scholarly journals Carcinoma with Triphasic Differentiation Arising from Inverted Papilloma in Sinonasal Sinus: A Rare Case with Molecular Characterization

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1827
Author(s):  
So-Woon Kim ◽  
Kiyong Na
Keyword(s):  
Sarcomatoid Carcinoma ◽  
Excisional Biopsy ◽  
Inverted Papilloma ◽  
Molecular Characteristics ◽  
Rare Presentation ◽  
Oncogenic Mutations ◽  
Spindle Cell Proliferation ◽  
The Right ◽  
Maxillary Sinuses

Small cell neuroendocrine carcinoma (SNEC) is a rare subset of tumors in the sinonasal sinus. Combined tumors are exceedingly rare. Here, we describe a 65-year-old male with a mixed tumor of SNEC and sarcomatoid carcinoma arising in an inverted papilloma, containing squamous cell carcinoma in situ (SqCCis) in the sinonasal sinus. We evaluated the molecular characteristics of the two separate carcinoma components using next-generation sequencing. The patient presented with a nasal obstruction. Computed tomography showed a mass infiltrating the right ethmoid and maxillary sinuses. An excisional biopsy was performed. The tumor was found to have three morphologically distinct components. The first was SqCCis arising in an inverted papilloma, which was positive for cytokeratin and P40. The second consisted of nests of densely packed small round cells representing SNEC-positive neuroendocrine markers. The third was a solid sheet of anaplastic spindle cell proliferation, which was negative for the above markers. Oncogenic mutations such as FBXW7, TP53, and EGFR were detected in both SNEC and sarcomatoid carcinoma, and MYCL amplification was observed only in the SNEC component. This case highlights an extremely rare presentation of combined SNEC and sarcomatoid carcinoma arising from an inverted papilloma in the sinonasal sinus.

scholarly journals Unique case of inverted papilloma of septum with nasopharyngeal carcinoma: Is it a metachronous tumour?

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092203
Author(s):  
Susanne Flach ◽  
Aaron SJ Ferguson ◽  
Sharon White ◽  
Paul S White ◽  
Jaiganesh Manickavasagam
Keyword(s):  
Malignant Transformation ◽  
Inverted Papilloma ◽  
High Rate ◽  
Unique Case ◽  
Solitary Lesion ◽  
Poorly Differentiated Carcinoma ◽  
Nasopharyngeal Biopsy ◽  
Poorly Differentiated ◽  
The Right

Inverted papilloma is a rare and benign tumour. It affects the nasal cavity and paranasal sinuses, has a high rate of recurrence and is associated with malignant transformation. Only few cases of a poorly differentiated carcinoma arising from inverted papilloma have been reported, none of which in the nasopharynx. We report a case of a 37-year-old female, who presented originally in 2012 with inverted papilloma of the nasal septum which was surgically resected. Nasopharyngeal biopsy from 2014 was reported as carcinoma in situ and treated with local endoscopic resection. Three years later she presented with a solitary lesion of the right Eustachian tube opening, confirmed as invasive poorly differentiated carcinoma. Imaging revealed T4 N2b M0 malignancy with skull base and prevertebral space invasion, likely extension into right temporal lobe and malignant adenopathy. Although rare, malignant transformation of inverted papilloma in unusual places should be considered during workup and monitoring of patients.

scholarly journals B Cell Lymphoma, Unclassifiable, Transformed from Follicular Lymphoma: A Rare Presentation with Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-9
Author(s):  
Anila Kanna ◽  
Swati Agrawal ◽  
Kumar Jayant ◽  
Varun Kumar Pala ◽  
Mohammad Altujjar ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
B Cell ◽  
Cell Lymphoma ◽  
Tumor Regression ◽  
B Cell Lymphoma ◽  
Excisional Biopsy ◽  
Complete Response ◽  
Rare Presentation ◽  
Mediastinal Disease ◽  
The Right

B cell lymphoma, unclassifiable, with features of diffuse large B cell lymphoma and classical Hodgkin’s lymphoma (BCLu-DLBCL/CHL) is more commonly known as gray zone lymphoma. These cases more often present with mediastinal disease. In this report, we present a very rare case of BCLu-DLBCL/CHL without mediastinal involvement, transformed from follicular lymphoma (FL) to BCLu-DLBCL/CHL. This patient initially presented with a mass in the right neck; biopsy of the lymph node showed predominantly nodular, follicular pattern. Immunohistochemical (IHC) staining of tumor cells expressed positivity for mature B cell markers CD20, CD19, CD10, CD23, CD45, and CD38 but negative for CD5,11c. Hence, diagnosed with FL, he was given rituximab, cyclophosphamide, vincristine, and prednisone (RCVP) regimen, followed by maintenance rituximab. He showed good response. After 2 years, he presented again with a mass in the right side of the neck. Although the needle core biopsy of this mass was suggestive of B cell lymphoma, excisional biopsy showed morphological features of DLBCL as well as foci of histological pattern of CHL. IHC staining expressed positivity for CD20, CD79a, PAX5, and CD15 and CD30 consistent with DLBCL and CHL. He was diagnosed with BCLu-DLBCL/CHL. The patient received “ACVBP” (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) followed by radiation. BCLu-DLBCL/CHL is clinically an aggressive tumor with poorer outcomes, but our case showed complete response to ACVBP regimen with tumor regression.

Inflammatory Sarcomatoid Carcinoma: A Case Report and Discussion of a Malignant Tumor With Benign Appearance

2005 ◽  
Vol 129 (10) ◽  
pp. 1334-1337 ◽  
Author(s):  
Tatjana Antic ◽  
Umesh Kapur ◽  
Wickii T. Vigneswaran ◽  
Kiyoko Oshima
Keyword(s):  
Frozen Section ◽  
Left Lung ◽  
Sarcomatoid Carcinoma ◽  
High Clinical Suspicion ◽  
Spindle Cell Proliferation ◽  
Epithelial Phenotype ◽  
History Of ◽  
Mixed Inflammatory Infiltrate ◽  
Poorly Differentiated ◽  
The Right

Abstract Inflammatory sarcomatoid carcinoma is an aggressive tumor with an unusually benign appearance. We report the case of a 65-year-old man with a history of inoperable poorly differentiated carcinoma of the right lung, for which he had received chemoradiotherapy. A new solitary mass was discovered 4 years later in the left lung on surveillance computed tomography. The patient underwent thoracotomy with a wedge biopsy on which frozen section was performed. The nodule was vaguely granulomatous and associated with a mixed inflammatory infiltrate and a deceptively bland spindle cell proliferation. Results of immunoperoxidase studies, however, showed that the nodule contained neoplastic cells with an epithelial phenotype that were invading the pulmonary vessels. These are features of the rare inflammatory sarcomatoid carcinoma. In contrast to sarcomatoid carcinomas, this case highlights the deceptively benign appearance of inflammatory sarcomatoid carcinoma. This leads us to concur with the recommendation to exercise caution when attempting the diagnosis of apparently benign lesions on intraoperative frozen section in patients with high clinical suspicion of malignancy.

scholarly journals Intramuscular hemangioma in masseter muscle: a rare presentation

2020 ◽  
Vol 6 (4) ◽  
pp. 790
Author(s):  
E. Siva Kumar ◽  
C. A. Swapna ◽  
Lavanya Karanam
Keyword(s):  
Masseter Muscle ◽  
Histopathological Examination ◽  
Young Male ◽  
Neck Region ◽  
Excisional Biopsy ◽  
Rare Presentation ◽  
Parotid Region ◽  
Intramuscular Hemangioma ◽  
The Right ◽  
Work Up

<p class="abstract">Intramuscular hemangioma contribute to less than 1% of all hemangioma forming around 0.8%. It is commonly located in trunk and extremities. Only 10 to 20% can be found in the head and neck region arising from masseter and trapezius. We present a rare case of a young male with intramuscular hemangioma of masseter muscle. A 20 year old male patient presented to the OPD with complaints of swelling over right side of face over parotid region for the past 6 years. On clinical examination, there was a oblong swelling of about 3×2 cm around the right parotid region. In MRI neck the features were suggestive of intramuscular hemangioma in the right masseter muscle. The patient was planned for an excisional biopsy. Histopathological examination confirmed the diagnosis of intramuscular hemangioma. Although intramuscular hemangioma of masseter is a very rare possibility, still it should be kept in consideration in the list of differential diagnoses of the tumours around parotid region. As this diagnosis will make a difference in the work up plan and management of the patient.</p>

scholarly journals A Rare Presentation of Actinic Keratosis Affecting the Tarsal Conjunctiva and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Selina Khan ◽  
Melanie Chak
Keyword(s):  
Actinic Keratosis ◽  
Uv Light ◽  
Light Exposure ◽  
Excisional Biopsy ◽  
Eyelid Margin ◽  
Rare Presentation ◽  
Upper Eyelid ◽  
The Right ◽  
Learning Points

We report an unusual case of actinic keratosis (AK) of the tarsal conjunctiva in a 63-year-old man. Examination revealed a crusty, leukoplakic lesion prone to bleeding on the tarsal conjunctiva of the right upper eyelid. This was treated by surgical excisional biopsy. At 1-year follow-up, there was no evidence of recurrence and the surgical site was completely healed without conjunctival scarring. Current opinion cites excessive exposure to ultraviolet (UV) radiation, in particular UV-B in sunlight, as the causative agent in developing AK. In the case we present, the tarsal conjunctiva is an unusual place for actinic keratosis due to the lack of direct UV-light exposure. The key learning points are to evert the upper eyelid during examination especially if the lesion involves the eyelid margin and, secondly, to ensure risk factors are addressed during the history.

scholarly journals Concurrent Inverted Papilloma and Squamous Cell Carcinoma with Intradural Extension Presenting with Frontal Lobe Syndrome

2021 ◽  
Author(s):  
Abdul Jaleel ◽  
Pavithran V. M. ◽  
Shanavas Cholakkal ◽  
Vineeth Kadangot Kuthampulli
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Frontal Lobe ◽  
Squamous Cell ◽  
Benign Lesion ◽  
Lateral Wall ◽  
Inverted Papilloma ◽  
Intracranial Extension ◽  
Rare Presentation ◽  
Frontal Lobe Syndrome

Abstract Inverted papilloma is an uncommon tumor mostly arising from the lateral wall of the nasal cavity and displays a benign but locally aggressive behavior. Intracranial extension is an extremely rare presentation of inverted papilloma. Extension occurs either as a benign lesion or due to malignant transformation. We report a case of concurrent inverted papilloma and squamous cell carcinoma presenting with epistaxis and recent-onset altered behavior and memory impairment. After literature review of similar cases having inverted papilloma with intracranial extension, we could identify a total of 12 cases, most of which were recurrences of a primary inverted papilloma that were resected before extension into the cranial cavity. Most cases were of extradural extension, and intradural spread resulted in poor prognosis on follow-up. Concurrent inverted papilloma and squamous cell carcinoma extending into the anterior cranial fossa and frontal lobe is a very rare clinical entity and can present as frontal lobe syndrome.

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

scholarly journals Squamous Cell Carcinoma Arising at a Skin Graft Donor Site: Case Report and Review of the Literature

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110084
Author(s):  
Weston Thomas ◽  
Kevin Rezzadeh ◽  
Kristie Rossi ◽  
Ajul Shah
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Skin Graft ◽  
Donor Site ◽  
Skin Grafting ◽  
Excisional Biopsy ◽  
Graft Donor ◽  
The Right

Introduction: Skin graft reconstruction is a common method of providing wound coverage. Rarely, skin grafting can be associated with the development of squamous cell carcinoma (SCC) in the graft donor site. Case Report: The patient is a 72-year old male with a 15-year history of bilateral hip wounds. He underwent a multitude of treatments previously with failed reconstructive efforts. After presenting to us, he underwent multiple debridements and eventual skin grafting. Within 4 weeks of the final skin graft, a mass developed at the skin graft donor site at the right thigh. Excisional biopsy returned a well differentiated keratinizing SCC. Discussion/Conclusion: This case demonstrates the acute presentation of SCC in a patient following a skin graft without known risk factors. The purpose of this unique case report is to highlight a very rare occurrence of SCC at a skin graft donor site.

scholarly journals EXPRESS: Chronic thromboembolic pulmonary hypertension following pulmonary embolism with a right ventricular thrombus: A report of two cases

2021 ◽  
pp. 204589402110136
Author(s):  
Tailong Zhang ◽  
Weitao Liang ◽  
Longrong Bian ◽  
Zhong Wu
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Imaging Features ◽  
Pulmonary Endarterectomy ◽  
Right Heart ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Right ◽  
Cardiac Masses

Right heart thrombus (RHT) accompanied by chronic thromboembolic pulmonary hypertension (CTEPH) is a rare entity. RHT may develop in the peripheral veins or in situ within the right heart chambers. The diagnosis of RHT is challenging, since its symptoms are typically non-specific and its imaging features resemble those of cardiac masses. Here, we report two cases of RHT with CTEPH that presented as right ventricular masses initially. Both patients underwent simultaneous pulmonary endarterectomy (PEA) and resection of the ventricular thrombi. Thus, when mass-like features are confirmed by imaging, RHT should be suspected in patients with CTEPH, and simultaneous RHT resection is required along with PEA.

Basal Cell Carcinoma of Prostate With MSMB–NCOA4 Fusion and a Probable Basal Cell Carcinoma In Situ: Case Report

2021 ◽  
pp. 106689692110173
Author(s):  
Vilde Pedersen ◽  
Katrine S. Petersen ◽  
Klaus Brasso ◽  
Olga Østrup ◽  
Anand C. Loya
Keyword(s):  
Prostate Cancer ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Carcinoma In Situ ◽  
Pathological Examination ◽  
Molecular Characteristics ◽  
Histological Lesion ◽  
Basal Cell Carcinomas

Basal cell carcinomas of prostate (BCCP) are very rare. Most arise in the transition zone and thus are associated with lower urinary tract symptoms and rarely associated with elevated prostate-specific antigen (PSA). These features make diagnosis/early diagnosis difficult because of the routine protocols followed. Basal cell carcinomas have distinctive histopathological, immunohistochemical, and to some extent also different molecular characteristics. Basal cell carcinoma in situ (BCCIS) is a nonexistent histological lesion as per the current literature, but here is an attempt to describe it through this case. A 74-year-old man presented with hematuria and previous diagnosis of prostatic hyperplasia. Based on this history, he underwent a prostatectomy ad modum Freyer. Pathological examination surprisingly revealed a diffusely infiltrative tumor with nonacinar adenocarcinoma morphology and many glandular structures probably representing BCCIS. Tumor was diagnosed as BCCP. Patient presented with metastasis to the abdominal wall 8 months postprostatectomy. BCCP is an aggressive type of prostate cancer, which might be challenging to diagnose based on routine protocols. This results in delayed diagnosis and treatment and thus poor prognosis. Furthermore, patients with this subtype of prostate cancer need appropriately designed, and maybe a totally different follow-up regimen as PSA is of no use for BCCP patients. Finally, diagnosis of BCCIS, if agreed upon its existence needs to be studied in larger cohorts as a precursor lesion.

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