HighlightsIt is a rare anomaly of abnormal testicular migration.It was seen in a 24 year old with associated left inguinal hernia.He underwent left sided meshplasty and orchidectomy.It is usually discovered on surgical exploration.It’s important due to risk of malignant transformation of the ectopic testis.

INTRODUCTIONMastalgia, or breast pain, is a common complaint that may affect up to 70% of women in their lifetime.1 It is not unusual for women to have 2-3 days of mild breast pain premenstrually but 8-30% of women report moderate to severe breast pain with duration of 5 or more days each month.2 Fifteen percent of women who present to a breast clinic with mastalgia will require treatment. 3Breast pain is classified as cyclical mastalgia, noncyclical mastalgia and non-specific extra-mammary pain. Cyclical mastalgia is a breast pain that has clear relationship to the menstrual cycle. Non-cyclical ABSTRACT Background:The aim of the present study is to observe the clinical profile and management of mastalgia. The objectives of the present study were to assess the clinical profile of breast diseases causing mastalgia, to study the response of mastalgia to the following three drugs: Danazol, Bromocriptine, topical non-steroidal anti-inflammatory drugs (topical diclofenac gel). Methods: It was prospective type of study. Inclusion criteria: Patients of age group 15-50 years, all patients suspected or diagnosed for breast pathology with mastalgia. Exclusion criteria: immune-compromised patients, all patients undergoing surgical removal of breast lump, pregnant females. Evaluation of pain was done using visual analog scale, prior to giving the treatment and after giving the treatment each week for the first month and thereafter monthly for the next 6 months. Results:The clinical profile of mastalgia was as follows: fibroadenosis accounting for 37 (46.25%), followed by 10 (12.5%) cases of fibroadenoma, 08 (10%) cases of mastitis, 06 (7.5%) cases of breast abscess, 03 (3.75%) cases of duct ectasia, 02 (2.50%) cases of galactocoele, 02 (2.50%) cases of breast carcinoma and 12 (15%) cases of nonspecific extra-mammary pathology. Patient's response rate to different drugs included in the study was: 64.8% to danazol, 56.9% to bromocriptine and 76.01% to topical diclofenac gel. Conclusions: Cyclical mastalgia accounted for more proportion of patients than non-cyclical mastalgia. Common causes of mastalgia being fibroadenosis, followed by fibroadenoma, mastitis, breast abscess, duct ectasia, galactocoele, breast carcinoma and non-specific extra-mammary pathology. Danazol and bromocriptine are effective in treatment of mastalgia, though they show different side effect profiles and varying patient compliance.

Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist Soft in consistency Non tender Non compressible Mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigations were normal. Ultrsonography showed giant cell tumor of Extensor Digitorum sheath. X-ray: soft tissue swelling and MRI was suggestive of extensor tendon sheath extraskeletal synovial Koch's, or giant cell tumor of tendon sheath. Excision of swelling was planned and intraoperatively, rice bodies were seen inside it. Histopathological examination showed caseous necrosis with granuloma formation. Patient was put on DOT1 therapy. Tuberculous tenosynovitis was first described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were first described in 1895 by Reise. Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with extensive curettage lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia.

Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. 57 years old male presented with swelling over the left wrist since 3 years. Three swellings over dorsal aspect of the left wrist, soft in consistency, non tender, non compressible mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigation were normal. Ultrasonography showed Giant-cell tumor of Extensor Digitorum sheath. Xray: soft tissue swelling MRI suggestive of Extensor Tendon sheath Extraskeletal Synovial Koch's or Giant cell tumor of tendon sheath. Then planed for excision of swelling and intra-operative fi nding were rice bodies. Histopathological examination showed caseous necrosis with granuloma formation. Patient put on DOT1 therapy. Tuberculous tenosynovitis was fi rst described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were fi rst described in 1895 by Reise Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with Extensive curettage, lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the signifi cance of loose bodies when performing routine excision of innocuous looking wrist ganglia.

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