RESUMO
Granular cell tumour (GCT) is tumours showing neuroectodermal differentiation. It occurs mostly in the dermis and subcutaneous tissue and occurrence in the muscle layer is rare. The most common site is the head and neck region. It has been known to occur in the vulva, with clitoris being a very rare site. Granular cell tumours are slow growing tumours, which are mostly asymptomatic. We report a case of lump in the clitoris in a 42-year-old woman which was managed with surgical excision. Histopathology confirmed the diagnosis of granular cell tumour. Very few cases of granular cell tumour of clitoris have been reported in literature till date. Although mostly benign, the differential diagnosis of granular cell tumour should be borne in mind by the clinicians in cases of clitoral lump.
RESUMO
Dengue and chikungunya infections are commonly encountered by the clinicians in a tropical country like India. We report this case to emphasize the rare manifestations of self-limiting intrapartum bradycardia in fetuses of chikungunya and dengue infected mothers. A primigravida at 32 weeks of gestation presented with history of fever for one day. The blood investigations were positive for both dengue and chikungunya virus infection. On the third day of fever, NST showed a low baseline fetal heart rate of 95 to 100 beats per minute but good beat to beat variability and three accelerations in 10 minutes. This pattern persisted for 48 hours. Although, the finding initially appeared alarming, the change in baseline heart rate of fetus was transient and self-limiting and recovered completely. Hence, a judicious approach and close fetal surveillance can avoid hasty decisions regarding an early termination of pregnancy.