Papillary Neoplasms of the Gallbladder and Extrahepatic Bile Ducts: A Report of Two Cases With Associated Invasive Carcinoma.

Intracholecystic papillary neoplasm (ICPN) of the gallbladder is a macroscopically visible premalignant lesion protruding into the gallbladder lumen, with infrequent association with invasive adenocarcinoma. Intraductal papillary neoplasm of the bile ducts (IPNB) is a non-invasive lesion characterized by intraductal papillary or villous architecture. Both ICPN and IPNB are rare findings in the gallbladder and biliary tract pathology. Diagnosis relies on clinical manifestations, imaging techniques, and comprehensive histological examination. Here, we present two cases: a 63-year-old male with mild abdominal pain found to have a gallbladder mass, diagnosed histologically as ICPN with associated invasive carcinoma; and a 65-year-old female with chronic jaundice and a large tumor mass in the common bile duct, histologically diagnosed as IPNB with associated invasive carcinoma. These cases highlight the importance of a careful and thorough microscopic examination to rule out differential diagnoses and to reveal any potential invasive carcinoma associated with these uncommon lesions.

Multimodal Therapy of Locally-Advanced Penile Cancer: A Case Report With Literature Review.

Cancer of the penis is a rare tumor that occurs in the elderly. Because of its rarity, it is often not diagnosed early, and its treatment poses difficulties for practicing oncologists. We report the case of an elderly patient treated for locally advanced squamous cell carcinoma (SCC) of the penis, with a review of the literature. A 71-year-old man, who had been complaining of pruritus on the penis two years ago, presented with an ulcerated lesion on the prepuce and the glans. A biopsy of the lesion with pathological study showed a SCC of the penis. Pelvic MRI showed tumor thickening centered on the glans of the penis, infiltrating the fascia and the spongy urethra with discrete upstream dilatation and bilateral inguinal adenomegaly. CT scan of the neck, chest, abdomen, and pelvis showed no secondary localizations. Treatment initially consisted of carcinological surgery by a partial penectomy with bilateral inguinal lymph node dissection. The tumor was therefore classified as pT3N3M0. A PET CT scan performed later was in favor of local and regional recurrence. Surgery was not feasible, so concomitant chemo-radiotherapy was indicated at a total dose of 70 Gy in 35 fractions of 2 Gy concomitantly with platinum-based chemotherapy, withgood evolution.

When Tuberculosis Defies Appearances: The Tale of a Deceptive Abdominal Mass on Imaging.

Tuberculosis poses a significant public health challenge, especially in highly endemic countries. Rarely, it appears as an abdominal mass resembling a malignant abdominal tumor and can be misleading on imaging, so early diagnosis remains a challenge, and confirmation may require invasive examinations such as laparotomy. The most characteristic radiological appearance is that of a solid, hypervascular, or peripherally enhancing mass with a hypodense center. We present a case of retroperitoneal tuberculosis that simulated a teratoma on imaging. This case highlights the diagnosis difficulties even in endemic countries, despite advances in imaging techniques such as ultrasound and computed tomography.

A Rare Case of Trichobezoar Revealing Undiagnosed Celiac Disease.

Trichobezoar is a relatively rare condition in children, mainly observed in young girls with psychiatric disorders. While documented cases of trichobezoar associated with celiac disease exist, such occurrences remain uncommon in the literature. The association between the two can be explained either by behavioral disorders resulting from a deficiency in iron and folic acid or directly by celiac disease. Treatment is predominantly surgical, and psychological support plays a crucial role in preventing the likelihood of recurrence. We present an unusual case involving the discovery of gastric trichobezoar in a 15-year-old girl who had undiagnosed celiac disease. The condition manifested after she experienced abdominal pain and pallor.

Gastric Adenocarcinoma With Unusual Clear Tubulopapillary Morphology: A Case Report.

Gastric clear cell adenocarcinoma is an extremely rare variant of papillary adenocarcinoma of the stomach. It is associated with a poor prognosis due to its frequent lymphovascular invasion and also its higher risk of recurrence. It is characterized morphologically by a clear appearance of tumor cells, which can be easily confused with a metastasis of a clear cell carcinoma, particularly of renal origin. Very few cases have been previously reported in the literature, which makes it a very poorly known variant. Here, we report the case of a 64-year-old patient who presented with a polypoid lesion in the pylorus, revealed by epigastric pain and chronic vomiting. Histological analysis showed a gastric clear cell adenocarcinoma with a tubulopapillary architecture. Immunohistochemical examination excluded a metastasis of renal origin. Through this case report, we highlight the importance of recognizing such an uncommon and unusual variant of gastric adenocarcinoma, to prevent any potential misdiagnosis.

Giant Poroid Hidradenoma of the Forearm.

Poroid hidradenoma represents an uncommon and benign tumor originating from skin adnexa. It falls under the category of sweet duct neoplasms, along with poromas. It affects the elderly population most frequently. Typically, it emerges as a small, distinct, and painless lump beneath the skin's surface, often occurring on the head and neck regions. It is characterized by a low risk of malignant transformation. Accurate identification relies especially on histomorphological analysis considering the intricate resemblance it shares with other tumors originating from eccrine glands. Poroid hidradenoma has only recently been recognized, and only a limited number of cases have been reported in the medical literature. In this instance, we present an unusual occurrence of a giant poroid hidradenoma on the left forearm of an elderly patient.

Appendiceal duplication: a case report of horseshoe-shaped appendix and implications for patient safety.

Appendiceal anomalies, particularly double appendices, are rare and mainly detected during non-appendiceal surgery in adults. Misrecognizing them can have serious consequences, both clinically and legally. It is critical that surgeons pay attention to the anatomical variations of the vermiform appendix, and always consider the possibility of duplicated appendix when diagnosing a right iliac fossa pain. Misdiagnosis can lead to life-threatening medical complications for the patient, with medico-legal implications.

Solitary Necrotic Nodule of the Liver: A Benign Mimicker of Malignancy.

Solitary necrotic nodule (SNN) of the liver is an uncommon and benign finding in liver pathology. Typically, it appears as a single and asymptomatic lesion, primarily located at the subcapsular region of the right lobe of the liver. Unfortunately, it is easy to mistake this benign lesion for a primary or secondary neoplastic lesion, making it a potential diagnosis pitfall for liver malignancies. The diagnosis of SNN can be difficult to determine as the imaging findings frequently lack specificity. This brings out the importance of histomorphological examination to accurately identify this lesion, and to rule out any possible malignancies. We report here the case of a 35-year-old woman with a history of squamous cell carcinoma of the cervix, who presented a solitary nodule on her liver that was falsely diagnosed as a metastatic lesion in the liver at imagery. The aim of this article is to highlight the importance of using special stains and immunohistochemical staining for diagnosing SNN and excluding any necrotic metastases of the liver. We demonstrated that the absence of a reticulin meshwork in the necrotic core should prompt consideration of a necrotic metastasis in the liver, rather than a solitary necrotic nodule.

Infertility revealing intratubular germinal cell neoplasia of the testis: Case report and review of the literature.

INTRODUCTION: Testicular cancer is the most frequent solid tumor in young people. Most germ cell tumors of the testis, with the exception of vitelline tumors and teratomas in children, and spermatocytic seminoma in the elderly, derive from a common precursor. This precursor, initially described as carcinoma in situ (CIS), is now referred to as intratubular Germinal Cell Neoplasia (ITGCN). CASE PRESENTATION: We report the case of a 37-year-old man with intratubular Germinal Cell Neoplasia (ITGCN) on a testis already treated for cryptorchidism in a context of infertility. We proposed active surveillance, but the patient preferred radiotherapy. DISCUSSION: The origin of ITGCN is still not fully understood. The detection of ITGN is often incidental since it typically does not present with noticeable symptoms, and clinical examination may appear normal. The standard treatment for ITGCN is scrotal radiotherapy. CONCLUSION: The standard treatment for ITGCN is scrotal radiotherapy. However, for patients who desire to preserve fertility, regular observation may be considered as an alternative.

Unusual Presentation of an Ileal Duplication Cyst: A Case Report.

Duplication cyst (DC) of the digestive tract is a rare embryological anomaly, presenting as a cystic formation that could be attached to any part of the digestive tract, it is a thin-walled structure made of two layers, an inner layer that is frequently lined by an alimentary epithelium, surrounded by a smooth muscle layer often shared with the adjacent digestive segment. DCs are most commonly located in the distal ileum; sometimes, they are associated with other visceral or skeletal anomalies. They are frequently discovered during childhood, following a bowel obstruction or abdominal pain. Here we report a rare case of an ileal DC lined by a pseudostratified and ciliated epithelium, discovered in an adult patient following intestinal obstruction syndrome.

Acute epididymitis revealing isolated testicular tuberculosis: A rare case report.

Genitourinary tuberculosis is a rare form of extrapulmonary tuberculosis that affects the kidneys, ureters, prostate, vas deferens, seminal vesicles, testes, and epididymis. Testicular tuberculosis is a very unusual form, We report a rare case of unilateral testicular tuberculosis that manifested as orchi-epididymitis. The main treatment for urogenital tuberculosis is antituberculosis therapy, possibly combined with surgery.

Retroperitoneal desmoid tumor in a patient with familial adenomatous polyposis: A case report.

Desmoid tumors are benign fibroblastic neoplasms, with locally invasive features and a tendency of recurrence. They are considered an aggressive non-metastatic fibromatosis. The retroperitoneal location is extremely rare. Their exact mechanism of occurrence is still controversial, but could be related to a genetic predisposition, hormonal factors or traumatic factors, including surgery. This entity faces management difficulties due to its rarity, the variable circumstances of its discovery, and the non-specific clinical manifestations. Their sensitivity to chemotherapy and radiotherapy is limited and surgery remains the only curative treatment in symptomatic cases, however observational waiting could consist the most appropriate management in selected asymptomatic patients, moreover it could avoid unnecessary morbidity from surgery or radiotherapy, which makes the management of this condition a multidisciplinary decision and should be adapted to fit the patients individually. We report a case of a retroperitoneal desmoid tumor in a 31-year-old woman with a history of familial adenomatous polyposis, through which we will discuss this extremely rare neoplastic entity.

Diffuse Large B-Cell Lymphoma Revealed by Splenic Abscess: A Case Report.

Diffuse large B-cell lymphoma (DLBCL) is one of the most common non-Hodgkin lymphomas. It has no typical or specific clinical features. DLBCL revealed by an abscess is a rare entity. CT is sensitive in detecting splenic abscesses, and it can define the exact location and extent of the abscess as well. The splenic abscess is associated with typhoid fever, AIDS, abdominal infections, pneumonia, bacterial endocarditis, and urogenital infections, parasitic abscesses, organ transplantation, or neoplastic diseases. DLBCL is not usually related to its etiology. Elective open splenectomy, both diagnostic and therapeutic, is the gold standard method of management today and has low morbidity and mortality rates, with even lower rates for laparoscopic splenectomy. The diagnosis of DLBCL is based on the anatomopathological and immunohistological examination. We report a case of a man with a splenic abscess initially treated as an abscess of bacterial origin; however, the lack of improvement in his condition led us to perform a splenectomy, and the anatomopathological study revealed a DLBCL.