Solitary esophageal leiomyoma with eosinophilic infiltrate: case report and review of the literature.

Leiomyomas are common benign tumors of the esophagus representing 10% of all mesenchymal tumors of the gastrointestinal tract. Prominent numbers of eosinophils involving a leiomyoma have only rarely been described. They have never been described involving a solitary leiomyoma of the esophagus. We present an unusual case of a solitary esophageal leiomyoma with a prominent number of eosinophils and mast cells, review the previous literature regarding this topic and discuss possible causes of the eosinophil infiltrate.

Metastatic ocular melanoma to the left ventricle inducing near-syncope attacks in an 84-year-old woman.

Cardiac tumors may represent mechanical causes for syncope by limiting left ventricular filling and/or by obstructing the left ventricular outflow tract. Malignant melanoma is known to metastasize to the myocardium or pericardium, but there are only a very limited number of reports describing endocardial involvement by the tumor. We describe herein an 84-year-old woman who presented with daily near-syncope episodes, 9 years after treatment for a choroidal melanoma. The echocardiography and the pathologic examination revealed a metastatic melanoma. This is the first reported case of an ocular melanoma metastasizing to the heart and presenting as a left ventricular intracavitary pedunculated mass.

Trichilemmal horn: case presentation and literature review.

A trichilemmal horn is a histologically unique, uncommonly reported lesion, characterized by a plate-like nodule that extends from the epithelium into the dermis and has a prominent basement membrane. At the periphery of the nodule, there is palisading of basal cells. Trichilemmal keratinization is present in the overlying horn and is composed of orthokeratosis with focal parakeratosis. We describe a 22-year-old white women with a trichilemmal horn on her left elbow and review the literature. With the addition of our patient, trichilemmal horns have been described in 28 patients. They have been observed more often in women (15) than in men (11). The patients ranged in age from 16 to 78 years; more than 60% were 50 years of age or older. Trichilemmal horns were most common on the extremities (12 cases) and the head (11 cases). The diagnosis of a trichilemmal horn should be considered when a cutaneous horn shows trichilemmal keratinization in the absence of dermal inflammation.

Heterotopic abdominal pregnancy treated at laparoscopy.

OBJECTIVE: To report a case of laparoscopic treatment of a heterotopic primary abdominal pregnancy after IVF with preservation of the concurrent intrauterine pregnancy. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A woman with a heterotopic abdominal pregnancy after IVF-ET. INTERVENTION(S): Pituitary down-regulation with luteal leuprolide acetate, ovulation induction with menotropins, IVF-ET, progesterone in oil for luteal support, laparoscopy, and resection of the abdominal gestation. MAIN OUTCOME MEASURE(S): Human chorionic gonadotropin levels, pelvic ultrasound examinations, and laparoscopic and pathologic findings. RESULT(S): A heterotopic abdominal pregnancy occurred after IVF-ET and was treated successfully with laparoscopy. The concurrent intrauterine pregnancy was delivered at term. CONCLUSION(S): Early diagnosis of an ectopic abdominal pregnancy allowed successful laparoscopic treatment, without sequelae to the intrauterine gestation.

Incidental focal acantholytic dyskeratosis.

BACKGROUND: Focal acantholytic dyskeratosis is a distinctive histologic pattern characterized by (1) suprabasilar clefts around preserved papillae, (2) acantholytic and dyskeratotic cells at all levels of the epidermis, and (3) hyperkeratosis and parakeratosis. These histologic changes have been observed as an incidental finding in a variety of skin lesions. OBJECTIVE: Our purpose was to identify the lesions associated with incidental focal acantholytic dyskeratosis. METHODS: Eight specimens containing incidental focal acantholytic dyskeratosis were retrospectively evaluated, and the published literature describing lesions with incidental focal acantholytic dyskeratosis was reviewed. RESULTS: The ages of the eight patients ranged from 29 to 53 years. Incidental focal acantholytic dyskeratosis was seen in nevi with architectural disorder (four lesions), scars (two lesions), a ruptured follicle (one lesion), and a seborrheic keratosis (one lesion). Incidental focal acantholytic dyskeratosis was either present in the "clinically normal-appearing" skin adjacent to the lesion (five lesions) or within the lesion (three lesions). Twenty-one additional cases of incidental focal acantholytic dyskeratosis have previously been reported. CONCLUSION: Incidental focal acantholytic dyskeratosis has been described in benign and malignant epithelial lesions, fibrohistiocytic lesions, inflammatory lesions, melanocytic lesions, and miscellaneous lesions. This pathologic change was observed either within the actual lesion or in the immediately adjacent epithelium. The cause of this clinically benign, microscopically intriguing condition remains to be determined.