Renal mucinous tubular and spindle cell carcinoma.

Mucinous tubular and spindle cell carcinoma is a rare variant of renal cell carcinoma, which has recently been described. It has a low malignant potential and is usually confined to the kidney. These are thought to be of the loop of Henle or distal nephron origin. We report a 65-year-old male who presented with flank pain, hematuria and a well-defined renal mass that was diagnosed as mucinous tubular and spindle cell tumor.

Localized amyloidosis of urinary bladder: a diagnostic dilemma.

Amyloidosis is a heterogeneous group of disorders affecting a single-or multiple-organ system and presents as generalized or localized disease. Both generalized amyloidosis and localized amyloidosis can be primary or secondary. Localized amyloidosis affects organs like urinary bladder, lung, larynx, skin, tongue and the region around the eye, producing detectable nodular masses which are clinically suspected as malignancy. We present six cases of localized urinary bladder amyloidosis that were clinically and cystoscopically suspected as bladder tumor or cystitis, which occurred over a period of last 10 years. Histology in all cases revealed diagnosis of primary amyloidosis. None of them had any stigmata of secondary disease. The cases were treated by simple transurethral resection of bladder. Two out of the six cases recurred after 3 to 5 years of initial presentation and were asymptomatic thereafter. Amyloidosis of the bladder is a rare condition which often mimics bladder neoplasm clinically and cystoscopically and histological examination is a must for definite diagnosis and proper management.

Extraneural metastases in anaplastic ependymoma.

Ependymoma are rare glial neoplasm, it rarely metastasize outside the central nervous system. We present a case of anaplastic ependymoma with extraneural metastases with review of literature. A ten-year-old male child presented with anaplastic ependymoma of choroid plexus and treated with craniospinal radiotherapy in 1998. He had intracranial recurrence in 2004, confirmed by biopsy. He was given adjuvant chemotherapy in form of PCV. At 10 months after completion of chemotherapy, he developed extracranial scalp metastasis and so was treated with palliative local radiation therapy to the scalp metastasis and systemic chemotherapy with oral Etoposide. Scalp metastasis completely disappeared and ataxia improved. After five cycles of chemotherapy, the patient had progression of disease in form of scalp and cervical lymph node metastasis confirmed by fine needle aspiration cytology, biopsy and immunohistochemistry. He was given salvage chemotherapy (carboplatin + ifosfamide + etoposide) at 3-weekly. He had partial response and was still on chemotherapy till May 2007.