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Splenogonadal fusion is a rare anomaly consisted of abnormal connection between spleen and gonad or derivatives of the mesonephros. It is usually presented as a painless scrotal mass in children, adolescents or men younger than 25 yoa. In most of the cases the diagnosis is made at pathologic examination of the removed tissue. The scarceness of reports in the literature underlines the rarity of this entity. Here we report a case of splenogonadal fusion in a 19-year-old male with a torsed testicle and history of polytrauma. [ABSTRACT FROM AUTHOR]

Castleman's disease is characterized by lymphadenopathy, with or without systematic symptoms .It comprises of two distinct types, monocentric type which is a benign lymphoproliferative disease, and multicentric type, which is associated with human immunodeficiency virus (HIV) infection . A 36 year old man was attended due to palpation of a sizable, painless mass in the right axilla. He had a previous history of intravenous drug addiction. His medical history, also revealed repeated scratches from his cat. Moreover, his clinical examination revealed the presence of a swollen lymph node group in the right axilla and multiple lacerations in the upper extremities. No other palpable lymph node groups were detected. The serological tests for HIV and Bartonella were negative. A resection of the lymphatic block was performed and the biopsy culture was negative. However, biopsy revealed monocentric Castleman disease, hyaline - vascular type, which is a rare manifestation of the disease since it usually presents as mediastinal, hilar or intraabdominal lymphadenopathy, and rarely as a single peripheral. The resection of the lymphatic block was sufficient to cure the patient. The monocentric Castleman disease is a rare but possible cause of peripheral lymphadenopathy . [ABSTRACT FROM AUTHOR]

The article presents a case study of a 34-year-old woman with a month history of lower abdominal pain who presented in the hospital. It says that ultrasound and pelvic computed tomography revealed a right ovarian mass with eight centimeter (cm) in diameter. It mentions that the patient undergo right salpingo-oophorectomy and she was free of recurrence four years following the surgery.

The article presents a case study of a 47-year-old woman who was evaluated for complaints of intermittent pain at the abdomen's right lower quadrant and secondary amenorrhea for about in the last five months. A tumor at the right ovary was revealed by ultrasound sonography. She was subjected to bilateral salpingo-oophorectomy and abdominal hysterectomy. It mentions that by immunohistochemical examination of the tumor, the patient was diagnosed with pure Sertoli-cell tumor.

We report a case of renal cell carcinoma metastasis to the duodenum., Competing Interests: None declared., (© 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Fungal necrotizing skin and soft tissue infection (NSSTI) represents a rare clinical entity. An extremely rare case of NSSTI, following an open tibia fracture in a 36-year-old male caused by both Syncephalastrum spp. and Fusarium solani species complex (SC) is presented. The infection was diagnosed through direct microscopy, cultures and histology. The disease had a long course. The patient underwent a total of seven consecutive surgical debridements, while proper and timely antifungal treatment was initiated and included liposomal amphotericin B and voriconazole. He gradually recovered and 4 years later he is completely functioning and healthy. Invasive fungal infections are well-documented causes of high morbidity and mortality in immunocompromised individuals, whereas in immunocompetent hosts, trauma-related fungal infections have also been reported. It is of note that Syncephalastrum spp. has very rarely been identified to cause infection in immunocompromised or immunocompetent hosts, whereas Fusarium spp. has rarely been involved in skin necrotic lesions in non-immunocompromised individuals. A high suspicion index, especially in necrotic lesions in trauma patients, is pivotal for early diagnosis, which may lead to lower mortality as well as lower amputation rates. Definite diagnosis through microscopy, histology and/or cultures are of paramount importance, whereas PCR testing may also be extremely useful.

Although severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) affects mainly the respiratory system, the gastrointestinal tract is also considered a site of viral activity. We hereby present the case of a 74-year-old male patient with the diagnosis of new-onset ulcerative colitis. One month earlier, the patient presented fever, running nose, and diarrhea and was tested positive for SARS-CoV-2. Studies with COVID-19 patients revealed significant changes in gut microbiota composition and alterations in immune responses that could lead to chronic inflammation and manifestations of inflammatory bowel disease. We review additional cases of ulcerative colitis presented after SARS-CoV-2 infection and summarize the possible mechanisms that underlie the gastrointestinal abnormalities in COVID-19 patients., Competing Interests: Conflict of interest: None., (Copyright © 2022 The Authors.)

Colonic metastasis due to pancreatic adenocarcinoma is extremely rare. Although it is rare, colonic metastasis should be included in the differential diagnosis of colonic mass., Competing Interests: None declared., (© 2021 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Purpose: We aimed to assess the clinical and predictive role of contrast-enhanced ultrasonography (CEUS) as the primary method for imaging evaluation of prostatic artery embolization (PAE) for the treatment of symptomatic benign prostatic hyperplasia (BPH)., Methods: Thirty-one patients with symptomatic BPH, treated with PAE from October 2016 until February 2018, were enrolled in this prospective, single-center study. Microspheres (100-700 µm) were utilized for PAE. International prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow (Qmax), prostatic volume (PV) and post void residual volume (PVR) were measured at baseline and at 1, 3, and 6 months post PAE. Unenhanced transabdominal US was utilized for PV and PVR measurements; prostatic enhancement was studied with transabdominal CEUS at baseline, during the procedure, 1 day and 1, 3, and 6 months post PAE. Technical success was defined as embolization of the PA of at least one pelvic side. Clinical success was based on the improvement of IPSS and QoL, with no need for any additional treatment. Follow-up time ranged from 6 to 18 months (mean, 9.7±4.3 months). Clinical success rates were calculated and changes in prostatic enhancement were correlated with the outcome parameters., Results: Technical success rate was 90.3%. Clinical success rates at 3, 6, and 12 months post PAE were 85.7%, 85.7%, and 79.1% respectively. Improvement of outcome parameters (baseline vs. 6-month values) was statistically significant, with 12.4 points mean reduction of IPSS (50.4%, P = 0.003), 2.0 points mean reduction of QoL (45.4%, P < 0.001), 30.3 mL mean reduction of PV (30.2%, P < 0.001), 72.6 mL mean reduction of PVR (51.8%, P = 0.005) and 8.6 mL/s mean increase in Qmax (103%, P = 0.002). The most significant complications were bladder ischemia (n=1), and ischemic rectal ulcer (n=1), both attributable to nontarget embolization, with complete recovery. CEUS 1 day post PAE demonstrated prostatic infarcts in 26/28 (92.8%) patients. The percentage of prostatic infarction (pPI, defined as prostatic infarcted volume 1 day post PAE divided by baseline PV) was 1%-71%. There was a very strong positive correlation between pPI and prostate shrinkage (r=0.81, P < 0.001), but a weak correlation between pPI and the improvement of the other outcome parameters (r= 0.01-0.36; P = 0.093-0.965). However, in the subgroup of patients with indwelling bladder catheter (9/28 patients), successful removal of the catheter was achieved only in patients with pPI>10%., Conclusion: CEUS appears to be a practical method for the study of the local ischemic effect of PAE, with potential predictive value.

type of low differentiated carcinoma of the nasopharyngeal region characterized by marked infiltration of lymphocytes in the area involved by tumor. However, carcinomas with this peculiar morphologic feature have been also described in various anatomic locations and they are generally designated «lymphoepithelioma-like carcinomas». Those of the urinary bladder are uncommon as they account of 0.4%-1.3% of all bladder carcinomas. They may coexist with the conventional urothelial carcinoma. Given their rarity, there is poor information regarding their behaviour. Here we present a new case of lymphoepithelioma-like carcinoma in the bladder and we discuss its characteristics and prognosis.

Introduction. Castleman's disease (CD) is a rare lymphoproliferative disorder. CD is divided into two clinical subtypes: the most common unicentric and the less usual multicentric subtype. The majority of unicentric CD affects the mediastinum, while neck, abdomen, and axilla are less common locations. Case Presentation. Herein, we describe a rare case of unicentric CD in the right axilla in a 36-year-old white male with a medical history of hepatitis C virus infection admitted to our hospital due to palpation of a painless mass in the right axilla. Complete excision of the lesion was performed and, one year after the diagnosis, patient was free of the disease. Conclusions. Although infrequent, it is important to include CD in the differential diagnosis when evaluating axillary lymphadenopathy particularly in young patients with a low-grade inflammation process and chronic disease even in the absence of an abnormal blood picture or organomegaly.

Prostatic involvement in granulomatosis with polyangiitis (GWP), formerly known as Wegener's granulomatosis, is rare, mostly arising in the context of systemic involvement. Prostatic involvement as the first manifestation of this systemic disease is exceptionally rare. We hereby present the case of a 41-year-old male patient who underwent transurethral prostate resection for what was initially diagnosed as suppurative, focally necrotizing prostatitis. Prolonged postoperative fever that did not respond to various treatments, as well as the subsequent appearance of a left pleural effusion, a left upper pulmonary lobe lesion and cutaneous nodules, led to a reevaluation of histological slides which, along with the determination of serum c-ANCA/anti-PR3 antibody levels, established the diagnosis of GWP. Physicians, and especially urologists and infectious diseases specialists, should be aware of this rare association and consider GWP in the event of nonresolving prostatitis, especially when characteristic symptoms from other systems appear., (© 2014 S. Karger AG, Basel.)

Pseudosarcomatous myofibroblastic proliferations are very unusual entities of unknown etiology. Despite its benign nature, this entity can easily be misdiagnosed (both clinically and histologically) as a malignant neoplasm. Hereby, we report a case of a 15-year-old woman who presented to our hospital with a broad-based polypoid mass located in the left posterior wall of the urinary bladder. The patient underwent a transurethral resection of the lesion. Morphologic and immunohistochemical findings suggested the diagnosis of pseudosarcomatous myofibroblastic proliferation. The patient is free of recurrence 5 years after surgery., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Introduction: Giant cell arteritis is the most common form of large-vessel vasculitides. However, it is probable that extracranial involvement is underdiagnosed in patients with classical giant cell arteritis. In the recent literature most cases of giant cell arteritis have been described in conjunction with aortic aneurysms or dissections. Nonetheless the coexistence of giant cell arteritis and retroperitoneal fibrosis is extremely rare. Here, we describe a case of giant cell arteritis at a very early clinical stage, in a woman with coexistence of retroperitoneal fibrosis., Case Presentation: We report a case of giant cell arteritis at a very early clinical stage, in a 47-year-old Greek woman with coexistence of retroperitoneal fibrosis who was admitted to our hospital with a history of high-grade fever and mild right periumbilical abdominal pain for the past 30 days. In the context of fever of unknown origin, an abdomen computed tomography was ordered. A temporal artery biopsy was also performed because during hospitalization she complained of a headache. Examination of eosin and hematoxylin slides from biopsy specimens of her temporal artery, showed lesions consisting of predominantly lymphocytes, few plasma cells and occasional polymorphonuclear leucocytes. In addition no giant cells were detected in examining biopsies at multiple levels. This was consistent with giant cell arteritis according to the American college of Rheumatology criteria. An abdomen computed tomography revealed the presence of a retroperitoneal soft-tissue mass located anteriorly to the upper infrarenal aorta at the site of the scintigraphic uptake. The computed tomography and magnetic resonance imaging characteristics of the mass were consistent with retroperitoneal fibrosis, and its morphology suggestive of benignity. Our patient started oral prednisolone and was afebrile from day one., Conclusions: In our experience this is the first case of retroperitoneal fibrosis due to giant cell arteritis occurring at the same time. Involvement of the aorta (aortitis) and its branches has been also observed in a subset of patients with giant cell arteritis. In addition, giant cell arteritis has been associated with a markedly increased risk of aortic aneurysm particularly thoracic aortic aneurysm.

Gastrointestinal stromal tumors (GISTs) represent the majority of primary mesenchymal tumors of the gastrointestinal tract. They are generally considered to be solitary tumors and therefore the synchronous occurrence with other primary malignancies of gastrointestinal track is considered a rare event. Here we present the case of a 75-year-old man admitted to our hospital with a 10-day history of gastrointestinal bleeding. Colonoscopy revealed an ulcerative mass of 4 cm in diameter in the ascending colon. Gastroscopy revealed a bulge in the gastric body measuring 1 cm in diameter with normal overlying mucosa. Surgical intervention was suggested and ileohemicolectomy with regional lymph node resection along with gastric wedge resection was performed. Pathologic examination of the ascending colon mass showed an invasive moderately differentiated adenocarcinoma stage III B (T3N1M0). Grossly resected wedge of stomach showed a well circumscribed intramural tumor which microscopically was consistent with essentially benign gastrointestinal stromal tumor (according to Miettinen criteria). The patient did not receive additional treatment. Two years later the patient showed no evidence of recurrence or metastasis.

Introduction: Cartilaginous tumors involving the small bones of the hands and feet are usually benign such as enchondroma, chondromyxoid fibroma and chondroblastoma. The small bones of the hands and feet are rarely involved by primary chondrosarcoma. Proximal phalanges are the most common sites in the hands, but the fourth digit is the least common site., Case Presentation: We report a case of a 76-year-old Greek female who presented to our hospital with a painful swollen mass measuring 4.5 × 2.6 cm on the fourth digit of the left hand. The radiograph showed a destructive, permeative lytic tumor of the proximal phalanx with extension into soft tissue. The patient underwent curettage, and the microscopic examination of the specimen revealed grade 2 chondrosarcoma., Conclusion: Cartilaginous tumors involving the small bones of the hands and feet are usually benign such as enchondroma, chondromyxoid fibroma and chondroblastoma. Primary chondrosarcoma is the third most common malignancy of bone after myeloma and osteosarcoma, but the small bones of the hands and feet are very rarely involved by chondrosarcoma (1% of all chondrosarcoma). However, in these cases differentiation between a benign lesion and chondrosarcoma may be difficult. Occasionally chondrosarcoma of the hands and feet is associated with multiple recurrences or distal metastasis.

The rarest subtype of malignant fibrous histiocytoma (MFH) is the inflammatory type, which due to its peculiar clinical presentation may mimic an infectious process such as an abscess. The rarity of this disease and the unique features of its presentation may mislead the surgeon with consequent catastrophic results for the patient. In this study, a case report of a 65-year-old female patient with a soft-tissue inflammatory MFH presenting as a lumbar abscess and a review of the current literature are presented.

Pure Sertoli cell tumor (SCT) is a rare sex cord tumor and a subtype of Sertoli-Leydig cell tumors according to the WHO Classification. They lack a Leydig cell component and do not contain the immature neoplastic stroma found in the neoplasms of the Sertoli-Leydig cell category. The age of the patients ranges between two and 79 years. Sertoli cell tumors occur in women of reproductive age but a few can also occur in children. The most common clinical presentation when occurring in children is isosexual pseudoprecocity. Women of reproductive age and postmenopausal women frequently present with abdominal pain, swelling and menstrual abnormalities. Occasionally SCTs occur in patients who have Peutz-Jeghers syndrome. The tumors are hormone functional in 40-60% of cases. They are often estrogenic, occasionally also androgenic or rarely both. Grossly they are usually yellow to brownish, solid or with several cystic areas. Microscopically they show always almost a tubular growth pattern, but they may also have other growth patterns which can be extensive, making the correct diagnosis difficult. These histologic patterns may result in SCTs mimicking other ovarian tumors. The immunohistochemical panel which usually includes EMA, inhibin, chromogranine, CD99 and calretinin is often helpful in establishing the diagnosis. Most SCTs are Stage I, unilateral, cytologically bland, and clinically benign, but occasional examples are high stage. About 11% of Stage I tumors have worrisome histologic features that may portend an adverse outcome.