Clinical and Complementary Diagnosis of Sinus Neoplasia in Horses

Background: Sinus neoplasms are reported as low frequency in horses. Its clinical characteristics are often nonspecific, depend on complementary methods for diagnosis, and when diagnosed, generally they are already advanced, limiting therapeutic possibilities. The objective of this case series was to detail clinical aspects and complementary exams for sinus neoplasms for early diagnosis, comparing them with the literature.Cases: Four horses were treated at the College of Veterinary Medicine and Animal Science of the University of São Paulo, with different clinical signs and previous diagnoses, which when evaluated by respiratory endoscopy, radiography, oral cavity evaluation and histopathological exams, revealed the diagnosis of anaplastic carcinoma, poorly differentiated carcinoma, ossifying fibroma and lymphoma. Previous diagnosis, based mainly on clinical signs, were sinusitis secondary to apical infection, ethmoidal hematoma, sinus cyst and sinusitis secondary to periapical disease. The cases of anaplastic carcinoma (case 1) and lymphoma (case 4) presented with an advanced degree of the disease with involvement and destruction of paranasal structures and adjacent tissues, in addition to a poor general condition, which made surgical treatment impossible and led to euthanasia. In these cases, previous treatment was made to apical infection and periodontal disease with secondary sinusitis, but negative evolution led to suspicion of neoplasia, confirmed by histopathological exam of incisional biopsy of the mass in oral cavity. Benign ossifying fibroma (case 3) presented with progressive respiratory difficulty due to occlusion of the lumen of some nasal meatus and radiographic signs of invasion and deformation of the adjacent bones, it was submitted for surgical excision and there was no recurrence until hospital discharge. The poorly differentiated carcinoma (case 2) was a multilobulate neoformation in the ethmoidal region, similar to ethmoid hematoma in endoscopic and radiographic evaluation, it was submitted for excision and two sessions of electrochemotherapy with bleomycin, associated with administration of piroxicam, which obtained a good result until the period of 1 year after discharge.Discussion: It was found that many characteristics are common with these types of neoplasms, and the clinical signs, such as nasal secretions, airway obstruction, increased facial volume, severe alterations in oral cavity, although unspecific, suggest the differential diagnosis for neoplasms. It is important to differentiate from other diseases noting the evolution and growth of these tumors, like in cases 1 and 4, especially the growth to internal tissues, using complementary methods described here, like endoscopic and radiographic examination. Late identification or even manipulation of neoplasms, without proper diagnosis, leads to a few prognoses regarding life. When it is possible to perform surgical excision, complementary methods are important to guide the procedure, and definitive diagnosis is made through histopathologic exam and some need immunohistochemistry analysis. Cases 2 and 3 had surgical access, were submitted to excision and treatment with good results, both with close monitoring in first months and prolonged quality of life. These results highlight the importance of complementary methods for early diagnosis, correct intervention and monitoring of evolution.Keywords: sinus neoplasia, paranasal sinus, tumor, head, horses.

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Poorly Differentiated Carcinoma and Anaplastic Carcinoma of the Thyroid

Thyroid FNA Cytology ◽

10.1007/978-981-13-1897-9_49 ◽

2019 ◽

pp. 371-384

Author(s):

Francesca Maletta ◽

Jasna Metovic ◽

Marco Volante ◽

Mauro Papotti

Keyword(s):

Anaplastic Carcinoma ◽

Poorly Differentiated Carcinoma ◽

Poorly Differentiated

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Oral Myxoma in a Steer

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.87492 ◽

2018 ◽

Vol 46 ◽

pp. 4

Author(s):

Maria Helena Barros Pinto ◽

Guilherme Reis Blume ◽

Jussara Teixeira Medeiros ◽

Ubirajara Oliveira Bilego ◽

Fabiano José Teixeira De Sant'Ana

Keyword(s):

Drinking Water ◽

Oral Cavity ◽

Alcian Blue ◽

Clinical Signs ◽

Surgical Excision ◽

Northeastern Brazil ◽

Blue Staining ◽

Malignant Neoplasms ◽

Current Case ◽

Myxoid Matrix

Background: Myxoma is a benign neoplasm of mesenchymal cells producing a myxomatous matrix rich in mucopolysaccharides. This tumor occasionally has been described in older dogs and cats, and rarely occurs in other species. In ruminants myxomas can be found in the rumen and omasum, but there are no reports of these neoplasms involving the oral cavity of cattle. Only one case of myxoma was diagnosed in a 40-year study of 606 neoplasms in cattle in South Africa. Similar retrospective studies done in cattle from southern and northeastern Brazil also detected a single case of cutaneous myxoma. The current study reports the clinical and pathological findings of a rare occurrence of bovine oral myxoma.Case: A 22-month-old male crossbreed steer (Bosindicus) from the municipality of Rio Verde, GO (17°44′42″S 50°55′00″W), Brazil, presented a history of sialorrhea. There is no another affected animal in the herd. Clinical evaluation revealed mild swelling in the lower incisive gum. Treatment with flumetasone IM for three consecutive days was performed. Two months after this procedure, there was a considerable increase in the size to a flat, firm mass of 16x13x9 cm. Other clinical signs included emaciation and severe difficulty in feeding and drinking water. After surgical excision, fragments of the tumor were collected for histopathology. There is no local recurrence within approximately one year of the surgery. Microscopically, the lamina propria was found to be expanded and replaced by a nonencapsulated, moderately cellular, poorly demarcated, neoplastic proliferation. The lesion was composed of numerous loosely arranged bundles of cells in an abundant myxoid matrix. The bulk of the tumor parenchyma was formed by spindle or stellate cells with poorly demarcated borders and scant, eosinophilic cytoplasm. The nuclei were oval and hyperchromatic. Mild anisocytosis and anisokaryosis were present, along with rare mitotic figures. The myxoid matrix presented strong positive labeling to mucin by the Alcian blue staining. Based on the anatomopathological and histochemical findings, a diagnosis of myxoma was established.Discussion: Neoplasms of connective tissue originate from poorly differentiated fibroblasts and can produce collagenous (fibroma/fibrosarcoma) or mucinous (myxoma/myxosarcoma) stroma. In some cases, it is difficult to establish a histopathological classification and to distinguish between benign and malignant neoplasms, for which assessment of cell morphology, mitotic index, and biologic behavior are required. Very few cases of myxoma have been previously reported in cattle, this neoplasm and it was never diagnosed in the oral cavity of this species. Thre majority of neoplasms diagnosed in the oral cavity of cattle are squamous cell carcinomas and papillomas, although sporadic cases of lingual fibroma, lingual mastocytoma, odontoma and ameloblastic fibroma have been described. In the current case, the steer presented weight loss and difficulty in feeding and drinking water, probably due to the large volume of the neoplasm. Similar clinical signs can occur in cattle affected by other types of large neoplasms in the oral cavity. After surgical excision, the animal of the current report presented general improvement and considerable weight gain. The myxoma-related pathologic findings observed in the present case are similar to those described in other studies. Because myxoma is considered an infiltrative neoplasm, postoperative recurrence can occur; however, this was not noted in the current case and reports of myxoma in other species. The main differential diagnosis for myxoma is fibroma; the presence of mucin (Alcian blue positive) in the intercellular matrix as seen in the current case confirms the diagnosis of myxoma.

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Mucinous Ovarian Tumors With Anaplastic Mural Nodules: Case Report

Frontiers in Medicine ◽

10.3389/fmed.2021.753904 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xinxin Zou ◽

Hao Huang ◽

Qingyu Zhang ◽

Zhen Ma ◽

Yumei Chen ◽

...

Keyword(s):

Surgical Excision ◽

Exploratory Laparotomy ◽

Cystic Mass ◽

Anaplastic Carcinoma ◽

Diagnostic Methods ◽

Cystic Tumors ◽

Partition Walls ◽

Poorly Differentiated ◽

The Right ◽

Mural Nodules

Ovarian mucinous cystic tumors may be associated with various types of mural nodules, which can be classified as benign or malignant (anaplastic carcinoma, sarcoma, carcinosarcoma). However, anaplastic malignant nodules have rarely been reported. Here, we present a case of a 35-year-old woman who presented with abdominal discomfort. Ultrasonography showed a large cystic mass in the pelvic and abdominal cavities measuring 337 × 242 mm. Abdominal computed tomography revealed upper anterior and posterior uterine pelvic cystic lesions based on multiple nodule partition walls and classes. During hospitalization, the patient underwent exploratory laparotomy, which revealed a poorly differentiated ovarian malignant tumor, and subsequent surgical excision was performed. The pathological analysis of the surgical samples of the right ovary revealed a mucinous ovarian tumor, while the mural nodules were classified as anaplastic carcinoma. After surgery, the patient started receiving chemotherapy. Unfortunately, the patient died 6 months later. Mucinous tumor occurring with an anaplastic carcinoma is rare, and the current diagnostic methods are not sufficient in providing an early and accurate diagnosis. Most patients are already in the advanced stage upon diagnosis and combined with poorly differentiated pathological features, the prognosis is extremely poor. Clinicians need to improve the clinical evaluation before surgery and conduct preoperative preparation and communication to improve the prognosis of patients as much as possible.

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PD‑L1 expression and immune cells in anaplastic carcinoma and poorly differentiated carcinoma of the human thyroid gland: A retrospective study

Oncology Letters ◽

10.3892/ol.2021.12814 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Soledad Cameselle‑García ◽

Sámer Abdulkader‑Sande ◽

María Sánchez‑Ares ◽

Gemma Rodríguez‑carnero ◽

Jesús Garcia‑Gómez ◽

...

Keyword(s):

Retrospective Study ◽

Thyroid Gland ◽

Immune Cells ◽

Anaplastic Carcinoma ◽

Human Thyroid ◽

Poorly Differentiated Carcinoma ◽

Poorly Differentiated

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Oral masses in African pygmy hedgehogs

Journal of Veterinary Diagnostic Investigation ◽

10.1177/1040638719878870 ◽

2019 ◽

Vol 31 (6) ◽

pp. 864-867

Author(s):

Gabriela Del Aguila ◽

Cristian G. Torres ◽

Francisco R. Carvallo ◽

Carlos M. Gonzalez ◽

Federico F. Cifuentes

Keyword(s):

Oral Cavity ◽

Clinical Signs ◽

Surgical Excision ◽

Gingival Hyperplasia ◽

Mesenchymal Tumors ◽

Caudal Portion ◽

Neural Origin ◽

Oral Neoplasms ◽

The Right ◽

Privately Owned

African pygmy hedgehogs ( Atelerix albiventris) frequently develop oral neoplasms, and most of these neoplasms are malignant. We characterized oral masses detected in hedgehogs at clinical examination. During a 1-y period, we diagnosed oral cavity masses in 27 privately owned hedgehogs; 16 were female and 11 were male, with ages of 2–7 y (mean: 4.3 y). Eight masses were non-neoplastic and were diagnosed as gingival hyperplasia (GH). Nineteen masses were neoplastic, of which 17 were squamous cell carcinomas (SCCs) and 2 were mesenchymal tumors (1 spindle cell tumor of probable neural origin, and 1 hemangiosarcoma). The GHs were noninvasive, exophytic, and did not recur after surgical excision. The SCCs were highly invasive tumors that induced facial deformation and were located in the caudal portion of the oral cavity, with 12 of them arising from the right-caudal maxilla. Thus, clinical signs, growth pattern, and anatomic location can be used to suspect a diagnosis of SCC among the other possible diagnoses, such as GH, in this location. However, histopathology is necessary for confirmation. Also, hemangiosarcoma should be considered among the differential diagnoses.

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Incident of Thyroid Carcinomas and Other Pathologies with Age Correlation in Patients Presented with Palpable Thyroid Masses Undergoing Thyroidectomies

Annals of Punjab Medical College ◽

10.29054/apmc/2021.733 ◽

2021 ◽

Vol 15 (1) ◽

pp. 77-81

Author(s):

Mahwish Niaz ◽

Keyword(s):

Papillary Carcinoma ◽

Multinodular Goiter ◽

Follicular Adenoma ◽

Anaplastic Carcinoma ◽

Cell Adenoma ◽

Thyroid Carcinomas ◽

Hürthle Cell ◽

Poorly Differentiated Carcinoma ◽

Poorly Differentiated ◽

Age Range

Background: Thyroid cancer is the leading cause of death both in developing and developed countries. Patients present with enlarged thyroid. Radiology shows hot and cold nodules. Thyroidectomy or lobectomy is done to rule out malignancy. Objective: To determine the incidence of thyroid carcinomas and other pathologies in thyroidectomy specimen of different age group patients presenting with clinically enlarged thyroid. Study Design: Cross-sectional study. Settings: Department of Histopathology, Foundation University Medical College (FUMC), Islamabad and Department of surgery, Fauji Foundation Hospital (FFH), Rawalpindi Pakistan. Duration: from Jan 2012 to March 2019. Methodology: All the thyroidectomies specimens send from Surgery department of FFH to Histopathology Department of FUMC during study period and fulfilling the pre-set criteria were included in the study. All the data and results were analyzed using SPSS version 17.0. Results: Out of 500 total patients, 89% (n=445) were diagnosed as having multinodular goiter, 2.6% (n=13) thyroiditis, 2.2% (n=11) follicular adenoma, 0.8% (n=4) Hurthle cell adenoma, 0.2%(n=1) hyalinizing trabacular adenoma and thyroid carcinomas. The carcinomas comprised 2.6%(n=13) papillary carcinoma, 0.8%(n=4) poorly differentiated carcinoma,0.8%(n=4) anaplastic carcinoma,0.6%(n=3) medullary carcinoma and 0.4%(n=2) follicular carcinoma. In 445 patients of multinodular goiter 158 patients were in the age range of 41-50 years, in 13 cases of thyroiditis 7 were in the age range of 31-40 years, in 11 cases of follicular adenoma 4 patients were in the age range of 31-40 years, in 4 cases of hurthle cell adenoma 3 patients were in the age range of 41-50 years, in 13 cases of papillary thyroid carcinoma 5 patients were in the age range of 31-40 years, in 4 cases of poorly differentiated carcinoma 2 patients were in the age range of 41-50 years and in 4 cases of anaplastic carcinoma 2 patients were in the age range of 61-70 years. Conclusion: The study concluded that thyroid carcinomas collectively constituted 5.20% of the study cases. Papillary carcinoma was the most frequent malignant neoplasm constituting 2.6 % and occurring mostly in the age range of 31-40 years, while anaplastic carcinoma comprised of 0.8% of malignant lesions occurring in the age range of 61-70 years. The most frequent cause of thyroid enlargement was multinodular goiter (89%) with majority of the patients in the age range of 41-50 years.

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Chronic Cutaneous Hyalohyphomycosis by Paecilomyces

The Open Dermatology Journal ◽

10.2174/1874372201408010004 ◽

2014 ◽

Vol 8 (1) ◽

pp. 4-7 ◽

Cited By ~ 1

Author(s):

N. Boufflette ◽

J.E. Arrese ◽

P. Leonard ◽

A.F. Nikkels

Keyword(s):

Case Report ◽

Clinical Signs ◽

Surgical Excision ◽

Clinical Aspects ◽

Immunosuppressed Patient ◽

Necrotizing Vasculitis ◽

Delay In Diagnosis ◽

Clinical Presentations ◽

Immunocompromised Hosts ◽

Immunocompetent Patients

Paecilomyces lilacinus is a ubiquitous saprophytic fungus that rarely causes infections in humans, frequently affecting the eyes and the skin. Cutaneous and subcutaneous infections mainly occur in immunocompromised hosts but have occasionally been reported in immunocompetent patients. The clinical spectrum is highly heterogeneous and diagnosis is often delayed. A 60-year-old woman with idiopathic chronic necrotizing vasculitis treated since 10 years with a series of immunosuppressive therapies presented since three years various clinical presentations of chronic hyalohyphomycosis caused by P. lilacinus. Diagnosis was only obtained three years after the first clinical signs, following the histologic analysis of the surgical excision of a cutaneous abscess. Treatment with oral voriconazole was successful. This case report illustrates the highly heterogeneous clinical aspects of hyalohyphomycosis by P. lilacinus leading to a delay in diagnosis and treatment, particularly in the immunosuppressed patient.

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Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

Medicina ◽

10.3390/medicina57030271 ◽

2021 ◽

Vol 57 (3) ◽

pp. 271

Author(s):

Saverio Capodiferro ◽

Luisa Limongelli ◽

Gianfranco Favia

Keyword(s):

Early Diagnosis ◽

Oral Cavity ◽

Head And Neck ◽

Clinical Outcomes ◽

Systemic Disease ◽

Clinical Manifestations ◽

Systemic Diseases ◽

Special Issue ◽

Hard Tissues ◽

Current Special Issue

Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.

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Challenging Diagnosis in NUT Carcinoma

International Journal of Surgical Pathology ◽

10.1177/10668969211019532 ◽

2021 ◽

pp. 106689692110195

Author(s):

Grosse Claudia ◽

Grosse Alexandra

Keyword(s):

Nuclear Protein ◽

Hematological Malignancy ◽

Undifferentiated Carcinoma ◽

Squamous Differentiation ◽

Poorly Differentiated Carcinoma ◽

Poorly Differentiated ◽

Nut Carcinoma ◽

Disseminated Disease ◽

Generation Sequencing

Nuclear protein in testis (NUT) carcinoma represents a highly aggressive, poorly differentiated carcinoma that is genetically defined by rearrangement of NUT gene. The histomorphological appearance ranges from entirely undifferentiated carcinoma to carcinoma with prominent squamous differentiation. NUT carcinoma can display neuroendocrine features. Although it is typically distributed along the midline axis, it may manifest in nonmidline locations. The majority of patients develop rapidly disseminated disease. We illustrate 2 cases of NUT carcinoma, one located in the lung, which closely resembled a neuroendocrine carcinoma, and the other one with assumed lung origin demonstrating metastatic dissemination with diffuse bone involvement, which was clinically first suspected to be a hematological malignancy. Due to its undifferentiated nature, NUT carcinoma may be confused with many entities. NUT immunohistochemistry is considered to be sufficient for the diagnosis. Fluorescence in-situ hybridization analysis and next-generation sequencing are currently used to confirm the diagnosis.

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