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Primary pancreatic hydatid cyst is a rare form of echinococcosis, even in endemic areas. The present study reports the case of a 67-year-old male patient with a primary pancreatic hydatid cyst who presented with severe epigastric pain, vomiting and fever for a period >2 weeks. An endoscopic ultrasound revealed a cystic lesion in the pancreatic head with a solid component. A computed tomography scan and magnetic resonance imaging confirmed the ultrasound finding. Under general anesthesia, the patient underwent total pancreatectomy and splenectomy. A histopathological examination confirmed a primary pancreatic hydatid cyst. Hydatid cysts rarely occur primarily in the pancreas. They may spread to the pancreas through the hematogenous route. Various procedures can be performed for cyst removal, depending on the size and location of the cysts. Open surgery, laparoscopy and hybrid options are available; however, to date, the gold standard is open surgery to prevent spillage and reduce the chance of recurrence. Although rare, primary pancreatic hydatid cysts can occur, with surgery being the main treatment modality due to the vague preoperative diagnosis based on imaging. [ABSTRACT FROM AUTHOR]

Nipple adenoma, an uncommon benign tumor, typically appears between the fourth and fifth decades of life, occasionally manifesting in accessory breasts. The embryonic mammary ridges give rise to accessory breasts along the milk line, and the lack of involution results in supernumerary breasts, including accessory nipples. This study aims to report a case of adenoma originating from an accessory breast nipple. The present study describes the case of a 23-year-old female patient who presented with right axillary discomfort and swelling. A physical examination revealed a tender, non-inflamed lump. A breast ultrasonography revealed features compatible with an accessory nipple, confirmed by excisional biopsy revealing adenoma. Throughout the 4-month follow-up period, no signs of recurrence were observed. Although rare, accessory breast tissue can harbor neoplasms, with nipple adenoma posing a diagnostic challenge often confounded with Paget's disease. Histologically, nipple adenomas exhibit diverse patterns, emphasizing the importance of a precise diagnosis. Adenoma of the accessory nipples is a rare condition that necessitates proper clinical assessment. Surgical excision remains the standard, yielding favorable outcomes. [ABSTRACT FROM AUTHOR]

Epidermal inclusion cyst (EIC) is a benign lesion rarely discovered within lymph nodes. The present case report introduces an EIC incidentally discovered during an axillary lymph node biopsy in a patient with invasive ductal carcinoma of the breast. A 55-year-old woman presented with a breast mass. Ultrasound revealed a suspicious mass, and a core needle biopsy confirmed the diagnosis of invasive ductal carcinoma. Lumpectomy and sentinel lymph node biopsies were performed. Histopathological examination revealed tumor-free lymph nodes, with one of them harboring a keratinous EIC. EICs typically arise from entrapped epidermal cells. Their presence in lymph nodes is exceptionally rare. While the origin of such inclusions remains unclear, various theories exist, including anomalous embryonic development, implantation, and metaplasia. This report highlights the unique presentation of an EIC within an axillary lymph node. Recognizing this entity is crucial to avoid misdiagnosis of malignancy and unnecessary interventions. [ABSTRACT FROM AUTHOR]

Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare variant of renal cell carcinoma (RCC). It is predominately observed in adults and is generally considered an indolent variant with a better prognosis relative to the other forms of RCC. The present study describes the case of a 69-year-old male patient with a prior history of renal cyst who presented with a 3-month history of back and abdominal pain. The patient had right-sided loin tenderness. An abdominal ultrasound showcased a well-defined hypoechoic lesion, which measured 23x26 mm, found on the lateral aspect of the right kidney. A computed tomography (CT) scan of the chest and abdomen with contrast material revealed evidence of a well-defined exophytic mass (3x3 cm) within the lower pole of the right kidney. The patient was managed through a right partial nephrectomy, and the histopathological examination confirmed the diagnosis of MTSCC. At 3 months after the surgery, there was no recurrence or distant metastasis on the CT scan of the chest, abdomen and pelvis. Due to its rarity, there is limited information available regarding the treatment of MTSCC. Usually, tumors with no metastasis are managed by surgical excision, while metastatic MTSCCs have a very controversial approach, mainly consisting of immunotherapy. The case described herein underscores the importance of including MTSCC in the differential diagnoses for RCC. Partial nephrectomy and tumor excision may have a good outcome. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is a heterogeneous and complex disease with numerous pathophysiologic variants. ~40% of patients succumb due to the progression of the disease, making RCC the most fatal of the common urologic malignancies. Prognostic factors are indicators of the progression of the disease, and the precise determination of these factors is important for evaluating and managing RCC. In the present study, it was aimed to determine and find associations among the histopathological features of RCCs and their impact on survival and metastasis. This is a cross-sectional study of RCC cases who have undergone partial or radical nephrectomy from March 2008 to October 2021 and have been pathologically reviewed at Shorsh General Teaching Hospital in Sulaimani, Iraq. The data in the pathology studies were supplemented by follow-up of the patients to obtain information about survival, recurrence and metastasis. In total, 228 cases of RCC were identified, among whom 60.5% were men and 39.5% were women, with a median age of 51 years. The main tumor types were clear cell RCC (71.1%), papillary RCC (13.6%), and chromophobe RCC (11%). Various measures of aggressiveness, including tumor necrosis, sarcomatoid change, microvascular invasion, and parameters of invasiveness (invasion of the renal sinus and other structures), were significantly correlated with each other, and they were also associated with reduced overall survival and an increased risk of metastasis on univariate analysis. However, on multivariate analysis, only tumor size and grade, and microvascular invasion retained statistical significance and were associated with a lower survival rate. In conclusion, pathological parameters have an impact on prognosis in RCC. The most consistent prognostic factors can be tumor size and grade, and microvascular invasion. [ABSTRACT FROM AUTHOR]

Concurrence of renal cell carcinoma (RCC) and urothelial carcinoma (UC) in the same kidney is a rare phenomenon. It is critical to define this unusual disease to avoid a delay in diagnosis and improve the prognosis. The present study describes a case of a 71-year-old patient with synchronous ipsilateral RCC and UC of the renal pelvis and ureter. The patient presented with intermittent attacks of left loin pain with frank hematuria for 3 months and a weight loss of 5 kg over the same period of time. The patient had been a chronic heavy smoker for >45 years. Physical examination revealed stable vital signs; however, a mobile, non-tender mass was palpated in the left upper abdomen. A left nephroureterectomy with the removal of a bladder cuff was performed. Histopathological examination revealed a papillary RCC with a pathological stage of pT1N0Mx and a high-grade UC of the renal pelvis and ureter with a pathological stage of pT3-pN1-pMx. The postoperative recovery was good, and the patient was referred to an oncology center for further management. Previous reports have failed to identify definitive risk factors for the concurrence of RCC and UC. However, 24% of the patients in the various case reports in the literature were smokers. The most common presenting complaints included weight loss and painless hematuria. The concurrence of RCC and UC in the same kidney is a rare entity, and it frequently leads to a worse prognosis than the occurrence of RCC alone. Radical nephroureterectomy is the main line of treatment for patients with upper tract UC. [ABSTRACT FROM AUTHOR]

Crohn's disease (CD) is a granulomatous inflammatory bowel disease. Around 25% of CD patients exhibit extraintestinal manifestations, though pulmonary involvement is rare. This study presents a case of CD causing pleural effusion. A 43-year-old man visited the pulmonology clinic with a dry cough for one-month, right-side pleuritic chest pain, and exertional dyspnea. He was treated with antihistamines and antitussive syrup, with incomplete relief. A chest CT scan showed bilateral mild pleural effusion. Given his occasional black stools and high serum calprotectin, a colonoscopy confirmed CD. Pulmonary manifestations may involve airway, parenchymal, and interstitial pathologies, but no distinctive pathological findings differentiate CD's pulmonary manifestations from other causes. In conclusion, isolated bilateral pleural effusion and the underlying pleuritis as a pulmonary manifestation of CD-characterized by dry cough and pleuritic chest pain, particularly preceding the diagnosis of CD-is extremely rare but possible., Competing Interests: The authors declare that they have no competing interests., (© The Author(s) 2024. Published by Oxford University Press.)