Testicular metastasis in a case of squamous cell carcinoma of the lung.

Testicular metastases are a rare finding. Typically, a testicular metastasis will present as a complication of progressive disease or as a primary sign of malignancy. Excluding lymphoma and leukemia, prostate cancer is the most common primary site that metastasizes to the testes. Testicular metastases resulting from squamous cell carcinoma of the lung have rarely been reported in previous literature. Here, we report a case of stage IV squamous cell carcinoma of the lung with metastases to the brain and multiple bilateral lung lesions. Following palliative systemic chemotherapy, this patient was found to have a right testicular mass. Pathology reports confirmed that this was a testicular metastasis of squamous cell lung carcinoma origin.

Fetal membrane patch and biomimetic adhesive coacervates as a sealant for fetoscopic defects.

Iatrogenic preterm premature rupture of membranes after fetoscopic procedures affects 10-47% of patients, secondary to the non-healing nature of membranes and the separation of layers during the entry. In this study we developed an in vitro model to mimic the uterine wall-fetal membrane interface using a water column with one end sealed with human fetal membranes and poultry breast, and a defect was created with an 11 French trocar. Further, a fetal membrane patch in conjunction with multiphase adhesive coacervates modeled after the sandcastle worm bioadhesive was tested for sealing of an iatrogenic defect. The sealant withstood an additional traction of 12 g for 30-60 min and turbulence of the water column without leakage of fluid or slippage. The adhesive is non-toxic when in direct contact with human fetal membranes in an organ culture setting. A fetal membrane patch with multiphase adhesive complex coacervates may help to seal the defect and prevent iatrogenic preterm premature rupture of the membranes.

Sex cord tumor with annular tubules in a young adolescent with Von Willebrand's disease.

BACKGROUND: Ovarian sex cord tumor with annular tubules (SCTAT) is a rare form of ovarian neoplasm. CASE: A 12-year-old female presented with menometrorrhagia. During her evaluation, she was both diagnosed with von Willebrand disease (VWD) and found to have an ovarian neoplasm, which was ultimately determined to be an ovarian sex cord tumor with annular tubules (SCTAT). SUMMARY AND CONCLUSION: As her diagnosis was temporally associated with her worsening symptoms and the presence of an ovarian mass, this tumor may have played a role in her VWD diagnosis. There are no previously reported cases of SCTAT associated with VWD. This case reminds physicians of the importance of evaluating patients with menometrorrhagia for bleeding conditions, in addition to considering hormone-secreting ovarian neoplasms, including SCTAT.

Cervical thymic anomalies--the Texas Children's Hospital experience.

OBJECTIVES/HYPOTHESIS: To review the presentation and management of cervical thymic cysts and ectopic thymic tissue at Texas Children's Hospital over the last 25 years. STUDY DESIGN: Case report and case series using retrospective chart review. METHODS: A case report is presented of a recently diagnosed thymic cyst highlighting diagnostic, management, and treatment strategies available for optimizing management of patients with significant mediastinal extension. We then present a retrospective review of cervical thymic anomalies at a tertiary academic medical center over a 25-year span (1983-present). Data extracted include patients' characteristics, clinical presentation, diagnostic workup, surgical management, and postoperative complications. RESULTS: Fifteen patients were found to have a pathological diagnosis of cervical thymic cyst, and 10 patients had a diagnosis of ectopic thymic tissue in the neck. This is the largest case series of cervical thymic anomalies presented in the literature to date. Patients' characteristics, diagnostic techniques, and treatment strategies are discussed. CONCLUSIONS: Cervical thymic anomalies are a rare but necessary part of the differential diagnosis of a cervical mass. Computed tomography scan can both narrow the preoperative differential diagnosis and aid in surgical planning for thymic cyst excision. A full discussion of the embryology, clinical presentation, and management of cervical thymic cysts and a review of the current literature is presented.

Epithelial-mesenchymal transition markers in pancreatic ductal adenocarcinoma.

OBJECTIVES: Expression of transcription factors that mediate epithelial-mesenchymal transition (EMT), such as Twist and Slug, is correlated with poor prognosis in many tumor types. Selected EMT markers were studied in a series of pancreatic ductal adenocarcinomas (PDAs) and benign pancreatic tissues to determine whether expression levels correlated with diagnosis, histologic grade, or patient outcome. METHODS: Immunohistochemical stains for Twist, Slug, and N-cadherin were performed using a tissue microarray containing 68 PDAs and 38 samples of normal pancreas or chronic pancreatitis tissues. RESULTS: Twist and Slug were identified in both the nucleus and cytoplasm of benign pancreatic ductal epithelium, chronic pancreatitis, and PDA. Compared with normal ductal epithelium, nuclear levels of Twist are decreased in PDA. None of the other EMT markers showed significant differences in staining indices among the diagnostic groups. There were no correlations between EMT marker expression and histologic grade. Epithelial-mesenchymal transition marker expression was not associated with N-cadherin expression, patient outcome, or duration of survival. CONCLUSIONS: Decreased expression of nuclear Twist is observed in malignant pancreatic epithelium. However, use of Twist as a diagnostic marker is precluded because decreased expression is also seen in chronic pancreatitis. None of the markers studied were predictive of patient outcome.