A 51-year-old male presented to our hospital's outpatient department with complaints of swelling in left thigh since six year. The swelling was insidious, gradually progressive in size, not associated with pain, fever or discharge. There was no history of weight loss or loss of appetite. There was no history of any antecedent trauma or any direct impact on the area. Medical history revealed no bleeding diathesis or anticoagulant therapy.Physical examination revealed a well defined fluctuant swelling in the lateral aspect of left thigh, measuring 17x10x5 cm in size. The swelling was globular in shape with smooth surface with no tenderness and no local rise in temperature. The lesion was cystic in consistency and compressible with smooth edges and the overlying skin was smooth and could be pinched. The lesion could be moved over the underlying muscles. Distal neurovascular status was normal. Ultrasound revealed a large subcutaneous cystic lesion showing mobile internal echoes, extending from hip to the knee region. MRI revealed a well defined unilocular cystic lesion measuring 20x10x6 cm which was hyperintense on both T1-weighted and T2-weighted sequences, seen along the left proximal fascia lata, in close proximity to underlying vastus lateralis and gluteus maximus muscles with maintained intervening fat planes. Fluidfluid level with dependent hypointensity was seen within the lesion. The cyst showed a thin smooth capsule which was hypointense on all sequences, and multiple small hypointense mural nodules were seen projecting into the lumen [Table /Fig-1a Morel-lavallee lesion (MLL) represents post traumatic subcutaneous cyst generally overlying bony prominences like greater trochanter, lower back, knee and scapula. A 51-year-old man presented with a swelling in left thigh since six years which was insidious in onset, gradually progressive in size and not associated with pain, fever or discharge. There was no history of trauma or any associated constitutional symptoms. Since there was no history of trauma recalled by the patient the clinical dilemma was between soft tissue sarcoma and cold abscess. We report a case of slow growing painless mass lesion of thigh, diagnosed on Magnetic Resonance Imaging (MRI) as morel lavallee lesion and describe its salient imaging features with treatment options.[

Angiomyoma of the extremity is a notoriously elusive preoperative diagnosis, as the list of differentials for its described classic clinical features of a painful mobile subcutaneous mass is quite vast. Imaging features described for angiomyomas are far from being specific. On ultrasound, angiomyomas are mostly described as a well-defined solid mass lesion showing robust internal vascularity. On T2-weighted MRI they have been described as homogenous to heterogeneously hyperintense relative to skeletal muscle. We report a pathologically proven angiomyoma around the knee joint in a middle aged man, describe its clinical and imaging features, and outlay an approach in diagnosing this rare entity as a differential for painful subcutaneous mass lesions.

Tuberculosis caused byMycobacterium tuberculosispresents a major health challenge in endemic countries and spares no organ in the human body. This infection is a mimicker of various disease processes such as metastasis, lymphoproliferative diseases, and other granulomatous conditions such as sarcoidosis and fungal infections. The most challenging and important differential is metastasis, especially in the disseminated form of tuberculosis. We present a histopathologically proven case of isolated hepatosplenic tuberculosis that was provisionally diagnosed as lymphoma due to its unusual, restricted involvement of the liver and spleen.

Amongst the varied, diverse causes of intraabdominal masses in infancy and early childhood, gastric teratomas (GTs) account for a very small proportion. A worldwide literature search reveals only around one hundred cases of GT and also supports the fact that its preoperative diagnosis remains elusive. Here we report the case of a two-month-old male who presented to the pediatric surgery outpatient department of Kasturba Medical College and Hospital, Karnataka, India, with progressive distension of abdomen since birth. Clinically, a large firm, non-mobile and non-tender mass involving all four quadrants of the abdomen was seen. Ultrasound revealed a large solid-cystic mass with internal septations extending from the epigastrium up to the pelvis. Computed tomography revealed a large intraperitoneal fat containing solid-cystic mass lesion showing curvilinear and chunky areas of calcification, with the mass focally indenting the posterior gastric wall and showing focal polypoidal intragastric extension. Exploratory laparotomy revealed a large cystic tumor with a solid component, arising from lesser curvature of the stomach, showing focal intraluminal extension across the posterior gastric wall, and occupying the whole lesser sac and abdominal cavity. The tumor was excised in toto along with the body of the stomach. Histopathological examination showed mature tissue derived from all three germ cell layers and confirmed the diagnosis of mature gastric teratoma. The patient was disease free at one-year follow-up.