Male breast involvement in chronic lymphocytic leukemia. A case report and review of the literature.

Male breast lymphoma is a rare extranodal lymphoma occupying the mammary gland, and it could be either primary or secondary. A 78-year-old man presented an enlargement of the right breast. He had no medical history of interest. On physical examination, a unilateral, painless breast lump was found, with no skin changes or nipple discharge. There was no palpable lymphadenopathy. Routine laboratory tests revealed leukocytosis and lymphocytosis. Excisional biopsy of the breast lesion revealed mammary tissue infiltration by chronic lymphocytic leukemia (CLL) with plasmacytoid features and immunoglobulin G∕kappa monotypic expression. To our knowledge, this is the first report of male breast involvement by CLL. Considering important the collection of clinicopathological data of all reported male breast lymphoma cases, a literature review is presented.

External Oblique Muscle Schwannoma: A Rare Anatomical Presentation.

INTRODUCTION: Schwannomas or neurilemmomas are rare, benign, and usually solitary lesions that arise from the nerve sheath. In the majority of cases, these tumors involve the extremities, head, neck, and trunk. CASE PRESENTATION: In the present study, a 52-year-old man presented to our surgical department for the evaluation of a symptomatic lump in his left lateral abdominal wall. CT and MRI confirmed the presence of a cystic mass located between the external and internal oblique muscles. Histopathology and immunohistochemistry confirmed it to be benign schwannoma. DISCUSSION: Schwannomas have rarely been reported in the abdominal wall. To the best of our knowledge, this is the first case of schwannoma located in the left upper abdominal wall and the fifth case of abdominal wall schwannoma reported according to the reviewed medical literature. CONCLUSION: Benign schwannoma should be included in the differential diagnosis of cystic and symptomatic lesions of the abdominal wall. The treatment of choice is surgical excision, and recurrence is extremely rare.

A Rare Coexistence of Medullary Thyroid Cancer with Graves Disease: A Case Report and Systematic Review of the Literature.

BACKGROUND Graves disease is occasionally associated with thyroid cancer. The most common histological type of thyroid cancer in patients with Graves disease is papillary followed by follicular. Medullary thyroid cancer and Graves disease have been reported simultaneously only in a few cases in the literature. CASE REPORT A case of coexistence of Graves disease and medullary thyroid cancer is described in this report. The patient was diagnosed with Graves disease 8 years ago. Although he had an initial successful treatment with carbimazole, in the last 2 years no steady euthyroid function was achieved. Total thyroidectomy was considered as the optimal treatment. An incidental medullary microcarcinoma with maximum diameter 0.5 cm was identified by pathology report. CONCLUSIONS Medullary thyroid cancer has been reported in patients with Graves disease in 15 cases, including the current case. Medullary thyroid cancer is aggressive, and a delayed diagnosis would be harmful. Hence, patients with Graves disease should be evaluated regularly by a thyroid specialist.

Gastric schwannoma: report of two cases and review of the literature.

INTRODUCTION: Gastrointestinal schwannomas are benign, slow-growing and usually asymptomatic tumors. In some cases bleeding, epigastric pain and palpable mass may be occurring. Preoperative diagnosis is challenging due to the difficulty of differentiation from other submucosal tumors. Diagnosis is most often provided through the histology report. CASE PRESENTATION: In this study we report two cases of gastric tumors with the suspicion of a GIST preoperatively but histologically confirmed to be gastric schwannomas. Two patients of our study gave to us their written consent for publication. Research work has been reported with the PROCESS criteria. DISCUSSION: Surgical resection should be considered the mainstay of treatment in patients with gastric schwannomas. Possible complications such as bleeding or pyloric stenosis can be presented. The size and location of the tumor, as well as its relation to the surrounding organs, are essential factors in determining the type of resection. CONCLUSION: Gastric schwannomas are usually presented us submucosal mass. Preoperative diagnosis is challenging due to the difficulty of differentiation from other submucosal tumors. Endoscopic Esophagogastroduodenoscopy with biopsy and endoscopic ultrasound is essential to determine the nature of these lesions. Resection of the lesion in healthy borders is the treatment of choice. Patho-logical examination usually revealed positive S-100 protein and negative CD34, CD117, Actin and desmin strains.