Extra-adrenal retroperitoneal ganglioneuroma

Ganglioneuromas are benign tumors that originate from primordial neural crest cells. We report a retroperitoneal ganglioneuroma arising from the left paraspinal region. A twenty-year old woman presented with left lumbar pain. Neurological workup was normal. Imaging revealed a left paraspinal retroperitoneal mass measuring 9.74 x 6.19 x 4.30 centimeters. Complete surgical removal was uneventful. During follow-up, left lumbar pain improved and imaging showed no evidence of the disease

Villonodular synovitis of left knee joint: role of external radiotherapy

We report a case of villonodular synovitis of left knee joint treated with surgery and adjuvant postoperative external radiotherapy. The patient presented with long standing history of left knee joint swelling and pain which restricted his daily activities. He did not get relief with pain killers. The patient was operated for maximal excision of synovial tissue. Histology confirmed the diagnosis of villonodular synovitis. Postoperative left knee joint MRI showed residual disease. He received adjuvant external beam radiotherapy. Currently, he is free of disease and disability after four years

Malignant phyllodes tumor of the breast metastasizing to the peritoneal cavity

A fifty-three year old Bahraini female presented with painless rapidly growing mass in the right breast of 3 months duration; no nipple discharge was found. Family history was positive for breast carcinoma in situ in her sister. Lumpectomy was performed. Histopathology proved to be phyllodes tumor; therefore, mastectomy was performed to avoid local recurrence. The patient received local radiation to the mastectomy scar. Four months after the initial surgery, she developed a nodule in the mastectomy scar, left breast lump in the upper outer quadrant and intra-abdominal mass. A fine needle aspiration of the mass in the left breast showed spindle cells with focal atypia and a necrotic background. True-cut biopsy of the intra-abdominal mass showed the metastatic stromal component of the malignant phyllodes tumor with malignant spindle cells. The patient condition worsened, developed bilateral pleural effusions. Adriamycin chemotherapy was planned, but the disease was aggressive enough to end her life within weeks

Management of primitive neuro-ectodermal tumor of the vagina in a sickle cell disease patient

A twenty-five years old female, a known case of sickle cell disease, presented with frequent and heavy periods of six months duration. Pelvic ultrasound and MRI showed a vaginal mass pushing the bladder anteriorly; the diagnosis of cervical fibroid was considered. Histopatholgical examination of the mass revealed a very rare entity of primitive neuro-ectodermal tumor of the vagina. This is the first recorded patient of sickle cell disease with primitive neuro-ectodermal tumor of the vagina. The management was challenging in dealing with her disease and preserving her fertility

Gastric leiomyosarcoma: first case report from the Kingdom of Bahrain and review of literature

Gastric leiomyosarcoma are very rare tumors. We are reporting the first case of gastric leiomyosarcoma diagnosed in Bahrain and documented in the cancer registry. Unfortunately, the patient died due to rapidly progressing nature of the disease despite the multimodality treatment

Fulminant amebic colitis a life threatening rare entity

To present two uncommon cases of Fulminant Amebic Colitis. Retrospective study. Surgical and Medical Department at Salmaniya Medical Complex. From March to September 2008, two cases of fulminant Amebic Colitis were seen and reviewed as far as their presenting features, investigation, characteristic histopathologic picture, and management. Two cases of Amebic Colitis were found in the hospital records during the last ten years. Both presented to the clinic within the last six months. Both patients were males, young, from poor socio-economic class and are originally from Indian subcontinent. Both had vague and mild presentation. One progressed to massive lower GI bleeding and the other one progressed to colonic perforation and peritonitis. The second case had CT scan, which showed signs of colitis and suspected perforation but was not diagnostic of Amebic Colitis. The first case had subtotal colectomy and primary anastomosis; while, the second case had limited colectomy with proximal colostomy and distal mucus fistula. The diagnosis was based on histopathology of the resected specimens. Serology was confirmatory in only one patient. Fulminant Amebic Colitis is a rare entity. Clinical awareness and early surgical intervention are very important in the outcome. Two cases of fulminant Amebic Colitis have been managed by colonic resection of the affected part, in addition to Metronidazole and broad-pectrum antibiotic

Cerebral toxoplasmosis in an HIV positive patient: a case report and review of pathogenesis and laboratory diagnosis

Toxoplasmosis is a worldwide infection. It may have acute or latent clinical presentations. Because of defective cell mediated immunity, patients are at a higher risk of developing toxoplasma encephalitis. We report the first biopsy diagnosed case of cerebral toxoplasmosis in an HIV positive patient from the Kingdom of Bahrain and review the pathogenesis, pathology and laboratory diagnosis

Pseudo-angiomatous stromal hyperplasia: benign tumor of the breast

Pseudo-angiomatous stromal hyperplasia [PASH] is a rare benign tumor of the breast which poses a clinical challenge in distinguishing it from malignancy. We are reporting a young married woman, who presented to the clinic with right breast painless large lump. The patient was managed surgically. Fine needle aspiration-cytology did not confirm the diagnosis. The final diagnosis was arrived at through histopathology