We present three male patients who had a rare presentation of anal fistula reaching the genital tract. Patient 1: a 44-year-old diabetic man presented initially to urology clinic complaining of penile and scrotal masses increasing in size for 6 months. Patient 2: a 67-year-old diabetic man presented with chronic sinus discharge from the scrotum. Patient 3: a 37-year-old diabetic man who presented with chronic sinus draining pus-like material from the scrotum for 1 year. Patients 1 and 2: following diagnosis of perianal fistula by MRI fistulography, complete excision of the fistula was done. This required tracking the fistula surgically, a perineal midline incision to release the fistula and excision of the fistula opening in the anal canal. The patients were doing well postoperative and no recurrence of fistula at 1-year follow-up. Patient 3: he refused surgical intervention. Penile mass or scrotal discharge has not been reported to be caused by fistula-in-ano.

A 48-year-old male patient with a history of hypertension presented to the emergency department unconscious and suspected to have a Cerebrovascular Accident (CVA). A plain CT scan was done which revealed old infarctions in multiple areas supplied by the vertebrobasilar system. The basilar artery appeared to be calcified, curved, dilated, and located outside the pontine groove. The CT scan shows occluded basilar artery see (the red arrow). The basilar artery was occluded because of the artery condition. The basilar artery occlusion is rare and it occurs in 1% of all strokes.

Giant melanocytic nevus is a rare dermatological condition. However, total involvement of male genitalia and pubic area has never been reported in the literature and this presentation is considered the first reported case of such condition. The choice of reconstructive intervention should be tailored to the patient's expectations, body habitus and previous surgical procedures.

No abstract

No abstract