Small cell cancer of the prostate.

De novo small cell cancer of the prostate is a rare tumor and has different presentation, behavior, and outcome compared with adenocarcinoma. A 66-year-old man presented with symptoms masquerading as a rectal tumor. Primary symptoms were intermittent constipation and diarrhea without any urinary symptoms. Initial staging showed only 2 large pelvic nodes. Prostate-specific antigen was 4.8 ng/L. A transrectal prostate biopsy confirmed small cell histology. After having no response to hormones and carboplatin-etoposide, a course of palliative radiotherapy, docetaxel chemotherapy, and defunctioning colostomy offered palliation. Liver and lytic bone metastases developed later; the patient died 9 months after the presentation.

Lichen planus in a case of Good's syndrome (thymoma and immunodeficiency).

Patients with thymoma are mostly investigated for autoimmunity but a few patients may have underlying immunodeficiency that is referred to as Good's syndrome (GS). Cardiothoracic surgeons must always consider this diagnosis when undertaking thymectomy, as immunoglobulin levels can be easily measured and is readily available. The immunodeficiency in GS can be life-threatening and more importantly, it is not reversed by thymectomy. Collaborative care with an Immunologist for these patients is strongly recommended.