ABSTRACT
Benign osteoblastic anomalies are uncommon bone tumors and commonly divided into osteoid osteomas and benign osteoblastomas according to their biological behaviour. Among these primary benign bone tumor osteomas are the most commonly found at the site of skull and face. Osteomas are usually asymptomatic as they increase in size slowly. Therefore, present study was designed to evaluate the clinical, radiological, and surgical aspects of osteomas in patients with giant skull lesions. Methods: This study was conducted in CNS Hospital, Centre for Neurosciences and Narayan Superspeciality hospital, Meerut and SVBP Hospital associated with LLRM Medical College, Meerut between the period of 2015 and 2018. The 12 successive patients with giant osteomas were treated surgically in the hospital. The patient population consisted of adult female patient ranging from 12 to 70 years with median age of 40 years and having giant cranial osteomas involving the cranial vault and some with extension into the paranasal sinuses or orbital wall. Results: Most common site of lesions was frontal portion of skull. Further, most common complaint of the patients was headache (50%). Further, slowly growing mass (44.4%) was the second most common complaint followed by proptosis in one patient. The mean diameter was 5.75 cm with range of 3 to 10 cm in all patients. The mean time duration of the patients of the onset of the tumor was 3 years with range from 6 months to 5 years. Histopathology picture of the patients revealed that tumors were composed of oestoid lamina. Further, different quantity of osteoid with major cement lines were found in trabeculae of laminae. Conclusion: Osteomas are normally benign tumors without any symptoms; However, surgical removal could be required for the cosmetic reasons. On the other hand, for the osteomas with different symptoms surgical treatment is the only choice of treatment. A considerable precaution and care of blood supply and surrounding brain tissue should be taken during radical extraction of the giant tumors.
ABSTRACT
OBJECTIVE: The present study aims at establishing the exact role and limitation of ultrasound in pediatric acute abdomen. METHODS: Fifty children less than 14 years of age presenting with acute abdomen were evaluated by US and other imaging modalities. The mean age of presentation was 3 1/2 years. Maximum number of cases were seen in less than two years of age. There were 17 cases of intussusception with US sensitivity and specificity of 88.2% and 100% respectively and positive and negative predictive values of 100% and 94.5% respectively. There were 13 cases of appendicitis. US was diagnostic in 11 with sensitivity and specificity of 91.6% and 97%; the positive and negative predictive values were 91.6% and 97% respectively. RESULTS: There were two cases each of congenital bands, adhesive intestinal obstruction, malrotation of bowel with volvulus, incarcerated inguinal hernia, hypertrophic pyloric stenosis, duplication cyst and pseudopancreatic cyst, one case each of trichobezoar, Meckel's diverticulum, ureteric calculus and worms as a cause of intestinal obstruction. The sensitivity of US for diagnosing specific cause of acute abdomen was found to be 77.5%. The main limitation of US was in the diagnosis of acute intestinal obstruction such as congenital bands and adhesions. CONCLUSION: US should now be considered as imaging modality of choice in pediatric acute abdomen. However, at times, plain radiography, conventional contrast studies and CT may be vital to reach the true diagnosis.