There are 1% to 2% of lymphoma cases that include the testis as primary testicular non-Hodgkin lymphoma (NHL). In 35% of cases, it involves both testes and is usually seen as a painless testicular mass. Therefore, in most cases, the management option is radical orchiectomy. The overall prognosis in these cases is poor, as most cases are associated with systemic disease. We report a case of a 42-year-old male who presented with painless right scrotal swelling for three months. The only serologic marker of solid tumors that was elevated was ßHCG; others were unremarkable. Ultrasonography was initially ordered as well and showed a heterogeneous intra-testicular lesion of relatively low echogenicity. According to the given age, epidemiology, and clinical presentation, the suspicion of a germ cell tumor was highly likely. Therefore, a right radical inguinal orchiectomy was done, and the specimen was sent for histopathology, which came back as B-cell non-Hodgkin lymphoma. The clinical presentation and the overall picture of the investigations made in this case mimicked a germ cell tumor presentation.
Ureteral injury is one of the major complications related to colorectal and gynecologic procedures. Injuries are sometimes identified intraoperatively, but the diagnosis of ureteral injury is often delayed. Ureterocolic fistula is a relatively rare condition and mostly due to obstructing calculi, diverticular disease of the colon, radiotherapy, cancer, or trauma. Here in, we present a boy with an iatrogenic left ureterocolic fistula following multiple colonic surgeries that were complicated by an un-noticed left ureteric injury. This injury was not diagnosed early and the patient presented later with recurrent UTIs and decreased left differential renal function which necessitated open left nephroureterectomy.
Ureter , Ureteral Diseases , Urinary Fistula , Male , Humans , Female , Child , Urinary Fistula/etiology , Urinary Fistula/complications , Ureteral Diseases/diagnosis , Ureteral Diseases/etiology , Ureter/surgery , Ureter/injuries , Colon , Iatrogenic Disease
INTRODUCTION AND IMPORTANCE: Schwannomas are benign tumors of the nerve sheath, they do not typically present on the abdominal wall and cause symptoms. To the best of our knowledge, this is the second symptomatic case of schwannoma in upper abdominal wall reported according to the reviewed English medical literature. CASE PRESENTATION: A 25-year-old man post renal transplant two year ago. He presented with left hypochondrial painfull swelling, and redness. On examination, local examination revealed a lesion located in the anterior abdominal wall swelling, 3 × 3 cm, tender with minimal erythema and hotness but no discharge. An ultrasound showed superficial oval shaped with thick wall and mildly increased peripheral vascularity without internal vascularity. He underwent surgical excision and the histopathology result was schwannoma. CLINICAL DISCUSSION: Usually, a patient presents asymptomatic with a slow growing mass. However, the symptoms can vary and depending on the location. Furthermore, a growing lump can start putting pressure on the nerves around the area, and patients can show symptoms accordingly. The likability of ultrasound to pick up a well-circumscribed mass and reaching a definitive diagnosis without histopathology is nearly impossible. Therefore, a complete excision and histopathology confirmed the presence of schwannoma. CONCLUSION: Upon the rarity of schwannomas presenting in atypical regions, such as the abdominal wall. A painful mass on the abdominal wall should raise the suspicion of benign schwannoma. The recurrence rate after the treatment of choice is unusual. Moreover, complete surgical excision of the mass is the definitive treatment.
