SUMMARYAggressive angiomyxoma (AAM) is a rare locally aggressive neoplasm of mesenchymal origin which occurs mainly in adult women. High local recurrence rate after surgery is due to incomplete surgical excision and most of the reported cases originate in the pelvis. We present a case of massive angiomyxoma arising from the abdomen and extending into the pelvis and perineum. A 23-yearold woman presented with a swelling of the left lower abdomen with discomfort and pain for 4 years. The swelling increased in size progressively and involved the perineum. At surgery the mass was abutting the urinary bladder and rectum. On microscopy there were typical features of AAM. Our case is being reported due to the rarity of its presentation. Close follow-up is necessary as there is high chance of recurrence. BACKGROUND

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Identification of factors predicting the outcome of surgery for chronic pancreatitis and preparation of a scoring system to predict the outcome following surgery. A total number of 76 patients who had undergone surgery for chronic pancreatitis were prospectively followed at Department of General Surgery, S.C.B. Medical College, Cuttack during the period from 2010-2013. Data on demographic details, pain score, opioid addiction, exocrine and endocrine insufficiency, insulin requirement and morphology of pancreas on imaging were recorded. On follow up, improvement in pain score and exocrine and endocrine insufficiency were recorded. Factors affecting surgical outcome were determined and a scoring system was done. The mean age of patients was 39.7±7.9 years (range 18-58 years). Chronic alcohol intake was the predominant cause accounting for 56% (n=34) cases. Mean pain score at admission on Visual Analogue Scale (VAS) was 5.98. Twenty-six patients (43.3%) were found to have endocrine insufficiency and 22 (36.6%) patients had exocrine insufficiency. Forty-two patients underwent Partington-Rochelle procedure, and 18 patients underwent Frey’s procedure. Eighty percent of patients (n=48) had significant pain relief. On logistic regression, preoperative VAS score, number of previous admissions, opioid dependence, main pancreatic duct (MPD) diameter, number and site of calcifications were found to be significant in predicting pain relief. Cohort of patients with chronic pancreatitis likely to get benefit from surgery can be predicted preoperatively.