Papers by SWARJITH NIMMAKAYALA
International Journal of Science and Research (IJSR), 2017
Extra-adrenal retroperitoneal paragangliomas are extremely rare neuroendocrine neoplasms with an ... more Extra-adrenal retroperitoneal paragangliomas are extremely rare neuroendocrine neoplasms with an incidence of 2-8 per million. They emanate from embryonic neural crest cells and are composed mainly of chromaffin cells located in the para-aortic sympathetic chain. They synthesize, store and secrete catecholamines due to which they may present with symptoms of hypertension like headache, sweating and palpitationand sometimes they may present with vague symptoms like pain abdomen and lump abdomen.On the other hand, they may remain silent and non-functional. Histopathologically and tumor marker wise, non-functional and the functional tumours are absolutely same. Primary methods of pre-operative diagnosis include imaging techniques which also help in surgical planning and pre-operative preparation of the patient. Non-functional tumours often escape preoperative diagnosis and create intraoperative complications. We present a case of non-functional extra-adrenal retroperitonealparaganglioma occurring in a 50-yearold male patient presenting with mass per abdomen. On Ultrasonongraphy, suspicion was towards a retroperitoneal mass of probable lymph nodal origin. On CT Scan , A large well defined heterogeneously enhancing mass lesion with solid and necrotic areas and few tiny foci of central calcifications is seen in left side of mesenteric measuring 11.4cm *11.7cm*9.6cm(AP*TD*CC). No bowel invasion is seen. Prominent vessels are seen around the mass. IMP-Mass lesion left side of abdomen-likely mesenteric origin (? Malignant). The patient was posted for surgical resection of the mass. Per-operatively, the patient developed hypertensive crisis. Post operative period was uneventful and patient recovered well. This report highlights the importance of pre-operative diagnosis which is vital in the management of extra-adrenal retroperitoneal paraganglioma.
Colorectal region is the most common site of gastrointestinalmalignancy and represents about 15% ... more Colorectal region is the most common site of gastrointestinalmalignancy and represents about 15% of all cancer-related deaths. The incidence peaks around seventh decade of life and less than 20% presents before the age of 50. But colorectal carcinoma in children is very rare, with an incidence of only 1.3 per million. [1] Because of this rarity, clinical managementand treatment strategies are generally extrapolated from experience with adults. [8] However, many small series and case reports suggest that children are more likely than adults to have an advanced-stage disease at presentation, unfavourable (mucinous) tumour histology, and a pooroutcome. [9] A boy was admitted with acute intestinal obstruction and underwent laparotomy and which showed that patient had colonic mass and was proven to have adenocarcinoma colon on histopathology and was planned for chemotherapy.
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Papers by SWARJITH NIMMAKAYALA