Paragangliomas are rare neuroendocrine tumors that frequently arise in the organ of Zuckerkandl (OZ). Surgical resection remains the cornerstone of treatment. Although vascular resection and reconstruction have been reported in a few cases, no prior reports have documented the simultaneous resection of both the aorta and inferior vena cava (IVC), along with their bifurcation. We present the case of a 50-year-old man with a large paraganglioma of the OZ, successfully managed through combined resection of the aorta, IVC, their bifurcation, and the psoas muscle. Dacron Y-grafts were used to reconstruct both the aorta and IVC. This case underscores the importance of detailed anatomical knowledge of major vessels, meticulous vascular control, and the technical intricacies of vascular reconstruction. We emphasize the significance of comprehensive perioperative management and provide a literature review on en bloc vascular resection for paraganglioma, offering insights into current surgical practices and outcomes.

Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with a dismal prognosis. Atezolizumab plus bevacizumab (atezo-bev) is the recommended palliative treatment, and approximately 10% of the patients may experience a complete response (CR), according to the mRECIST criteria. The treatment duration is until disease progression or unacceptable side effects occur. Long-term continuation can cause potential toxicities and a substantial financial burden, making early treatment discontinuation a viable option. This report describes durable CR after discontinuing atezo-bev treatment in three patients with HCC and PVTT.

During routine dissection, we observed a unique case of unilateral polydactyly in the left foot of a 61-year-old male cadaver. We observed the medial head of the quadratus plantae (QP) muscle, which gave off an additional tendinous slip before joining the lateral head of QP. The 4th tendon of the flexor digitorum longus (FDL) was bifurcated into two tendinous parts after receiving a thin fibrous slip from the tendinous slip of the medial head of QP. The medial division of the 4th tendon of FDL passed forward and attached to the base of the distal phalanx of the 5th toe. The extra tendinous slip from the medial head of QP was attached distally to the lateral division of the 4th tendon of FDL and formed a common anomalous tendon to the 6th toe. The knowledge of this variation would be helpful in reconstructive foot surgeries and correction of congenital deformities.

Background: In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.Case presentation: He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement. Conclusions Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.

Paragangliomas are rare neuroendocrine tumors that frequently arise in the organ of Zuckerkandl (OZ). Surgical resection remains the cornerstone of treatment. Although vascular resection and reconstruction have been reported in a few cases, no prior reports have documented the simultaneous resection of both the aorta and inferior vena cava (IVC), along with their bifurcation. We present the case of a 50-year-old man with a large paraganglioma of the OZ, successfully managed through combined resection of the aorta, IVC, their bifurcation, and the psoas muscle. Dacron Y-grafts were used to reconstruct both the aorta and IVC. This case underscores the importance of detailed anatomical knowledge of major vessels, meticulous vascular control, and the technical intricacies of vascular reconstruction. We emphasize the significance of comprehensive perioperative management and provide a literature review on en bloc vascular resection for paraganglioma, offering insights into current surgical practices and outcomes.

Paragangliomas are rare neuroendocrine tumors that frequently arise in the organ of Zuckerkandl (OZ). Surgical resection remains the cornerstone of treatment. Although vascular resection and reconstruction have been reported in a few cases, no prior reports have documented the simultaneous resection of both the aorta and inferior vena cava (IVC), along with their bifurcation. We present the case of a 50-year-old man with a large paraganglioma of the OZ, successfully managed through combined resection of the aorta, IVC, their bifurcation, and the psoas muscle. Dacron Y-grafts were used to reconstruct both the aorta and IVC. This case underscores the importance of detailed anatomical knowledge of major vessels, meticulous vascular control, and the technical intricacies of vascular reconstruction. We emphasize the significance of comprehensive perioperative management and provide a literature review on en bloc vascular resection for paraganglioma, offering insights into current surgical practices and outcomes.

During routine dissection, we observed a unique case of unilateral polydactyly in the left foot of a 61-year-old male cadaver. We observed the medial head of the quadratus plantae (QP) muscle, which gave off an additional tendinous slip before joining the lateral head of QP. The 4th tendon of the flexor digitorum longus (FDL) was bifurcated into two tendinous parts after receiving a thin fibrous slip from the tendinous slip of the medial head of QP. The medial division of the 4th tendon of FDL passed forward and attached to the base of the distal phalanx of the 5th toe. The extra tendinous slip from the medial head of QP was attached distally to the lateral division of the 4th tendon of FDL and formed a common anomalous tendon to the 6th toe. The knowledge of this variation would be helpful in reconstructive foot surgeries and correction of congenital deformities.

During routine dissection, we observed a unique case of unilateral polydactyly in the left foot of a 61-year-old male cadaver. We observed the medial head of the quadratus plantae (QP) muscle, which gave off an additional tendinous slip before joining the lateral head of QP. The 4th tendon of the flexor digitorum longus (FDL) was bifurcated into two tendinous parts after receiving a thin fibrous slip from the tendinous slip of the medial head of QP. The medial division of the 4th tendon of FDL passed forward and attached to the base of the distal phalanx of the 5th toe. The extra tendinous slip from the medial head of QP was attached distally to the lateral division of the 4th tendon of FDL and formed a common anomalous tendon to the 6th toe. The knowledge of this variation would be helpful in reconstructive foot surgeries and correction of congenital deformities.

Background: In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.Case presentation: He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement. Conclusions Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.