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Features and Management of Late Relapse of Nonseminomatous Germ Cell Tumour.

BACKGROUND: Late relapse (LR) of nonseminomatous germ cell tumour (NSGCT) is uncommon, with limited data published. LR is defined as relapse occurring after a disease-free interval of 2 yr. OBJECTIVE: To review features of NSGCT LR in a UK tertiary centre. DESIGN SETTING AND PARTICIPANTS: A total of 3064 patients were referred from January 2005 to December 2017. We identified patients who experienced LR after initial pathology demonstrated NSGCT and reviewed data for their original and LR presentation and management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Outcomes included time to L

[CT and MRI findings in patients with autoimmune pancreatitis].

OBJECTIVE: To evaluate computed tomography (CT) and magnetic resonance imaging (MRI) findings in patients with autoimmune pancreatitis (AIP). METHODS: The imaging findings of pancreas and extra-pancreas in 24 patients with AIP were retrospectively reviewed. Among them, CT scan was performed in 18 patients, MRI in 11, and bGth CT and MRI in 10. RESULTS: The pancreas showed diffuse enlargement (25%, 6/24), focal enlargement (37. 5%, 9/24), combined enlargement (25%, 6/24) ,and no enlargement (12. 5%, 9/24). Unenhanced CT showed hypoattenuation in AIP area (n = 2) . After intravenous injection

[Differential diagnosis of deep vein thrombosis].

UNLABELLED: The incidence of deep venous thrombosis (DVT) is high in numerous surgical and medical diseases [1]. There are increasing data o … rmalities (right common iliac artery; compression of the left common iliac vein, malignant disease, retroperitoneal fibrosis, internal iliac compression of the external iliac vein, latent femoral hernia compression of the femoral vein, masses in the thigh (large tumours, true or false aneurysms, popliteal masses/aneurysms, large Baker's cysts), changes in the wall or with …

Mesenteric panniculitis. Part 2: prevalence and natural course: MDCT prospective study.

BACKGROUND: Mesenteric panniculitis (MP) is an uncommon benign inflammatory condition of unknown etiology that involves the adipose tissue of the mesentery. I can be evaluated as a single disease with two pathological subgroups: MP, representing the very large majoritary subgroup where inflammation and fat necrosis predominate and Retractile Mesenteritis, rarely found, where fibrosis and retraction predominate. OBJECTIVE: To re-estimate the prevalence of MP in general population through a large prospective study, to compare the results with those of the literature and to evaluate the natural

Comparison of clinical findings between histologically confirmed type 1 and type 2 autoimmune pancreatitis.

BACKGROUND AND AIM: Type 2 autoimmune pancreatitis (AIP) has been reported mainly in Western countries and is thought to be very rare in Asia. The aim of this study was to compare the prevalence, clinical profiles, detailed radiological findings, and steroid responsiveness between type 1 and type 2 AIP in Korea. METHODS: From 120 patients diagnosed with AIP between January 2003 and August 2010, 52 patients with histologically confirmed type 1 (n = 37) or type 2 (n = 15) AIP were included. RESULTS: The median age of patients with type 2 AIP was significantly lower than that of patients with t

68Ga-PSMA PET-CT Imaging of Metastatic Adenoid Cystic Carcinoma.

AIM: The diagnosis, severity and extent of a sterile inflammation or a septic infection could be challenging since there is not one single t … eases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. METHODS: In September 2020, the inflammatory and infectious diseases focus group (IIFG) of the Italian Association of Nuclear Medicine (AIMN) proposed to realize a procedural paper about the clinical applications of [1 …

Advanced laparoscopic surgery for the removal of rectovaginal septum endometriotic or adenomyotic nodules.

In the pelvis, three different forms of endometriosis (Donnez et al, 1992) must be considered: (1) peritoneal, (2) ovarian, (3) rectovaginal septum. By evaluation of the mitotic activity and the stromal vascularization, we have recently suggested (Nisolle et al, 1993) that peritoneal red lesions were the most aggressive form of the disease and progress to the so-called typical or black lesion, which must be considered as an enclosed implant surrounded by fibrosis. This type of infiltration must be clearly differentiated from the rectovaginal endometriotic nodule. Koninckx (1993) recently descr

Gastrointestinal complications of cocaine use: a narrative literature review.

BACKGROUND: Cocaine is the second most widely used illicit substance worldwide and exerts potent sympathomimetic effects by inhibiting the r … and large-bowel perforation), inflammatory/fibrotic disease (enteritis, enterocolitis, strictures, retroperitoneal fibrosis), hepatobiliary and pancreatic injury, splenic infarction/hematoma/rupture, and other presentations including gastric antral vascular ectasia, an inflammatory bowel disease (IBD)-mimicking phenotype, and, rarely, acalculous cholecystitis. A systemat …

Diagnostic delay and histopathological subtyping challenges in idiopathic multicentric Castleman disease, not otherwise specified: a case report of a three-hospital odyssey.

BACKGROUND: Castleman disease (CD) is a group of rare and heterogeneous lymphoproliferative disorders. Accurate diagnosis and subtyping remain challenging. This report describes a rare case of idiopathic multicentric Castleman disease, not otherwise specified (iMCD-NOS), highlighting the causes of misdiagnosis, diagnostic strategy, and critical features of clinical subtyping. CASE PRESENTATION: A 53-year-old male presented with a 4-month history of persistent right submandibular lymphadenopathy. During this period, he experienced two febrile episodes (max temp 39.0 °C), each lasting 2 days, w

Outcome of endovascular abdominal aortic aneurysm repair in patients with conditions considered unfit for an open procedure: a report on the EUROSTAR experience.

OBJECTIVE: Endovascular abdominal aortic aneurysm repair (EAR) can be performed in patients whose conditions were previously considered unfi … inal approach (previous laparotomies, hostile abdomen, and obesity) and local anatomic factors (eg, retroperitoneal fibrosis, inflammatory aneurysm, dissections, and enterostomy) were present in 19% of the patients with conditions that were unfit for open surgery and in only 1% of the category unfit for anesthesia. In contrast, severe pulmonary disease was present in 33% …

A Case of Autoimmune Hepatitis Initially Manifesting as Hepatic Encephalopathy.

Autoimmune hepatitis (AIH) is a T-cell-mediated liver disease characterized by elevated transaminases, circulating autoantibodies, hypergammaglobulinemia, and interface hepatitis. A 66-year-old female patient visited our department due to recurrent episodes of altered consciousness, sleep-wake inversion, and asterixis, indicating hepatic encephalopathy (HE). Her liver biopsy results clearly demonstrated interface hepatitis. The patient's severe HE does not parallel her relatively stable liver function and was attributed to a wide retroperitoneal collateral vein shunting blood directly into the

Staged Hand-Assisted Bilateral Native Nephrectomy for Management of Posttransplant Polyuria in an Adult with Dent's Disease.

Polyuria after kidney transplantation causes graft dysfunction and increased thrombotic risk. We present a case of a polyuric adult with Dent's disease who underwent staged bilateral native nephrectomies, the first operation before transplant and the second four months after transplant. This led to improved allograft function maintained during four years of follow-up. The retroperitoneal laparoscopic approach was well tolerated and allowed continuation of peritoneal dialysis before transplantation. A staged approach helps regulate fluid balance perioperatively and may be tailored to individual

Imaging of abdominal and pelvic infections in the cancer patient.

Infections are the most commonly encountered complications in patients with cancer. The classical signs and symptoms of infections are often not present in this patient population, which makes the diagnosis more challenging. Host factors play a major role in the development and prognosis of infections in cancer patients; these can be related to the underlying type of malignancy (solid organ versus hematological), tumor burden, anatomic obstruction, altered integrity of barriers (skin or mucosa), treatment-related factors (from chemotherapy, radiation treatment, surgery, interventional procedur

Small Cell Carcinoma of the Gallbladder: Case Report and Comprehensive Analysis of Published Cases.

Background. Gallbladder small cell carcinoma is a rare and highly aggressive malignancy with no established standard of care treatment. We described here a case report of small cell gallbladder cancer and we then performed a comprehensive review of 72 case reports of this disease. Methods. Published case reports of small cell carcinoma of the gallbladder between 1983 and 2014 were reviewed. Treatment modalities and survival were analyzed for metastatic and localized disease. Results. Median overall survival for all patients was 13 months. Metastatic disease was identified in 72% of cases. Trea

MPO-ANCA-Associated Hypertrophic Pachymeningitis Mimicking IgG4-Related Disease: A Case Report and Literature Review.

Hypertrophic pachymeningitis (HP) is a rare and chronic clinical disease characterized by thickening of the dura mater, leading to persistent headache, cranial neuropathy, seizures, and other neurological symptoms. Immune-mediated causes, particularly antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and IgG4-related disease (IgG4-RD), are among the most common etiologies. We report a case of a 54-year-old female with recurrent headache, blepharoptosis, hearing loss, and markedly elevated inflammatory markers. Blood tests, and serum levels of IgG4 were within normal ranges. Cont

Metastatic Plasmacytoid Bladder Cancer Harboring a CDH-1 Mutation and Producing High Levels of CA 19-9. A Case Report and Literature Review.

BACKGROUND Plasmacytoid urothelial carcinoma (PUC) is a rare and aggressive variant of urothelial cancers. Herein, we report a patient with CDH-1 mutated PUC who presented with disseminated peritoneal metastasis and high levels of CA 19-9. CASE REPORT A 65-year-old female presented to the hospital with vomiting, obstructive jaundice, and acute renal failure. Imaging studies showed bilateral hydronephrosis, bladder wall thickening without masses, and dilation of both common bile and pancreatic ducts without pancreatic masses. Carbohydrate antigen (CA) 19-9 was elevated at >17 000 U/mL. Repeated

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… Magnetic resonance imaging (MRI) of the abdomen and pelvis confirmed the bladder wall thickness without any masses, lymphadenopathy, or retroperitoneal fibrosis. …

Case Report: Acute kidney injury due to minimal dilated obstructive nephropathy in the context of gastric cancer.

Postrenal obstruction is a rare but reversible cause of acute kidney injury (AKI), often underrecognized when hydronephrosis is mild or absent. We present a 55-year-old woman with gastric cancer who developed severe AKI requiring hemodialysis. Initial non-contrast abdominal CT revealed only mild bilateral hydronephrosis without obvious ureteral obstruction. Given these subtle radiologic findings and a history of chemotherapy and NSAID exposure. Initially, a multidisciplinary team attributed the AKI to intrinsic renal causes. Subsequent renal biopsy revealed only minimal glomerular changes, ins

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… Notably, 60%-66% of these cases result from extrinsic ureteral compression by retroperitoneal fibrosis (RPF) or metastatic malignancy ( 62 , 63 ). Among them, 86% of AKI cases with negative initial imaging were eventually diagnosed as obstructive through urography ( 62 ). … Abbreviations AKI, acute kidney injury; PM, peritoneal metastasis; MDT, multidisciplinary team; KDIGO, Kidney Disease: Improving Global Outcomes; RUS, retrograde ureteral stenting; PCN, percutaneous nephrostomy; ECGO, Eastern Cooperative Oncology Group; RPF, retroperitoneal fibrosis. …

Atypical Causes of Urinary Tract Obstruction.

Acute kidney injury due to urinary tract obstruction invariably suggests lower urinary tract obstruction or bilateral ureteric obstruction since obstruction of a single kidney while the contralateral kidney is normal and not obstructed would not cause a perceptible rise in creatinine. Assuming a total body volume of 42 L, 70 kg male that generates approximately 1400 mg of creatinine daily (20 mg/kg/day) who has complete urinary tract obstruction would experience a 3.33 mg/dL per day increase in serum creatinine. Thus, for an individual who had prior normal renal function and who presents with

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… UTO may result from stones or external compression from tumors, adenopathy, or retroperitoneal fibrosis. Early diagnosis of UTO is important since most cases can be corrected and delay in therapy can lead to irreversible renal injury. …

Navigating the Diagnostic Maze: A Case Report of Immunoglobulin G4-Related Disease.

Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory condition characterized by significant infiltration of immunoglobulin G4 (IgG4)-positive plasma cells within affected tissues, with or without elevated serum IgG4 levels. The prevalence of IgG4-RD remains largely undetermined due to diagnostic challenges, as the condition is frequently unrecognized or misdiagnosed. This report describes a case of a 63-year-old man who was ultimately diagnosed with this rare condition after an extensive two-year period of elusive symptoms. Initially presenting with intermittent body pai

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… These include Mikulicz disease [ 3 ], chronic sclerosing sialadenitis (Kuttner's tumor) [ 4 ], Riedel’s thyroiditis, mediastinal fibrosis, retroperitoneal fibrosis (Ormond’s disease), periaortitis, idiopathic hypocomplementemic tubulointerstitial nephritis, multifocal fibrosclerosis, and inflammatory …