Spontaneous partial rupture of the upper renal tract

Spontaneous partial rupture of upper renal tract is rare and is usually associated with urolithiasis. Other causes include instrumentations, trauma, pelvic cancer, retroperitoneal fibrosis, fluid overload, and pregnancy. We report two cases (46-year-old and 41-year-old men) of upper renal tract rupture. The first case had rupture of the ureter proximal to stone impaction and the second case had fornicial rupture secondary to stone impaction at the uretero-vesical junction. In contrast to ureteral rupture, fornicial extravasation is more common and the symptoms are always mild. The mechanism of ureteral rupture can be explained as either pressure around the ureteral wall due to stone impaction, or a tear caused by pressure during the passage of the stone. Fornicial rupture occurs when intra-pelvic pressure is greater than 35cm H2O. It is important to distinguish true rupture of the ureter from fornicial tear with extravasation, because both the outcome and treatment are different.

Her-2/neu gene overexpression in breast carcinoma and its association with clinicopathological characteristics of the disease

To assess the frequency of Her-2/neu gene amplification in breast cancer and its association with clinicopathologic characteristics of the disease. Cross-sectional comparative study. Study was carried out at Surgical Unit I, Holy Family Hospital, Rawalpindi, from January 2005 to December 2006. A total of 50 patients diagnosed of having breast cancer on biopsy of breast lump were included in the study. All patients underwent mastectomy and samples were submitted to AFIP [Armed Forces Institute of Pathology, Rawalpindi] for histopathology and determination of estrogen and progesterone receptors and Her-2/neu gene amplification. Moreover, association of Her-2/neu amplification to other characteristics like tumor size, node involvement, histological grade and presence of estrogen and progesterone receptors were also studied. Out of 50 patients, 18 [36%] were positive for Her-2/neu over expression. Among the various prognostic factors, age showed a statistically significant relation to Her-2/neu positivity [p=0.001]. The Her-2/neu positive cancers were larger in size [mean size of 7.9 +/- 3.615 and 5.4 +/- 1.906 cm in Her-2/neu positive and negative cases respectively; p=0.002]. Her-2/neu positive cases had statistically significant relation to number of involved lymph nodes [mean number of 9.9 and 4.4 lymph nodes in Her-2/neu positive and negative cases respectively; p=0.001]. Tumor grade and nuclear grade had no statistically significant relation to Her-2/neu status [p=0.19 and 0.434 respectively]. Both estrogen and progesterone receptors are inversely related to Her-2/neu positivity [p=0.028 and 0.006 respectively]. The pathological and clinical characteristics of Her-2/neu positive and negative subsets differ, and Her-2/neu over. expression was associated with other poor prognostic factors of age, tumor size and number of nodes involved. There was an inverse relation of Her-2/neu status and hormone receptor

Leiomyoma of the urinary bladder with bladder stone

Leiomyoma of the urinary bladder is a rare benign mesenchymal tumour. We describe here a case of leiomyoma of the urinary bladder in a 65-year-old gentleman who presented with haematuria, passage of clots and combined obstructive and irritative urinary symptoms. The investigations revealed a vesical calculus and a mass on the left lateral wall of the urinary bladder. Cystolitholapaxy and transurethral resection of the tumour was performed. Histopathological report of the resected tumour revealed a leiomyoma of the urinary bladder. So far, a leiomyoma of the urinary bladder and a concomitant vesical calculus have not been described in literature