Mucinous cystadenoma of the appendix misdiagnosed as cystic hydatid disease of the liver: a case report

<p>Abstract</p> <p>Introduction</p> <p>Primary neoplastic lesions presenting with a mucocele of the appendix are very rare and can be divided into benign variants of mucinous adenomas or cystadenomas, mucinous tumours of uncertain malignant potential or mucinous cystadenocarcinomas. Most of these tumourous mucoceles are asymptomatic and are found incidentally. The major complication of neoplastic mucinous appendiceal tumours is the development of a pseudomyxoma peritonei due to spreading of mucin-producing cells within the abdominal cavity.</p> <p>Case presentation</p> <p>A 44-year-old man presented with a history of non-specific symptoms of right upper abdominal pain. Abdominal ultrasound and computed tomography scan identified a cystic mass consistent with the morphological characteristics of an echinococcal hydatid cyst. After completing systemic albendazole therapy, an explorative laparotomy revealed a cystic tumour of the appendix. Ileocaecal resection was performed and pathology reports confirmed the diagnosis of a mucinous cystadenoma of the appendix. The postoperative course was uneventful.</p> <p>Conclusion</p> <p>Here we present the case of a man with a mucinous cystadenoma of the appendix mimicking cystic hydatid disease. We discuss the importance of re-evaluation and differential diagnostic reflections in cases of appendiceal mucocele.</p

Pleomorphic adenoma of the lacrimal gland: is there a role for biopsy?

Aim To review the literature on biopsy of lacrimal gland pleomorphic adenoma (LGPA) and to examine the validity of the prohibition against biopsy in LGPA. Method Literature review. Results LGPA is usually diagnosed preoperatively based on clinical and radiological characteristics, as current teaching advises complete excision without prior incisional biopsy. The caveat against biopsy is based on older studies that reported increased recurrence rates with increased risk of malignant transformation after incomplete excision or biopsy. On the basis of a detailed examination of the literature on biopsy of both LGPA and pleomorphic adenoma of the salivary glands, it appears that there is no clear evidence to support the claim that biopsy increases the risk of recurrence or of malignant transformation of LGPA. Conclusion Lacrimal gland tumours are uncommon lesions and optimal management depends to a great extent on a definite preoperative diagnosis. Preoperative biopsy should therefore be considered in all lacrimal gland mass lesions and management should be tailored to the biopsy findings. If surgical resection is then required, it may be prudent to excise the biopsy tract to ensure complete removal of the tumour.T Lai, V C Prabhakaran, R Malhotra and D Selv

Cerebral small vessel disease - Genetic risk assessment for prevention and treatment

Cerebrovascular disease is a major burden to individuals and their communities worldwide. Stroke is one of the leading causes of death and disability, and the prevention and treatment of stroke can be improved with a better understanding of its causation. Cerebral small vessel disease (SVD) is a subset of cerebrovascular disease, and has an equally large impact on an individual's quality of life. Although many risk factors are involved, we propose that genetics has a significant role in the pathogenesis of SVD through a complex interplay of environmental and multigenetic factors. Advances in molecular technology have enabled the human genome to be investigated both at a population and, more recently, an individual level. A better understanding of the molecular basis of SVD will enable the development of therapies to help in its prevention and treatment. This review assesses the molecular genetics underlying cerebral SVD.Lam, Ada; Hamilton-Bruce, M Anne; Jannes, Jim; Koblar, Simon Ahttp://adisonline.com/moleculardiagnosistherapy/Abstract/2008/12030/Cerebral_Small_Vessel_Disease__Genetic_Risk.2.asp