Open Access Case Report

Manubriosternal Distruption– A Rare Traumatic Entity

N. Shajini, M. V. Pradeep Anand

Asian Journal of Case Reports in Surgery, Page 6-9

Despite an increased frequency of chest trauma encountered, manubriosternal joint (MSJ)  disruption from blunt injury without associated spine or rib injuries are a rare occurrence and are often outside the focus of acute care surgeons. However, being a marker lesion for severe trauma, here we report the case of a 32 year old male who suffered MSJ disruption following a motor vehicle collision managed non-operatively and also review the mechanism and management of these injuries.

Open Access Case Report

Inflammatory Myofibroblastic Tumor of the Spleen: A Report of Two Cases

Viju Kumar Bharathan, Vimal Iype, Santhosh John Abraham

Asian Journal of Case Reports in Surgery, Page 10-15

Owing to the lack of typical clinical features and imaging characteristics, inflammatory myofibroblastic tumors (IMT) of spleen can cause diagnostic dilemmas. Here, we report two such cases of splenic IMT. Our first patient was a lady who was detected to have an incidentally splenic lesion characterized as angiosarcoma on CT scan. Splenectomy was done, Immunohistochemistry (IHC) was suggestive of IMT. After four years, follow-up imaging revealed a lesion in the liver, core biopsy was suggestive of metastasis from IMT. She was started on steroids and is on follow-up. Our second patient was an 83 year old gentleman who was detected to have adenocarcinoma sigmoid colon. CT scan revealed a splenic lesion, suggestive of lymphoma or metastasis. Anterior resection and splenectomy was done. IHC of splenic lesion was suggestive of IMT. He is asymptomatic at 9 months follow-up. The two cases of splenic IMT presented us with different challenges in management. In the first case, the patient developed a metachronous lesion in the liver four years after splenectomy, which is a rare occurrence as per literature. In the second case, the co-existence of splenic IMT with adenocarcinoma colon led to suspicion of metastatic disease, we could not find any similar case reported in literature. Thus, although splenic IMT is rare, it can cause significant diagnostic and therapeutic challenges. Surgery is mostly curative, but follow-up is essential in view of possibility of local recurrence and metastasis.

Open Access Case Report

Role of MRI in the Diagnosis of Dysembryoplastic Neuroepithelial Tumours (DNET): Two Case Reports

Zineb Abbad El Andaloussi, Ali Laanait, Hind Arbouni, Aicha Merzem, Hasna Belgadir, Nadia Moussali, Naima Elbenna

Asian Journal of Case Reports in Surgery, Page 16-21

Aims: Show the value of MRI in the diagnosis of DNET.

Presentation of Case: We report two cases of DNET, in two patients aged 17 and 14 years, with epilepsy resistant to medical treatment, with no neurological deficit on clinical examination. On MRI, the first case shows a temporal cortical lesion and the second a parietal lesion, with no mass effect or peri lesional edema.

Discussion and Conclusion: Dysembryoplastic neuroepithelial tumors (DNET) are benign brain tumors clinically revealed by partial seizures occurring in young patients under 20 years of age, with normal neurological examination. Imaging contributes to the diagnosis, it is a cortical sus-tentorial lesion, without mass effect or peri lesional edema. The temporal location is the most frequent, followed by the frontal location more rarely parietal and occipital. It is a generally stable tumor. Surgery is the only treatment for DNET, it allows epilepsy to be controlled in 85%, but confirmation remains histological.

Open Access Case Report

Impaled Metallic Rod- a Serious Threat to a Child’s Life

Misauq Mazcuri, Tanveer Ahmad, Seemin Jamali, Nazish Sikander, Muhammad Shoaib Lodro, Anum Asif

Asian Journal of Case Reports in Surgery, Page 22-26

Penetrating chest wall injuries are life threatening necessitating prompt surgical management. Impaled foreign body in thorax requires major intervention and removal under direct vision. We report a 14 year old boy presenting to emergency department with impaled metallic foreign body to the posterior chest wall. He was anxious, however stable clinically. On examination, foreign body was found penetrating the left 7th intercostal space 2 cm away from midspinal line. Chest x-ray showed radiopaque sharp object within left hemithorax. After blood products were arranged, general anesthesia was given without manipulation of foreign body. Posterolateral thoracotomy was done one intercostal space above injury, metallic rod was found penetrating lung one centimeter from thoracic aorta. It was removed under vision, intercostal bleeder was ligated, lacerated lung repaired. Chest cavity was thoroughly irrigated, no cerebrospinal fluid leak was observed. Patient was extubated on table and shifted to ward. No neurological deficit was identified and the patient was discharged on third post-operative.

Open Access Case Study

Isolated Duodenal Carcinoma from Ductal Breast Carcinoma with 7 Years of Latency

Prashant Deo Ranjan, Neeraj Saxena, Devadatta Poddar, Akash Kumar

Asian Journal of Case Reports in Surgery, Page 1-5

Advanced Breast cancer mostly metastasizes to the bone, liver and lungs. Metastatic to the duodenum from the primary breast cancer is extremely rare and encountered only after occurrence of symptoms. Diagnosis is only confirmed by histopathology and Immunohistochemistry. However lobular cancers of breast are mostly associated with serosal metastasis to pleura and abdomen but here, we report a rare case of isolated duodenal carcinoma from ductal breast carcinoma with 7 years of latency without taking the adjuvant chemotherapy and radiotherapy.