An unusual case of extensive xanthogranulomatous orchitis in a diabetic patient.

OBJECTIVE: We report an unusual case of extensive xanthogranulomatous orchitis (XGO) in association with poorly controlled diabetes mellitus. CLINICAL PRESENTATION AND INTERVENTION: A 65-year-old Kuwaiti man with poorly controlled diabetes mellitus presented with a painful left testicular swelling of 1 year duration. Testicular tumor markers were normal. Scrotal ultrasonography showed a mass lesion of mixed echotexture, which almost replaced the testicular parenchyma. Left-sided orchiectomy was performed with the clinical diagnosis of testicular neoplasia. Subsequent examination revealed the diagnosis of XGO, and the patient is well 2 years after the operation. CONCLUSION: Extensive tumorous XGO associated with diabetes mellitus has not been previously reported. We offer this case to highlight the implied role of poorly controlled diabetes mellitus in the pathogenesis of XGO.

Gastric heterotopia of the anus: report of two rare cases and review of the literature.

Heterotopic gastric mucosa is an extremely rare occurrence in the anorectal region, with 41 reported cases till date. Of these, in only nine cases the heterotopic tissue has been found to be located within 2 cm of the dentate line. We report two cases of gastric heterotopia in the anus - one, in a 55-year-old man; and the other, in a 35-year-old woman. Sigmoidoscopy showed presence of a single sessile anal polyp in the first patient and hemorrhoid in the other. Pathologic examination of the biopsy specimens revealed fundic-type gastric mucosa in both the cases. Both the patients had complete resolution of symptoms after the excision. We present these cases to highlight the significance of recognizing this unusual histologic entity. To the best of our knowledge, the second case represents the first reported description of gastric heterotopia in association with hemorrhoid.