Metaplastic meningioma with pure and extensive cartilaginous transformation: A diagnostic dilemma

Meningiomas are the most common extra-axial central nervous system tumours and often discovered in the middle to late adult life and especially in women. About 85%-90% of meningiomas are benign, 5%-10% are intermediate-grade, and 3%-5% are malignant. Metaplastic meningioma is a rare subtype of WHO Grade I meningioma histologically characterized by the presence of mesenchymal components. The presence of pure and extensive cartilaginous differentiation in meningiomas is extremely rare and remains a diagnostic dilemma. We report, perhaps the first case of this entity in a 52-year-old woman and discuss the pathogenesis, the imaging features and the histopathologicals data.

Diagnostic Dilemma with a Case of Primary Bronchopulmonary Actinomycosis Causing Unilateral Destroyed Lung: A Case Report and Literature Review

Among chronic pulmonary infections, pulmonary actinomycosis is a rare one, caused by a gram-positive microaerophilic bacterium called Actinomyces. Aside from cervicofacial or abdominopelvic actinomycosis, pulmonary involvement is rare, and sometimes this type of infection results in a misdiagnosis of pulmonary tuberculosis or carcinoma. Clinical presentation of pulmonary actinomycosis could be acute or subacute, with lobar involvement. However, the disease is most commonly diagnosed at the chronic phase, with patients presenting mild fever, weight loss, and occasional hemoptysis. Here, we described the case of a 30-year-old male patient, presented with a history of respiratory complaints for more than three years and was diagnosed clinically and radiologically as a case of a destroyed left lung. Later on, post-operative tissue diagnosis was confirmed—pulmonary actinomycosis.

Left-sided appendicitis:Review of 95 published cases and a case report

AIM:To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM).METHODS:We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA,accessed via PubMed and Google Scholar databases.RESULTS:Ninety-five published cases of LSAA were evaluated and a 25-year-old female,who presented to our clinic with left lower abdominal pain caused by LSAA,is reported.In the reviewed literature,fiftyseven patients were male and 38 were female with an age range of 8 to 82 years and a median age of 29.1 ± 15.9 years.Sixty-six patients had SIT,23 had MM,three had cecal malrotation,and two had a previously unnoted congenital abnormality.Fifty-nine patients had presentedto the hospital with left lower,14 with right lower and seven with bilateral lower quadrant pain,and seven subjects complained of left upper quadrant pain.The diagnosis was established preoperatively in 49 patients,intraoperatively in 19,and during the postoperative period in five;14 patients were aware of having this anomaly.The data of eight patients were not unavailable.Eleven patients underwent laparoscopic appendectomy,which was combined with cholecystectomy in two cases.Histopathological examination of the appendix specimens revealed adenocarcinoma in only two of 95 patients.CONCLUSION:The diagnosis of left lower quadrant pain is based on well-established clinical symptoms,physical examination and physician's experience.

The Triple Procedure:Analysis of Structural,Functional&Refractive Outcome

To analyse the outcome of Triple procedure(Combined penetrating keratoplasty,cataract extraction and intraocular lens implantation)is a surgical technique for visually disabling corneal conditions with associated cataract.METHODS:The medical records of 120 patients who underwent triple procedure between January 2007 and December 2011 in terms of demographic data,past ophthalmic history,indications for surgery were retrospectively reviewed.Salient preoperative data included the initial visual acuity at the time of presentation,slit lamp findings of cornea(scar,haze,vascularisation,stromal folds with bullae),anterior chamber,lens details,intraocular pressure status,posterior segment examination with the help of indirect ophthalmoscope or B scan ultrasongraphy.RESULTS:A total of 120 corneal triple procedures performed were included in this study.Of 120 patients,25(20.83%)were male and 95(79.17%)were female.Mean age of these patients was 42.45+/-15.85 years(range 9 to 75 years).The mean postoperative follow up was 15.08+/-12.8 months(range,1.5 to 49 months).Failed therapeutic grafts(42.5%)-was the common indication found for surgery.Preoperatively,intraocular pressure was increased in 11(9.16%)patients.Conventional triple procedure in terms of combined penetrating keratoplasty with extracapsular cataract extraction with intraocular lens implantation(PK+ECCE+IOL)was performed in 114(95%)eyes,01(0.83%)eye underwent keratoplasty with phacoemulsification with intraocular lens implantation(PK+PE+IOL),and secondary intraocular lens implantation(PK+IOL)in 05(4.17%)eyes.CONCLUSION:Triple procedure is an effective surgical option in corneal diseases associated with cataract.It provides an optimal visual and refractive outcome especially in high risk grafts situation.