A solitary congenital self-healing histiocytosis. Report of a case and review of the literature.

Congenital self-healing histiocytosis (CSHH), and especially the solitary variant, is a rare primary skin disorder. We report on a newborn with a congenital solitary ulcerated skin nodule. Extracutaneous involvement was not found. A skin biopsy was performed at the age of 44 days and revealed a dense dermal infiltrate of large histiocytic cells. Immunohistochemical study revealed that the cells of the dermal infiltrate were Langerhans' cells which were strongly positive for S- 100 and negative for lysozyme, leukocyte common antigen and alpha-1-antichymotrypsin. The skin lesion involuted spontaneously over the next month without any treatment. The clinical, histopathological and immunohistochemical results fulfilled the criteria of solitary CSHH. We herein report the first case of CSHH in Taiwan and the twelfth case of solitary CSHH in the world.

Rhabdomyosarcoma of the vagina in a postmenopausal woman: report of a case and review of the literature.

Most rhabdomyosarcomas (RMSs) of the female genital tract occur in infants and young children as sarcoma botryoides. Vaginal RMS occurring in a postmenopausal woman is extremely rare. To our knowledge, only three vaginal RMSs have been reported in patients who were over 50 years of age. Herein, the first case in Taiwan and the fourth case in the world is reported, and the pertinent literature is briefly reviewed. A 63-year-old woman complained of a few days of abnormal vaginal bleeding. Vaginal examination demonstrated two black polypoid tumors located at the left-lateral and posterior wall of the vagina. The patient had previously undergone a vaginal total hysterectomy for rectocele and urine incontinence, so surgical treatment including local wide excision and bilateral salpingo-oophorectomy were performed under the diagnosis of malignant vaginal tumor. The clinical, histopathological, and immunohistochemical studies revealed a group Ia pleomorphic RMS. Postoperative radiotherapy was performed. The patient remains alive and well 12 months after a combined therapy.

Krukenberg tumor in pregnancy with delivery of a normal baby: a case report.

Successful termination of a pregnancy and delivery of a normal infant in a young woman with Krukenberg tumor is reported. This association has rarely been described previously. The persistent gastrointestinal symptoms mimicking the early nausea and vomiting of pregnancy mask the presentation of a tumor in the stomach. Growth of the fetus leading to abdominal distension masks the presence of the metastatic ovarian tumor in the pelvic cavity. Thus, early diagnosis of the tumor may be delayed. We emphasize the importance of differentiation between physiological morning sickness and unusual persistent gastrointestinal symptoms in pregnant women. Persistent unusual gastrointestinal symptoms need careful evaluation by panendoscopic examination.

Malignant mixed müllerian tumor of the ovary: report of a case and review of the literature.

Malignant mixed Müllerian tumors (MMMTs) have been reported to occur in the female genital tract, especially in the uterine corpus. However, MMMT of the ovary is very rare and to best knowledge, no previous case has been reported in the literature of Taiwan. A 63-year-old female, with unique MMMT of the ovary, is described as having tumor with both carcinomatous and sarcomatous elements. The carcinomatous component was mainly composed of undifferentiated carcinoma. Small foci of glandular or papillary differentiation could be found. The sarcomatous component was composed of islands of atypical cartilaginous elements. Immunohistochemical studies revealed carcinomatous and heterologous sarcomatous elements respectively. Carcinomatous elements were cytokeratin and epithelial membrane antigen (EMA) positive, whereas heterologous sarcomatous elements were vimentin and S-100 positive. The patient received a left salpingo-oophorectomy and omentectomy without further chemotherapy or radiotherapy. The patient, already in the advanced stage, expired one month after the initial diagnosis.

Ulceronodular gastritis in secondary syphilis.

Syphilitic gastric ulcers are rarely diagnosed and are almost always a manifestation of the tertiary stage. We describe the case of a 21-year-old man who developed such an ulcer during the secondary stage.

Autosomal dominant polycystic kidney disease: an unusual presentation as unilateral renal mass in the infant.

The onset of autosomal dominant polycystic kidney disease in infants and children is unusual, and renal involvement is typically bilateral. The presentation of a unilateral renal mass in such a disorder is extremely rare. We report a 2-month-old infant with autosomal dominant polycystic kidney disease presenting with unilateral renal involvement; the literature concerning this entity is reviewed.

Small cell lung carcinoma: clinicopathological, immunohistochemical, and ultrastructural study.

Sixty-seven cases of small cell lung carcinoma (SCLA) in Tri-Service General Hospital (TSGH) during the past 16 years were studied. For patients with extensive stage of disease, the mean survival time and 2-year survival rate were 7.2 months and 3.1% versus 13.4 months and 16.7% for patients with limited stage. A better prognosis was obtained by treatment with a combination of intensive chemotherapy and radiotherapy. Immunohistochemical studies were performed by the peroxidase-antiperoxidase method. The positive rates in descending order were bombesin (80%), synaptophysin (74.3%), neurofilament (68.6%), neuron-specific enolase (60%), low molecular weight cytokeratin (54.3%), high molecular weight cytokeratin (25.7%), chromogranin-A (22.9%), adrenocorticotrophic hormone (0). Seven cases were examined and found to be ultrastructure; only 3 cases were found to contain neurosecretory granules. We emphasize that electron microscopy is not necessary as a routine diagnostic procedure, while light microscopy should be employed whenever possible; the immunohistochemical study should be considered within this context.