Open Access Case Report

Anaplastic Oligodendroglioma with Cervical Metastases after Prolonged Remission Period

Hanzali Jumastapha, Sakina Ghauth

Asian Journal of Case Reports in Surgery, Page 21-25

Aims: Oligodendroglioma is thought to never metastasize outside the brain. We report a case of oligodendroglioma with cervical metastasis and to share our experience in managing this case.

Presentation of Case: A 72-year-old gentleman was referred to our clinic with a history of painless left-sided neck swelling. He had a previous history of anaplastic oligodendroglioma which was treated with surgery, radiotherapy, and chemotherapy. Fine needle cytology showed metastatic carcinoma suggestive of glial origin. We proceeded with excision of the tumour and histopathological examination confirmed it to be metastatic oligodendroglioma.

Discussion: Oligodendrogliomas account for 2.9% of all gliomas. It was previously thought to never metastasize extra-cranially. However, there have been many case reports that have proven otherwise. Literature reviews have shown that it can metastasize to any site, albeit rarely.

Conclusion: In a patient with a history of anaplastic oligodendroglioma with a progressively enlarging mass elsewhere, a diagnosis of metastatic oligodendroglioma must be included as the main differential diagnosis.

Open Access Case Study

Ileoileal Intussusception Due to Ectopic Pancreas Mimicking as Lipoma: A Case Report

L. Soundara Rajan, Ajay Gulati, Kim Vaiphei, Vikas Gupta

Asian Journal of Case Reports in Surgery, Page 1-4

Ectopic pancreas is a rare congenital disorder in which pancreas can develop in any place other than its usual location. Ectopic pancreas in small intestine causing intussusception in adults is rare. We report a case of ileal ectopic pancreas with intussusception who presented with obstruction.

Open Access Case Study

Laparoscopic Extraperitoneal Repair of Incarcerated Bladder Inguinal Hernia

Fahrettin Acar, Bayram Çolak, Mustafa Sahin

Asian Journal of Case Reports in Surgery, Page 5-9

Introduction: Cases of inguinal bladder hernia are rare, with bladder involvement seen in 1–4% of inguinal hernias. Surgical repair is currently the standard treatment, and careful surgical planning is necessary to avoid complications including bladder injury.

Case Presentation: A 62-year-old man presented to our Emergency Department with 15-day history of progressively worsening right lower quadrant pain, groin bulge and dysuria. Physical exam revealed an irreducible right inguinal hernia associated with urinary urgency on attempted reduction. Magnetic resonance imaging was ordered and demonstrated inguinal hernia with bladder protrusion into the right scrotum. The patient underwent Laparoscopic extraperitoneal reduction and hernia repair and made a quick postoperative recovery without complications.

Discussion: Inguinal bladder hernia most often presents in older, obese males and clinicians should have a high index of suspicion when assessing patients with inguinal hernia. Preoperative diagnosis based on history, physical and radiologic imaging allow for careful surgical planning and prevention of severe complications including bladder injury and leakage.

Conclusion: We present a case report of incarcerated inguinal bladder hernia in a middle-aged man that presented as right lower quadrant pain, groin pain and dysuria. The hernia was Laparoscopic extraperitoneal repair reduced and the defect repaired without complications.

Open Access Case Study

A Fatal Presentation of Primary Cutaneous Mucormycosis in an Immunocompetent Adult

Poojitha Yalla, Saumya Bhagat, L. Badareesh, Mary Mathew

Asian Journal of Case Reports in Surgery, Page 10-14

Background: Mucormycosis is an opportunistic fungal infection, affecting immunosuppressed hosts. Infection in an immunocompetent individual is uncommon, with varying degrees of severity. Usual clinical presentations include rhinocerebral and pulmonary mucormycosis, with cutaneous, gastrointestinal and disseminated forms being less common.

Case Report: A 68-year-old immunocompetent adult, presented with acute onset non-traumatic large necrotizing wound over the right thigh, after receiving initial treatment at a primary center for 2 weeks. On evaluation, the patient was found to be in early sepsis, and emergency extensive debridement was done with the continuation of IV antibiotics. Fungal cultures were suggestive of Mucormycosis and treatment initiated with systemic and topical antifungal agents, despite which the patient continued to deteriorate with acute renal failure and eventually succumbed to the sepsis. Conclusion: High clinical suspicion and apt investigations are essential to initiate the appropriate antifungal therapy and to prevent life-threatening invasive infection.

Open Access Case Study

Superior Mesenteric Artery Syndrome: A Rare Cause of Duodenal Obstruction (Case Report)

Fatima Zahra Bensardi, Bassam Daif, Abdelillah El Bakouri, Khalid Elhattabi, Abdelaziz Fadil

Asian Journal of Case Reports in Surgery, Page 15-20

Superior mesenteric artery (SMA) syndrome or what is called Wiklie’s syndrome is one of the rare etiologies of duodenal obstruction. It is due to decrease in Aortomesenteric angle and Its incidence is its incidence remains unknown. We report a case of a twenty-seven-year old male patient presented to our “Visceral Surgical Emergency Department, UHC ibn Rochd, Casablanca, Morocco” with with an epigastric pain evolving for 2 days, associated with bilious vomiting. The diagnosis of Wiklie’s syndrom was established by abdominal CT-scan. Transmesocolic Gastrojejunostomy was performed by laparotomy. After seven months follow-up, this patient was asymptomatic.

Superior mesenteric artery syndrome is a rare cause of duodenal obstruction that we must always think about. Persistent vomiting after history of weight loss should raise the suspicion of this diagnosis. Upper gastro intestinal endoscopy can exclude mechanical causes of duodenal obstruction. Contrast enhanced CT scan is can confirm the diagnosis of Wiklie’s syndrome.