Papillary Cystadenofibroma of the Epididymis: A Case Report.

To date, only 1 example of cystadenofibroma of the epididymis has been reported in the English literature. Here, we present a second cystadenofibroma originating from the epididymis of a 54-year-old man who presented with painful swelling in the scrotum. The scrotal mass measured 6.3 cm and contained a clear yellow, serous to gelatinous fluid-filled cyst with internal papillae. Microscopically, the mass contained both stromal and epithelial components. The stromal component consisted of spindle cells arranged in small intervening fascicles, forming simple cyst and papillae. The cyst and papillae were lined by cuboidal to columnar and ciliated epithelium. Immunohistochemistry staining showed that the stromal component was positive for estrogen receptor, progesterone receptor, and CD10, which are characteristic of ovarian-type stroma. However, the epithelium lining was positive for keratin cocktail AE1/3&CAM5.2, CD10, PAX8, androgen receptor, and alpha-1 antitrypsin, suggesting a possible Wolffian duct origin.

A new identified complication of intracystic hemorrhage in a large pineal gland cyst.

Pineal gland cysts are typically asymptomatic, benign cysts most commonly found incidentally in adults. In rare cases, a large pineal gland cyst can be complicated by intracystic hemorrhage, which could then manifest with neurological symptoms. We report a new complication of intracystic hemorrhage in a large pineal gland cyst in a 40-year-old man with new onset seizures.

Spontaneous tumor lysis syndrome in a patient with metastatic hepatocellular carcinoma.

OBJECTIVE: To report a case of spontaneous tumor lysis syndrome (STLS) of a solid tumor in a patient who had undiagnosed metastatic hepatocellular carcinoma. CLINICAL PRESENTATION AND INTERVENTION: A 70-year-old man with a medical history of alcohol abuse, withdrawal seizure and hypertension presented to the emergency department after being found unresponsive by his landlord. The patient had a bulky mass in the liver, classic laboratory abnormalities, oliguric renal failure and elevated alpha fetoprotein. He had never been treated with cytotoxic therapy. He was treated aggressively with fluid resuscitation and sodium bicarbonate, but he continued to be oliguric and the deterioration of his renal function also continued. Due to a minimal response to treatment and a poor prognosis, he was discharged to hospice for palliative care. CONCLUSION: This case showed that STLS should be in the differential diagnosis of a patient who has malignant disease and has developed classic laboratory abnormalities and renal failure even without previous cytotoxic therapy.