Sialoblastoma.

Sialoblastoma should be considered in the diagnosis of a perinatal neck swelling that appears to be contiguous with the submandibular salivary gland. These are exceedingly rare perinatal salivary tumors of epithelial origin with variable biologic behavior including the potential for local and systemic recurrence. We report the case of a 3-month-old boy who presented with a submandibular swelling of insidious onset that was initially thought to be a lymph node enlargement.

Chylous ascites following liver resection--case report.

Chylous ascites is an intraperitoneal collection of fluid that appears milky because of the presence of unusual amounts of fat. It is a result of interference, interruption, or obstruction of lymph flow through chyle-transporting vessels, and remains rare as a complication of surgical intervention. Liver resection has been infrequently reported as a cause of chylous ascites. We report a case of chylous ascites developing after laparotomy and right lobe liver resection, which was diagnosed early and managed conservatively with minimal morbidity. The key lies in awareness of the condition, early diagnosis, and aggressive management with nutritional support.

Urogenital sinus, rectovaginal fistula, and an anterior stenosed anus--another cloacal variant.

The persistent cloaca is one of the most complex and challenging developmental malformations. It is a rare anomaly occurring only in the female newborn and is represented by the association of urogenital sinus with an anorectal malformation (ARM). Each case is probably unique. We report here one such case of cloaca with the VATER association-tracheoesophageal fistula (TOF) with a urogenital sinus, rectovaginal fistula, and an anteposed stenosed anus, along with preaxial syndactyly of the right hand. The spine, renal, and cardiac systems were normal. Interim management was directed towards repair of the TOF and a right transverse defunctioning colostomy. Despite thorough radioendoscopic preoperative investigations, the complexity of the cloacal anomaly was not delineated until surgery. This case is a rather rare combination of an intermediate form of the cloacal-ARM spectrum. Such patients present with many diagnostic and therapeutic problems. Interval surgery should be directed towards decompression of the affected organ systems, and definitive surgery must be carefully planned and, whenever possible, done in a single stage with simultaneous multisystem repair to correct all significant malformations related to the cloacal complex.