A Case of Symptomatic Cowper's Syringocele in an Adult Male: Diagnosis and Management.

Background: Cowper's syringocele is cystic dilation of the excretory bulbourethral gland duct. This entity is common in the pediatric population but is rare or underdiagnosed in the adult population. Syringoceles are usually classified based on the configuration of the duct's orifice to the urethra with symptoms varying between irritative and/or obstructive accordingly. To the best of our knowledge, only few cases were reported in the literature. Case Presentation: We present the case of a 27-year-old male patient presenting with obstructive lower urinary tract symptoms. Pelvis MRI, retrograde urethrography, and flexible cystourethroscopy were performed and a diagnosis of imperforate Cowper's syringocele was made. Endoscopic unroofing with holmium:YAG laser was performed. The patient is free of symptoms 12 months postoperatively. Conclusion: Cowper's syringocele is a rare entity that should be considered in certain adult patients presenting with either storage or voiding symptoms. Ultrasonography is useful in detecting closed cystic lesions; however, antegrade urethrography and retrograde urethrography are gold standards to rule out communication with the urethra. Symptoms tend to resolve spontaneously and initial treatment is conservative. With persistent symptoms, endoscopic unroofing or marsupialization with cold knife or holmium:YAG laser is recommended as standard treatment.

An uncommon cause for a non-healing cutaneous fistula in the parotid gland area - A case report.

INTRODUCTION: Orocutaneous fistulae of dental origin are uncommon but well documented in the literature. This condition is often misdiagnosed because of the multiplicity of manifestations and the atypically presentation of the condition. Dental symptoms are rare. This makes diagnosis and treatment a challenging process. PRESENTATION OF A CASE: A 67-year-old patient presented in the emergency room with an abscess in the parotid area. After incision and drainage the patient developed a non-healing fistula in the region of the parotid. Multiple treatment attempts and several investigations did not solve the problem. Finally, a panoramic x-ray showed a hidden, infected and displaced tooth in the right mandibular angle. After surgical extraction of the tooth and fistula excision, healing was uneventful and there was no recurrence. DISCUSSION: Given the diagnostic challenge, the real origin of the condition is frequently only discovered after several unnecessary interventions that may have harmed the patient. The key to early diagnosis is dental examination and dental radiographs. The goal of treatment is the elimination of the infection by surgical extraction of the tooth or non-surgical endodontic therapy. CONCLUSION: Early diagnosis and rapid treatment minimize patient discomfort and reduce the probability of further complications. The differential diagnosis of sinus tract of dental origin should be considered in any case of unclarified non-healing skin lesion in the head and neck area, especially if initial treatments have failed. An early interdisciplinary approach is essential.

Primary Carcinoid Tumor of the Testis: A Case Report and Review of the Literature.

Carcinoid tumors usually arise in the gastrointestinal tract. Immunocytohistochemical and radiologic studies are important in detecting the primary tumor site. Primary carcinoid tumors of the testis are particularly rare with a high malignant potential warranting long-term follow-up. We present the case of a primary carcinoid tumor of the testis with long-term surveillance.

Implant Supported Fixed Dental Prostheses Using a New Monotype Zirconia Implant-A Case Report.

Currently, titanium or specific titanium alloys are the most often used materials for the fabrication of dental implants. Many studies have confirmed the osseointegrative capacity and clinical long-term performance of moderately rough titanium implants. However, disadvantages have also been reported with regard to peri-implant infections and the titanium metal properties. Tooth colored ceramic implants have attracted the interest of clinicians since the end of the 1960s. Initially, alumina was used for the fabrication of ceramic implants; however, due to the poor biomechanical properties, alumina implants are not commercially available any more. Since end of the 1990s, zirconia has been established in dentistry due to its superior biomechanical properties compared to other oxide ceramics such as alumina. Currently, zirconia is the material of choice for the fabrication of ceramic implants. Zirconia implants show superior biocompatibility compared to titanium and other metals. Additionally, it has been reported that zirconia implants with a micro-rough surface topography show at least a comparable osseointegrative capacity and similar clinical survival rates to moderately rough titanium implants. The present case reports a fixed implant-supported reconstruction of a large edentulous space with compromised local bone conditions using new monotype zirconia dental implants with a micro-rough surface topography.

Metastatic prostate adenocarcinoma presenting with pulmonary symptoms: a case report and review of the literature.

INTRODUCTION: Prostate cancer has a high tendency to spread to bone. Pulmonary metastasis and generalized lymphadenopathy commonly develop after pelvic and bone involvement have already occurred. Few patients with prostate cancer present initially with symptomatic metastatic lung lesions and lymphadenopathy without any other concomitant distant dissemination. CASE PRESENTATION: We report a case of a 73-year-old white male who sought medical help for symptoms of cough, hemoptysis, and dyspnea. A chest X-ray was done revealing multiple "cannon ball" infiltrates involving all segments of the lung parenchyma. Fine-needle aspiration cytology under computed tomography guidance of a subpleural lesion revealed adenocarcinomatous cells. Despite the absence of any detectable osseous lesions and with the presence of multiple hilar, mediastinal, para-aortic, and pelvic lymphadenopathy, the patient had a complete work-up in search for the primary adenocarcinoma. His prostate specific antigen was 146 ng/ml and a prostatic biopsy done, revealing an acinar prostatic adenocarcinoma. A tru-cut biopsy of a lung lesion under computed tomography guidance showed a metastatic prostatic adenocarcinoma positive for prostate specific antigen stain. CONCLUSION: This case sheds light on an unusual metastatic pattern of prostatic adenocarcinoma. It also emphasizes the importance of including prostate cancer in the differential diagnosis of men with adenocarcinoma of unknown origin.

[Soft tissue surgery with the diode laser--theoretical and clinical aspects]. / Weichteilchirurgie mit dem Diodenlaser--theoretische und klinische Aspekte.

Currently laser light of different wavelengths is used for all kinds of surgical procedures in oral and maxillofacial surgery. In this regard especially the diode laser is mainly used, because of its excellent effects on oral soft tissues. On the basis of various oral soft tissue lesions in 40 patients the benefits of the diode laser in daily practice are demonstrated. Intraoperative and postoperative clinical findings were excellent due to the sufficient cutting abilities, the good coagulation effect and the extremely small zone of thermal necrosis to surrounding tissues. By this the diode laser has proven as an alternative solution to conventional electrosurgery and scalpel. The precise treatment in the contact application mode, which allowed an easier and more controlled guidance of the laser beam, was another advantage of the fiber-assisted laser system. In conclusion the results show that the diode laser is a useful instrument in oral soft tissue surgery.