Current guidelines recommend dual-tracer sentinel lymph node biopsy in post neo-adjuvant chemotherapy node-negative (ycN0) breast cancer. Standard dual-tracer requires radiocolloid, which is often unavailable in low-to-middle-income countries. We evaluated a combination of methylene blue and fluorescein dyes as a low-cost alternative.
Subcutaneous filariasis is an uncommon manifestation of lymphatic filariasis, which remains a major parasitic disease in tropical and subtropical regions, particularly in India. Although the disease classically presents with lymphatic obstruction, hydrocoele, lymphoedema, and elephantiasis, localised subcutaneous filariasis is uncommon and may clinically resemble a benign soft-tissue lesion. High-resolution ultrasonography can facilitate diagnosis by demonstrating the characteristic ‘filarial dance sign’, representing motile filarial worms within dilated lymphatic channels.
Massive scrotal elephantiasis secondary to lymphatic filariasis is a disabling condition prevalent in endemic regions, causing severe physical, functional and psychosocial disability. Resected scrotal tissue may approach 30 kg, with a concomitant filarial hydrocoele. The penis is usually buried within the scrotal mass and then causes urinary soiling, giving a constant embarrassing smell, but may exhibit a Ram's horn deformity. The perineal skin is consistently uninvolved and may be used for total scrotal reconstruction in all cases. The inner lining of the prepuce is also spared and utilized for penile shaft coverage.
