Fibroma of the cecum: report of a case

A woman suffering from recurrent attacks of abdominal pain was found at operation to have a fibroma of the cecum. The clinical, operative and pathologic findings are described. The medical literature was reviewed and the lesion was found to be uncommon. The importance of specific histologic stains to distinguish the true fibroma from other spindle-cell tumors is stressed.     

Fiberglass dermatitis: report of two cases

Fiberglass is widely used for insulation and as a reinforcement filling material. Handling fiberglass products may induce contact dermatitis. We report on the first two cases of fiberglass dermatitis reported in Taiwan. The first patient suffered from a severe pruritic eruption two hours after repairing a roof with wave-form ceiling boards. Erythematous maculopapules were present on both hands and finger webs. The second patient was a quality controller of printed circuit boards (PRCBs). She presented with erythematous maculopapules on the face and excoriated papules and lichenified plaques on the trunk and forearms, which had been present for two years. Scrapings of the skin lesions from both patients showed fiberglass spicules of 7.5 to 8 microns in diameter. Similar fibers were detected in scrapings from the wave-form ceiling board and PRCB. Histopathology of the second case revealed spongiotic psoriasiform dermatitis. Patch tests in case 2 with the plastics and glues series, epoxy resin and scrapings from the PRCBs were all negative. Fiberglass dermatitis may be easily misdiagnosed. Clinically, it may resemble scabies, eczematous dermatitis, folliculitis, petechiae and urticaria. A high index of suspicion is essential for a correct diagnosis.     

Ameloblastic fibro-odontoma: report of two cases

Ameloblastic fibro-odontoma is a rare odontogenic tumour. It affects young people and is usually located in the posterior jaws. Two cases of this tumour are presented: both lesions had produced an asymptomatic swelling. The histology showed the presence of an odontogenic epithelium immersed in a fibrous mesenchyme; dental hard tissues were also present. No recurrences were found after 12 and 4 years from the surgical enucleation of the tumour.     

Cervical adenitis: report of two cases

OBJECTIVES: A recent review or meta-analysis of epidemiologic studies concluded that persons with asbestos-related pleural plaques do not have an increased risk of lung cancer in the absence of parenchymal asbestosis. The reviewer inferred that this conclusion provided indirect supportive evidence for the proposition that asbestosis is a necessary precursor of asbestos-related lung cancer. The objective of the present communication is to contest these claims. METHODS: Finnish epidemiologic data and population statistics were used to estimate the apparent risk ratio of lung cancer associated with radiographic signs of pleural plaques. Power calculations were applied to compute the needed population sizes to demonstrate that the association is statistically significant. RESULTS: Unrealistically large population studies would be needed to observe the statistical relation between pleural plaques and lung cancer, quantitated as a risk ratio of 1.1, resulting from relatively low levels of environmental asbestos exposure. In realistic and valid epidemiologic studies on heavily exposed subpopulations, a two- or threefold risk can be identified. CONCLUSIONS: Uninformative studies should not be interpreted as providing suppressive evidence that pleural plaques are a noncausal risk indicator of lung cancer. Even for the null hypothesis, the inference that asbestosis is a necessary causal link between asbestos and lung cancer is illogical.     

Leiomyoma of the bladder: report of two cases

We report 2 cases of leiomyoma of the urinary bladder. A 41-year-old female visited our hospital with the complaint of pollakisuria. A solid tumor of the urinary bladder was found by ultrasonography. A large shadow defect at the left-anterior wall was shown by drip infusion pyelography (DIP). Computed tomographic scan (CT) and magnetic resonance imaging (MRI) also revealed a large tumor. T1-weighted image revealed a homogeneous low intensity tumor and T2-weighted image disclosed heterogeneous low intensity tumor. Cystoscopy revealed a large submucosal tumor. Partial cystectomy was performed, and she has had neither recurrence nor metastasis for 36 months. A 32-year-old male was referred to our hospital with the complaint of macrohematuria. A solid tumor of the urinary bladder was found by ultrasonography. A shadow defect was not clearly detected by DIP. A large tumor was detected on the anterior wall by MRI. T1-weighted image showed a homogeneous low intensity tumor and T2-weighted image disclosed a high intensity tumor. Cystoscopy revealed a submucosal tumor on the anterior wall. Urine cytology did not suggest a malignancy. The biopsied specimens revealed only an inflammatory change in the mucosa. Partial cystectomy was carried out. He has had neither recurrence nor metastasis for 29 months. Histological diagnosis in both cases was leiomyoma of the urinary bladder.     

Sarcoidosis presenting as an intra- or extra-axial cranial mass: report of two cases

Sarcoidosis may also present as an extra- or intra-axial mass involving the central nervous system. These lesions are sometimes operated upon, because a neoplasm is suspected. We report two cases of unusual tumour-like extra- and intra-axial sarcoidosis. The extra-axial mass was just medial to the jugular foramen. Its morphology and signal characteristics differed from the more common lesions in this area. The intra-axial mass was in the temporal lobe, with only minor leptomeningeal involvement. Extra-axial sarcoidosis can be confused with a meningioma because these lesions can give relatively low signal on T2-weighted images. Intra-axial masses are presumed to represent a propagation and fusion of multiple leptomeningeal granulomas through the Virchow-Robin spaces in the brain; this pattern can be sought on contrast-enhanced T1-weighted images.     

Trigeminal neurinomas in infants: report of two cases

Two cases of trigeminal neurinoma in two infant girls aged 3 and 6 months are reported. Both presented with temporal cranial vault bulging at birth. The 6-month-old patient suffered onset of focal fits 1 month before admission and her neurological examination revealed no abnormalities. The 3-month-old patient had right exophthalmus and a subcutaneous fronto-orbital plexiform neurofibroma at birth. Neurological examination disclosed a sensory deficit of the first trigeminal nerve division. She also had a family medical history of von Reckling-hausen's disease. The incidence of trigeminal neurinomas in children is reviewed. The patients in these two cases are the youngest recorded; the cases are the only ones reported in infants. Clinical, radiological, and therapeutic aspects are discussed.     

Enamel pearls in the primary dentition: report of two cases

Concentrations of the polyamines, putrescine, spermidine and spermine were investigated in rat brains, in which chemical kindling or single convulsion had been induced by intraperitoneal injection of pentylenetetrazol (PTZ). A single injection of 60 mg/kg of PTZ produced tonic-clonic convulsion and increased the putrescine concentration 8 h after the injection. At lower doses of PTZ (10 and 30 mg/kg), neither marked behavioral seizure nor significant change in any polyamine concentration was observed. On the other hand, repeated injections of 30 mg/kg of PTZ eventually resulted in intense motor seizures (PTZ kindling) and increased the concentrations of all three polyamines. The most marked increase was detected in putrescine 1-48 h after the intense seizures. The increase in putrescine was clearly higher in PTZ kindling than in single convulsion. These results suggest that increases in polyamine concentrations are involved in neuronal excitability in the epileptic brain.     

Malignant lymphoma of the testis: report of two cases

Two cases on non-Hodgkin's malignant lymphoma (NHL) of the testis are reported. A 63-year-old man with left painless scrotal swelling underwent orchiectomy. Although prophylactic irradiation was performed under the diagnosis of seminoma, subsequent immunohistochemistry revealed NHL, large diffuse cell type (B type). He had stage IEA disease. Chemotherapy with cyclophosphamide, adriamycin vincristine and prednisolone was performed. The second case was in a 63-year old man with right painless scrotal swelling. Orchiectomy revealed NHL, diffuse medium cell type (B type). Because of tumor in the retrosternum, he had stage IIIEA disease. Chemotherapy and irradiation to the contralateral testis was performed.     

Pagetic sarcoma of the calvarium: report of two cases

DNA-based mutation analysis on the connexin 32 gene was performed in 49 families with Charcot-Marie-Tooth disease (CMT) type 1 but without duplication involving the chromosomal region, 17p12-p11.2. Mutations were identified in five of the 49 families, and four of the five mutations were hitherto undescribed: Va137Met, Glu57His, Arg142Glu, Val177Ala. X-linked CMT sometimes lacks evidence for X-linked transmission and cannot be differentiated from CMT type 2, especially in females with mildly decreased nerve conduction velocity. Therefore, molecular analysis is useful for molecular pathology of their disease.     

Werdnig-Hoffmann disease: report of two cases?]

Two cases of familial spinal muscular atrophy with onset in infancy are reported. The author makes an attempt to categorize them and concludes by Werdnig-Hoffmann disease.     

Mediastinal cystic lymphangioma: report of two cases

Cystic lymphangioma is an extremely rare mediastinal benign tumor characterized by congenitally enlarged lymphatic vessels. It is often diagnosed incidentally because it is only symptomatic when it grows to be very large. We present two cases of mediastinal cystic lymphangioma and review the literature.     

Unusual cranio-cerebral injuries: report of two cases in Nigerians

Two unusual cases are reported in which nails were driven into the heads of victims of criminal assults in Nigeria. The special risk to the superior sagittal sinus is discussed.     

Multiple urethral calculi in children: report of two cases

Multiple urethral calculi are rarely found in children. We report herein two unusual cases of children found to have multiple urethral calculi. In one, the calculi formed proximal to a stricture and in the other they formed within a diverticulum. Both patients required urethrotomy for removal of the calculi. A unique cause of urethral stricture is also described in case 1.     

Cholesterol granuloma in the middle cranial fossa: report of two cases

We report two cases of cholesterol granuloma in the middle cranial fossa. On CT the lesions appeared as a nonspecific, nonenhancing soft-tissue mass with bone erosion. On MRI they were seen as areas of high signal intensity surrounded by a low-intensity peripheral zone on both T1- and T2-weighted images. Cholesterol granuloma is thought to occur when pneumatised cells in the temporal bone become obstructed. Although this lesion usually occurs in the petrous bone, it can extend to the middle cranial fossa. The diagnosis and surgical management are discussed.     

Synovial sarcoma of the vulva: a report of two cases

We report two cases of synovial sarcoma arising in the vulva. The patients were 30 and 37 years old and presented with a painless mass that was interpreted clinically as a cyst. The tumors were 2.0 and 1.2 cm in greatest diameter. Histologically, they were composed of epithelial cells forming solid nests and gland-like and papillary structures surrounded by spindle-shaped cells. Immunohistochemically, the epithelial cells stained for cytokeratin and the spindle-shaped cells for vimentin. Ultrastructurally, the epithelial cells had prominent intercellular junctions and narrow microvilli and were separated from the spindle-shaped cells by a basal lamina. The spindle-shaped cells were closely apposed with focal intercellular contacts. One tumor recurred locally 3.5 years after excision, but the patient was alive and well 1 year after a re-excision and radiation therapy. The other patient was alive and well 4 years after an excision. These tumors are the first reported examples of synovial sarcoma arising in the vulva.     

Wernicke's encephalopathy and dialysis: report of two cases

Wernicke encephalopathy is considered a complication of dialytic therapy, but there are few reports of this complication. We report a 57 years old man and a 45 years old woman, with grade IV renal failure, who after acute peritoneodialysis and chronic hemodialysis respectively, had a confusional syndrome that responded to the administration of thiamine. CT scans in both patients discarded abnormal blood collections or new cerebrovascular episodes. The man bad two previous cerebrovascular episodes, a severe anemia that was corrected, angina and an episode of arrhythmia during the dialytic procedure previous to the confusional episode. The woman had an acute uremic syndrome and a concomitant urinary tract infection during the confusional episode. Wernicke encephalopathy must be suspected in patients in dialysis with confusional episodes.