Giant fibroids are known to arise from the uterus, and very rarely from the broad ligament. Large fibroids often undergo hyaline, cystic, and at times, red degeneration. In the present case, cystic degeneration with intervening septations in an adnexal mass raised the suspicion of ovarian neoplasm as the ovaries were not seen as separate from the lesion. The ultrasonographic and contrast-enhanced computed tomographic findings of this case were characteristic of ovarian neoplasm. The differential diagnosis included rare possibility of giant fibroid with cystic degeneration. The diagnosis was confirmed on histopathological examination. The patient underwent excision of the broad ligament fibroid, hysterectomy, and bilateral salpingo-oophorectomy. Magnetic resonance imaging has a role in the diagnosis of such lesions.
Conjoined twins are a rare entity. Only few cases have been reported in the medical literature. They are a rare and exclusive type of monozygotic twins. They are caused by a faulty division of the embryonic disk. Due to high post-natal morbidity and mortality, an early pre-natal diagnosis is a must. All the monozygotic twins should be carefully screened for conjoinnment and if it is present, the type and the degree of sharing of the foetal organs should be delineated. There are many associated anomalies, of which congenital heart defects are the major prognostic factors. Here, we are reporting a case of thoraco-omphalopagus in which there was sharing of the foetal heart, liver and the intestinal loops.
Autosomal recessive polycystic kidney disease (ARPKD) is one of the most common inheritable disease manifesting in infancy and childhood with a frequency of 1:6,000 to 1:55,000 births. The patient in her second trimester presented with a history of amenorrhea. Ultrasound examination revealed bilateral, enlarged, hyperechogenic kidneys, placentomegaly, and severe oligohydramnios. The pregnancy was terminated. An autopsy was performed on the fetus. Both the kidneys were found to be enlarged and the cut surface showed numerous cysts. The liver sections showed changes due to fibrosis. The final diagnosis of autosomal recessive polycystic kidney disease was made based on these findings. In this article, we correlate the ante-natal ultrasound and histopathological findings in autosomal recessive polycystic kidney disease.
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