Adenoid cystic carcinoma of the lacrimal gland metastatic to the kidney: case report and review of the literature

INTRODUCTION

Adenoid cystic carcinoma (ACC) is a malignant neoplasm that arises within secretory glands. It rarely occurs in the lacrimal gland. Kidney metastases are very rare.

CASE PRESENTATION

We report a case of a 76-year-old female patient treated with right radical nephrectomy because of the tumour mass of the right kidney. Well-circumscribed, firm, grey mass was found on the lower pole of the kidney. Histologically, tumour was considered to be ACC. Retrospective history data showed ACC of the lacrimal gland surgically treated 14 years before with metastasis to the lung operated seven years before. Our diagnosis was metastatic ACC to the kidney.

CONCLUSION

ACC has a remarkable capacity for recurrence. To our knowledge, in the English-speaking area (PubMed), 10 cases of ACC metastatic to the kidney have been described to date, and this is the second reported case of kidney metastasis from primary lacrimal ACC.

Persistence of primary MALT lymphoma of the urinary bladder after rituximab with CHOP chemotherapy and radiotherapy

We present a case of a patient with primary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the urinary bladder that persisted after chemotherapy, immunotherapy and radiotherapy.

CASE REPORT

A 48-year-old male underwent a routine ultrasound examination. A tumour mass in the urinary bladder was found and a transurethral biopsy was performed. Pathohistological examination revealed MALT lymphoma. Results of computed tomographic scan, positron emission tomography scan and bone marrow biopsy defined the tumour as primary malignant lymphoma of the urinary bladder. The patient received eight cycles of chemo-immunotherapy (CHOP) and radiotherapy. Five months after therapy, there is a partial radiological remission, but with metabolic progression of the tumour. To our knowledge, this is the first case of MALT lymphoma of the urinary bladder with chemo-immunotherapy and radiotherapy resistance.

The use of color duplex ultrasound and magnetic resonance imaging in the dissolution of idiopathic recurrent priapism in patient with congenital penile curvature--a case report

Priapism, penile erection characterized as prolonged and devoid of sexual stimulation or excitement is a rare condition. It is critical to distinguish between low- and high-flow priapism, because the treatment algorithm differs markedly for these 2 conditions. The diagnosis is made clinically and confirmed with color Doppler ultrasonographic imaging (CDUS). We present a 21 year old men with high-flow priapism and left lateral congenital penile curvature. A duplex Winter shunt procedure was employed with corporeal irrigation of heparin solution and adrenalin solution instillation, but the priapism returned 12 hours after. Following several days slow instillation of phenilephrine or adrenaline solution accompanied by oral flutamide therapy resulted in complete detumescence. We used both CDUS and magnetic resonance imaging (MRI) before and after treatment of priapism. Although CDUS has been the primary modality for cross-sectional imaging of the penis, the superior soft-tissue contrast and spatial resolution afforded by MRI provide an opportunity to advance imaging evaluation of this organ.

Clear cell variant of urothelial carcinoma in urinary bladder; a clinicopathological and immunohistochemical study--a case report

The clear cell variant urothelial carcinoma of urinary bladder is very rare and unusual neoplasm defined histologically by clear cell pattern and glycogen-rich cytoplasm. Our case of clear cell carcinoma was diagnosed with immunohistochemistry stain. A 72-year-old man, presented with painless macroscopic hematuria in November 2007. Evaluation revealed papillary tumor in urinary bladder. A transurethral resection of the bladder tumor (TUR-Bt) was performed. Histopatologic evaluation showed superficial transitional cell carcinoma and carcinoma in situ. On three month follow-up, a solitary pedunculated tumor was detected again in the left wall of the urinary bladder. A repeated transurethral resection of the bladder tumor (reTUR-Bt) was performed in February 2008. The pathological diagnosis was difficult due to diffuse clear cell appearance. Immunohistochemistry stain showed urothelial carcinoma and finally it was diagnosed as clear cell variant. Urothelial carcinoma has many variants that show a variety of appearances and characteristics. These should be well known for evaluation and optimal treatment.