Giant cystic pheochromocytoma with low risk of malignancy: A case report and literature teview

Giant pheochromocytomas are rare silent entities that do not present with the classical symptoms commonly seen in catecholamine-secreting tumors. In many cases they are accidentally discovered. The algorithm to diagnose a pheochromocytoma consists of biochemical evaluation and imaging of a retroperitoneal mass. The female patient in this case report presented with a palpable abdominal mass and was cured with surgical resection. She suffered no recurrence or complications on follow-up. The left retroperitoneal mass measured 27 × 18 × 12 cm and weighed 3,315 grams. Biochemical, radiological, and pathological examinations confirmed the diagnosis of a pheochromocytoma. In this paper, we report on our experience treating this patient and provide a summary of all giant pheochromocytomas greater than 10 cm reported to date in English language medical journals. Our patient’s giant cystic pheochromocytoma was the fourth heaviest and fifth largest maximal diameter identified using our literature search criteria. Additionally, this tumor had the largest maximal diameter of all histologically confirmed benign/low metastatic risk pheochromocytomas. Giant cystic pheochromocytomas are rare entities requiring clinical suspicion coupled with strategic diagnostic evaluation to confirm the diagnosis

Right sided spleen laying retro-duodenal: A case report and review of the literature

Introduction: Unlike left sided accessory spleen that are seen in 10–30% of cases at autopsy, cases of right accessory spleens are extremely rare. This congenital body of healthy splenic tissue simulates tumors from neighboring organs and presents a challenge in formulating a differential diagnosis. Presentation of case: We present the case of a patient whose CT scan of the abdomen showed a large mass, 11 × 8 cm, arising retro-duodenal and lying just anterior to the right kidney. To the best of our knowledge, this is the only case where the accessory spleen was found retro-duodenal, directly anterior to the kidney and completely separate from the supra-renal gland. The chief complaint of the patient was right upper quadrant pain, radiating to the back, and colicky in nature. The patient was diagnosed with duodenal gastro-intestinal stromal tumor and a retro-peritoneal sarcoma. The mass was removed via a Kocher’s incision and immunohistological examination showed that it was a right sided accessory spleen. The patient’s left sided spleen appeared normal. Discussion: Efforts to distinguish an accessory spleen from a retroperitoneal tumor with available scans, percutaneous biopsy or biochemical tests are inconclusive. Differential diagnosis between a retroperitoneal tumor and an accessory spleen can only be made after surgical exploration. Conclusion: This case highlights the fact that surgeons should consider the possibility of an accessory spleen when making a differential diagnosis of retroperitoneal tumors

New sub-millimeter limits on dust in the 55 Cancri planetary system

We present new, high-sensitivity sub-millimeter observations towards 55 Cancri, a nearby G8 star with one, or possibly two, known planetary companion(s). Our 850 $\mu$m map, obtained with the SCUBA instrument on the James Clerk Maxwell Telescope, shows three peaks of emission at the 2.5 mJy level in the vicinity of the star's position. However, the observed peaks are 25\arcsec--40\arcsec away from the star and a deep $R$-band optical image reveals faint point sources that coincide with two of the sub-millimeter peaks. Thus, we do not find evidence for dust emission spatially associated with 55 Cancri. The excess 60 $\mu$m emission detected with ISO may originate from one or more of the 850 $\mu$m peaks that we attribute to background sources. Our new results, together with the HST/NICMOS coronographic images in the near-infrared, place stringent limits on the amount of dust in this planetary system, and argue against the existence of a detectable circumstellar dust disk around 55 Cnc.Comment: 11 pages, 2 PostScript figures, to appear in The Astrophysical Journal Letter

Far-infrared and sub-millimetre imaging of HD 76582's circumstellar disc

Debris discs, the tenuous rocky and icy remnants of planet formation, are believed to be evidence for planetary systems around other stars. The JCMT/SCUBA-2 debris disc legacy survey ‘SCUBA-2 Observations of Nearby Stars’ (SONS) observed 100 nearby stars, amongst them HD 76582, for evidence of such material. Here, we present imaging observations by JCMT/SCUBA-2 and Herschel/PACS at sub-millimetre and far-infrared wavelengths, respectively. We simultaneously model the ensemble of photometric and imaging data, spanning optical to sub-millimetre wavelengths, in a self-consistent manner. At far-infrared wavelengths, we find extended emission from the circumstellar disc providing a strong constraint on the dust spatial location in the outer system, although the angular resolution is too poor to constrain the interior of the system. In the sub-millimetre, photometry at 450 and 850 µm reveals a steep fall-off that we interpret as a disc dominated by moderately sized dust grains (amin = 36 µm), perhaps indicative of a non-steady-state collisional cascade within the disc. A disc architecture of three distinct annuli, comprising an unresolved component at 20 au and outer components at 80 and 270 au, along with a very steep particle size distribution (γ = 5), is proposed to match the observations

Dust in the 55 Cancri planetary system

The presence of debris disks around $\sim$ 1-Gyr-old main sequence stars suggests that an appreciable amount of dust may persist even in mature planetary systems. Here we report the detection of dust emission from 55 Cancri, a star with one, or possibly two, planetary companions detected through radial velocity measurements. Our observations at 850$\mu$m and 450$\mu$m imply a dust mass of 0.0008-0.005 Earth masses, somewhat higher than that in the the Kuiper Belt of our solar system. The estimated temperature of the dust grains and a simple model fit both indicate a central disk hole of at least 10 AU in radius. Thus, the region where the planets are detected is likely to be significantly depleted of dust. Our results suggest that far-infrared and sub-millimeter observations are powerful tools for probing the outer regions of extrasolar planetary systems.Comment: 8 pages and 2 figures, to appear in the Astrophysical Journa

Phase II Study of Vicriviroc versus Efavirenz (both with Zidovudine/Lamivudine) in Treatment-Naive Subjects with HIV-1 Infection

Background. Vicriviroc (VCV) is a CCR5 antagonist with nanomolar activity against human immunodeficiency virus (HIV) replication in vitro and in vivo. We report the results of a phase II dose-finding study of VCV plus dual nucleoside reverse-transcriptase inhibitors (NRTIs) in the treatment-naive HIV-1-infected subjects. Methods. This study was a randomized, double-blind, placebo-controlled trial that began with a 14-day comparison of 3 dosages of VCV with placebo in treatment-naive subjects infected with CCR5-using HIV-1. After 14 days of monotherapy, lamivudine/zidovudine was added to the VCV arms; subjects receiving placebo were treated with efavirenz and lamivudine/zidovudine; the planned treatment duration was 48 weeks. Results. Ninety-two subjects enrolled. After 14 days of once-daily monotherapy, the mean viral loads decreased from baseline values by 0.07 log10 copies/mL in the placebo arm, 0.93 log10 copies/mL in theVCV25 mg arm, 1.18 log10 copies/mL in the VCV 50 mg arm, and 1.34 log10 copies/mL in the VCV 75 mg arm (P < .001 for each VCV arm vs. the placebo arm). The combination-therapy portion of the study was stopped because of increased rates of virologic failure in the VCV 25 mg/day arm (relative hazard [RH], 21.6; 95% confidence interval [CI], 2.8-168.9) and the VCV 50 mg/day arm (RH, 11.7; 95% CI, 1.5-92.9), compared with that in the control arm. Conclusion. VCV administered with dual NRTIs in treatment-naive subjects with HIV-1 infection had increased rates of virologic failure, compared with efavirenz plus dual NRTIs. No treatment-limiting toxicity was observed. Study of higher doses of VCV as part of combination therapy is warrante

An Unbiased Survey of 500 Nearby Stars for Debris Disks: A JCMT Legacy Program

We present the scientific motivation and observing plan for an upcoming detection survey for debris disks using the James Clerk Maxwell Telescope. The SCUBA-2 Unbiased Nearby Stars (SUNS) Survey will observe 500 nearby main sequence and sub-giant stars (100 of each of the A, F, G, K and M spectral classes) to the 850 micron extragalactic confusion limit to search for evidence of submillimeter excess, an indication of circumstellar material. The survey distance boundaries are 8.6, 16.5, 22, 25 and 45 pc for M, K, G, F and A stars, respectively, and all targets lie between the declinations of -40 deg to 80 deg. In this survey, no star will be rejected based on its inherent properties: binarity, presence of planetary companions, spectral type or age. This will be the first unbiased survey for debris disks since IRAS. We expect to detect ~125 debris disks, including ~50 cold disks not detectable in current shorter wavelength surveys. A substantial amount of complementary data will be required to constrain the temperatures and masses of discovered disks. High resolution studies will likely be required to resolve many of the disks. Therefore, these systems will be the focus of future observational studies using a variety of observatories to characterize their physical properties. For non-detected systems, this survey will set constraints (upper limits) on the amount of circumstellar dust, of typically 200 times the Kuiper Belt mass, but as low as 10 times the Kuiper Belt mass for the nearest stars in the sample (approximately 2 pc).Comment: 11 pages, 7 figures (3 color), accepted by the Publications of the Astronomical Society of the Pacifi

Resolving debris discs in the far-infrared: early highlights from the DEBRIS survey

We present results from the earliest observations of DEBRIS, a Herschel Key Programme to conduct a volume- and flux-limited survey for debris discs in A-type through M-type stars. PACS images (from chop/nod or scan-mode observations) at 100 and 160 micron are presented toward two A-type stars and one F-type star: beta Leo, beta UMa and eta Corvi. All three stars are known disc hosts. Herschel spatially resolves the dust emission around all three stars (marginally, in the case of beta UMa), providing new information about discs as close as 11 pc with sizes comparable to that of the Solar System. We have combined these data with existing flux density measurements of the discs to refine the SEDs and derive estimates of the fractional luminosities, temperatures and radii of the discs.Comment: to be published in A&A, 5 pages, 2 color figure

The Nearby Evolved Stars Survey I. JCMT/SCUBA-2 Submillimeter Detection of the Detached Shell of U Antliae

We present the highest resolution single-dish submillimetre observations of the detached shell source U Antliae to date. The observations were obtained at 450 and 850m with SCUBA-2 instrument on the James Clerk Maxwell Telescope as part of the Nearby Evolved Stars Survey. The emission at 850m peaks at 40 arcsec with hints of a second peak seen at 20 arcsec. The emission can be traced out to a radius of 56 arcsec at a 3 level. The outer peak observed at 850m aligns well with the peak observed at Herschel/PACS wavelengths. With the help of spectral energy distribution fitting and radiative transfer calculations of multiple-shell models for the circumstellar envelope, we explore the various shell structures and the variation of grain sizes along the in the circumstellar envelope. We determine a total shell dust mass of (2.0 0.3) 105 M and established that the thermal pulse that gave rise to the detached shell occurred 3500 500 yr ago