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Primary renal leiomyosarcomas are rare, aggressive tumors. They constitute 1–2% of adult malignant renal tumors. Although leiomyosarcomas are the most common histological type (50–60%) of renal sarcomas, information on renal leiomyosarcoma is limited. Local or systemic recurrences are common. The radiological appearance of renal leiomyosarcomas is not specific, therefore renal leiomyosarcoma cannot be distinguished from renal cell carcinoma by imaging methods in all patients. A 74-year-old female patient presented to our clinic complaining of a palpable mass on the right side of her abdomen in November 2012. The abdominal magnetic resonance imaging revealed a mass, 25 × 24 × 23 cm in size. Her past medical history revealed that she has undergone right radical nephrectomy in 2007, due to a 11 × 12 × 13 cm renal mass that was then reported as renal cell carcinoma on abdominal magnetic resonance imaging, but the pathological diagnosis was low-grade renal leiomyosarcoma. The most recent follow-up of the patient was in 2011, with no signs of local recurrence or distant metastases within this four-year period. The patient underwent laparotomy on November 2012, and a 35 cm retroperitoneal mass was excised. The pathological examination of the mass was reported as high-grade leiomyosarcoma. The formation of this giant retroperitoneal mass in 1 year can be explained by the transformation of the lesion’s pathology from low-grade to a high-grade tumor.

INTRODUCTION Malignant peripheral nerve sheath tumors (MPNSTs) are rare, up to one half of the MPNSTs occur in patients with neurofibromatosis type-1 (NF-1), while the rest are sporadic. Here, we present a 52-year-old woman with MPNST of the vulva without NF-1. We will discuss basics of the disease, treatment options and follow-up strategies. PRESENTATION OF CASE 52-year-old female admitted to our hospital with complaint of abnormal uterine bleeding and rapidly growing vulvar mass. Excisional biopsy of the mass showed MPNST of the vulva. Afterwards, the patient underwent radical vulvectomy with inguinofemoral lymph node dissection. Short after the surgery, multiple lung metastasis were shown and responded to chemotherapy, but rapid local recurrence occurred short after the completion of the chemotherapy. DISCUSSION The primary treatment option in MPNSTs is surgical excision with or without adjuvant therapy. There is not enough data about the role of systemic chemotherapy in the management of MPNSTs and it still remains controversial. CONCLUSION In general, radiation therapy has not been demonstrated to improve overall survival. Complete surgical resection of the primary tumor is the mainstay of the treatment.

Objective. It has been reported in recent studies that nephron-sparing surgery (NSS) is as effective as radical nephrectomy (RN) for pT1a and pT1b renal cell carcinoma (RCC). In order to decrease the rate of tumor recurrence, resection of a small amount of normal parenchyma surrounding the tumor is widely recommended. Although a 0.5-1.5-cm wide resection margin is recommended no agreement has been reached concerning the thickness of the surgical margin. In this study we tried to determine whether routine frozen-section biopsy from the surgical bed is mandatory during NSS for RCC. Material and methods. The study involved 19 renal units of 18 patients who underwent partial nephrectomy for solid renal tumors (

Osteoblastoma is an uncommon bone tumor most often found in the vertebral column, long bones of the appendicular skeleton, and in the small bones of hands and feet.’ The jaws are rarely involved. Strand-Pettinen et al found 33 cases reported in the literature and added a case of their own.* Although considered a benign neoplasm, osteoblastoma may show an aggressive behavior3 or even sarcomatous transformation4 An aggressive osteoblastoma of the maxilla has been reported.’ An osteoblastoma in the mandible, although rare, can recur6 and may resemble osteosarcoma histologically. A case of osteoblastoma of the mandible that recurred within a year after initial treatment is presented.

background. Microcystic adnexal carcinoma is a rare, slowly progressing, malignant tumor of sweat gland origin. objective. A case of microcystic adnexal carcinoma of the breast with a history of 20 years is presented. methods. On initial examination, the ulcerative cutaneous mass was fixed to the underlying breast tissue and chest wall. Both the macroscopic appearance of the tumor and its location suggested a glandular breast carcinoma. However, an incisional biopsy revealed the nature of the tumor as microcystic adnexal carcinoma of the breast skin. Following the diagnosis, a wide excision of the tumor was carried out for the final treatment. results. To our knowledge this is the first case of microcystic adnexal carcinoma arising in the breast skin presented in the literature. conclusion. This case demonstrates that microcystic adnexal carcinoma can occur on the breast skin and should be treated with wide excision due to its locally aggressive behavior.

background. Malherbe tumors, also known as pilomatricomas, are benign cutaneous tumors of hair matrix origin. objective. To discuss a rare case of multiple pilomatricoma of the head and neck region in a very young patient. methods. A 14-month-old baby presented with two lesions, one appearing on the preauricular region and the other on the nasolabial fold. One of the lesions showed significant ulceration. results. Excisional biopsy was performed for both of the lesions. Although the histopathologic examination suggested pilomatricoma as the diagnosis, the lesion with ulcerations exhibited increased mitosis which made us consider pilomatrix carcinoma in its differential diagnosis. conclusion. Increased mitoses, an uncommon unexpected feature for pilomatricoma, can be a marker for more aggressive biologic behavior.

The scar tissue that forms after lumbar dissection is a severe complication and a cause of lumbar and radicular pain. It was recently shown that radiotherapy could inhibit peridural fibrosis after laminectomy. In this study, the efficiency of external irradiation was compared with spinal membrane application.Thirty male New Zealand rabbits underwent L5 laminectomy. Ten rabbits each received a single fraction of 900-cGy external irradiation administered by 9-MeV electron beam 24 h after the surgery. Ten other rabbits each had spinal membrane applied during laminectomy. The remaining 10 rabbits constituted the control group. All of the rabbits were killed 30 days after the laminectomy. Axial histologic sections through the laminectomy defect were evaluated. Each specimen was scored for the extent and density of fibrosis and arachnoidal adherence.The extent and density of fibrosis and arachnoidal adherence differed significantly between the control group and the treatment groups (p0.05). However, the extent and density of fibrosis and arachnoidal adherence did not differ significantly between the spinal membrane and irradiation groups (p0.05).This preliminary study showed that high-single-fraction/low-total-dose administered postoperatively can successfully inhibit postsurgical epidural fibrosis as effectively as applied spinal membrane.

Congenital granular cell tumor, also known as congenital epulis, is a very rare lesion seen in newborns. The typical presentation is a solitary nodule occurring on the gingiva of the anterior alveolar ridge of either jaw. Multiple-site involvement is seen very seldom but has been noted on the same or different alveolar ridges. However, tongue involvement is exceptional, and there have been only three cases reported involving both the alveolus and the tongue. A female newborn with multiple congenital epulis on the mandibular alveolar ridge and tongue is presented, and her preferred treatment and histopathological diagnosis are discussed.

In vivo preservation of tissues may exist as a problem in experimental and clinical research. Adipose tissue, nerves, and vessels are the tissues that are usually preserved in vivo for future use or for the evaluation of results in experimental research. Limited volume and difficult conditions in such areas in animal models usually create disappointing results, because of the difficulty in distinguishing the experimental from the surrounding tissues; the insufficiency of the volume of space; and the lack of compliance in animals. A new rat model for in vivo preservation studies is described. A muscular pocket designed between the external and internal oblique muscles is a good choice as an animal model for tissue preservation in plastic surgery research.

Prevention of the production of thromboxane A2--a potent vasoconstrictor and aggregating metabolite of arachidonic acid--or infusion of the stable analogues of prostacyclin--which is another cyclo-oxygenase metabolite of arachidonic acid--has been shown to be beneficial in cerebral vasoconstriction. Endothelin-1, a peptide derived from endothelial cells, has been shown to induce a long-lasting cerebral vasoconstriction both in vivo and in vitro. The purpose of this study was to investigate the role of a novel thromboxane A2-synthase inhibitor UK 38485 on the acute vascular and morphological effects of Endothelin-1 applied intra-arterially on rabbit basilar arteries. The inguinal region of twenty four anaesthetized albino rabbits of both sexes were dissected and a catheter was inserted into the aorta via the femoral artery, for control angiography of the basilar artery and intra-arterial injection of ET-1 (0.25 ng total dose) and UK 38485 at a dose of 0.05 microgram kg-1 min-1 for 20 min or saline. Angiographic vasoconstriction quantification and morphological investigations of both vessels and brain stem either by light microscopy or transmission electron microscopy were the techniques applied for the study. We found out that, although the systemic administration of UK 38485 resulted in a potent antagonism of the acute vasoconstriction as visualized in angiographic studies, it did not affect the morphological changes induced by Endothelin-1 on the vessel wall. The results indicated that there might have been an interaction between Endothelin-1 and the prostaglandin synthesis mechanism in acute cerebral vasoconstriction.

Osteoblastoma is a rare primary bone tumor that is curable by complete excision. There are few data about the effectiveness of chemotherapy or radiotherapy in the treatment of recurrent osteoblastoma. We report a 13-year-old girl with recurrent osteoblastoma who, after in complete surgical excision, responded to treatment with radiotherapy and later with chemotherapy. Surgery remains the treatment of choice for osteoblastoma. Radiotherapy and chemotherapy either alone or together may be useful in selected patients with recurrent, aggressive tumor or in patients with surgically unresectable disease. (C) 1997 Wiley-Liss, Inc.

In this study intra-arterial Endothelin-1 was applied to rabbit basilar arteries and morphological findings were compared between two groups who were either perfusion fixed or immersion fixed. We planned to establish the quantitative dimension of the drug-induced morphological alterations, independent of the fixation technique's effect. There was an abundance of collagenous fibres deposited among the smooth muscle cells which was not observed in control arteries and after immersion fixation. These degenerative changes are similar to the finding following subarachnoid haemorrhage. The only fixation-related difference was the fact that lamina elastica interna was not corrugated in the perfusion fixation group. It is concluded that, the observed changes in the connective tissue of the arterial wall alter the passive elastic properties and so affect the degree of the response to the vasoactive messengers.

We report a case of large renal hemangioma that completely filled the collecting system in a 43-year-old man. Most of the renal hemangiomas are small in size and this situation is extremely rare. The diagnosis and treatment of the case is discussed.