The present results provide some explanation for the previously noted high incidence of Kaposi's sarcoma in Saudi transplant patients.

ObjectiveTo review the mode of presentation and clinical course of patients with prostate cancer during a specified period, as the detection rate is tending to increase, with most patients presenting at an advanced stage, and yet the overall incidence and prevalence rates are low.Patients and methodsWe retrospectively reviewed all aspects of care for patients who were diagnosed between May 2006 and July 2010.ResultsIn all, 76 men had a histologically confirmed prostatic adenocarcinoma diagnosed between May 2006 and July 2010 (mean age 71.1 years, SD 8). The median (range) prostate-specific antigen level at diagnosis was 52 (1.2–16,230) ng/mL. Of the patients, 74% had a Gleason grade of ⩾ 7 on diagnosis, and 64% had extraprostatic disease on presentation. Active surveillance was adopted in four patients, and four others were maintained on watchful waiting. Six patients had a radical prostatectomy, in one of whom it was a salvage procedure. Six patients received external-beam radical radiotherapy, five of whom had neoadjuvant, concurrent and adjuvant hormonal therapy. All remaining patients were treated primarily with androgen-deprivation therapy (ADT). Of the patients on hormonal manipulation, in 56% the cancer became castrate-resistant within the mean (SD) follow-up of 17.2 (15) months. Of patients treated primarily with ADT, 34% died. The death rate among the whole group was 23%. Both percentages include both prostate cancer-specific and non-specific mortality.ConclusionAn advanced stage of disease at presentation mandates an early-detection, hospital-based screening programme. Further research should include many more patients and be based in several centres.

Background: Pure red cell aplasia is characterized by anemia, reticulocytopenia and diminished bone marrow erythroid precursors. It has multifactorial etiology and consequently several therapeutic interventions. Case:In August 2017, a young patient was diagnosed to have pure red cell aplasia. She was given immunosuppressive therapy for approximately two months but this treatment was stopped due to intolerance. Later on she developed herpes zoster infection that was treated with valacyclovir. Subsequently, it was noted that the patient became blood transfusion independent due to normalization of her hemoglobin and regeneration of the erythroid precursors in the bone marrow.Discussion: Varicella zoster virus behaves differently from other members of the herpes group of viruses such as cytomegalovirus and Epstein-Barr virus. Two retrospective studies, performed in patients with malignant hematological disorders and bone marrow failure, have shown that infection with the virus may cause stimulation of the three cell lines in the bone marrow and superior overall survival. Conclusion:The outcome of the patient presented confi rms the fi ndings of the two studies showing long-term benefi cial effects of varicella zoster virus infections in immunocompromised individuals.

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It is a known fact that the retroperitoneum is the commonest metastatic site for testicular germ cell tumours. Contrary to this we are hereby reporting a case of an advanced testicular non-seminomatous germ cell tumour (NSGCT) presenting with a huge anterior abdominal wall metastatic mass and no evidence of retroperitoneal lymphadenopathy. A 36 yearold gentleman who underwent bilateral orchidopexies as a child, presented with a huge anterior abdominal wall mass engulfing the external genitalia. Incisional biopsy showed a yolk sac tumour. He was treated primarily with immediate chemotherapy with a dramatically good response. This was followed by right radical orchidectomy. Unfortunately, a few months later he developed recurrences into the anterior abdominal wall as well as brain metastasis. We conclude with two main messages. Firstly, previous inguino-scrotal procedures can significantly alter the lymphatic drainage from the testicles. Secondly, primary chemotherapy before orchidectomy can have a very favourable outcome in selected patients.