Clinical, laboratory, and pathologic findings from a case of primary extramedullary plasmacytoma of the testis and sinuses in a patient with acquired immunodeficiency syndrome (AIDS) are presented. To our knowledge this is the first case in the English literature of a primary testicular plasmacytoma in an HIV-infected patient. The findings in this report and those of others confirm the difference in the pattern of plasma cell tumor (PCT) presentation in patients infected with AIDS from those in non-infected individuals, suggesting that these tumors should be considered in the differential diagnosis of AIDS-associated malignancies.

Myxomas are rare, benign tumors of uncertain etiology. Based on the published data, there have been few reported cases of eyelid nerve sheath myxomas and two cases of orbital myxomas. Eyelid nerve sheath myxomas have a similar presentation to neurothekeoma of the myxoid variety, and historically these two diagnoses have been considered interchangeable. At present, the proper diagnosis can be found through protein immunoreactivity with histological staining. Currently in published literature, there has not been documentation of a family history with eyelid growth in patients diagnosed with nerve sheath myxomas. In this case report, we present a 19-year-old male with a potential third recurrence of nerve sheath myxoma who reports a family history of similar eyelid lesions.

Purpose The following case describes a 28-year old African American male who presented with squamous cell carcinoma of the lacrimal duct. Despite its size and location, his tumor showed complete resolution with non-surgical treatment. Observations The patient presented with a 4-month history of dacryocystitis-like symptoms in the right eye, with no prior medical history and a history of tobacco smoking. Pathology indicated that SCC arose as nests within a benign sinonasal inverted papilloma. He received cisplatin chemotherapy and radiotherapy with tumor resolution in 4 months. Several months after the end of treatment, he experienced irreversible visual deterioration which led to enucleation of the right eye. The patient has remained in remission for 4 years following the treatment. Conclusions The complete resolution of the mass with non-surgical management supports the most recent literature endorsing a multidisciplinary approach for localized tumors. Our patient is the only African American identified in the literature and the youngest reported patient to present with this tumor. Most case studies have not emphasized race, ethnicity and demographics, although it is known that morbidity in malignancy is impacted by these factors.

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Introduction/Objective Streptococcus agalactiae, Group B Streptococcus (GBS), is a major cause of neonatal sepsis and infections in pregnant women. However, incidence of invasive GBS infections has more than doubled in the last two decades with highest risk in adults 65 years or older. Other risk factors are diabetes, malignancy, and immunocompromised state. Bacteremia and skin soft tissue infections are the most common invasive infections in nonpregnant adults. Rarely GBS infection has a fulminating pyrogenic exotoxin-mediated course characterized by acute onset, multiorgan failure, shock, and sometimes death, referred to as toxic shock-like syndrome. Methods A 77-year-old hypertensive female with uncontrolled type 2 diabetes mellitus and a history of bilateral foot ulcers presented to the hospital in probable septic shock. Clinical diagnosis of necrotizing fasciitis was made and she underwent bilateral lower limb amputations. Results Grossly soft tissue appeared gray. Microscopically fascia was necrotic without neutrophils present and Gram stain revealed sheets of Gram positive cocci. These findings reflected histopathologic Stage III necrotizing fasciitis, which is associated with 47% mortality. Autopsy showed a similar histology of Stage III necrotizing fasciitis involving the surgical stump. Erythema and desquamation of the upper limbs bilaterally and multi-organ failure met the clinical picture of Streptococcal Toxic Shock Syndrome (STSS) and fulfilled the criteria for TSS due to Group A Streptococcus (GAS), defined by The Working Group on Severe Streptococcal Infections. Conclusion Group B Streptococcal Toxic Shock-Like Syndrome may have a similar outcome to STSS caused by GAS and other pathogens and, in limited studies, mortality has been 30% or greater.