Parathyroid carcinoma: a case report

Parathyroid carcinoma [PTC] is an extremely rare malignancy that typically presents with severe primary hyperparathyroidism [PHPT]. More often the surgeon is confronted with the diagnosis after simple parathyroidectomy for presumed benign parathyroid adenoma. This results in unacceptably high recurrence rate ranging from 1/3-2/3 of patients. Faced with the rarity of the disease and lack of reliable preoperative diagnostic test; a high-index of preoperative and intraoperative suspicion of malignancy is warranted in patients with severe hyperparathyroidism as en-block-resection of the gland along with surrounding adherent tissue during the initial exploration offers the only potential cure of the disease. Herein, we present a 46-year-old lady who presented with severe form of PHPT, eventually proved to be caused by PTC. We will also review the literature related to this extremely rare tumor, highlighting the difficulties encountered in its management

association between lymphovascular invasion and other prognostic indicators in operable breast cancer: experience at King Hussein medical center

Objective: To evaluate the association between lymphovascular invasion [LVI] and different clinicopathologic features of invasive breast cancer

Methods: Clinicopathologic and demographic data from a cohort of 298 patients, who were referred to surgery clinics at King Hussein Medical Center [KHMC] between 2007 and 2014, were retrieved and analyzed

Results: The average age of the cohort under investigation was 51.2 years with most of the patients having invasive breast carcinoma. Lymphovascular invasion was detected in 53% of the patients. Patients with lymphovascular invasion were more likely to have larger tumors [4.2 vs. 3.3cm p=0.02]. Additionally, they were more likely to have progesterone negative [p=0.032], and Her2 positive tumors [p=0.003]. Patients with negative Lymphovascular were more likely to have negative perineural invasion [p=0.0001]

Conclusion: Lymphovascular invasion was associated with larger tumors, Progesterone negativity and Her-2 positivity. Lymphovascular invasion should be incorporated in tumor classification and treatment modality selection

Eccrine porocarcinoma: a case with local recurrence, regional lymph node and extensive cutaneous metastases

A 64-year old male patient presented to the dermatology clinic with few weeks history of multiple papulonodular skin lesions over the left thigh, associated with limb edema and palpable lymph nodes in the left inguinal region. The patient had a skin lesion over his left ankle, excised 7 months earlier and the pathology report came with the diagnosis of squamous cell carcinoma. A biopsy was taken from one of the thigh lesions, and histopathological examination revealed metastatic porocarcinoma into the overlying skin with lymphatic infiltration. A histopathological review of the first biopsy showed a porocarcinoma, apparently completely excised. In conclusion, this case presentation highlights the tendency of porocarcinoma for local recurrence and metastasis to skin and lymph nodes

Myeloid sarcoma of the kidney preceding acute myeloid leukemia

Myeloid Sarcoma is a rare extramedullary tumor, consisting of primitive granulocytic precursor cells. We report the case of a 50-year-old man, who presented with a renal mass. After nephrectomy, histological examination revealed a myeloid sarcoma in association with a renal cell carcinoma. Seven weeks after nephrectomy the patient developed acute myeloid leukemia

Cryotherapy for the management of genital warts in pregnancy: a five-year observational study

This observational study aims to review our experience in using cryotherapy for the management of genital warts during pregnancy over a five-year period. Fifty-three pregnant women with established genital warts were managed during the period from January 2000 to April 2005. There were 23 patients in the first trimester, 22 in the second, and 8 in the third trimester. Base line laboratory investigations were performed to establish any abnormalities and any other concurrent sexually transmitted diseases before starting treatment in each patient. Sexual abstinence or the use of protective barriers was advised to all patients. Cryotherapy was performed for the treatment of all genital warts. The treatment was on an out-patient basis, and the women were followed up every two weeks throughout pregnancy, and every month afterwards until nine months post delivery. Infants were also examined at birth and at nine months of age. There was dramatic response to local cryotherapy during pregnancy against genital warts, with 84.9% clearance of lesions prior to delivery. There were no cases of premature labour or premature rupture of membranes directly related to treatment, and there were no cases of neonatal genital or laryngeal involvement. Although no recurrences of lesions were observed before delivery, there was an overall recurrence rate of 45.3% at nine months post delivery. Cryotherapy is an effective and safe method for the treatment of genital warts throughout pregnancy

potential relation between telogen effluvium and iron deficiency in adult females

To examine the association between chronic telogen effluvium and iron deficiency in adult females. Seventy-two adult menstruating women with chronic telogen effluvium and 30 healthy adult females were enrolled into the study. All women were interviewed and clinically examined. The hair pull test was additionally utilized as part of the physical examination for the assessment of hair growth. Laboratory tests included measurements of hematocrit, serum ferritin levels, liver function tests, renal function tests, thyroid hormones, serum testosterone, and dehydropiandrosterone. The results of hematocrit values and serum ferritin levels in patients and controls were analyzed and statistically compared. Patients with chronic telogen effluvium and low serum ferritin levels were given oral iron treatment in the form of ferrous sulphate 600 mg daily for 4 months. At the end of the study period improvement in their hair growth and serum ferritin levels re-assessed. The mean age of patients was 26 years and for controls was 32 years. Hematocrit measurement were similar in both groups, but there was a statistically significant difference in the mean serum ferritin levels [p<0.05] between patients and controls [18.7 and 47.6ng/mL, respectively]. All patients treated with iron had elevation in their serum ferritin levels, and most of them experienced improvement in their hair growth. There was a significant association between low serum ferritin levels and chronic telogen effluvium, therefore, serum levels may be of value in the evaluation of adult menstruating women with chronic diffuse hair loss