Solitary fibrous tumor of the pancreas: Case report and review of the literature.

Solitary fibrous tumor (SFT) is a mesenchymal tumor typically located in the pleura, but can also be found as an asymptomatic mass in other areas, including the liver, peritoneum, kidney and salivary glands. However, SFT rarely locates in the pancreas. We present such a case of pancreatic SFT, along with a review of all reported cases. A 55-year-old man was treated surgically for an asymptomatic pancreatic mass after a rigorous preoperative control. Histologic examination of the resected specimen showed characteristics of an SFT. As only 15 cases of pancreatic SFT have been reported so far, an attempt to compare the cases was considered intriguing. We found that patients with pancreatic SFT were mainly women (81.25%), with a median age of 54 years at the time of diagnosis and a median tumor size of 5.83 cm. Pancreatic SFTs were revealed incidentally in 50% of cases, and all of them showed an enhancement through arterial computed tomography. All tumors were positive for CD34, ten were positive for Bcl-2, and twelve were negative for S100. The diagnosis of this pancreatic tumor is established by a combination of clinical suspicion, imaging procedures and histological findings, and is confirmed by immunohistochemical staining. Although the behavior of SFTs is rather benign, close clinical follow-up is recommended due to a potentially malignant nature.

Heterotopic mesenteric ossification of ileostomy - "intraabdominal myositis ossificans".

UNLABELLED: Heterotopic mesenteric ossification is a rare clinical entity with less than 40 reported cases. Moreover, heterotopic mesenteric ossification around a stoma is described in fewer cases. CASE PRESENTATION: An 81-year-old male patient, who underwent a sigmoidectomy two years ago for a sigmoid colon cancer, was admitted in our Department in order to be investigated for a local recurrence of his disease. Because of unresectable pelvic lesions, the patient was taken in the operating room for a palliative double barrel ileostomy. The patient presented two weeks after the ileostomy clinical signs suggesting its obstruction. A revision of the ileostomy is performed. Macroscopically, the end part of the ileostomy was inflamed and resected. Histological findings revealed heterotopic ossification of the mesentery. CONCLUSIONS: The surgeon should be alert to the possibility of heterotopic ossification, especially within a previously operated wound and be prepared for the difficulties it may cause during reopening of an incision, during the operation itself, at closure of the wound and, if not removed, also in the postoperative setting.

In situ mantle cell lymphoma in the nasopharynx.

BACKGROUND: Mantle cell lymphoma (MCL) is a B-cell neoplasm with an aggressive clinical course. Recently, an indolent type of MCL has been described under the term in situ MCL. METHODS AND RESULTS: We report a case of a 70-year-old woman who presented with nasal obstruction. A mass, located in the nasopharynx, was found. Histologic examination revealed lymphoid hyperplasia characterized by CD5 and cyclin D1-positive mantle zone cells, findings consistent with in situ MCL. Three years later, a new biopsy was performed, which showed the same histologic and immunohistochemical (IHC) findings to those observed in the first biopsy. The diagnosis of in situ MCL was confirmed by fluorescence in situ hybridization (FISH) analysis for t(11;14). Since then, the patient has remained free of an overt lymphoma. CONCLUSIONS: In situ MCL may be observed in the nasopharynx, and it would be appropriate to perform cyclin D1 immunostain in cases with marked follicular hyperplasia accompanied by clinical suspicion of lymphoma.