Nasopharyngeal salivary gland anlage tumour

A salivary gland anlage tumour [SGAT] is a very rare type of benign tumour that usually presents in early infancy with respiratory distress which is exacerbated upon feeding. We report a full-term male neonate who was referred to the Al Nahdha Hospital, Muscat, Oman, in 2015 with severe neonatal respiratory distress due to a nasopharyngeal obstruction immediately after birth. Computed tomography and magnetic resonance imaging revealed a well-circumscribed mass in the nasopharynx, without intracranial extension. Histopathological analysis of the lesion confirmed a diagnosis of SGAT. Following excision of the tumour, the postoperative period was uneventful. No recurrence was observed over the next two years. This case report highlights the importance of the early recognition of this extremely rare and potentially life-threatening, yet easily curable, condition

Correlation of intraoperative frozen section report and histopathological diagnosis of central nervous system tumors - a six-year retrospective study

Objectives: To evaluate the degree of agreement between the intraoperative frozen section [FS] reporting of central nervous system [CNS] tumors and final histopathological diagnosis based on permanent paraffin section

Methods: All CNS tumor cases with a diagnosis at FS and subsequent permanent section [n = 261] taken from 2007 to 2012 were retrospectively reviewed. Twenty percent of FS were double-checked by a senior pathologist as part of the study and the intraobserver agreement between the pathologist and the agreement between final report, and initial FS report was estimated by the intraclass correlation coefficient [ICC]

Results: A total of 261 cases were reviewed. The most common diagnosis was glioblastoma [grade IV] and meningioma [grade I-II] forming 45.6% of cases. Fifty-three cases were subjected to intraobserver agreement of histological diagnosis. There was nearly perfect intraobserver agreement on histopathology [ICC = 0.9]. Out of 261 cases, 224 cases showed a strong agreement between the FS diagnosis and final histological diagnosis [ICC = 0.747]. A discrepancy between the FS and final diagnosis were found in eight cases. The disagreement did not relate to any specific tumor type. However, in three cases, the discrepancy was in the grading of the glioma. In 29 cases, a definite opinion could not be given on FS as the samples examined were nonrepresentative

Conclusions: Histopathological slides classified by World Health Organization criteria of CNS tumors had excellent intraobserver agreement. Our results show a moderate to high degree of agreement in the intraoperative diagnosis of CNS lesions using FS. However, there are limitations, and some lesions are a diagnostic challenge. There is a need to improve our diagnostic skills and knowledge of possible errors and establish better communication with neurosurgeons

Post-aural nodular fasciitis

Nodular fasciitis is a rare benign lesion. Here we report a case of post-auricular nodular fasciitis, which was misdiagnosed by fine-needle aspiration cytology [FNAC] as pleomorphic adenoma. Physical examination of an 18-year-old male revealed a right post aural firm immobile mass. Radiology suggested the presence of a hypo-dense to iso-dense subcutaneous mass. The swelling was excised and sent for histopathological examination which suggested the diagnosis of nodular fasciitis. FNAC reported pleomorphic adenoma of unusual location should raise the suspicion of nodular fasciitis

uncommon presentation of giant cell tumor

Giant Cell Tumors commonly occur at the ends of long bones. However in rare cases, they can occur in the bones of the hands and feet. Tumors in these locations occur in younger patients; in addition, these tumors are more commonly multifocal and are associated with a higher risk for local recurrence than tumors at the ends of long bones. Since lesions in the small bones may be multifocal, a patient with a giant cell tumor of the small bones should undergo a skeletal survey to exclude similar lesions elsewhere. Primary surgical treatment ranges from curettage or excision with or without bone grafting to amputation. The success of surgical treatment depends on the completeness with which the tumor was removed. We are presenting a case report of a 34 year old female, who presented with a swelling in the right hand, following trauma. X-ray of the hand showed an osteolytic expansile lesion at the base of the 1[st] metacarpal bone. The lesion was initially curetted and then treated by local resection with bone grafting. Histological examination revealed a typical benign giant cell tumor composed of closely packed stromal cells with a variable admixture of giant cells. Follow up at the end of one year did not reveal any recurrence of the tumor

Splenic pathology in traumatic rupture of the spleen: a five year study

To study the histopathology of spleens with a history of traumatic rupture with a view to establish possible predisposing factors to the rupture. This study examined the gross and microscopic features of consecutive cases of splenectomies done for traumatic rupture during a five year e=period in order to evaluate the presence or absence of any pathology prior to rupture. Of the 17 cases of splenectomy during this period, 14 were normal and 3 cases showed pathology other than rupture. In the five year period of studying splenic pathology in traumatic rupture, 82% of the spleens showed normal histology except for the rupture. 18% of the cases showed different pathological findings on histopathology which could have contributed to the rupture