Przeglądanie według Autor "Priya, Madhu"

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Atypical extra nasopharyngeal angiofibroma in an unusual location: tonsil posterior pillar (oropharynx)
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Mittal, Shweta; Priya, Madhu; Varshney, Saurabh; Angral, Sumeet; Xavier, Joyson; Malhotra, Manu; Bhardwaj, Abhishek; Kumar, Amit; Tyagi, Amit Kumar
Introduction. Angiofibroma is a benign, locally aggressive highly vascular tumor that typically affects young adolescent males and has a pathognomonic epicenter of origin in the nasopharynx. The atypical angiofibromas share the same histological features as that of Juvenile nasopharyngeal angiofibroma, however they differ significantly in their clinical features. Aim. Here we are reporting a very rare case of atypical angiofibroma in an adult male presenting as a non-vascular mass in the oropharynx with posterior pillar as the subsite. Description of the case. A 26-years old male patient presented with chief complaints of foreign body sensation and mass in throat for one and a half months which was gradually progressive in size. Histopathological examination revealed a lesion with an intricate mixture of blood vessels, irregular fibrous stroma with loose edematous and fibrous area along with multinucleated stromal cells which was suggestive of angiofibroma. Conclusion. Oropharyngeal angiofibroma, being an atypical angiofibroma in terms of site and presenting complaints, presents a diagnostic challenge. Though rare, it should always be kept as a differential diagnosis in any oropharyngeal mass irrespective of its vascularity, typical age or sex of the patient.
Parotid pilomatrixoma: Diagnostic trap and management dilemma
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Bhardwaj, Abhishek; Angral, Sumeet; Chandra, Sharath; Malhotra, Manu; Priya, Madhu; Varshney, Saurabh; Singh, Arpana; Raj, Ritu
Introduction. Pilomatrixoma is a benign cutaneous adnexal neoplasm originating from the matrix cells of the hair follicles. Usually a slow growing and painless lesion, it must be considered in differential diagnosis of a preauricular swelling. Rapidly progressive lesion with skin fixity and missed subtle cytological features may lead to a misdiagnosis of parotid neoplasm resulting in management dilemma. Aim. This report emphasizes consideration of pilomatrixoma as a differential diagnosis in a similar clinical scenario, the role of frozen section during surgery and fascia lata interposition to prevent Frey’s syndrome. A brief review of literature is presented. Description of the case. We present a similar dilemmatic case of a 19 years old male with preauricular swelling. Based on cytology and image findings, a diagnosis of parotid neoplasm with possible malignancy was made. Surgical exploration revealed primarily a subcutaneous lesion with partial attachment to superficial surface of parotid. Lesion was excised with a cuff of normal parotid tissue. Frozen section confirmed it to be a nonmalignant lesion with possibility of pilomatrixoma. Fascia lata was interposed between parotid and thin skin flap to avoid gustatory sweating. Patient is on follow up for 6 months without recurrence or any complication. Conclusion. Pilomatrixomas can be misdiagnosed in case of lesions in subcutaneous plane in parotid region. In such cases, the differential diagnosis should include tumor and non-tumor lesions of skin and parotid gland. Importance of frozen section should also be kept in mind and the pathologist should be engaged at the time of surgical excision of the tumor. Interposition of soft tissue between parotid and thin skin flap helps prevent gustatory sweating in such cases. A high index of suspicion is needed for proper diagnosis and management of these lesions.
Triple thyroglossal duct cysts in an adult: a rare case report and review of literature
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Bhardwaj, Abhishek; Gupta, Kartikesh; Malhotra, Manu; Priya, Madhu; Verma, Mamta
Introduction. Thyroglossal duct cyst (TDC) is the most common cause of congenital neck mass. These can present anywhere from foramen caecum to mediastinum. Usually presents as a solitary cyst, the double thyroglossal cyst is very rare and a triple thyroglossal cyst has never been reported. Aim. Herein, we report an atypical case of triple thyroglossal cyst, at levels of hyoid, thyrohyoid membrane and thyroid isthmus managed surgically without any complication. Description of the case. We are presenting case of a 48-year-old female who presented to us with the complaint of anterior neck swelling since birth. On work up it was diagnosed as a case of the thyroglossal duct cyst and was intraoperatively found to have 3 distinct cystic swellings connected to a common stalk lying beneath the hyoid. It was successfully treated by modified Sistrunk’s procedure. There was no evidence of recurrence on follow up for 6 months. Considering atypical presentations, there are 9 cases reported with the double thyroglossal duct cyst, TDC within the thyroid gland and sublingual TDC. Such presentations make the diagnosis more challenging, leading to improper treatment. Conclusion. We are presenting this case as there is no case reported in English literature with a triple thyroglossal duct cyst. An awareness that thyroglossal cyst can present as multiple cysts is important for clinician in order to perform correct surgical management and to avoid the most feared complication of recurrence.