Malignant mesothelioma of the tunica vaginalis

Case report of a new case of malignant mesothelioma of the tunica vaginalis testis. A mediterranean male age 62, presented with enlargement and swelling of the scrotum, treated as orchiepydidymitis within the previous 3 months. Physical and ultrasonography examination showed a left scrotal mass with extension to the skin of the scrotum. After surgery (orchiectomy and partial hemiscrotectomy) and histopathology diagnosis of locally advanced malignant mesothelioma, CT showed metastasis in retroperitoneum, Lung and Liver. The patient undergoes chemotherapy and radiotheraphy with a poor prognose. We review the diagnosis, histopathology and therapeutical approach for this uncommon kind of paratesticular tumor (less than 80 cases reported in the last 30 years).     

Does primary melanoma of the bladder exist?

Primary melanoma of the urinary bladder is a rare neoplasm to which very strict diagnostic criteria apply. Although reports of previous cases exist, these criteria have yet to be met. We report a case of a young lady from whom a malignant melanoma of the bladder was resected. This was presumed to be primary as detailed investigation failed to find any other site from which metastases could have originated. We discuss the diagnostic criteria of this entity and stress the difficulty in conclusively demonstrating that, despite some of these criteria being met, a lesion such as this is primary in origin. This case could be the longest surviving patient with primary melanoma of the bladder, however we will never be able to prove that spontaneous regression of an undiagnosed extravesical primary malignant melanoma did not occur.     

Report of 2 new cases of bladder inverted papilloma, one with them complicated with acute urinary obstruction

Inverted papilloma is a rare tumour (2.2% of urothelial tumours) considered to be benign. The bladder is the most frequent site and growth tends to be endophytic towards the submucosa. Haematuria and obstruction symptoms appear to be the most typical clinical manifestations. Contribution of two cases of inverted bladder papilloma; one showing very unusual clinical development with relapsing acute urinary obstruction. Strict follow-up is recommended in spite of its benign behaviour as it may become associated to transitional cell carcinoma. Literature review on this tumoral entity in terms of etiology, clinical manifestations, diagnosis and treatment.     

Analysis of anti-reflux surgery failure

Recurrent gastroesophageal reflux following fundoplication is a challenging problem, because it is usually refractory to medical treatment and a second, technically difficult, antireflux operation is required. Different factors that may contribute to surgery failure have been identified in children. We present 8 cases who underwent redofundoplication after failed procedures, from a total number of 96 patients operated on due to gastroesophageal reflux. Four patient's had their initial fundoplication performed at our institution. Six patients were neurologically impaired, six had chronic pulmonary disease, and two had esophageal atresia. The main presenting symptoms were recurrent vomiting (n = 8) and aspiration (n = 4). Gastroesophageal reflux was confirmed by barium swallow and endoscopy. Operative findings showed wrap breakdown in two cases, warp breakdown associated with hiatal hernia in five, wrap breakdown associated with paraesophageal hernia in two cases, and paraesophageal hernia with normal wrap in one. A second Nissen procedure were performed in five cases, whereas a Collis-Nissen gastroplasty was realized in three with a short esophagus. Six patients had a successful outcome remaining symptom free, one has severe disphagia, and one has recurrent vomiting. In our experience, patients with recurrent gastroesophageal reflux disease should undergo an antireflux procedure tailored to specific anatomic or functional abnormalities.     

Necrotizing histiocytic lymphadenitis (Kikuchi-Fujimoto disease) in a 7-year-old girl

Kikuchi-Fujimoto's disease is a rare self-limited condition of young adults that usually involves the cervical lymph nodes and is associated with fever, rash and some haematological alterations. Diagnosis is based on characteristic pathologic findings that permit differentiation of this disease from lymphoma, systemic lupus erythematous and infectious lymphadenopathies. We describe a case of 7 year-old female presenting with cervical localization of Kikuchi-Fujimoto's disease. To our knowledge, this case results the earliest affection of this disease. Our proposal with this article is to remind the pediatricians and pediatric surgeons of this poorly recognized entity when children ask for cervical masses and fever.     

Progressive acquired lymphangioma: report of a case and review of the literature

We present 2-year-old patient with a allopecia lesions in scalp, and clinique diagnostic of Cutis Aplasia. The anatomopathologic study have diagnosed the lesions as Acquired Progressive Lymphangioma (APL). Is a rare vascular tumour that has a tendency to appear in childhood an to progress slowly over the years. It could present as a solitary erythematous macule or plaque and a simple excision is usually curative. Our patient is the youngest reported in the literature.     

Sperm antigens recognized by antisperm antibodies present in sera of infertile adults and prepubertal boys with testicular failure

Immunoblotting of a repertoire of sperm antigens reacting with antisperm antibodies present in sera of infertile adults and prepubertal boys with testicular failure was performed. In the subgroups selected for this study, 55% of examined infertile women, 65% of infertile men and 64% of prepubertal boys with gonadal failure gave positive results by Western blotting with extracted sperm antigens. Sperm antigens with molecular weights of 57, 58, 62, 63 and 66 kDa were the most immunodominant entities recognized by antisperm antibodies from prepubertal boys. No positive reactions were detected by Western blotting in a control population of fertile adults, whereas in a group of prepubertal healthy boys only one sample revealed reactivity against sperm antigens of 58 and 70 kDa.