Search

Gangrenous cystitis is an exceedingly uncommon diagnosis characterized by bladder mucosa and submucosal necrosis. The presence of non-specific symptoms and signs complicates the diagnostic process. Necrotizing fasciitis is a rare infection affecting the deep soft tissues, causing progressive destruction of the muscle fascia and rapid systemic spread. This study aimed to elucidate the atypical presentation of rare gangrenous cystitis in the literature, highlighting its potential to lead to necrotizing fasciitis. An 82-year-old female patient was admitted with abdominal and pelvic pain complaints. Computed tomography of the lower abdomen revealed free air-fluid densities in the pelvic region, raising the suspicion of intestinal perforation. Exploratory laparotomy diagnosed the patient with gangrenous cystitis and necrotizing fasciitis. Pathological examination confirmed the presence of necrosis. In patients presenting with acute abdominal symptoms, when free air-fluid levels are observed in imaging studies of the pelvis, rare diagnoses such as gangrenous cystitis should not be overlooked, even if the patient’s history indicates anuria.

Angiomyolipomas (AMLs) are mesenchymal tumors that typically originate from the kidneys and contain smooth muscle cells, fat cells, and blood vessels. They are usually benign in nature but can be fatal due to complications. AMLs almost always involve the kidneys, and only a few studies have reported the possibility of extrarenal involvement as a rare entity. In this study, we examined a patient who presented to our clinic with left-sided pain and was found to have a large AML measuring approximately 15 cm in size in the left kidney. The patient underwent a simple left nephrectomy, and AML was diagnosed after histopathological examination, with intact surgical margins. During the patient’s routine 6-month follow-up visits, approximately four years after nephrectomy, a mass of approximately 13 cm was observed in the nephrectomy bed and radiologically interpreted as a recurrent AML. A tru-cut biopsy of the mass confirmed AML diagnosis. The patient was treated with selective arterial embolization, which was successful without any complications. We believe that our rare case of recurrent large AML will contribute to the diagnosis and treatment choices for patients with recurrent renal and extrarenal AML in the future and will add to the existing literature.

Worldwide, clinically detected prostate cancer is the second most common malignancy, with an estimated 1.1 million new cases in 2012. Standard active treatments for prostate cancer include radiotherapy and/or radical prostatectomy (RP) (for clinically localized prostate cancer). Also active surveillance is a management strategy to avoid or delay the potential harms caused by radical treatments. At this point, a pathology report plays a major role. Appropriate handling and systematic examination of a RP specimen is essential for the identification of tumor characteristics such as grade, volume, pathological stage, and surgical margin status. Although some minor differences in macroscobic evaluation may be seen among authors, it is essential to paint and sample the entire prostatectomy specimen. Most prostate tumors are heterogeneous and multifocal compared to tumors of other organs. This makes macroscopic assessment of prostatectomy specimen challenging and sampling of a representative material from the main tumor focus difficult. Also determining tumor burden and to interpret all surgical margins total sampling of the material is essential.

The number of patients with type 2 diabetes using dipeptidyl peptidase-4 (DPP-4) inhibitors is increasing across the world. Although this class of antidiabetic medications is generally safe and associated with less side effects compared to other oral antidiabetic medications, they could also cause some side effects such as skin rashes. Herein we report a case of type 2 diabetes patient who developed a painful maculopapular rash induced by linagliptin, a widely used DPP-4 inhibitor. A localized painful maculopapular rash developed on the palmar faces of the patient’s hands almost 1 day after the initiation of the drug. The patient was using intensive insulin therapy before linagliptin was started. There was no eruption on the other body parts except the palmar faces of the hands. Following the discontinuation of the drug, the rash disappeared in about four days. The patient had no history of urticaria and did not use an ACE inhibitor. As far as we know, this is the first case report of a skin rash induced by linagliptin in the Turkish literature. This case report highlights a rare and lesser known side effect of linagliptin, a new member of DPP-4 inhibitors.