Intrahepatic Portosystemic Shunt in a Young Female: Views from a Developing Country.

A young female presented to us with abdominal distension along with pedal edema. She had no prior medical or surgical history apart from a caesarean section done a few years prior. Initial workup showed low hemoglobin, low serum albumin and slight raised ESR. Her LFTs were slightly deranged. Ultrasound abdomen had evidence of portal hypertension along with splenomegaly. While ultrasound hepatic Doppler revealed a portosystemic shunt between the portal vein and the left hepatic vein, with a shunt ratio of 7.1%. CT scan abdomen confirmed these findings and a diagnosis of Type III intrahepatic portosystemic shunt and spleno-renal shunt was made. Since the patient was currently asymptomatic, she was advised regular follow-ups and was managed conservatively.

Solitary Fibrous Tumor of Kidney.

Solitary fibrous tumor of kidney is an unusual condition. It is spindle cell tumor with mesenchymal in origin so most commonly reported cases are in pleura, and extra-pleural sites are very rare. It is mostly benign in nature but malignant variant are also reported. Treatment is en bloc resection as in other sites whether pleural or extra-pleural. Prognosis is excellent. This tumor is difficult to diagnose only on imaging features; so for diagnosis, histopathology is needed mostly with immunohistochemical markers like CD34, CD99, Bcl2 proteins. A middle-aged male presented initially with clinical and radiological features, suspected of renal cell carcinoma. Surgery was performed, which proved solitary fibrous tumor on histopathology; and patient on follow-up remained tumor-free till the last follow-up.