Extra Adrenal Paraganglinoma : A Case Report.

Extra adrenal pheochromocytomas (EAPs) commonly arise in the organ of Zuckerkandl. There presentation symptoms are similar to pheochromocytomas. Biochemical investigation demonstrating elevated blood and urine catecholamines and there metabolites along with imaging studies such as ultrasonography (USG) ,CT, MRI and 131I labeled MIBG (meta-iodobenzylguanidine) scan help in achieving the diagnosis.We present a 35 yr old adult female, who presented with severe headache, abdominal pain and episodes of vomiting , examination revealed a firm to hard retroperitoneal mass right to umbilicus, she was hypertensive and had raised urinary VMA. Clinically an extra adrenal paraganglinoma was suspected . USG abdomen and CT guided FNAC confirmed the diagnosis.Tumor was removed with right mid laparotomy leading to cure of disease.

Post-cholecystectomy Mirizzi's syndrome: magnetic resonance cholangiopancreatography demonstration

A long cystic duct remnant may be found after laparoscopic cholecystectomy. Stone may form in the remnant cystic duct and can cause postcholecystectomy syndrome. Remnant cystic duct calculus may rarely result in postcholecystectomy Mirizzi's syndrome. Traditionally, Mirizzi's syndrome has been diagnosed with endoscopic retrograde cholangiopancreatography [ERCP] and treated with open surgery. We report a case of postcholecystectomy Mirizzi's syndrome that developed 3 years after laparoscopic cholecystectomy. A non-invasive diagnosis of Mirizzi's syndrome was made comprehensively by magnetic resonance cholangiopancreatography. Endoscopic stone removal was achieved successfully with ERCP without any complication

Painful phantom eye

During a period of one year and three months, I examined a total of 56 patients with empty orbits to assess the incidence of painful phantom eye after the loss of a globe, and to study the effectiveness of appropriate preoperative explanation and early postoperative fitting of an ocular prosthesis in the prophylaxis and treatment of this unusual and vexing condition. The patient were divided into two groups: Group 1 included 44 patients who had their eyeballs removed elsewhere, and Group 2 comprised of 12 patients who underwent enucleation or evisceration our institution. Our patients had surgery for panophthalmitis, nine patients; crushed globe, one patient; retinoblastoma, one patient; and expulsive hemorrhage, one patient. Nine of these patients had evisceration and three had enucleation. Two out of 44 patients in Group 1 had symptoms of a painful phantom eye and responded well to proper fitting of a prosthesis and reassurance. None of the patients in Group 2 developed painful phantom eye, placing the overall rate of occurrence of a phantom eye at 3.6% in patients with a surgical loss of the globe. [Pakistan Journal of Ophthalmology 10:77-78, October, 1994.]

Acute mastoiditis in perspective

Thirty cases of acute mastoiditis with sub periosteal abscess were treated at Federal Government Services Hospital over a period of 8 years. The salient feature in these cases was the presence of extensive cholesteatoma in the mastoid presenting mainly in the paediatric age group. These children belonged to poor communities, were malnourished and attended hospital in a state of emergency. The presentation and course of these cases confirms the aggressive and potentially serious nature of the pathology requiring early medical attention in order to avert impending complications. Significantly all patients had a history of ear discharge prior to abscess formation. It appears that in our environment most cases of acute mastoiditis with abscess formation develop from chronic otitis media with cholesteatoma

Plasmacytoma of the nasal cavity

A case reported of 50 year old male with repeated epistaxis and mass in right nasal cavity. It was approached through lateral rhinotomy which revealed its attachment to lateral wall of the nose but there was no bony erosion. Excision biopsy confirmed it to be a plasmacytoma