RESUMO
A rapidly growing soft tissue mass in the axilla of an infant raises the suspicion of a lipoblastoma or a liposarcoma. Excisional/incisional biopsy is vital in confirming the diagnosis and hence avoiding aggressive extirpation. This case report highlights the role of histopathology and immunohistochemistry as the gold standard in differentiating a lipoblastoma from a liposarcoma. In some cases where the histopathology is inconclusive, genetic rearrangement of the PLAG1 (pleomorphic adenoma gene 1) oncogene on chromosome 8q12 helps in confirming the diagnosis of lipoblastoma.
Assuntos
Lipoblastoma/diagnóstico , Lipossarcoma Mixoide/diagnóstico , Axila/patologia , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Lipoblastoma/patologia , Lipossarcoma Mixoide/patologiaRESUMO
BACKGROUND: To assess the role of diagnostic and therapeutic value of anorectal myectomy in cases of chronic refractory constipation. MATERIALS AND METHODS: Twenty-eight patients 11 months to 9 years of age presenting with chronic constipation, with contrast enema showing dilated rectum and sigmoid colon were included in the study. Anorectal myectomy under general anaesthesia was carried out in these selected patients and were followed-up for up to 6 months to 5 years. Clinical improvement was measured by post-operative bowel habits and relief of symptoms. RESULTS: Twenty-two patients improved clinically; partial response in 4 patients, no response in 2 patients. Two patient required further pull through surgery and was found to have transition zone at the recto-sigmoid level. Ten patients had aganglionosis (of which 5 had ganglion cells present in the proximal part of speciment), 7 had normal histology, 7 had hypoganglionosis, 2 had intestinal neuronal dysplasia, one had nerve hypertrophy and one had immature ganglia. CONCLUSION: Anorectal myectomy is an effective and technically simple procedure in selected patients with chronic refractory constipation, for both diagnostic and therapeutic purpose. Because apart from confirming Hirschsprung's disease, it also therapeutically relieves symptoms in 93% of patients with chronic refractory constipation.
Assuntos
Constipação Intestinal/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Reto/cirurgia , Criança , Pré-Escolar , Doença Crônica , Constipação Intestinal/fisiopatologia , Defecação , Feminino , Seguimentos , Humanos , Lactente , Masculino , Estudos Retrospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
Diphallus is a very rare condition. We report a case of a newborn with absent anal opening and duplication of external genitalia. Examination of the external genitalia showed two well formed penises with fully descended testis within each of the separate hemiscrotums along with soft tissue mass resembling accessory buttock behind the hemiscrotum. Staged reconstruction of duplicated genitalia and anorectal malformation was done. We achieved excellent cosmetic and functional external genitalia.
Assuntos
Anus Imperfurado/cirurgia , Divertículo Ileal/diagnóstico , Pênis/anormalidades , Procedimentos de Cirurgia Plástica/métodos , Doenças Uretrais/diagnóstico , Fístula Urinária/diagnóstico , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/cirurgia , Anus Imperfurado/diagnóstico , Terapia Combinada , Seguimentos , Genitália Masculina/anormalidades , Genitália Masculina/cirurgia , Humanos , Recém-Nascido , Masculino , Divertículo Ileal/cirurgia , Pênis/cirurgia , Recuperação de Função Fisiológica , Medição de Risco , Resultado do Tratamento , Doenças Uretrais/cirurgia , Fístula Urinária/cirurgiaRESUMO
Complete excision of a prostatic utricle through posterior sagittal rectum retracting approach is reported in an infant.
