Sympathetic chain Schwannoma

Schwannomas are rare, benign, slowly growing tumors arising from Schwann cells that line nerve sheaths. Schwannomas arising from the cervical sympathetic chain are extremely rare. Here, we report a case of a 70-year-old man who presented with only an asymptomatic neck mass. Physical examination revealed a left sided Horner syndrome and a neck mass with transmitted pulsation and anterior displacement of the common carotid artery. Computed tomography CT showed a well-defined non- enhancing mass with vascular displacement. The nerve of origin of this encapsulated tumor was the sympathetic chain. The tumor was excised completely intact. The pathologic diagnosis was Schwannoma Antoni type A and Antoni type B. The patient has been well and free of tumor recurrence for 14 months with persistence of asymptomatic left sided Horner syndrome. The clinical, radiological and pathological evaluations, therapy and postoperative complications of this tumor are discussed

Comparison of students' performance in the traditional oral clinical examination and the objective structured clinical examination

To find out whether the objective structured clinical examination [OSCE] using standardized patients allows the same evaluation of students as the traditional oral clinical examination [TOCE] using real patients. The results of 4 cohorts of students [904 students] in the end of posting examination [using the TOCE], and the end of year examination [using OSCE] during the academic years 2003-2006 at King Abdulaziz University, Faculty of Medicine, Jeddah, Kingdom of saudi Arabia were analyzed retrospectively. Spearman's correlation coefficient was calculated for comparison of performance in the different parts of the 2 examinations. There was a strong positive correlation between the results of the OSCE and the final grade of the students [r = 0.786], and between the TOCE and the final grade of the students [r=0.591]. The coefficient for correlation between the results of the OSCE and TOCE was 0.406. The OSCE can be used for the evaluation of clinical skills like the TOCE with better objectivity and reliability

Wandering spleen.

Congenital malformations of the spleen are rare. We report 3 cases of wandering spleen presented as abdominal or pelvi-abdominal mass. Two patients were suffering from chronic lower abdominal pain with thrombosed splenic pedicle and the third patient had an acute abdomen. All patients underwent splenectomies. Abdominal ultrasound, computerized tomography, Doppler ultrasound, and radioisotope studies were used to confirm the diagnosis. The clinical, diagnostic and treatment modalities are discussed

Structural study on cultured isolated fetal rat pancreatic islets

To perform a morphometric and structural study of the cultured isolated fetal rat pancreatic islets. Islets of the fetal rat pancreas, aged 22 days were isolated by the standard procedure of collagenase digestion and culture technique. The islets were cultured for 1, 2, 3, 4 and 5 days. The islets were counted under a dissecting microscope and islet diameter and purity were measured under a phase contrast microscope fitted with a calibrated grid. The islet specimens were fixed in buffered neutral formalin, dehydrated in alcohol and embedded in parablast. Sections were stained with hematoxylin and eosin. This study was conducted in King Fahd Medical Research Center, Faculty of Medicine, King Abdul-Aziz University, Kingdom of Saudi Arabia, during 2003 and 2004. The purity of the cultured islets gradually increased with time and was significantly different between the cultured groups. The number of the cultured islets gradually decreased with time. The islet diameter gradually increased with culture period. The islet purity and diameter were significantly different between the cultured groups. Parablast sections stained with hematoxylin and eosin showed that the shape and histological structure of the cultured islets were intact. The results of the present work represent an extensive morphometric structural study of isolated cultured fetal islets. The culture islet diameter and purity showed gradual increase with culture period, while the islet number showed gradual decrease

Hepatocellular carcinoma with cutaneous metastasis

We report a 60-year-old male patient with hepatocellular carcinoma HCC who presented with cutaneous metastasis of the chest wall and ribs destruction. The tumor was advanced, and the patient died next day

Gigantic jejunal leiomyosarcoma

Jejunal leiomyosarcoma is a rare neoplasm. We report a case of gigantic leiomyosarcoma of the jejunum in a 30-year old man who presented with abdominal distension, pain and constipation. Computerized tomography scan revealed a giant tumor filling the entire abdominal cavity. Fine needle aspiration cytology was suspicious. At laparotomy, a huge jejunal leiomyosarcoma measuring 30 x 25 x 19 cm and weighing 13 kg was completely excised. To the best of our knowledge, this is the first case of a giant jejunal leiomyosarcoma

Pancreatic tuberculosis: a rara occurrence

Pancreatic tuberculosis is a rare clinical entity and may present diagnostic difficulties. It can mimic carcinoma of the pancreas. However, it is a curable disease once the diagnosis is established. We report a case of pancreatic tuberculosis in which percutaneous Computerized Tomography guided biopsy confirmed the diagnosis. Patient recovered completely following a nine month course of anti-tuberculos chemotherapy. Therefore, percutaneous computerized tomography guided biopsy of the pancreas can lead to precise diagnosis without the need for laparotomy