Successful treatment for retroperitoneal cavernous hemangioma adjacent to the renal hilum via the laparoscopic approach: a case report

Introduction. Cavernous hemangiomas are common benign tumors of the skin or liver but can also rarely originate from the retroperitoneal space, especially adjacent to the renal hilum. Qualitative characterization of these retroperitoneal tumors using available imaging modalities is relatively difficult. Case presentation. A 40-year-old Japanese woman was incidentally noted to have a round homogenous tumor adjacent to the left renal hilum on computed tomography. The preoperative diagnosis was paraganglioma according to hormonal and clinical findings. The tumor was successfully resected via a laparoscopic approach, and histopathological examination of the tumor revealed cavernous hemangioma. Conclusions: Cavernous hemangioma is a rare but relatively benign disease when considering the different types of retroperitoneal tumors. We were able to effectively treat the retroperitoneal cavernous hemangioma via laparoscopy

Chronic Nonspecific Jejunitis - A -

A 29-yr-old Japanese man presented with left lumbar pain. Laboratory tests were suggestive of an inflammatory disease but serological, bacteriological, and markers of auto immunity were all negative. Gastroduodenal endoscopy showed slight mucosal congestion of the gastric antrum but the duodenum showed normal villi. Colonoscopy showed no abnormalities, and small bowel enema and jejunoscopy were normal. Abdominal ultrasonography and CT scans showed wall thickening of the small intestine. At laparoscopically-assisted wedge biopsy of jejunum, focal edema was noted mainly affecting the midjejunum together with enlarged mesenteric nodes. Histopathological examination of the surgical biopsy material showed focal neutrophilic infiltration in the mucosa and submucosa without granuloma. The lymph node showed nonspecific changes with no granulomas. Although the etiology could not be identified, the patient responded well to clarythromycin treatment

Composite pheochromocytoma of the adrenal gland: a case series

Background: Composite pheochromocytoma is a rare pathological condition characterized by elements of both pheochromocytoma and neurogenic tumors. However, detailed clinical outcomes of this tumor have not been fully shown. From 2007 to 2013, we experienced three cases of adrenal composite pheochromocytoma. In this report, we investigate the clinicopathological features of these three cases of composite pheochromocytoma and compare them with previously reported cases. Case presentations: Cases 1 and 2 were a 29-year-old Japanese woman and a 59-year-old Japanese man, respectively. They underwent laparoscopic left adrenalectomy, and pathological examination revealed composite pheochromocytoma-ganglioneuroma. Case 3 was a 53-year-old Japanese man who had been receiving hemodialysis for 17 years. He underwent laparoscopic right adrenalectomy, and pathological examination revealed composite pheochromocytoma-ganglioneuroblastoma. Although the Ki67-positive rates varied from 1.0 to 6.2% among the three cases, no clinical recurrences occurred. Despite the relatively high rate of Ki67 positivity, complete tumor resection resulted in favorable clinical outcomes. Conclusion: We experienced three cases of adrenal composite pheochromocytoma. Although the clinical findings and treatment outcomes of composite pheochromocytoma were similar to those of ordinary pheochromocytoma, further studies of the biological behavior and genetic profiles of composite pheochromocytoma are necessary to achieve a better understanding of this tumor