Nonmidline yolk sac tumour of the head and neck region in an infant with Dandy Walker syndrome--case report and review of literature.

Germ cell neoplasms are among the most commonly observed tumors in the pediatric age group. However, yolk sac tumors, which form a common subtype occur rarely in the head and neck region. In this paper we share our experience of one such rare case and review the literature about this condition.

Primary gastric lymphoma in a boy.

Primary gastric lymphoma is an extremely uncommon entity in children, and diffuse large-cell-type lymphoma in this age group is still rarer. An 11-year-old boy with primary gastric lymphoma who responded to CHOP regime is reported.

Gastric volvulus in childhood.

Gastric volvulus is an uncommon condition more so in the paediatric age group. The cause of gastric volvulus may be idiopathic or secondary to various congenital or acquired conditions. In this short series of three patients, one had volvulus which was due to ligamentous laxity and mobile spleen, second had congenital postero-lateral diaphragmatic defect and the third had hiatus hernia.

Atypical mesoblastic nephroma. A potentially malignant variant of congenital mesoblastic nephroma. Review of literature & report of four cases.

Atypical Mesoblastic Nephroma (AMN) is a rare infantile renal tumour which may behave aggressively, in contrast to conventional Mesoblastic nephroma. During a 10 year period we encountered four cases of AMN. The mean age of presentation was three months. Size varied from 9-18 cms. All were soft and fleshy with a weight varying from 290-1200 gms. Three cases revealed cystic changes. Hemorrhage and necrosis was seen in all four cases. One case had associated Nephroblastomatosis Complex. The capsule and ureter were involved in one case each. Two of the four patients died of distant metastasis. Thus a close periodic follow up by non-invasive imaging techniques is indicated for early detection of recurrence and or metastasis in cases of AMN.

Intrathoracic enteric foregut duplication cyst.

A one month old male child presented with respiratory distress since day 10 of life. There was intercostal retraction and decreased air entry on the right side. Investigations revealed a well defined cystic mass in the posterior mediastinum with vertebral anomalies, the cyst was excised by posterolateral thoracotomy. Histopathology revealed it to be an enteric foregut duplication cyst.

Colloid carcinoma of rectum in a 11 year old child.

The rarity of rectal carcinoma in children has prompted us to report this patient who presented with bleeding per rectum and constipation. Histopathological examination of biopsy revealed the growth to be a colloid carcinoma of rectum and it was inoperable on exploratory laparotomy. There are three factors which contribute to an overall poor prognosis of rectal carcinoma in children viz. delay in diagnosis, advanced stage of disease and poorly differentiated histology.

Crossed renal ectopia.

A 2 year old male child presented with mass on right side of abdomen. The clinical diagnosis of renal lump was made and rest of the examination did not reveal any abnormality. His intravenous pyelography showed non-functioning left kidney. Cystoscopy and ascending pyelography on left side showed normal ureteric orifices and crossing of the left ureter to opposite side. Ectopic kidney was removed without any damage to the lower pole of the right kidney.

Splenic cyst.

An 11 year old boy presenting with cystic lump in left hypochondrium was diagnosed to have splenic cyst and treated successfully by splenectomy. Large, infected cyst involving hilum was the indication.

Adenocarcinoma of the colon in a child.

A rare case of a 10 year old boy presenting with history of lower GI bleeding for one year and acute intestinal obstruction was diagnosed as adenocarcinoma of the colon on exploration. One year follow-up after radical colectomy did not show any recurrence.

Benign neonatal pneumoperitoneum--an enigma.

A case of neonatal pneumoperitoneum in absence of a bowel perforation or intrathoracic pathology has been reported. The cause of such a rare manifestation remains to be established.

Chylothorax--a conservative approach (a case report).

Lymphatic blockage due to a non-specific inflammation probably of a filarial origin caused dilatation and ectasia of lymph channels at thoracic inlet of a child. Transudation of lymph through these channels led to chylothorax. The present case report highlights the significance of conservative approach towards this complex problem.

Developmental anomalies associated with hypospadias.

Hundred and thirty patients with hypospadias were studied between 1983 and 1990, with an aim of analysing the associated anomalies in these patients. Urogenital anomalies were observed in 30% and extra-urogenital anomalies were noted in 16%. Undescended testis was the most frequently seen anomaly, having been noted in 6.9% of 130 cases. Vesico-ureteral reflux was present in 5.4% and inguinal hernia in 3.8%. The incidence of these anomalies increased in proportion to the severity of penile deformity. The present article emphasizes the need for systemic urological and endocrinal examination, especially in severe cases of hypospadias.

Intussusception in infancy and childhood: evaluation of a prognostic scoring pattern.

This is a retrospective analysis of 82 patients of intussusception in infancy and childhood. Males were more than females in the ratio 2.4 : 1, the ages varied from 2 months to 12 years. Majority (73%) were less than 1 year old. Commonest presentations were pain, vomiting, distension, palpable lump and blood and mucus in stools. The management of these patients varied from barium enema reduction (3 cases), reduction by surgery and manipulation (59 cases) and resection with primary anastomosis (20 cases). We analysed our patients by giving scores based on clinical criteria. We concluded that the patients in our circumstances do not show any correlation of the scoring pattern with morbidity or mortality, chances of reduction by barium enema or manually. Resection, however, did correlate with a high incidence of death (75%). Resections were required slightly more in ileo-ileal intussusceptions than in those having a colonic involvement, morbidity in the form of wound dehiscence, and sepsis was higher in those patients who had undergone resections.