Essential thrombocythemia in a two-year-old child, responsive to hydroxyurea but not aspirin

Essential thrombocythemia [ET] is a myeloproliferative neoplasm that occurs mostly in patients above the age of 50 years. Its incidence in children is very rare, with around 100 cases reported in the literature. High-risk patients are defined by previous life threatening major thrombotic or severe hemorrhagic complication or age > 60. Those patients probably benefit from cytoreductive therapy. On the other hand, antiplatelet drugs are recommended for patients with low risk group. Although rare, ET should be considered in the differential diagnosis of persistent thrombocytosis in children, even at a very young age. A constellation of clinical, pathologic, and molecular testing are essential for diagnosis. Given the rarity of these cases, there is currently no consensus for treatment guidelines in children, especially in asymptomatic patients. We describe a case of a two year old girl who presented with unexplained, isolated thrombocytosis which persisted for eight years. Bone marrow biopsy demonstrated typical features of ET. Over the course of the disease, hydroxyurea, but not aspirin, showed better control of symptoms and lowered the platelets level

Prostatic adenocarcinoma and chronic lymphocytic leukemia: a case report

We report a rare case of a collision tumor. Our patient was found to have prostatic adenocarcinoma colliding with chronic lymphocytic leukemia, with no previous risk factors or even a clinical suspicion. We review the literature for similar cases and make an attempt to address the possible shared risk factors

Unusual anatomic location of a primary intracranial yolk sac tumor

A nongerminomatous germ cell tumor occurring in the brain parenchyma is extremely rare. A 2-year-old boy presented with symptoms of abnormal movements in the hand and mouth. MRI scanning revealed a lesion occupying the left temporoparietal region. Craniotomy was performed and the tumor was removed by en bloc resection. Histological examination revealed that the tumor was arranged in a reticular pattern, and Schiller-Duval bodies were evident at the center of the tumor. Immunohistochemical study showed that the tumor cells were positive for alpha-fetoprotein and vimentin, but negative for glial fibril-lary acidic protein. The histological diagnosis was pure yolk sac tumor

Unusual association between adrenal leiomyoma and autoimmune disease

Adrenal leiomyoma is a rare solid tumor of unknown etiology. Here, we present a case of a 38-year-old woman, a known case of Hashimoto's thyroiditis, presented with right adrenal mass incidentally discovered by computed tomography imaging. The mass was non-functioning according to laboratory results, but because the mass increased in size in a follow up visit, she underwent right adrenalectomy. The histological findings confirmed the diagnosis of adrenal leiomyoma, which was supported by a panel of immunohistochemical stains. Surprisingly, there was a dense lymphocytic infiltrate in the background of the tumor, forming germinal centers. Although most of the reported adrenal leiomyoma cases are associated with immune deficiency, none of the previous cases was associated with an autoimmune disease. We report a case of an unusual adrenal leiomyoma with a dense lymphocytic infiltrate