Retroperitoneal blue cell round tumor (Ewing sarcoma in a 35 years old male)- case report.

INTRODUCTION: Ewing sarcoma is a highly aggressive tumor. It's common presentation is primary bone tumor, but very rarely as soft tissue sarcoma both of which are under the spectrum of Ewing sarcoma family of tumors (EFT). CASE PRESENTATION: A 35 years old male who presented with advanced locally spreading tumor. He was diagnosed after presenting with epigastric pain and melena, CT abdomen revealed the retroperitoneal mass. CT guided core biopsy taken and was diagnosed as Ewing sarcoma. The patient presented with mass already grown so he was not a surgical candidate. Patient was managed symptomatically till he was sent for palliative care in a Sarcoma centre in Jordon and passed away on October 2021. DISCUSSION: Ewing Sarcoma family of tumors are group of small round blue cell tumors that are histogenetically related. The better known is Ewing 's sarcoma (EWS). It is a malignant small blue round cell tumor with variable degree of neuroectodermal differentiation. Retroperitoneal tumor are mostly malignant and accounts for one third of soft tissue sarcoma. They usually present as large masses at the time of the diagnosis. So they do not produce symptoms until they grow large enough to compress or invade contagious structures. CONCLUSION: ES-EWS is an aggressive tumor with high incidence of local recurrence and distant metastasis that's why is was given its poor prognosis characteristic. Multimodality treatment including surgical resection, chemotherapy and High dose radiotherapy will help in better survival rate.

Recurrent Ulcerations in an 84-Year-Old Male Diagnosed with Hailey-Hailey Disease.

Hailey-Hailey disease (HHD), or familial benign chronic pemphigus, is a rare inherited acantholytic dermatosis. It is an autosomal dominant disease affecting the intertriginous areas. HHD has been characterized by flaccid blisters, erosions, and macerations that are limited to flexural (friction-prone) areas. The painful blisters and erosions significantly decrease patients' quality of life. There are multiple types of therapy related to this disorder. Many of the studies have suggested benefits from steroid therapy in addition to oral antibiotics.

Glycogen rich clear cell carcinoma of the breast: a rare subtype with good prognosis.

Glycogen rich cell carcinoma (GRCC) is a rare subtype of primary malignant neoplasm of the breast. Less than 150 cases have been reported since its first description, thus, making its prognosis unclear and vary from one literature to another. Here we present a 5-year cancer free after the completion of chemotherapy, radiotherapy and targeted-therapy in a 55-year-old female patient with GRCC of the breast. The purpose of reporting this case is to increase the knowledge about this rare subtype of breast cancer and chance of better survival.

Sporadic Burkitt's Lymphoma of the Hypopharynx: A Case Report.

Burkitt's lymphoma is a rapidly growing, high-grade B-cell non-Hodgkin lymphoma that has three distinct variants. Of these, sporadic Burkitt's lymphoma most frequently involves the gastrointestinal system, and the hypopharynx is a rare site of occurrence. Here, the authors report a case of sporadic Burkitt's lymphoma in a 28-year-old male who presented with change of voice as the only complaint. On examination, a mass was found in the hypopharynx that obstructed the laryngeal inlet. The patient underwent an elective examination under general anesthesia and biopsy of the lesion. Histopathological examination confirmed the diagnosis of sporadic Burkitt's lymphoma, following which surgical tracheostomy was performed with complete excision of the mass. A prompt diagnosis is vital to ensure appropriate management of rapidly evolving tumors, such as Burkitt's lymphoma. When diagnosing hypopharyngeal masses, a high index of suspicion is required, as other diseases may appear with similar presentations.

Review - Bacteria and their extracellular polymeric substances causing biofouling on seawater reverse osmosis desalination membranes.

Biofouling in seawater reverse osmosis (SWRO) membranes is a critical issue faced by the desalination industry worldwide. The major cause of biofouling is the irreversible attachment of recalcitrant biofilms formed by bacteria and their extracellular polymeric substances (EPS) on membrane surfaces. Transparent exopolymer particles (TEP) and protobiofilms are recently identified as important precursors of membrane fouling. Despite considerable amount of research on SWRO biofouling, the control of biofouling still remains a challenge. While adoption of better pretreatment methods may help in preventing membrane biofouling in new desalination setups, it is also crucial to effectively disperse old, recalcitrant biofilms and prolong membrane life in operational plants. Most current practices employ the use of broad spectrum biocides and chemicals that target bacterial cells to disperse mature biofilms, which are evidently inefficient. EPS, being known as the strongest structural framework of biofilms, it is essential to breakdown and disintegrate the EPS components for effective biofilm removal. To achieve this, it is necessary to understand the chemical composition and key elements that constitute the EPS of major biofouling bacterial groups in multi-species, mature biofilms. However, significant gaps in understanding the complexity of EPS are evident by the failure to achieve effective prevention and mitigation of fouling in most cases. Some of the reasons may be difficulty in sampling membranes from fully operational full-scale plants, poor understanding of microbial communities and their ecological shifts under dynamic operational conditions within the desalination process, selection of inappropriate model species for laboratory-scale biofouling studies, and the laborious process of extraction and purification of EPS. This article reviews the novel findings on key aspects of SWRO membrane fouling and control measures with particular emphasis on the key sugars in EPS. As a novel strategy to alleviate biofouling, future control methods may be aimed towards specifically disintegrating and breaking down these key sugars rather than using broad spectrum chemicals such as biocides that are currently used in the industry.

Juvenile Psammomatoid Ossifying Fibroma (JPOF) of Proximal Radius: A Rare Entity.

BACKGROUND: Juvenile psammomatoid ossifying fibroma (JPOF) is a rare fibro-osseous lesion that usually occurs in the facial bones. The pathognomonic histopathologic feature is the presence of spherical ossicles, which are similar to psammoma bodies. It is considered to be a unique lesion because of its reported tendency to occur in children and adolescents and its tendency for locally aggressive growth. Because this lesion is aggressive in nature with high recurrence rate, early detection and complete surgical excision are essential. CASE REPORT: Herein, we present a case of 11 year old girl, who presented to our clinic with history of gradual onset pain around right elbow associated with limitation of right forearm rotation for 3 months. After getting informed consent, we performed needle biopsy and histopathologically it was diagnosed as Psammomatoid type juvenile ossifying fibroma (JPOF) of proximal radius. We performed extensive debridement, curettage of entire cystic lesion involving the proximal radius and filled the cavity with allograft bone granules and intramedullary titanium elastic nail through fibular strut graft, bridging the cystic lesion. CONCLUSION: As far as our knowledge there is no reported case of psammomatoid type of juvenile ossifying fibroma of proximal radius. We believe that such tumors in long bones are aggressive and have tendency for recurrence. Definitive diagnosis is utmost important for proper planning, surgical excision and reconstruction of long bones and need regular follow up to look for any recurrence or malignant transformation.

Characterisation and comparison of bacterial communities on reverse osmosis membranes of a full-scale desalination plant by bacterial 16S rRNA gene metabarcoding.

Microbiomes of full-scale seawater reverse osmosis membranes are complex and subject to variation within and between membrane units. The pre-existing bacterial communities of unused membranes before operation have been largely ignored in biofouling studies. This study is novel as unused membranes were used as a critical benchmark for comparison. Fouled seawater reverse osmosis membrane biofilm communities from an array of autopsied membrane samples, following a 7-year operational life-span in a full-scale desalination plant in Western Australia, were characterised by 16S rRNA gene metabarcoding using the bacterial primers 515F and 806R. Communities were then compared based on fouling severity and sampling location. Microbiomes of proteobacterial predominance were detected on control unused membranes. However, fouled membrane communities differed significantly from those on unused membranes, reflecting that operational conditions select specific bacteria on the membrane surface. On fouled membranes, Proteobacteria were also predominant but families differed from those on unused membranes, followed by Bacteriodetes and Firmicutes. Betaproteobacteria correlated with stable, mature and thick biofilms such as those in severely fouled membranes or samples from the feed end of the membrane unit, while Alpha and Gammaproteobacteria were predominantly found in biofilms on fouled but visually clean, and moderately fouled samples or those from reject ends of membrane units. Gammaproteobacteria predominated the thin, compact biofilms at the mid-feed end of membrane units. The study also supported the importance of Caulobacterales and glycosphingolipid-producing bacteria, namely Sphingomonadales, Rhizobiales and Sphingobacteriia, in primary attachment and biofilm recalcitrance. Nitrate-and-nitrite-reducing bacteria such as Rhizobiales, Burkholderiales and some Pseudomonadales were also prevalent across all fouled membranes and appeared to be critical for ecological balance and biofilm maturation.

A rare combination of ovarian and uterine leiomyomas with goblet cell carcinoid of the appendix.

We present a case of the rare combination of unilateral ovarian leiomyoma, uterine leiomyoma, and goblet cell carcinoid tumor of the appendix in a premenopausal woman who presented with right iliac pain. Immunohistochemistry study for desmin (muscle marker) and chromogranin and synaptophysin (neuroendocrine markers) confirmed immunophenotyping origin. Interestingly, both tumors showed positive reaction for estrogen receptor. To our knowledge, such a combination has not been reported previously in the literature. In this paper, the pathogenesis and differential diagnosis of both types of tumors are discussed.

Primary adrenal leiomyosarcoma in an arab male: a rare case report with immunohistochemistry study.

Primary adrenal leiomyosarcoma is a rare form of adrenal mesenchymal tumors. Immunohistochemistry (IHC) together with histology takes a major role in determining the tumor type and predicting their biological behavior and differentiating them from adrenal cortical carcinoma. Appropriate radiological investigation is necessary to rule out metastatic disease from primary tumors elsewhere in the body. In this case, we report a primary leiomyosarcoma of the adrenal gland in a 61-year-old Bahraini male clinically presumed to be a renal neoplasm.

Adrenal cyst presenting as hepatic hydatid cyst.

Introduction. Although adrenal cysts are uncommon, the incidence rate is increasing with the advances in radiological technologies. The incidental detection of adrenal cysts nowadays has become more frequent as a result of the increase usage of high quality imaging modalities. Adrenal cysts originate from the adrenal gland and can be classified into either true or pseudocyst. Presentation of Case. In this report, we described an adrenal cyst of endothelial type, in a 30-year-old lady who was mistakenly diagnosed to have a hydatid cyst both clinically and by imaging. Discussion. Although adrenal cysts are uncommon, the incidence rate is increasing with the frequent use of various high quality radiological technologies. Adrenal cyst should be considered in the differential diagnosis when dealing with upper abdominal cysts. The size of the adrenal cyst can vary from a few millimeters up to 50 cm in diameter. Most of the adrenal cysts are unilateral, while 8%-15% of those cysts do present bilaterally. The majority of cases are diagnosed between the 3rd and 5th decades. Conclusion. Although most of the adrenal cysts are benign in nature, surgical excision is advisable especially when the cysts are greater than 5 cm in diameter and in the case of suspecting malignancy.

Pernicious anemia in a young Bahraini female.

Pernicious anemia (PA) is an autoimmune disorder associated with atrophic gastritis, presence of antibodies to gastric parietal cells and intrinsic factor (IF) and vitamin B2 malabsorption leading to megaloblastic anemia. It has a comparatively higher prevalence in people of North European origin, is uncommon in Arabs and usually affects the elderly. This report, the first from Bahrain, describes a rare case of PA in young female. The presenting symptoms, clinical and laboratory features were similar to those described in classical elderly Caucasian patients. No association with any other autoimmune disease was detected.