Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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Uterine adenosarcoma is a rare tumor composed of benign epithelium in combination with malignant mesenchymal components. Misdiagnosis is common due to the lack of specific clinical manifestations and the rarity of such tumors in young age groups. The mean age at diagnosis is 58.6 years, and <10% of patients are younger than 40 years. ⋯ Histopathologic examination finally confirmed uterine adenosarcoma. The patient had no evidence of residual tumor or recurrence during six months of follow-up. Key Words: Uterus, Adenosarcoma, Mixed tumor.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsImprovement of Three Duodenal Re-leaks: Two-way Vacuum-assisted Closure.
We share our experience of a two-way vacuum-assisted closure (VAC) technique that allows patients to heal when generalised peritonitis develops because of a recurrent duodenal leak. Two patients underwent omentoplasty for duodenal ulcer perforation and one patient underwent antrectomy, gastrojejunostomy, and tube duodenostomy. Two-way VAC was performed by taking an abdominal fluid culture and washing the abdomen with 6-12 litres of warm saline. ⋯ The patients were subsequently discharged. Controlling the primary source is often difficult when treating duodenal re-leaks, and two-way VAC can localise the source of the peritonitis and remove toxic peritoneal material. Key Words: Open abdomen, Vacuum-assisted closure, Severe peritonitis, Duodenal leak.
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Paratesticular liposarcoma (PLS) is a rare type of genitourinary malignancy in the spermatic cord presenting as scrotal swelling. In this case study, we report an 82-year male who presented with prolonged left scrotal swelling and pain that did not respond to analgesic treatment for one week. His ultrasound confirmed increased fluid content in the left scrotal compartment in the form of septated hydrocele, and hydrocelectomy was planned. ⋯ The pathological examination revealed a dedifferentiated liposarcoma. To our knowledge, this is the first report of liposarcoma of the spermatic cord with hydrocele in the literature. Key Words: Liposarcoma, Spermatic cord, Scrotal swelling, Hydrocele.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsCryptococcal Meningoencephalitis in an Immunocompetent Patient.
Cryptococcal meningitis (CM) is an uncommon opportunistic infection in immunocompetent hosts; and causes significant mortality and long-term morbidity. Cryptococci primarily cause disease in immunocompromised hosts, but rarely can lead to severe disease in immunocompetent individuals. A 64-year man, with no known immunosuppressive illnesses, presented in the Emergency Department with gait disturbances and lethargy for one year, which got worsened recently. ⋯ The patient was treated with anti-fungal medications. It is highly essential for emergency physicians and other clinicians to think of atypical neurological manifestations of meningitis in immunocompetent individuals. Key Words: Cryptococcus, Immunocompetent, Antifungal treatment, Meningitis.