Mucinous adenocarcinoma of ectopic breast tissue of the vulva

Ectopic breast tissue has been described rarely in the vulva and is known to develop a variety of pathologic changes. Our review of the literature found a total of 11 reported cases of primary infiltrating ductal adenocarcinoma arising in ectopic breast tissue of the vulva. We report what we believe is the first case of primary mucinous adenocarcinoma arising in ectopic breast tissue of the vulva diagnosed by characteristic histopathologic features and immunohistochemical stain results. We discuss the criteria used in diagnosis of primary breast carcinoma of the vulva and review previously reported cases.     

A look at colorectal cancer screening in women

Aroutine physical examination often includes a digital rectal examination (DRE) and a fecal occult blood test (FOBT). To determine the diagnostic yield of these tests in women younger than age 50, the author performed a literature review. This article reviews the most recent research on the DRE and FOBT, outlines guidelines for colorectal screening, and discusses the efficacy and benefits of these guidelines.     

Renal Metabolism of β2-Microglobulin

beta 2-microglobulin (beta 2M) is a protein of 11,800 daltons which occurs in the plasma of normal individuals at concentrations of approximately 2 microgram/ml. It is presumed to be relatively freely filterable. More than 99% of the filtered beta 2M is taken up by an active reabsorptive mechanism and catabolized by the renal tubule. The data presented here demonstrate that renal extraction is only slightly diminished by complete ureteral obstruction. The renal extraction of beta 2M is greater than can be accounted for by filtration alone. These data indicate that some uptake of beta 2M occurs from the peritubular capillary circulation. The loading of animals with beta 2M is associated with a marked tubular proteinuria suggesting that this protein may play a part in inducing tubular injury.     

Emergency contraception knowledge, attitudes, practices, and barriers among providers at a military treatment facility

The safety and efficacy of postcoital administration of oral contraceptives, commonly called "emergency contraception pills" (ECPs), have been well documented; nonetheless, this method of preventing pregnancy is underused in the United States. Through the use of surveys, the current study assessed providers' knowledge, prescribing practices, attitudes, and barriers regarding ECPs at a military treatment facility in the southwest United States. Results showed a lack of knowledge of ECP provision, with 34% believing treatment had to be initiated in 48 or fewer hours, and 60% believing two doses must be taken within 24 hours or more of each other. Slightly more than one- half (54.4%) of the providers reported having prescribed an ECP; those who had prescribed had more positive attitudes about ECPs. Perceived barriers included women not asking for ECPs, concerns about safety of ECPs, and issues regarding liability. A discrepancy between providers' perceived and actual knowledge about ECPs supports the need for better education for all providers who care for women.     

Adenomatoid tumor of the adrenal gland with micronodular adrenal cortical hyperplasia

We report a case of an adenomatoid tumor (AT) of an adrenal gland with micronodular adrenal cortical hyperplasia (ACH). A 51-year-old man was found to have newly developed hypertension with clinical evidence of primary aldosteronism. A computerized tomogram of the abdomen revealed a solitary mass in the right adrenal gland. He underwent a right adrenalectomy for a presumptive clinical diagnosis of a solitary aldosterone-producing adrenal cortical adenoma. On histopathologic examination, the adrenal gland demonstrated an AT, diagnosed by the characteristic histological features, immunohistochemical stain results, and electron microscopic findings. The surrounding adrenal cortex showed multiple small hyperplastic cortical nodules. After the adrenalectomy, the patient's blood pressure normalized. Primary AT of the adrenal gland coexisting with micronodular ACH associated with hypertension has not been previously reported.