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Leiomyomas are benign tumors originating from smooth muscles. Uterus is the common site they are originated. However, genitourinary leiomyomas are the least common type of non-uterine types. We are reporting a case of right-side scrotal spermatic cord leiomyoma in a 26-year-old man presenting as a painless mass. According to the ultrasonography report as an extratesticular mass, he underwent trans-inguinal tumor resection surgery. A well-defined creamy-white ovoid mass with whorling cut surface which was tightened to the posterior of the cord was resected and then sent to pathology service where histologically the diagnosis of leiomyoma was made. Leiomyoma, having concerned its rarity, can be a possible differential diagnosis of extratesticular masses

Abdominal migraine (AM) is one of the variants of migraine and is rare in the adults. This case report describes a 45- year- old woman with diagnosis of adult abdominal migraine.  The patient had improved with anti-migraine drugs. This disorder should be considered in the adult patients with abdominal pain who be normal complete gastrointestinal work up.

A thirteen-year-old boy with a right flank mass and painless gross hematuria is presented. The patient underwent open biopsy and the result was a huge primitive neuroectodermal tumor (PNET) of right kidney. Radical nephrectomy was performed for him and the treatment process continued with systemic chemotherapy.

Mild pericardial effusion is common in severe form of hypothyroidism but massive pericardial effusion with or without cardiac tamponade is rare.  A 49 year-old male with a short stature, large head and facial puffiness, was brought to the emergency department because of progressive altered mental status and severe dyspnea. Cardiac tamponade and hypothyroidism were diagnosed in work ups. Lack of thyroid tissue in his imagines, confirmed the diagnosis of thyroid agenesis. With pericardiocenthesis, hydration and starting levothyroxine his clinical symptoms were resolved dramatically. Our case was presented with full-blown clinical manifestations and irreversible consequences of congenital hypothyroidism. This shows us the important role of newborn screening tests.

Emphysematous  pyelonephritis is a urologic emergency condition characterized by an acute  and severe necrotizing parenchymal and perirenal infection caused by Gas-forming uropathogens. predisposing  factors include diabetes,immunosuppression conditions, urinary tract obstruction associated with urinary calculi or papillary necrosis and significant renal functional impairment. The overall mortality rate has been reported to be between19%to 43% and few cases in kidney allograft have been reported. All of the documented cases of emphysematous pyelonephritis have occurred in adults Juvenile diabetic patients do not appear to be at risk. Female are affected more often than male.we report A 66-year-old  diabetic man with ESRD (end stage renal disease) received deceased renal transplant two mounts after transplantation admitted in hospital , with complain of reduced urine out-put an increase in serum creatinine (Cr) level,fever and abdominal pain.. The patient was treated with 250 mg intravenous imipenem q12h and 1 g intravenous vancomycin  and patient take under hemodialysis  every other day for one week, An ultrasound guided percutaneous  nephrostomy accomplished  and  fortunately he did  considerably respond clinically and radiologically the transplanted kidney  was saved.

With an increase in the application of acupuncture, more complications will be encountered; physicians must be familiar with these complications. We report a case of neuroma formation in the superficial peroneal nerve territory after acupuncture. A 44-year-old woman, after acupuncture for low back pain felt numbness and pain on the lateral side of the dorsum of her left foot. Electrodiagnostically, the patient's symptom was related to superficial peroneal nerve injury. An acupuncturist must be aware of possible complications of needling specially near nerves. Manipulation of the needle may increase risk of nerve injury.

Cervical spondylotic myelopathy is the result of degenerative spinal disease of the cervical spine may lead to significant clinical morbidity. Our patient complained of upper limb weakness and non-dermatomal numbness and gait disorder, which were treated as Guillain-Barre Syndrome and chronic peripheral neuropathy. He was assessed in our clinic and with diagnosis cervical spondylotic myelopathy and was performed decompression surgery. His symptom was dramatically relief. So the aims of this report to emphasize consider cervical myelopathy as the differential diagnosis for cervical pain, upper limb weakness and numbness and gait disorder.

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