Diagnostic Dilemma in a Thyroid Incidentaloma: Second Primary versus Metastatic Nodule?

Sarcomatoid change in buccal carcinoma is a rare and aggressive variant of Squamous Cell Carcinoma (SCC) and most often a diagnostic dilemma. There are some reports of second primary sarcomatous tumours in the oral cavity and nasopharynx post irradiation. Synchronous and metachronous lesions in this category in the oral cavity and neck have also been reported. Spindle cell neoplasms comprise a diverse collection of benign and malignant tumours. These tumours are uncommon in the oral cavity, accounting for <1% of all tumours of oral region. It is an unusual aggressive variant that frequently recurs and metastasises. Herein, the author present a case report of a 45-year-old Indian male with a sarcomatoid lesion according to his previous reports in the oral cavity of five months duration at presentation. The patient presented late as he was not willing for surgery and hence a very extensive 9×5 cm lesion was observed. In addition, he had trismus, multiple, firm, fixed lymph nodes in the ipsilateral neck. The biopsy of the oral cavity tumour showed a histological appearance of spindle shaped cells with penetration of basement membrane suggestive of sarcomatoid carcinoma. He was treated with repeated ablative laser technique for the primary and metastatic nodes in the neck disease and chemotherapy. The patient resumed normal activities 14 days after the laser ablation.

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Further Ultrastructural Observations on Metastatic Nodules of Human Breast Cancer

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010010086x ◽

1968 ◽

Vol 26 ◽

pp. 224-225

Author(s):

John L. Swedo ◽

R. W. Talley ◽

John H. L. Watson

Keyword(s):

Breast Cancer ◽

Human Breast Cancer ◽

Estrogen Therapy ◽

Specimen Preparation ◽

Human Breast ◽

Autophagic Vacuoles ◽

Previous Communication ◽

Linear Profiles ◽

Metastatic Nodule

Since the report, which described the ultrastructure of a metastatic nodule of human breast cancer after estrogen therapy, additional ultrastructural observations, including some which are correlative with pertinent findings in the literature concerning mycoplasmas, have been recorded concerning the same subject. Specimen preparation was identical to that in.The mitochondria possessed few cristae, and were deteriorated and vacuolated. They often contained particulates and fibrous structures, sometimes arranged in spindle-shaped bundles, Fig. 1. Another apparent aberration was the occurrence, Fig. 2 (arrows) of linear profiles of what seems to be SER, which lie between layers of RER, and are often recognizably continuous with them.It was noted that the structure of the round bodies, interpreted as within autophagic vacuoles in the previous communication, and of vesicular bodies, described morphologically closely resembled those of some mycoplasmas. Specifically, they simulated or reflected the various stages of replication reported for mycoplasmas grown on solid nutrient. Based on this observation, they are referred to here as “mycoplasma-like” structures, in anticipation of confirmatory evidence from investigations now in progress.

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Abstract #330 Insulinoma or Prancreatic Adenocarcinoma – A Diagnostic Dilemma?

Endocrine Practice ◽

10.1016/s1530-891x(20)46674-1 ◽

2019 ◽

Vol 25 ◽

pp. 143-144

Author(s):

Muhammad Ansar ◽

Joseph Dillon

Keyword(s):

Diagnostic Dilemma

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VHL: a diagnostic dilemma

Nature India ◽

10.1038/nindia.2009.251 ◽

2009 ◽

Keyword(s):

Diagnostic Dilemma

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Hubungan ekspresi p53, Bcl-2, c-Myc dan MMP-9 dengan gambaran klinikopatologi karsinoma sel skuamosa kepala-leher

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v46i1.147 ◽

2016 ◽

Vol 46 (1) ◽

pp. 53

Author(s):

Azwar Azwar ◽

Sofia Mubarika ◽

Agus Surono

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Tumor Location ◽

Neck Squamous Cell Carcinoma ◽

Second Primary ◽

Cross Sectional ◽

P53 Expression ◽

Local Metastasis

Latar belakang: Karsinoma sel skuamosa kepala dan leher merupakan salah satu kanker terseringdi seluruh dunia. Pendekatan pengobatan agresif dan multidisiplin telah dilakukan, namun belum adapeningkatan yang signifikan dalam kelangsungan hidup 5 tahun, selama 20 tahun terakhir. Kegagalanpengobatan terjadi dalam bentuk kekambuhan lokoregional, metastasis jauh, dan/atau tumor primer kedua.Berbagai penanda molekular tumor telah diteliti untuk mengetahui potensinya dalam memprediksi hasilpenyakit atau respon terhadap terapi.Tujuan: Mengetahui hubungan ekspresi protein p53, Bcl-2, c-Myc,dan MMP-9 berdasarkan gambaran klinikopatologis karsinoma sel skuamosa kepala dan leher di RumahSakit dr. Zainoel Abidin.Metode: Studi menggunakan desain cross sectional. Sampel terdiri dari 60blok parafin karsinoma sel skuamosa kepala dan leher. Prosedur pewarnaan imunohistokimia dilakukandengan menggunakan antibodi monoklonal terhadap p53, Bcl-2, c-Myc, dan MMP-9. Ekspresi proteinp53, Bcl-2, c-Myc, dan MMP-9 dianalisis secara imunohistokimia pada karsinoma sel skuamosa kepaladan leher kemudian hasilnya dihubungkan dengan parameter klinikopatologis seperti usia, jenis kelamin,lokasi tumor, diferensiasi tumor, metastasis kelenjar getah bening dan stadium tumor, kemudian dianalisisstatistik dengan Chi square.Hasil: Hasil penelitian menunjukkan terdapat hubungan bermakna tingkatekspresi p53 dengan metastasis lokal (p=0,021) dan ada hubungan bermakna tingkat ekspresi MMP-9dengan lokasi tumor (p=0,026). Tidak terdapat hubungan ekspresi p53, Bcl-2, cMyc, dan MMP-9 terhadapusia, jenis kelamin, stadium tumor, diferensiasi histologi, tingkat T, N, dan metastasis jauh.Kesimpulan:Ada hubungan ekpresi p53 dengan metastasis kelenjar limfe regional dan ekspresi MMP-9 dengan lokasitumor pada karsinoma sel skuamosa kepala dan leher. Kata kunci: Karsinoma sel skuamosa kepala dan leher, p53, Bcl-2, c-Myc, MMP-9 ABSTRACTBackground: Head and neck squamous cell carcinoma (HNSCC) is one of the most commoncancers world wide. Although aggressive and multidisciplinary approach to the treatment has been done,there is no significant improvement in 5-year survival in the last 20 years. Treatment failure occurredin the form of locoregional recurrence, distant metastasis, and/or a second primary tumor. A variety oftumor molecular markers have been studied to determine their potential in predicting disease outcome orresponse to the therapy. Purpose: To investigate correlation p53, Bcl-2, c-Myc, and MMP-9 expressionto clinicopathologic parameter in head and neck squamous cell carcinoma patient in dr. Zainoel Abidinhospital. Methods: Cross sectional design study. The sample was consisted of 60 paraffin blocks ofhead and neck squamous cell carcinoma. Procedure of immunohistochemical staining used monoclonalantibodies against p53, Bcl-2, c-Myc, and MMP-9. Expression of p53 protein, Bcl-2, c-Myc, and MMP-9were analyzed by immunohistochemistry in head and neck squamous cell carcinoma. Then, the results were linked to clinicopathologic parameters such as age, sex, tumor location, tumor differentiation,lymph node metastasis and tumor stage, and statistically analyzed with Chi square. Results: The resultsshowed there were significant correlation between p53 expression level with local metastasis (p=0,021)and significant correlation of MMP-9 expression levels with tumor location (p=0,026). There were norelationship of p53, Bcl-2, cMyc and MMP-9 expressions based on age, sex, stage tumor, histologicdifferentiation, level of T, N, and distant metastases. Conclusion: There were relationships between p53expression with local metastasis and MMP-9 expression with tumor location in head and neck squamouscell carcinoma. Keywords: Head and neck squamous cell carcinoma, p53, Bcl-2, c-Myc, MMP-9

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