Papillary carcinoma of thyroglossal duct cyst

Carcinoma arising from thyroglossal duct cyst [TGDC] is rare and account for 1 - 2% of all excised cysts. It is debatable the origin of these tumours whether primarily arising from the TGDC or from metastasis from the thyroid gland. Papillary carcinoma is the most common encountered histological type but the diagnosis usually obtained postoperatively. The aim of this study is to highlight this rare condition and to discuss the origin of these tumours. The preoperative diagnostic technique, histological criteria for diagnosis and treatment modalities were highlighted. Retrospective study. Pathology Departments, Military Hospital and Salmaniya Medical Complex, Bahrain. Patients with TGDC papillary carcinoma who have been diagnosed postoperatively on histological examination after simple Sistrunk's operation during the study period from January 2002 to December 2008 were followed up for six and two years respectively. Patients' characteristics, clinical presentations and outcomes were reviewed. Two patients were encountered during the study period. Both presented with classical features of congenital midline thyroglossal duct cyst. The first patient had a localised tumour and was free of tumour recurrence for 6 years postoperatively. The second patient's tumor spread to surrounding tissue and lymph nodes, which necessitated aggressive surgery. Papillary Carcinoma of the TGDC is a rare entity, it is usually a localised disease which has excellent prognosis after simple surgery in most cases We present two cases of carcinoma of TGDC diagnosed postoperatively after simple Sistrunk's operation; one case had no recurrence and the other had widespread dissemination, which necessitated aggressive surgery. The histological diagnostic criteria of these tumours, their origin from the duct or the main gland were reviewed with treatment modalities

Scrotal elephantiasis: a first case report from Bahrain

Scrotal elephantiasis is a disease that is rarely seen outside the tropical sectors of Africa, Asia, Central and South America. Unlike those endemic regions, where the disease is caused mostly by a filariasis; in developed countries, it is usually secondary to other non-infectious conditions or rarely hereditary. A seventy-eight year old patient presented to the urology clinic with a painful gross scrotal swelling for more than 6 years. The disease proved to be inflammatory and was assumed to be due to filariasis. Subtotal scrotectomy was undertaken followed by scrotal reconstruction with satisfactory cosmetic and functional outcome. To our knowledge, this is the first case of inflammatory probably infectious scrotal elephantiasis to be reported from Bahrain

Actinomycosis of the gallbladder

Actinomycosis of the gallbladder or major biliary ductal system is rare, and to our knowledge, there are fewer than 50 cases reported. We present a case with secondary perforation in a 48-year-old diabetic man who had no prior history of cholecystitis, or cholelithiasis. The diagnosis was made by demonstrating Actinomyces Israeli in the microbiology culture of gallbladder bile, and subsequently confirmed histologicaly in the cholecystectomy specimen. We reviewed the pathogenesis of abdominal and gallbladder actinomycosis, the diagnostic and therapeutic approaches of this rare disease

Schwannoma of a nasal septum, uncommon presentation

This paper describes an uncommonly presented schwannoma of the nasal septum. One of the patients following up in the ENT department of Bahrain Defence Force Hospital was found to have a mass sited in the anterior portion of the nasal septum. The patient was aware of the mass and his only complaint was a regional itching sensationand nasal obstruction. A needle aspiration of the mass was performed and the result was found to be yield less. The patient was then taken to the theatre and the mass was dissected, removed and sent for histopathology evaluation. The result proved to be a benign schwannoma, which is an extremely rare site of presentation