Xanthogranulomatous reaction is rare begin disease affects many different organs, in clinical practice it is well known to affect kidney and gallbladder, but also affect male genital organs including (Testis, epididymis, and spermatic cord), we report a case 70-year old, diabetic patient presented with right scrotal swelling, had history of prior TURP, tumor markers was within normal range, ultrasound shows multiple hypo echoic lesions with moderate hydrocele, exploration done: pus found within tunica vaginalis, and destructed testicular tissue with necrosis, culture revealed (E.Coli), histopathology showed xanthogranulomatous orchitis.

Objective The incidence of thyroglossal duct diseases in the general population is about 7%. We aimed to demonstrate the clinical presentations and management of thyroglossal duct diseases. Methods We conducted a retrospective review of all patients who underwent surgery for histopathologically confirmed thyroglossal duct cyst, sinus, or fistula at a single center. Results A total of 151 cases were included in this study. There were more female patients (87, 58%) than male patients (64, 42%). The patients’ ages ranged from 1 to 63 years old. The most prevalent complaint was painless upper midline neck swelling (93.3%). Most cases were diagnosed as thyroglossal duct cysts (137, 90.7%). Six cases (4%) were associated with carcinoma. All the cases were managed using the modified Sistrunk procedure. There were no procedure-related complications, and five cases of recurrence. Conclusions Although thyroglossal duct cyst is the most common neck anomaly in children, it may also present with various characteristics later in life. This condition can be managed successfully without complications and with a low recurrence rate.

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Introduction There are multiple management modalities for idiopathic granulomatous mastitis, but the treatment of choice is still under debate. This study aims to evaluate the diagnosis and outcomes of different management modalities in patients with idiopathic granulomatous mastitis and to identify the risk factors associated with recurrence. Method This is a single-group cohort study that included those patients who had idiopathic granulomatous mastitis. Ultrasonography was conducted for all of the cases using LOGIQ E9 with an ML6-15 transducer (5-15 MHz). A core needle biopsy was conducted to take samples from the cases for histopathological examination. The patients were put on steroid therapy. Whenever the cases did not respond to the steroid therapy, treatment with a combination of low-dose steroids and methotrexate was started. In the lack of response to conservative treatments, surgical interventions were started. Results Sixty-three cases with a confirmed histopathological diagnosis of granulomatous mastitis were included. The mean age of patients was 35.7 years. The history of more than one childbirth was positive in a large portion of the cases (82.5%). The lesion side was unilateral in 58.7% of the cases. A large proportion of the lesions were classified as BI-RADS category 2. The best treatment outcome was yielded by a combination of low-dose steroids and incision and drainage. The factors of age, lesion area (cm2), skin thickening, and white blood cell count enhanced the chance of recurrence. Conclusion Incision and drainage in combination with a low dose of steroids can give an acceptable outcome with a low rate of recurrence.

Various studies on the etiology and other aspects of granulomatous mastitis (GM) have been performed; however, a lot of controversies have arisen. The present study aimed to present the clinicopathological findings and identify the sensitivity and resistance of isolated bacteria in patients with GM. In this cross-sectional study 63 female patients with a confirmed histopathological diagnosis of GM were included. A core needle biopsy was conducted for the patients to obtain a sample for histopathological examination and bacterial culture. In total, 46 types of antibiotics were used to determine the sensitivity and resistance of each isolated bacterial species. All the medical and clinical records of the patients were acquired through the completion of a questionnaire form in person or, if necessary, through the evaluation of their medical records in the database of the relevant center. The majority of the patients were in the premenopausal or perimenopausal period. GM was unilateral in 58.7% of the patients. The most common symptom was pain, followed by fever and chills. The mean ranges of the erythrocyte sedimentation rate, C-reactive protein, IL-6, IL-17, C5a, white blood count, neutrophil-to-lymphocyte ratio, and prolactin tests were significantly elevated in comparison to the normal ranges. In total, nine different bacterial species were isolated from the bacterial culture of the core biopsy samples, and 50% of the isolated bacterial species were sensitive to trimethoprim-sulfamethoxazole. Since there is no consensus on the etiology of GM, any additional studies related to this aspect expand the current understanding of this puzzling condition.

Introduction and importance: Osseous metaplasia is an extremely rare finding in the breasts, especially in association with benign tumors. This paper aims to present the first case of synchronous breast fibroadenoma with osseous metaplasia and invasive lobular carcinoma (ILC). Case presentation: A 45-year-old female presented with right breast lump for a year. She was hypertensive and had been pregnant for 9 times, in which 5 of them were aborted. Upon examination, there was a painful large mass in right breast. Ultrasound (US) showed multiple masses in the right breast, with the largest one measuring 32 × 16 mm and containing macrocalcification. US also revealed two benign masses in the left breast. Mammography showed an ill-defined asymmetrical density toward the nipple in right breast with two large macrocalcifications. Wide local excision was performed for the right breast, and histopathology examination revealed fibroadenoma with osseous metaplasia, and ILC. Clinical discussion: Although osseous metaplasia is rare, it has been observed in various parts of the body that contain soft tissues. To date, only a few cases have been reported in the breast with all of them being associated with malignant neoplasms. It is believed that these heterotrophic bony tissues develop when stromal fibroblasts are transformed by metaplasia into osteoblasts. Conclusion: Despite its rarity, benign osseous metaplasia can still occur in the breasts, most commonly in middle-aged females with a painful lump being the first presentation. Highlights