Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsSelf-expanding Metallic Stent Placement in Malignant Terminal Ileal Stricture.
Malignancies of gastro-intestinal tract cause stricture formation that leads to intestinal obstruction. In such cases, either surgery or placement of self-expanding metallic stents (SEMS) are options of palliation. For left sided colorectal obstruction, SEMS have been widely used and reported. ⋯ SEMS placement, particularly in the ileocecal region, is technically difficult. Few studies on SEMS deployment in right sided colon have been reported till now. We report a case of metastatic signet ring cell carcinoma of rectosigmoid junction with malignant terminal ileal stricture palliation done with placement of SEMS.
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We report a case of a mature cystic teratoma of urinary bladder in a 17-year female, which is extremely rare. The patient presented with pain in suprapubic region for one year. ⋯ Resection of the lesion was done with wide margin by transurethral resection of bladder tumor (TURBT). Histopathological examination showed fragments of skin, sebaceous glands, fat and muscle cells, confirming mature cystic teratoma.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsIsolated Bilateral Superior Rectii Paresis: A Rare Anomaly.
We present a case of bilateral isolated superior rectus paresis in a 13-year girl who presented with alternating exotropia and hypertropia. She demonstrated bilateral paresis of elevation in abduction with an overaction of both the contralateral yoke muscles, i.e. inferior obliques. Neuroimaging did not reveal a lesion along the pathway of the third nerve nor hypoplasia of the superior rectus muscle. ⋯ At 1 year, the patient is well aligned and happy. Isolated extraocular muscle pareses are rare events, which present occasionally to the strabismus surgeons and need to be looked out for if the patient's strabismus looks peculiar. We believe we are the first to report an isolated paresis of the superior rectus muscle in Pakistan.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsSurgically-assisted Rapid Maxillary Expansion under Local Anesthesia.
Developmental, traumatic and congenital factors, among many others, may lead to transverse maxillary deficiency (TMD). TMD can be corrected by orthodontic treatment, and may also require surgical intervention. ⋯ Whether or not to separate, the pterygomaxillary junction is also one of the most common subjects of debate in this regard. In this case presentation, the transverse expansion of the maxilla was completed by means of surgically-assisted rapid maxillary expansion operation performed under local anesthesia without separating the pterygomaxillary junction and nasal septal osteotomy; and the patient, in whom orthodontic treatment had been completed, made a successful recovery without complications.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsRecurrent, Large, Extraskeletal Osteosarcoma at the Back.
Extraskeletal osteosarcoma is a rarely identified variety of sarcomas throughout the world, which is still a dilemma for the surgeons' community with respect to its diagnosis and treatment. It is slow-growing in nature, and attains a huge size usually at presentation, which puts the clinician in jeopardy with regard to its management. Our case is the first of its variety documented in Pakistan. ⋯ We did the excisional biopsy of the mass, followed by complete removal with intact margins. Histopathology revealed extraskeletal osteosarcoma as the final diagnosis. We suggest that this tumor should be included in the differential diagnosis of all large, recurrent soft tissue masses in the body.