Solitary rectal ulcer syndrome: a clinicopathological study of 13 cases

Solitary rectal ulcer syndrome [SRUS] is a rare disorder that has a wide spectrum of clinical presentation and variable endoscopic findings. To further characterize the clinical and pathological features, a retrospective, hospital-based clinicopathological study was conducted. All cases of SRUS diagnosed at Farwania Hospital, Kuwait, between 2002 and 2007 were retrieved from the computerized filing system. The histological slides were reviewed by two authors to confirm the diagnosis. Immunohistochemical stain for smooth muscle actin [SMA] was performed. The clinical files were reviewed for clinical features and endoscopic findings. Thirteen cases were identified: 8 males and 5 females. The age range was 15-85. Rectal bleeding, constipation, and abdominal pain were the most common presenting symptoms and were seen, either alone or in various combinations, in 12 of the 13 cases. Rectal ulceration was the most common endoscopic finding, being seen in 9 of thel3 cases; 3 of these cases had multiple ulcerations. Two patients had rectal polyps, with one of them having multiple polyps. The histological examination revealed surface serration, fibromuscular obliteration of the lamina propria, and crypts' distortion in all the cases. Seven of the cases had diamond crypts. Ectatic mucosal vessels were a common finding. Positivity for SMA in the lamina propria was seen in all examined cases. SRUS is a rare disorder and only 13 cases were diagnosed in Farwania hospital over a 6-year period. The clinical presentation of our patients was variable. The presence of polyps and multiple ulcerations on endoscopy is further evidence that SRUS is a misnomer. Surface serration, fibromuscular obliteration, and crypts' distortion are the most characteristic features. The presence of diamond crypts is an additional diagnostic feature

Ossifying fibromyxoid tumor of soft parts: report of a rare tumor in Kuwait

To report a rare case of ossifying fibromyxoid tumor of soft tissue in Kuwait. A 60-year-old woman presented with a painless tumor, increasing in size and located in the left buttock, which had been present for an uncertain duration. The patient underwent an excisional biopsy. Pathological examination revealed a 7.5-cm well-circumscribed mass with a lobulated cut surface. Histologically, the tumor was encapsulated by an incomplete shell of lamellar bone. The tumor had variable cellularity, and, in areas, contained myxoid stroma. The tumor cells had eosinophilic cytoplasm with vesicular round-to-oval nuclei. Sparse mitoses were noted. Immunohistochemical stains demonstrated that the tumor cells expressed vimentin, S100 and neuron-specific enolase, with the latter expressed focally. To the best of our knowledge, this is the first case of ossifying fibromyxoid tumor of soft parts to be reported in Kuwait. Therefore, pathologists and clinicians should be aware of this tumor