Mucoepidermoid carcinoma (MEC) is a salivary gland tumor commonly arising from the parotid gland. MEC has various presenting symptoms, including a painless, slow-growing mass below or anterior to the ear lobule. However, an unusual presentation can also be in the form of post-auricular swelling. Other more common benign differentials for post-auricular swelling include lymphadenopathy, epidermoid cysts, and lipomas. Thus, diagnosing a postauricular swelling as MEC solely based on clinical presentation is challenging, and a high suspicion, as well as a multidisciplinary approach with various radiological investigations such as computed tomography (CT) and magnetic resonance imaging (MRI), are required in collaboration with histopathological assessment for an accurate diagnosis of this malignancy. Prognosis depends on various factors, including the grade of the tumor, the patient\'s age, and comorbidities, as well as the stage at the time of diagnosis. Early diagnosis and surgical intervention are the mainstays of treatment, which can be followed by adjuvant radiotherapy based on the stage of the malignancy. This is a report of a patient who presented with post-auricular swelling, which was initially misdiagnosed as a benign necrotic lymph node. After further evaluation, it was found to be a mucoepidermoid carcinoma of the parotid gland, which was managed by surgical excision and radiotherapy.

UNASSIGNED: Cystic hygromas are congenital lymphangiomas that arise from a developmental anomaly in the lymphatic system. Typically detected in early childhood, their incidence in adolescents and at the chest wall or axillary area is rare.
METHODS: We report two cases, a 14-year-old male child (Case I) and a 1-year-old male infant (Case II), who presented with swelling in unusual locations, the right axillary region and the right anterolateral chest wall respectively. Local examination findings were indicative of a cystic hygroma in the first case, while in the second case, characteristic transillumination was not seen due to a complication: hemorrhage within the cyst. The diagnoses were established after a correlation of the patient\'s history, and clinical findings with radiological investigations. Both underwent surgical intervention and had no complications. Histopathology of the post-operative specimens confirmed the diagnoses.
CONCLUSIONS: The diagnosis of cystic hygroma is made in the totality of thorough history taking, clinical examination, and radiological and histopathological investigations. Though most cases typically manifest before the age of two years and in the cervicofacial area, unusual locations and delayed presentation can occur. Surgical excision is a safe and effective treatment modality for these lesions.
CONCLUSIONS: Although a rare entity, cystic hygroma should be considered a possible differential diagnosis of any swelling in the pediatric population.

Chronic mesenteric ischemia (CMI) is a rare cause of abdominal pain with risk factors as Diabetes, Hypertension, smoking and age above 65-year-old age. A 55 -year-old man, a heavy smoker, with no other risk factor for chronic mesenteric ischemia, presented with a recurrent episodes of abdominal pain. Many differential diagnoses were excluded, CT angiography was showed Inferior Mesenteric artery (IMA) and superior Mesenteric artery (SMA) stenosis, then the Intervention was done successful. Gastric ulcers that are resistant to treatment, H. pylori negative and with no history of non-steroidal anti-inflammatory drugs (NSAID) use should be investigated for a possible ischemic.

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Hydatid cyst is an anthropozoonotic disease caused by Echinococcus for which man is an accidental intermediate host. The hydatid disease commonly involves the liver and lungs. Involvement of extrahepaticopulmonary sites is extremely rare and only a few isolated cases have been reported. In 2022, a 49 year old female from the southern part of Indian subcontinent presented to us with recurrent hydatid cyst of liver co-existing with hydatid cyst of the left broad ligament, twenty years following the initial procedure. She underwent exploratorylaparotomy and cystectomy and was then managed by ERCP and stenting following which she is asymptomatic till date. Though there are no hard and fast rules, the management of such cases mandate proper exploration to avoid any recurrence. Tailored surgical approaches maybe required according to the patient condition for effective, safe and recurrence free treatment of hepatic hydatidosis.

Conventionally, leprosy has been divided into various spectra of presentation ranging from the tuberculoid to the lepromatous pole, as well as histoid, pure neuritic leprosy and reactional states. This however is an oversimplification as leprosy can present in unusual clinical forms that may obfuscate the diagnosis. Our objective was to highlight unusual clinical presentations of leprosy occurring across all spectra of the disease. Our case series describes eight uncommon presentations of leprosy seen over a period of 10 y from 2011 to 2021, wherein clinical diagnosis followed by a histopathological confirmation of leprosy was performed. These include rare presentations such as psoriasiform plaques, Lazarine leprosy, verrucous plaques and hypertrophic scarring. Many of these rare presentations remain hitherto unreported, such as primary hypogonadism and annular plaques mimicking erythema annulare centrifugum and erythema gyratum repens. Sarcoidosis and syphilis have been labeled as great mimickers in dermatology. The current case series and review is an attempt to highlight a multitude of unusual presentations of leprosy that need a separate mention to make a correct and timely diagnosis and prevent the debilitating sequelae of this otherwise treatable infectious disease.

UNASSIGNED: Scaphoid fractures are common wrist injuries and are commonly missed. Patients present with radial-sided wrist pain. Computed Tomography and Magnetic Resonance Imaging help in better planning, with analysis of comminution, torn ligaments, timely diagnosis, and intricate fixation prevent avascular necrosis, non-union, and carpal collapse.
UNASSIGNED: We present a rare scenario of right hand dominant 42 years male with scaphoid waist fracture, where the fracture fragment was unusually displaced 4 cm proximal to the wrist in the volar compartment of the forearm. Urgent open reduction and internal fixation with a Herbert screw was done. At 1 year follow-up, fracture united, with satisfactory range of motion and functional outcomes of the wrist.
UNASSIGNED: Timely diagnosis and urgent operative intervention for unstable displaced scaphoid fractures with rigid fixation provides long-term satisfactory outcomes and prevents complications.

UNASSIGNED: Adrenal myelolipomas are rare, benign tumours with an incidence of 0.08-0.2%. They present between the fifth and seventh decade of life [1].
METHODS: Our patient presented with complaints of vomiting and left lumbar pain of four weeks duration. Blood work revealed dyselectrolytemia. Contrast enhanced computed tomography of the abdomen and pelvis confirmed the diagnosis and the patient was planned for an adrenalectomy. Histopathology report revealed the pathology. She is currently on routine follow up and is disease free. Written informed consent was obtained from the patient for publication of this case report and its accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request. This case report has been reported in line with the SCARE criteria [2].
UNASSIGNED: With the increased use of imaging modalities of the abdomen, they are now considered to be the second most common cause of adrenal incidentalomas (6-16%) [3]. Most tumours are small, asymptomatic and often go undiagnosed. Large tumours can cause chronic pain and other nonspecific symptoms.
CONCLUSIONS: Though myelolipomas are identified on routine CT scans, on a background of dyselectrolytemia, a further evaluation is of utmost importance to rule out the possibility of a functioning tumour.

Epidermoid cyst (EC) is a cyst containing keratin and its breakdown products, that is surrounded by an epidermoid wall. EC can occur in both men and women, especially in young- and middle-aged adults. The clinical features of EC include asymptomatic, well-demarcated, and skin-colored to yellowish subcutaneous or dermal nodules with a punctum on the middle of the lesion which can occur anywhere on the body. This type of cyst is usually solitary with diameter up to 5 cm, or rarely, there are multiple with diameters of more than 5 cm, which is classified as a giant EC. Here, we report a case of generalized multiple ECs with a giant EC on the left gluteal region of a 19-year-old male with complaints of asymptomatic skin-colored nodules with central punctum on the right temple, chest, back, and gluteal regions for five years. Correlation between the clinical and histopathological findings in the form of cysts containing keratin and lined by wall composed of stratified squamous epithelia established the diagnosis of EC. The patient underwent surgical procedures for the skin-colored nodules on the chest, back, and gluteal regions. He also received triamcinolone acetonide intralesional injection for the skin-colored nodule on the right temple. After four months of follow-up, there was no recurrence, and all the skin-colored nodules were completely removed. EC should always be considered when diagnosing a skin-colored nodule even if the manifestations are generalized multiple and giant nodules, as in our case, demonstrating a rare and unusual case of EC, to the best of our knowledge.

Hydatid disease (HD) is an infection with the metacestode stage of the tapeworm Echinococcus. It is commonly seen in South America, The Middle East, Eastern Mediterranean, Africa and China. Hydatid cysts usually affect the liver followed by the lungs. Involvement in other organs has been reported. However, in the majority of the cases, cysts are localized in one organ or one region. We report a rare case of a 36-year-old woman who presented to the hospital in Syria with long-standing history of non-specific abdominal pain. Computerized tomography showed several hydatid cysts in the liver, spleen, left lung, mediastinum (adjacent to the aortic arch), both breasts and above the right gluteal muscles.