Prostate cancer commonly metastasizes bones and lymph nodes, but it very rarely spreads to the gastrointestinal tract. However, only five cases of prostate cancer metastatic to the stomach have been previously reported in the literature. We report a case of a 69-year-old man with metastatic prostate cancer who presented with upper gastrointestinal bleeding (UGB) 4 years after the diagnosis. Esophagogastroscopy revealed multiple ulcerations in the gastric body and histopathological examination confirmed gastric metastasis that originated from prostate cancer. Chemotherapy could not be given because of patient's refusal. He was treated with LHRH agonist. We suggest that for a man with prostate cancer diagnosed with UGB, stomach metastasis should be considered in the differential diagnosis of UGB.
Extramedullary hematopoiesis (EMH) is a condition that usually coexists with hematological disorders and rarely causes mass formation. It can occur anywhere in the body, but very rarely becomes a tumorlike mass in the posterior mediastinum and paravertebral region. A 41-year-old female patient presented with respiratory distress. Radiologically, multiple large mass lesions were detected in the posterior mediastinum, localized bilaterally at paravertebral regions. Diagnostic studies with transthoracic biopsy specimen were showed that the mass lesion was consisting of myelocytes, lymphocytes, erythrocytes and megakaryocytes, so the case was reported as EMH. The case was presented to make a differential diagnosis, because it mimics solid neoplasms at unusual localizations, and may accompany hematological disorders.
Leydig cell tumors are rare testicular tumors of the male gonadal interstitium. Although uncommon, Leydig cell testicular neoplasms are the most common sex cord-stromal tumors and comprise 1–3% of all testicular neoplasms. This tumor is always benign in children and approximately 90% are benign in adults. In most cases, patients present with an incidental finding of a testicular mass on scrotal ultrasonography during evaluation of hydroceles or varicoceles or during diagnostic workup for infertility. Leydig cell tumors have been primarily managed with radical inguinal orchiectomy. However, conservative management with testis-sparing surgery in younger adults and children were reported in the literature. Here we report a case of bilateral Leydig cell tumor of the testis treated with radical orchiectomy who presented with the complaint of infertilityand no disease recurrence in followup for 9 months. The patient is currently disease-free and under androgen supplemantation for androgen insufficiency. We recommend complete exam and diagnostic workup in patients with infertility and azoospermia.
Mesothelial/monocytic incidental cardiac excrescence (MICE) is a rare benign lesion composed of a mixture of histiocytes, mesothelial cells, fibrin, adipocytes and scattered inflammatory cells without a vascular network or supporting stroma. Its pathogenesis is controversial with some authors favoring an artifactual theory while others consider a reactive phenomenon. To date, only 41 cases of MICE have been reported in the literature. We describe an additional case of MICE in a 24-year-old female with antiphospholipid syndrome. A mobile hyperechogenic mass attached to the left ventricular surface of the aortic valve was documented by transthoracic echocardiography (TTE). The patient did have cardiac catheterization one month before the cardiac surgery. Histopathologic and immunohistochemical examination showed a lesion composed of histiocytes and mesothelial cells together with fibrin and scattered inflammatory cells. To our knowledge, this is the first case of MICE detected in a patient with antiphospholipid syndrome.
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