Anterior segment optical coherence tomography in ocular surface tumours and simulating lesions.

This study aims to systematically review the reported literature on the use of anterior segment optical coherence tomography (AS-OCT) in ocular surface tumours and simulating lesions. A systematic literature search was done using PubMed, Scopus, and Web of Science databases between January 2002 and December 2021. On AS-OCT, ocular surface squamous neoplasia typically demonstrate epithelial thickening, epithelial hyperreflectivity, and an abrupt transition between normal and abnormal epithelium. Conjunctival nevi usually show mildly hyperreflective epithelium of normal thickness, internal hyperreflectivity, and intralesional cysts which is the hallmark of this tumour. Primary acquired melanosis presents with normal thickness epithelium, basal epithelial hyperreflectivity, and absence of cysts. Conjunctival melanoma demonstrates hyperreflective normal/thickened epithelium, hyperreflective basal epithelium, internal hyperreflectivity, and absence of intralesional cysts. Conjunctival lymphoma shows homogenous, low-medium reflective subepithelial lesions with smooth borders, and dot-like infiltrates. Benign reactive lymphoid hyperplasia findings are similar to lymphoma but the infiltrates are more hyperreflective compared to lymphoma. Pterygium shows thickened conjunctival epithelium, epithelial hyperreflectivity, and subepithelial wedge-shaped hyperreflective tissue separated from the overlying epithelium by a cleavage plane. Pinguecula demonstrates mildly thickened epithelium and similar findings with pterygium but does not extend beyond the corneal limbus. This review shows that AS-OCT, as a noninvasive tool, has potential uses in the differential diagnosis of ocular surface tumours and simulating lesions. Major limitations of AS-OCT include limited visualization of the posterior border of thick, keratinized, and pigmented tumours and lack of assessment of large conjunctival tumours in a single cut.

Ipsilateral Lymphatic and Venous Malformations Affecting the Midface Area.

A 22-year-old woman presented with progressive swelling of the nasal conjunctiva in the left eye. Anterior segment examination revealed a diffuse cystic appearance to the inferonasal bulbar conjunctiva and plica semilunaris. Anterior segment swept-source optical coherence tomography (OCT) revealed clear hyporeflective spaces demarcated by hyperreflective septae in the affected conjunctiva, consistent with the diagnosis of lymphatic malformation (LM). Magnetic resonance imaging revealed a well circumscribed intraconal mass located inferonasally in the left orbit. Systemic examination revealed a lesion similar to LM on the left hard palate. The left conjunctival mass was excised subtotally. Subsequently, a transconjunctival anterior orbitotomy was performed and the left orbital mass was completely removed intact. Histopathologically, the conjunctival mass was diagnosed as LM and the orbital mass as venous malformation (VM). This case represents a rare coexistence of histopathologically proven conjunctival LM and orbital VM as well as a presumed LM of the hard palate, all 3 lesions occurring in the ipsilateral midface area.

Recurrent renal giant leiomyosarcoma.

Primary renal leiomyosarcomas are rare, aggressive tumors. They constitute 1-2% of adult malignant renal tumors. Although leiomyosarcomas are the most common histological type (50-60%) of renal sarcomas, information on renal leiomyosarcoma is limited. Local or systemic recurrences are common. The radiological appearance of renal leiomyosarcomas is not specific, therefore renal leiomyosarcoma cannot be distinguished from renal cell carcinoma by imaging methods in all patients. A 74-year-old female patient presented to our clinic complaining of a palpable mass on the right side of her abdomen in November 2012. The abdominal magnetic resonance imaging revealed a mass, 25 × 24 × 23 cm in size. Her past medical history revealed that she has undergone right radical nephrectomy in 2007, due to a 11 × 12 × 13 cm renal mass that was then reported as renal cell carcinoma on abdominal magnetic resonance imaging, but the pathological diagnosis was low-grade renal leiomyosarcoma. The most recent follow-up of the patient was in 2011, with no signs of local recurrence or distant metastases within this four-year period. The patient underwent laparotomy on November 2012, and a 35 cm retroperitoneal mass was excised. The pathological examination of the mass was reported as high-grade leiomyosarcoma. The formation of this giant retroperitoneal mass in 1 year can be explained by the transformation of the lesion's pathology from low-grade to a high-grade tumor.

Malignant peripheral nerve sheath tumor of the vulva, an unusual differential diagnosis for vulvar mass.

INTRODUCTION: Malignant peripheral nerve sheath tumors (MPNSTs) are rare, up to one half of the MPNSTs occur in patients with neurofibromatosis type-1 (NF-1), while the rest are sporadic. Here, we present a 52-year-old woman with MPNST of the vulva without NF-1. We will discuss basics of the disease, treatment options and follow-up strategies. PRESENTATION OF CASE: 52-year-old female admitted to our hospital with complaint of abnormal uterine bleeding and rapidly growing vulvar mass. Excisional biopsy of the mass showed MPNST of the vulva. Afterwards, the patient underwent radical vulvectomy with inguinofemoral lymph node dissection. Short after the surgery, multiple lung metastasis were shown and responded to chemotherapy, but rapid local recurrence occurred short after the completion of the chemotherapy. DISCUSSION: The primary treatment option in MPNSTs is surgical excision with or without adjuvant therapy. There is not enough data about the role of systemic chemotherapy in the management of MPNSTs and it still remains controversial. CONCLUSION: In general, radiation therapy has not been demonstrated to improve overall survival. Complete surgical resection of the primary tumor is the mainstay of the treatment.

Unusual coexistence of pulmonary sclerosing hemangioma and pericardial cyst.

Pulmonary sclerosing hemangioma is an uncommon tumor, thought to be a benign neoplasm. Pericardial cysts are also uncommon benign abnormalities, most often found incidentally on chest radiography. We describe the case of a 51-year-old woman in whom both lesions were incidentially detected on a routine chest radiograph. Enucleation of the pulmonary sclerosing hemangioma and simultaneous resection of the pericardial cyst were undertaken.

Erectile dysfunction: initial symptom of a patient with lung cancer.

INTRODUCTION: Penile metastases are rare and represent the advanced stage of the primary tumor. The patients usually have a history of a previously diagnosed malignancy and when metastasis to penis occurs, the most common findings would be priapism, pain, and difficulty in voiding. AIM: We aimed to present a patient who had erectile dysfunction as the initial symptom of lung cancer. Besides the unusual clinical presentation, the sonographic and magnetic resonance imaging (MRI) findings of the penile metastasis were also not typical. METHODS: A 57-year-old man with erectile dysfunction was admitted to the Department of Urology. On physical examination, there was a rigid, smooth, immobile, and painless mass at the base of the corpora cavernosa. Ultrasonography and MRI were performed in order to delineate the nature of the lesion. RESULTS: Radiological findings could not lead to a certain diagnosis and the lesion could not be resected completely during the surgery. Therefore, biopsy of the corpus cavernosum penis was performed. The histopathological diagnosis was metastatic malignant epithelial tumor consistent with nonsmall cell carcinoma. Further investigations revealed a metastatic lung cancer. CONCLUSIONS: Penile metastasis may rarely be the initial presentation of a malignancy and erectile dysfunction may be a seldom symptom.

Total resection of inferiorly located sacral chordoma with posterior only approach: case report and review of the literature.

Chordoma is a primary sacral neoplasm of ectodermal origin and makes up %1- 4 of all primary bone tumors. It is usually present on the midline cerebrospinal axis and the most common locations are the spheno-clival region and the sacrum. The treatment of primary sacral tumors represents a challenge because of a large tumor mass at presentation and a hemorrhage risk in surgery. Sacral tumors may present a difficult problem to the surgeon who desires to obtain a clear margin of excision. Using the retrorectal fat tissue as a cleavage line in the posterior approach guides the neurosurgeon to resect the tumor totally and reduce the hemorrhage in sacral chordomas. In this case report, we tried to discuss the advantages of using of retrorectal fat tissue as a cleavage line in sacral chordomas under the literature.

Leiomyoma in a female urethral diverticulum.

Neoplasms arising within urethral diverticula are rare. It is important to know if a diverticulum is filled by tumor, but traditional diagnostic methods, such as voiding cystourethrography, cannot detect a tumor or diverticulum, as in our case. We report an unusual case of leiomyoma developing in a female urethra diverticulum and review the literature.

Chronic Sclerosing Sialadenitis (Küttner's tumour) of the Parotid Gland.

Chronic sclerosing sialadenitis is a chronic inflammatory salivary gland disease. Küttner reported 4 cases of submandibular gland lesions for the first time in 1896. Chronic sclerosing sialadenitis is a very rare inflammatory lesion of the parotid gland and cannot be easily distinguished from salivary malignant masses. We reported a 28-year-old male with a painful parotid tumour, which grew slowly for 4 years.

Primary apocrine adenocarcinoma of the scrotum with distant metastasis: a case report.

A 53-year-old man presented with weakness, loss of weight, pain in upper and lower extremities, and back pain. He had an intermittent abscess like discharge from a left hemi scrotal lesion. Thoraco abdomino pelvic computerized tomography revealed diffuse, multiple and hypodense lesions in the liver parenchyma. Bone scan showed multi metastatic disease of the bone. Complete resection of the scrotal lesion was performed. In histopathological examination, apocrine adenocarcinoma was diagnosed.

A case of tubulocystic carcinoma simultaneously occurring with clear cell type renal cell carcinoma and micropapillary urothelial carcinoma of bladder.

The coexistence of multiple and synchronous primary neoplasms in the genitourinary system has rarely been described in the literature. To our knowledge, this is the first report of a very rare tumor, a "tubulocystic carcinoma," simultaneously occurring with micropapillary urothelial carcinoma in the bladder and clear cell type renal cell carcinoma in the same kidney. Tubulocystic carcinoma is a recently entitled tumor. It had been thought to arise from the distal collecting duct for a period of time and was therefore named as a low-grade collecting duct carcinoma. Microscopically, the tumor is defined as being tubulocystic or having tubulopapillary architecture and a low nuclear grade with hobnail morphology. Its progression and treatment protocol are uncertain.

Benign multicystic peritoneal mesothelioma.

Benign multicystic peritoneal mesothelioma is a rare tumor that occurs mainly in women in their reproductive age. It is characterized by the formation of multiple, thin-walled, multilocular cysts that frequently produce large, intra-abdominal masses. The short follow-ups and possible etiologies based on the published reports make it difficult to draw any firm conclusions.

[Osteochondritis dissecans occurring in the patella and medial femoral condyle in the same knee]. / Ayni dizde patella ve medial femoral kondilde görülen osteokondritis dissekans.

Osteochondritis dissecans (OCD) is a condition in which a portion of articular cartilage separates from the bone together with the underlying subchondral bone. Its classical localization is the medial femoral condyle. We presented a 14-year-old boy who had OCD lesions in both the medial femoral condyle and patella in the same knee joint. He presented with complaints of pain, swelling, and locking following sports activities. Magnetic resonance imaging showed completely detached loose bodies causing instability. Arthroscopic treatment was performed including in situ fixation of the condylar lesion and debridement of patellar lesions. At six-month follow-up, he had full range of motion of the knee joint, with some pain in the patellar grind test.

Metastatic malignant melanoma of the uterine cervix: first diagnosed on liquid-based cytology.

Malignant melanomas of the female genital tract are uncommon lesions. The first case of vulvar melanomas with a subsequent malignant melanoma of the cervix diagnosed based on liquid-based cytology without evidence of gross pathology is described.

Primary ovarian leiomyosarcoma: a review of the clinical and immunohistochemical features of the rare tumor.

UNLABELLED: Primary pure ovarian leiomyosarcomas constitute a malignant subgroup of ovarian smooth muscle tumors which comprise only 1% of ovarian tumors. Their origin, etiology, histologic features, clinical behavior, and optimal treatment are still obscure. Malignant behavior is almost always associated with any 2 of coagulative necrosis, cellular atypia, and mitotic index greater than 10. Immunohistochemical and electron microscopic evaluations may improve diagnostic accuracy. Traditionally, International Federation of Gynecology and Obstetrics (FIGO) staging and treatment of ovarian sarcomas have been the same as for epithelial ovarian carcinomas. Although surgery was performed for all cases, the extent of surgery is debatable. Benefit and modality of adjuvant therapy is controversial. The prognosis of primary pure ovarian leiomyosarcomas is extremely poor depending on tumor stage, tumor size, grade, and mitotic index and mostly recurs in abdomen and pelvis. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to state how rare primary ovarian leiomyosarcoma (POLMS) is, explain that because of its rarity the best diagnostic and treatment modalities are not conclusive, and recall that the authors reviewed the literature to bring the readership current on POLMS.