Medico language

Once a professor of surgery was traveling with his post graduate in a car. In between when they parked for relaxation the PG saw the tyre on one side and shocked to see the tyre as seen in picture. the professor as usual asked him to present what has happened.PG :There is evidence of a solitary,well circumscribed lobulated non-pulsatile ,sessileiisoappearing-tyre lesion at the supero-lateral aspect of tyre noted, smooth surface,Cystic, partially reducible, compressible,non tender,not mobile, resonant over the swellingpresumably filled with air & seen just abutting the metallic rim with no obvious erosion,
General examination revealed no finding sProfessor : what’s it?P.G:Possibly an Uncomplicated Tyrocele. differential diagnosis Tyroma, tyrogenic aneurysm, chronic Calcified tubogenic aneurysm, tyropneumtocele,rare possiblity of tyrogenic ca .Traumatic tubal cyst also possiblitydue to An Acute blunt mechanical injury,chronic frictIon trauma to surface covering.Professor:. What will you?Whole part resection and water immersion test.Prof :Any precaution ?PG: never F N A C to be attempted .FNAC/Biopsy may “puncture” the swelling leading to blast inury.Prof: what’s the management?PG: if water immersion test is negative… only total Tyre replace ment.if test showed puncture either hot or cold tubosealant application.If multiple secondary cysts or multiple punctures are seen thenTemporary stephnoplasty following total tubo -tyre replacemnt,or single stage total tubo -tyre replacemnt if stephney is new.Follow up suggested for other tyres.Prognosis is very good.Prof,: ok go ahead.