Giant cervical teratoma masquerading as lymphatic malformation

Teratomas are composed of multiple tissues foreign to the organ or site from which they arise. They are tumours which consist of solid or organoid masses containing tissues derived from all three or any of the three blastodermic layers. Their histologic features are heterogeneous and may include cystic or solid areas as well as mature and immature components. They can develop from any part of body. The commonest area of occurrence is sacrococcygeal region followed by retro peritoneum. They rarely occur in cervical region.

A giant congenital ranula: ignorance leading to feeding difficulties

The term “Ranula” originates from the Latin Word Rana which means “underbelly of a frog.” Ranula are epithelial retention cyst or mucus extravasation pseudo cyst arising from the sublingual glands. They are rare in children. A one-year-old female was brought to paediatric surgery emergency OPD by her mother with complaints of swelling arising from oral cavity since birth, gradually increased in size to attain current size. Mother also gives History of difficulty in feeding. Clinical examination revealed a large protruded tongue, with a cystic swelling in the floor of the mouth measuring around 6×4 cm, with elevation of the tongue. Child was further evaluated; ultrasound was suggestive of ranula. Marsupialisation of the cyst was done. Intraoperatively, cyst fluid was aspirated for analysis and cyst wall was opened and excised, lateral margins of cyst were sutured to base of mouth. Cyst fluid analysis revealed elevated amylase and normal LDH levels. The post-operative period was uneventful. The histopathology report showed a pattern consistent with ranula. Child was followed up for a period of 1 year and there was no evidence of recurrence. We report a case of giant congenital ranula. The rarity of this condition in children and its atypical size make this case report unique. We treated the child with marsupialization and there was no recurrence noted. Hereby I would like to state that congenital symptomatic ranulas though rare can be managed with marsupialisation.

Self-knotting of infant feeding tube in urethra in male child an unfortunate complication-case report

Urethral catheterisation is a common routine procedure. Knotting of infant feeding tube in genitourinary tract is a rare complication. Various methods have been used in the removal of a knotted catheter. The methods include gentle but sustained traction under general anaesthesia, open cystostomy and endoscopic retrieval.

Congenital bilateral scrotal agenesis with bilateral cryptorchidism: a case report

Congenital bilateral scrotal agenesis is very rare anomaly and characterized by the absence of scrotal rugae. It may be associated with other extra-genital anomalies as a part of a syndrome. Etiology is unknown but may be due to primary failure of labioscrotal folds development or secondary to localized 5-alpha-reductase type 2 deficiency. Various surgical techniques used for neoscrotum construction with different types of complications. In index case, we performed bilateral orchidopexy without creating neoscrotum.

Bilateral peri-renal macrocystic lymphatic malformation in pediatric age-unusual presentation

Lymphatic malformations are benign lesions, found in children, most common locations are neck and axillary regions. We report here a case of bilateral Peri-renal macrocystic lymphatic malformation in a 12-year-old female, masquerading as bilateral renal cysts. A 12-year-old female presented with complaints of pain in right flank for one week associated with fullness in right flank. On evaluation a provisional diagnosis of right perirenal lymphangioma was made and ultrasound guided pigtail drainage done. The pigtail output was 200-300ml daily for a week and it was removed and child was discharged. However, on follow up, CT was done and bilateral peri-renal lymphatic malformation(right>left) was diagnosed. Patient was then planned for exploratory laparotomy which revealed bilateral perirenal cyst, circumscribing both the kidneys completely. Excision of bilateral cysts was done and sent for histopathological evaluation. Cyst Fluid analysis revealed normal creatinine, LDH, total cholesterol, total protein, triglycerides, urea levels. Post-operative period was uneventful. Histopathological examination revealed cystic lesions formed by endothelial cells with focal inflammation, no signs of malignancy were seen. The child was followed up post-operatively and there was no evidence of recurrence. Perirenal lymphatic malformation is a rare entity. The entity is thought to be the result of the obstruction of the perirenal lymphatics. We are presenting this case for its rarity and unusual presentation. Macro cystic Lymphatic malformations are common diagnosis but around the kidneys, there are only very few cases reported in literature. Prognosis of cystic lymphatic malformation is excellent.

Mermaid baby or sirenomelia: a lethal congenital anomaly

Mermaid syndrome is a very rare, lethal congenital anomaly. It is associated with other congenital anomalies and is incompatible with life. Typical clinical features are fused lower limb from perineum to ankle and single umbilical artery. Etiology is multifactorial and is extreme form of caudal regression syndrome. When diagnosed in early gestation, termination of pregnancy may be considered.