Differential diagnosis and therapy of rare testicular tumors

The origin, differential diagnosis and therapy of rare testicular tumors are reviewed. 5% of all testicular tumors are rare tumors. Most of these rare tumors are of non-germ cell origin.     

肝脏少见肿瘤的CT诊断

目的：探讨CT增强扫描在肝脏少见肿瘤的诊断及治疗方案选择中的价值。方法：回顾性分析8例经手术及病理检查证实、2例经肝脏穿刺活检证实的肝脏少见肿瘤的CT增强表现特征，并对比分析相关的临床表现、实验室检查和手术所见。结果：病理组织学检查证实，本组10例中良性肿瘤3例、恶性肿瘤7例，CT增强扫描显示，5例为囊实性，5例为实质性；8例表现为不均匀强化，2例淋巴瘤无明显强化。CT可较准确地显示肿瘤与肝内血管的毗邻关系以及对肝邻近组织器官的推压与侵犯等，与手术所见一致。临床表现和实验室检查对肝脏少见肿瘤定性诊断价值不大，但有助于与肝细胞癌鉴别。结论：CT增强扫描对肝脏少见肿瘤定性诊断较困难，但结合临床表现与实验室检查仍有助于与肝细胞癌相鉴别；CT增强扫描可准确判断肿瘤的解剖部位及其对邻近组织器官侵犯的情况，从而帮助制定合理、详细的手术方案。     

Fibromatoses and related tumors of the hand in children. A clinicopathologic review

Benign and malignant tumors of the hand are rare in children. This article reviews some of the common tumors that affect the hand in children, with an emphasis on clinico-pathologic correlations. Illustrated case histories on some rare tumors are also included.     

Extra-gastrointestinal stromal tumor of the pancreas: case report and a review of the literature

Gastrointestinal (GI) stromal tumors are mesenchymal tumors that arise from the GI tract. In rare cases, these tumors are found in intra-abdominal sites unrelated to the GI tract and are immunohistochemically similar to their GI tract counterparts. Primary pancreatic GI stromal tumors are very rare, with only 4 previous cases reported.     

Malignant mesodermal (mesenchymal) tumors of bladder

Malignant mesodermal tumors originating in the bladder are rare. Only a few cases could be found in large series of autopsies or in gathered series of primary retroperitoneal space tumors. Sarcomas originating in the bladder wall grow rapidly and usually infiltrate into neighboring tissues. Two cases of such rare tumors are presented. The polar discrepancy between the clinical situation and the histopathologic findings are emphasized. Therapeutic outlines for these rare cases are suggested.     

A Pilot Feasibility Study of a Rare Skin Tumor Database

BACKGROUND: In the United States melanoma is the only individually reported skin cancer. There are no large state or national registries for nonmelanoma skin cancer. Nevertheless, rare, that is, nonmelanoma, nonepithelial, tumors can also be locally aggressive and metastasize. OBJECTIVES: This study's purpose was to demonstrate that Mohs surgeons can share data to create a rare skin tumor database. This database may serve as a model for a nationwide database. MATERIALS AND METHODS: We retrospectively reviewed the surgery logs of five Mohs surgery practices in the Houston, Texas, area for rare-nonmelanoma, nonepithelial-skin cancers. A total of 42,279 biopsy-proven cancers of the skin treated with Mohs micrographic surgery were reviewed. Tumor data including type, prevalence, year of treatment, and the treating Mohs surgeon(s) were compiled and analyzed. RESULTS: Forty-three types of rare tumors were identified. A total of 317 rare tumors were treated. No practice saw more than 28 rare tumor types. Atypical fibroxanthoma was the rare tumor most often treated. CONCLUSIONS: Colleagues can cooperate to create a database of rare tumors removed by Mohs micrographic surgery. A range of tumors greater than that seen in any single practice is now available for study. This should provide the impetus for a nationwide rare skin tumor database.     

Tumeur glomique extradigitale : une cause rare de douleur chronique de cheville

Glomus tumors are rare benign tumors. The most frequent localization is the hand, particularly, the fingers. An atypical anatomical localization remains rare. It can make the diagnosis difficult and delayed, which alters the quality of life of the patients. The diagnosis is confirmed by histological examination. We report a very rare localization of glomus tumor in the ankle region and we discuss the epidemiological, diagnostic, and therapeutic aspects of these tumors.     

Solitary eosinophilic granuloma of sternum

Primary bone tumors of the chest wall are uncommon, although a wide variety of both benign and malignant tumors arise within the chest wall. Among those tumors, sternal tumors are rare and usually malignant. We report an extremely rare case of eosinophilic granuloma developed in the sternum in a 30-year-old woman. She presented anterior chest pain and somewhat tender mass over the sternum. Chest roentgenogram, computed tomography scanning of the thorax, and total body bone scintigraphy revealed an isolated lytic lesion in the corpus sterni. A tru-cut biopsy of the mass exhibited the typical histologic appearance of eosinophilic granuloma. The solitary lesion was removed completely surgically. This rare condition should be kept in mind in differential diagnosis of sternal lesions.     

Primary adenocarcinoma of the epididymis: case report

Primary epididymal malignancies are uncommon and usually benign. Benign paratesticular tumors are most commonly adenomatoid, while the most common malignant paratesticular tumors are rhabdomyosarcomas. Approximately 25% of all epididymal tumors are malignant, and of the benign tumors, 60% to 78% are adenomatoid tumors. According to a recent MEDLINE search using epididymis and adenocarcinoma as key words, reports of a primary epididymal adenocarcinoma are extremely rare with only 23 cases in the literature. We report a case of epididymal adenocarcinoma with clinical follow up and metastatic natural history of this rare malignancy.     

Primary right atrial synovial sarcoma manifesting as transient ischemic attacks

Primary tumors of the heart are rare and most of them benign. The majority of benign cardiac tumors are myxomas while almost all malignant cardiac tumors are sarcomas. We present a case of primary right atrial synovial sarcoma, a form of sarcoma particularly rare in the heart. The tumor manifested clinically as transient ischemic attacks probably related to a patent foramen ovale allowing paradoxical tumor embolization.     

Gastroduodenal intussusception due to gastrointestinal stromal tumor (GIST) treated by laparoscopic billroth II distal gastrectomy

Gastrointestinal stromal tumors are rare tumors of the gastrointestinal tract. They, however, occur most commonly in the stomach where they present with abdominal pain, bleeding, and obstruction. Many are asymptomatic and are discovered incidentally or at postmortem. We present a case-report of a rare complication of gastrointestinal stromal tumors of the stomach causing gastroduodenal intussusception and how patient was successfully managed by laparoscopic Billroth II distal gastrectomy.     

A Case of a Giant Borderline Phyllodes Tumor Early in Pregnancy Treated with Mastectomy and Immediate Breast Reconstruction

Breast tumors in pregnancy are often times diagnosed at advanced stages secondary to difficulty distinguishing between pathologic from normal physiologic changes. Often benign, phyllodes tumors are rare fibroepithelial stromal tumors of the breast, most commonly diagnosed in the 4th and 5th decades of life. However, these tumors may be characterized by malignancy with metastases in 10% of cases. In this paper, we report a novel case of a young woman presenting at 8 weeks gestation with a large borderline phyllodes tumor. An exceedingly rare condition, with only nine previously reported cases, phyllodes tumors in pregnancy frequently display more aggressive characteristics with larger median tumor size, more malignant potential, and more rapid growth rate. Here, we describe our experience safely and effectively treating this rare condition in a young gravid women with mastectomy and immediate breast reconstruction in the second trimester.     

Pleomorphic adenoma of the submandibular gland

Pleomorphic adenomas of the submandibular glands are exceedingly rare tumors in the pediatric practice. Patients usually present with a painless and mobile mass without any other associated symptoms. Radiologic studies are usually unable to differentiate benign from malignant tumors in most cases. Recurrences are rare with complete en bloc excision of the tumor and the submandibular gland. Except for the rare cases of malignant transformation, the prognosis is excellent.     

Nonlinear optical microscopy for label-free detection of gastrointestinal neuroendocrine tumors

Neuroendocrine tumors (NETs), which are rare and slow-growing neoplasms, pose a diagnostic challenge as they are clinically silent at the time of presentation. Here, gastrointestinal neuroendocrine tumors were researched by nonlinear microscopy, and results demonstrate that this technique has the capability to identify neuroendocrine tumors in the absence of labels and can, in particular, detect rare neuroendocrine tumor cells, vascular invasion, desmoplastic reaction, and fibroelastosis induced by neuroendocrine tumors. These conclusions highlight the possibility of nonlinear optical microscopy as a diagnostic tool for label-freely differentiating neuroendocrine tumors by these histopathologic features.     

Giant cell tumor of the capitate

Giant cell tumors are primary bone tumors most often observed in the metaepiphyses of long bones; location in the hand, especially the carpal bones, is rare. We report a patient with recurrent giant cell tumor of the capitate and discuss treatment and prognosis in this rare site.     

Primary adenocarcinoma of the epididymis: Case report

Primary epididymal malignancies are uncommon and usually benign. Benign paratesticular tumors are most commonly adenomatoid, while the most common malignant paratesticular tumors are rhabdomyosarcomas. Approximately 25% of all epididymal tumors are malignant, and of the benign tumors, 60% to 78% are adenomatoid tumors. According to a recent MEDLINE search using epididymis and adenocarcinoma as key words, reports of a primary epididymal adenocarcinoma are extremely rare with only 23 cases in the literature. We report a case of epididymal adenocarcinoma with clinical follow up and metastatic natural history of this rare malignancy. This revised version was published online in August 2006 with corrections to the Cover Date.     

Testicular neoplasms in the prepubertal male

Unlike adult neoplasms, prepubertal testicular tumors are frequently benign. Yolk sac tumors, which are always malignant, constitute the majority among the histological types of neoplasm reported in the literature. Teratomas are benign in the pediatric population and are the second-most commonly reported testicular tumors. The remaining tumors are exceedingly rare and almost always benign; however, juvenile granulosa cell tumors, undifferentiated stromal tumors, and Sertoli cell tumors may rarely possess metastatic potential. Therefore, testicular neoplasms are varied, rare and often benign. However, even when they are malignant, long-term survival is excellent with prompt diagnosis and treatment. Following an English-based Medline literature search, this article reviews a concise approach towards the management of these individual tumors based on an analysis of the literature in the English language that addresses testicular neoplasms in prepubertal males.     

Cystadenoma of the seminal vesicle

Primary tumors of the seminal vesicle are quite rare with most reported cases being carcinomas. However, benign tumors of the seminal vesicle are extremely rare. We report a case of a cystadenomas of the seminal vesicles in a 46-year-old asymptomatic man, which was detected incidentally by computed tomography.     

Case report: primary ovarian carcinoid: a rare tumor causing unexpected manifestations in a previously undiagnosed woman

Although carcinoid tumors arising from midgut structures are rare, the existence of these tumors is well documented. However, carcinoid tumors arising from the reproductive organs, such as primary ovarian carcinoids, are rare and sparsely documented. Because of this rarity, a small percentage of women may present with ovarian masses that are not properly diagnosed as carcinoid tumor creating unexpected hemodynamic changes under general anesthesia. However, prior knowledge of the clinical manifestations of this rare entity may improve the sensitivity of the preoperative evaluation and allow the anesthesiologist to take precautions as a result of the suspicion of ovarian carcinoid.     

Stromal testis tumors in infants. a report of two cases

Gonadal stroma tumors account for 8% of pediatric testicular tumors and are therefore exceedingly rare. They generally exhibit a benign behavior. We report two consecutive cases of gonadal stroma tumors in infants. A 5-month-old boy presented with a Sertoli cell tumor and a 2-month-old boy with a juvenile granulosa cell tumor without systemic disease. Both were diagnosed incidentally during routine examinations. Organ-sparing surgery and radical orchiectomy, respectively, was the therapy of choice. Although neonatal testicular tumors are rare, they should be considered in the differential diagnosis of a newborn with a scrotal mass.