Myoepithelioma breast: Clinically masquerading as breast carcinoma

Pure myoepithelioma of breast is an extremely rare tumor. Only a few cases have been reported in the literature so far. A 30-year old female presented with a large fungating mass arising from the areolar region of her right breast of six months duration. A clinical diagnosis of breast carcinoma was made and a mastectomy was performed. The specimen measured 23×22×9 cm with attached skin, and showed a large white ulcerated growth with areas of necrosis and hemorrhage. No normal breast tissue, nipple or areolar region was seen. Histopathological examination showed oval to spindle cells arranged in fascicles and bundles with whorling pattern in places showing mild pleomorphism with oval to spindle-shaped vesicular nuclei, prominent eosinophilic nucleoli, eosinophilic cytoplasm and clear cell changes in places, along with perivascular hyalinization and collagenization. Differential diagnosis of pleomorphic hyalinizing angiectatic tumor, solitary fibrous tumor, perivascular epithelioid cell tumor, mammary type myofibroblastic tumor and myoepithelioma were all considered. Immunohistochemistry for vimentin, smooth muscle actin, calponin, caldesmon, p63, epithelial membrane antigen, S-100, CD-31, CD-34, muscle specific antigen, myogenin, desmin, and pancytokeratin was carried out. On the basis of positive staining for vimentin, actin, p63 (nuclear), calponin and caldesmon (focal), a final diagnosis of myoepithelioma was considered; however, cytokeratin negativity was an unusual finding. This case was considered worthy of documentation because of its rarity, and because it highlights the importance of proper clinical examination and radiological examination to prevent misdiagnosis.

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Primary Leiomyosarcoma of the Penis: A Review and Update of the Literature

Edelweiss: Cancer Open Access ◽

10.33805/2689-6737.110 ◽

2019 ◽

pp. 43-51

Author(s):

Anthony Kodzo-Grey Venyo

Keyword(s):

Tumor Cells ◽

Tunica Albuginea ◽

Smooth Muscle Actin ◽

Giant Cells ◽

Resection Margins ◽

Positive Staining ◽

Alpha Smooth Muscle Actin ◽

Complete Excision ◽

Eosinophilic Cytoplasm ◽

Abundant Eosinophilic Cytoplasm

Less than 50 cases of Primary Leiomyosarcomas of the Penis (PLOP) have been reported despite this PLOPs are the second most common sarcomas of the penis. The usual site for the development of PLOP is the shaft or base of the penis but the malignancy can affect any site of the penis. PLOPs are likely to be superficially located above the tunica albuginea in comparison with deep seated PLOPs. Superficial PLOPs may be asymptomatic or they may present as lumps, ulcers or nodules on the penis. Deep PLOPs may manifest with dysuria and difficulty with micturition when they compress the urethra. Diagnosis of PLOP is based upon the pathology examination features of specimens of the penile lesion that show interlacing fascicles of spindled-cells that have abundant eosinophilic cytoplasm, focal juxta-nuclear vacuoles and blunt ended nuclei and moderate to severe nuclear atypia, rarely atypical multi-nucleated giant cells and focal necrosis tend to be seen. There may be evidence of many mitoses. Immunohistochemistry studies of PLOP tend to show tumor cells that exhibit positive staining for desmin, muscle specific-actin, and alpha smooth muscle actin. Most often superficial PLOPs tend to be treated by wide complete excision of the tumor with tumor free and clear surgical resection margins. Deep seated PLOPs have also been treated by complete excision in various forms depending upon the site and size of the tumor and some of these have included Wide excision, partial penectomy and total penectomy alone and sometimes with adjuvant chemotherapy/radiotherapy. Some cases of deep PLOPs tend to be associated with the development of recurrences and metastases as well as death of the patient and hence deep PLOPs are aggressive tumors. Some people are of the opinion that chemotherapy and radiotherapy are not effective for the adjuvant treatment of PLOP. For this reason it would appear that there is need for the development of new chemotherapy medicaments that would effectively destroy PLOP tumor cells. There is need to undertake a global multi-center treatment trial of immunotherapy, chemotherapy and radiotherapy in order to streamline the treatment of PLOPs especially deep PLOPs.

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Sphenoid Sinus Metastasis as the Presenting Manifestation of a Prostatic Adenocarcinoma: Case Report and Overview of the Literature

Case Reports in Oncological Medicine ◽

10.1155/2012/819809 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

I. Puche-Sanz ◽

F. Vázquez-Alonso ◽

J. F. Flores-Martín ◽

H. Almonte-Fernández ◽

J. M. Cózar-Olmo

Keyword(s):

Sphenoid Sinus ◽

Histopathological Examination ◽

Specific Antigen ◽

Transrectal Ultrasound ◽

Axial Skeleton ◽

Subsequent Treatment ◽

Prostatic Adenocarcinoma ◽

Positive Staining ◽

Magnetic Resonance Imaging Mri ◽

The Right

Although a metastatic presentation of an occult prostatic adenocarcinoma is not uncommon, the majority of these patients present with bone metastasis affecting the axial skeleton. Cranial metastases to the paranasal sinuses are extremely rare. A 56-year-old man presented with loss of vision and numbness of the right side of the face. Computed tomography (CT) scan and cranial magnetic resonance imaging (MRI) revealed a mass invading the sphenoid sinus. The patient underwent surgery to remove the lesion, and the histopathological examination suggested metastasis of an adenocarcinoma, with positive staining to prostatic specific antigen (PSA). However, serum PSA was 4 ng/mL, and the patient did not report any lower urinary tract symptoms or bone pain. Transrectal ultrasound-guided biopsy revealed prostatic adenocarcinomas with a Gleason score of 8 [4 + 4]. The subsequent treatment consisted of radiotherapy and androgen deprivation, followed by first- and second-line chemotherapy (docetaxel and cabazitaxel) when the disease progressed. The patient achieved a good response with the last cycle of cabazitaxel and after a 5-year followup is currently alive. Cranial metastases of prostate adenocarcinoma are rare, and there is currently no standard treatment for these patients. Whenever possible, surgery combined with radiotherapy and hormonotherapy is the recommended option.

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Cellular Testicular Fibroma of Gonadal Stroma with Extensive Myoid Differentiation: A Mimicker of Testicular Leiomyoma

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46672.14735 ◽

2021 ◽

Author(s):

Anuradha CK Rao ◽

Sanila Rahim ◽

Nazran Akbar Hussain

Keyword(s):

Spindle Cell ◽

Histopathological Examination ◽

Smooth Muscle Actin ◽

Lower Abdominal Pain ◽

Testicular Tissue ◽

Serum Markers ◽

Mitotic Figure ◽

Adult Males ◽

Left Testis ◽

Eosinophilic Cytoplasm

Fibroma of the testis is a rare benign Sex Cord Stromal Tumour (SCST) of probable gonadal stromal origin, occurring in adult males. Characterised by slow and insidious growth, it is devoid of hormonal association and serum markers. Clinically, it can mimic seminoma and requires histopathological examination for identification. Microscopic characteristics include hypercellular spindle cell areas and hypocellular hyaline plaques. Authors report a case of a 41-year-old male presenting with complaints of lower abdominal pain and dysuria. Ultrasonography (USG) showed enlarged left testis with heterogenous echotexture. With a clinical diagnosis of testicular tumour, orchidectomy was performed. Histology showed a well circumscribed, encapsulated cellular neoplasm comprising of spindle and fusiform cells in fascicles, nodules and bundles. The cells showed fusiform vesicular nuclei and eosinophilic cytoplasm, focal epithelioid cells with grooved nuclei and occasional mitotic figure. Stromal collagen fibres and hyalinisation were noted. Testicular tissue was seen compressed peripherally. The tumour cells demonstrated positive reactivity for Smooth Muscle Actin (SMA), h-Caldesmon and inhibin, negative for S-100 and CD34 (Cluster of Differentiation) on Immunohistochemistry (IHC). Literature review helped in arriving at a diagnosis of cellular Testicular Fibroma (TF) with myoid differentiation. Testicular spindle cell lesions are rare, and comprise of different entities, one of which is TF. Histology and IHC are useful aids in diagnosis. Awareness of the differential diagnosis and the IHC markers can help in arriving at a conclusive diagnosis.

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A Therapeutic and Diagnostic Dilemma: Granular Cell Tumor of the Breast

Case Reports in Medicine ◽

10.1155/2011/972168 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 9

Author(s):

Ahmet Pergel ◽

Ahmet Fikret Yucel ◽

A. Serdar Karaca ◽

Ibrahim Aydin ◽

Dursun Ali Sahin ◽

...

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Granular Cell Tumor ◽

Histopathological Examination ◽

Granular Cell ◽

Excisional Biopsy ◽

Final Diagnosis ◽

Cell Tumor ◽

Immunohistochemical Examination ◽

Diagnostic Dilemma

Six to eight percent of granular cell tumors are seen in the breast. Although mostly benign, they rarely have malignant features clinically and radiologically reminding of breast cancer. This may lead to a potential misdiagnosis of breast carcinoma and overtreatment of patients. The final diagnosis is made by immunohistochemical examination. We performed excisional biopsy on a patient who was diagnosed to have a breast mass. The histopathological examination of the mass revealed granular cell tumor.

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Uncommon Giant Corneal Keloid: A Case Report and Literature Review

10.21203/rs.3.rs-78812/v1 ◽

2020 ◽

Author(s):

Shang Li ◽

Lei Jiang ◽

Xiaolin Xu ◽

Ke Yang ◽

Ying Jie

Keyword(s):

Smooth Muscle Actin ◽

Visual Outcome ◽

Vascular Wall ◽

Final Diagnosis ◽

Large Mass ◽

Pathological Examination ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Positive Staining ◽

Anterior Lamellar Keratoplasty

Abstract Background: Corneal keloid is a rare kind of clinical disease. Surgery is the only treatment in the end, but the literature reports vary. This is a case study of the diagnostic and treatment course for a patient with giant corneal keloid.Case presentation: A 36-year-old young man was admitted to the hospital because of a large mass on the surface of the left cornea. A slit lamp examination revealed that the lesion covered the entire cornea and protruded from the surface of the eyeball, so that the left eyelid could not be closed normally. B-scan of the eye showed that the internal structure of the left eye was normal. The mass was surgically removed and send for pathological examination, and then the ocular surface reconstruction was taken by deep anterior lamellar keratoplasty. Histopathologic study showed irregular epithelium, the absence of Bowman’s layer and hyperplastic collagen fibers, which are consistent with the diagnosis of corneal keloid. Immunohistochemical revealed positive staining for vimentin in lesion subject and smooth muscle actin (SMA) in vascular wall. The corneal graft remained clear 4 months after surgery and the patient was satisfied with the visual outcome. A final diagnosis of giant corneal keloid was reached.Conclusion: Corneal keloid should be suspected in cases of enlarging white glistening corneal nodule after trauma. Deep anterior lamellar keratoplasty is one of the effective surgical option for corneal keloids.

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An ectopic adrenocortical oncocytic adenoma in the liver highly mimicking hepatocellular carcinoma: case report and literature review

Diagnostic Pathology ◽

10.1186/s13000-021-01097-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jingci Chen ◽

Xueshuai Wan ◽

Yao Lu ◽

Wenze Wang ◽

Dachun Zhao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Tumor Cells ◽

Correct Diagnosis ◽

Specific Antigen ◽

Final Diagnosis ◽

Arterial Phase ◽

Adrenocortical Adenoma ◽

Ki 67 ◽

Eosinophilic Cytoplasm ◽

Oncocytic Adenoma

Abstract Background Ectopic adrenocortical tissue is a lesion usually found incidentally during autopsy or inguinal surgery. Here, we demonstrate an extremely unusual case of intrahepatic adrenocortical adenoma which highly mimicks hepatocellular carcinoma (HCC) and brings challenges for clinicians and pathologists. The diagnostic pitfalls have been discussed in detail to provide clues for guiding differential diagnosis and future treatment. Case presentation A 44-year-old man was admitted into our hospital for evaluation of a hepatic mass identified during routine examination. Enhanced CT revealed its margin displayed apparent enhancement in arterial phase, but hypointensity in portal and delayed phase. HCC was suspected and partial hepatectomy was performed. Microscopically, cells were arranged in solid sheets. Most of the tumor cells were large, polygonal, had prominent nucleoli and were rich in eosinophilic cytoplasm. Pleomorphic nucleus was frequently found. Focally, smaller cells were found with small nuclei and granular cytoplasm. Immunohistochemically, tumor cells were negative for Arg-1, glypican-3 (GPC3), hepatocyte specific antigen (HSA), and positive for synaptophysin (Syn), α-inhibin, and Melan A. The Ki-67 index was 1 %. The final diagnosis was ectopic adrenocortical oncocytic adenoma and the patient was uneventful after the surgery. Conclusion Intrahepatic adrenocortical adenoma in the liver can hardly be diagnosed through radiology and little experience in pathology has been reported. In the present case, massive oncocytic changes and huge pleomorphism add greatly to the difficulties of making correct diagnosis. This lesion should be carefully kept in mind and a combination of markers is suggested for differentiating from HCC.

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F.N.A.C. AS DIAGNOSTIC TOOL OF PAROTID TUMORS AND ASSOCIATED PITFALLS IN CORRELATION WITH HISTOPATHOLOGY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.1153 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Bhawana Pant ◽

Sanjay Gaur ◽

Prabhat Pant

Keyword(s):

Preoperative Diagnosis ◽

Histopathological Examination ◽

Clinical Information ◽

Final Diagnosis ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Cytological Diagnosis ◽

Tertiary Referral Centre ◽

Clear Cut ◽

Parotid Tumors

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated Contrast enhanced computerized tomography(CECT) and Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of parotid surgeries were done. . Final diagnosis was made on histopathological examination. Result :The most common tumour came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten cases there was no clear cut association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.

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Immunohistochemical detection of procalcitonin in fibrolamellar hepatocellular carcinoma

Clinical Journal of Gastroenterology ◽

10.1007/s12328-021-01354-1 ◽

2021 ◽

Author(s):

Kotaro Matsumoto ◽

Kentaro Kikuchi ◽

Ayako Hara ◽

Hiromichi Tsunashima ◽

Koichi Tsuneyama ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Histopathological Examination ◽

Epigastric Pain ◽

Positive Staining ◽

C Reactive Protein ◽

Fibrolamellar Hepatocellular Carcinoma ◽

Tumor Biopsy ◽

Reactive Protein ◽

Right Lobe ◽

The Right

AbstractA 25-year-old woman with fever and epigastric pain was referred to our hospital. Blood examination showed significant liver dysfunction, markedly high C-reactive protein (CRP 19.1 mg/dL) and procalcitonin (48.3 ng/mL) levels. Dynamic computed tomography showed a tumor approximately 120 mm in size in the right lobe of the liver, but with no abscess formation. The patient was hospitalized and started on antibiotics; her CRP level improved, but the procalcitonin level did not decrease. Histopathological examination of the liver tumor biopsy revealed fibrolamellar hepatocellular carcinoma (FLC). Positive staining of the FLC with an anti-procalcitonin antibody suggested the production of procalcitonin.

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