Granular cell tumor of the male breast. A case report

Granular cell tumor of the male breast is an extremely rare neoplasm. The case of a 64-year-old man with a periareolar lump in the upper medial quadrant of his left breast of recent onset is reported. At clinical examination, it was a poorly circumscribed, irregular, hard, mobile 1 cm mass. No axillary lymph nodes were palpable. The patient was submitted to ultrasound scan which showed a 1 cm periareolar solid hypoechoic lesion with an acoustic shadowing and subsequently to fine needle biopsy that revealed the presence of also atypical ductal hyperplasia. For this reason he was submitted to excision biopsy. The definitive histology was of granular cell tumor. The immunohistochemical investigations showed an intense positiveness for S-100 protein; the staining with PAS showed a diffuse positiveness. At 18 months after treatment the patient had no recurrence of disease. Granular cell tumor of the male breast is a neoplasm whose differential diagnosis with carcinoma is often possible only with definitive histology. For this reason, also in front of a mammary lump strongly suspicious for carcinoma, it's always necessary to think it can be this neoplasm and therefore to wait for the necessary histopathologic confirmation.     

Carcinoma of the fourth part of the duodenum: Report of a case

Primary carcinoma of the duodenum is rare, accounting for only 0.35% of all gastrointestinal carcinomas, and carcinoma of the fourth part of the duodenum constitutes approximately 10% of duodenal carcinomas. Since the predominant symptoms of tumors in this part of duodenum are related to upper intestinal obstruction, the diagnosis is usually made late. We report the case of a 66-year-old man who presented with anemia, weight loss, and upper intestinal obstruction, and was found to have advanced primary carcinoma of the fourth part of the duodenum by upper gastrointestinal series and computed tomography (CT). A review of the literature indicates that survival, which is related to nodal status, the grade of the tumor, and surgical results, seems to be longer in patients with carcinoma in this part of the duodenum compared to those with carcinomas in other parts of the duodenum. Moreover, segmentary resection has been reported to achieve a favorable outcome.     

Granular cell tumor occurring in the chest wall: a case report

Granular cell tumors are uncommon soft tissue neoplasm of nerve sheath origin, which are predominately benign. Granular cells can be found at any site in the body including the tongue, skin, subcutaneous tissue, breast, gastrointestinal, and urogenital systems. However, granular cell tumors have only been rarely described in the chest wall. Here we report a case of a granular cell tumor that occurred in the chest wall of a 59-year-old woman, along with a review of the literature.     

Granular cell tumor of the orbit: case report and review of the literature

This is a case report of orbital granular cell tumor in a 65-year-old female who came to our attention with progressive medial displacement of her right eye for the past two years. Clinical, radiologic, histologic, and ultrastructural features of the tumor are described and a review of 18 previously reported cases is given.     

Solitary fibrous tumor of the fourth ventricle: case report

A rare case of solitary fibrous tumor, located wholly within the fourth ventricle, is reported. A 57-year-old male presented with headache and nausea. The preoperative magnetic resonance images revealed a well circumscribed mass in the fourth ventricle that exhibited a low intensity on T1-weighted images and homogeneously enhanced with gadolinium. Vertebral angiogram revealed a tumor stain supplied from the choroidal branches of the posterior inferior cerebellar artery. The tumor was totally resected through a midline suboccipital approach. Histologically, the tumor was composed of spindle-shaped cells growing in fascicles within a collagenous matrix. Immunohistochemical staining demonstrated vimentin and the CD34 positivity of tumor cells. Solitary fibrous tumor is a newly described entity, which should be considered in the differential diagnosis for dural-based lesions.     

Leydig cell tumor of the testis presenting male infertility: a case report

A 33-year-old male was referred to our hospital for male infertility with painless swelling of the left scrotal content. Left high orchiectomy was performed under the diagnosis of left testicular tumor. Histologically, this testicular mass was a Leydig cell tumor. We reviewed 55 cases of Leydig cell tumor of the testis previously reported in Japan, and reported the hormonal profile in our case before and after surgery.     

Granular cell myoblastoma of the bronchus in a child: A case report

Granular cell myoblastoma of the right main bronchus in a 5-year-old girl is reported. The tumor extended to the lower trachea from the right main bronchus which was occluded completely by the tumor. The diagnosis was established histologically by a obtaining bronchoscopic biopsy specimen. Right pneumonectomy was carried out to control pulmonary suppuration caused by the tumor obstruction of the bronchus. External radiotherapy and interstitial brachytherapy were successfull to control the growth of the residual tumor. She has been free from symptoms for about 12 years after the treatment.     

Rare presentation of a gastrointestinal stromal tumor with spontaneous esophageal perforation: A case report

INTRODUCTIONGastrointestinal stromal tumors (GISTs) of the alimentary canal are malignant tumors with <1% of cases diagnosed in esophagus. These cases require special consideration given their close proximity to vital structures and propensity to be highly aggressive. Management of patients with GISTs has been transformed since the introduction of tyrosine kinase inhibitors. In this report, we present an unusual case of GIST with spontaneous esophageal perforation.PRESENTATION OF CASEA 39-year-old Caucasian male presented to our hospital with complaints of severe chest and abdominal pain. A diagnostic chest radiograph revealed a moderate right-sided pleural effusion. Subsequently, an esophagram demonstrated a perforation proximal to an elongated stricture in the distal esophagus. A left thoracotomy was performed whereby a large mediastinal mass firmly attached to the esophagus and gastroesophageal junction was encountered. The neoplasm involved proximal one-third of the stomach and perforated into the right hemithorax. Histopathological evaluation of the tumor led to a diagnosis of GIST.DISCUSSIONGISTs of the gastroesophageal junction are uncommon and may rarely present with esophageal perforation. The standard of care for treating GIST at present includes tyrosine kinase inhibitors. This pharmacologic agent, along with improved surgical techniques and understanding of molecular markers for accurate diagnosis, will assuredly continue to improve overall survival of patients with GISTs.CONCLUSIONWhen stricture or achalasia is detected on imaging, GIST should be considered in the differential diagnosis for individual patients. Additionally, chest and abdomen CT scans of may be performed to confirm presence of a tumor mass, thereby ruling out achalasia.     

Traumatic perforation of the duodenum: report of 5 cases

The results of surgery in 5 cases of traumatic rupture of the duodenum are presented. The site of the laceration, the time between trauma and operation, associated lesions, diagnostic routine and type of operation are specified. The mortality encountered (40%) should be related to the seriousness of the lesions.