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Primitive neuroectodermal tumor (PNET) is usually an aggressive, rapidly progressing and metastasizing tumor. Occurrence of this type of tumor in the kidney is considered as unusual and few cases have been reported so far. We present a metastatic PNET arising probably from the kidney in a 17-year-old female patient with local invasion and metastasis to the stomach. PNET should be considered as a differential diagnosis of a large heterogeneous soft tissue mass in the abdomen, especially in those with widely local invasion and metastases..

Although triple (Omeprazole, Amoxicillin, and Metronidazole) and quadruple (Omeprazole, Tetracycline, Metronidazole, and Bismuth Subcitrate) therapeutic regimens for H. pylori eradication has been studied much in the general population, there is a lack of data in renal transplanted patients. So, this study aimed at comparing regimens in these patients who were considered being immunocompromised. The present clinical trial was carried out in Mashhad, Iran in 2010. Fifty-five patients who had received a kidney transplant in six months or earlier and referred for chronic dyspepsia were selected. They were resistant to H2-receptor antagonists or proton pump inhibitors therapy and had positive Rapid ‎Urea Test. They randomly divided into two groups: triple and quadruple therapy. The treatment duration in both groups was similar (antibiotics for two weeks plus omeprazole for 4 weeks). Urea Breath Test (UBT) was performed two weeks after treatment for assessment of its result. Total numbers of 39 patients (71%) were positive for H. Pylori which were divided into triple therapy group (21 patients) and quadruple therapy (18 patients). Overall, the treatment was successful in 80% (71% in triple therapy and 89% in quadruple one) which was not different significantly between the groups (p=0.247). The result of this study revealed that the prevalence of H. pylori infection in renal transplant patients is similar to the normal population. In these cases, triple and quadruple therapies were similar in eradication of H. pylori. So, triple therapy can be recommended in renal transplant recipients.

A 46 years old gentleman was admitted to hospital following a 10 months history of sever diarrhea. On examination، the patient appeared as mildly dehydrated though his vital sings were within normal limits. important result tests were: Bun=55 mg/dl Na=149 mEq/dl WBC=11. 6*103/ml Hemoglobin=16. 2 g/d Cr=3 mg/dl K=3. 9 mEq/dl HCT=49. 7% Plt=324*103 Tbo/ul Neutr=74% After ten days administration of IV fluid، BUN and createnine gradually became normal (Cr=1. 1mg/dl، BUN=14mg/dl). There was no macroscopic or microscopic gastrointestinal pathology in upper and lower endoscopy. We took biopsies even from ileum terminal. We suspected endocrine tumors and pancreatic disorders، so we requested abdominal and pelvic CT scan (IV and oral contrast) and hormonal tests such as serum cortisole، metanephrin، normetanephrine، which were all normal. We therefore did an octrotide scan which was again normal. Because almost all organic etiologies of chronic diarrhea were excluded، we focused on neurological and psychological causes of chronic diarrhea. Therefore we consulted with neurologist & psychiatrist and they recommended brain CT scan and EEG which were normal. After complete interview، the psychiatrist diagnosed PTSD and depressive disorder NOS and prescribed imipramin 25mg/day. After 10 days the chronic diarrhea improved. As we excluded all the organic causes، we concluded likely the patient had IBS with PTSD and depressive disorder NOS.

Colonic lipomas are benign adipose tumors that do not usually cause symptoms. Giant colonic lipoma (GCL) is an uncommon finding at endoscopy which may lead to iron deficiency anemia (IDA) with or without macroscopic ulceration. The choice of therapeutic procedure to treat symptomatic GCLs has been controversial. A case of GCL presented with occult bleeding and IDA is reported in this article. IDA resolved following the successful removal of the GCL by a combination of endoloop ligation and snare cautery technique.