Sporadic lateral ventricular hemangioblastoma presenting with Intraventricular and Subarachnoid Haemorrhage

Intraventricular hemangioblastoma [HB] is very rare; few cases of intraventricular HB have been reported in the literature, either sporadically or in association with von Hippel-Lindau disease. Furthermore, the incidence of ventricular haemorrhage from HB seems to be uncommon. We report a unique case of sporadic HB of the right lateral ventricle presenting with intratumoural and intraventricular haemorrhage in addition to multifocal intracranial superficial siderosis, indicating the presence of a subarachnoid haemorrhage [SAH] as well. Such a combination has not been reported before. In the future, the detection of an intraventricular mass in association with ventricular haemorrhage, with or without SAH, should include HB as a differential diagnosis, particularly when the imaging appearances are not typical of the more common intraventricular tumours

Breaking the needle diameter limit for radiofrequencythermal ablation for hepatocellular carcinoma. A new technique

A significant number of hepatocellular carcinomas are meet with beyond the ablation field of yet available needles. A new technique had been attempted to increase the field of radiofrequency ablation of expandable electrode needles in the treatment of hepatic neoplasms much larger than the routinely covered size of 5-7 cm according to the needle size overcoming the technical difficulties usually met with in the overlapping balls technique due to the hyperechoic focus that develops at the needle tip making reinsertion difficult and inaccurate. 40 patients were included in the study, all presented with hepatic neoplastic mass lesion that range in size between 7 and 10 cm in its maximum diameter. In this technique, two or three needles were inserted from the start into the mass with accurate estimation of the exact field of ablation of each needle trying to cover the whole extent of the mass before application of radiofrequency waves. All had a pretreatment helical [triphasic] CT study for accurate delineation of the whole extent and vascularity of the mass. Two needles were sufficient to cover the whole extent of the mass in 23 patients [57%] while in the remaining 17 patients [43%] three needles were necessary. The procedure was done under general anathesia and ultrasound guidance, patients tolerated procedure well with smooth recovery. No major complications. Follow up spiral [triphasic] CT was done 2 weeks after ablation revealed percentage of tumour necrosis of 90% or more in 30 patients [75%], 70-90% in 6 patients [15%] while in the remaining four patients [10%] the percentage was 50-70% necrosis. In conclusion this technique should be considered in the treatment of hepatic masses larger than the usual field of the needle

Clinicopathological and sonographic correlation of the pre-operative and the operative findings in undescended testis

Twenty -six cases of undescended testes were studied in a prospective way in a period from January 1998 to June1999. The age ranges between 2 months and 12 years with a mean of 4 years and a peak incidence of 4 years. The site of the undescended testis was right side in 14 cases, left sided in 6 cases and billateral in 6 cases. The clinically palpable testes were in 16 cases and impalpable in 10 cases. Associated hernia was present in 22 cases, and associated anomalies were present in one case as transverse [paradox] ectopia of the testis. Ultrasound diagnosis revealed positive testes in 22 cases and negative in 4 cases. The sonographer gave no inconclusive result. At exploration, testes were found in all cases except for 1 case, which proved to be anorchism. Out of the 22 positive cases of ultrasound all cases were recovered surgically. Out of the 4 cases of negative ultrasound, three were found at different locations and fixed in the scrotum. Fidelity of ultrasound diagnosis in this series proved to be 23 cases [22 positive and 1 negative] out of 26 with a score of 88.4%