Case Report: Uterine Adenosarcoma With Sarcomatous Overgrowth and Malignant Heterologous Elements

A 46- year-old woman presented a uterine adenosarcoma originating in the lower uterine segment. The diagnosis was made in an endometrial biopsy and confirmed in the pathological examination of the complete surgical specimen, both identifying heterologous malignant elements. In addition, complementary immunohistochemical studies were performed. We reviewed the literature, illustrating the clinical and morphological characteristics and the differential diagnoses to be evaluated.

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Severe ileum bleeding following adjuvant capecitabine chemotherapy for locally advanced colon cancer: a case report and review of the literature

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02443-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

You Zou ◽

Shuang Liu ◽

Jianhong Wu ◽

Zhen Sun

Keyword(s):

Colorectal Cancer ◽

Case Report ◽

Adjuvant Chemotherapy ◽

Gastrointestinal Bleeding ◽

Cancer Patients ◽

Emergency Surgery ◽

Pathological Examination ◽

Terminal Ileitis ◽

Surgical Specimen ◽

Colorectal Cancer Patients

Abstract Background Capecitabine is a prodrug that is enzymatically converted to its active form, fluorouracil (also called 5-fluorouracil), which is commonly used as adjuvant chemotherapy in colorectal cancer patients. Severe gastrointestinal bleeding induced by capecitabine is rare. Here, we are presenting the first case report of surgery specimen assisted diagnosis of this uncommon condition. Case presentation A 63-year-old Chinese male with a history of colon adenocarcinoma and right hemicolectomy presented with severe lower gastrointestinal bleeding 2 days after finishing capecitabine administration during the first cycle of XELOX adjuvant chemotherapy. Because of the negative findings of active bleeding points by digital subtraction angiography (DSA) or colonoscopy, emergency laparotomy and partial enterectomy were performed. The bloody diarrhea had resolved after surgery and a terminal ileitis was diagnosed after pathological examination of the surgical specimen. Conclusions Terminal ileitis induced by capecitabine is likely to be underreported. It should be considered more often as a cause of severe gastrointestinal bleeding during or after treatment with capecitabine agents. Emergency surgery may achieve satisfactory outcomes if endoscopic hemostasis is ineffective. Highlights of this case 1. Gastrointestinal bleeding following capecitabine treatment in colorectal cancer patients might be life-threatening. 2. Terminal ileitis induced by capecitabine should always be considered in the differential diagnosis of severe gastrointestinal bleeding. 3. Awareness of the risk factors such as deficiency of dihydropyrimidine dehydrogenase, advanced age, or right colectomy may aid in reducing capecitabine-related morbidity. 4. When severe bleeding occurs, emergency surgery may achieve satisfactory outcomes if medical and endoscopic interventions are ineffective.

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Breast Fibromatosis, A Rare Benign Tumor Mimicking Breast Carcinoma: A Case Report

Tumori Journal ◽

10.1177/0300891620914129 ◽

2020 ◽

Vol 106 (1_suppl) ◽

pp. 9-9

Author(s):

R. M. Samaka ◽

A. Y. Abu-Zeid

Keyword(s):

Case Report ◽

Spindle Cell ◽

Case Reports ◽

Surgical Excision ◽

Left Breast ◽

Metaplastic Carcinoma ◽

Primary Breast Tumor ◽

Pathological Examination ◽

Rare Benign Tumor ◽

Immunohistochemical Studies

Objectives: Fibromatosis is a rare breast lesion that is considered locally aggressive tumor without metastasis. It doesn't need more than surgical excision with clean margins as a treatment but the recurrence is very common. Breast fibromatosis clinically mimics other lesions as fibromatosis like metaplastic tumor of breast. Therefore, recognition of breast fibromatosis is important for surgeons and histopathologists, in order to set a proper plan for management and avoid unnecessary extensive surgery. Comprehensive search revealed only 33 case reports as it's compromising less than 0.2% of all primary breast tumor. Case summary Methods and Materials: A 35 years old female patient complained of palpable left breast mass for four months. Her imaging belonged to BI-RAD (4) assessment category. The pathological examination of the core biopsy showed B3; spindle cell lesion. The patient underwent surgical excision of the mass and the histopathologic assessment revealed an infiltrative uncapsulated lesion composed of proliferated spindle shaped cells (mixed fibroblasts and myofibroblast like cells) arranged in sweeping fascicles with occasional extravasated RBCs. There was no mitosis, necrosis or atypia. There was no associated hyperplasia, atypical hyperplasia, insitu or invasive components. Results: Immunohistochemical studies showed positivity for SMA and B- Catenine and negativity for Pan CK and P63 that confirm our diagnosis. Conclusion: The conclusion of this case report is to stress upon keeping breast fibromatosis in mind as a potential differential diagnosis for fibromatosis like metaplastic carcinoma and other mimics of spindle cell lesions in breast.

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Carcinosarcoma of oesophagus: A case report

Indian Journal of Pharmaceutical and Biological Research ◽

10.30750/ijpbr.2.1.16 ◽

2014 ◽

Vol 2 (01) ◽

pp. 99-102

Author(s):

Dinisha Einstien ◽

R. Priavadhana ◽

B. O. Parijatham

Keyword(s):

Weight Loss ◽

Case Report ◽

Oesophageal Cancer ◽

Oesophageal Carcinoma ◽

Malignant Cells ◽

Rare Type ◽

Surgical Specimen ◽

Bulky Mass ◽

Immunohistochemical Studies ◽

Tentative Diagnosis

Oesophageal carcinosarcoma is a rare type of oesophageal cancer composed of both epithelial and mesenchymal components, occuring with an incidence of about 0.1-1.5 % of all oesophageal tumors. Most of the cases have been reported from Japan. Very few cases have been reported from India. We report a case of 65 year old female who presented with dysphagia and weight loss. Endoscopy revealed a bulky mass and the preliminary diagnosis was oesophageal carcinoma. On histology of the surgical specimen, the tumour revealed both epithelial and sarcomatous malignant cells. A tentative diagnosis of oesophageal carcinosarcoma was made. Immunohistochemical studies showed positivity for both pancytokeratin and vimentin thus confirming the diagnosis.

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Heterotopic Sex Cord-Stromal Proliferation: A Case Report

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqab191.163 ◽

2021 ◽

Vol 156 (Supplement_1) ◽

pp. S77-S78

Author(s):

I Lagerstrom ◽

M Uy ◽

N Teschan

Keyword(s):

Case Report ◽

Fallopian Tube ◽

Incidental Finding ◽

Ovarian Tissue ◽

Endometrial Biopsy ◽

Definitive Treatment ◽

Bilateral Mastectomy ◽

Surgical Specimen ◽

True Incidence ◽

Pelvic Pressure

Abstract Introduction/Objective Sex cord-stromal cells at extraovarian sites are extremely rare and due to the low number of cases reported, the true incidence is unknown. We present the case of a patient with symptomatic uterine fibromas that had a benign extraovarian heterotopic sex cord-stromal proliferation. Methods/Case Report A 44-year-old female presented with pelvic pressure and discomfort. Past medical history is significant for breast cancer treated with bilateral mastectomy in 2019 followed by radiation treatments. The patient had no menses since January 2020 but had begun noticing spotting prior to the onset of her pelvic pressure and discomfort. Pelvic ultrasound revealed an enlarged uterus consistent with fibroids and a right adnexal mass. Endometrial biopsy following the ultrasound was normal. The patient desired definitive treatment and a total abdominal hysterectomy and bilateral salpingo-oophorectomy was subsequently performed. Gross examination of the surgical specimen revealed a fibroid uterus and normal appearing bilateral ovaries and fimbriated fallopian tubes. Histopathology showed a uterus with leiomyomata and serous cystadenofibromas in bilateral ovaries. The left fallopian tube fimbria showed a well-circumscribed proliferation of pale, ovoid cells in a microfollicular pattern. Rare cells with grooved nuclei were present. No significant atypia and no mitotic activity were identified. Immunohistochemical staining was positive for inhibin, WT-1, and vimentin. Negative stains include EMA, GATA-3, GCDFP 15, mammaglobin, chromogranin, and calretinin. Final diagnosis was determined to be benign fallopian tube with heterotopic sex cord-stromal proliferation. Results (if a Case Study enter NA) NA Conclusion This case highlights a rare, incidental finding. These lesions are postulated to represent non-neoplastic embryologic remnants. However, most heterotopic sex cord-stromal proliferations are found in fimbriae, which could suggest that they arise from heterotopic ovarian tissue exposed during ovulation. The incidence of these benign proliferations is expected to increase as routine sampling of adnexal structures is becoming more commonplace, which presents diagnostic challenges for pathologists.

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Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

BMJ Case Reports ◽

10.1136/bcr-2019-233179 ◽

2020 ◽

Vol 13 (12) ◽

pp. e233179

Author(s):

Eric Garrels ◽

Fawziya Huq ◽

Gavin McKay

Keyword(s):

Cognitive Impairment ◽

Case Report ◽

Potassium Channel ◽

Limbic Encephalitis ◽

Psychiatric Symptoms ◽

Differential Diagnoses ◽

Visual Hallucinations ◽

Voltage Gated ◽

History Of ◽

Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

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Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

Journal of International Medical Research ◽

10.1177/0300060520966484 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052096648

Author(s):

Yu Wang ◽

Jie Liu

Keyword(s):

Case Report ◽

Primary Hyperparathyroidism ◽

Bone Disease ◽

Distal Humerus ◽

Left Lobe ◽

Pathological Examination ◽

Hypoechoic Mass ◽

Brown Tumors ◽

Restricted Mobility ◽

The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

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Cholesterol Granuloma of the Maxillary Sinus—A Case Report and Literature Review

Allergy & Rhinology ◽

10.1177/2152656720984785 ◽

2021 ◽

Vol 12 ◽

pp. 215265672098478

Author(s):

Abdulrahman Alghulikah ◽

Norah Musallam ◽

Ibrahim Sumaily ◽

Amany Fathaddin ◽

Surayie Aldossary

Keyword(s):

Case Report ◽

Literature Review ◽

Maxillary Sinus ◽

Review Article ◽

Unusual Presentation ◽

Differential Diagnoses ◽

Anatomical Site ◽

Cholesterol Granuloma ◽

Comprehensive Literature Review

Cholesterol Granulomas of the Maxillary Sinus, considered an unusual presentation at this anatomical site. Over last 2 decades, only few cases are reported in the literature (English) and no available comprehensive reviews or studies on this entity. Herein in this article we present a comprehensive literature review of the available reports of 16 cases along with reporting a new case which we managed, aided with its histopathological pictures. This review article can be a reference for practitioners in the field of otorhinolaryngology who may encounter these cases. Also, it attracts the attention to consider this pathology among the differential diagnoses of nasal masses. Moreover, including a described pathological imaging may help young pathologist to identify this pathology.

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Gorham Stout disease: a case report from Syria

Oxford Medical Case Reports ◽

10.1093/omcr/omaa121 ◽

2021 ◽

Vol 2021 (1) ◽

Author(s):

Asil Esper ◽

Sami Alhoulaiby ◽

Areege Emran ◽

Safwan Youssef ◽

Zuheir Alshehabi

Keyword(s):

Case Report ◽

Femoral Head ◽

Bone Formation ◽

Clinical Picture ◽

Bone Matrix ◽

Differential Diagnoses ◽

Rare Entity ◽

Relative Improvement ◽

Cellular Atypia ◽

Pathologic Fractures

Abstract Gorham-Stout disease (GSD) is a rare entity that destroys the bone matrix resulting mainly in osteolysis, pain and pathologic fractures among a broader clinical picture. We report a case of a 60-year-old female with a sudden discovery of pathologic fractures in the pelvis and the absence of the left femoral head. On biopsy, no cellular atypia was found, instead disturbed bone formation with prominent vascularity with scattered foci of necrosis & osteolysis, which lead to the diagnosis of GSD. Possible differential diagnoses were discussed and excluded. The patient was put on Bisphosphonate that led to a relative improvement in the symptoms. This disease needs a more thorough investigation to identify the key cause, what is beyond the scope of this report.

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First bioacoustic and morphological data for the presence of Pelophylax bedriagae in Bulgaria

Acta Scientifica Naturalis ◽

10.2478/asn-2018-0008 ◽

2018 ◽

Vol 5 (1) ◽

pp. 54-63

Author(s):

Simeon Lukanov ◽

Georgi Popgeorgiev ◽

Nikolay Tzankov

Keyword(s):

Morphological Characteristics ◽

Morphological Data ◽

Marsh Frog ◽

Water Frog ◽

Pelophylax Ridibundus ◽

Mating Calls ◽

The Town ◽

Pelophylax Bedriagae ◽

Made In

AbstractWater frog mating calls from two localities were studied and analyzed. Recordings were made in the summer of 2010 at the Arkutino swamp near the town of Primorsko and at the Vurbitza River near the town of Momchilgrad. A total of 154 calls were analyzed and the results suggested the presence of both the Marsh frog (Pelophylax ridibundus) and the Levant frog (Pelophylax bedriagae) in both sites, with the former being more frequent in Vurbitza River, and the latter – in Arkutino. At Vurbitza, we also captured and measured 2 specimens, which morphological characteristics differed from P. ridibundus and matched those of P. bedriagae. These are the first localities for P. bedriagae in Bulgaria.

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Ovarian abscessation and oophoritis in a first lactation dairy cow: a case report

Livestock ◽

10.12968/live.2021.26.5.228 ◽

2021 ◽

Vol 26 (5) ◽

pp. 228-232

Author(s):

David Charles ◽

Victoria Wyse ◽

Katie Waine ◽

Mark Wessels

Keyword(s):

Case Report ◽

Dairy Cow ◽

Transrectal Ultrasound ◽

Rare Condition ◽

Pathological Examination ◽

The Right

A 28-month-old first lactation dairy cow presented as ‘oestrus not observed’ and transrectal ultrasound showed a hyperechoic mass on the right ovary. The mass continued to grow despite treatment, and 8 weeks later a right-sided ovariectomy was performed. A single, large, cavitated mass was found on gross pathological examination with histopathology confirming ovarian abscessation and oophoritis, a rare condition in cattle.

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