scholarly journals Clinicopathological analysis of primary carcinoid tumour of the ovary arising in mature cystic teratomas

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110346
Author(s):  
Fengcai Yan ◽  
Quan Zhou ◽  
Yulin Lin ◽  
Chunkai Yu ◽  
Hong Chang ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Carcinoid Tumour ◽  
Mature Teratoma ◽  
Thyroid Tissue ◽  
Case Series ◽  
Cytokeratin 19 ◽  
Histopathological Analysis ◽  
Retrospective Case ◽  
Carcinoid Tumours ◽  
Thyroid Transcription Factor 1

Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of patients with primary ovarian carcinoid tumours arising in mature cystic teratomas. Methods This retrospective case series analysed the data from patients with primary ovarian carcinoid tumours arising in mature cystic teratomas. Results The study enrolled four patients. Histopathological analysis of the tumours identified the following subtypes: insular ( n = 1), trabecular ( n = 1) and strumal ( n = 2). All four primary ovarian carcinoid tumours originated from a mature teratoma. The morphology of the primary ovarian carcinoids was similar to other neuroendocrine tumours. Strumal carcinoids were composed of different proportions of thyroid tissue intimately admixed with carcinoid tumour. Tumour tissue was arranged in insular and/or trabecular patterns. The nucleus of tumour cells displayed exquisite chromatin without obvious mitotic figures. Tumour tissues were positively stained for neuroendocrine markers chromogranin A, synaptophysin and CD56 to varying degrees. Strumal carcinoid tumours were cytokeratin 19 positive and thyroid transcription factor 1 negative. No recurrence or metastasis occurred during follow-up (12–71 months). Conclusion Primary ovarian carcinoid tumours arising in mature cystic teratomas are rare. Diagnosis and differential diagnosis should be confirmed by clinical features, histopathological characteristics and specific immunophenotyping.

SP6.1.10 Can gallbladder polyp surveillance be justified? Experience of a large DGH

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nicholas Bradley ◽  
Michael Wilson ◽  
Christopher Shearer ◽  
Timothy Heron ◽  
Katie Robertson ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Case Series ◽  
District General Hospital ◽  
Pathological Examination ◽  
Histopathological Analysis ◽  
Low Grade ◽  
Retrospective Case ◽  
Gallbladder Polyps ◽  
Abnormal Pathology ◽  
Gallbladder Malignancy

Abstract Aims Gallbladder polyps are typically an incidental finding on sonographic or pathological examination with an estimated prevalence of 0.3 – 9.5%. Their role as a precursor to gallbladder malignancy is disputed. The 2017 European Joint Society Guidelines (ESGAR/EAES/EFISDS/ESGE) aim to standardise management of gallbladder polyps detected prior to cholecystectomy. We aim to describe our experience in the management of gallbladder polyps in a district general hospital. Methods This single centre retrospective case series included consecutive cholecystectomies over an 8-year period, identified through pathology records. Medical records were interrogated to identify the presence of gallbladder polyps identified pre-operatively and at subsequent histopathological analysis. Results 3835 cases were included. Four cases (0.1%) had an adenocarcinoma identified; none of these had pre-operatively identified polyps. Two cases (0.05%) were found to have lesions with high-grade dysplasia, 1 of which had a 17mm polyp preoperatively. One case (0.03%) had cellular atypia, without a pre-operative polyp. Forty six cases (1.2%) were found to have low-grade dysplasia; 1 (2.2%) of these had adenomyomatosis pre-operatively but none had pre-operative polyps. Overall, 53 patients (1.4%) had abnormal pathology with only 1 (1.9%) of these having a pre-operative polyp identified. Conclusions Our results suggest that in the real-world setting, intensive surveillance of gallbladder polyps has limited utility in identifying cases of gallbladder malignancy. The burden on services produced by adherence to strict surveillance guidelines is difficult to justify and a less arduous approach is unlikely to significantly influence the management or outcome in patients with gallbladder malignancy.

scholarly journals Orbital solitary fibrous tumors: a multi-centered histopathological and immunohistochemical analysis with radiological description

2020 ◽  
Vol 40 (3) ◽  
pp. 227-233
Author(s):  
Hind Manaa Alkatan ◽  
Abrar K. Alsalamah ◽  
Abdulrahman Almizel ◽  
Khalid M. Alshomar ◽  
Azza MY Maktabi ◽  
...  
Keyword(s):  
Sample Size ◽  
Case Series ◽  
Adult Patients ◽  
Histopathological Analysis ◽  
Retrospective Case ◽  
Female Ratio ◽  
Male Predominance ◽  
Tissue Diagnosis ◽  
Solitary Fibrous Tumors ◽  
Rare Tumors

ABSTRACT BACKGROUND: Solitary fibrous tumors (SFT), formerly called hemangiopericytoma, are rare tumors derived from mesenchymal cells originally described in the pleura, but these tumors may affect extraserosal tissues including the lacrimal gland and orbit. OBJECTIVE: Conduct a multi-centered clinical, radiological and histopathological analysis of 17 orbital SFT cases. DESIGN: A retrospective case series. SETTING: Three eye centers in two countries. PATIENTS AND METHODS: The data collected from the charts of 17 adult patients presenting with tissue diagnosis of orbital hemangiopericytoma or SFT from January 2003 to December 2018 included demographics, clinical imaging and histopathological information including immunohistochemical (IHC) characteristics. MAIN OUTCOME MEASURES: The demographic characteristics, clinical presentation, and histopathological patterns or variants of SFT were analyzed. SAMPLE SIZE: 17 adult patients. RESULTS: Mean age was 45 years (range 23-80 years). Male to female ratio was 3:1. The right eye was affected in 12 (70.5%) patients. Commonest presentation was proptosis in 13/17 (76% of patients). Other symptoms were impaired motility (29%) and ptosis (11%). Lesions mostly affected the medial orbit (35%), then orbital apex in 11%. The histopathological classic pattern-less variant was the commonest. One case with aggressive behavior, multiple recurrences and atypical features was encountered. Immunohistochemical (IHC) markers used included CD34 expression in all cases, Bcl-2 expression in 10/11, CD99 in 9/9 and Vimentin in 4/4. STAT6 was used in 2 cases. CONCLUSIONS: SFTs are rare tumors affecting the orbit in both genders equally in their mid-forties, but showed male predominance in our analysis with a predominant classic histopathological pattern. Tissue diagnosis is essential and requires IHC studies for confirmation. LIMITATIONS: Sample size is relatively small owing to the rarity of this tumor in the orbit. CONFLICT OF INTEREST: None.

Thyroid Cancer Incidentally Found in Radical Surgery for Laryngeal/Hypopharyngeal Cancer

2009 ◽  
Vol 141 (3) ◽  
pp. 343-346 ◽  
Author(s):  
Chien Shih ◽  
Cheng-Ping Wang ◽  
Pei-Jen Lou ◽  
Ya-Ling Hu ◽  
Tsung-Lin Yang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Laryngeal Cancer ◽  
Radical Surgery ◽  
Thyroid Tissue ◽  
Case Series ◽  
Distant Metastases ◽  
Hypopharyngeal Cancer ◽  
Conservative Approach ◽  
Retrospective Case ◽  
One Year

OBJECTIVES: To report on four patients with thyroid cancer found in their specimen of laryngectomy for laryngeal/hypopharyngeal cancer. STUDY DESIGN: Retrospective case series. SETTING: Patients with laryngeal cancer and hypopharyngeal cancers treated at our institution between 1991 and 2005 were enrolled. SUBJECTS AND METHODS: There were 463 patients with laryngeal cancer and 219 patients with hypopharyngeal cancers under retrospective review. RESULTS: There were 254 patients with laryngeal caner and 130 patients with hypopharyngeal cancer receiving surgery. Thyroid cancer was observed in the resected thyroid gland in two cases of laryngeal cancer and in two cases of hypopharyngeal cancer. They received treatment only for their laryngeal/hypopharyngeal cancers. Two patients died of distant metastases from larynx/hypopharynx cancer within one year. The other two patients are currently alive without disease from either of the two types of cancer. CONCLUSIONS: It is rare to discover an unexpected simultaneous thyroid cancer confirmed postoperatively from thyroid tissue partially removed in laryngectomy. A conservative approach is suggested for such patients.

scholarly journals Characteristics and Unexpected COVID-19 Diagnoses in Resuscitation Room Patients during the COVID-19 Outbreak—A Retrospective Case Series

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Sebastian Bergrath ◽  
Olaf Aretz ◽  
Hendrik Haake ◽  
Adrian Ringelstein ◽  
Ingo Greiffendorf ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Critically Ill ◽  
Case Series ◽  
Rt Pcr ◽  
Retrospective Case ◽  
Pharyngeal Swab ◽  
Resuscitation Room ◽  
Polymerase Chain ◽  
Initial Knowledge ◽  
Diagnostic Outcomes

Introduction. Emergency department (ED) triage regarding infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is challenging. During the coronavirus disease 2019 (COVID-19) outbreak in Germany, the diagnostic outcomes of critically ill patients admitted to the resuscitation room in the ED of our academic 754-bed hospital should be analyzed. Methods. All resuscitation room patients between March 1st and April 15th 2020 were included in this retrospective study. Every patient with suspicion of SARS-CoV-2 infection received a pharyngeal swab for real-time polymerase chain reaction (rt-PCR), divided in the clinical subgroups of “highly suspicious for COVID-19” and “COVID-19 as differential diagnosis.” All respiratory and infectious symptoms were included as at least “differential diagnosis” as an expanded suspicion strategy. Results. Ninety-five patients were included (trauma n=14, critically ill n=81). Of 3 highly suspicious patients, 2 had rt-PCR positive pharyngeal swabs. In 39 patients, COVID-19 was defined as differential diagnosis, and 3 were positive for SARS-CoV-2. Of them, pharyngeal swabs were positive in 1 case, while in 2 cases, only tracheal fluid was rt-PCR positive while the pharyngeal swabs were negative. In one of these 2 cases, chest computed tomography (CT) was also negative for ground-glass opacities but showed a pulmonary abscess and pulmonary embolism. Conclusion. We recommend an expanded suspicion strategy for COVID-19 due to unexpected diagnostic outcomes. Personal protective equipment should be used in every resuscitation room operation due to unexpected cases and initial knowledge gaps. Furthermore, tracheal fluid should be tested for SARS-CoV-2 in every intubated patient due to cases with negative pharyngeal swabs and negative chest CT.

scholarly journals Poorly Differentiated Thyroid Carcinoma Arising in Struma Ovarii

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Surapan Khunamornpong ◽  
Jongkolnee Settakorn ◽  
Kornkanok Sukpan ◽  
Prapaporn Suprasert ◽  
Sumalee Siriaunkgul
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Carcinoma ◽  
Ovarian Neoplasms ◽  
Mature Teratoma ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Struma Ovarii ◽  
Poorly Differentiated Thyroid Carcinoma ◽  
Poorly Differentiated

Struma ovarii is an uncommon type of ovarian mature teratoma with a predominant thyroid component. The morphological spectrum of the thyroid tissue ranges from that of normal thyroid to proliferative adenoma-like lesions and thyroid-type carcinomas (malignant transformation). The histologic features of ovarian strumal lesions sometimes cause diagnostic problems due to the confusion with other types of ovarian neoplasms and the difficulty in the prediction of their clinical behavior. We report an extremely rare case of poorly differentiated thyroid carcinoma arising in struma ovarii. A 22-year-old woman presented with a 15 cm right ovarian mass. The tumor showed a predominantly tubular pattern which raised a differential diagnosis between endometrioid adenocarcinoma and Sertoli cell tumor. A review of the gross specimen with additional tissue sampling helped identify the teratomatous and strumal nature, with a support by immunohistochemical staining. Despite FIGO stage IA by optimal staging procedure and the absence of identifiable lymphovascular invasion, the patient developed pulmonary metastasis 15 months after surgery and died from the progression of the disease 7 years after the diagnosis. This case emphasizes the importance of macroscopic examination of the specimen and the awareness of this uncommon tumor in the differential diagnosis of ovarian neoplasms.

scholarly journals The Challenge of Melanocytic Lesions in Pediatric Patients: Clinical-Pathological Findings and the Diagnostic Value of PRAME

2021 ◽  
Vol 11 ◽  
Author(s):  
Giuseppina Rosaria Umano ◽  
Maria Elena Errico ◽  
Vittoria D’Onofrio ◽  
Giulia Delehaye ◽  
Letizia Trotta ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Malignant Melanoma ◽  
Disease Incidence ◽  
Case Series ◽  
Lower Limbs ◽  
Similar Distribution ◽  
Immunohistochemical Expression ◽  
Retrospective Case ◽  
Neoplastic Cells ◽  
Wide Range

Pediatric melanoma is a rare disease especially in children aged younger than 10 years old. Recent estimates report a rise of disease incidence in both adults and children. Diagnostic work-up is challenging in pediatric melanoma, as it displays a wide range of clinical presentations. Immunohistochemical biomarkers have been reported as predictors of malignancy in melanoma, however data specific to pediatric melanoma are poor. Our study aims to contribute to provide evidence of pediatric melanoma clinical features and differential diagnosis in this patient population. We describe our experience with a retrospective case series of pigmented skin lesions including malignant melanoma, atypical spitzoid tumor, and benign nevi in children and adolescents aged less than 16 years. We described the clinical and demographic characteristics of the cohort and evaluated the immunohistochemical expression of the PReferentially expressed Antigen in MElanoma (PRAME) for differential diagnosis of melanoma in children. The series displayed a similar distribution of melanoma between males and females, and the most common site of melanoma onset were the upper and lower limbs. In our cohort, PRAME was negative in most cases. Focal and slight positivity (from 1 to 5% of the neoplastic cells) was observed in four cases (two Spitz nevi and two atypical Spitz tumors). A moderate positivity in 25% of the neoplastic cells was observed in one case of atypical Spitz tumor. Immunohistochemical expression of PRAME might be useful in the differential diagnosis of malignant melanoma.

scholarly journals Single Centre Based Clinicopathological Experience of Adrenal Tumours Including Some Rare Entities

2020 ◽  
Author(s):  
Moumita Maiti ◽  
Ranu Sarkar ◽  
Krishnendu Maiti
Keyword(s):  
Mature Teratoma ◽  
Age Distribution ◽  
Case Series ◽  
Histopathological Diagnosis ◽  
Adrenocortical Adenoma ◽  
Retrospective Case ◽  
Ki 67 ◽  
Female Ratio ◽  
Adrenal Tumours ◽  
Uncommon Presentation

Adrenal tumours are relatively uncommon neoplasms, broadly divided into adrenal cortical and medullary tumours. They show bimodal age distribution. This is a retrospective case series of 36 cases of adrenal tumours over three years (September 2016- August 2019) in NRS Medical College Kolkata, West Bengal, India. Apart from Haematoxylin and Eosin (H&E) staining relevant Immunohistochemistry (IHC) (synaptophysin, Ki-67, Human Melanoma Black 45 (HMB 45) were done for proper histopathological diagnosis. Amongst 36 cases, 12 cases (34%) were myelolipoma, five cases (14%) were neuroblastoma, six cases (17%) of adrenocortical adenoma, two cases (06%) adrenocortical carcinoma, five cases (14%) pheochromocytoma, two cases (06%) mature teratoma, one case (03%) of epitheiloid PECOMA (Perivascular epithelioid cell tumour), one case haemorrhagic pseudocyst (03%) and two cases (06%) were metastasis from renal cell carcinoma. Eleven patients had specific hormonal symptoms. Bimodal age distribution with 10 cases in younger than 14 years, eight cases in more than 50 years and rest 18 cases were in range of 14-50 years. Overall male: female ratio is 5:4 but myelolipoma was common in female. We have encountered few rare entities-Epithelioid PECOMA (angiomyolipoma), Pheochromocytoma with Von Hippel-Lindau (VHL), Receptor for Neurotrophic Factor (RET) Mutation and uncommon presentation with Cushing’s Syndrome, one Adrenal Oncocytoma and two Mature Teratoma.

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