Epidermoid Cyst of the Testis: Unveiling a Rare and Uncommon Diagnosis | Chapter 12| Medicine and Medical Research: New Perspectives Vol. 8

Epidermoid cysts of the testis are rare benign tumors that often pose a diagnostic challenge due to their clinical and radiological resemblance to malignant testicular masses. Accurate differentiation is crucial to avoid unnecessary radical surgical interventions. The case of a 27-year-old male who presented with dull pain and progressive enlargement of the left testicle over several months has been reported. Physical examination revealed an enlarged, dense, and irregular left testicle, with no history of trauma or inflammation. Scrotal ultrasonography identified a heterogeneous mass measuring 25 x 17 x 18 mm with minimal vascularization. Laboratory tests, including AFP, B-HCG, and LDH, were within normal limits. Imaging with a chest, abdominal, and pelvic CT scan showed no signs of metastatic disease. The patient underwent a left-sided radical orchiectomy, during which a 7-8 mm lymph node was excised from the inguinal canal. Histopathological examination confirmed the diagnosis of an epidermoid cyst, characterized by a cystic structure lined with stratified squamous epithelium filled with keratinous material. This case highlights the importance of early and accurate diagnosis in distinguishing epidermoid cysts from malignant testicular tumors, enabling organ-sparing surgery when appropriate. The report underscores the need for further studies to enhance the characterization and differentiation of these rare entities.

 

Author (s) Details

 

Vladimer Papava

Department of Urology, Tbilisi State Medical University, Georgia

 

Giorgi Sinauridze
Department of Urology, Tbilisi State Medical University, Georgia.

 

Valeriane Kvakhajelidze
Pineo Clinic, Georgia.

 

Andro Dzneladze
Pineo Clinic, Georgia.

 

Irakli Gakhokidze
Department of Radiology, Aversi Clinic, Georgia.

 

Leli Shanidze
Department of Laboratory, Tbilisi State Medical University, Georgia.

 

Levani Donadze
Pineo Clinic, Georgia.

 

Tamar Didbaridze
Department of Microbiology, Tbilisi State Medical University, Georgia.

 

Tamta Mamasakhlisi
Department of Internal Medicine, N. Kipshidze Central University Clinic of Tbilisi State Medical University (Former Republican Hospital), Georgia.

 

Ema Gergedava
Gidmedi Clinic, Georgia.

 

Otar Goguadze
Pineo Clinic, Georgia.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v8/2328

Role of Magnetic Resonance Imaging (MRI) in Diagnosing and Classifying Mullerian Duct Anomalies: A Case Series | Chapter 7 | Medical Science: Trends and Innovations Vol. 1

Background: The pair of mullerian ducts in females is responsible for the development of the female reproductive system, namely, fallopian tubes, uterus, cervix, and upper part of the vagina. Mullerian duct anomalies (MDAs) arise from the aberrant development of the uterus, cervix, and vagina, impacting the potential for successful conception and full-term pregnancy. This category encompasses a diverse range of developmental defects, leading to a spectrum of clinical presentations such as amenorrhea, infertility, recurrent miscarriages, intrauterine growth retardation, malposition of the fetus, preterm labor, and retained placenta.

Case(s): In this study, 17 cases of MDA are presented with a wide array of clinical manifestations. The varied symptoms included amenorrhea, infertility, repeated miscarriages, intrauterine growth retardation, malposition of the fetus, preterm labor, and retained placenta. Accurate categorization of these cases is crucial for determining the appropriate surgical intervention. While ultrasonography aids in the initial diagnosis of MDA, our focus on accurate classification necessitates the use of magnetic resonance imaging (MRI).

Conclusion: The findings underscore the significance of MRI in precisely categorizing MDA, and facilitating effective management strategies. The 17 cases presented demonstrate the diverse spectrum of MDA manifestations, emphasizing the need for tailored surgical interventions for successful conception and optimal pregnancy outcomes. The use of MRI proves instrumental in guiding clinical decisions, offering a comprehensive understanding of MDA, and informing targeted interventions to enhance reproductive success. Female infertility can be attributed to MDA, and in many cases of MDA, appropriate surgery can lead to successful conception. Furthermore, in some cases, surgery cannot lead to conception. Thus, correct classification of individual cases with MRI is essential for not only successful conception through appropriate surgery but also for avoidance of unnecessary surgical intervention.

 

Author (s) Details

Bhavya Kataria
Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

 

Shibani Mehra
Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v1/4000

MDCT in Management of Ovarian Masses | Chapter 11 | Advancement and New Understanding in Medical Science Vol. 10

 Ovarian tumors are epithelial, mesenchymal, mixed epithelial and mesenchymal, sex stromal and germ cell tumors. Serous and mucinous cystadenoma and adenocarcinoma are differentiated by larger solid component, papillary projections and thick enhancing septae. Serous cyst adenomas and carcinomas are usually bilateral   and have more papillary projections as opposed to mucinous neoplasms (usually unilateral and papillary projections are less marked). CT is the modality for staging. Adjacent pelvic organ involvement may be difficult to diagnose accurately. In a large ovarian tumour, it may be difficult to identify uterus which is partially or completely surrounded by tumour.  Focal obliteration of fat plane or tumour encasement of bladder or recto-sigmoid is highly suspicious of involvement of the structures Pelvic side wall invasion is suspected when tumour lies within 3mm of pelvic side wall or when iliac vessel is surrounded or displaced by tumour. Teratomas are having solid, cystic, fat component and calcification. Brenner’s tumor is detected incidentally. Sex cord sclerosing stromal tumors are unilateral and may be hormonally active. Krukenberg metastases are solid and bilateral.

Author(s) Details:

Sujata Patnaik,
Department of Radiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V10/article/view/13962

A Review on Prevalence and Risk Factors of Gallstone Disease in Uganda | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 4

Introduction: Globally, the burden and complications from gallstone disease are a major public health issue. It contributes significantly to health care costs and is a common cause of surgical intervention. Most sickle cell disease (SCD) patients have radiolucent stones, probably of pigment type, containing little or no calcium. While most patients with gallstones are asymptomatic, only 20% after 10 years become symptomatic. The prevalence of gallstone disease varies among different populations. The purpose of this review is to understand the profile of gallstone disease patients in Uganda which may facilitate better treatment options and may reduce the complications of gallstone disease.

Discussion: In Uganda, the prevalence of gallstone disease is high in patients presenting to hospital. The risk factors for gallstone disease include a previous history of biliary symptoms and the use of hormonal contraceptives. SCD in Sub-Saharan Africa is also a major health problem and a risk factor for gallstone disease. Acute abdominal pain in SCD patients was thought to be due to sickle cell crises until the advent of ultrasonography. Differentiating between acute cholecystitis and sickle cell crises may be difficult. An increased production of unconjugated bilirubin from a sickle cell crisis may precipitate acute cholecystitis. While in SCD patients with acute cholecystitis, a haemolytic crisis may occur.

Conclusions: While the prevalence of gallstone disease in Uganda from hospital-based studies is high the majority of patients are symptomatic at presentation. In the general population, the prevalence of gallstones may be determined using abdominal ultrasound as a screening tool. Any SCD patient who has an abdominal crisis should have an abdominal ultrasound to prevent missing any episodes of acute cholecystitis.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

Please see the link here: https://stm.bookpi.org/ANUMS-V4/article/view/13177

A Brief Overview on Malignancy Risk Index in Pelvic Mass Differentiation | Chapter 13 | Current Innovations in Medicine and Medical Science Vol. 6

 In this branch, MRI and its componentes are inspected. We understand that simplicity of Malignancy Risk Index prediction allows providing, accompanying good accuracy, aid in characteristic preoperative diagnosis middle from two points benign and malignant tumors. Ovarian tumor is seen as ultimate aggressive gynecological cyst. The morbidity of ovarian tumor is second to cervical cancer and endometrial cancer, but the humanness ranks first of gynecological tumors. Ovarian cancer is the sixth superior cause of mortality from tumor in women. Nearly 70% of epithelial ovarian malignancies are found at an advanced stage, when the 5-year endurance rate is around 25%. The virulence risk index (MRI) of ovarian tumors associates menopausal status, ultrasound traits and CA-125 serum levels, and has the aim of improving the preoperative distinction betwixt benign and diseased ovarian tumors So, we approuch this tool to regard in what way or manner we should be find best choice way to treat women accompanying pelvic mass.

Author(s) Details:

Nadejda Fainbaum,
Department of Gynecology and Obstetrics, Faculty of Medicine of Petropolis, Rj, Brazil.

Claudio Sergio Batista,
Brazilian Academy of Military Medicine, Brazil.

Please see the link here: https://stm.bookpi.org/CIMMS-V6/article/view/8621

Novel Diagnostic Technique – Elastography | Chapter 05 | New Horizons in Medicine and Medical Research Vol. 3

 The goal of this review is to highlight this innovative imaging modality, as well as its mechanism of action, clinical applications, and advantages over traditional ultrasonography. Elastography, which is based on the principle of physical elasticity, entails applying pressure to the medium being studied and determining the resultant strain distribution by measuring tissue motion. The relationship between tissue elasticity and hardness and palpation is based on the basic idea that an object must have a change in consistency as compared to the surrounding tissues in order to be perceptible. For both ultrasound and MR imaging, elastography approaches have been developed. Due to its obvious source of mechanical contrast and tremendous diagnostic potential, elasticity imaging has gotten a lot of attention.

Author(S) Details

Anu Vijayan
Al Azhar Dental College, Thodupuzha, Kerala, India.

M. L. Asha
SGR Dental College & Research Institute, Bangalore, India.

S. Naveen
PMNM Dental College & Hospital, Bagalkot, West Bengal, India.

Ingita Mukhejee
Department of Oral Medicine & Radiology, India.

View Book:- https://stm.bookpi.org/NHMMR-V3/article/view/6334

A Surgical Overview on Modified Alvarado Scoring | Chapter 09 | Issues and Developments in Medicine and Medical Research Vol. 2

 The vermiform appendix, as the name implies, is a small, worm-shaped tube that emerges from the caecum's posteromedial wall. Appendicitis is an inflammation of the vermiform appendix's inner lining that spreads to its other sections. In most Surgical Emergency Rooms, acute appendicitis is the most prevalent surgical emergency. It is critical to make the accurate diagnosis; nevertheless, if you wait too long, you risk perforation and a considerable increase in morbidity and mortality. Scoring systems, ultrasound, computer programmes, computed tomography, magnetic resonance imaging, and laparoscopy are all recommended for assisting in the diagnosis of appendicitis. For the early identification of acute appendicitis, several scoring systems have been employed around the world. The Alvarado scoring system, which is based on history, physical examination, and some laboratory findings, is one of the most practical rating systems. The Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value of the Modified Alvarado Score are all acceptable. In surgical emergencies, modified Alvarado and ultrasonography can be used combined to diagnose cases of acute appendicitis.

Author(S) Details

Varun Dogra
General Surgery, University of Kashmir, India.

Ishfaq Ahmad Gilkar
General Surgery, University of Kashmir, India.

Silvi .
Department of Pathology, University of Jammu, India.

View Book:- https://stm.bookpi.org/IDMMR-V2/article/view/5438

Impact of Health Education Intervention on Uptake of Random Screening for Cervical & Breast Cancers among Rural Women in Villages of Gurgaon Cluster, Haryana, India: A Cross-Sectional Study | Chapter 14 | Recent Developments in Medicine and Medical Research Vol. 12

 Disease awareness and socio-cultural practises influence rural women's treatment seeking behaviour and uptake of preventative screening for breast and cervical cancers. In Gurgaon villages chosen at random by our financial partner, DLF Foundation, Gurgaon, this study was performed to evaluate rural women's awareness and understanding of cervical and breast cancers, as well as their attitudes and uptake for primary screening for these diseases. A cross-sectional study was conducted on 603 women between the ages of 21 and 65 who attended women's cancer awareness and screening camps, where they were randomly screened for breast and cervical cancers. Out of 603 women who participated in various camps organised in several villages within Gurgaon between 2014 and 2016, 235 women (39%) were checked for cervical and breast cancers. Furthermore, 365 women (61%) were taught how to conduct a self-breast examination. 88 (37.44 percent) of the 235 persons assessed were found to have genital infections, for which they were given free drugs. Out of 235 women tested, 99 (42%) were suspected of having cervical or breast abnormalities and were recommended for additional testing (Pap smear, USG Abdomen, and Mammography in 20 cases) to confirm the condition and offer treatment recommendations. Only 38 of the instances, on the other hand, followed the protocol for follow-up. All participating women received specially created, easy-to-understand pamphlets (in Hindi) on the four women's cancers (endometrial cancer, breast cancer, ovarian cancer, and cervical cancer). The most significant conclusion was that rural women had little understanding of cervical and breast cancer screening, as well as the symptoms, risk factors, and preventative screening for these cancers. Effective education and large-scale primary screening are required in India to lower the burden of cervical and breast cancers. Low family finances and a lack of mobility have been reported to make it difficult for women to access to health centres while enduring the severe symptoms of these diseases. Because the majority of rural women never have their cervical and breast cancers examined, the study indicated that cancer awareness programmes, as well as on-site primary screening for cervical and breast cancers using simple, cost-effective procedures, can considerably benefit them.

Author(S) Details

P. Cheena Chawla
World Healthal Trust, 34, Knowledge Park 1, Greater Noida -201310, India.

Anil Kumar Chawla
World Healthal Trust, 34, Knowledge Park 1, Greater Noida -201310, India.

Seema Chaudhary
World Healthal Trust, 34, Knowledge Park 1, Greater Noida -201310, India.

View Book:- https://stm.bookpi.org/RDMMR-V12/article/view/4680

Determining the Role of Aspiration Cytology in Splenic Lesions | Chapter 3 | Recent Developments in Medicine and Medical Research Vol. 11

 Background: Since the turn of the century, splenic fine needle aspiration cytology (FNAC) has been utilised as a diagnostic technique, with the first report being in 1916. It has a reputation for being dangerous and difficult to judge, yet these stereotypes are completely false. The FNAC test is still the easiest, cheapest, and safest way to diagnose a problem.

The purpose of this research was to assess and determine the diagnostic value of aspiration cytology in splenic lesions.

Methods: In our retrospective investigation, fine needle aspiration cytology (FNAC) of the spleen was conducted in 34 patients, with 28 cases aspirated under ultrasonological guidance and 6 cases aspirated blindly. There were 23 male and 11 female patients with ages ranging from 2 to 69 years old, as well as 8 juvenile patients. Prior to the procedure, all necessary precautions and testing were completed, including a coagulation profile.

Results: Bloody aspirates were found in five of the 34 FNAC instances, whereas normal splenic aspirates were found in the other two. A definitive diagnosis could be made in 27 of the instances. Extramedullary hematopoiesis was the most common non-neoplastic condition (8 cases), followed by tuberculosis (4 cases), kala azar (3 cases), and storage disease (3 cases), and granulomas (2 cases). In the neoplastic group, we had two cases of non-Hodgkins lymphoma, one case of Hodgkin lymphoma, two cases of hairy cell leukaemia, and one case of histiocytosis. There were no significant variations in cellularity when aspiration was done blindly or with ultrasound assistance. There were no procedural issues uncovered during our investigation.

As a result, when used as a primary inquiry and carried out with extreme caution, FNAC spleen is a safe, low-cost, fast, and highly diagnostic treatment.

Author(S) Details

Shweta Garg
Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India.

Nisha Malik
Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India.

Veena Sharma
Department of Pathology, LLRM Medical College, Meerut, Uttar Pradesh, India.

View Book:- https://stm.bookpi.org/RDMMR-V11/article/view/4645

A Case Report on Full Term Broad Ligament Pregnancy | Chapter 11 | Highlights on Medicine and Medical Science Vol. 17

 A broad ligament pregnancy is a very uncommon ectopic pregnancy with a high maternal and perinatal mortality rate. It's much less likely that such pregnancies will be carried to term. Ultrasonography can aid in diagnosis, however it is normally done during a laparotomy. G2P1 came to see us with stomach pain at 39 weeks of pregnancy, which was an unscheduled visit. On ultrasound, a live foetus was discovered with severe intrauterine growth restriction (estimated foetal weight of 1.98 kg), transverse lying, severe oligohydramnios, and full placenta praevia. The patient was taken to the operating room for a caesarean section. The foetus was removed alive and the broad ligament, placenta, left fallopian tube, and ovary were excised after an intraoperative diagnosis of left broad ligament pregnancy. The post-operative time went without a hitch. To avoid a negative foetal or maternal outcome, a high index of suspicion and rapid therapeutic intervention are required.

Author (S) Details

Vidhi J. Shah
Department of Obstetrics and Gynecology, Saraswati Hospital, Badsam Bypass Road, Rajasthan, India.

View Book :- https://stm.bookpi.org/HMMS-V17/article/view/2614

Investigating the Differentiation of Exophytic Renal Masses with Determination of the Angular Interface to Renal Parenchyma in US and CT| Chapter 9 | Current Topics in Medicine and Medical Research Vol. 8

 Aims: Using the angular interface sign in ultrasonography (US) and computerised tomography ( CT) to assess if benign exophytic renal masses can be differentiated from malignant lesions. Background: For the interpretation of charecteristics of the cystic renal masses, the Bosnian classification of renal cysts has been widely used. Although the known sensitivity , specificity and time consumption values contrast with improved modalities for further evaluation of the Bosnian 3 or higher group, a biopsy is also needed. Materials and methods: A total of 71 cases of exophytic renal mass (2 cm or more) were investigated in the US (n = 23), CT (n = 21) and US + CT (n = 16) on the basis of angular interface between January 2008 and June 2010 and were included in this report. Two radiologists studied the renal interface relationships and categorised them as having an angular or broad interface. Results: Renal mass diagnosis with a specific indication is a reference for further assessment and treatment of these lesions. In this way, unnecessary, time-saving and cost-effective surgical procedures can be avoided. Exophytic renal masses with high specificity (91 percent) and precision (87 percent) can be distinguished as malignant or benign using only the angular interface sign in the US or CT as well. No statistically significant difference between the two readers' findings was found. For the device symbol, there was nearly perfect interobserver agreement. For cystic lesions, in all but two Bosnian Category 1 cases, the angular interface sign was calculated. In the malignant community, in only two cases of renal cell carcinoma, the angular interface sign was determined; there was a large interface sign in other primary or metastatic malignant lesions. Conclusion: with 87 percent precision, exophytic renal masses can be distinguished as malignant or benign with only the angular interface sign in US or CT and often in opposition to dynamic-contrast examinations. This approach includes a lack of additional exposure to radiation or contrast media, time savings, and cost effectiveness.

Author(s) Details

Duzgun Yildirim
Department of Radiology, Acıbadem University, Istanbul, Turkey.

Halil Bozkurt

Department of Urology, Izmır Buca Training and Research Hospital, Izmır, Turkey.

Abdullah Cirakoglu

Department of Urology, Ordu Training and Research Hospital, Ordu, Turkey.

Mutlu Sahin
Department of Surgery, University of Health Sciences Keçiören Training and Research Hospital, Ankara, Turkey.

Bengi Gurses
Department of Radiology, Koç University Hospital, Istanbul, Turkey.

Baki Ekci
Department of Surgery, Yeditepe University Hospital, Istanbul, Turkey.

Özlem Güngör
Department of Radiology, Sancaktepe Professor İlhan Varank Training and Research Hospital, Istanbul, Turkey.

View Book :- https://bp.bookpi.org/index.php/bpi/catalog/book/316