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The testis and epididymis were separate from the lesion. The lump was dissected from the cord structure. The cut surface was white, solid and hard to the touch. The testis was repositioned in the scrotum and the inguinal incision was closed in layers. The patient's postoperative recovery was uneventful.Microscopic examination revealed cells arranged in well defined fascicles with central hyperchromatic nuclei and a moderate amount of eosinophilic cytoplasm (Fig. 2). There were 4 mitoses per 10 high power fields. Small foci of necrosis were noted with the appearances of a spindle cell lesion of probable smooth muscle origin. The high cellularity, pleomorphism, necrosis and mitotic activity suggested this was a malignant tumour. The tumour was classified as a grade 2 (differentiation = 2, mitoses = 1, necrosis = 1) on the Fédération Nationale des Centres de Lutte Contre le Cancer system. These histological features were suggestive of a leiomyosarcoma. The immunohistochemistry revealed interlacing fascicles of smooth muscle (positive for desmin, smooth actin and negative for S 100) ( Fig. 3A and Fig. 3B). The histology showed infiltration at edges with margins positive for tumour.The diagnosis of leiomyosarcoma and positive margin on histology prompted us to refer the patient to the regional sarcoma clinic for further treatment. His staging CT san of the chest, abdomen and pelvis did not reveal any local or distant tumour. Subsequently, he underwent a left radical orchidectomy with histology showing fibrosis of the spermatic Case ReportA 51-year-old man presented with a 2-year history of painless lump in the left hemiscrotum. He had no history of trauma, sudden increase in size or associated pain. The patient denied any lower urinary tract symptoms. His previous medical history included recurrent renal stone disease. Clinical examination of the scrotum revealed a 3 cm, non-tender, firm-to-hard lump at the root of the scrotum separate from the left testis. The lump was not freely mobile and was attached to the left spermatic cord. The routine blood investigations were normal. Ultrasound scan of the scrotum showed normal appearance on the right side, with a distinct and well circumscribed 4 × 3.2 × 2.5 cm lesion of mixed heterogeneous echogenicity on the left side. It was abutting the upper pole of the left epididymal head but separate from the epididymis and the testis. The lesion itself showed increased vascularity (Fig. 1A and Fig. 1B).The patient was offered a radical orchidectomy along with excision of the spermatic cord mass, but he declined to have an orchidectomy and opted only for excision of the mass. Upon operating we discovered that he had a lump arising from the cord near the root of the left hemiscrotum. AbstractA 51-year-old man presented with a 2-year history of painless lump in the left hemiscrotum. Scrotal examination demonstrated a 3-cm, firm-to-hard mass attached to the left spermatic cord. Scrotal ultrasound scan revealed a heterogeneous mass separate from the left testis and epididymis. An orch...

A 70-year-old woman with an ileal conduit developed stones in both kidneys and the right ureter. A Double-J stent was placed to facilitate treatment of the stone on the right side. After nearly complete clearance on the right side, an attempt to retrieve the stent was unsuccessful because of a knot at the proximal end that was impacted at the ureteroilial anastomotic site. We describe removal of this impacted knotted stent with a conservative approach.

Primary renal lymphoma is a rare disease. The basis for diagnosis of this entity has been described and its existence is widely accepted. Localized deposition of amyloid is also a rare phenomenon. A case of primary lymphoma with localized amyloid deposition is reported here.

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