Inflammatory myofibroblastic tumor of epididymis: a case report and review of literature.

BACKGROUND: Epididymal inflammatory myofibroblastic tumor, also known by various other synonyms is a rare benign disease. Only eight cases have been reported to date. The most common presentation is a scrotal mass of variable duration. For a scrotal mass it is difficult to distinguish a benign or malignant etiology, in addition to the origin whether from testis or epididymis. As a result the definitive diagnosis can only be established by surgical exploration. CASE PRESENTATION: We report the ninth case of epididymal IMT who based on clinical and radiological findings underwent radical orchidectomy, with the histology suggestive of inflammatory myofibroblastic tumor. At 4 years follow up the patient is free of disease recurrence. CONCLUSION: IMT though rare should be considered in the differential diagnosis of epididymal mass. Clinically it is often difficult to distinguish the origin of mass and even though the disease has benign nature and course it is crucial to counsel patients for orchidectomy as definitive diagnosis is established on surgical exploration.

Low grade papillary transitional cell carcinoma pelvic recurrence masquerading as high grade invasive carcinoma, ten years after radical cystectomy.

BACKGROUND: Tumor recurrence following radical cystectomy for a low-grade superficial transitional cell carcinoma (TCC) is exceedingly uncommon and has not been reported previously. CASE PRESENTATION: We describe a case of a young male presenting with anorexia, weight loss and a large, painful locally destructive pelvic recurrence, ten years after radical cystoprostatectomy. The pathology was consistent with a low-grade urothelial carcinoma. After an unsuccessful treatment with cisplatin-based chemotherapy, the patient underwent a curative intent hemipelvectomy with complete excision of tumor and is disease free at one year follow-up. CONCLUSION: A literature review related to this unusual presentation is reported and a surgical solutions over chemotherapy and radiotherapy is proposed.

Vesicoenteric, vesicovaginal, vesicocutaneous fistula -an unusual complication with intravesical mitomycin.

Intravesical instillation of mitomycin C is a routine practice for treatment of superficial transitional cell carcinoma of bladder. Despite usual precautions serious side effects like fistulation can occur with diverse presentation as illustrated by this report. The pathology demonstrates a dense necrotic and massive inflammatory reaction in the peri vesical tissue following the extravasation of an intravesically administered chemotherapeutic agent. The severe inflammatory tissue response and the necrotic effect associated with the extravasated chemotherapeutic agent could potentially lead to local sepsis with a subsequent fistula formation.