Primary hydatidosis of female genital tract: a case report.

Hydatid cysts are known to occur in most organs especially in the endemic areas. The diagnosis of primary hydatid cyst in female genital tract is rare and difficult. A high degree of clinical suspicion should be there for doing pre-operative investigations to exclude hydatid cyst of female pelvis. The patient presented with a lump in lower part of abdomen, which enlarged gradually over last 2 years. A provisional diagnosis of malignant ovarian cyst was made pre-operatively. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was done and whole of the specimen was sent for histopathological examination. On macroscopic examination, one cystic mass was present on the right side of uterus adherent to its anterior wall and second one was in the Douglas' pouch adherent to left adenexa and surrounding structures. The patient responded well to the surgical treatment followed by albendazole administration.

Adenocarcinoma of the urachus.

During the past 5 years, three patients with adenocarcinoma of the urachus were treated at our hospital. Abdominal ultrasonography helped clinch the diagnosis in all cases. All patients underwent surgical excision of the neoplasm with partial cystectomy. The clinical, radiological, and histological findings, as well as the pathogenesis of this rare neoplasm are discussed along with the surgical management.

Primary reconstruction to avoid wound breakdown following groin block dissection.

We report our experience of immediate reconstruction of the groin using the deep inferior epigastric artery (DIEA) myocutaneous flap following 32 consecutive ilioinguinal block dissections for groin metastases in patients with penile carcinoma. All groin wounds healed primarily, resulting in a short postoperative hospital stay. Transferring one or both DIEA flaps did not lead to any significant functional disability.

Inguinal pick in invasive penile carcinoma: can it stage node negative patients?

In node negative patients of invasive penile carcinoma, prophylactic lymphadenectomy is associated with considerable morbidity, while a "wait and watch" policy is associated with up to 20% cancer related mortality in many series. In between, selective node biopsies, including sentinel node biopsies, have been suggested to stage these patients. However, these procedures are unreliable and associated with high false negative rates. The inguinal pick procedure was devised by us to stage these patients more accurately. It is more elaborate that the previously described selective biopsies and includes biopsy of all identifiable nodes in the inguinal region, including the sentinel node area. In our experience of the procedure in 52 patients with invasive penile carcinoma, it was positive in 5 patients (9.6%). However, 7 of the 47 patients with negative result developed inguinal recurrences and 3 other patients developed distant metastases on follow up. The 5-year disease free survival of inguinal pick positive and negative patients was 100% and 82.9%, respectively. The sensitivity of the procedure in detecting regional spread in these patients was only 72%. Thus, the inguinal pick, though associated with no morbidity, can be meaningful only if it is positive and a negative result does not guarantee absence of regional metastases in node negative patients of invasive penile carcinoma.