Large Abdominal Lump Research Articles

A rare presentation of gastric gastro-intestinal stromal tumour managed by stomach preserving surgery: a case report

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the alimentary canal that account for 0.1–3% of all gastrointestinal malignancies. Vast majority of these tumors have oncogenic gain-of-function mutations of the KIT receptor tyrosine kinase. The mainstay of treatment is complete surgical resection followed by adjuvant therapy with tyrosine kinase inhibitors (Imatinib). We present a case report of 47 years old male presenting with a large abdominal lump, later diagnosed as a Gastrointestinal stromal tumor and underwent stomach preserving sleeve gastrectomy.

Huge pelvic retroperitoneal cyst masquerading as hydrosalpinx: A case report with review of the literature

Primary retroperitoneal cysts (RPCs) are a rare surgical entity and are mostly detected incidentally. Usually, they are asymptomatic. At times, they may attain a huge size and may present with a large abdominal lump. Often, they pose a dilemma at diagnosis and for management. Though the laparoscopic approach has been described for their surgical excision, open surgery is still the preferred approach. We herein present a case of a voluminous retroperitoneal pelvic cystic mass in a 40-year-old female, which was diagnosed as hydrosalpinx on a magnetic resonance imaging scan. The patient was referred to us by the specialist in gynecologic laparoscopy after the incidental discovery of the RPC during his surgical intervention, purportedly for large hydrosalpinx. At our hospital, 4 days after the above intervention, she underwent laparoscopic complete excision of the cyst. Her postoperative recovery was uneventful and she was discharged on postoperative day 3 without any complications. Histopathology was suggestive of Mullerian inclusion cyst. This case report aims to share a rare case of a large primary retroperitoneal pelvic cystic lesion, which caused a diagnostic challenge preoperatively but was eventually managed successfully, laparoscopically.

Retroperitoneal fetiform teratoma in an infant

Fetus in fetu is a rare intra-abdominal mass secondary to abnormal embryogenesis in a diamniotic monochorionic pregnancy. Teratoma, unlike fetus in fetu, does not show the vertebral axis or regional distribution of the organs. We report a 9-month-old male infant who presented with a large abdominal lump. The retroperitoneal mass was excised. On opening the sac, well-formed fetus-like structure was seen. The mass was connected to a yolk sac-like structure. The mass had the rudimentary head, thorax, abdomen, and finger-like buds giving a fetiform appearance but without vertebral column. Histopathological examination confirmed fetiform teratoma. The outcome was favorable.

Spontaneous gall bladder perforation masquerading as a large abdominal lump: An uncommon presentation of a common entity

Gall bladder perforation (GBP) is an uncommon complication of acute cholecystitis. Usually patients with GBP present with localized or diffuse peritonitis defending on their ability to localise the site of perforation. We recently cared for a 65-year-old female with GBP who presented to us with a painful large anterior abdominal lump and jaundice. On investigations, a large subcapsular liver collection was identified along with a perforation at the fundus of gall bladder and a calculus at the lower end of the common bile duct (CBD). The patient underwent pigtail catheter drainage of the collection under ultrasound guidance, endoscopic retrograde cholangiopancreatography, and papillotomy for CBD stone retrieval, followed by elective laparoscopic cholecystectomy with uneventful recovery. This case report highlights the fact that in a patient with gall stone disease presenting with a painful abdominal lump, the possibility of underlying GBP should be considered and the treatment should be individualised based on clinical condition of the patient.

Retroperitoneal fetus-in-fetu: another supportive evidence for twinning theory

An 8-year-old boy with large abdominal lump causing upper abdominal fullness is presented. Clinically it mimicked a trichobezoar because of the restricted side-to-side mobility of the lump. The lump, however, had calcification and radiological features of fetus-in-fetu (FIF). At laparotomy, a fetiform mass covered with fatty tissue was delivered out of a retroperitoneally located sac (in the bed of stomach). The fetiform mass had an identifiable upper limb bearing digits, one of them also bearing nail. Though histopathological examination did not reveal the presence of vertebral bodies, an advanced differentiation of the bony ends, bearing cartilage qualified the mass as FIF. There was family history of twinning with the elder siblings being dizygotic twins. The origin and diagnostic criteria of FIF are discussed and reference is made to a high likelihood of a twinning as the preceding event in this case.