The hospital autopsy: the importance in keeping autopsy an option

Autopsy has been one of the most powerful diagnostic tools in medicine for over a century. Despite its importance in establishing cause of death and elucidating pathophysiology of disease, rates of hospital autopsies continue to decline. In this study we aim to determine if physicians believe autopsies are essential to patient care through discussion of autopsy with families. At the same time, we analyzed whether families are more willing to consent to autopsy if physicians are involved in autopsy discussion at the time of death, and what may be the reasons for not wanting an autopsy. Our results showed a doubling in autopsy consent when autopsy was discussed by the physician. Additionally, the biggest reason for families not consenting to autopsy was because they believed they already knew what caused death. The emergence of Coronavirus 2019 (COVID-19) has re-established the value of autopsy, as seen by increased autopsy rates in the past year. This study demonstrates that physician conversation with families on autopsy leads to an increased chance of autopsy consent.

Solitary Fibrous Tumor of Head & Neck Region: Problems in Diagnosis Due to “Borderline” Features.

Aims: To report SFT in a 45 years male who had a lobulated tumor in neck for longest duration of 18 years with borderline histomorphology. Presentation of Case: The case discussed is of a forty-five year old Indian man who presented with painless mass in right side of neck for the duration of 18 years with rapid enlargement in last one year. Discussion: Solitary fibrous tumor is an unusual spindle cell neoplasm arising from primitive mesenchymal cell with distinct “patternlesss pattern” on histomorphology. The commonest site for this tumor is pleura but in recent years it has been described in various anatomic sites and is known to involve any region of the body. The extra- pleural sites include extremities, pelvis, head and neck and urogenital region. SFT of Head and Neck region is rare and usually involves deep soft tissues. Morphologically SFT resembles many benign and malignant soft tissue tumors. Conclusion: SFT is a rare tumor in neck region and has to be differentiated meticulously from other common and rare soft tissue tumors. Close follow up is essential after complete surgical excision in cases with “borderline” histomorphology.

Solitary fibrous tumor of nasal cavity: a rare case report with review of literature.

Solitary fibrous tumor is an unusual soft tissue neoplasm. Commonly the tumor is located in pleural cavity but recently has been described in many extra-thoracic locations. Nose and paranasal sinuses are rare sites for this tumor and so far less than 30 cases have been reported in the literature. In the nasal cavity the tumor usually presents as a polypoidal intranasal mass in a middle aged patient. Erosion of adjacent structures may occur but tumor does not metastasize. Local excision is almost invariably curable. We report SFT in a 50 year old patient with involvement of unilateral nasal cavity and all paranasal sinuses.