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Paper reports a case of Massetric muscle cysticercosis diagnosed on sonography. Clinically patient presented with a solitary lesion, was considered to be a benign cyst, a tumor of mesenchymal tissue or salivary gland?, Lesions in the maxillo-facial region may present first to a dentist and, in endemic areas, cysticercosis should be included in the differential diagnosis of solitary nodular lesions of the oral cavity even though they are considerably rare.

Reading the short stories of L’Exil et le Royaume, we show that Camusian heroes are all faced with the "solitaire ou solidaire" dilemma, that they aspire to communicate with the other and the world, in short, to the kingdom, but face a triple isolation – geographical, political and psychological – which proves to be the essence of their exile. However, we find that, because he is placed in a different geopolitical context – South America and not the pre-war Algeria – the protagonist of "La Pierre qui pousse" escapes this fate, the isolation and loneliness that can lead to solidarity and even brotherhood.

The mongoose family (Herpestidae) has provided a wealth of data on life history patterns and behavior of its more social species but little is known about the many solitary mongoose species. Here, we provide the 1st longterm data on life history patterns and the biology of the solitary slender mongoose (Galerella sanguinea) in the Kalahari Desert, South Africa. Slender mongooses are strictly diurnal, solitary foragers, opportunistically hunting vertebrates and invertebrates. Life history patterns, such as a prolonged period of offspring dependence, including age at 1st emergence, at 1st foraging, and at weaning, compared to social meerkats (Suricata suricatta), seem to be an adaptation to their mainly solitary life style. [ABSTRACT FROM AUTHOR]

Two implicit and two explicit schemes preserving the local momentum conservation laws exactly on any time–space region are proposed for the regularized long-wave equation. With appropriate boundary conditions, the schemes will be energy- and mass-preserving globally. Combining with the momentum conservation laws, we obtain the priori estimates of the numerical solution and the error estimates in l ∞ norm for the proposed implicit schemes. Numerical experiments show the excellent performance of the proposed schemes and the numerical results coincide with the theoretical ones. [ABSTRACT FROM AUTHOR]

Objective: To assess the diagnostic accuracy of combined use of conventional grayscale US and sono-elastography in differentiating benign and malignant solitary thyroid nodules. Materials and methods: This prospective study included 50 patients with solitary thyroid nodules being evaluated using grayscale US followed with sono-elastography (USE). Suspicious conventional sonographic data for malignancy then evaluated using USE were classified according to Rago criteria with calculation of strain ratio. The diagnostic performances of grayscale US, elastography with Rago criteria, for predicting thyroid malignancy were compared and cutoff value for strain ration was statistically analyzed. Finally all patients with solitary nodule were subjected to US-guided FNAC and 35 patients recommended for surgery in the form of 12 patients underwent total thyroidectomy and 23 patients underwent thyroidectomy with neck dissection. Results: 30 females (60%), and 20 males (40%) were included (Mean age 38) with final diagnosis comprised 29 (58%) pathologically proved benign thyroid nodules and 21 (42%) pathologically proved malignant nodules. US showed significant relation between markedly hypo-echogenicity, oval than tall, margin irregularity, presence of micro-calcification with diagnosis of thyroid malignancies with p value <0.001. Regarding sonoelastography, there was significant relation between elastography scores 4 and 5 and thyroid malignancies showing sensitivity of 80%, a specificity of 100%, and p value <0.001. The most accurate strain ratio cutoff value among studied cases was 2.52. Combination of grayscale US and sono-elastography yielded better results with sensitivity of 92%, specificity of 95%, PPV of 89%, NPV of 92% and diagnostic accuracy or efficacy of 96%. Conclusion: Combined use of USE and grayscale US, showed superior performance in the differentiation of malignant and benign thyroid nodules compared with each technique alone. Suspicious US criteria with elasticity Rago scores 4 and 5 and strain ratio more than 2.52 are the most predictive signs of malignancy. [ABSTRACT FROM AUTHOR]

Background: Metastatic choroidal carcinomas that originated from the gastrointestinal tract are extremely rare. We report a case of suspected solitary choroidal metastasis from gastric adenocarcinoma. Case presentation: The patient was a 60-year-old man who had undergone laparoscopic distal gastrectomy with D1+ lymphadenecetomy for gastric cancer. The clinical stage was T1bN0M0 (TNM classification), but the pathological stage was T4aN0M0 beyond expectation. Adjuvant chemotherapy with oral Tegafur, Gimeracil, Oteracil potassium (TS-1) was initiated. But he suddenly complained of decreased visual acuity in his right eye about 8 months later. This was suspected to be caused by choroidal metastasis of gastric adenocarcinoma. Chemotherapy with paclitaxel (PTX) and intensity-modulated radiotherapy (IMRT) achieved complete remission and spared the patient from going blind. Conclusions: This case demonstrates that we should be aware of the possibility of choroidal metastases, when visual symptoms arise during treatment of gastric cancer. [ABSTRACT FROM AUTHOR]

The genus Heliophobius Peters, 1846 comprises at least six cryptic, topotypical species in the Heliophobius argenteocinereus Peters, 1846 species complex. The current study investigated the breeding patterns of a wild-caught population from Tanzania where the putative species Heliophobius argenteocinereus emini Noack, 1894 resides. Individuals were collected on a monthly basis for an entire calendar year. Assessment of fœtus presence, gonadal histology, reproductive-tract morphometrics in combination with gonadal steroid (plasma progesterone and œstradiol-17β in females and testosterone in males) measurements and field observations revealed that rainfall is important for the onset of breeding. The results further confirmed that breeding is limited to a single, yearly reproductive event synchronised to the long rainfall pattern. The distinct breeding peak in July is associated with an elevation in gonadal mass, increase in concentrations of reproductive hormones, and presence of Graafian follicles and corpora lutea in the ovaries of females. These reproductive parameters coincided with the end of the long rainfall period, whereas presence of young in the maternal burrow system corresponded with the start of the short rainfall of East Africa. These findings confirm Heliophobius has a single breeding opportunity each year, and this species is therefore vulnerable to any changes that may impact their climatically attuned breeding patterns. [ABSTRACT FROM AUTHOR]

Key points Emotions are accompanied by concordant changes in visceral function, including cardiac output, respiration and digestion. One major forebrain integrator of emotional responses, the amygdala, is considered to rely on embedded visceral afferent information, although few details are known., In the present study, we retrogradely transported dye from the central nucleus of the amygdala (CeA) to identify CeA-projecting nucleus of the solitary tract (NTS) neurons for synaptic characterization and compared them with unlabelled, near-neighboor NTS neurons., Solitary tract (ST) afferents converged onto NTS-CeA second-order sensory neurons in greater numbers, as well as indirectly via polysynaptic pathways., Unexpectedly, all mono- and polysynaptic ST afferent pathways to NTS-CeA neurons were organized exclusively as either transient receptor potential cation channel subfamily V member 1 (TRPV1)-sensitive or TRPV1-resistant, regardless of whether intervening neurons were excitatory or inhibitory., This strict sorting provides viscerosensory signals to CeA about visceral conditions with respect to being either 'normal' via A-fibres or 'alarm' via TRPV1 expressing C-fibres and, accordingly, this pathway organization probably encodes interoceptive status., Abstract Emotional state is impacted by changes in visceral function, including blood pressure, breathing and digestion. A main line of viscerosensory information processing occurs first in the nucleus of the solitary tract (NTS). In the present study conducted in rats, we examined the synaptic characteristics of visceral afferent pathways to the central nucleus of the amygdala (CeA) in brainstem slices by recording from retrogradely labelled NTS projection neurons. We simultaneously recorded neuron pairs: one dye positive (i.e. NTS-CeA) and a second unlabelled neighbour. Graded shocks to the solitary tract (ST) always (93%) triggered EPSCs at CeA projecting NTS neurons. Half of the NTS-CeA neurons received at least one primary afferent input (classed 'second order') indicating that viscerosensory information arrives at the CeA conveyed via a pathway involving as few as two synapses. The remaining NTS-CeA neurons received viscerosensory input only via polysynaptic pathways. By contrast, ∼3/4 of unlabelled neighbouring neurons were directly connected to ST. NTS-CeA neurons received greater numbers of ST-related inputs compared to unlabelled NTS neurons, indicating that highly convergent viscerosensory signals reach the CeA. Remarkably, despite multifibre convergence, all single NTS-CeA neurons received inputs derived from only unmyelinated afferents [transient receptor potential cation channel subfamily V member 1 (TRPV1) expressing C-fibres] or only non-TRPV1 ST afferent inputs, and never a combination of both. Such segregation means that visceral afferent information followed separate lines to reach the CeA. Their very different physiological activation profiles mean that these parallel visceral afferent pathways encode viscerosensory signals to the amygdala that may provide interoceptive assessments to impact on behaviours. [ABSTRACT FROM AUTHOR]

We propose higher-order approximation formulae recovering the surface elevation from the pressure at the bed and the background shear flow, for small-amplitude Stokes and solitary water waves. They offer improvements over the pressure transfer function and the hydrostatic approximation. The formulae compare reasonably well with the asymptotic approximations of the exact relation between the pressure at the bed and the surface wave in the zero vorticity case, but they incorporate the effects of vorticity through the solutions of the Rayleigh equation. Several examples are discussed. [ABSTRACT FROM AUTHOR]

This small, mixed-methods study sought to understand the use of special housing units among formerly incarcerated men. In the present study, 110 participants were placed in solitary confinement, ranging from ≤30 days to 20 years, with a mean of 2 years (SD = 2.55). These men ranged in age from 35 to 67 years, with a mean age of 46 years. Years of incarceration ranged from less than 30 days to 34 years; the mean number of years incarcerated was 4 (SD = 6.39). Of the 110 participants, qualitative interviews were conducted with 30 men to explore their experiences during time spent in solitary. The qualitative themes that emerged from the study were getting special housing units might be used for punishment, getting used to solitary, and getting solitary might mean peace of mind. Personalized reentry plans for men placed in special housing units facilities are urgently needed. [ABSTRACT FROM AUTHOR]

Metastatic spread of malignant phaeochromocytoma is known to involve multiple organs including the axial skeleton. Its presentation as a solitary lesion in the long bones of the extremities is extremely rare. We report a unique case of solitary metastatic phaeochromocytoma presenting in the distal femur, 16 years after excision of primary abdominal tumor. A 60 year old female, operated for adrenal phaeochromocytoma 16 years back was detected to have a bone tumor in her left distal femur. Chest and abdominal CT evaluation including bone scintigraphy confirmed the lesion to be solitary. Magnetic resonance imaging of the left femur revealed the tumor to be of aggressive nature. It involved whole of the distal femoral metaphysis with bone destruction, soft tissue extension and an impending pathological fracture. The tumor was histopathologically confirmed to be phaeochromocytoma. Patient underwent wide surgical resection of the tumor along with simultaneous endoprosthetic reconstruction. Following surgery, rehabilitation was rapid and effortless with patient ambulating independently. She had pain free full range of knee movements and resumed her daily activity uneventfully. On 18 months follow up the patient had no recurrence or complications. Late and solitary skeletal metastasis of malignant phaeochromocytoma although rare, can occur in the distal femur mimicking a primary bone tumor. Wide surgical excision and simultaneous endoprosthetic reconstruction should be considered as a treatment option. This not only permits limb salvage and early rehabilitation, but also restores form and function of the limb. [ABSTRACT FROM AUTHOR]

Determining social contacts among solitary carnivores is difficult given their often nocturnal and secretive nature. We used proximity-sensing radiocollars to quantify social contacts and den sharing among striped skunks (Mephitis mephitis) in suburban Flagstaff, Arizona, United States, in summer, autumn, and winter 2012-2013. During June and July, we followed 6 males and 5 females and, in spite of overlapping home ranges, they had few social contacts (range = 0-7), and all were brief, nocturnal encounters. From October through February, we followed 8 males and 9 females and found that patterns of contacts were similar for males and females except for significantly higher diurnal contacts (co-denning) among females in winter. Females varied in denning behavior; 1 female denned continuously in the same location from early November to late January, while at the other extreme 1 female moved among 10 different dens across the same time period. Several females moved to new communal dens in late January, resulting in new combinations of females co-denning. Males visited multiple female dens throughout winter. Overall, our data were consistent with previous studies in documenting overlapping home ranges of both sexes with few social contacts in summer, male intolerance but lack of male territoriality, and divergent social behavior in winter, with females co-denning while males generally denned alone. Our study differed from others in documenting more social interaction and movement during winter, often through nocturnal visits by males to female dens, and a shift in denning associations among females near the end of January. [ABSTRACT FROM AUTHOR]

Lymphangioleiomyomatosis (LAM) is a progressive disorder of unknown etiology that predominantly affects the lungs, and the resulting respiratory failure can be fatal. Extrapulmonary LAM is a rare disease that often occurs concurrently with pulmonary LAM. Usually, extrapulmonary LAM presents as a localized, well-circumscribed mass. Due to the rare occurrence of extrapulmonary LAM and its atypical location, extrapulmonary LAM is often difficult to diagnose prior to surgery. The present study describes the clinicopathological features of primary liver LAM in a 26-year-old woman. To the best of our knowledge, the present study presents the first case of a primary solitary extrapulmonary form of LAM in the liver. [ABSTRACT FROM AUTHOR]

In oral cavity neurogenic tumors are rare, especially if they are malignant. Neurofibromas are the benign tumors of nerve sheath origin involving multiple nerve fascicles of the smaller branches of peripheral nerves. They may present as solitary lesions or as a part of generalized syndrome of neurofibromatosis also known as von Recklinghausen's disease (VRD) or very rarely as multiple neurofibromas without VRD. Oral solitary neurofibromas are not uncommon, but histologically plexiform variant is a rare form. This article describes a case of oral solitary plexiform neurofibroma with a review of literature. [ABSTRACT FROM AUTHOR]

Very recently, the KdV6 was extended to a $$(2+1)$$ - dimensional equation by a direct way. Here, by using the ' $$\hat{kp}$$ -operator' the extension of that equation is done in a rigorous mathematical formulation. Polynomial solutions to the closed form equation are obtained via the unified method. It is found that via nonlinear interactions of traveling waves the solutions of the constructed equation may not be unique. Also, these solutions may show solitary or explosive shock waves. [ABSTRACT FROM AUTHOR]

The solitary Plasmacytoma (SP) is a rare lesion characterized by localized accumulation of monoclonal plasma cells neoplastic without evidence of systemic myelomatosis. It représente 5% of all plasma cell tumors. Its diagnosis is based on three essential elements, radiology, immunohistochemical examination, and biological investigation. The treatment is based on radiation. Prognosis depends on its evolution or to a Multiple myeloma which requires regular monitoring of patients with this lesion. This work shows through a clinical case of a woman aged 58 years, The clinical, radiological and histological appearence of this lesion, and the treatement are described. [ABSTRACT FROM AUTHOR]

Objective: To investigate the long-term outcomes of pulmonary nodules detected on chest computed tomography in a consecutive cohort of patients with newly diagnosed or recurrent head and neck squamous cell cancer staged between 2001 and 2003. Results: The study included 222 patients, 148 patients with newly diagnosed head and neck cancer (group 1) and 74 patients with recurrent cancer (group 2). Abnormalities were identified in 101 patients (45.4 per cent); these were predominantly benign in group 1 (61.7 per cent) as compared to predominantly malignant in group 2 (64.3 per cent) (Fisher's exact test; p = 0.0009). Only four patients (7.4 per cent) with an initially benign-looking pulmonary nodule went on to develop malignancy over time, conferring a negative predictive value of 93 per cent for the whole cohort. Conclusion: Chest computed tomography abnormalities in patients with recurrent head and neck cancer are statistically more likely to be malignant. Very few patients with an initially benign-appearing nodule develop chest malignancy over time. [ABSTRACT FROM AUTHOR]

Priodontes maximus (Kerr, 1792), called the giant armadillo, is monotypic and by far the largest extant armadillo. Average adult weight is about 30 kg (in captivity, as high as 80 kg). Its carapace extends about halfway down its sides, making it impossible to curl up tightly. It is dark brown to black dorsally, with a broad light band around the lower part of its carapace. It primarily digs to escape, enhanced by its 20-cm, sickle-shaped nail on its 3rd forefingers. P. maximus is widely distributed in South America but nowhere abundant. It is affected by habitat loss and fragmentation, agriculture, hunting, collection for museum specimens, and illegal animal trafficking. P. maximus is listed as "Vulnerable" by the International Union for Conservation of Nature and Natural Resources. [ABSTRACT FROM AUTHOR]

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The role of metastasectomy on survival in advanced/urologic malignancies still remains unclear. Renal cell carcinoma (RCC) is the most common solid tumor within the kidney. 25-30 % of patients have metastases at manifestation. Urothelial carcinoma (UC) consists of bladder carcinoma, upper urinary tract urothelial cell carcinoma and urethral carcinoma. Bladder cancer is the ninth most common cancer worldwide. Half of patients with muscle invasive bladder cancer have lymph node or distant metastases. In metastatic disease first-line treatment is multi-agent platinum-based systemic chemotherapy. Testicular cancer is the most common cancer in men between the age of 15 and 35. Testicular tumors represent excellent oncologic outcomes. Prostate cancer is the most common solid tumor in Europe. Surgical resection of metastases can be considered as a treatment choice in advanced/metastatic urologic malignancies to improve survival rates, particularly in RCC and UC. Metastasectomy can be suggested in conjunction with effective chemotherapy if complete resection is possible. Solitary metastasectomy can represent better survival rates compared to multiple metastasectomy even if multiple metastases confined to single organ. Site of metastases is one of the main determinants of successful metastasectomy such as lung metastasectomy in urothelial cell carcinoma and liver metastasectomy in RCC may lead to better oncologic outcomes. Due to the lack of the relevant data it is not possible to make an evidence-based recommendation on the role of metastasectomy for solitary-/organ-confined metastases of prostate cancer, testicular cancer and penile cancer. [ABSTRACT FROM AUTHOR]

Metastatic cardiac tumors are more common than the primary ones and they most commonly involve the pericardium or myocardium. Very rarely they may show partial or total intracavitory growth. Ours is one such case of solitary intracavitory cardiac metastasis in a patient with adenocarcinoma of the right lung who presented with hemoptysis and palpitation. Echocardiography and histopathological study clinched the diagnosis.

Angiokeratomas (AK) are a group of capillary vascular malformations encompassing several unrelated conditions, predominantly seen on the lower extremities. AK can be classified into localized and diffuse forms. The diffuse forms comprise Fabry′s disease, which is the result of α-galactosidase deficiency. The cutaneous AK includes the Mibelli type, the Fordyce type, angiokeratoma circumscriptum (AC), and ′solitary and multiple papular angiokeratoma′. We describe a case of AC with unusual features including late onset and palmar affection. Amongst the possible therapeutic options, cryotherapy was considered. However, the patient was lost to follow up.

A case of 65-year-old female with intrasellar mass was operated on under the diagnosis of pituitary adenoma. The final diagnosis of plasmacytoma was made by immunocytochemical stain of IgG and electron microscopical findings. Postoperatively, the radiological studies of systemic skeletal bone and cytology of bone marrow were normal. However, the serum IgG was high, and the urinary Bence-Jones protein (kappa type) was positive. Although these laboratory data normalized after operation and irradiation, the patient converted to severe multiple myeloma and expired one and half year after operation. [ABSTRACT FROM AUTHOR]

Primary cutaneous T-cell lymphoma is a rare lymphoproliferative disorder accounting for 2% of all lymphomas. Mycosis fungoides (MF) is a rare, albeit commonest form of primary cutaneous T cell lymphoma. MF d′emblee is an uncommon variant which is easily mistaken clinically for epithelial malignancy. Diagnosis at cytology is challenging due to low degree of suspicion, rare occurrence and diverse morphology. We report a case of 51-year-old male presenting with a solitary nodulo-ulcerative lesion over right thigh. Smear showed atypical lymphocytes with hyper-convoluted cerebriform nuclei along with few mature lymphocytes consistent with MF. To our knowledge, this is the first report of unilesional MF d′emblee diagnosed at fine needle aspiration cytology (FNAC). Our case emphasizes that FNAC is an accurate method for early diagnosis and clinical staging of patients with MF.

A 59-year-old woman presented with a history of rapidly progressive recurrent tumor of 6.5 cm diameter of the scalp. Histopathological examination revealed a case of malignant cylindroma. There has been no recurrence or metastases and the patient is disease free at the end of 15 months postoperatively. Malignant transformation occurs less often in solitary form of cylindroma, but once transformed, tumors behave aggressively with extensive local infiltrative growth or metastases. The case is reported to document a rare case of malignant cylindroma arising in a patient with solitary cylindroma on the parieto-temporal region.

To emphasize that solitary hydatid cyst can be localized in the soft tissue and present as a soft tissue mass even in an unusual site like face, we report the case of a 42-year-old male patient presenting with a slowly growing mass in right temporal region. Computed tomography (CT) scan showed an encapsulated mass with multiple cysts. Histopathological examination revealed the characteristic findings, which were consistent with soft-tissue hydatid disease. In the absence of visceral organ involvement, this is the first reported case of a primary subcutaneous hydatid cyst in the skin of face in India. In the English literature, only one case of this kind has been reported till date. When imaging methods confirm cystic nature of a swelling, even in unusual sites, one should always keep a possibility of hydatid cyst and manage accordingly during surgery to avoid precipitation of acute anaphylaxis.

Localized solitary plasmacytoma of the bone is a rare disease and is characterized by only one or two isolated bone lesions with no evidence of disease dissemination. We report a case of solitary plasmacytoma of the rib in a 43-year-old female. The patient underwent complete en-bloc resection of the chest wall including rib, muscle, and parietal pleura. Patient is asymptomatic without any recurrence after two and half years of follow up.

The plasma cell neoplasm may present as Extramedullary Plasmacytoma (EMP) in soft tissues in bone as a Solitary Plasmacytoma of bone (SPB) or as a part of multi focal disseminated disease Multiple Myeloma (MM). The majority of 80% occurs in head and neck region. In our case, a 62-year-old male patient presented with a non tender swelling of short duration. The swelling was noted obliterating the vestibular depth in right lower mandibular region. The radiological features were non specific.

We report the case of a three-year-old male child who presented with a single painless subcutaneously located upper lid mass of 1.2 Χ 1.5 cm with a central depression. The mass could be easily separated from overlying skin on complete excision biopsy and showed a never described before whitish brain like appearance consisting of multiple lobes and gyri, which histopathologically proved to be molluscum contagiosum (MC). Tests to investigate underlying immunodeficiency did not show any evidence of immunocompromised state.

Myofibromas are rare benign tumors with myofibroblastic origin. They occur especially in cutis and subcutaneous tissue of the head and the neck, less frequently on the extremities. Myofibromas grow very slowly and are often painless, which is why patients often present relatively late. In the literature, there were many reports about intraosseous myofibromas of the craniofascial bones but reports of the trunk and extremities in adults are very rare. The authors present a very rare case of an intraosseous myofibroma of the ribs resulting in pathological fracture, including a research of literature from other cases of intraosseous myofibromas of the trunk or extremities., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Cross-sectional imaging of the upper abdomen, especially if intravenous contrast has been administered, will most likely reveal any acute or chronic disease harbored in the spleen. Unless imaging is performed with the specific purpose of evaluating the spleen or characterizing a known splenic lesion, incidentally discovered splenic lesions pose a small challenge. Solitary benign splenic lesions include cysts, hemangiomas, sclerosing angiomatous nodular transformation (SANT), hamartomas, and abscesses, among others. Sarcoidosis and tuberculosis, although predominantly diffuse micronodular disease processes, may also present as a solitary splenic mass lesion. In addition, infarction and rupture, both traumatic and spontaneous, may take place in the spleen. This review aims to describe the imaging features of the most common benign focal splenic lesions, with emphasis on the imaging findings as these are encountered on routine cross-sectional imaging from a multicenter pool of cases that, coupled with clinical information, can allow a definite diagnosis.

Objective: Tuberous sclerosis is a rare genetic condition caused by TSC1 or TSC2 mutations that can be inherited, sporadic, or the result of somatic mosaicism. Subependymal giant-cell astrocytoma (SEGA) is a major diagnostic feature of tuberous sclerosis complex (TSC). This study aimed to present a series of cases in which a pathological diagnosis of SEGA was not diagnostic of tuberous sclerosis., Methods: The authors retrospectively reviewed a clinical case series of 5 children who presented with a SEGA tumor to Johns Hopkins All Children's Hospital and St. Louis Children's Hospital between 2010 and 2022 and whose initial genetic workup was negative for tuberous sclerosis. All patients were treated with craniotomy for SEGA resection. TSC genetic testing was performed on all SEGA specimens., Results: The children underwent open frontal craniotomy for SEGA resection from the ages of 10 months to 14 years. All cases demonstrated the classic imaging features of SEGA. Four were centered at the foramen of Monro and 1 in the occipital horn. One patient presented with hydrocephalus, 1 with headaches, 1 with hand weakness, 1 with seizures, and 1 with tumor hemorrhage. Somatic TSC1 mutation was present in the SEGA tumors of 2 patients and TSC2 mutation in 1 patient. Germline TSC mutation testing was negative for all 5 cases. No patient had other systemic findings of tuberous sclerosis on ophthalmological, dermatological, neurological, renal, or cardiopulmonary assessments and thus did not meet the clinical criteria for tuberous sclerosis. The average follow-up was 6.7 years. Recurrence was noted in 2 cases, in which 1 patient underwent radiosurgery and 1 was started on a mammalian target of rapamycin (mTOR) inhibitor (rapamycin)., Conclusions: There may be intracranial implications of somatic mosaicism associated with tuberous sclerosis. Children who are diagnosed with SEGA do not necessarily have a diagnosis of tuberous sclerosis. Tumors may carry a TSC1 or TSC2 mutation, but germline testing can be negative. These children should continue to be followed with serial cranial imaging for tumor progression, but they may not require the same long-term monitoring as patients who are diagnosed with germline TSC1 or TSC2 mutations.

Neurofibroma is a benign tumor of the peripheral nerve. It usually presents as multiple tumors and as a part of von Recklinghausen's disease. However, rarely, it can occur in solitary form. The clinical diagnosis of solitary neurofibroma poses a challenge to clinicians as a plethora of benign and malignant lesions of the oral cavity have similar clinical presentations. We present a rare case of solitary neurofibroma of the maxillary soft tissue. A systemic clinical examination was performed to rule out neurofibromatosis. Computed tomography showed displaced teeth and bone destruction. Magnetic resonance imaging showed an ill-defined T2 hyperintense lesion involving the posterior aspect of the tooth-bearing alveolar process of the maxilla. The diagnosis of neurofibroma was confirmed by histological analysis and immunohistochemical studies. The tumor was successfully managed with excision. Three years of follow-up showed no recurrence. Solitary neurofibroma of the oral cavity is a very rare presentation. Neurofibroma in the maxilla with bone destruction is reported for the first time in the literature. This article will add to the current literature due to the atypical location and presentation of the tumor., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mokhtar et al.)

Infantile myofibromatosis (IM) is the most common fibrous disorder of infancy and early childhood. Solitary intracranial involvement is rare and often unrecognized. This makes its early diagnosis and adequate management difficult. The majority of lesions are localized to the skull or dura with variable intracranial extension. Herein, we report a misdiagnosed and aggressive presentation of a solitary IM of the petrous bone. Our aim is to discuss histopathological differential diagnoses and management difficulties., Competing Interests: The authors declare that they have no competing interests., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.)

A glomus tumor is a neoplasm composed of cells from the glomus body which is a contractile neuromyoarterial structure that affects blood pressure and thermoregulation by altering cutaneous blood flow. This cutaneous tumor can be benign or rarely malignant, solitary or multiple, and digital or extradigital. A benign glomus tumor usually presents as a non-familial, solitary, and subungual lesion. Multiple glomus tumors are less common, may be autosomal dominantly inherited, and extradigital. In contrast to a digital glomus tumor that often occurs within the nailbed or fingertip pulp of a young woman, a glomus extradigital tumor (GET) typically appears on the extremity or trunk of an older man. The diagnosis of a glomus tumor may be suspected based on clinical evaluation; it classically presents with a clinical triad of symptoms which includes lesion-associated tenderness, pin-point pressure pain, and cold sensitivity. However, cold-induced exacerbation of pain is frequently absent in extradigital glomus tumors; this may contribute to a delay in establishing the diagnosis of a glomus tumor in these individuals. Radiographic studies can support the diagnosis, but tissue specimen examination is necessary to establish the diagnosis. Resolution of tumor-associated pain is usually achieved following the complete excision of the neoplasm. A woman with a glomus tumor located on her wrist is described; her painful tumor was not sensitive to cold and was misdiagnosed clinically as a possible foreign body reaction to either a wood splinter or glass shard. The diagnosis of an extradigital glomus tumor was established after a microscopic examination of the tissue specimen following an excisional biopsy using a 3-millimeter punch biopsy tool. The neoplasm-related pain ceased and did not recur after the tumor had been completely removed. In conclusion, a glomus tumor is included in the differential diagnosis of a painful cutaneous neoplasm; however, misdiagnosis and/or substantial delay in diagnosis may occur if the tumor is extradigital or it lacks cold sensitivity or both. Therefore, the clinician needs to entertain the possibility of an extradigital glomus tumor when evaluating a patient with a tender, temperature-insensitive skin lesion that is not located on the fingers or toes., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2023, Cohen et al.)

Neonatal liver abscess is a rare condition with a high mortality rate. However, in a low-resource setting, high clinical vigilance and the use of readily accessible diagnostic modalities can help in early diagnosis and, along with appropriate medical management, prevent lethal complication., Case Presentation: We present the case of a patient who presented with one day of sudden abdominal distension and two episodes of projectile nonbilious vomiting. A solitary liver abscess was diagnosed using ultrasonography and contrast-enhanced computed tomography findings, and the patient was treated conservatively with parenteral broad-spectrum antibiotics. Following the completion of the antibiotic dose, an ultrasound of the abdomen reveals that the size of the liver abscess has decreased., Clinical Discussion: Neonatal liver abscess is a rare clinical condition that causes significant morbidity and mortality in premature and term babies. In a neonate with potential risk factors, a high index of suspicion is required to make the diagnosis. Baseline tests, as well as computed tomography with or without contrast, aid in the definitive diagnosis of a hepatic abscess. For management, a multidisciplinary approach should be considered, including correction of the predisposing factor as well as appropriate medical and/or surgical intervention., Conclusion: Neonatal liver abscess is frequently overlooked due to its rarity. Thus, whenever a neonate exhibits the aforementioned clinical spectrum, it should be considered in the differential diagnosis, and a diagnostic workup and treatment should be initiated as soon as possible to avoid debilitating complications., Competing Interests: All the authors declare that they have no conflicts of interest., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

BACKGROUND: Gallstones represent a major health problem across the world. In the United States the prevalence is about 10% and increasing up to 30% in advance age people. Its Prevalence in Islamic Republic Pakistan is around 15 to 20 %. OBJECTIVE: Aim of our study is to assess the differences in clinical presentation between single and multiple gallstones. DESIGN: Comparative study. SETTING: This study was conducted at surgical department of Liaquat University Hospital Jamshoro, Sindh, Pakistan. DURATION: 1st Feb 2010 to 31st January 2014. SAMPLE SIZE: Total one hundred patients. METHODOLOGY: All sonographically diagnosed patients of gallstones admitted into the ward. Clinical presentation like signs, symptoms and preoperative ultrasound findings of all patients were noted on predesigned performa, than after all necessary preoperative workup patients fit for surgery underwent cholecystectomy under elective conditions. The gallbladder was incised and the gallstones were exposed. The number of stones (single or multiple) in each gallbladder was recorded and on this basis all patients were divided into two groups. Group "A" labeled as a single stone and group "B" multiple stone. RESULTS: The age range from 20 to 70 years, mean age was 44±5.5 years. Incidence of disease is about five times higher in female than males (80% female, 20% male). 80% of patients had multiple stones, 20% patients had single stones. Majority of patients of group "A" has colicky type of pain and located in right upper quadrant and majority of group "B" patients has dull pain and located in Epigastrium. Other clinical symptoms like dyspepsia, vomiting and fever have no major difference in both groups. Sonographic findings are also almost same in both groups. CONCLUSION: It is concluded from our study that the clinical and Sonographic presentation is almost same in both groups, except site and type of pain. [ABSTRACT FROM AUTHOR]