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Choristomas are congenital lesions presenting normal tissue in an abnormal location. A conjunctival dermolipoma is a congenital choristomas tumor usually localized in the temporal aspects of the bulbar conjunctiva, near the lateral canthus. It may be associated with developmental anomalies of the second branchial arch, such as Goldenhar syndrome. The association between dermolipoma and lateral canthal cleft without other congenital anomalies is uncommon. The purpose of this paper is to present a series of isolated choristomas in the lateral canthus associated with a lateral cleft. We present 3 cases of dermolipoma at the lateral canthus associated with isolated lateral cleft. The dermolipomas’ appearance ranges from a flat lesion to a large pedunculated tumor, obliterating the lateral conjunctival fornix. A partial removal of the dermolipoma was done with canthoplasty to close the lateral coloboma. Surgical management of dermolipoma with partial excision aimed at reducing visible tumor produced good cosmetic results, without complications. Microscopic examination of the tumor revealed a mass covered by stratified squamous keratinized epithelium. The mass comprised largely of mature adipose tissue interspersed with bundles of collagen. The presence of pilosebaceous units was also noted. Based on these features, a histopathological diagnosis of a dermolipoma was made. The association between dermolipoma and isolated lateral canthal cleft is much less common than the associations with other distinguishing abnormalities. In summary, these cases illustrate that dermolipomas are also a part of a wide spectrum that characterizes benign growths of the eyelids. Level of evidence: Level V, therapeutic study.

The aim of this study is to investigate the clinical presentation and outcomes associated with endoscopic endonasal resection of Rathke cleft cysts (RCCs). The authors retrospectively studied a series of 13 patients who were diagnosed with RCCs after endoscopic endonasal resection at the Second Xiangya Hospital between June 2016 and December 2017. All 13 patients (8 women) underwent a purely endoscopic endonasal approach (EEA) for fenestration and aspiration of RCCs with excision of the cystic wall. The patient ages varied from 25 to 67 years (mean, 45.1 years), and the follow-up period ranged from 8 to 25 months (mean, 16.6 months). Headache was a presenting symptom in all 13 patients, with 11 (80%) out of the 13 having experienced postoperative improvement of their headaches. Six (46%) of the 13 patients were admitted with pituitary dysfunction, all of them had postoperative improvement. Four (31%) of the 13 patients had temporary postoperative pituitary dysfunction, although there was not any permanent pituitary dysfunction. Six patients had intraoperative complications with CSF leaks, and after the operation, three of them developed temporary diabetes insipidly, one of them had a postoperative infection, and another one had postoperative cerebrospinal fluid leaks, who was treated with absolute bed rest for 7 days. No patient experienced recurrent cysts. EEA is a safe and effective approach for the treatment of symptomatic RCCs. Notably, it is appreciated for protecting and restoring pituitary function; however, the postoperative recurrence rate still lacks a large sample related to the long time follow-up study. Complete aspiration of the cysts' contents with partial excision of the cyst wall is usually sufficient for treatment.

Tunical plaque incisions are common techniques utilized during grafting procedures for Peyronie’s disease. The aim of this review was to examine the different tunical incisional and excisional techniques, as well as outcomes and complications of recent graft procedures utilizing these strategies. Studies on tunical incision, partial excision, and grafting techniques vary with regards to their surgical outcomes, post-operative erectile dysfunction rates, and other complications. Overall, significant penile straightening has been reported in recent studies of incision and grafting for Peyronie’s disease. Prospective trials comparing the different tunical incisional techniques are needed to better plan surgical interventions for Peyronie’s disease.

In the January issue of this journal, an interesting study on “Management of complications arising from transvaginal mesh kit procedures” [1] and a “Review of synthetic meshrelated complications in pelvic floor reconstructive surgery” [2] reopened this much debated problem. First, we straightaway want our readers to know our conflicting interests and also our major concern for objectivity, though B.J. is a patent holder on ProliftTM and both authors have a large implication in studies of the French TVM group and in the many training sessions on this surgical procedure and its complications. Unlike nearly all previous editorials, we would like here not only to describe potential hazards but also encourage the reader to analyse them objectively. In our opinion, complications of vaginal meshes are often overestimated, sometimes overemphasised, often poorly described and managed. Complications can be overestimated because it is always easier to publish a complication in an important urologic or gynaecologic journal than to follow hundreds of patients in a long prospective survey. It is only through this latter approach that we can really assess the complications rate. The second reason is linked to the fact that it is often unclear whether complications implicated with the use of mesh are actually due to the mesh or the surgical technique. Today, the six published randomised controlled trials (RCTs) do not show more complications in the arm with prosthetic meshes than in the arm without meshes, but discriminating power is insufficient. Whilst waiting for large national registers results, we added up the severe complications of three significant series: a Scottish one reporting 289 patients [3], a Scandinavian one with 148 patients [4] and the results of the French TVM group gathering 1,541 patients and not yet published. On these 2,078 patients, apart from partial excision of meshes after vaginal exposure (2.6%), there were 55 severe complications: haemorrhages >500 ml or important haematoma (1.2%), deep infection (0.9%), visceral erosion (0.1%) and removal of a mesh for pain or dyspareunia or other severe complication (0.9%). In the same way, if we put together all series published on ProliftTM, 1,882 interventions, the percentage of each of these severe complications is never over 2.5%, and the maximal reported rates are 12% for mesh exposition, 17% for prosthetic contraction and 9% for de novo dyspareunia. We will later come back on the sexual impact of these interventions. These complication rates must be known by the surgeons (and, of course, their patients!), but they do not seem unacceptably high. Complications may sometimes be overemphasised by surgeons who do not use meshes for vaginal repair but are referred the most severe complications which might bias their opinion. Sexual problems are most frequently put forward by the detractors of vaginal prosthetic meshes. That remains the main concern for surgeons, so some only propose vaginal implants to non-sexually active women. The first publications, we must admit, did not precisely analyse functional and sexual consequences of these Int Urogynecol J (2009) 20:893–896 DOI 10.1007/s00192-009-0926-6

Traumatic isolated rupture of the popliteus tendon has been described as a rare cause of haemarthrosis of the knee. There has been only one reported case of spontaneous rupture of the popliteus tendon in the English literature before. We present the case of a 70-year-old lady who had spontaneous rupture of the popliteus tendon without history of significant trauma. She presented with a painful locked knee without any features of instability. The diagnosis was made on arthroscopy of the knee and she made a complete recovery after partial excision of the torn tendon. Our literature review looks at treatment options in relation to best functional outcome.

The intravaginal midurethral sling operations have become a trend to treat female stress urinary incontinence. Cases of complications requiring surgical revision are rarely reported. We report on seven patients with complications necessitating surgery. Six patients with vaginal erosion were treated with transvaginal excision of migrated tape and fibrotic tissues around the vaginal wall, and one patient with bladder erosion was treated with suprapubic minimal laparotomy and transvaginal partial excision of the tension-free vaginal tape (TVT). The incidence of polypropylene mesh erosion was 1.1% in this study. All patients recovered well from our surgical intervention, except the bladder erosion patient who needed anticholinergic medication to treat postoperative urgency and urge incontinence.

Giant pseudocyst is a rare type of complication following incisional hernia repair and its correct management is still unknown. Herein, we describe two unreported cases of giant pseudocyst after inguinal hernia repair. Both patients underwent surgical treatment with partial excision of the pseudocapsule. The two patients were free from recurrence after 6 and 10 months of follow up, respectively. Subtotal surgical removal of the pseudocapsule is a definitive treatment.

Haemorrhagic necrosis of residual pituitary tumour following partial excision has not previously been well described. This is differentiated from post-operative sellar haematoma due to inadequate haemostasis on the basis of absent free clot. The authors report two cases of large macroadenomas with significant supra-sellar extension which were complicated by haemorrhagic necrosis of residual tumour following initial surgery. The literature is reviewed and possible pathophysiogical mechanisms are discussed.

A boy who presented with massive ascites was found to have tumors involving the urinary bladder, omentum, and retroperitoneum. Laparotomy demonstrated inflammatory pseudotumors. The patient was managed by partial excision of the tumors and chemotheraphy. Abdominal ultrasound and computed tomography at 4-month follow-up showed complete resolution of the tumors and no ascites.

A 3-year-old girl with massive cavernous lymphangiomatosis, a huge lipoma, and several types of hemangiomata is presented. A deep lipoma on the back was removed. The left margin of the lipoma intertwined with several cysts of cavernous lymphangiomas, resulting in continuous fluid accumulation postoperatively. At the first operation, a partial excision of cavernous lymphangiomas of the forearm was also performed. The forearm healed uneventfully, except for a moderate degree of hypertrophic scarring. As a result of a literature review, it can be stated that the case presented does not conform to any well-defined entity and would appear to represent a new syndrome to be categorized under congenital hamartomatous disorders. Everyone is interested in the fate of massive lymphangiomatoses such as this, and in the effects on several tissues or organs, such as breasts, muscles and bones.

Congenital solitary, non-parasitic liver cysts are uncommon lesions that are rarely diagnosed antenatally. The cystic nature of the antenatally-diagnosed abdominal cyst in our case was confirmed postnatally by ultrasound. Partial excision with marsupialisation and release of extrinsic bands on the second part of the duodenum was done.

A young male presented with visual complaints of one year duration, epistaxis and nasal blockage of 3 months duration. He had bilateral proptosis and bitemporal hemianopia and a mass near the; roof of nasal cavity. Skull skiagram showed enlarged sella and computed tomography showed erosion of sella and a central mass. Partial excision of supra and parasellar tumour was done which on histopatho-logical examination revealed Esthesioneuroblastoma. This was followed by radiotherapy and CCNU twice, at 6 weeks interval. He is doing well after 1 year and 9 months of follow up.

Background: Total or partial excision of the clavicle has been advocated for many neoplastic and non neoplastic conditions. But the functional outcome after claviculectomy for tumours, has not been clearly described. By this study, we aim to analyze the oncological and functional outcome after claviculectomy for tumours of the clavicle. Methods: Between 1991 and 1998, twelve patients underwent claviculectomy for various tumours. Histopathologically, Ewing′s sarcoma was the commonest. These patients were followed up for a variable period ranging from 2 to 9 years with a mean follow up of 4.9 years. Results: Functional results were analyzed using AMSTS scoring system. Functional outcome was excellent in 5 cases and good in 7 cases. Two patients of Ewing′s sarcoma died of disease and the rest were continuously disease - free at their latest follow up. Conclusion: Partial or total claviculectomy can be successfully employed for bone tumours with good oncological and functional results. A new classification system for claviculectomy is reported, based on the extent of resection

Alar base-wedge excisions are an integral part of the rhinoplastic procedure. They tend to reduce the nostril floor, the alar height, or both. Some geometrical forms are presented relating to the individual abnormalities. Emphasis is put on the usefulness of this procedure.

An unusual case of Peyronie's disease in a 22-year-old male is presented. The patient complained of sluggish erection of the pendulous portion of the penis. A fibrous plaque in the tunica albuginea at the base of the penis extended into the corpus cavernosum cross-sectionally. Histology was consistent with Peyronie's disease. Some improvement was obtained by partial excision of the plaque.

Six personal cases of giant cell tumours of the sellar region, as well as 19 cases collected from the literature are reported. Clinical findings are described, and the factors affecting the post-operative course are discussed. Radical excision of the growth and recurrence-free course were exceptional. As a general rule, biopsy and partial excision were performed. Progression of signs and symptoms was frequent in the follow-up.

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In einem kritischen Uberblick wird unterstrichen, das die malignen Irismelanome in 4,1 % der Falle trotz der operativen Behandlung mit Iridektomie und Enukleation durch Metastasen zum Tode fuhren. Sie haben einen ausgesprochen infiltrativen Charakter und sind in 50% der Falle im Moment der Operation schon in die Nachbarschaft eingedrungen. Bei den malignen Melanomen des Ciliarkorpers scheint die Neigung zur Metastasenbildung und zum Wachstum in die benachbarten Gewebe noch starker ausgepragt. Die gegenwartige Unsicherheit der Urteilsbildung macht die Einhaltung gewisser Regeln, die genau aufgezahlt werden, empfehlenswert.

A case of red grain mycetoma on the scalp is described. The disease, caused by Actinomadura pelletieri, is extremely rare in this part of the world, and from India this is perhaps the first case with scalp involvement. The lesion showed satisfactory response to partial excision followed by chemotherapy with streptomycin.

This paper presents a rare case of intracrania ependymoma originating from the floor of third ventricle of a 12 year old girl. It manifested as a painless, progressively increasing swelling at the medial angle of left eye with proptosis which was without any extracranial metastasis. Excision biopsy was made by external ethmoidectomy revealed it to be an ependymoma. Partial excision combined with chemotherapy showed no recurrence and no evidence of metastasis for six months.