A 29-year-old male presented with complaints of swelling in the right side of umbilicus for six months associated with dull ache for two months. It was gradually increasing in size and there was no other symptom. There was no significant past or family history.A globular intraperitoneal lump approx 5x4 cm was found in umbilical region which was firm, mobile, and mildly tender with smooth surface and margin, no fixity but not moving with respiration. Ultrasonography (USG) of whole abdomen showed it as intra abdominal abscess or cyst. Fine needle aspiration cytology revealed a few monolayered clusters of colonic mucosal cells, some muscle fibres and mucin strings in the background of blood with no atypical or malignant cells. Contrast enhanced computerized tomography Revealed an oval hypodense (+25 HU) and mildly enhancing (+46 HU) focal lesion in intraperitoneal cavity with retroperitoneal extension suggestive of leiomyoma or GastroIntestinal Stromal Tumour. Colonoscopy and endoscopy showed no polyps.Exploratory laparotomy revealed a mass 6x5x4 cm [Table/ Fig-1] in ileal mesentery. It was excised along with 20cm of ileum and end to end anastomosis in two layers.Histopathologically [Table/ Fig-2], a lesion in the subepithelium composed of cells with blunt ended nuclei arranged in sheets, fascicles, whorl and haphazard patterns was found. Hyalinised capillaries were interspersed with focal lymphocytic infiltration and cells with moderate nuclearr atypia in peripheral areas characterized MF. Postoperative days were uneventful and discharged on 10 th day. Adjuvant radiotherapy (50 Gy) was given to our patient in the post operative period. Follow up for three years which included USG abdomen and colonoscopy didn't reveal any new pathological lesions. DISCUSSIONThe term 'desmoid' was coined by Muller in 1838 and was derived from Greek word 'desmos' meaning band or tendon [1]. These are rare tumours, arising from musculo-aponeurotic elements accounting for about 0.03% of all neoplasm and 3.5% of all fibrous tissue neoplasm [2]. It is commonly seen in reproductive years of A 29-year-old male presented with a swelling on the right side of the umbilicus for six months and dull aching pain for two months. Fine needle aspiration cytology, ultrasonography, contrast enhanced computerized tomography findings were inconclusive. After Exploratory laparotomy, a mass approx 6x5x4 cm in ileal mesentery was identified and excised along with 20cm of ileum. End to end anastomosis was done and specimen was sent for histopathology which confirmed the diagnosis of MF. Considering the rarity of this tumour and difficulties in diagnostic and therapeutic ambit, we believe it is justified to describe this case which came to our observation.women, often during and after pregnancy [1,3]. Desmoid tumours (DT) are histologically benign, but they may show local recurrence after excision [3].

The association of testicular torsion and cerebral palsy is a well-known fact. But the infrequent presentation to emergency room makes the clinician sceptical. Such a presentation often puzzles the residents regarding the diagnosis and the treatment. Here we present a case of an adolescent boy aged with cerebral palsy 13 years with incessant crying and not feeding well for last 3days. Right inguinal region showed a tender globular swelling with absence of testis in scrotum along with signs of septicaemia. The inguinal exploration was performed under general anaesthesia which revealed gangrenous right testis. Right orchidectomy and left orchidopexy was performed and the patient recovered well. This case is reported for its complexity due to lack of reliable history, delayed presentation and associated comorbidities posing challenges to the treating surgeons.

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