Primary carcinoid tumor of testis.

A case of pure, primary testicular carcinoid tumor in a forty-four-year-old male is reported. The patient presented with painless testicular enlargement, and testicular tumor was diagnosed. Orchiectomy was performed, and histology revealed a primary argentaffinoma. The patient is well and symptom free two years after diagnosis.

Hypoadrenia following adrenal venography in Cushing's disease.

Three patients with Cushing's disease are reported. In two patients the hyperfunction of the adrenal glands ceased following selective adrenal venography, moreover hypoadrenia has developed. In the third case necrosis following venography was proved by surgery and confirmed by histology. Regarding the therapeutic possibilities of Cushing's disease the use of this diagnostic procedure is taken into consideration but not recommended.

Histological evaluation of multiple testicular biopsies helping assisted reproduction.

Because of the fall in population in Europe, the evaluation of causes of male infertility is becoming more and more important. Testicular biopsy is a useful method of examination in the area of assisted reproduction. Testicular biopsies of 85 infertile males were evaluated histologically. According to the sperm count, 31 patients had azoospermia, 22 oligo-astheno-teratozoospermia (OATS), 29 oligozoospermia, and 3 astheno-teratozoospermia. The biopsies were carried out by atraumatic microsurgery. Samples were taken from the upper inner and lower outer quadrant of both sides. Bouin-fixed, paraffin-embedded blocks were cut and HE slides examined. Samples taken from azoospermic patients showed atrophy, maturation arrest, normal histology or Sertoli cell-only syndrome. Oligozoospermic patients presented maturation arrest, hypospermatogenesis or normal histology. In the OATS group maturation arrest hypospermatogenesis and atrophy were found. The spermatogram groups showed significant correlation with the homogeneity of the spermatogenesis. The sperm count alone is not sufficient in assessing spermatogenesis. Four samples give more adequate information than just one, because spermatogenesis is not homogeneous in the testis. After evaluating diagnostic biopsies, tissue for TESE can be taken from the most appropriate location in the testis.

Polytenosynovitis caused by Toxoplasma gondii.

Two cases are reported of polytenosynovitis involving the wrists and ankles and caused by toxoplasmosis, together with the investigations that led to the diagnosis. Medical and surgical treatment of the first patient and medical treatment only of the second patient gave satisfactory results.

Acute carcinomatous myopathy associated with ovarian carcinoma.

A case of acute, fatal, rapidly progressive pure myopathy associated with ovarian carcinoma is described. The first symptoms of carcinomatous myopathy occurred 8 months after surgical treatment and combined chemotherapy. The patient died 2 months after onset of myopathy. The clinical and pathologic findings of the myopathy are discussed.

[Surgical treatment of liver adenoma caused by contraceptive agents]. / Anticoncipiens kezelés kapcsán létrejövö máj-adenoma operált esete

PIP: The authors describe the case of a 31-year old woman who had been taking Infecundin for 5 years. The subject was hospitalized in order to undergo surgery for kidney ptosis. After opening the peritoneum, the surgeon detected a resistance the size of a fist in the right lobe of the liver. The resistance was palpable in the right hypocondrium. The routine laboratory analysis and tests concerning the liver function revealed no sign of any disorder. The authors performed a selective coeliography, following the Seldinger procedure. This confirmed the existence in the right lobe of the liver, of a 15 x 20 cm growth. The angioarchitecture was largely diseased and after further examinations, malignant hepatoma was diagnosed. The patient underwent a transrectal laparotomy. The study of other similar cases has revealed that these liver tumors often cause acute abdominal hemorrhages. In their conclusion, the authors draw attention to the fact that there is a very strong probability that liver adenomas are related to the use of oral contraceptives.^ieng

[Oral contraceptives and liver tumors]. / Az orális fogamzásgátlók és májdaganat.

PIP: The case is described of a 36-year old female patient who developed a benign hepatic cell adenoma after having taken oral contraceptives (OCs) for several years. The tumor, which was situated on the central part of the right lobe, because of disintegration and hemorrhage broke through to the surface and caused a massive subcapsular hemorrhage. After subtotal hepatectomy the patient recovered uneventfully, and has remained symptom-free since that time. As far as is known, this was the 2nd successful subtotal hepatectomy in Hungary. The authors review the literature on the relationship between OCs and liver tumors. They call attention to the rapidly increasing occurrence, in Hungary, of these tumors, and to a tendency to life-threatening hemorrhages, which in the majority of cases require extensive hepatic resection. They describe various possibilities and methods of surgical care.^ieng

[Parvovirus B19 infection in hydrops fetalis]. / Parvovírus B19-infekció foetalis hydropsban.

In a retrospective study from 210 foetal autopsies carried out in a period between 1992 and 1999 fifteen hydropic foetuses were found. The cause of the hydrops was shown to be Rh incompatibility in one case only. The cause of hydrops was not discernible in one case. In the others pathological examination clarified the cause and pathomechanism of non-immune hydrops. One isolated cystic hygroma, one monochorionic twin pregnancy with twin to twin transfusion, one case of sacrococcygeal teratoma and 4 cases of congenital heart diseases were reported. Postmortem interphase cytogenetic examination showed X0 monosomy in 2 cases. In further 4 foetuses pathognomic viral inclusions in the proerythroblasts raised the probability of parvovirus B19 infection what was confirmed by immunohistochemistry and electronmicroscopic examination. The occurrence of the parvovirus B19 associated cases of foetal hydrops was shown to be higher (4/15) in this series than in the literature. The accumulation of cases in 1998 is suggestive of an outbreak. The prenatal diagnostic implications and the attempts on further management are also discussed.