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.     

Septicemia due to Shigella. A case report and review of the literature

To develop a proper protocol for biological exposure monitoring of acetone, we evaluated whether exposure to acetone on the previous day affects the biological monitoring value at the end of a work day. One hundred and ten male workers exposed to acetone in three acetate fiber manufacturing plants were monitored using a liquid passive sampler on two consecutive working days after 2 days without exposure. Urine samples were collected at the start of the workshift and the end of the shift on both days for each subject. For ten exposed workers urine samples were collected approximately every 2 h during and after the first working day until the following morning. Acetone concentrations in urine (Cu) at the start of the first working day were 1.3 +/- 2.4 (range: ND-14.1) mg/l in nonexposed workers and 2.4 +/- 5.6 (range: ND-40.3) mg/l in exposed workers. The urinary acetone concentration at the beginning of the second working day indicated that urinary levels of acetone do not decline to background level by the following morning when exposure concentration exceeds 300 ppm. However, linear regression analysis demonstrated that the relationship between environmental exposure level and urine level was similar on the 1st day and the 2nd day. Thus, although urine acetone levels did not return completely to baseline after high exposures, under the present exposure levels the exposure on the previous day did not significantly affect urinary acetone at the end of the workshift of the next day.     

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.     

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.     

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.     

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.     

A rare case of ovarian leiomyoma. A case report with review of literature]

We report an exceptional case of ovarian leiomyoma in 73 years old patient. Leiomyoma of the ovary is a very rare tumor. Most cases are asymptomatic, this benign neoplasm is usually found incidentally on routine pelvic examination, at surgery or at autopsy. The available literature is reviewed. The possible histogenesis of ovarian leiomyoma was discussed.     

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.     

Brown tumor in association with secondary hyperparathyroidism. A case report and review of the literature

The anti-inflammatory agent D-myo-inositol-1,2,6-trisphosphate (1,2,6-IP3) has shown beneficial effects in experimental burns following systemic administration. The purpose of this study was to investigate the effect of topical 1,2,6-IP3 cream on a standardised full-thickness 1 cm2 burn injury in rats. The experimental cream contained a transcutaneous absorption enhancer, hexylbetaine. Five different treatment groups were used. Two experimental groups of burned rats received either 1,2,6-IP3 cream with hexylbetaine (n = 10) or without hexylbetaine (n = 10). Two burned control groups were treated either with hexylbetaine cream (n = 10) or placebo cream (n = 10), while a third control group was untreated (n = 14). The various creams (0.5 g) were administered to the experimental burn area and allowed to remain for 3 h covered with an occlusive dressing. Spectrophotometrical quantification of Evans blue albumin extravasation was used to evaluate the effect of the experimental creams on vascular permeability following the burn trauma. Results showed a significant reduction of albumin extravasation both by 1,2,6-IP3 (p<0.05) and by hexylbetaine alone (p<0.01), as compared to placebo cream-treated animals. The transcutaneous absorption enhancer hexylbetaine did not further improve the effect of 1,2,6-IP3 on burn oedema. In conclusion, both topical 1,2,6-IP3 and hexylbetaine induced a significant reduction of albumin extravasation in burned skin. The effect of 1,2,6-IP3 could be related to previously shown anti-inflammatory actions of the agent, while the mechanisms of actions of hexylbetaine remain to be investigated.     

Metastatic follicular thyroid carcinoma to the mandible: a case report and review of the literature

OBJECTIVES: To describe the patterns of protective equipment use by in-line skaters in Winnipeg, Manitoba and nearby rural communities. METHODS: In-line skaters were observed for three months in 1996 at 190 urban and 30 rural sites selected using a formal sampling scheme. Age, gender, protective equipment use, skating companions, correct helmet use, and use of headphones were recorded. RESULTS: Altogether 123 in-line skaters were observed at 61 sites, including one rural site. No skaters were observed at the remaining sites. There were 37 adults and 86 children; 56% were male. Helmet use was 12.2% (95% confidence interval (CI) = 6.4% to 18.0%), wrist guard use was 16.3% (95% CI = 9.7% to 22.8%), knee pad use was 9.8% (95% CI = 5.2% to 16.4%), and elbow pad use was 7.3% (95% CI = 3.4% to 13.4%). Children were more likely to wear a helmet than teens 12-19 years of age (relative risk (RR) = 30, 95% CI = 4.01 to 225). Adults were more likely to wear wrist guards than children (RR = 4.32, 95% CI = 1.87 to 9.94). No gender differences were found. Incorrect helmet use was documented in four skaters; three skaters were wearing headphones. CONCLUSIONS: Low rates of protective equipment use were documented in our region, significantly lower than those reported in the literature. Barriers to equipment use are not known, and should be examined by further study. In-line skating safety programs should be developed, promoted, and evaluated. Teens should be targeted for future preventive efforts.     

Primary tracheal non-Hodgkin's lymphoma. A case report and review of the literature

BACKGROUND: Primary tracheobronchial non-Hodgkin's lymphoma (NHL) is an uncommon occurrence. The authors report a patient who presented with primary tracheal NHL, the sixth such patient described in the literature. METHODS: Using a MEDLINE search, 41 additional patients presenting with symptomatic primary or secondary tracheobronchial NHL were identified. The characteristics, management, and outcome of these patients are described. RESULTS: Patients with NHL of the upper respiratory tract present with dyspnea, wheezing, and cough, and frequently are misdiagnosed as having asthma. The majority of patients have additional sites of intrathoracic disease with tracheobronchial involvement occurring in the setting of advanced or relapsed NHL. Low grade histology is seen most commonly in patients with primary tracheal NHL. Several patients demonstrate the typical histologic features of mucosa-associated lymphoid tissue. Surgery, chemotherapy, and radiation therapy have been used alone or in combination for treatment. The outcome of these patients does not appear different from that observed in patients with lymphomas of similar histology and stage that do not involve the tracheobronchial tree. CONCLUSIONS: Thoracic surgeons, pulmonologists, and oncologists should recognize that NHL can rarely be confined to the trachea or bronchi. NHL should be considered in the differential diagnosis of airway obstruction, because it represents a highly treatable malignancy.     

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.     

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.     

Congenital pseudoarthrosis of the radius. A case report and review of the literature

Congenital pseudoarthrosis of the radius (CPR) is rare. Only ten cases seem to have been found in the literature. Congenital pseudoarthrosis of the radius usually is associated with neurofibromatosis or fibrous dysplasia. This is a report of a congenital pseudoarthrosis of the left radius associated with congenital dislocation of the left hip in a five-month-old girl. Apart from the pseudoarthrosis, there were no visible abnormalities. This patient was treated successfully with excision of the pseudoarthrosis, shortening osteotomy of the ulna, grafting, and intramedullary fixation of both the radius and the ulna. Review of the literature disclosed the extreme difficulties in treating this condition. It was also found that vascularized fibular graft has been used successfully.     

Megaesophagus and pneumonia associated with Mycobacterium chelonei. A case report and a literature review

The case of a 37-year-old woman who developed a subacute, bilateral, noncavitary pneumonia 5 years after a colon interposition esophagoplasty is presented. Mycobacterium chelonei, subspecies abscessus, was assigned a pathogenic role based on the findings of (1) a clinical and roentgenographic picture consistent with tuberculosis, (2) sputum smears showing acid-fast bacilli, (3) repeated sputum cultures yielding heavy growths of Mycobacterium chelonei, subspecies abscessus, and (4) a 12-mm by 12 mm-skin test response to homologous antigen (purified protein derivative-CL) with no response to an equivalent dose of purified protein derivative-S. The patient recovered fully without significant antituberculous chemotherapy. A survey of the literature revealed 11 similar case reports featuring a documented association between megaesophagus and pulmonary infection with rapidly growing mycobacteria.