Hepatic mesenchymal hamartoma (HMH) is a rare benign paediatric liver tumour. We present an 8-month-old female infant referred with a 2-month history of progressive abdominal distension and poor oral intake. Contrast-enhanced computed tomography identified a massive heterogeneous right hepatic mass measuring 10.7 × 14 × 15.4 cm, extending to the pelvis, crossing the midline, and abutting major vascular structures. Ultrasound-guided Tru-cut biopsy confirmed HMH. Following multidisciplinary team (MDT) discussion, open right hepatectomy was performed achieving complete tumour excision with clear surgical margins of 7 mm. Histopathology confirmed a benign biphasic mesenchymal-biliary proliferation without atypia or malignant transformation. The patient had an uneventful postoperative recovery with preserved liver function. Radiological follow-up at 4 months demonstrated a clear operative bed with no residual or recurrent disease. This case highlights the diagnostic and surgical challenges of giant HMH and the critical role of an MDT approach in achieving curative resection.

Telesurgery, the use of robotic systems to perform operations remotely, represents a growing frontier in minimally invasive surgery. We report a rare and pioneering case of a 16-month-old male with left pelviureteric junction obstruction. The child underwent robotic-assisted pyeloplasty performed via a telesurgical approach. The procedure was completed successfully without intraoperative or postoperative complications. The child recovered uneventfully. To our knowledge, this is among the youngest reported cases of robotic-assisted pyeloplasty performed via SSI Mantra Robotic system (Sudhir Srivastava Innovations Pvt. Ltd., India. It highlights the feasibility of telerobotic interventions in urology.

Primary mucinous adenocarcinoma of the renal pelvis is an exceptionally rare malignancy that often mimics chronic stone disease or infected hydronephrosis. We report a 55-year-old man presenting with bilateral flank pain, bilateral nephrolithiasis, and giant right hydronephrosis. Ultrasound and contrast-enhanced computed tomography suggested obstructive infected hydronephrosis caused by a large ureteropelvic junction stone. During surgery, abundant gelatinous mucin and thickened friable renal pelvic mucosa raised suspicion for malignancy. Biopsy and final histopathology confirmed moderately differentiated mucinous adenocarcinoma. This case highlights the diagnostic difficulty of this tumor and the importance of intraoperative suspicion and histopathological assessment in longstanding obstructive stone disease.

Low-grade urothelial carcinoma of the bladder with an atypical stromal reaction and accumulation of osteoclast-like giant cells is a rare form of urothelial cancer. A meta-analysis of literature data over the past 53 years revealed 30 publications containing a total of 50 cases of this form of urothelial cancer. In [2]/3 of the cases, the primary tumor was located in the bladder, while the remaining cases were located in the renal pelvis. The disease is extremely aggressive: the median survival time is 12 months, and distant metastases are detected in 65% of cases. The article describes a clinical case of a patient with primary multiple synchronous cancers, including poorly differentiated urothelial carcinoma with osteoclast-like differentiation of the bladder, papillary renal carcinoma, and acinar adenocarcinoma of the prostate.

Mucinous cystic neoplasms of the liver (MCN-L) are rare cystic tumors defined by the presence of ovarian-type subepithelial stroma beneath mucin-secreting epithelium and carry a risk of malignant transformation, necessitating complete surgical excision. Giant MCN-L lesions are exceptionally uncommon, and data regarding minimally invasive management of such large tumors remain limited. A 44-year-old woman (American Society of Anesthesiologists I) presented with a six-month history of progressive right-sided abdominal fullness. Contrast-enhanced computed tomography revealed a large 27 × 18 × 19 cm thin-walled, unilocular cystic lesion arising from the posterior segments of the right hepatic lobe, extending into the pelvis. Laboratory investigations demonstrated microcytic hypochromic anemia (hemoglobin 9.6 g/dL), with preserved liver and renal function. Serum tumor markers showed carcinoembryonic antigen of 0.70 ng/mL, carbohydrate antigen 19-9 of 11.33 U/mL, cancer antigen-125 of 13.3 U/mL, and alpha-fetoprotein of 9.27 ng/mL. Hydatid serology was negative. The patient underwent laparoscopic right posterior sectionectomy (segments VI and VII) with cholecystectomy. Approximately 4.5 L of clear fluid was aspirated in a controlled manner to decompress the cyst and improve operative exposure. Complete excision of the cyst-replaced posterior sector was achieved. The operative time was approximately 210 minutes with an estimated blood loss of 150 mL. Histopathological examination confirmed mucinous cystic neoplasm with mucin-secreting epithelium (cytokeratin 7 positive, cytokeratin 20 negative) and characteristic ovarian-type stroma expressing estrogen and progesterone receptors, without dysplasia or malignancy. The postoperative course was uneventful, and the patient was discharged in stable condition. At one-year follow-up, there was no evidence of recurrence. This case highlights that laparoscopic right posterior sectionectomy is feasible for giant MCN-L, even when the lesion exceeds 25 cm, provided careful decompression and appropriate surgical expertise are available. At 27 cm, this represents one of the largest MCN-L successfully managed using a purely laparoscopic approach. Complete excision remains essential due to the malignant potential of these lesions.

A 66-year-old woman was referred for evaluation of a large pelvic mass suspected to be ovarian cancer. Contrast-enhanced computed tomography (CECT) revealed a giant multiseptated cystic pelvic mass with enhancing solid components; although its superior aspect closely abutted the gastric serosa, its predominant pelvic location raised concern for an adnexal malignancy. Subsequent [18F]fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) demonstrated mild uptake confined to the viable solid portion (SUVmax 2.72) without hypermetabolic nodal or distant metastases. Exploratory laparotomy revealed a giant pedunculated tumor arising from the gastric antrum and descending into the pelvis. Histopathology confirmed an epithelioid gastrointestinal stromal tumor positive for CD117, DOG1, and CD34. This case highlights an important diagnostic pitfall in which a giant exophytic gastric GIST may mimic ovarian cancer because of its pelvic location and cystic-solid appearance. Careful correlation of CECT, fused [18F]FDG PET/CT, and pathologic findings is essential for accurate assessment of the organ of origin in large abdominopelvic masses.

The southern giant pouched rat (Cricetomys ansorgei) is a large rodent utilised in recognition of landmines, pulmonary tuberculosis and Brucella infection. Additionally, they are kept as pet animals. The aim of this study was to describe the radiological anatomy of the pelvis and hind limb and to provide measurements of the hind limb bones in southern giant pouched rats. Radiological examinations were performed in 10 live and five dead adult southern giant pouched rats. The pelvis had a relatively short pelvic symphysis and the ischial tuberosities were less prominent. The obturator foramina and cranial opening of the pelvis had a pear-shape. The proximal extremity of the femur had well-developed major, minor and third trochanters, with the major trochanter extending higher than the femoral head. All rats had medial and lateral fabellae. Ossicles of the menisci were visualised. The mineralised popliteal sesamoid bone was not seen. Tibia and fibula were fused in the distal third of the crus. Seven tarsal bones were seen and the tarsal sesamoid bone was present in all rats. Five slender metatarsal bones and digits were present. The os penis was seen in all male rats. The tibia was the longest bone of the hind limb. This study has provided the radiological anatomy of the pelvis and hind limb of the southern giant pouched rat. Information from this study will be beneficial to anatomists, clinicians and students in more understanding of the functional anatomy of the pelvis and hind limb of southern giant pouched rats.

Musculoskeletal complaints of the shoulder/pelvic girdle are symptoms frequently described in patient care and are attributed to degenerative changes associated with increasing patient age. Polymyalgia rheumatica(PMR) is the second most common differential diagnosis of an inflammatory genesis after rheumatoid arthritis and should be ruled out. Patients diagnosed with PMR exhibit symptoms such as acute weakness, pain, morning stiffness in the neck, shoulders and pelvis. The manifestation of B-symptoms is possible. The clinical examination should encompass differential diagnoses and complications, such as giant cell arteritis. Laboratory testing shows elevated levels of inflammatory markers in almost all cases. Arthrosonography reveals tenosynovitis of the biceps tendon, bursitis or joint effusion of the hip. The initial treatment for PMR is the administration of steroids. In cases of disease activity, methotrexate, sarilumab or rituximab may be considered as potential treatment options.

Chondrosarcoma is one of the most common primary malignant bone tumors in adults, with a predilection for sites such as the pelvis and femur. This article reports a rare case of giant chondrosarcoma originating from the manubrium sterni in a 42-year-old male patient. The patient presented to the outpatient clinic with chest pain accompanied by chest wall swelling. Physical examination revealed a firm mass at the manubrium, and chest CT demonstrated osteolytic destruction of the sternum. Needle biopsy pathology was suggestive of chondrosarcoma. A multidisciplinary team performed a radical resection of the sternal tumor. The postoperative outcome was favorable, with a stable thoracic cage. Histopathological examination confirmed the diagnosis of grade II chondrosarcoma.

Intussusception is a condition in which one segment of the intestine (intussusceptum) telescopes into the lumen of an adjacent segment (intussuscipiens), potentially leading to obstruction. Giant colonic lipomas are rare and often asymptomatic, but when large enough, can serve as a lead point for intussusception. We present the case of a 62-year-old male patient who presented with nausea and vomiting. A computed tomography (CT) abdomen/pelvis without contrast showed intussusception of the ascending colon into the transverse colon without bowel obstruction, along with a lobulated fatty mass at the tip of the intussusceptum. This mass was suspected to be a colonic lipoma serving as the lead point. Due to the patient's benign abdominal exam, emergent surgical intervention was deferred. A colonoscopy then revealed a large, 5 cm pedunculated lipoma in the transverse colon near the hepatic flexure. An Endoloop was applied and tightly cinched around the base of the lesion. He was discharged in stable condition with recommendations for close gastroenterology follow-up. The purpose of presenting this case is to highlight the utilization of endoscopy in management of colonic intussusception caused by a structural lesion, as well as the importance of considering intussusception as the cause of a patient's nausea and vomiting (although it is a rare cause in adults). A CT scan is helpful in establishing this diagnosis and guiding management. Furthermore, if intussusception is suspected in an adult, it is important to consider a structural lesion that may be acting as a lead point, such as an intraluminal tumor or mass.

BACKGROUND AND CLINICAL SIGNIFICANCE: Intravenous leiomyomatosis is a very rare disease that occurs in women of childbearing age and perimenopausal women. It starts from the wall of the venous blood vessels of the uterus or pelvis, which spread upward along the blood vessels to the inferior vena cava. When the tumor extends into the cardiac chambers, patients are at high risk for perioperative anesthesia when they undergo surgery. CASE PRESENTATION: A 38-year-old female patient was admitted to the hospital due to recurrent syncope. Transthoracic echocardiography revealed a mass occupying the right atrium and inferior vena cava. The mass prolapsed into the right ventricle through the tricuspid valve. The patient experienced a sudden loss of consciousness and exhibited respiratory arrest with facial and lip cyanosis during general anesthesia induction. We tried a new anesthesia induction method - extracorporeal circulation was established before induction of anesthesia, which allowed the surgery to proceed successfully. CONCLUSION: This case provides a new ideal for anesthesia management for patients with giant intracardiac and intravenous leiomyomatosis.