Primary papilloma of the proximal ureter in a 13-year old boy: A rare case.

INTRODUCTION: Approximately 1 percent of the tumors observed in the upper urinary tract are primary tumors of the ureter. The exact diagnosis is done by a histologic study. Most cases need surgery, which is done by complete resection of the tumoral segment of the ureter. PRESENTATION OF CASE: This study presents a 13-year-old boy who referred to Ali Asghar pediatric hospital with complaints of right flank pain and hematuria for four months. The ultrasonography revealed moderate-grade hydronephrosis. The retrograde urography confirmed a 1.5 cm lesion with filling defects in the proximal segment of the right ureter. The abdominal CT-scan confirmed a 1.5 cm filling defect lesion with a smooth margin in the right proximal ureter adjacent to the ureteropelvic orifice. On cystoscopy, a sessile mass developed in the proximal portion of right ureter and providing pronounced dilation of the ureter and ipsilateral hydronephrosis. Histopathology examination revealed a benign neoplasm composed of a delicate fibrovascular core covered by normal-appearing urothelium. The patient underwent a successful proximal segment resection of the ureter by surgery. DISCUSSION: Benign tumors of the ureter are much less frequent than malignant ones. Mostly, they involve the lower third of the ureter. Pain, hematuria, and hydronephrosis are the most clinical signs. The final diagnosis can be established with the histologic examination. The choice treatment in is segmental ureterectomy. CONCLUSION: Primary ureteral papilloma is extremely rare in the child. The histopathology study is essential for ruling out malignancy. The recurrence and progression of ureteral papilloma are controversial.

Correlation between serum level of fibroblast growth factor 2 and severity of reflux nephropathy.

INTRODUCTION: Fibroblast growth factor 2 (FGF2) is a potent mitogenic factor of cortical fibroblasts and induces kidney fibrosis. We hypothesized that serum levels of FGF2 has an association with the severity of vesicoureteral reflux (VUR) and renal parenchymal scar. MATERIALS AND METHODS: Between 2007 and 2009, a total of 28 children with VUR were enrolled in this study and were compared with 52 healthy children. All children with VUR underwent technetium Tc 99m dimercaptosuccinic acid renal scintigraphy. Fibroblast growth factor 2 was measured in both groups. RESULTS: The mean level of FGF2 was 65.0 ± 19.0 pg/mL in the VUR group and 62.5 ± 15.3 pg/mL in the control group (P > .05). There was no correlation between serum levels of FGF2 and sex, age, or the grade of VUR. Of the 28 children with VUR, 19 had renal parenchymal scar on dimercaptosuccinic acid renal scintigraphy. The mean serum level of FGF2 was not significantly different in the children with and without renal parenchymal scar. CONCLUSIONS: This study showed no correlation between serum FGF2 and renal parenchymal scar or grade of VUR.

Her2/neu Expression in Wilms' Tumor and Correlation With Histopathologic Findings.

BACKGROUND: Wilms' tumor is an emberyonal tumor arising from remnants of immature renal tissue. Her2/neu is an onco-protein which mediates cellular proliferation, differentiation and survival. METHODS: In the current study, we analyzed Her2/neu expression in 40 Wilms' tumors. The clinico-demographic data of 40 patients with Wilms' tumor were retrieved. Immunohistochemical staining for HER2/neu was performed. Her2/neuimmunoreactivity was evaluated by Canadian Consensus 2007 scoring system. RESULTS: Among the 38 specimens with epithelial component, 68.5% were positive for Her2/neu, whereas there was immunoreactivity in 37% of 38 blastemal, and 12% of 31 stromal components. The Her2/neu expression was significantly higher in early stages (81.5%) than in advanced stages (36.4%) in epithelial component, but not in other components. CONCLUSION: This study suggested that Her2/neuexpression is associated with epithelial cell differentiation accompanied by lower stages of tumor. No significant relationship was found between Her2/neu positivity and tumor size and patient's age and gender.

First report of a thyroid abscess in the pediatric age group caused by Arcanobacterium haemolyticum.

Thyroid abscess is a rare event especially in the pediatric age group. We report a 2-year-old girl with thyroid abscess who presented with fever and an anterior painful neck mass. Culture of the aspirated fluid yielded Arcanobacterium haemolyticum, which is one of the etiologies of pharyngitis and rash in children and, especially, young adults. As far as we are aware this is the first report of thyroid abscess in the pediatric or adult age group caused by Arcanobacterium haemolyticum.