognosis worsens.

Calcified Fibrous Tumor of Jejunum: A Rare Case Report.

A calcifying fibrous tumor (CFT) is a benign fibroblastic tumor of soft tissues occurring at all ages with no gender predilection. Earlier, it was called a pseudotumor. It may or may not present with symptoms. It can occur anywhere in the body - the most common sites are the stomach, pleura, and intestines. Our study is presented as a case of Intussusception in a young male with symptoms of pain, abdomen, and nausea. The patient underwent an excision of the tumor, and the tumor was examined histo-pathologically and immunohistochemically, showing spindle-shaped cells in dense collagenous tissue with mild inflammation. In this case, a study we are explaining the Clinical and morphological features of the CFT and how to differentiate it from other mesenchymal tumors.

Pancreatic Resection for Pancreatic Tumors our Experience at Suburban Hospital.

Introduction: Resection of pancreatic tissue is necessary for many pancreatic diseases. The most common form of cancer, pancreatic duct adenocarcinoma, manifests with early metastases and is thought to be resistant to other currently known treatment regimens. Such tumors present a complex and difficult management and handling challenge for a surgeon. Surgical resection affords a better prognosis with a median survival of 14-20 months following resection and up to 25% 5-year survival rates. In this study, data from 75 pancreatic resections for diverse malignant pancreatic lesions will be presented. Methods: At a teaching institute in Central India, this ongoing longitudinal study began in 2009 and was carried on till 2018. Only 75 of the 122 patients who underwent pancreatic resection were deemed appropriate for the current study. All patients were thoroughly examined after being admitted before being given the option of surgery. There were 22 female patients and 53 male patients. The age range for the group was 34-67 years. Results from a range of different malignancies and various pancreatic resection procedures are presented in this study. Results: One of the most aggressive cancers, pancreatic adenocarcinoma, responds to surgical treatment better than other alternative techniques. Out of 75 patients in our series, 32 had pancreatic head cancer, 28 had periampullary cancer, 2 had duodenal cancer, 8 had distal cholangiocarcinoma, and 1 had mucin-producing cystadenocarcinoma. Four patients had pancreatic cancer in both the body and tail. Fifty-three men and 22 women, ages 34-67 years, Whipple's operation and distal pancreatectomy were the most frequent procedures. In our series, survival ranged from 18 to 24 months, and the 5-year survival rate was 12%, which is primarily seen with periampullary carcinoma. Conclusion: The sole option for long-term survival or a cure for pancreatic cancer is surgery. Chemoradiation is ineffective as a first line of treatment. However, some reports contend that palliative chemotherapy actually improves the quality of life. The biology of the illness rules and determines the result; the kind of surgery performed had no bearing on survival, morbidity, or fatality. Context: The above study was taken up in the context of - pancreatic tumors and pathological types, how imaging helps in deciding the plan of surgical management without biopsy. Outcomes of pancreatic resections for pancreatic cancer. Settings and Design: In a suburban hospital which is a tertiary care center, this longitudinal prospective study was conducted from 2009 to 2018.

Résumé Introduction: La résection du tissu pancréatique est nécessaire pour de nombreuses maladies pancréatiques. La forme de cancer la plus courante, l'adénocarcinome du canal pancréatique, se manifeste par des métastases précoces et on pense qu'elle est résistante aux autres schémas thérapeutiques actuellement connus. De telles tumeurs présentent un défi de gestion et de manipulation complexe et difficile pour un chirurgien. La résection chirurgicale offre un meilleur pronostic avec une survie médiane de 14 à 20 mois après la résection et jusqu'à 25 % de taux de survie à 5 ans. Dans cette étude, les données de 75 résections pancréatiques pour diverses lésions pancréatiques malignes seront présentées. Méthodes: Dans un institut d'enseignement du centre de l'Inde, cette étude longitudinale en cours a débuté en 2009 et s'est poursuivie jusqu'en 2018. Seuls 75 des 122 patients ayant subi une résection pancréatique ont été jugés appropriés pour l'étude actuelle. Tous les patients ont été soigneusement examinés après leur admission avant de pouvoir subir une intervention chirurgicale. Il y avait 22 patients de sexe féminin et 53 patients de sexe masculin. La tranche d'âge du groupe était de 34 à 67 ans. Les résultats d'une gamme de différentes tumeurs malignes et de diverses procédures de résection pancréatique sont présentés dans cette étude. Résultats: L'un des cancers les plus agressifs, l'adénocarcinome du pancréas, répond mieux au traitement chirurgical que les autres techniques alternatives. Sur les 75 patients de notre série, 32 avaient un cancer de la tête du pancréas, 28 un cancer périampullaire, un cancer duodénal, 8 un cholangiocarcinome distal et 1 un cystadénocarcinome producteur de mucine. Quatre patients présentaient un cancer du pancréas au niveau du corps et de la queue. Cinquante-trois hommes et 22 femmes, âgés de 34 à 67 ans, l'opération de Whipple et la pancréatectomie distale étaient les procédures les plus fréquentes. Dans notre série, la survie variait de 18 à 24 mois et le taux de survie à 5 ans était de 12 %, ce qui est principalement observé dans le carcinome périampullaire. Conclusion: La seule option pour survivre à long terme ou guérir le cancer du pancréas est la chirurgie. La chimioradiothérapie est inefficace en première intention. Cependant, certains rapports affirment que la chimiothérapie palliative améliore réellement la qualité de vie. La biologie de la maladie gouverne et détermine le résultat ; le type d'intervention chirurgicale pratiquée n'avait aucune incidence sur la survie, la morbidité ou le décès. Contexte: L'étude ci-dessus a été reprise dans le contexte des tumeurs pancréatiques et des types pathologiques, comment l'imagerie aide à décider du plan de prise en charge chirurgicale sans biopsie. Résultats des résections pancréatiques pour le cancer du pancréas. Paramètres et conception: Dans un hôpital de banlieue qui est un centre de soins tertiaires, cette étude prospective longitudinale a été menée de 2009 à 2018. Mots-clés: Complications, résections pancréatiques, résultats.