giant hemorrhagic adrenal pseudocyst

To report a rare case of a giant hemorrhagic adrenal pseudocyst and highlight the importance of this entity to clinicians. A 57-year-old woman presented with a 1-year history of abdominal pain and distension. Ultrasonography and multislice computed tomography revealed a giant cystic [partially solid] mass over the left suprarenal region measuring 20 x 17 x 15 cm. A complete endocrine workup failed to detect any hormonal hypersecretion. The patient was treated with tumor excision through transabdominal pararectal approach. Histopathological examination revealed a hemorrhagic adrenal pseudocyst. To our knowledge the case presented here appears to be one of the largest hemorrhagic adrenal pseudocysts reported so far. Radiological and clinical features of the tumor are nonspecific and histopathological examination is essential to establish definitive diagnosis. An open, laparotomic adrenalectomy is the preferred surgical technique for better control of such a large mass with active bleeding inside

Giant testicular mixed germ cell tumor

We report a case that we believe to be the largest example of a testicular mixed germ cell tumor with a clearly defined histology pattern. Clinical Presentation and Interventions: A 21-year-old patient consulted a urologist concerning a giant testicular mass. At the time of presentation the tumor measured 29 ' 20 ' 16 cm, with a weight of 4,850 g. Serum -fetoprotein was over 15,000 ng/ml, while -human chorionic gonadotropin was normal. Chest X-ray and CT revealed multiple bilateral metastases. Histopathology revealed a mixed germ cell tumor containing 80% of yolk sack tumor, 10% of teratoma and 10% of embryonal carcinoma. Orchiectomy and chemotherapy were successful in the treatment of primary tumor and bilateral lung metastases. This tumor grew to extraordinary dimensions because of the patient's failure, due to fear, lack of knowledge and embarrassment, to seek medical help and to health professionals' negligence when performing regular check-ups