Minutus

I would like to know your opinion about this case
Mr Xavier aged 59 .diagnosed to have Malignant fibrous histocytoma.In the left mid thigh . Operated thrice with in 1&half years .Last operation on 4/6/01 .Pain and swelling reappeared with in 4 months .Pains are burning type agg at night ,on slightest motion ,lying on painful side , on exposure to fanning or air , so does not use fan (earlier hot pt ), does not cover as sweating agg .some times pains are pricking type Left leg has pitting oedema. Sensation of numbness below the left knee (after the anaesthesia for third operation)

Appetite decreased takes only liquids easy satiety , .thirst decreased drinks small quaintest at a time . Prefers warm food .Aversion to sweets , spices , chillies . so rice water (his main food) is taken with little salt no curry (less than usual salt is used ) Sleep decreased and impossible due to pain . sweats decreased almost nil.
Morally he is a fluric acid . Never cared for his family . Alcoholic for more than 55yrs (started to drink at the age of 5) selfish ,with many extra marital relation felt proud to tell about this to his wife .during case taking told that females die on him with shining eyes . Always boast , tries to show that he is great .
CTof Lower extremity report 19/10/01 anatomy is distorted due to previous surgeries. Large mass lesion showing multiple irregular thick septation enhancing solid components centrally and peripherally noted in medial and posterior part of the thigh extending from the level approximately 5cm above the medial condyle of left femur . No calcification. lesion 8cms(AP) * 9cms (trns ) in its thickest part at the proximal thigh and is thinner inferiorly . Lt obturator involved .A part of abbuctor longus , adductor longus, brevis and magnus not seen . Cortical break noted in femorl shaft medially in the lower part probably there is minimal periosteal rection and irregularity No sclerosis or sequistera.
Impression Large lesion of multiloculated appearance ,predominantly cystic with solid component and with infiltration of muscles and bone ....recurrence of soft tissue tumour . Possibility of an associated abscess should also be considered as the features .

As the Case is of advanced patho , and the pt being Silecea 1M (complementry of fluric acid ) was given on 1/12/ 01 ,pain increased with rise in temp at the site on the following day , on 8/12/01 on the medial side of mid thigh a 0.5cms diameter circle appeared with reddeness, as if going to point but till today on pointing .pt has severe pain .

Akhilesh Raja
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I would like to know your opinion about this case
Mr Xavier aged 59 .diagnosed to have Malignant fibrous histocytoma.In the left mid thigh . Operated thrice with in 1&half years .Last operation on 4/6/01 .Pain and swelling reappeared with in 4 months .Pains are burning type agg at night ,on slightest motion ,lying on painful side , on exposure to fanning or air , so does not use fan (earlier hot pt ), does not cover as sweating agg .some times pains are pricking type Left leg has pitting oedema. Sensation of numbness below the left knee (after the anaesthesia for third operation)

Appetite decreased takes only liquids easy satiety , .thirst decreased drinks small quaintest at a time . Prefers warm food .Aversion to sweets , spices , chillies . so rice water (his main food) is taken with little salt no curry (less than usual salt is used ) Sleep decreased and impossible due to pain Sleepy but cannot sleep, when going into sleep delusion as if somebody calling him or feels as if falling and wakes. sweats decreased almost nil. Stools Constipated No stools for 3-4 days Feels as if a ball is obstructing the bowel movement.
Morally he is a fluric acid . Never cared for his family . Alcoholic for more than 55yrs (started to drink at the age of 5) selfish ,with many extra marital relation felt proud to tell about this to his wife .during case taking told that females die on him with shining eyes . Always boast , tries to show that he is great .
CTof Lower extremity report 19/10/01 anatomy is distorted due to previous surgeries. Large mass lesion showing multiple irregular thick septation enhancing solid components centrally and peripherally noted in medial and posterior part of the thigh extending from the level approximately 5cm above the medial condyle of left femur . No calcification. lesion 8cms(AP) * 9cms (trns ) in its thickest part at the proximal thigh and is thinner inferiorly . Lt obturator involved .A part of abbuctor longus , adductor longus, brevis and magnus not seen . Cortical break noted in femorl shaft medially in the lower part probably there is minimal periosteal rection and irregularity No sclerosis or sequistera.
Impression Large lesion of multiloculated appearance ,predominantly cystic with solid component and with infiltration of muscles and bone ....recurrence of soft tissue tumour . Possibility of an associated abscess should also be considered as the features .

As the Case is of advanced patho , and the pt being Silecea 1M (complementry of fluric acid ) was given on 1/12/ 01 ,pain increased with rise in temp at the site on the following day , on 8/12/01 on the medial side of mid thigh a 0.5cms diameter circle appeared with reddeness, as if going to point but till today no pointing .pt has severe pain .

Akhilesh Raja
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Dear Akhilesh,

When I read your case notes I focused primarily on the mental symptoms and
the remedy which leapt out at me had much of Platina about it, e.g. the
haughtiness and arrogance, sexual promiscuity, boasting, etc. Platina also
has the tendency to produce fibroids and induration.

I hope this helps,

Hugh