UNASSIGNED: Neurofibroma, a rare benign tumor of the peripheral nervous system, can manifest anywhere along a nerve from the dorsal ganglion to its terminal branches. Myxoid neurofibroma can present as a solitary non-tender nodule and is often confirmed by positive immunohistochemical staining for S-100 protein. However, in 50% of cases, neurofibromas are associated with neurofibromatosis.
UNASSIGNED: We present a case of a 34-year-old male with mild pain in the posterior part of his left thigh, accompanied by a slowly-growing swelling particularly noticeable when flexing his knee. It had gradually increased in size over several months, which the patient observed as a decrease in the degree of knee extension. Initial biopsy indicated schwannoma with no evidence of malignancy. Four years later, the swelling increased in size and necessitated resection surgery, revealing an irregular giant tumor measuring 8 *6 *4.5 cm, adherent to adjacent structures, including the femur, muscles, popliteal artery and vein, and a branch of the sciatic nerve. Pathological analysis reclassified the diagnosis to low-grade myxoid neurofibroma. Follow-up MRI three months later showed gross total resection without residual or recurrence of the tumor.
UNASSIGNED: Solitary neurofibromas are often small in size, ranging from 1 to 2 cm in the greatest dimension. Alternatively, tumors that occur as a part of genetic neurofibromatosis tend to be multiple and often grow to large sizes. In our case, the patient didn\'t have neurofibromatosis as he didn\'t meet its diagnostic criteria despite having a giant tumor measuring approximately 8*6*4.5 cm. To our knowledge, this is the first report of giant myxoid solitary neurofibroma of the thigh apart from neurofibromatosis. Thus, this type of tumor should be considered in the differential diagnosis of tumors at this location.

OBJECTIVE: To identify predictors of morbidity in GO through an analysis of associated anomalies, defect characteristics and management strategies.
METHODS: PubMed and Ovid EMBASE databases were searched from 2013 to 2023. Primary end points assessed correlation of morbidity with gestational age (GA), birth weight (BW), eviscerated organs, defect size, associated anomalies and management strategy.
RESULTS: Twenty articles were included for analysis with a total of 1009 GO. Median GA was 37 weeks (27-41), with a median BW of 2700 g (900-6000). 143 cardiovascular anomalies, 238 pulmonary anomalies, 98 musculoskeletal anomalies, 53 urogenital anomalies, 94 gastrointestinal anomalies, 11 neurological anomalies and 43 chromosomal anomalies were identified. 82 had unspecified additional anomalies, of which 20 and 17 were defined as major and minor, respectively. 123 neonates were managed with primary closure, 206 neonates with staged closure and 312 neonates with conservative treatment. Complications included sepsis, respiratory compromise, feeding dysfunction and closure-related adverse events. Long-term morbidity included home ventilation (n = 72), long-term parental nutrition (n = 36), and delayed motor neurodevelopment (n = 21). Main predictors of morbidity were pulmonary hypertension/hypoplasia, major congenital anomalies, greater defect size and liver herniation.
CONCLUSIONS: Key predictors of poor outcomes include the presence of additional congenital anomalies, defect size, liver herniation and pulmonary hypertension/hypoplasia.

UNASSIGNED: Giant aortic aneurysms, defined as those exceeding 10 cm in diameter, present considerable risk to life if not addressed. Thoracoabdominal aortic aneurysms (TAAAs) are particularly perilous due to their propensity for rupture.
METHODS: We report a case of gastrointestinal obstruction manifesting from a giant thoracoabdominal aortic aneurysm with a contained leak and acute rupture. The patient presented with abdominal pain, nausea, vomiting, and intolerance to oral intake.
UNASSIGNED: Certain conditions and infections predispose individuals to the development and expansion of giant aneurysms. This report details a massive chronic TAAA with a confined leak that led to a circumferential mural thrombus and an acute rupture within it. The patient was resuscitated and underwent urgent aorto-renal reconstruction surgery due to the presentation of upper gastrointestinal obstruction.
CONCLUSIONS: Though upper gastrointestinal obstruction is an extremely rare manifestation of giant thoracoabdominal aneurysm, it should be considered as a differential diagnosis in similar cases.

Lipomas are common, well-circumscribed neoplasms of mesodermal origin, characterized by being slow, painless growths that are mostly subcutaneous, not invasive, and not recurring after surgery. Lipomas are the most prevalent kind of mesenchymal tumor, yet giant lipomas are rare in the cervical region and the occipital area. We report a 46-year-old female with diabetes insipidus was referred with a giant occipital cervical tumor, which she had noticed for 17 years and which had rarely given her any complaints of compressive symptoms. The clinical assessment indicated a firm, painless, and mobile swelling, which demonstrated features of venous ectasia, and there was no external ulceration. Ultrasonography and MRI of the neck revealed a large, subcutaneous fatty tumor with distinctive echographic features on both modalities, including hyperintense signals on T1 and T2 and no ring enhancement after Gadolinium injection. Due to the mass being smooth, round, and not attached to any structure, the patient underwent surgical enucleation under general anesthesia, resulting in full recovery without complications. Pathology revealed a benign adipose tissue tumor without liposarcoma, and there were no difficulties observed during follow-up for two years.

Mature cystic teratomas exhibit a variety of tissues within their pathology. In adults, teratomas typically originate in the gonads. However, one of the rarest origins is the lung, making intrapulmonary teratoma (IPT) exceedingly uncommon. In infants, extragonadal teratomas are more common, with only two cases of IPT reported in the literature. While the clinical presentation in infants and adults is similar, fever appears to be unique to infant cases. We present a case of a one-year-old female who exhibited respiratory distress and fever. A chest X-ray revealed an opaque right hemithorax, initially leading to a diagnosis of pneumonia. Despite intravenous (IV) antibiotic treatment, there was no improvement. A subsequent chest computed tomography (CT) scan revealed a large mass with heterogeneous densities occupying the entire right hemithorax, indicative of IPT. The mass was successfully excised, and the infant was discharged on the 11th postoperative day without complications. This case adds to the limited literature on giant IPT in infants compared to the two previously published cases.

Giant peptic ulcer of the stomach is defined with a diameter of more than 3 cm. About 2/3 of them are benign peptic ulcers and perforate in 1%-2% of all peptic ulcer stomach perforations. High rates of postoperative morbidity and mortality are reported. The treatment options include omental patch repair, jejunal serosal patch repair, duodenal exclusion, and gastric resection. Postoperative omental patch repair failure is reported and is strongly associated with the ulcer diameter. This case reports a giant peptic stomach ulcer perforation in a female patient treated successfully with omental patch repair, according to Cellan-Jones.

OBJECTIVE: We analysed closure techniques in the treatment of giant omphalocele. A challenging pathology where there lacks consensus.
METHODS: Cochrane, MEDLINE and EMBASE were searched between 1 January 1992 and 31 December 2022 using terms and variations: omphalocele, exomphalos, giant, closure and outcome. Papers were selected using Preferred Reporting Items for Systematic review and Meta-Analyses 2020 criteria. Data collected included demographics, timing and technique of surgical repair, morbidity and mortality.
RESULTS: We identified 342 papers; 34 met inclusion criteria with a total 356 neonates. Initial non-operative management was described in 26 papers (14 dressings, eight silo, four serial sac-ligation). Operative techniques by paper were as follows: Early closure: nine primary suture closure without patch, two primary closure with patch and four mixed methods. Delayed closure: five simple, four-component separation technique, four tissue expanders, one Botox/pneumoperitoneum and two with patch. Median number of procedures was two (1-6) in the early group versus three (1-4) in the delayed. The most favourable was early primary closure with biological patch. The most unfavourable was delayed closure with patch. Cumulative reported mortality remained high, mostly due to non-surgical causes.
CONCLUSIONS: Definitions of giant omphalocele in the literature were heterogeneous with a variety of management approaches described.

Eyelid sebaceous carcinoma is a rare malignant tumor. Surgical excision is generally the standard curative treatment. However, in cases where surgery is not possible due to locally advanced tumors, definitive radiotherapy can be considered an option. A 71-year-old man presented with a history of eyelid sebaceous carcinoma dating back two years. The tumor, measuring 93 x 55 x 56 mm and located on the right upper eyelid, was not surgically resected. He was then treated with intensity-modulated radiotherapy, receiving a total dose of 70 Gy in 35 fractions. After 24 months, the patient shows no local recurrence.

A 74-year-old woman in good general health presented with a 5-year history of progressive hair loss over several years, interpreted as female androgenetic alopecia (AGA), and was treated with topical 5% Minoxidil without improvement. The patient\'s relevant medical history revealed infiltrating, triple-negative apocrine carcinoma of the right breast four years before, treated by quadrantectomy, radiation, lymphadenectomy and chemotherapy, with no recurrence at the last follow-up. On examination, there was an asymptomatic 15 × 15 cm firm and whitish area of scarring alopecia on the central scalp. Dermoscopy revealed multiple arborizing vessels and many telangiectasia. The clinical considerations included mainly cutaneous metastasis of breast carcinoma (alopecia neoplastica), pseudopelade of Broque and morpheaform basal cell carcinoma (BCC). A histopathologic examination revealed characteristic changes of morpheaform BCC with basaloid islands and cords of atypical basaloid cells diffusely infiltrating the dermis, embedded in a sclerotic and hypervascularized stroma. Secondary alopecia neoplastica due to morpheaform BCC on the scalp is an exceedingly rare entity, possessing subtle clinical features that may mimic both scarring and non-scarring alopecia. Delayed recognition may contribute to aggressive behavior and extensive local destruction. Treatment with hedgehog inhibitors in locally advanced BCC of the scalp, both in adjuvant and neoadjuvant modalities, is promising.

Background  Intracranial cavernous malformations (CMs), commonly known as cavernomas or cavernous angiomas, are low-flow, well-circumscribed vascular lesions composed of sinusoidal spaces lined by a single layer of endothelium and separated by a collagenous matrix without elastin, smooth muscle, or other vascular wall elements. A diameter greater than 3 cm for a CM is unlikely. These lesions may have atypical appearances on magnetic resonance imaging (MRI). MRI with advanced techniques such as a susceptibility-weighted image or T2-gradient echo, a diffusion-weighted image and corresponding apparent diffusion coefficient map, and diffusion tensor tractography have revolutionized the diagnostic approach to these lesions. Materials and Method  The present study reviews the etiopathogenesis, clinical manifestations, MRI strategy, and MRI appearances of the CMs, with a few examples of the giant CMs from our archive. Results  Intracranial giant CMs may have unexpected locations, sizes, numbers, and varied imaging appearances due to repeated hemorrhages, unusual enhancement patterns, intense perifocal edema, and unusual associations, making the differential diagnosis difficult. Conclusion  Familiarity with the MRI appearances of the giant intracranial CMs and the differential diagnosis improves diagnostic accuracy and patient management.