Bilateral leiomyoma of epididymides.

Leiomyoma is a relatively uncommon neoplasm of the epididymis derived from smooth muscle cells. A case of primary leiomyomas simultaneously occurring in both epididymides is reported in a 58-year-old man, clinically presenting painless intra-scrotal masses. The examination of the epididymis characterizes clinically by a firm solid, well-circumscribe mass, and histological spindle cells arranged in interlacing bundles with varying admixtures of fibrous and hyalinized connective tissue. Clinical, histopathologic and immunohistopathologic features, with briefly reviewed relevant literatures describing 7 cases of bilateral leiomyoma of epididymides are discussed. The patients with the mean age of 56.6 years (range 47-62 years) had epididymal mass measuring 5 to 75 millimeters (mean 21.3 millimeters). This is the first reported description of bilateral leiomyoma of epididymides in Thailand.

Cystinuria: cause of recurrent renal stones in a 4-year-old girl.

This paper presents the case report of a 4-year and 6-month old girl with cystinuria. She clinically presented with recurrent radiopaque renal stones since the age of 3 years. She received 2 subsequent operations of pyelolithotomy combined with ureterolithotomy at the age of 3 years 6 months, and pyelolithotomy alone at the age of 5 years. She was initially diagnosed as having cystinuria by the presence of hexagonal plate crystals in her acidified urine and positive for the urinary cyanide-nitroprusside test. The diagnosis was confirmed by urinary amino acid analysis using quantitative ion-exchange chromatography which revealed increased amounts of cystine and dibasic amino acids of lysine and ornithine. In spite of maintaining a high fluid intake and alkalinizing urine by giving potassium citrate after the first operation, recurrent renal stones were found. Therefore, after the second operation, D-penicillamine was additionally introduced. During the 18-month follow-up, although there were recurrent renal stones, the rate of stone formation was slower. To the authors' knowledge, this is the first case report in Thailand.