Ectopic sphenoid sinus pituitary adenoma masquerading as metastatic head and neck cancer

2021 ◽  
Vol 14 (3) ◽  
pp. e240411
Author(s):  
Augustine Chai ◽  
Alvin Yong Quan Soon ◽  
Bundele Manish ◽  
Jian Li Tan
Keyword(s):  
Pituitary Adenoma ◽  
Sphenoid Sinus ◽  
Surgical Excision ◽  
Metastatic Carcinoma ◽  
Selective Neck Dissection ◽  
Diagnostic Dilemma ◽  
Duct Carcinoma ◽  
Positron Emission ◽  
Total Parotidectomy ◽  
Tomography Scan

A 68-year-old Chinese man was found to have a lobular mass in the sphenoid sinus which extended to the clivus and the roof of the nasopharynx on a staging MRI scan performed for his high-grade parotid salivary duct carcinoma. Further positron emission tomography scan showed that this lesion was fluorodeoxyglucose (FDG) avid. This proved to be a diagnostic dilemma. The patient underwent a total parotidectomy, left selective neck dissection and a transphenoidal biopsy of his nasal lesion. Final histology revealed that this lesion was a synchronous ectopic sphenoid sinus pituitary adenoma (ESSPA). Initial differential diagnoses that were considered included a chordoma, metastatic carcinoma and nasopharyngeal carcinoma. However, an important differential with a neoplastic appearance and a tendency for positive FDG uptake is an ESSPA. It requires dedicated immunohistochemical staining to diagnose, and its mainstay of treatment is surgical excision.

Pitfalls and Key Features of a Case of Sclerosing Pneumocytoma: A Cytological Challenge?

2016 ◽  
Vol 60 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Monica Onorati ◽  
Marta Nicola ◽  
Chiara Luisa Bianchi ◽  
Francesco Bini ◽  
Nadia Bellaviti ◽  
...  
Keyword(s):  
Lung Nodule ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Lung Tumour ◽  
Current Case ◽  
Sclerosing Hemangioma ◽  
Positron Emission ◽  
Key Features ◽  
Needle Aspiration Cytology ◽  
Tomography Scan

Background: The aim of the current case report is to re-evaluate the key features and pitfalls of fine-needle aspiration cytology (FNAC) in the diagnosis of sclerosing pneumocytoma (previously named sclerosing hemangioma) and to establish the importance of FNAC in addressing a proper surgical strategy. Case: Herein we documented a case of a 70- year-old man with a lung nodule which showed a hypermetabolic uptake on positron emission tomography. He therefore underwent FNAC under computed tomography scan guidance with a 22-gauge needle. The cytopathological examination allowed a diagnosis of sclerosing pneumocytoma. A wedge surgical excision was performed and the histological examination confirmed the cytological diagnosis. Conclusion: FNAC is a fundamental tool for distinguishing sclerosing pneumocytoma from a malignant lung tumour and together with clinical, radiological and pathological multidisciplinary assessment is indispensable in planning appropriate surgical management. Cytopathologists should be aware of the pitfalls and key features of the cytopathological diagnosis of sclerosing pneumocytoma, which can significantly change the surgical approach to the patient and protect him from aggressive overtreatment.

scholarly journals Benign cemento-ossifying fibroma: a rare case report

2018 ◽  
Vol 4 (2) ◽  
pp. 585
Author(s):  
Gurbax Singh ◽  
Jasmine Kaur ◽  
Jai Lal Davessar ◽  
Latika Kansal ◽  
Ajay Singh
Keyword(s):  
Sphenoid Sinus ◽  
Rare Case ◽  
Surgical Excision ◽  
Ossifying Fibroma ◽  
Computed Tomography Scan ◽  
Rare Case Report ◽  
History Of ◽  
The Right ◽  
Slow Growing ◽  
Tomography Scan

<p>Cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion commonly seen in the head and neck regions. It is considered as a benign, locally aggressive neoplasm that requires surgical excision. COF has traditionally been considered to be slow growing. We report a case of 11 year-old girl who presented to the ENT Department of our hospital with 7 months history of nasal obstruction, proptosis and headache. Computed Tomography scan images showed a mass in the right nasal cavity. This case is notable because involvement of the sphenoid sinus is rare. </p>

scholarly journals Hodgkin Lymphoma and Castleman Disease: When One Blood Disease Can Hide Another

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
L. Filliatre-Clement ◽  
H. Busby-Venner ◽  
C. Moulin ◽  
G. Roth-Guepin ◽  
A. Perrot
Keyword(s):  
Hodgkin Lymphoma ◽  
De Novo ◽  
Surgical Excision ◽  
Castleman Disease ◽  
Emission Tomography ◽  
Excision Biopsy ◽  
Computed Tomography Scan ◽  
Blood Disease ◽  
Positron Emission ◽  
Tomography Scan

We describe a rare case of Castleman disease associated de novo with Hodgkin lymphoma. The incidence of Castleman disease is rare; only a few studies have described it in de novo association with Hodgkin lymphoma. The patient described here complained of unique evolutionary axillary adenopathy. A positron-emission tomography/computed tomography scan revealed hypermetabolic activity in this area. Diagnosis was based on a total excision biopsy of the adenopathy. The patient underwent complete remission with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy for treating Hodgkin lymphoma after surgical excision of the unicentric Castleman disease lesion.

scholarly journals Pleomorphic liposarcoma of the chest wall: A case report

2017 ◽  
Vol 3 (4) ◽  
pp. 19
Author(s):  
Delandy H.Y. McConnell ◽  
David St. Michel ◽  
Alan J. Shienbaum ◽  
Amrit Nayar ◽  
Darshan Roy
Keyword(s):  
Chest Wall ◽  
Surgical Excision ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Positron Emission Tomography Scan ◽  
Pleomorphic Liposarcoma ◽  
Computed Tomographic ◽  
Positron Emission ◽  
Histopathologic Analysis ◽  
Tomography Scan

Liposarcomas represent the most common type of soft tissue sarcoma. Liposarcoma is sub-classified into dedifferentiated, myxoid, pleomorphic, and unspecified types, with the pleomorphic form being the most rare. The most common locations of this tumor are the popliteal fossa, retroperitoneum, neck and genitourinary system. Primary axillary, chest wall and intrathoracic origin of this lesion is extremely rare with few studies available to guide treatment. This study describes the wide surgical excision of a pleomorphic liposarcoma of the chest wall, which was successfully resected after obtaining magnetic resonance imaging, computed tomographic angiogram, and positron emission tomography scan. We also describe how the definitive diagnosis was established by histopathologic analysis.

scholarly journals Retinoblastoma in an adult: a diagnostic dilemma

2019 ◽  
Vol 12 (10) ◽  
pp. e230537
Author(s):  
Ritika Mukhija ◽  
Neiwete Lomi ◽  
Saumya Kumar ◽  
Seema Sen
Keyword(s):  
Choroidal Melanoma ◽  
Emission Tomography ◽  
Positron Emission Tomography Scan ◽  
Provisional Diagnosis ◽  
Diagnostic Dilemma ◽  
Positron Emission ◽  
Poorly Differentiated ◽  
Anterior Choroidal ◽  
The Right ◽  
Tomography Scan

We report a case of a man aged 35 years who presented with the chief complaint of painless diminution of vision in the right eye for 4 months. Examination revealed a large inferior retinochoroidal mass along with retinal detachment. An anterior choroidal mass with moderate internal reflectivity was seen on B-scan ocular ultrasonography and MRI and CT scan were indicative of a mitotic aetiology. Fluorodeoxyglucose-positron emission tomography scan ruled out any other systemic foci of involvement. Based on the above findings, a provisional diagnosis of amelanotic choroidal melanoma was made and he was taken up for choroidal aspiration biopsy, wherein the cytopathology report revealed hypercellularity with no identifiable pigments. In view of the above, a diagnosticandtherapeutic enucleation was performed; however, the histopathology report of the enucleated specimen revealed poorly differentiated retinoblastoma. This case highlights that the diagnosis of retinoblastoma should be kept in mind even in adult patients.

Liver rheumatoid nodules imitating liver malignancy: a rare occurrence

2020 ◽  
Vol 13 (12) ◽  
pp. e234366
Author(s):  
Jason Wee ◽  
Salar Sobhi ◽  
Bastiaan De Boer ◽  
Dan Xu
Keyword(s):  
Histological Analysis ◽  
Granulomatous Inflammation ◽  
Needle Aspiration ◽  
Upper Respiratory Tract ◽  
Positron Emission Tomography Scan ◽  
Liver Malignancy ◽  
Positron Emission ◽  
Right Lobe ◽  
Upper Respiratory ◽  
Tomography Scan

We describe a case of a 61-year-old man with a background of rheumatoid arthritis who presented to the emergency department with a single-reported episode of haemoptysis on the background of an upper respiratory tract infection. A CT scan revealed an incidental 40 mm mass in upper right lobe of the liver abutting the diaphragmatic surface. A subsequent positron emission tomography scan confirmed the mass and raised the possibility of another lesion in the liver raising the suspicion of malignancy. The case was complicated by the inability to perform a fine needle aspiration biopsy due to the mass’ proximity to the diaphragm. After discussion with the patient, it was decided to resect the affected liver segment. Histological analysis of the mass revealed localised necrotising granulomatous inflammation suggestive of a rheumatoid nodule, which is seldom reported in the literature.

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