Laparoscopic orchiectomy and simultaneous inguinal herniorrhaphy technique by the transperitoneal route in adult patients

In recent years, laparoscopy has begun to be widely used in many clinics for the diagnosis and repair of nonpalpable testes. Because the technique is noninvasive, it is also used to repair inguinal hernias via the retroperitoneal route. The technique and results of performing laparoscopic orchiectomy and herniorrhaphy simultaneously by the transperitoneal route in patients with abdominal testis and ipsilateral inguinal hernia were addressed in this clinical study. Between 1996 and 2001, laparoscopic intervention was applied in 44 patients ranging in age from 20 to 27 years (average, 23 years) who had both unilateral nonpalpable testis and ipsilateral inguinal hernia. The patients underwent laparoscopic orchiectomy and transperitoneal herniorrhaphy. They were followed for 6 to 24 months postoperatively (average, 16 months). No complications developed during the operation or early postoperative period in any of the patients. No case of recurrent hernia was encountered during the followup period. Efficient laparoscopic transperitoneal hernia repair can be achieved during laparoscopic orchiectomy performed in patients with abdominal testis and ipsilateral inguinal hernia. When this method is used, patients can be discharged on the day after the operation and are able to resume their daily activities within a very short time.     

Multicentric malignant peripheral nerve sheath tumor

We present a case of malignant peripheral nerve sheath tumor of multicentric origin, an extremely rare condition. A 25-year-old man was admitted to hospital with presenting symptoms of cough, dyspnea and left lateral back pain. Computed tomography and magnetic resonance imaging revealed extrapleural masses in the left hemithorax in addition to synchronous left inguinal mass. After surgical resection of the masses from the thoracic and inguinal regions, histological examination confirmed the preoperative diagnosis of malignant peripheral nerve sheath tumor.     

Placental mesenchymal dysplasia associated with trisomy 13: sonographic findings

Placental mesenchymal dysplasia (PMD) is a rare placental abnormality with sonographic and macroscopic features similar to those seen in a partial hydatidiform mole, and which has usually been reported with a normal female karyotype. We report a case of prenatally suspected PMD associated with trisomy 13. Sonography performed at 17 weeks' gestation showed multiple cystic spaces in the placenta resembling molar tissue, and a fetus with postaxial polydactyly and an atrial septal defect. An amniocentesis revealed a fetal karyotype of 46,XY,der(13), t(13;13)(q11;q11)[20]/47,XY,+13[11], consistent with trisomy 13. Cordocentesis confirmed the cytogenetic diagnosis. Histopathologic examination of the placenta following termination of the pregnancy at 22 weeks' gestation showed enlarged stem villi with loose connective tissue and cistern formation and no evidence of trophoblastic hyperplasia or stromal trophoblastic inclusions, which was consistent with PMD. PMD should be considered in the differential diagnoses of a placenta showing multiple cystic lesions on prenatal sonography, and karyotypic analysis should be performed.     

Myxoid neurofibromas of the breast: mammographical, sonographical and MRI appearances

Neurofibromas arise from elements in the peripheral nervous system and are rarely detected in the breast. Neurofibromatosis is a phakomatosis that displays a wide spectrum of clinical expression with neurocutaneous abnormalities and involvement of multiple organ systems. Neurofibromas are more common in neurofibromatosis Type 1. They can show variable amounts of myxoid change, which affect their radiological findings. In this paper, we present a patient with neurofibromatosis Type 1 with mammographical, sonographical and MRI findings of myxoid neurofibromas in her left breast.