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We report a case of primary stomach carcinoma arising in the atypical epithelium, which was accompanied with ossification. The patient was a 73-year-old man, who was operated because of the possibility of advanced Type IIa carcinoma. Grossly, a large papillary polypoid lesion was recognized in the anterior wall of the antrum near the pylorus ring. Histological study revealed well differentiated tubular adenocarcinoma arising in the atypical epithelium; ossification was found in the stroma without necrosis, calcification or chondrification. Ossification arising in primary stomach carcinoma is very rare. Only five cases of ossification in primary stomach carcinoma have been reported in the world literature; two of these were Japanese patients. Probably ours is the first reported case with both stomach carcinoma and ossification arising in the atypical epithelium.

Tumor in the spermatic cord is infrequent. Further, among such cases, it is extremely rare to encounter a carcinoma other than a nonepithelial malignant tumor; almost all are metastatic tumors. We recently experienced an interesting case of spermatic cord tumor in a 78-year-old male. He entered our hospital with the chief complaint of a right inguinal tumor. He underwent 2 operations to excise the tumor. The extirpated tumor mass from the right spermatic cord was composed of adenocarcinoma with abundant fibrous stroma, which is considered to be metastasis from the other viscerae. We were unable to find the primary focus in spite of extensive clinical and pathological examinations. In an autopsy about four months after the 2nd operation, the tumor was confirmed to be primary intrahepatic bile duct carcinoma, which is called cholangioma. There have been only 20 cases of metastatic spermatic cord tumor reported in Japan. However, we considered that this is the 1st case caused by cholangioma in Japan and even in other countries.

The first case was a congenital renal arteriovenous fistula in a 33-year-old woman and the second case was a secondary renal arteriovenous fistula in a 67-year-old man. Both cases were seen with asymptomatic gross hematuria without any cardiovascular symptoms. In case 1, the arterial stage of right selective renal angiogram demonstrated a cirsoid type arteriovenous fistula in the right kidney; then, partial nephrectomy was performed. Angiogram of case 2 demonstrated arteriovenous fistula in the lower part of the right kidney. In this case arterial embolization was performed. After reviewing the literature, we believe that partial nephrectomy or arterial embolization is the most useful operative procedure to treat almost all cases of the cirsoid type renal A-V malformation. Conservative treatment of arteriovenous fistula has increased during the post 10 years.