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Xanthogranulomatous Cholecystitis (XGC) is difficult to diagnose by surgeons preoperatively. XGC is often mistaken for, and may predispose to, gallbladder carcinoma (GBC). Most of the patients present with features of chronic cholecystitis and pain. Radiological features can be helpful for assuming XGC but cannot rule out any other pathology. Cholecystectomy is encouraged to be performed as soon as the diagnosis of XGC is established to prevent the occurrence of complications. However laparoscopic cholecystectomy may not be feasible in all patients and conversion to open or subtotal cholecystectomy is done. XGC can only be confirmed by histological findings, thus always causing a surgical dilemma and difficulty for the surgeon.

Retinoblastoma amounts to be the most common intraocular childhood malignancy. More than 95% retinoblastoma are diagnosed before age five. Retinoblastoma may be sporadic or inherited. In both cases the tumor origin is biallelic mutation. Staging of retinoblastoma is based on intraocular location, extraocular & extraorbital spread, central nervous system involvement and systemic metastases. Diagnosis and management of retinoblastoma demands multidisciplinary approach, for which accurate imaging is indispensable. Concerns of the effects of radiation in retinoblastoma have led to a shift from radiation therapy to chemotherapy and locoregional treatment and magnetic resonance imaging becoming the standard imaging modality for diagnosis, staging and treatment monitoring. Keywords: Retinoblastoma, Retinoblastoma with Intracranial extension, Recurrent retinoblastoma.

The incidence of penile cancer has been reported to be around 0.005 % in males, with less than 5% of then being sarcomas among all types of penile malignancies Primary penile sarcoma is a rare disease that affects men of all ages. Different subtypes of primary penile sarcoma exist, with the rarest being pleomorphic sarcoma. Only few cases have been reported on pleomorphic sarcoma of penis with undifferentiated type being most commonly reported. No report on high grade pleomorphic sarcoma has been previously reported in the English literature. We report an extremely rare case of undifferentiated pleomorphic sarcoma of the penis in a 62-year-old patient who initially presented with a recurrent or residual penile lesion. The tumor was surgically excised, but the patient experienced local recurrence and died of metastatic disease 18 months after initial presentation. Keywords: Penile sarcoma penile cancer urogenital sarcoma.

Background The presence of isolated metachronous adrenal metastasis in patients with esophageal cancer is rare. There is significant controversy regarding the management of such patients. Adrenal metastasectomy has been shown to be of benefit in some reports. Minimally invasive approach, although the gold standard for adrenalectomy, has not been used commonly in a postesophagectomy setting owing to the anticipated technical difficulties. We describe one such case wherein this approach helped in early recovery and long-term survival. Case presentation A 59-year-old male of Asian ethnicity presented with an isolated left adrenal nodule, 3 years after an Ivor Lewis esophagectomy for a lower esophageal adenocarcinoma. The biopsy of the nodule was suggestive of metastatic adenocarcinoma. The patient underwent laparoscopic excision of the left adrenal gland. Conclusion Adrenal metastasectomy, in postesophagectomy patients can provide good oncological control. Laparoscopic approach, though technically challenging, can provide results equivalent to those of open surgery, albeit with less morbidity.

Introduction: The association between inflammation and malignancies is being recognized. In this study, we assessed the use of preoperative neutrophil–lymphocyte ratio (NLR) and lymphocyte–monocyte ratio (LMR) in predicting cancer-specific survival (CSS) and inguinal node involvement in patients with carcinoma penis. Methods: Sixty-nine patients operated for squamous cell carcinoma penis with inguinal node dissection between 2012 and 2020 were identified. We recorded the type of surgery (partial/total penectomy), T stage, grade, lymphovascular invasion (LVI), perineural invasion (PNI), pathological status of inguinal nodes and nodal stage (pN1–3), extranodal extension (ENE), and CSS. The hemogram performed within 2 weeks of surgery was used for calculating NLR and LMR. Results: Partial penectomy was the most common surgery (65.22%) and pT2 was the most common stage (53.62%). Grade 2 was seen in 66.67%, LVI in 34.78%, PNI in 37.68%, 52.17% had inguinal node involvement with pN3 being the most common (36.23%), and 36.23% had ENE. Kaplan–Meier analysis revealed that NLR of >3 and the LMR ≤3 indicated an inferior CSS (P = 0.05 and 0.04, respectively). T stage, inguinal node involvement, LVI, pN stage, and ENE were also associated with inferior CSS (P < 0.05). On multivariate analysis, T stage was significantly associated with CSS (P = 0.02). The NLR >3 and LMR ≤3 were also significantly associated with the presence of pathological inguinal node involvement (P = 0.001 and 0.026). Conclusion: NLR and LMR may help in predicting CSS and inguinal node involvement in patients of carcinoma penis.

Ventral hernias (VHs) are common in the bariatric population with incidence of around 8% of patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB). The factors contributing to the incidence of VH includes high intra-abdominal pressures, previous histories of abdominal surgeries, defects in fascial structure and reduced healing tendency. There is a high index of suspicion in BS patients with VH for hernia complications which can be lethal after LRYGB. Here, we present a case where VH complicated the LRYGB surgery.

Laparoscopic sleeve gastrectomy (LSG) at present one of the most commonly performed surgical treatments for morbid obesity worldwide. There are some complications regarding this procedure in the literature. This report presents a patient who developed acute pancreatitis immediate post-LSG. Patient was referred to our institute on 10th post-operative day with a complaint of fever, nausea, abdominal pain and leucocytosis. A diagnostic laparoscopy showed pancreatitis. Post-operatively, the patient was managed on treatment line of acute pancreatitis and recovered well. LSG is a common procedure in bariatric, and the most common complications are leakage and bleeding from the suture line. However, we encountered pancreatitis after LSG which is a rarely reported complication after LSG. We hypothesise that the development of acute pancreatitis in patients undergoing LSG is not well recognised and reported.

Laparoscopic splenectomy is gaining popularity due to less morbidity and minimal operative complications. Nowadays, laparoscopic splenectomy is the approach of choice for both benign and malignant diseases of the spleen. Splenic pseudocyst due to non-traumatic cause has been very rarely reported in literature. We report an interesting case of a rare large splenic pseudocyst without a history of previous abdominal trauma, treated successfully by laparoscopic technique and discuss literature for the same.

Abstract Desmoid tumours are a rare type of tumours. Retroperitoneal desmo id is an uncommon mesenchymal neoplasm presenting as a firm mass with locally aggressive features. Desmoid tumour account for 0.03% of all tumours and 3% of all the soft tissue tumours. It usually manifests as a well-circumscribed or ill-defined, solid mass on cross-sectional imaging. The confirmatory diagnosis of these tumours is made by histological examination and immunohistochemistry. Surgical resection of the tumour is the treatment of choice in Desmoid tumours and also helps in clearing the diagnostic dilemma it creates in patient because of its rare nature. Here, we present a rare case of a Large Retroperitoneal Desmoid-type Fibromatosis of renal origin in a 28-year-old female, which was successfully treated surgically at specialised oncology centre in India.

Primary lumbar hernia is a rarely encountered hernia. Surgical correction is the standard treatment for lumbar hernia, and either an open or laparoscopic procedure can be performed with equivalent success. However, open repairs are most commonly performed. Here, we present a case of a primary lumbar hernia that was successfully treated laparoscopically and discuss surgical modalities of treatment reported in the literature. There are two laparoscopic approaches: transabdominal and extraperitoneal. The main advantage of the laparoscopic approach is that it helps the surgeon to precisely locate and evaluate the characteristics of the defect. It also has a lower morbidity rate, shorter length of hospital stay, less postoperative pain, and an earlier return to daily routine activities than the open approach. In the present study, a patient with a superior lumbar hernia was treated laparoscopically by the transabdominal approach. Laparoscopic repair in such cases is feasible and achieves a good result when done by an experienced laparoscopic hernia surgeon.

Adrenal incidentaloma (AI) has now become a common finding in clinical practice with advances in abdominal imaging. The prevalence of AI as reported in the literature is 0.2%-3%. Ganglioneuroma (GN) is often a benign non-functioning adrenal tumour, which has been rarely reported as AI in literature. Confirmed diagnosis of GN can only be done by histopathological examination. GNs are often asymptomatic even if they are large, and adrenalectomy is treatment for GN, with good prognosis after surgical removal. Here, we report a patient with an incidental adrenal mass that was managed laparoscopically and diagnosed as an adrenal GN on histopathology.