Metastasis to the bladder from pancreatic adenocarcinoma presenting with hematuria.

Pancreatic adenocarcinoma infrequently involves the urinary tract. Hematuria may result from either direct invasion of the kidneys or from metastases to the urinary tract. The bladder may be involved in the late stages from metastases, but rarely is it associated with hematuria since mucosal involvement is very unusual. We report a second case of bladder metastases and hematuria as a presenting symptom of pancreatic carcinoma.     

Parotid lymph node metastasis from adenocarcinoma of the urachus

The parotid gland and its lymph nodes are frequent sites of metastases from head and neck cancers. However, metastasis from a distant primary below the clavicle is unusual. These originate from a variety of sites, most commonly the lung, kidney and breast. A case of a 59-year-old woman with parotid lymph node metastasis from an adenocarcinoma of the urachus, diagnosed on the basis of two discrete periparotid masses on CT and the patient's history, is presented.     

Metastasis to the bladder from pancreatic adenocarcinoma presenting with hematuria

Pancreatic adenocarcinoma infrequently involves the urinary tract. Hematuria may result from either direct invasion of the kidneys or from metastases to the urinary tract. The bladder may be involved in the late stages from metastases, but rarely is it associated with hematuria since mucosal involvement is very unusual. We report a second case of bladder metastases and hematuria as a presenting symptom of pancreatic carcinoma.     

Carcinoma of the urachus.

Characteristic roentgenographic and anatomical features of a mucinous adenocarcinoma of the urachus were observed in two patients. Both presented with a midline anterior abdominal mass in the supravesicular area. The tumor contained fine stippled calcification in one case. The cystogram demonstrated an irregular filling defect in the bladder dome in the other case. Ultrasonographic examination in one case was helpful in delineating the nature, size, and location of the mass in detail.     

Mucinous colloid adenocarcinoma of the lung with lymph node metastasis showing numerous punctate calcifications

Mucinous colloid adenocarcinoma (MC) of the lung represents a rare but distinctive variant of primary pulmonary adenocarcinoma, which usually shows favorable prognosis. We describe the case of a 70-year-old man who had a well-demarcated mass with numerous punctuate calcifications in the right middle lobe. Four months after surgery, multiple bone metastases were found and the poor prognosis was suggested. This is the first case of primary pulmonary MC with the characteristic imaging findings and the rare aggressive clinical feature.     

Duodenal adenocarcinoma presenting as a mass with aneurismal dilatation

Duodenal adenocarcinoma is frequent. Aneurysmal dilatation of the small bowel is reported to be a lymphoma characteristic imaging finding. A 57-year-old male was found to have a duodenal adenocarcinoma with aneurismal dilatation on imaging which is an exceptional feature. On laparotomy, the wall thickening of the dilated duodenum extended to the first jejunal loop, with multiple mesenteric lymph nodes and ascites. Segmental palliative resection with gastro-entero-anastomosis was done. Histopathology revealed a moderately differentiated adenocarcinoma with neuro-endocrine differentiation foci. Wide areas of necrosis and vascular emboli were responsible for the radiological feature of the dilated duodenum with wall thickening.     

Adenocarcinoma of the urachus with vesicoenteric fistula

A case of mucoid adenocarcinoma of the urachus demonstrated by ultrasonography, cystography, and computerized tomography is presented. The inhomogeneous, echogenic mass was confluent with the anterior-superior aspect of the bladder but was also associated with a fistula between the bladder and small intestine, a finding not previously reported.     

Ectopic prostate tissue presenting as a giant pelvic mass with seeding nodules

We report a case of ectopic prostate tissue presenting as multiple lesions resembling a giant pelvic mass with seeding nodules. A 60-year-old man was admitted to the general surgery department of our hospital with an incidentally discovered pelvic mass on computed tomography performed at an outside hospital. The computed tomography scan showed a well-demarcated heterogeneous enhancing mass of 14 cm on the right side of the urinary bladder, and other similarly small nodules were observed in the pelvic cavity and perianal area. Physical examination showed a palpable mass in the suprapubic area; however, the patient did not complain of urinary system symptoms. Laboratory examination showed an elevated level of prostate-specific antigen (12.18 ng/mL). Suprapubic incision and mass resection were performed. The surgeon removed two of the masses and dissected the pelvic lymph nodes. Pathological examination confirmed that both masses were ectopic prostate tissues, and focal adenocarcinoma (<5%) was noted in the largest mass (Gleason score, 3 + 3 = 6). The Prostate-specific antigen level returned to normal postoperatively.     

Flank mass and pain in a 72-year-old man

This patient had retroperitoneal multiseptated masses, which extensively invaded the right flank and thigh musculature. The radiologic, pathologic, and clinical findings were consistent with a retroperitoneal pseudomyxoma from an appendiceal mucocele.