Systemic infections with Trichosporon beigelii (cutaneum). Report of three new cases

Three new cases of systemic mycosis due to Trichosporon cutaneum are reported and compared with the 23 previous reports. Two patients had acute leukemia and one patient had a lymphoblastic lymphoma. Blood cultures in two patients and cerebrospinal fluid in the third patient were positive for T. cutaneum. Only one patient recovered after antimycotic therapy and concomitant remission of his leukemia. At autopsy, the two other patients showed widespread infection with T. cutaneum. The authors conclude that diagnosis and management of such infection in the immunosuppressed host are difficult and the prognosis is poor.     

Case reports. Isolation of two Trichosporon cutaneum strains from urine

Two strains of Trichopsoron cutaneum were isolated from the urine of two male patients. Antifungal susceptibility and cross-reactivity with Cryptococcus antigen latex agglutination text as well as the patients' situation are reported.     

Primäre Magenmykose,durch Trichosporon cutaneum verursacht: Primary Gastric Mycosis,Caused by Trichosporon cutaneum

Zusammenfassung: Eine durch gastroskopische, histologische und mykologische Untersuchung bewiesene, von Trichosporon cutaneum verursachte isolierte primäre Mykose kommt zur Demonstration. Im Einklang mit literarischen Angaben betonen die Verfasser die Wichtigkeit der komplexen Behandlung und der planmäßigen Nachprüfung. Summary: A case of primary gastric mycosis caused by Trichosporon cutaneum is demonstrated. It was verified by gastroscopic, histologic and mycologic examinations. In accordance with data from the literature, the authors point to the importance of complex treatment and systemic follow-up investigations.     

Extracardiac rhabdomyoma: a report of two cases

Two case reports of extracardiac rhabdomyoma (adult type) are presented. The rare occurrence of extracardiac rhabdomyoma and its relatively benign nature makes a histological diagnosis very necessary, though often difficult to make. In both cases reported here, a diagnosis of extracardiac rhabdomyoma was given and treatment with local excision yielded good results. The importance of a histological diagnosis and treatment by only a local excision is stressed.     

Paraneoplastic pemphigus: a report of two cases

Paraneoplastic pemphigus (PNP) seems to be a separate autoimmune mucocutaneous disease. Forty-five cases have been reported. Almost all cases of PNP are associated with a tumour, mostly with haematologic malignancies. Pemphigus-like autoantibodies are detected by direct and by indirect immunofluorescence studies. These autoantibodies appear to be directed against a novel set of autoantigens. Two cases are presented with clinical, histologic, immunofluorescence and immunoprecipitation findings characteristic of PNP.     

Subcutaneous mycosis in a cat due to Staphylotrichum coccosporum

Summary. A 5.5-year-old, male, feline leucosis virus-positive cat developed a concurrent dermato-phytosis due to Microsporum canis and a subcutaneous infection due to Staphylotrichum coccosporum. St. coccosporum caused mycetoma-like lesions. The fungal elements revealed features like those seen in phaeohyphomycosis. Until now St. coccosporum has been described to be non-pathogenic. The pathogenicity of St. coccosporum was corroborated by experimental infection.
Zusammenfassung. Eine 5,5 Jahre alte, männliche, FeLV-positive Katze erkrankte an einer Microsporum canis -bedingten Dermatophytose, sowie einer durch Staphylotrichum coccosporum hervorgeru-fenen subkutanen Infektion. St. coccosporum verursachte Mycetom-ähnliche Granulome in der Unterhaut. Die Pilzelemente hatten ein für Phaeohyphomykose charakteristisches Erscheinungsbild. Bislang galt St. coccosporum als apathogen. Durch experimentelle Infektion konnte die Pathogenität von St. coccosporum bewiesen werden.     

Successful treatment of disseminated Trichosporon beigelii (cutaneum) infection with associated splenic involvement

Fungemia caused by Trichosporon beigelii (cutaneum) has been recently recognized as a fatal infection afflicting immunocompromised patients. The authors report the case of a leukemic patient who developed splenic infection from disseminated T. beigelii. Treatment with amphotericin B, 5-fluorocytosine, and splenectomy proved successful. The etiology of disseminated T. beigelii infection, visceral seeding, and combination antifungal therapy also are discussed.     

UFT in esophageal cancer: a report of two cases

We report two patients with esophageal cancer who responded to UFT. The patients were a 71-year-old female and a 61-year-old male, both of whom had recurrent disease in the esophagus or abdominal lymph nodes. They had received previous treatment consisting of radiotherapy and chemotherapy containing cisplatin, methotrexate and peplomycin. Each patient was administered UFT 400 mg/day p.o. No toxic effect was seen.     

Quintuple synchronous colon carcinoma: a report of two cases

Two patients with five synchronous colon cancers are reported. The diagnostic and surgical approach to synchronous colorectal tumors is discussed.     

Radiotherapy and Marfan syndrome: a report of two cases

Marfan syndrome (MFS) is a heritable disorder of the connective tissue which has been linked to mutations in the FBN (fibrillin-1) gene. Murine knockouts of the FBN gene show increased interstitial fibrosis and TGF-beta (tumor growth factor-beta) gene activation. Abnormal TGF-beta expression has previously been linked to radiation-induced fibrosis, suggesting a possible link between MFS and increased late effects following radiotherapy. Herein we report two cases in which MFS patients treated with radical radiotherapy without undue acute or late radiotherapy toxicity suggesting that radiotherapy should not be withheld from MFS patients. MFS patients may provide a unique clinico-translational setting to test associations between FBN mutations, TGF-beta activation and the risk of tissue fibrosis.     

Meningeal melanocytoma: report of two cases

Two cases meningeal melanocytoma, one each at cranial and spinal location, are described. Neurological deficits in both cases improved following surgery. Pathological features of this rare tumour are discussed.     

Post-traumatic glioma: report of two cases

We report two cases of brain glioma that developed in the scar of an old brain trauma. The first is that of a 40-year-old man who presented with severe headaches; CT and MRI showed a large mass in the right parietal region. The tumor was unresectable and surgical biopsy showed a glioblastoma multiforme. The patient had suffered a cranial trauma in a road accident 20 years previously with an intrathecal hematoma in the right parietal region. The second case concerns a 60-year-old man who, 15 years after severe head injury in a road accident, developed a glioblastoma multiforme which was localized in the scar of the brain contusion. These cases fulfill the established criteria for a traumatic origin of brain tumors and add further support to the relationship between cranial trauma and the onset of glioma. As stated by other authors, an association between head trauma and brain tumor risk cannot be ruled out and should be studied further.     

Renal oncocytoma: report of two cases

The clinico-radiologic, gross, microscopic and ultrastructural findings in 2 cases of renal oncocytoma are reported. The diagnosis of renal oncocytoma has important clinical and prognostic implications, since the neoplasia is usually benign despite its often large size. The differential diagnosis with other renal neoplasms, in particular renal cell carcinoma, is discussed. The problem of the pre-operatory diagnosis of renal oncocytoma is explored on the basis of clinico-radiologic findings and/or histologic examination of pre- or intraoperatory biopsy. In view of the tumor's benign nature, this diagnosis implies tumorectomy, but its close resemblance to renal cell carcinoma at present counsels nephrectomy. A final diagnosis of oncocytoma may be formulated only after histologic examination of several specimens and ultrastructural confirmation.     

Germ cell tumours confined to the supra-clavicular fossa: a report of two cases

Two cases of germ cell tumours in males presenting as a left supra-clavicular mass, with no evidence of disease in other sites, are reported. Biopsy showed seminoma in one case and teratoma in the other. Supra-clavicular germ cell tumour as an isolated finding after intensive investigations has not previously been reported.     

Invasive pulmonary mycosis due to Chaetomium globosum with false‐positive galactomannan test: a case report and literature review

In this case, the authors report Chaetomium globosum as a cause of invasive pulmonary infection in a patient with Wegener's granulomatosis. Fungal hyphae (KOH and Calcofluor) were seen on direct microscopy of lung biopsy sample and bronchoalveolar lavage (BAL) sample. C. globosum isolated on culture clinched the diagnosis of invasive pulmonary infection by Chaetomium spp. A positive galactomannan of serum and BAL was repeatedly seen and was utilised for follow‐up and as prognostic marker in patient management. The patient was successfully treated with liposomal amphotericin B followed by voriconazole. All the Chaetomium infections reported till date since 1980 are reviewed. Chaetomium spp. with its unique ecology has a hidden clinical potential to cause invasive mould infections.     

A biliary endocrine cell carcinoma: a report of two cases

An endocrine cell carcinoma is a carcinoid tumor that has an especially malignant prognosis. We herein report on 2 cases of a biliary endocrine cell carcinoma. Case 1 involved a 68 year old man manifesting a fever, jaundice, hepatomegaly and a ballooned gallbladder. After decreasing the jaundice by PTCD, an exploratory abdominal operation was performed. As a tumor was found at the papilla of Vater, a pancreaticoduodenectomy was done. Case 2 involved a 72 year old woman who was diagnosed as having a gallbladder tumor and cholelithiasis. She was given a cholecystectomy and a choledocholithotomy. These 2 cases had hepatic metastasis within a year and subsequently died. Procedurally, an endocrine cell carcinoma should be treated separately from classical carcinoid tumors.     

Overdose of lomustine: report of two cases

Two male patients with high-grade gliomas were treated with subtotal or total resection and radiotherapy followed by a lomustine-containing chemotherapy regimen. Both patients took lomustine at an oral dose of 800 mg over five days instead of their regular doses of 200 and 240 mg. Grade 4 neutropenia and thrombocytopenia developed in both patients within two weeks of the last lomustine dose. One of them was admitted to hospital because of febrile neutropenia. Neutropenia and thrombocytopenia were detected in the other patient when he was examined in the emergency room following a generalized convulsion. Both patients recovered from the severe myelosuppression caused by lomustine. No other organ toxicities were observed.