Resection of Retroperitoneal Extra-Adrenal Pheochromocytoma: A Case Report.

Extra-adrenal pheochromocytomas are rare catecholamine-producing tumors that arise from chromaffin cells outside the adrenal glands. We report on the case of a 62-year-old male who initially presented with upper respiratory tract symptoms and was found to have a suprapubic pelvic mass and an asymptomatic right inguinal hernia. The diagnostic evaluation involved an abdominal ultrasound, a CT scan, followed by an MRI, which revealed a well-marginated large mass whose characteristics indicated a retroperitoneal sarcoma. Upon successful surgical resection, the mass was found to be encapsulated and no peripheral structure invasion was present; the right inguinal hernia was repaired, and a double J-stent was placed. Histopathological examination revealed extra-adrenal pheochromocytoma. This case report sheds light on diagnostic and therapeutic challenges when dealing with extra-adrenal pheochromocytomas and the importance of considering them as a differential diagnosis when presented with a case of retroperitoneal mass.

Atypical presentation of currarino syndrome: A case report.

INTRODUCTION: Currarino syndrome is a rare congenital disorder characterized by a triad of anorectal malformation, a sacral bone defect, and a presacral mass. It results of an abnormal separation of the ectoderm from the endoderm caused by HLXB9 mutation in chromosome 7q36 in 50% of cases. The disorder is mostly hereditary as it can also be sporadic with a variable expression spectrum. PRESENTATION OF CASE: The case of a previously healthy 3-month-old girl with abdominal distension, post-prandial vomiting, obstipation, and anuria of 5 days' history is presented in this article. Abdomino-pelvic magnetic resonance imaging (MRI) showed a large cystic multilobulated mass in the sacrococcygeal region with a dural communication evident of an anterior sacral meningocele. 1 year later, the child came back with constipation and was found to a have a malignant mixed germ cell tumor in the presacral area, a very rare presentation in Currarino syndrome. DISCUSSION: In a child presenting with at least one of the features of Currarino syndrome's triad, a diagnosis should be suspected. After reviewing the literature, the syndrome is usually missed and hence is under diagnosed. MRI is the best imaging modality for diagnostics and follow-up for any mass, benign or malignant, can bring life saving measures. Most masses are benign but can undergo malignant transformation even after resection. De novo malignancy is very rare and is described in our case. CONCLUSION: Physicians treating patients with spinal dysraphism should suspect a diagnosis of Currarino syndrome by follow up imaging for any new benign or malignant growth.

Xanthogranulomatous oophoritis secondary to talcum powder. Case report and review of the literature.

Xanthogranulomatous inflammation of the ovary (xanthogranulomatous oophoritis) is a rare condition, usually representing a complication of tubo-ovarian abscess following pelvic inflammatory disease (PID). We report a case of xanthogranulomatous oophoritis that occurred in a 31-year-old Lebanese lady, eight years following an open appendectomy as a reaction to talcum powder present on surgical gloves.

Ewing sarcoma/primitive neuroectodermal tumor (PNET) of the vulva. Case report and review of the literature.

Ewing sarcoma is a rare highly malignant neoplasm that is mostly encountered as a primary bone tumor of childhood. Extra osseous occurrence is less frequent and cases involving the vulva are very rare with only twelve reported to date. We report the case of a Ewing sarcoma that presented as a vulvar mass in a 28-year-old Lebanese lady and briefly review the differential diagnosis as well as the published literature regarding the clinical presentation and prognosis.

Small cell neuroendocrine carcinoma of the urinary bladder: report on two cases and review of the literature.

Small cell (Neuroendocrine) carcinoma of the urinary bladder is a rare but highly aggressive malignancy. The neoplastic cells exhibit both neuroendocrine and epithelial differentiation. It is morphologically indistinguishable from the more common pulmonary small cell carcinoma. It can occur either in association with urothelial (transitional cell) carcinoma or in a pure form. Presenting signs and symptoms are non specific. Histologically, it can mimic poorly differentiated urothelial carcinoma and lymphoma. Muscle invasion is almost invariably present at diagnosis and mortality is mainly due to metastases rather than loco regional recurrence. The optimal therapeutic modality is still controversial. In this article, we report on two cases occurring in a pure form and we briefly review the published literature regarding the clinical presentation, morphology, differential diagnosis, prognosis and treatment.

Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test.

Inflammatory myofibroblastic tumor (IMT) is associated in 15-30% of cases with systemic symptomatology, such as prolonged fever, weight loss, elevated erythrocyte sedimentation rate (ESR), anemia, thrombocytosis, and leukocytosis. We report the case of a 4-year-old Lebanese boy who presented with high-grade fever of long duration, and a single (unpaired) positive Widal agglutination test. Blood culture was negative. A diagnosis of typhoid fever was made. An abdominal (mesenteric) IMT was incidentally discovered, 30 days after the fever had appeared. After surgery, the fever disappeared immediately, and the ESR returned to normal. We strongly favor the possibility of a false positive Widal test, due to polyclonal increase in serum immunoglobulins, which often occurs in IMT. We also think that IMT might be a mimicker of typhoid fever, both clinically and serologically. Physicians, especially pediatricians practicing in endemic areas, should probably be aware of this mimicry.

Cavernous hemangioma of the parotid gland.

In adults, hemangioma is a rare presentation of a parotid mass. In this report, we present a case of a 40-year-old lady complaining of a swelling in the right inferior parotid region. Imaging studies revealed a cystic lesion of the right parotid gland. Fine needle aspiration cytology was not significantly helpful in revealing the diagnosis. In the operating room, a vascular cystic lesion was found in the deep lobe of the right parotid gland. Pathological analysis confirmed the diagnosis of cavernous hemangioma. In this case report, we discuss a rare pathology in the adult population, and review different aspects in its diagnosis and treatment.