Pneumomediastinum is an extremely rare complication after laparoscopic inguinal hernia repair. Very few cases have been reported in the surgical literature to date and most reports indicate pneumoperitoneum from the transabdominal preperitoneal approach as a causative factor. This case report describes a patient in whom an elective total extraperitoneal inguinal hernia repair was...
Renal cell carcinomas (RCCs) commonly cause metastases to the lung, liver, bone and brain but rarely to the skeletal muscles. We describe solitary large masses located in the gluteus maximus and medius muscles in two patients who had a history of RCC treated with nephrectomy. Metastatic RCC must be distinguished from benign primary soft tissue tumors because it requires...
Necrotizing fasciitis is an uncommon infection mainly caused by Streptococcus pyogenes, which is also known as flesh-eating bacteria. It is often caused by bacteria, but can also be caused and complicated by fungus. We report a case of bacterial necrotizing fasciitis that was complicated by a fatal fungal infection, a rare clinical presentation affecting the upper limbs, head and...
A male cyclist presented with a swelling on the forehead. Six weeks before, he fell of his bike and smashed his head on the ground while wearing a helmet. A smooth lump of 1 cm had evolved on the temporal side of his forehead in a few weeks. Duplex ultrasonography demonstrated a dilated vessel with a minor defect in the luminal wall. Surgical exploration revealed an aneurysm of...
Cardiac myxoma, the most common primary cardiac tumor, usually develops in the left atrium. Right atrial myxomas are rare, especially those accompanied by pulmonary tumor embolism. We describe a case of a right atrial myxoma with a large tumor embolus in the left pulmonary artery. A 74-year-old man was referred to our hospital for the treatment of a right atrial tumor. Upon...
We report a rare case of chronic cough as the presenting symptom of a primary brainstem lesion. A 69-year-old gentleman presented with chronic cough followed by onset of progressive truncal ataxia, incoordination and nystagmus. Contrast-enhanced imaging showed a midbrain lesion extending into the cerebellum, confirmed as lymphoma by stereotactic brain biopsy. The patient was...
We present a case of a 73-year-old gentleman with an aortic endograft infection post endovascular abdominal aneurysm repair (EVAR), from whence erosion has come in from an acutely inflamed appendix. To our best understanding, there is no similar case published in the literature. Intra-operatively, there was obvious inflammation and oedema over the retroperitoneal tissue, with...
Traumatic ventricular septal defect (VSD) is a widely-recognized complication of both penetrating and blunt trauma. Most cases are repaired operatively without the long-term complications of pulmonary hypertension and heart failure that are associated with unrepaired congenital VSD in the pediatric population. To our knowledge, this is the first case report of a patient with a...
Talar compression fractures are uncommon orthopaedic injuries, especially in the immature skeleton. Fractures of the talar body constitute >5% of all foot and ankle fractures. The combination of a medial compression fracture and corresponding medial malleolar fracture is rare and not previously reported injury in the literature. We present a case report of a skeletally immature...
Malignant ovarian neoplasms diagnosed during pregnancy at advanced stages are very rare. The clinical course and prognosis of pregnant patients diagnosed with epithelial ovarian cancer is similar to that of non-pregnant patients. We describe our management of a woman diagnosed with FIGO IIIc ovarian cancer at Caesarean section. Immediately after surgery she suffered a pulmonary...
We are reporting the case of a 56-year-old woman who developed loss of consciousness during awake craniotomy. A thin subdural haematoma in the contralateral side of the craniotomy was identified with intraoperative magnetic resonance imaging and subsequently removed. Our case indicates that contralateral acute subdural haematoma could be a cause of deterioration of the conscious...
Transverse testicular ectopia (TTE) is a rare anomaly that is commonly associated with inguinal hernia. Most of the reported cases are in children with very few reported cases in adults. We report a case of 42 years, fertile male, who presented with left reducible inguinal hernia. During surgery, he was found to have a left indirect inguinal hernia with TTE with both testes on...
Liquid sclerotherapy, laser and surgery have been used in the treatment of head and neck vascular anomalies with variable success for many years. A multidisciplinary team consisting of plastic surgery, maxillofacial surgery and interventional radiology currently treats such lesions by converting liquid sclerosant into foam. Foam sclerotherapy is currently used successfully to...
Eosinophilic esophagitis (EE) is attributable to environmental factors, allergens and several immunological causes. The most typical symptoms include dysphagia and sensation of food impingement in the retrosternal area. Although its clinical features resemble those of gastroesophageal reflux, proton pump inhibitors are not effective for its treatment. The diagnosis of EE is...
The thyroid gland is a very rare site for head and neck schwannomas. Till date there have been only 19 reported cases in English literature. Only 25% of schwannomas occur in the head and neck region, most of them arising in relation to the peripheral nerves and cervical sympathetic chain. We report a similar case, with clinical and sonological features of a benign thyroid nodule...
Atrial myxomas are the most common primary cardiac tumors, representing ∼50% of all benign cardiac tumors. Patients with a left atrial myxoma (LAM) generally present with symptoms of mechanical obstruction of blood flow, systemic emboli or constitutional symptoms. Embolic complications may occur any time with progression of the tumor; therefore, myxoma is usually considered an...
There are two major forms of amyloidosis, primary amyloidosis (AL) and secondary amyloidosis. AL amyloidosis results from deposition of immunoglobulin light chains or their fragments. One such example is AL amyloidosis associated with multiple myeloma, in which overproduced immunoglobulin light chains get deposited onto tissues, leading to tissue dysfunction. Amyloidosis in the...
Since the term odontogenic keratocyst first appeared in the literature, controversy has surrounded its terminology and surgical management. Recent articles would suggest that surgical opinion is still divided between aggressive radical resection and a more conservative approach. We present an interesting case of a large keratocystic odontogenic tumour shown to have eroded through...
We present a case of a 64-year-old gentleman who developed a renal cell carcinoma (RCC) metastasis to his lower lip following successful treatment of the primary tumour. RCC is a common kidney tumour but skin metastases are considered rare. The authors describe the findings of this case and discuss the presentation, investigations and management of RCC skin lesions.
Although intravenous extension of uterine leiomyosarcomas has been described, extension into the inferior vena cava (IVC) and right atrium, so-called ‘intravenous leiomyosarcomatosis (IVLS)’, is rare. To our knowledge only a few cases have been described in the literature. We describe a case of recurrent uterine leiomyosarcoma to the retrohepatic IVC. The patient was initially...
Aortopulmonary artery fistulae are exceeding rare and may be associated with aortic arch aneurysms or thoracic aortic surgery. Here, we present a case of an aortopulmonary artery fistula in an 87-year-old woman with no history of aneursymal disease or thoracic surgery and discuss the likely aetiology and management of this condition.
Paragangliomas are rare neuroendocrine neoplasms originating from the embryological neural crest. In most cases, they exhibit a benign behavior. Here we report a case of a small symptomatic para-aortic paraganglioma, which was completely removed surgically and a review of the available literature regarding the optimal follow-up of a benign paraganglioma, since no guidelines are...
We present a case of a 61-year-old male presenting with post-prandial epigastric pain and marked weight loss. Investigation revealed calcific atherosclerosis of the abdominal aorta, coeliac axis, superior mesenteric (SMA) and renal arteries. He had undergone radiotherapy for testicular teratoma 34 years previously. Percutaneous mesenteric revascularization by primary stenting of...
A subglottic granuloma is one of the late-phase complications that can occur after intubation. It can cause a life-threatening airway obstruction; therefore, a rapid diagnosis and appropriate treatment plan is necessary. A 62-year-old male had undergone an emergency total arch replacement for acute aortic dissection. Postoperative ventilation support had been performed until the...
Bulking agent injected submucosally is an alternative effective treatment for faecal incontinence in elderly patients who fail conservative measures. Since most elderly patients are on antiplatelet therapy and are sometimes unaware of their medication, this can lead to serious complications.