If a patient presents with incision pain and a palpable mass after gynaecologic surgery, an incisional endometrioma should be considered. Surgical excision and hormone therapy are effective treatment approaches in these patients.

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Carcinosarcoma of the breast, also known as metaplastic carcinoma, is rare with very few cases reported in the literature. A 46-year old female patient presented with a mass in her left breast. Physical examination, ultrasonography and mammography findings were consistent with malignancy. The mass was totally removed. Histopathological examination revealed carcinosarcoma of the breast. Histologic grade of the tumour was III. Ki67 proliferation index was found 40% positive. Tumour cells were positive for p53 (70% positive), c-erb-B2 (5% positive), pancytokeratin and EMA in carcinomatous areas, and vimentin in sarcomatous areas. There was no metastasis in axillary lymph node and distant metastasis. The patient is receiving chemotherapy and is under follow-up in the 54th month. Along with a review of the literature, we present the information regarding the clinical and histological findings and treatment of the patient who was operated due to breast carcinosarcoma.KeywordsBreast; Carcinoma; Carcinosarcoma

An ileal perforation resulting from a migrated biliary stent is a rare complication of endoscopic stent placement for benign or malignant biliary tract disease. We describe the case of a 59-year-old woman with a history of abdominal surgery in which a migrated biliary stent resulted in an ileal perforation. Patients with comorbid abdominal pathologies, including colonic diverticuli, parastomal hernia, or abdominal hernia, may be at increased risk of perforation from migrated stents.

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IntroductionRenal oncocytomas are benign neoplasms derived from cells of the distal renal tubule, and comprise 5% to 7% of primary renal neoplasms. Oncocytomas are mostly asymptomatic, and the majority of tumors are discovered incidentally. In this case report, we present a case of a patient with a giant oncocytoma arising from her left kidney.Case presentationWe describe a 25-year-old Turkish woman who was admitted to our hospital with abdominal pain and a 3-year palpable abdominal mass, which was found present since her second pregnancy. Examination revealed a 15 × 20-cm mass in her abdominal cavity. Computed tomography revealed a mass with regular outlines, measuring 18 × 11 × 12 cm, associated with the left kidney, and causing marked hydroureteronephrosis. We excised the mass and performed a left nephrectomy on our patient. The immunohistopathology of the mass was consistent with renal oncocytoma. No local or distant metastasis was seen at 6 months postoperatively.ConclusionTo the best of our knowledge, this is the second largest renal oncocytoma described in the English language literature. This is also the first reported giant oncocytoma that presented during pregnancy.

Vesical diverticula frequently result from bladder outlet obstructions. However, giant vesical diverticula which cause acute abdomen or intestinal obstruction are very rare. Our review of the English medical literature found 3 cases of bladder diverticula which caused gastrointestinal symptoms. Here, we present a 57-yearold man with a giant diverticulum of the urinary bladder who complained of abdominal pain, nausea and vomiting, constipation, no passage of gas or feces, and abdominal distension for 3 d. A 20 cm × 15 cm diverticulum was observed upon laparotomy. The colonic obstruction was secondary to external compression of the rectum against the sacrum by a distended vesical diverticulum. We performed a diverticulectomy and primary closure. Twelve months postoperatively, the patient had no difficulty with voiding or defecation.