Dramatic resolution of bullous pemphigoid after surgery for gastric cancer: A case report

INTRODUCTION

An association between bullous pemphigoid (BP) and internal malignancy has been suggested. However, no reports have documented a dramatic improvement in BP after surgery for gastric cancer.

PRESENTATION OF CASE

An 82-year-old Japanese woman was admitted to a local hospital for severe fatigue. On examination, she was diagnosed with BP and gastric cancer. Her BP was resistant to steroid treatment; however, it improved dramatically after surgery for gastric cancer.

DISCUSSION

In this case, a strong relationship appeared to exist between BP and gastric cancer.

CONCLUSION

This is the first report of a dramatic improvement in BP after surgery for gastric cancer.Abbreviations: BP, bullous pemphigoid; CRP, C-reactive protein     

Bullous pemphigoid in patients receiving peritoneal dialysis: a case series and a literature survey

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease. Although several cases of BP in end-stage renal disease patients receiving peritoneal dialysis (PD) or hemodialysis have been reported, the incidence of BP in these patients remains unknown. We recently experienced three PD patients diagnosed with BP. The skin injury was likely to be a trigger of BP in all the three PD patients. Nifedipine and icodextrin exposures were possible factors directly or indirectly affecting the onset of BP, because they were common in the three cases. We also report that the incidence of BP in PD patients was 3/478.3 person-years in a single-center 10-year study. This case series with a literature survey describes that the skin and tissue injuries are potential triggers responsible for the onset of BP in dialysis patients and that the incidence of BP in these patients seems to be much higher than that in the general population.     

Vegetating erosive cutaneous lesions and pyogenic granuloma in the course of mucous membrane pemphigoid: a case report and review of literature

Mucous membrane pemphigoid (MMP) is a group of chronic autoimmune sub‐epithelial blistering disorders, which mostly affect the oral mucosa and the conjunctiva. MMP is very diverse in terms of both the clinical and immunological features (IgG and IgA autoantibodies may react with different antigens). MMP can be induced by infections and medication, including ophthalmologic medication, which may lead to the development of eye lesions. In contrast, a vegetating variant of MMP is extremely rare. Here, we report an MMP case that demonstrated unusual clinical features, that is, pyogenic granulomas on the conjunctivae and extensive vegetating erosions on the skin of intertriginous regions. All these lesions were considered to be induced by unconventional medication containing arsenic.     

Recurrence of bullous pemphigoid after surgery: report of a case

We report a 38-year-old woman with myoma uteri and bullous pemphigoid controlled by oral prednisolone (7.5 mg.day-1). She underwent transabdominal hysterectomy under epidural anesthesia using mepivacaine supplemented with intravenous midazolam and butorphanol, without untoward event. On the postoperative day 2, recurrence of bullous pemphigoid was noted. The skin lesion of pemphigoid was improved after increasing the prednisolone dose up to 60 mg a day.     

Renal allograft tuberculosis: report of three cases and review of literature

Renal transplant recipients are prone to a variety of infections due a persistent immunodepleted state. Incidence of tuberculosis in this population is much higher compared with the general population. While pulmonary tuberculosis still remains the commonest form in this population, renal allograft tuberculosis is very rare. We report two cases of isolated allograft tuberculosis and one case of allograft tuberculosis with coexistent pleuro-pulmonary and bone marrow involvement. All three cases had presented with pyrexia of unknown origin, wherein despite extensive investigations the cause was not found. In two cases the diagnosis was confirmed on histology. Two cases responded to non-rifampicin-based modified antitubercular treatment and one to conventional four-drug Rifampicin-based regimen. Graft function improved in two cases while in one case the graft was lost. Tuberculosis involving the renal allograft is a potential cause for graft dysfunction/loss and requires a high index of suspicion for diagnosis. Timely detection and early institution of therapy can help save the renal allograft.     

Spontaneous rupture of the quadriceps tendon in renal failure and long-term haemodialysis

Summary Four cases of rupture of the quadriceps tendon in patients on long-term haemodialysis and one in terminal renal failure are reported. Biopsy showed connective tissue elastosis which is known to develop in chronic acidosis. These changes may weaken the tendons.

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Résumé Présentation de 4 ruptures spontanées du tendon quadricipital chez des patients insuffisants rénaux chroniques, ayant subi des hémodialyses, et d'une cinquième survenue dans un cas d'insuffisance rénale au stade terminal.La biopsie du tendon quadricipital a permis de mettre en évidence une élastose du tissue conjonctif, dont on sait qu'elle apparaît dans les états d'acidose chronique.Ces changements de structure peuvent ainsi affaiblir les tendons.

     

Adult cystic nephroma: a case report and a review of the literature

A 23-year old women who underwent radical nephrectomy due to right renal mass is presented. The histopathological examination is reported as adult cystic nephroma, a rare benign lesion of the kidney. The epidemiology, differential diagnosis, histopathological features, and treatment alternatives are discussed and the literature is reviewed.     

Renal cell carcinoma: case report and literature review

Renal cell carcinoma arising from epithelial cells of the renal tubule is a highly aggressive and malignant tumor in all ages. Less than 2% of cases occur in childhood, relatively in older age group. Only a few pediatric series have been presented in the English literature. Tumor is presented with characteristic findings of flank pain, gross hematuria, and palpable mass. Although one half of the patients have metastasis at the time of diagnosis, most cases are currently being incidentally detected using improved imaging techniques. The overall prognosis in children appears to be similar to that in adults. Tumor stage and complete surgical resection have been reported as the most meaningful prognostic factors for the outcome. The incidence of metastatic disease is same as in adults. The effect of chemotherapy and immunotherapy, either preoperatively or postoperatively, is unclear. Cure is the most likely consequence in localized and completely resected tumors. Here, we present an 8-year-old boy with renal cell carcinoma demonstrating only hematuria without any pathological physical examination findings. The mass was described by abdominal ultrasonography and computed tomography in the left kidney. After the left nephroureterectomy, the patient was given no therapy.     

经皮肾镜取石术并发乳糜尿的诊治:附1例报告并文献复习

目的探讨经皮肾镜取石术(PCNL)并发乳糜尿的临床特点及治疗方法。方法回顾性分析2011年5月收治的1例PCNL并发乳糜尿的临床资料,并进行文献复习。患者,女,64岁,因左肾盂肾下盏结石行左侧微通道PCNL,术后当天发现左肾造瘘管和尿管均引出乳白色尿液,尿乳糜尿试验(+++),左肾造瘘管造影显示左肾周丰富的淋巴管显影。通过逆行插入肾盂输尿管连接部封堵器堵塞左输尿管上段,经左肾造瘘管注入2%硝酸银溶液15ml,每次留置10min,共3次。结果术后左肾造瘘管引流尿液变清,尿乳糜尿试验(-),随访9个月未见乳糜尿复发。结论经皮肾镜取石术并发乳糜尿较罕见,确诊依靠其临床表现、乳糜尿试验及相关影像学检查,低脂饮食、肾盂内硬化剂灌注和肾蒂淋巴管结扎术为其可选的治疗方法。     

Renal parenchymal malakoplakia —a case report and review of the literature

Malakoplakia is an inflammatory condition associated with persisting bacterial antigen in macrophages and characterised histologically by the Michaelis-Gutmann body, containing bacterial fragments. We review the pathogenesis of malakoplakia and report a novel form of treatment successfully used in an 8-week-old infant with bilateral renal malakoplakia. The patient presented with an acuteEscherichia coli urinary tract infection and enlarged kidneys. Antibiotic regimes were ineffective, but once the diagnosis was made treatment was changed to an immunosuppressive regime of prednisolone and azathioprine, to which she responded promptly. Renal malakoplakia should be considered in any patient with a urinary tract infection unresponsive to antibiotics and enlarged kidneys. Although a large proportion of patients with malakoplakia have an underlying systemic disorder, which may account for their abnormal macrophage function, the rest demonstrate either an isolated macrophage defect or no detectable anomaly at all. It is in this latter group we suggest that an immunomodulating regime can be curative.     

肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎一例并文献复习

目的探讨罕见的肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎病例的发病机制、病理特点、临床表现、诊断和治疗。 方法回顾性分析1例我院收治的肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎病例临床资料,复习相关文献并予以讨论。患者女,51岁,因"无痛性肉眼血尿6个月"入院,术前拟诊为左肾盂癌伴输尿管膀胱种植转移。 结果先后行膀胱镜检+活检术、经尿道膀胱肿物切除术、3D腹腔镜下左肾切除+左输尿管切除术,术中术后病理结果：左肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎,术后随访6个月未见异常。 结论肾盂脂肪瘤病和膀胱黄色肉芽肿性膀胱炎均为临床上罕见的良性疾病,同一患者同时合并有这两种疾病的病例暂未见报道。该病需与泌尿系统的其他良恶性肿瘤相鉴别,以便正确诊断与及时治疗。     

A complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient: a case for conservative management

Caliceal fistula is a rare complication after renal transplant and may lead to graft failure. We present a case of complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient who was successfully managed conservatively.     

Small cell carcinoma of the urinary bladder in a young man. A case report and literature review

Small cell carcinoma of the bladder is a rare entity characterized by an aggressive clinical behaviour with a high incidence of systemic metastases. We report a case of small cell carcinoma of the bladder in a young man. The primary local tumour was treated by radical surgery, pelvic radiation therapy and polychemotherapy according CDDP protocol. The patient died six months after surgery because disease progression. We also review and update the literature concerning this infrequently tumour.     

Retroperitoneal mucinous cystadenocarcinoma in a man: case report and review of the literature

In the English medical literature, 27 cases of primary retroperitoneal mucinous cystadenocarcinoma have been published. We report the second case of a primary retroperitoneal mucinous cystadenocarcinoma in a man. The patient was an 83-year-old man, with a large 26 x 20 x 16-cm retroperitoneal cystic mass causing abdominal discomfort and cachexia, who underwent excision of the mass. Prior reports suggest that this type of tumor has an aggressive clinical course, and surgical excision is the treatment of choice. These rare tumors need to be included in the differential of retroperitoneal cystic tumors.     

近25年我国胆管支气管瘘文献分析：附213例报告

目的：探讨我国胆管支气管瘘（BBF）患者的临床特点。 方法：检索1989—2013年发表有关BBF的中文文献,提取患者的临床资料并进行汇总分析。 结果：最终纳入51篇文献,共213例BBF患者。BBF患者男女比例为1.22:1,平均年龄为（50.4±11.1）岁,70.1%有既往手术史。BBF患者常见的临床表现有咳胆色素痰（96.5%）、咳嗽（94.5%）、发热（83.8%）、腹痛（79.3%）、胸闷/胸痛（76.2%）、黄疸（59.2%）、呼吸困难（13.5%）;原发病因中包括胆管结石（41.8%）、肝包虫（31.0%）、胆道蛔虫（5.6%）、原发性或转移性肝脏肿瘤（5.2%）、外伤（4.7%）、肝脓肿（4.2%）、先天性病因（2.3%）、多种因素（1.9%）、其他单因素（1.9%）及胆囊结石伴胆囊穿孔（1.4%）。90.6%患者接受了外科手术治疗,总体治愈率为89.5%,好转率为3.3%,病死率为6.2%。 结论：BBF较为罕见,原发病因较复杂;痰液胆色素检验及ERCP等可快速明确诊断;患者及时接受外科手术等治疗可取得良好的治愈效果。     

Tubulocystic renal cell carcinoma,a rare tumor entity: Review of literature and report of a case

Tubulocystic renal carcinoma is a recently described neoplasm of low grade malignancy which was not included in the last WHO 2004 classification. The tumor is extremely rare with less than one hundred cases reported to date. In this article, the literature about that rare renal neoplasm is reviewed and an additional case is reported.