Puncture-site metastasis in a radiologically inserted gastrostomy tube: case report and literature review.

Gastrostomy-site metastases from head and neck cancer have been reported numerous times following endoscopic insertion, with direct implantation being implicated. We present the first reported case of gastrostomy-site metastasis following radiological insertion, and discuss the mechanisms by which this may have occurred. These include: direct implantation, hematogenous dissemination, or the natural shedding of tumor cells into the gastrointestinal tract.

Benign mixed tumour of the skin with extensive ossification and marrow formation: a case report.

Benign mixed tumour of the skin (chondroid syringoma) is an uncommon skin adnexal tumour, usually presenting as a slow growing solitary painless nodule. The morphological appearances are similar to those of a pleomorphic adenoma of the salivary gland. Hair matrix and sebaceous differentiation can be seen in some lesions. Focal ossification is a rare finding. This report presents a case of a similar tumour arising in the cheek of a 43 year old white man, showing extensive ossification. Clinical, radiological, and pathological correlation and diagnosis proved to be difficult preoperatively. Only two cases of a benign mixed tumour with pronounced ossification have been reported so far, both in Japanese patients. This is the first reported case seen in a white man. Awareness of these lesions will avoid potential diagnostic pitfalls.

A case of primary Sjögren's syndrome, complicated by cryoglobulinaemic glomerulonephritis, pericardial and pleural effusions.

Primary Sjögren's syndrome (SS1) complicated by glomerulonephritis is rare and is usually associated with the presence of cryoglobulins. Cryoglobulinaemic glomerulonephritis as described in type II essential mixed cryoglobulinaemia, characterized by the presence of deposits of cryoglobgulins within the glomerular capillary lumen, occurring in SS1 has previously been reported only once in the literature. Our case was also complicated by pleural and pericardial effusions. We discuss the treatment options available for the renal lesion.

Florid reactive mesenchymal proliferation.

Florid reactive mesenchymal proliferation describes a benign soft tissue tumour found in the hand as well as at other sites. The histological appearance and rapid growth of the lesion may lead to an incorrect diagnosis of malignancy. We describe a case in a 79-year-old lady, unusual because of her age at presentation and long history, and review the literature.