Pleomorphic Adenoma of Superficial and Deep Parotid Gland: A Case Report.

Parotid gland is the largest salivary gland of the body. Pleomorphic adenomas are the most prevalent benign parotid gland tumors. They can eventually grow to a size where they weigh several kilograms if not timely addressed. The 'pleomorphic' characteristics are attributed to the origin of the tumor from the connective tissue and epithelium. Pleomorphic adenomas often arise from the superficial lobe, further extending into the parapharyngeal space and gland's other deeper tissues. Common incidence is noted in females between 30 and 50 years. Tumors typically present as asymptomatic swelling and progress slowly. The cornerstone of treatment is surgical removal of the tumor mass, with great care being given to protect the facial nerve. Most of these tumors are observed with the involvement of the superficial lobe; only a few are observed involving the deep lobe. This case report presents an intriguing case of a pleomorphic adenoma of superficial and deep parotid gland in a 65-year-old male. The left side of the patient's face had a steadily increasing, asymptomatic swelling on admission. Magnetic resonance imaging of the neck revealed a pleomorphic adenoma of the superficial and deep parotid gland. The patient underwent surgical excision of the parotid gland, which was uneventful.

Unveiling the Rarity: A Case Report of Malignant Melanoma of the Rectum.

Malignant melanoma of the rectum is an aggressive malignant tumor with anal pain and rectal bleeding as common clinical symptoms with a low incidence. Intestinal metastases are a common form of cutaneous melanoma. On a cellular level, the fibrous stroma is observed to be in the form of compact nests with a signet ring-like appearance. This is a case of a 67-year-old male with major complaints of altered bowel habits, a history of rectal bleeding for four months, and pain during defecation. Upon digital rectal examination, nearly half of the anal lumen was occupied by a fleshy mass. A detailed examination showed an ulcerating, black-colored nodule extending from the anorectal junction. Imaging studies confirmed a polypoidal lesion in the distal rectum. Histopathological examination of the biopsies revealed features consistent with malignant melanoma, supported by positive staining for HMB-45 and S-100 markers. The patient underwent an open abdominoperineal resection, followed by postoperative management and the initiation of chemotherapy. This case can be noted as underscoring the criticality of the diagnosis and treatment of rectal malignant melanoma and highlighting the importance of early recognition for improved patient outcomes.

Comparative Analysis of Robotic-Assisted Versus Laparoscopic Appendectomy: A Review.

Appendectomy ranks among the most common surgical procedures. Laparoscopic appendectomy has become increasingly popular among certain surgeons. Even laparoscopic appendectomy is considered the gold standard; many surgical subspecialties have adopted robotic surgery in the past 10 years. The robotic system is recognized for enhancing stability, visualization, precision, and spatial flexibility. Surgeons can operate with enhanced dexterity, reduced tremors, three-dimensional visualization, up to 10 times magnification, and control over four arms thanks to improved ergonomics that allow them to sit at a customizable console. The purpose of this study is to evaluate and compare the overall effects, such as intraoperative time, postoperative recovery, feasibility for surgeons, and cost-effectiveness, of robotic-assisted appendectomy and laparoscopic appendectomy through the available literature. It was found that both robotic and laparoscopic surgeries work well for appendectomy, but in some studies, it was found that robotic surgery comes with the perks of shorter hospital stays and quicker recovery, even though it is more expensive, and in some studies, no differences were observed in patient recovery postoperatively. Laparoscopic surgery is still a highly effective and commonly used method, with proven advantages over open appendectomy, despite taking longer for the procedure. We need more studies to fully understand the advantages and disadvantages of robotic surgery, especially when it comes to cost-effectiveness and wider health outcomes.

A Case of Redundant Sigmoid Colon and Sigmoid Volvulus.

The torsion of a dilated sigmoid colon around its own mesenteric axis is the cause of sigmoid volvulus, which frequently results in constipation and intestinal obstruction. The clinical presentation of sigmoid volvulus can be observed as nausea, constipation, abdominal distension, and abdominal pain. It is also reported to be insidious. Additionally, it causes blood obstruction, resulting in necrosis, bowel ischemia, and even intestinal perforation if not addressed on time. Physical symptoms might vary depending on the course of the disease but are usually observed as the classical trio of abdominal distension, abdominal pain, and constipation. Computed tomography imaging presents the sign of an inverted U, or classic coffee bean, aiding in the diagnosis of the sigmoid volvulus. A 38-year-old male was admitted to the emergency department of our tertiary care center with significant complaints of obstipation and abdominal pain. The medical history and physical examination revealed peritoneal symptoms, which warranted a prompt radiological imaging diagnosis. The patient was subjected to computed tomography, which was suggestive of sigmoid volvulus. The patient underwent an emergency laparotomy and sigmoidectomy, which were uneventful with no postoperative complications.

A Unique Presentation of a Giant Fibroadenoma in a Perimenopausal Female.

Giant fibroadenomas are common in young females and are rarely reported in perimenopausal or menopausal females. These fibroadenomas are observed as single, mobile, small to large, with distinct boundaries. These tumors are hyperplastic and characterized by their aberrant growth in both the epidermal and mesenchymal layers, which can be accompanied by pain in some instances. These tumors have similar clinical resemblances to other epithelial and stromal tumors, such as phyllodes tumors, except for the level of disease severity and malignancy. Treatment of giant fibroadenomas includes surgical resection. Surgical excision is done by complete excision of the fibroadenoma, with the rest of the breast tissue and the nipple-areolar complex preserved. Timely diagnosis can be helpful in the prevention of adverse outcomes. This is a case of a 40-year-old female who presented with a lump in her right breast, for which she underwent a wide local excision. On histopathology, it was found to be a giant fibroadenoma. Her postoperative recovery was uneventful.

Limberg Transpositional Fasciocutaneous Flap in Sacrococcygeal Pilonidal Sinus Disease (SPSD): A Case Series.

Introduction Among young male adults, sacrococcygeal pilonidal sinus disease (SPSD) is a prevalent condition. There are several possibilities for treatment, including both conservative and surgical methods. Medical supervision or conservative management is not the cutting-edge and preferred management nowadays. Although not fatal, it negatively impacts young people's quality of life in terms of schooling and means of subsistence and is socially awkward. Method About 10 individuals in this case series have serous drainage from the sinus in the sacral region, which is a common symptom. The patients were entitled to a full recovery from their illness. In all these patients, the Limberg flap procedure was recommended, and just one patient out of 10 had a minimal infection. Every patient was satisfied with how the surgery turned out. Overall, the Limberg flap (rhomboid flap) approach is becoming the norm for care since it has a lower rate of recurrence, fewer postoperative problems, and a shorter learning curve. Result Flap necrosis instances were absent in all the cases. And out of 10 cases, one patient came with a surgical site infection during the follow-up, suggesting a complication rate of 10%. Conclusion For the treatment of primary pilonidal illness, rhomboid excision utilising the Limberg transpositional fasciocutaneous flap technique is seen as a safer option that encompasses numerous sinuses. It requires less time in the hospital and has fewer postoperative problems.

Dietary Considerations in Cholecystectomy: Investigating the Impact of Various Dietary Factors on Symptoms and Outcomes.

Cholecystectomy is commonly performed to address gallstone diseases, including the development of gallstones, which can lead to symptoms such as nausea, vomiting, and abdominal pain. Bile acids (BAs) produced by the liver are primarily stored and concentrated in the gallbladder (GB). After cholecystectomy, the body's ability to digest lipids is reduced due to the absence of the GB. Post-cholecystectomy syndrome (PCS) can occur when abdominal symptoms manifest after surgery. The purpose of this review is to look at the various effects of different dietary factors on patients undergoing cholecystectomy, how they affect their overall health after surgery, and how they contribute to symptoms of PCS. Some individuals may experience mild discomfort or alterations in bowel patterns, especially after consuming high-fat meals. The findings from the conducted studies suggest that, although dietary changes are a common recommendation, these measures are not sufficiently supported by evidence when it comes to alleviating symptoms and improving outcomes post-cholecystectomy. The studies found that subjects who consumed particular foods, such as processed meat and fried fatty foods, had exacerbated symptoms after cholecystectomy. Further studies are still required to understand the precise food factors that might affect post-surgical symptoms, as well as outcomes, and to develop tailored measures to enhance patient care and long-term prognosis after undergoing cholecystectomy.

Amyand's Hernia With Sliding Component: A Case Report.

Amyand's hernia (AH) occurs when the appendix becomes part of an inguinal hernia. Amyand's hernias are typically discovered incidentally during surgery due to their variable clinical manifestations and features, such as caecum and appendix forming the sliding component in the present case. Claudius Amyand operated it for the first time in 1735. Due to the simple presentations that these patients typically exhibit, the diagnosis is extremely challenging. The choice between surgical modalities is influenced by the numerous, logically accepted advantages and disadvantages of management modalities, which are subject to debate. That being said, we believe that, in the absence of sepsis or inflammation, open repair using mesh - as long as a clean operating room and competent surgical skill are available - should be the gold standard approach.

A Rare Case of Submandibular Gland Squamous Cell Carcinoma: Diagnostic Challenges and Surgical Management.

Squamous cell carcinoma (SCC) in salivary glands is rare, often posing diagnostic challenges. This case report presents a 75-year-old male with progressively increasing swelling and pain in the right submandibular gland, eventually diagnosed as moderately differentiated SCC. The diagnostic journey involved fine needle aspiration cytology, imaging studies, and histopathological examination. The patient underwent surgical intervention, including submandibular gland excision and selective neck dissection, which successfully achieved local control. Subsequent postoperative follow-up indicated a favorable outcome, with no significant complaints. This report contributes insights into the multidisciplinary diagnostic approach and underscores the importance of imaging modalities in managing salivary gland SCC. This rare case emphasizes the need for ongoing research to refine management strategies for salivary gland SCC. By presenting a comprehensive diagnostic and therapeutic approach, this report contributes to the limited literature on this malignancy, emphasizing its rarity and the necessity for continued exploration of long-term outcomes. In conclusion, our case provides valuable insights into the medical knowledge surrounding SCC in salivary glands, warranting attention and further investigation.

Desmoid tumor of Meckel's diverticulum presenting as intestinal obstruction: A rare case report with literature review.

Meckel's diverticulum (MD) is among the many known congenital malformations of intestine. It is seen in approximately 2% of the population. Desmoid tumors are unusual. They are unique, well-differentiated, and fast-growing musculoaponeurotic fibromatosis tumors, contemplated as Grade 1 fibro sarcoma. They offer exclusive management challenges to surgeons. The most common presentation of desmoid tumors is of painless masses with sluggish growth. Rarely, they may present as intestinal obstruction leading to surgical emergency. We present the only case in history till date along with review of the relevant literature of a 65-year-old gentleman who presented to us with features of intestinal obstruction who successfully underwent elective segmental resection of ileum containing MD with its desmoid tumor. A multimodality approach is needed to tackle such kind of diseases with a team comprising oncosurgeons, oncophysicians, and radiation oncologist to design a standard treatment protocol.