Unusual metastasis of renal cell carcinoma. A case report with review of the literature

BACKGROUND: The occurrence of metastasis of renal cell carcinomas in the head and neck region is extremely rare. Metastasis in the larynx, hypopharynx, and the nasal sinuses has been reported. We report here about a 55-year-old female with metastasis in the soft palate and tonsil, which occurred 10 years following tumor nephrectomy. RESULTS AND CONCLUSIONS: The incidence of metastasis in renal cell carcinomas can be observed even many years following initial curative treatment of the primary tumor. Although rare in the region of the head and neck, they can often be mistaken for benign tumors such as hemangiomas or inflammatory tissue. The treatment of choice is radical surgical resection.     

Cutaneous metastasis of signet ring cell adenocarcinoma

A 20-year-old man with acute lymphoblastic leukaemia (ALL) in second complete remission underwent sibling donor transplant. Post-transplant there was haematological and immunophenotypic evidence of persisting disease. Cyclosporine was abruptly discontinued and following this the leukaemic clone disappeared. Discontinuation of immunosuppression may be of benefit in leukaemia which persists following transplant.     

Synchronous lingual granular cell tumor and squamous carcinoma. A case report and review of the literature

PURPOSE: The aim of this article is to determine the outcome of the pelvic pouch after the occurrence of a fistula. MATERIALS AND METHODS: From 1983 to 1995, 1,040 pelvic pouch surgeries were done at our institution. We reviewed the records of all patients with pouch-related fistulas. Data were collected from chart reviews and our pouch registry. RESULTS: Among 59 patients (22 males) with fistulas, mean age was 33 (range, 19-57) years. Preoperative diagnosis was mucosal ulcerative colitis (n = 52), indeterminate colitis (n = 6), and familial polyposis (n = 1). Site of fistulas included pouch/vaginal (n = 24), pouch/ cutaneous (n = 11), pouch/perineal (n = 16), and pouch/ presacral (n = 8). Postoperative diagnosis was mucosal ulcerative colitis (n = 40), Crohn's disease (n = 14), indeterminate colitis (n = 4), and familial polyposis (n = 1). One hundred eleven (range, 1-7) surgeries for treatment were performed. At a mean follow-up of 26 (range, 1-121) months, 19 pouches (32 percent) had been excised, 34 patients had functioning pouches and no fistula, 5 patients had a closed fistula but refused ileostomy closure, and 1-patient had died of unrelated causes (but the fistula was closed). Pouch type and preoperative diagnosis did not statistically affect pouch failure rates (P = 0.43 and 0.10. respectively). CONCLUSION: Successful treatment of fistula from a pelvic pouch can be achieved in more than 60 percent of patients. However, multiple procedures may be needed for a successful outcome. Ultimately, 32 percent had their pouches excised.     

Squamous cell carcinoma of the prostate: case report and review of literature

Carcinoma of the prostate, that is adenocarcinoma, is one of the most common malignancies in the male with an estimated incidence for 1991 of 122,000 new cases. On the other hand, squamous cell carcinoma of the prostate, with a median incidence of .5%-1% of all prostatic malignancies, has a similar clinical presentation but differs in treatment response and prognosis. We herein present one case of this histological pattern and review the literature pertaining to it.     

Primary squamous cell carcinoma of the endometrium report of a case and review of the literature

A case of primary pure squamous cell carcinoma of the endometrium in a 50-year-old woman is reported. There was deep myometrial and para-cervical invasion. There is no evidence of metastases 2 years after total hysterectomy and salpingo-oophorectomy and radiation therapy. The patient is probably the youngest suffering from such a tumor. A detailed review of the literature has been carried out.     

Intrapericardial teratoma. A case report and a literature review

A case of newborn intrapericardial teratoma is reported. The clinical, echocardiographic, tomographic and histologic features are described, and also, the therapeutic options. The newborn was submitted to surgical excision of the intrapericardial tumor and has a clinical follow-up greater than four years.     

Signet-ring cell carcinoma of the ileum: report of a case and review of the Japanese literature

We report herein the extremely unusual case of a 71-year-old woman with signet-ring cell carcinoma of the ileum. She originally presented with a 6-month history of intermittent nausea and abdominal distention, but initial examinations, including gastrointestinal fiberscopy, ultrasonography, and computed tomography (CT) scan, failed to reveal any cause of her symptoms. A barium-enema study performed 11 months after her initial visit demonstrated a narrow portion of the terminal ileum. An ileocecal resection was subsequently performed, and an epigastric subcutaneous tumor was simultaneously excised. The specimen contained a tumor with a stenotic lumen resembling a "lead pipe", an ulcerative portion, and mucosa with a granular appearance adjoining its proximal site. Many small aphthous lesions with IIa + IIc appearance were seen in the apparently normal mucosa. Histopathological examination confirmed a diagnosis of signet-ring cell carcinoma. The small aphthous lesions seemed to be metastases spread via the lymphatic vessels. Our review of the medical literature revealed three cases of signet-ring cell carcinoma of the jejunum; however, this is the first reported case of signet-ring cell carcinoma of the ileum.     

Stercoral perforation of the colon: case report and review of the literature

Stercoral perforation of the colon is a rarely reported illness, with 67 cases reported in the literature (1). A literature review revealed no case reports in the Emergency Medicine literature. A case report of a 47-year-old female with a history of chronic constipation and sudden onset of severe abdominal pain with physical signs of peritonitis is presented. Initial hematologic and radiologic investigations were normal. After 12 h of hospitalization, a fever developed, and the signs of peritonitis continued, but her abdominal X-ray studies and white blood count remained normal. Because of her persistent abdominal findings, laparotomy was carried out, at which time a stercoral perforation of the rectum was found. A colostomy was performed. This condition is notoriously covert, but if undetected may be life-threatening. A review of the literature will highlight suspected etiologies, diagnostic tests of choice, and a preferred treatment plan.     

Recurrent transitional cell carcinoma arising within an ileal conduit following cystectomy. A case report and review of the literature

Recurrent transitional cell carcinoma arising within an ileal conduit following cystectomy for malignant disease is rare. We report on a case in which such a recurrence occurred, well away from the ureteroileal anastomosis and without coexisting upper tract involvement. The possible pathogenesis of these recurrences is discussed and the existing literature reviewed. Although uncommon, the possibility of recurrence within a conduit should be considered in any patient who presents with haematuria following a resection for malignant disease.     

Granulomatous orchitis. A case report and review of the literature

We developed a method for determination of motor conduction along the mandibular and sensory conduction along the lingual and inferior alveolar nerves in 10 controls and 6 patients with lingual neuropathy following lower wisdom tooth extraction. Patients with lingual neuropathy had reduced/absent or delayed compound sensory action potentials and normal conduction along the fibers of the inferior alveolar nerve and mandibular nerve. The method provides a useful electrophysiological means of evaluating lingual nerve lesions.     

Squamous cell carcinoma of the prostate. Presentation of a case and review of the literature

The authors report the case of a young patient with an aneurysm of the ascending aorta and moderate aortic incompetence, who underwent a conservative operation at our institution. Dilatation of the sinotubular junction, particularly at the level of the non-coronary sinus of the aortic valve with loss of coaptation between the corresponding leaflet and the two coronary leaflets, was identified at the time of surgery as major cause of valve insufficiency. During surgery, the dilated ascending aorta and pathologic aortic sinus were replaced with a 26 Hemashield prosthesis tailored according to the David guidelines. An intraoperative post-repair transesophageal echo exam showed that the aortic valve appeared to be working competently. The post-operative course was uneventful and at one year, an echographic check of the aortic valve showed that it was fully competent, with normal leaflet motion. Conservative surgery can be a good option in selected patients with ascending aortic aneurysm and aortic valve insufficiency.     

Clear cell odontogenic carcinoma: A case report and literature review of odontogenic tumors with clear cells

For a period of 10 months, the perceptive-motor skills of golden hamsters were tested as part of an experiment to investigate vestibular controlled behaviour. We found that four out of 40 hamsters had more difficulties with swimming and equilibrium maintenance than the rest of the group. These disturbances either were apparent during the first months of testing or developed at a later period. In three hamsters the disturbances persisted over time while in one hamster performance in perceptive-motor skills increased. Histological examination with scanning electron microscopy revealed otoconial abnormalities in the saccule and/or the utricle. The otoconia were either malformed or replaced by spherulites. We conclude that the observed behavioural disturbances were caused by a defective peripheral vestibular organ. The results show similarities with data from pathology in other animals as well as in the human inner ear.     

Cirrhosis and pregnancy. A case report and review of the literature

A clinical case of a pregnant suffering from hepatic cirrhosis with ascites, splenomegaly and portal hypertension is described. The pregnancy carried on till the 31st week, even though with the repeated use of tocholytic agents. Cesarean section was performed because of the onset of serious jaundice and the decline of general maternal conditions. The infant, who had an Apgar score of 8 at the 1st and 5th minute, died on the 10th day because of accuse haemorrhagic interstitial pneumonitis in premature lungs and hepatopathy associated with widespread jaundice. The mother was discharged on the 25th day of the postpartum period, in light of the net improvement of her general metabolic condition, the sudden regression of the jaundice and the decrease of the cholestasis indices. A review of the literature discussing maternal complications fetal risks, management of pregnancy and delivery and outcome of the newborn are presented.     

Primary carcinoma of the ureteral stump: a case report and a review of the literature

A case is reported of primary carcinoma of the ureteral stump with metastases following nephrectomy for benign disease. The occurrence of disseminated tumor at the time of diagnosis is uncommon, having been reported in only 3 previous cases. The autopsy findings are discussed and the literature is reviewed.     

Death from fright: report of a case and literature review

A case report is presented illustrating the thesis that fear of fantasy material may trigger off a physiological process leading to death.     

Extraskeletal retroperitoneal osteosarcoma. A case report and review of the literature

Extraskeletal osteosarcomas, localized in the retroperitoneal space, are very rare neoplasms (only 200 cases have been described); the case indicated is the second one observed in Literature. The extraskeletal osteosarcomas are very malignant mesenchymal neoplasms reproducing osseous and cartilaginous tissue disconnected from the skeletal system. From a histological point of view, the extraskeletal osteosarcomas are constituted of osseous and cartilaginous tissue with osteo-fibro-chondroblastic cells: the different representation of three types of cells define the variety of extraskeletal osteosarcomas (osteoblastic, chondroblastic, fibroblastic). Histological and ultrastructural study failed to find differences between skeletal and extraskeletal osteosarcomas. In the clinical history of some patients traumas or irradiation has been referred; although extraskeletal osteosarcomas etiology is frequently unknown. Diagnosis is generally delayed because symptoms are often absent of uncertain. Prognosis of these neoplasms is always very poor, and specially in relation to the dimension and to the possibility of its radical removal. All patients died until 2-3 years after surgery.