Precocious puberty resulting from hypothalamic hamartoma is well known. Neurofibromatosis type 1 can also present with precocious puberty. However, hypothalamic hamartoma as the cause of precocious puberty in patients with neurofibromatosis type 1 has never been described in the literature. This rare occurrence of these two together in a patient with precocious puberty is reported.
Cerebral amyloidoma is a rare form of amyloidosis with a localized tumor like an amyloid deposition in the brain composed of insoluble fibrillary protein with cross beta-sheet conformation. Its usual presentation includes vision loss, seizures, behavioral changes, cognitive decline, and recurrent headaches. It has a benign course with a slow progression, and it is not associated with dissemination. We report a case of a 65-year-old Caucasian woman who presented with symptoms of progressively worsening cognitive dysfunction of six months' duration. From CT of the brain, it was found that she had a right frontal and left parietal hemorrhagic mass with a large amount of vasogenic edema and a midline shift. MRI showed heterogeneously enhancing hemorrhagic mass of 5.2 cm x 2.6 cm x 3.6 cm in size, with a satellite lesion. Initially, this was suspected to be a high-grade glioma vs. metastatic hemorrhagic lesions. She underwent stereotactic biopsy of the mass, and histopathology was consistent with cerebral amyloidoma with marked IgA lambda plasma cell differentiation. She did not have any evidence of systemic amyloidosis, and therefore, she is being clinically observed with a regular follow-up and annual CT surveillance. She has remained stable over the past two years, although she has residual cognitive dysfunction. Cerebral amyloidoma can mimic malignant central nervous system (CNS) neoplasms and should be considered as a differential of any single or multiple mass lesions occurring in the white matter region of the brain with a characteristic appearance of "hyperdense lesions" on CT. It is a benign disease with no metastatic potential that usually resolves entirely after resection.
Gastric adenocarcinoma of the cervix (GAC) represents a rare mucinous endocervical cancer unrelated to human papillomavirus (HPV). GAC has been found to comprise approximately 10% of cervical adenocarcinomas internationally. As more cases have been identified, GAC has been further classified into subtypes such as poorly differentiated versus well-differentiated (also referred to as mucinous or adenoma malignum). This cancer coined the term "gastric" subtype due to its similarity to the pancreaticobiliary and gastric tissue lining. With limited data and similar histological and genetic features of GAC, this malignancy poses a challenge for clinicians when differentiating between metastasis from the gastrointestinal tract and GAC. Here, we present a case of a 55-year-old female who presented with postmenopausal bleeding and was found to have stage IA1 endocervical adenocarcinoma of gastric subtype. The purpose of this article is to introduce a rare type of gastric adenocarcinoma with a unique site of origin in order to better understand this disease process and potentially help clinicians better diagnose and treat patients with this malignancy in the future.
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