Adrenal myelolipoma: a report of a case

This is a case report of an adrenal myelolipoma, accidentally diagnosed during a work-up for bladder tumor. A 67-year-old male presented with the chief complaint of gross hematuria. He was subsequently diagnosed as having a bladder tumor, which was resected transurethrally and was found to be a transitional cell carcinoma of Grade 2 and Stage pT2. During further examination for metastasis computed tomography (CT) scan revealed a round tumor (approximately 5 cm in diameter) in the left adrenal. A tentative diagnosis was reached based on the scan, and surgery was undertaken to remove the tumor. A well-encapsulated tumor, yellowish and partly dark brown in color and 60 grams in weight, was retrieved. The tumor consisted of mature lipoid cells with myeloid cells scattered among them which verified the pathological diagnosis of adrenal myelolipoma. The present case is the 16th clinical case of adrenal myelolipoma reported in the Japanese literature.     

Nodal marginal zone lymphoma: a heterogeneous tumor: a comprehensive analysis of a series of 27 cases

We have reviewed the clinical, morphologic, immunophenotypical, and molecular features of a series of 27 cases of nodal marginal zone lymphoma with the aim of defining this entity more precisely. The series was characterized by a relatively favorable clinical course, with a low clinical stage at diagnosis (59% patients with clinical stage I-II) and a 5-year overall survival probability of 79%. However, the disease persisted in a relatively large fraction of the patients, thus yielding a 5-year failure-free survival probability of 22%. Molecular and immunohistochemical analyses of the series revealed heterogeneity in the frequency of IgV(H) somatic mutation and in the expression of IgD, CD43, MUM1, and CD38. Apart from the absence of nuclear Bcl10, no clear distinction could be made from the expression profiling of other B-cell lymphomas claimed to be derived from marginal zone B cells. Additionally, the immunophenotype of the tumoral cells in all cases but one differed from that described in monocytoid B cells. It was characterized by a Bcl2-, p21+, cyclin E+ profile. The analysis of apoptosis-regulator proteins disclosed abnormalities in the expression of survivin and active caspase 3, which could partially explain the abnormal regulation of apoptosis observed in these tumors. Molecular and immunohistochemical data obtained in this study strongly imply that there is significant heterogeneity among the cases included in the category termed nodal marginal zone lymphoma.     

Brucella orchitis: a rare cause of testicular mass: report of a case

Brucellosis is a multiorgan infectious disease. The genitourinary system is affected in 2–20% of the cases and the most common form is orchitis. Rarely, patients may present with a testicular mass and it must be distinguished from malignant processes. We report brucellar orchitis, a rare cause of testicular mass, in a 22-year-old man. We described the clinicopathological features of this rare entity and reviewed the literature.     

Femoral shaft fracture below a pre-existing implant: a novel method of fixation: a case report

Femoral shaft fractures below or above a pre-existing implant in the elderly are not uncommon, and the ideal management of these fractures is not well defined. We report the use of a retrograde femoral nail for a femoral shaft fracture, linked to a pre-existing hip plate screw construct by locking the nail through the distal two holes of the plate. We were able to achieve a biomechanically stable construct with no gapped areas and no stress risers in osteopenic bone. This technique is one of the various methods that can be chosen to fix a fracture with a pre-existing implant proximally.     

Uncommon calcification of a pheochromocytoma: a case report

A 62-year-old man with a 2-year history of hypertension was referred for evaluation of severe back pain, but his blood pressure was normal during his hospital stay. Plain radiography and excretory urography demonstrated central and eggshell-like calcification in the left suprarenal area. Computed tomographic scan confirmed similar shapes for the left adrenal calcifications. Laboratory examination revealed that the urinary normetanephrine was elevated. Left adrenal venography showed that the mass was in the middle to lower portion of the left adrenal gland. The most likely diagnosis was, calcified pheochromocytoma. The left adrenal tumor was removed surgically through a thoracolumbar incision on September 19, 1985. The blood pressure rose to 186/102 mmHg at the time of tumor manipulation. The tumor was a markedly hard mass, which was 3.5 x 3.5 x 3.0 cm and weighed 20 g. The histopathologic diagnosis was calcified pheochromocytoma. The patient remained symptomless after the operation.     

Pseudarthrosis of a calcaneus fracture: a case report

Nonunion after a calcaneus fracture is rare. A forty-two-year-old man presented with complaints of extreme left heel pain on weight-bearing, that required him to use crutches. Clinical and radiological studies yielded a diagnosis of calcaneal nonunion. He had a history of an open calcaneal fracture that occurred in a traffic accident eight months before, for which he received cast treatment. He underwent surgical treatment (curettage, bone graft, and internal fixation) for the nonunion of the calcaneus. Eight months after the operation, no problem was observed at the union site, and the patient returned to his normal activity levels. He had a slight heel pain appearing only after walking long distances, which was attributed to the subtalar joint.     

Parathyroid adenoma autoinfarction: a report of a case

BACKGROUND: Parathyroid adenoma autoinfarction, although uncommon, is an entity that has been previously reported in the literature; however, the influence of intraoperative parathyroid hormone (PTH) monitoring on therapeutic management has not been reported. METHODS: We present a case of parathyroid autoinfarction that is unique in that it applies a new technology to parathyroid surgery: intraoperative PTH monitoring. RESULTS: Intraoperative PTH monitoring aided in the successful surgical management of this patient. CONCLUSIONS: Intraoperative PTH monitoring can serve as a therapeutic adjunct in the surgical management of parathyroid adenoma autoinfarction.     

Appendix-ureteroplasty in a child: report of a case

The use of vermiform appendix as a tube to replace right ureteral segment has been reported, rarely in child. Herein is reported a case of right ischemic ureteral stenosis following a reimplantation of the ureter for high grade reflux secondary to posterior urethral valves with only one functioning kidney. A long ureteral defect was bridged successfully by appendix interposition and then reimplanted in the bladder at four years of age. The interest of ureteroappendiculoplasty provides temporary solution to repair long ureteral defect, in spite of uncertain future, especially in childhood.     

Swallowing a safety pin: Report of a case

Ingestion of a foreign body is a frequent and wellknown medical problem with several diagnostic and therapeutic approaches.Usually,ingested foreign bodies pass through the alimentary tract without incident.In some cases,they can be lodged in the appendix and may cause appendicitis.We report a case of a 29-year old woman,suffering from mental illness,with a safety pin lodged in the appendix.Initially,the patient consulted for abdominal pain.After a period of waiting,during which time the foreign body did not move,a colonoscopy was performed but failed to see the safety pin.Then,the patient underwent a laparoscopic appendectomy.Pathological examination showed an ulcerative appendicitis.