Publications by authors named "Mamta Sengar"

23 Publications

  • Page 1 of 1

Atypical scrotal masses: Surgical surprise.

Trop Doct 2021 Aug 9:494755211036588. Epub 2021 Aug 9.

Director Professor, Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalya, New Delhi 110031, India.

We present three unusual cases of atypical scrotal lesions in children. The first was a firm left scrotal mass with the testis indistinguishable. The second with apparently a large hydrocoele, which was a cyst, and the third with multiple nodular lesions, pushing the left testis into the right hemiscrotum. These turned out to be a pigmented neuroectodermal tumour, a lymphatic malformation and neurofibromas respectively. Paediatric surgeons should be aware of such surgical surprises.
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http://dx.doi.org/10.1177/00494755211036588DOI Listing
August 2021

Lipofibromatosis: A Rare Diagnosis on Fine Needle Aspiration Cytology.

Turk Patoloji Derg 2020 ;1(1):268-274

Departments of Pathology, Chacha Nehru Bal Chikitsalaya, Geeta Colony, DELHI, INDIA.

Lipofibromatosis is a recently recognized slow growing rare pediatric tumor. Paucity of its cytological description in the literature leads to its pre operative misdiagnosis and further incomplete management. A twelve-month-old female presented with a rapidly progressive mass in the right thigh and buttock region. On examination, the mass was huge and involved the medial, posterior and lateral aspects of the thigh. The cytological smears showed mature adipocytes with few spindled out cells. FNA was reported as a lipoma, corroborating with the radiological presumptive diagnosis. However, histopathological and immunohistochemical features favoured a diagnosis of Lipofibromatosis. The cytological smears were reviewed and a cyto-histo correlation was established. The diagnosis of Lipofibromatosis rests upon classical cytological features in a clinically and radiologically suggestive picture. An early and accurate diagnosis if established can help the surgeon plan excision with wider margins as incomplete excision is associated with a high rate of recurrence.
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http://dx.doi.org/10.5146/tjpath.2020.01479DOI Listing
December 2020

Non-malignant fibroblastic/myofibroblastic tumors in pediatric age group: Clues and pitfalls to the cytological diagnosis.

Cytopathology 2020 03 7;31(2):115-121. Epub 2020 Feb 7.

Department of Paediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India.

Introduction: Fibroblastic/myofibroblastic tumors constitute 12% of all pediatric soft tissue tumors with the majority of them belonging to the benign and intermediate prognostic categories. They are often misdiagnosed owing to their variable clinical presentation and unusual microscopic features. The diagnosis, specially cytological diagnosis of benign and intermediate categories is difficult due to paucity of cellular component and increased amount of extracellular matrix as compared to malignant ones. We hereby discuss the Fine needle aspiration cytology (FNAC) findings of non-malignant fibroblastic/myofibroblastic lesion in the pediatric age group encountered at our institute.

Methods: All the benign and intermediate fibroblastic/myofibroblastic/fibroadipocytic lesions (age 0-12 years) diagnosed on FNAC over a period of 3½ years (Jan 2016- July 2019), with availability of corresponding histopathology were included in the study.

Results: A total of seven pediatric benign and intermediate fibroblastic/myofibroblastic lesions with histopathological confirmation were identified which included Infantile digital fibromatosis (IDF) (n = 2), Lipofibromatosis (n = 1), Fibrous hamartoma of infancy (FHI) (n = 1), Fibromatosis colli (FC) (n = 2) and myofibroma/myofibromatosis (n = 1). FNAC smears were mainly paucicellular with presence of benign spindle shaped cells in a collagenous stroma common to almost all the cases. A few additional findings such as degenerated skeletal muscle fibres, muscle giant cells and mature adipose tissue were also present in some cases.

Conclusion: Fibroblastic/myofibroblastic tumors although uncommon, form an important category that must be considered in the differential diagnosis of pediatric soft tissue tumors. FNAC cytology features when assessed in a proper clinical setting (specially the age and site of presentation) are helpful in suggesting probable preoperative diagnosis in these lesions.
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http://dx.doi.org/10.1111/cyt.12786DOI Listing
March 2020

Intraoral Foregut Cystic Developmental Malformations: Three cases with a brief review of literature.

Sultan Qaboos Univ Med J 2019 Aug 5;19(3):e257-e261. Epub 2019 Nov 5.

Department of Pathology, Chacha Nehru Bal Chikitsalya, Delhi, India.

Foregut cystic developmental malformations (FCDM) are a type of rare cystic lesion. The occurrence of FCDM is exceedingly uncommon in the intraoral location. We report three cases of FCDM with intraoral location who presented at Chacha Nehru Bal Chikitsalaya, New Delhi, India, in 2016, 2017 and 2018 with symptoms of respiratory distress and feeding difficulties. Two patients were male and one was female with an age range of 29 days to eight years. The clinical differential diagnosis included mucocele, ranula, dermoid, lymphangioma, teratoma, thyroglossal duct cyst, etc. All patients were treated with simple surgical excision and diagnosed, based on histopathology, with FCDM. These should be considered as differential diagnosis of head and neck midline cystic mass lesions. This case report aimed to discuss differential diagnosis and appropriate terminology for these cystic masses as there is varied and ambiguous nomenclature.
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http://dx.doi.org/10.18295/squmj.2019.19.03.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839678PMC
August 2019

Infantile digital fibromatosis: Clues and pitfalls for cytological diagnosis.

Cytopathology 2019 09 1;30(5):565-566. Epub 2019 Jul 1.

Department of Paediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India.

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http://dx.doi.org/10.1111/cyt.12734DOI Listing
September 2019

Retinal Anlage Tumor of Epididymis: A Diagnostic Challenge on Cytology.

Acta Cytol 2019;63(1):73-74. Epub 2018 Nov 19.

Department of Paediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi, India.

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http://dx.doi.org/10.1159/000494124DOI Listing
March 2019

Childhood Phimosis Secondary to Lichen Sclerosus: Is There a Spatial Pattern of Histopathological Changes?

Am J Dermatopathol 2018 Nov;40(11):824-828

Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi, India.

Introduction: The accurate histopathological diagnosis of the phimotic prepuce is indispensable because early diagnosis, treatment, and close follow-up are crucial in genital dermatosis such as lichen sclerosus (LS). This study analyzes the histopathological spectrum of childhood phimosis with special emphasis on LS. We also highlight a peculiar pattern of histopathological evolution in LS, prepuce.

Material And Methods: The histopathology slides of all the pediatric preputial circumcision specimens performed for the indication of pathological phimosis (n = 43) during the study period (2012-2017) were analyzed. Eight histopathological features viz. hyperkeratosis, hypergranulosis, epidermal atrophy, acanthosis, dermoepidermal cleft, upper dermal edema and homogenization, mid dermal lymphocytic band, and interface dermatitis were studied in each case, separately in inner preputial surface, tip, and outer preputial surface. On the basis of evolution of the disease and histopathological features, the lesions of LS were classified into early, established, and advanced.

Result: LS was found in 32 cases, whereas 11 cases showed nonspecific inflammation and fibrosis. The upper dermal homogenization (n = 29), dermoepidermal cleft (n = 28), and mid dermal band (n = 27) were the commonest histopathological changes. The established and advanced changes were confined to the inner preputial surface (n = 31), and the outer preputial skin surface was unaffected in all the cases. A peculiar histopathological evolution pattern was seen with established or advanced lesions, early lesion, and normal histology on the inner preputial surface, mucocutaneous junction, and outer preputial skin, respectively.

Conclusions: LS is a common cause of childhood phimosis. It shows a peculiar histopathological evolution that mandates the thorough analysis of inner mucosal surface.
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http://dx.doi.org/10.1097/DAD.0000000000001248DOI Listing
November 2018

Spigelian hernia in children: low versus classical.

J Pediatr Surg 2018 Nov 23;53(11):2346-2348. Epub 2018 Jun 23.

Department of Pediatric Surgery, Chacha Nehru BalChikitsalaya, Geeta Colony, Delhi 110031, India.

Purpose: Pediatric spigelian hernias are very rare. They are often missed or misdiagnosed. A series of cases with spigelian hernia, presented to a tertiary care center are presented here with emphasis on different anatomy of spigelian hernias with cryptorchidism and those without associated cryptorchidism.

Materials And Methods: Over a period of seven years, nine cases of spigelian hernia presented to our tertiary care center. Male:female ratio was 3:1.There was a preponderance of right sided hernias. Three patients had associated cryptorchidism. One patient had associated lumbar hernia. All three patients with cryptorchidism had low spigelian hernia while others had classical spigelian hernia.

Conclusion: There is a likelihood of anatomical variation in SH associated with UDT and those without UDT. Understanding this anatomy may help in correct scrotal placement of testis.

Type Of Study: Prospective Observational.

Level Of Evidence: 4.
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http://dx.doi.org/10.1016/j.jpedsurg.2018.06.016DOI Listing
November 2018

Occult intrasacral meningocele leading to inadvertent dural tap during caudal block detected by point of care ultrasonography.

Paediatr Anaesth 2016 Nov;26(11):1115-1116

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalya, Geeta Colony, Delhi, India.

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http://dx.doi.org/10.1111/pan.12973DOI Listing
November 2016

Mature Teratoma in a Supernumerary Ovary in a Child: Report of the First Case.

J Pediatr Adolesc Gynecol 2016 Feb 1;29(1):e5-7. Epub 2015 Aug 1.

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.

Background: Supernumerary ovary (ie, ovarian ectopia having no anatomic connection with the normally placed ovaries) is a rare gynecologic condition. To the best of our knowledge, only 1 pediatric case of supernumerary ovary has been reported to date in the English literature.

Case: A 4-year-old girl was assessed for foul-smelling vestibular discharge and was found to have a fistulous tract with opening near the vaginal orifice. Fistuloscopy revealed hair in the lumen of the tract. Computed tomography scan showed a retroperitoneal mass in continuation of the tract. Excision of the mass revealed a mature teratoma in a retroperitoneal supernumerary ovary.

Summary And Conclusion: Supernumerary ovary, a gynecologic rarity, is even more uncommon in children. Hence, a thorough clinical-radiological-pathological correlation is mandatory to diagnose extragonadal ovarian tumors arising in supernumerary ovaries.
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http://dx.doi.org/10.1016/j.jpag.2015.07.005DOI Listing
February 2016

Visceral sequestration with bladder exstrophy: associated or coincidence?

Indian J Pediatr 2014 Oct 5;81(10):1120-1. Epub 2014 Apr 5.

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi, 110031, India,

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http://dx.doi.org/10.1007/s12098-014-1418-3DOI Listing
October 2014

Spontaneous Biliary Perforations: An Uncommon yet Important Entity in Children.

J Clin Diagn Res 2013 Jun 1;7(6):1201-6. Epub 2013 Jun 1.

Assistant Professor, Department of Pediatric Surgery, King George's Medical University , Lucknow, UP, India .

Spontaneous or idiopathic biliary perforations are an infrequently encountered but an important cause of surgical jaundice in paediatric patients and one of the most common causes of surgical jaundice in infancy. A pre-operative diagnosis with a clinical history and physical findings may not be possible in most of the cases. The exact cause of the perforation remains unclear and the diagnosis is made at the time of laparotomy for an acute abdomen. An early, efficient and an effective surgical management is associated with a good prognosis; however, a delay in the correct diagnosis or an inappropriate management may result in bacterial contamination of the biliary ascites, with an unfavourable outcome. The relative rarity of this condition is reflected by the very few case reports, limited case studies and scarcity of published literature.
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http://dx.doi.org/10.7860/JCDR/2013/5429.3076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708237PMC
June 2013

Delayed repair of posttraumatic bronchial transection.

J Pediatr Surg 2013 Jul;48(7):1609-12

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi 110031, India.

Tracheobronchial injuries (TBI) are uncommon but potentially fatal injuries that can occur following blunt trauma to the thoracic region. Occasionally the diagnosis is not made at initial presentation, and patients present late with various sequelae. A 3 year old boy sustained blunt thoracic injury and developed respiratory distress, pneumothorax, and subcutaneous emphysema, which were managed conservatively with intercostal tube. Bronchoscopy performed to assess the cause of persistent collapse of the right lung and continued respiratory distress showed complete block of right main bronchus one cm away from the carina. Thoracotomy was performed and the transected ends of the bronchus were anastomosed. Postoperatively the right lung expanded with relief in respiratory distress. This report highlights the success of delayed repair of TBIs as an alternative to pneumonectomy.
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http://dx.doi.org/10.1016/j.jpedsurg.2013.05.015DOI Listing
July 2013

Multiple palpable nodules: do not miss the great toes.

Indian J Pediatr 2013 Dec 20;80(12):1065-6. Epub 2013 Jul 20.

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi, India.

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http://dx.doi.org/10.1007/s12098-013-1142-4DOI Listing
December 2013

Colorectal duplication with prostatorectal fistulae.

J Pediatr Surg 2013 Apr;48(4):869-72

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi, India 110031.

Tubular colonic duplications are rare malformations and its association with prostatorectal fistula is extremely rare with only one case reported to date. We report the successful management of an 8 year old child with communicating tubular colonic duplication with prostatorectal fistulae. Tubular colonic duplications may be difficult to diagnose due to varied presentations, therefore a high degree of suspicion should be present while managing children with isolated congenital recto urinary fistulas.
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http://dx.doi.org/10.1016/j.jpedsurg.2012.12.032DOI Listing
April 2013

Gastrointestinal mucormycosis: a success story and appraisal of concepts.

J Infect Public Health 2013 Feb 16;6(1):58-61. Epub 2012 Nov 16.

The Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Affiliated to Maulana Azad Medical College, Delhi 110031, India.

Mucormycosis is an opportunistic, life-threatening fungal infection caused by fungi of the class Zygomycetes. The disease has traditionally been reported in immunocompromised patients, premature infants, diabetics, transplant recipients, prolonged use of corticosteroids or in condition associated with increased availability of serum iron such as acidosis or deferoxamine administration. The infection is progressive and associated with a high mortality unless treatment is initiated promptly. The number of cases of gastrointestinal mucormycosis indexed on PubMed over the past 2 decades has shown an alarming rise. Moreover, the infection is being increasingly reported in patients without the traditional risk factors. We report successful management of an immunocompetent child with gastrointestinal mucormycosis who responded to aggressive treatment with surgical debridement and antifungal agents. The fungicidal activity of colistin (polymyxin E) has also been highlighted.
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http://dx.doi.org/10.1016/j.jiph.2012.08.004DOI Listing
February 2013

Is antenatal detection of Wilms' tumor a bad prognostic marker?

Indian J Med Paediatr Oncol 2011 Oct;32(4):214-6

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.

Antenatal detection of Wilms' tumor is rare and only nine cases have been reported till now in the English literature. We report a case of a 7-month-old child with prenatally detected renal mass managed by nephroureterectomy associated with intraoperative spill. The child developed recurrence while on DD4A chemotherapy. Salvage chemotherapy was initiated but there was no response after two cycles and the child expired due to tumor rupture.
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http://dx.doi.org/10.4103/0971-5851.95144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3343249PMC
October 2011

Intercostal variant of lumbar hernia in lumbocostovertebral syndrome: our experience with 6 cases.

J Pediatr Surg 2011 Oct;46(10):1974-7

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi—110031, India.

Lumbocostovertebral syndrome (LCVS) is a rare type of congenital lumbar hernia. Its features include lumbar hernia associated with genitourinary, vertebral, and rib anomalies. Less than 25 cases have been reported to date. We describe the clinical manifestations and associated anomalies in 6 cases of LCVS managed by us. The patients with suspected LCVS syndrome should be evaluated by detailed clinical history, examination, conventional radiography, magnetic resonance imaging spine, ultrasound abdomen, and echocardiography. The defect can be repaired using local tissues in infancy. There is a need for long-term follow-up for possible late recurrence and scoliosis.
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http://dx.doi.org/10.1016/j.jpedsurg.2011.05.010DOI Listing
October 2011

Gastric teratoma with predominant nephroblastic elements.

Pediatr Surg Int 2010 Sep 13;26(9):923-5. Epub 2010 Jul 13.

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya (affiliated to Maulana Azad Medical College), Delhi, India.

Gastric teratoma is an uncommon neoplasm in infancy. Most of the gastric teratomas described have mature elements while some have immature elements. Occurrence of nephroblastic rests in gastric teratoma has not been described in available literature earlier.
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http://dx.doi.org/10.1007/s00383-010-2670-xDOI Listing
September 2010

Prolapse of the rectum associated with spontaneous rupture of the distal colon and evisceration of the small intestine through the anus in an infant.

J Pediatr Surg 2008 Dec;43(12):2291-2

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, affiliated to Maulana Azad Medical College, Geeta colony, Delhi 110031, India.

Prolapse of rectum of varying degrees is a well-known entity in children. Spontaneous rupture of the rectum along with massive ileal evisceration because of increased intraabdominal pressure is a rare complication of rectal prolapse in the adults. Rectal prolapse in children is usually a benign condition. Known complications of the rectal prolapse in children include recurrent mucosal ulceration, bleeding, and proctitis. Spontaneous rupture of the rectum with or without ileal evisceration has not been previously reported in infants.
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http://dx.doi.org/10.1016/j.jpedsurg.2008.09.003DOI Listing
December 2008

Perineal lipoma associated with penoscrotal transposition in a neonate.

J Indian Assoc Pediatr Surg 2008 Oct;13(4):155-6

Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya and Maulana Azad Medical College, Geeta Colony, Delhi-110 031, India.

A neonate with perineal lipoma associated with penoscrotal transposition and bifid scrotum is reported.
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http://dx.doi.org/10.4103/0971-9261.44772DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788467PMC
October 2008

Combined abdominal and posterior sagittal approach for redo pull-through operation in Hirschsprung's disease.

J Pediatr Surg 2002 Aug;37(8):1156-9

Department of Pediatric Surgery, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.

Background/purpose: In Hirschsprung's disease (HD) redo pull-through (PT) is indicated for anastomotic complications and retained aganglionosis after a previous operation. Duhamel or Swenson method is used commonly for redo operations. The pelvic dissection may be difficult, especially in Swenson's type of operation, because of fibrosis resulting from previous surgery or its complications. To overcome this, the authors used a combined abdominal and posterior sagittal approach to perform redo pull-through of Swenson's type in 4 children.

Methods: Four boys (2.5 to 12 years) underwent redo pull-through for failed endorectal pull through (n = 2), persistent symptoms after 2 myectomies (n = 1) and late anastomotic disruption after Swenson's PT (n = 1). Abdominal dissection was done first to mobilize colon and resect aganglionic segment as far as the mid pelvis. The mobilized ganglionic colon was tacked to the pelvic rectal stump, hemostasis checked, and the abdomen closed. The lower pelvic dissection was done through the posterior sagittal route, under direct vision. The remainder of diseased rectum was excised, and the pull-through colon was retrieved and anastomosed to the anal stump. No covering colostomy was done.

Results: A rectocutaneous fistula developed in one patient, which healed spontaneously. All patients had increased stool frequency in the early postoperative period but improved with time. All patients have attained normal voluntary bowel actions, but one child has infrequent minor soiling. There was no anastomotic narrowing in any case.

Conclusions: Posterior sagittal approach is a useful alternative in difficult redo pull-through surgery. It offers excellent exposure, precise dissection, and direct anastomosis. There are minimal chances of complications, and continence is retained.
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http://dx.doi.org/10.1053/jpsu.2002.34462DOI Listing
August 2002
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