A rare presentation of low-grade appendiceal mucinous neoplasm within an amyand’s hernia: a case report

An Amyand’s hernia is characterised as the presence of the appendix in an inguinal hernial sac. During laparoscopic cholecystectomy for gallbladder polyps, an incidental Amyand’s hernia was discovered in a 75-year-old female patient. On examination, the hernia contained an appendiceal mucocele but no evidence of perforation. An open appendicectomy with tension-free mesh repair was performed for the hernia. The histopathological report of the appendix was a low-grade appendiceal mucinous neoplasm (LAMN), an entity that is just as rare as an Amyand’s hernia. The patient had the right inguinal swelling for over 10 years but it was thought to be an inguinal intramuscular cyst as reported on a previous abdominal ultrasound. Mucocele of the appendix may have a benign or malignant appendiceal progress, leading to individualised diagnosis and treatment. We review an Amyand’s hernia with LAMN and discuss the asymptomatic tendency yet malignant potential of appendiceal mucoceles along with treatment strategies.

Radical Resection of Primary Leiomyosarcoma of Inferior Vena Cava

@#Leiomyosarcoma of the Inferior Vena Cava (IVC) is a rare soft tissue tumour which accounts for only 0.5% of all soft tissue sarcomas. The patients usually presented with non specific clinical signs and often diagnosed at advanced stage. We reported a case of a 58-year-old lady who presented with right sided abdominal pain for 6 months. CT scan showed large Level 2 IVC tumour which encased the right renal vein and had no clear plane of demarcation with the caudate lobe of the liver. She underwent radical resection of the IVC tumour with the right kidney removed en bloc. Vascular reconstruction was not performed as established collateral veins present. She was nursed in Intensive Care Unit for 2 days and discharged well at day 5 post operatively. Histopathological examination results revealed leiomyosarcoma of IVC.

Successful pregnancy following resection of recurrent retroperitoneal liposarcoma

Retroperitoneal liposarcoma is rare in pregnancy. Management of recurrent disease following surgical resection remained a challenge especially when it is associated with pregnancy. A 30-year old primigravida conceived spontaneously four months following a second laparotomy for resection of recurrent RPLS. The primary surgery was performed four years earlier with optimum postoperative course in the absence of need for postoperative adjuvant treatment Histology of the recurrent tumor confirmed a well differentiated liposarcoma. She was monitored closely for any worsening of symptoms and underwent a MRI and an ultrasound at 12 and 22 weeks gestation respectively. The pregnancy continues to be uneventful and she safely delivered vaginally at 41 weeks gestation. Small RPLS during pregnancy do not pose great obstetrics management challenges. Early detection with multidisciplmary team management would anticipate possible complications to ensure both maternal and fetal wellbeing

rare case of intussusception associated with metastasize small cell carcinoma of lung

Intussusception is common cause of bowel obstruction in the paediatric age group compared to the elderly population. Many times, The diagnosis may be difficult because of asymptomatic nature of this bowel disorder. We hereby describe the case of a 75-year-old male who presented with lethargy, weakness, loss of movement in the joints and was found to be anemic. The haemoglobin level was low so he was transfused with packed cells. On gastrointestinal [GI] endoscopy, upper GI bleed was observed. A mass was observed beyond ampulla at the 2[nd] and 3[rd] part of the duodenal junction. Computerized tomography [CT] scan also showed a mass at the head of pancreas and the lesion at the left lung. In view of persistent bleed, 'Whipple's procedure' was performed. Histopathological examination showed small cell carcinoma of the lungs with metastasis to the pancreas and the jejunum. We here discuss the case of intussusception with intestinal metastasis which presented with gastrointestinal bleeding