Schwannoma: An uncommon dweller in the adrenal gland.

An elderly adult woman presented with upper abdominal pain to the urology department. Imaging studies revealed a right adrenal lesion with central necrosis, abutting the large vessels and suggestive of malignancy. Histopathology showed an encapsulated spindle cell tumor with marked nuclear atypia, cystic change, and hemorrhage. S100 immunomarker was strongly and diffusely positive. Final diagnosis was ancient schwannoma with secondary change. Schwannomas are rare in the adrenal gland, with <50 cases reported in the literature. These incidentally detected nonfunctional adrenal tumors need confirmation with histopathology and ancillary studies.

The resurgence of estrogens in the treatment of castration-resistant prostate cancer.

Use of exogenous estrogens in manipulating the androgenestrogen equilibrium was one of the earliest therapeutic strategies developed to treat prostate cancer which followed close on heels the discovery of hormone dependence of this tumor. Despite its well-documented benefit, estrogen therapy fell out of favor with the advent of other forms of androgen deprivation therapy (ADT) as the former registered a higher incidence of cardiovascular complications and poorer overall survival. Clearer understanding of the mechanism of action of estrogen coupled with the adoption of alternative routes of administration has triggered a renewed interest in estrogen therapy. Since then, many studies have not only proved the therapeutic benefit of estrogens but also explored the ways and means of minimizing the dreaded side effects deterring its use. Further, the fact that estrogen therapy offered a clear advantage of reduced cost of treatment over other treatments has led many countries to readopt it in the treatment of advanced prostatic cancer. We reviewed the published data on the use of estrogens in CRPC, which may affect its revival as an efficacious treatment option having minimal side effects, with modified dosage and route of administration. Estrogen therapy would be a less expensive option having equivalent or even better therapeutic effect than ADT in advanced carcinoma of prostate.

Mixed epithelial and stromal tumor - A solid-cystic renal neoplasm undergoing malignant transformation: A rare case report.

We present a case of 53-year-old female who came with the complaints of mass on the right side of the abdomen noticed 3 weeks back. There was no history of localized swelling or rise of temperature, no history of weight loss, or evening rise of temperature. On examination, there was a flank mass which was bimanually palpable and tender. Routine laboratory investigations were within normal limits, except for the presence of hematuria in routine urinalysis. Computed tomography scan abdomen revealed a large multiloculated solid-cystic mass lesion with septation in the right-sided kidney. Cystic renal cell carcinoma was suspected and conventional open right radical nephrectomy was done. Grossly, the tumor was solid-cystic containing blood-tinged fluid. Microscopy revealed a complex tumor with both epithelial and stromal proliferation and with the aid of immunohistochemistry a diagnosis of mixed epithelial and stromal tumor undergoing malignant transformation was concluded.