Composite haemangioendothelioma with neuroendocrine marker differentiation presenting as a pink-brown nodule.

We report a case of a 55-year-old female with an asymptomatic pink-brown nodule. Histological examination demonstrated a composite haemangioendothelioma with positive synaptophysin staining.

Multiple benign adnexal tumours: Anything but benign.

Muir Torre syndrome is an autosomal dominant disorder characterised by germline mutations in mismatch repair genes involved in DNA repair, leading to microsatellite instability and a propensity to tumour formation. We report a case of a 67-year-old gentleman who underwent biopsy of a smooth nodular lesion on the nasal tip, histopathologically consistent with sebaceous adenoma. Immunohistochemistry suggested a loss of MSH6. Subsequent colonoscopy identified a poorly differentiated adenocarcinoma, with loss of staining for MSH6 and a germline mutation identified on genetic analysis. These findings were consistent with a diagnosis of Muir Torre syndrome. Whilst there is controversy in the literature regarding universal screening for Muir Torre syndrome, the early detection of visceral neoplasms is crucial. The authors strongly support screening for Muir Torre syndrome (with patient consent) upon discovery of a cutaneous sebaceous neoplasm, even in the absence of a personal or family history of visceral malignancy.

Changes in productivity and contaminants in bald eagles nesting along the lower Columbia River, USA.

Previous studies documented poor productivity of bald eagles (Haliaeetus leucocephalus) in the lower Columbia River (LCR), USA, and elevated p,p'-dichlorodiphenyldichloroethylene (DDE), polychlorinated biphenyls (PCBs), dioxins, and furans in eagle eggs. From 1994 to 1995, we collected partially incubated eggs at 19 of 43 occupied territories along the LCR and compared productivity and egg contaminants to values obtained in the mid-1980s. We found higher productivity at new nesting sites along the river, yet productivity at 23 older breeding territories remained low and was not different (p = 0.713) between studies. Eggshell thickness at older territories had not improved (p = 0.404), and eggshells averaged 11% thinner than shells measured before dichlorodiphenyltrichloroethane use. Decreases in DDE (p = 0.022) and total PCBs (p = 0.0004) in eggs from older breeding areas occurred between study periods. Productivity was not correlated to contaminants, but DDE, PCBs, and dioxin-like chemicals exceeded estimated no-effect values. Some dioxin-like contaminants in eggs were correlated to nest location, with highest concentrations occurring toward the river's mouth where productivity was lowest. Although total productivity increased due to the success of new nesting pairs in the region, egg contaminants remain high enough to impair reproduction at older territories and, over time, may alter productivity of new pairs nesting near the river's mouth.