Debahuti Mohapatra

Two concurrent large epidermoid cysts in sublingual and submental region resembling plunging ranula: Report of a rare case

An elderly female patient presented to surgical outpatient clinic with complaint of gradual onset of painless submental and sublingual midline swellings for 6 months of duration. The swellings were noncompressible, nontranslucent, nonpulsatile, and nontender on palpation. Clinical diagnosis was plunging ranula or dermoid cysts. Ultrasound examination of sublingual swelling showed cystic lesion with particulate content. Submental swelling showed cystic swelling with few echogenic floating lobules inside suggesting possibility of epidermoid/dermoid cyst. Magnetic resonance imaging of the face showed homogeneous fluid content within the sublingual cystic lesion and heterogeneous fluid content with few floating nodules within submental swelling. Both cystic lesions were noncommunicative and were showing diffusion restriction and no fat signal. Radiological diagnosis was sublingual and submental epidermoid cysts. She was operated under general anesthesia, and two separate cystic masses were excised with intact capsule. Histopathological diagnosis of masses confirms epidermoid cyst. Several literature have reported isolated sublingual or submandibular epidermoid cyst. However, concurrent sublingual and submental epidermoid cysts with different imaging appearance are rarely reported.

Gossypiboma complicated with paraspinal abscess and lumbar sinus: An uncommon complication of posterior lumbar spinal surgery

A 42-year-old female presented with the complaint of purulent discharging sinus over posterior lumbar area following one month of lumbar spinal surgery for prolapsed intervertebral disc. Gossypiboma complicated with paraspinal abscess and sinus track formation over posterior lumbar area was diagnosed in magnetic resonance imaging which was confirmed in re- exploration of lumbar spinal operative site.

Cerebral venous sinus thrombosis: an unusual initial presentation of mucinous adenocarcinoma of stomach.

There is no standard treatment protocol that has been established. The prevailing opinion is that GS with or without bone marrow involvement should be treated as AML because of the high risk of metachronous AML occurrence. Systemic chemotherapy is significantly useful for these patients to have a good long‐term survival. Surgical therapy is the only reserved presenting clinical symptom due to mass effect. The long‐term prognosis of non‐leukemia GS is still despondent.

Congenital dermal sinus in mid-dorsal spine with large intramedullary dermoid cyst in an 18-months-old child

Intramedullary dermoid cyst is a rare entity. It is usually associated with spinal dysraphism and dermal sinus. Our case is an 18-months-old female child who presented with history of fever and mild difficulty in moving left leg. She had a sinus in mid dorsal spine since birth with history of intermittent discharge from it. On magnetic resonance imaging of spine she was diagnosed to have large intramedullary epidermoid/dermoid cyst in the D2-7 vertebral level with a sinus tract. A dermoid cyst along with the sinus tract was excised. Post-operative follow up period was uneventful with full recovery.

Esthesioneuroblastoma with early drop metastasis to spinal cord

436 Neurology India | Jul-Aug 2012 | Vol 60 | Issue 4 normal capillary bed within the subcutaneous fatty layer of the scalp.[2] Most patients with scalp AVMs complain of headache, tinnitus and a subcutaneous (SC) mass with a palpable thrill. Enlargement of the mass over time can lead to worsening of these symptoms. Factors such as trauma, birth, and hormonal imbalance have been suggested as possible causes for the progression of these lesions.[3] They grow by having feeders from subcutaneous or intracranial vessels. The hemodynamic changes within the AVM can result in aneurysm formation. A few decades ago manual compression of the feeding artery used to be a method of treatment with an expectation of disappearance of scalp AVM over a period of time. However, the results were never encouraging. Various therapeutic modalities available to manage these lesions include: surgical excision, vessel ligation, transarterial and transvenous embolization, injection of sclerosant into the nidus, and electrothrombosis.[4] Scalp AVMs are generally treated by surgical excision. However, there is a risk of recurrence due to collateral supply. Surgical excision is associated with large skin incision, blood loss, and sometimes damage to the facial nerve. Endovascular treatment is used as an adjunct to the surgery or in isolation. Injection of the AVM has been done directly or by using ultrasound guidance. Embolization of AVM can be done using liquid embolizing material e.g. NBCA, ethanol or solid material like surgecele and gelfoam. Some authors have used a combination of trombin and transarterial coil placement. As there is no method which can avoid recurrence, the endovascular procedures have an edge due to their minimally invasive nature. There are three stages of scalp AVM.[1] Type 1 (a and b) and Type 2 are the most suitable AVMs for endovascular procedures.

Occipital intradiploic epidermoid presenting as benign intracranial hypertension: A rare manifestation

Presentation of IDEM tuberculoma is usually subacute, but it can be chronic or acute or paradoxical. Contrast MRI is the investigation of choice.[1,2,5,8] Whole craniospinal axis should be scanned with contrast to pick up other asymptomatic lesions in the CNS. Medical treatment alone will not improve the deteriorating neurological status of these patients and surgical resection of the IDEM tuberculoma followed by full course of antitubercular chemotherapy results in good outcome.[4] Despite surgery, full course of ATT is a must for complete cure of the disease, thus avoiding potential neurological morbidity.[9] Also, use of steroids along with ATT is strongly recommended.[8]

A calcified epidermoid cyst within right lateral ventricle: A report of a rare case

A young patient reported to neurosurgery outdoor department with symptoms of increased intracranial pressure. Noncontrast computed tomography examination showed a single calcified mass within right lateral ventricle with mild hydrocephalus. Contrast-enhanced magnetic resonance imaging revealed nonenhancing single mass within right lateral ventricle with mild hydrocephalus. Intraventricular calcified choroid papilloma/calcified epidermoid were radiological differentials. The mass was excised, removed from the lateral ventricles and found to be calcified epidermoid on gross and microscopic examination, which is rare.

Isolated case of mucosal histoid Hansen's disease of the nasal cavity in a post-global elimination era

Histoid Hansens disease is a rare form of multibacillary leprosy with distinct clinical and histopathological features. This type of leprosy is a variant of lepromatous leprosy with a very high bacterial reserve. Of alarming concern is the discovery of an isolated mucosal histoid leprotic lesion inside the nasal cavity of a patient in the post-global leprosy elimination era. Our case had no history of leprosy or exposure to dapsone/multidrug therapy but had a heavy bacillary index. We are reporting this case to highlight the rarity of mucosal lesions due to histoid leprosy and involvement of the nasal cavity, as well as to create awareness and avoid misdiagnosis. This will help facilitate prompt treatment to minimize the complications and deformities of the patient and prevent its spread throughout the community.

Tuberculosis verrucosa cutis complicated with Pott's spine and a large iliopsoas abscess in a young pregnant woman: A case report and review of the literature

A young female patient reported to the dermatologist with a skin lesion that was diagnosed as tuberculosis verrucosa cutis (TVC) after skin biopsy. She did not continue antitubercular drugs as she was having vomiting due to pregnancy. She reported to our hospital with swelling and pain in the abdomen with 18 weeks of pregnancy. On imaging, she was diagnosed to have large iliopsoas abscess with tubercular spondylitis. She took antitubercular drugs after surgical drainage of the iliopsoas abscess. She delivered a healthy male baby. Follow-up imaging revealed resolution of the skin lesion, iliopsoas abscess, and tubercular spondylitis.