Pleomorphic adenomas (PA) are the most common benign salivary gland tumors. They arise from the major salivary glands, as well as the minor salivary glands. They may arise rarely from the palate, oral cavity, neck, and nasal cavity also. Yet, the fourth, fifth, and sixth decades of life are the most common for them to manifest. Forty percent of them occur in males and 60% in females. It is a benign mixed tumor, which has three components: an epithelial component, a myoepithelial cell component, and a mesenchymal component. A fibrous capsule separates these cells from the surrounding tissues. It generally presents as a slowly progressing painless swelling, which is well-delineated, nonsymptomatic, and not involving the facial nerve. Salivary gland tumors can be accurately diagnosed before surgery using fine-needle aspiration (FNA), ultrasonography (USG), and computed tomography (CT) scan. Calponin, cluster of differentiation 9 (CD9), glial fibrillary acidic protein (GFAP), Mcl-2, metastasis suppressor gene (NM23), p63, S-100, smooth muscle actin (SMA), and SRY-box transcription factor 10 (SOX10) exhibit the majority of the positive reactions in pleomorphic adenomas. The diagnostic marker pleomorphic adenoma gene 1 (PLAG1) is frequently employed since it is specific for pleomorphic adenoma. Although benign, these epithelial tumors have a propensity to recur and undergo malignant transformation if incompletely excised, leading to increased morbidity in these patients. A review of the consensus guidelines and literature was conducted, and the online literature on the subject from 2002 was included. This article is not a complete review of all the available literature; rather, it is a comprehensive review of the topic.

Background: A varicocele can be defined as an abnormal venous dilatation and/or tortuosity of the pampiniform plexus. It is generally reported that varicoceles are present in 15% of the general male population and 35% of men as a cause of primary infertility and in up to 80% of men as a cause of secondary infertility. Differences in venous drainage anatomy between the left and right internal spermatic veins, venous valve incompetence resulting in venous blood reflux, and increased hydrostatic pressure are the most commonly cited theories. Various surgical and non-surgical techniques are in use for treating patients with varicocele. Here we used a modified Palamo procedure to treat the patients and observed the outcome.Methodology: A total of 40 patients with varicocele were recruited for the study. A preoperative evaluation, along with serum testosterone levels and semen analysis, was done. A modified Palomo technique was used to treat varicocele. A postoperative follow-up with serum testosterone levels and semen analysis was done to observe improvement.Results: The mean (±SD) left testis size, right testis size, testosterone, sperm concentration, sperm vitality and sperm progressive motility were found statistically significantly higher in patients after surgery as compared to patients before surgery (p<0.05). However, there was statistically insignificant mean difference in semen volume between patients before surgery and patients after surgery (p>0.05).Conclusion: Modified Palomo procedure can be used to treat varicocele with good improvement in serum testosterone levels and semen parameters.

A variety of cutaneous disorders can present to the general surgeon either directly or by referral for surgical intervention. Some conditions are commonly seen and operated on by general surgeons which include lipoma, epidermoid cyst, etc. On the other hand, some are uncommon conditions like dermatofibrosarcoma protuberans and chondroid syringoma which require a high index of suspicion to diagnose. Most general surgeons are not familiar with the latest guidelines to treat such uncommon conditions. In this article, we provide a review of uncommon cutaneous disorders requiring surgical intervention that were encountered at our high-volume tertiary care center and a discussion about their etiology, presentation, diagnosis, management and follow-up with one case report of each condition. The objective of this article is to familiarize the general surgeon with these cutaneous disorders which though uncommon, will present in their practice at some point.