Gastrointestinal adenocarcinoma metastasizing to the vulva: a case report.

BACKGROUND: Metastatic vulval adenocarcinoma is a rare occurrence with only a few cases reported to date. They can arise from the breast, gastrointestinal system, or endometrium. CASE PRESENTATION: We present the case of a 55-year-old Black African woman who presented with vulval itching which progressed to warty lesions. Histology revealed a vulval adenocarcinoma which immunohistochemistry suggested was of gastrointestinal origin. Colonoscopy later confirmed an anorectal tumor as the primary site. Despite extensive chest metastases she looked surprisingly well and had no pulmonary symptoms. The major source of symptomatic distress was the itchy extensive warty lesions on her vulva. She has since had a vulvectomy which gave her significant symptomatic relief. CONCLUSIONS: This case was interesting as vulval adenocarcinoma is a rare histological diagnosis found in less than 10% of vulval cancers. Primary vulval adenocarcinoma is rare with most of these cancers being secondary metastases from a distant site. Her symptoms were predominantly vulval with no chest symptoms even though she had extensive pulmonary metastases. She has been clinically well except for the itching suggesting an indolent course.

Complete regression of early diffuse B-cell lymphoma in an HIV-positive patient on antiretroviral therapy alone.

There is no evidence that antiretroviral therapy (ART) alone may result in complete remission of aggressive non-Hodgkin's lymphomas even though it improves the overall prognosis. We report a case in which early diffuse large B-cell lymphoma regressed completely after ART alone, raising the possibility that this may be sufficient therapy in selected cases.

Pneumomediastinum in an HIV-infected patient with cytomegalovirus pneumonitis.

A pneumomediastinum is an unusual complication of respiratory infections in HIV-positive patients, usually reported in association with pneumocystis pneumonia. We describe a case of an HIV-positive patient with a pneumomediastinum who had cytomegalovirus pneumonitis. This is an important reminder to clinicians, since cytomegalovirus pneumonitis and pneumocystis pneumonia have a similar clinical and radiological presentation.

Bilateral HIV related ocular surface squamous neoplasia: a paradigm shift.

Four patients with bilateral ocular surface squamous neoplasia attended to at Sekuru Kaguvi Hospital Eye Unit are being presented to alert practitioners that OSSN is potentially a bilateral disease and its prevalence is likely to increase as the life expectancy of HIV infected patients is being positively affected by antiretroviral therapy. Reports on ocular diseases should be clear on laterality to avoid confusion between number of patients affected and number of eyes involved since the two cannot be used interchangeably.

Chronic knee stiffness and swelling in a Zimbabwean adolescent.

A 12-year-old Zimbabwean girl presented with tuberculous monoarthritis. She was moderately wasted, stunted and sexually immature. These clinical findings lead to the diagnosis of underlying HIV infection, which was thought to have been acquired from mother-to-child transmission.

Acinic cell carcinoma of the submandibular salivary gland presenting as a large cyst.

Acinic cell carcinomas are rare tumours of salivary gland origin, most commonly seen in middle-aged women and predominantly in the parotid gland. The case of a long-standing, predominantly cystic, acinic cell carcinoma located in the submandibular gland of a child is presented here. The tumour was successfully removed and there has been no recurrence.