Aggressive Gingival Metastasis of Adenocarcinoma of Unknown Origin: Case Report.

A case of localized soft tissue growth located on the lingual aspect of the left mandibular gingiva is reported in a 61-year-old male patient in whom excisional biopsy of the lesion was performed. The histopathologic diagnosis was adenocarcinoma. Further clinical and biopsy examinations taken from several organs indicated the presence of metastatic adenocarcinomas in the brain, spleen, lymph nodes, and liver. The oral tumor recurred after repeated surgical removal. Based on histopathological examination and immunoprofiling analysis the primary tumor probably originated in the gastrointestinal tract.

Selected immuno-histochemical markers in curettage specimens and their correlation with final pathologic findings in endometrial cancer patients.

To assess the immuno-histochemical expression of various markers in, endometrial biopsies of patients with endometrial cancer, and to correlate their expression with the final pathologic findings. Sixty-two patients with primary endometrial cancer who underwent surgical treatment were included in this study. Immuno-histochemical expression of estrogen receptor (ER), progesterone receptor (PR), p53, bcl-2, Her-2/neu and Ki-67 were assessed in curettage specimens, and review of the final pathology report from hysterectomy specimens was carried out. The expression of these markers in curettage was correlated with the final tumor characteristics obtained on hysterectomy specimens. Both ER and PR were significantly more expressed in endometrioid type (EC) than non- endometrioid type (NEC) (P value of 0.004 and 0.012). On the contrary, P53, Her-2 and Ki-67 showed higher positivity in NEC than EC (P value of 0.005, 0.025 and 0.002). Positive expression of ER and PR was significantly associated with low grade tumors and superficial myometrial invasion, whereas positive expression of Her-2 and Ki-67 was significantly associated with higher grade lesions, and deep myometrial invasion. Moreover, a statistically significant inverse relationship was observed between the positivity of P53, Her-2 and Ki-67 and the positivity of ER, PR. We found that determination of immuno-histochemical markers in curettage specimens might be helpful in predicting the final pathologic findings in patients with endometrial cancer. This might be helpful in planning the extensivity of the surgery.

Familial focal segmental glomerulosclerosis and retinitis pigmentosa: a new association.

The association of retinitis pigmentosa with renal disease is rare and occurs mainly in two conditions: medullary cystic disease and Bardet-Biedl syndrome; here we describe a case of retinitis pigmentosa with familial focal segmental glomerulosclerosis, which to the best of our knowledge has never been reported previously.

Xanthogranulomatous pyelonephritis: Analysis of 18 cases.

OBJECTIVE: To review and evaluate patients with a clinicopathological diagnosis of xanthogranulomatous pyelonephritis (XGP) with emphasis on the diagnostic methods and the effect of socioeconomic status on disease severity. METHODS: Data compiled from the previous history of the patients, clinical, laboratory, radioimaging findings, preoperative, operative, histopathological diagnosis and postoperative follow-up period were analysed. On the basis of presentation, XGP was classified as complicated and simple. RESULTS: There were 18 cases of XGP. The clinical characteristics included: calculi or obstruction in the urinary tract, and damage to the kidney, complication of urinary tract infection, anaemia, increased erythrocyte sedimentation rate and liver dysfunction. All patients had diffuse XGP. Associated pathological findings such as psoas abscess, nephrocutaneous fistula, renocolonic fistula and paranephric abscess were found in 33.3% of cases. Eleven of 14 patients (78.6%) who were evaluated by computed tomography (CT) had the correct diagnosis made prior to nephrectomy. Urine culture was positive in 88.9% of patients and Proteus mirabilis was the most common organism. CONCLUSION: Our experience with a small number of patients demonstrates that low socioeconomic status could be a risk factor in the development of complicated cases of XGP. CT is considered to be the best radiological test for correct preoperative diagnosis and evaluation of XGP. Nephrectomy and removal of all surrounding affected tissue proved to be curative for XGP.

Hypothyroidism due to Hashimoto thyroiditis post struma ovarii excision.

Struma ovarii is a rare ovarian teratoma that may produce hyperthyroidism. The association with Hashimoto thyroiditis HT, however is rare and has been reported in only one case. We report a case of HT following the resection of struma ovarii tumor, after which the patient became frankly, hypothyroid with elevated thyroid stimulating hormone and low thyroxin levels. Her thyroid peroxidase antibodies were positive. She improved after initiation of levothyroxine replacement therapy. We believe her euthyroid status preoperatively was due to thyroid hormone secretion by struma ovarii itself.

Benign mucinous cystadenoma with stromal luteinization during pregnancy: a hormonally responsive tumor and a rare cause of fetal intrauterine growth restriction.

A 32-year-old woman, gravida 4, para 3, had a benign right ovarian mucinous cystadenoma. It was diagnosed 1 month before conception, measured 9 x 7cm, and reached 33 x 24 x 20cm at 38 weeks gestation. Cesarean delivery of a 2250 g normal female infant took place, and the removal of a 6300 g right ovarian cystic mass was also performed. Microscopic and immunohistochemical studies of the cyst wall revealed stromal luteinization and a strong reaction with antiserum to testosterone, estrogen and progesterone.