scholarly journals An Unusual Presentation of Leiomyosarcoma Posing a Diagnostic Dilemma: A Case Report

2020 ◽  
Author(s):  
Smita Singh ◽  
Kusha Sharma ◽  
Vipan Kumar ◽  
Partap Yadav
Keyword(s):  
Smooth Muscle ◽  
Head And Neck ◽  
Histopathological Examination ◽  
Smooth Muscle Actin ◽  
Correct Diagnosis ◽  
Neck Region ◽  
Temporal Region ◽  
Diagnostic Dilemma ◽  
First Case ◽  
Painless Mass

Leiomyosarcoma (LMS) is a malignant tumour of smooth muscle origin commonly seen in genital and gastrointestinal location. However, its presence in the head and neck region in a young child is extremely rare. Authors present a unique case of LMS in a one year and five-month-old child who presented with a painless mass in the right temporal region of the head. Histopathological examination revealed a highly cellular tumour arranged in intersecting fascicles of spindle cells with brisk mitotic activity and interspersed areas of necrosis. On Immunohistochemistry (IHC), the tumour cells were positive for Smooth Muscle Actin (SMA), Desmin and Vimentin and negative for S100 and Myogenin. A diagnosis of LMS was thus, made. Head and neck sarcoma is a broad entity encompassing plethora of differentials with closely overlapping morphological features which renders them diagnostically challenging, this can be resolved by employing various immunohistochemical stains readily available in all laboratories. This case highlights the combined role played by histopathology and immunohistochemistry in arriving at the correct diagnosis. To the best of our knowledge, this is the first case of LMS reported in the temporal region of head and is distinct with respect to its rare incidence, location and age at presentation. LMS at this site may masquerade as deceptively benign painless mass and may not be suspected initially, however one should bear in mind that these are moderate-to-high grade tumours and any delay in management may portend poor prognosis. Timely and aggressive surgical management is thus, the mainstay of treatment and critical to patient survival.

scholarly journals Glomus cell tumour on the head of a cat

2018 ◽  
Vol 4 (2) ◽  
pp. 205511691880103
Author(s):  
Alessandro Conte ◽  
Emma Scurrell ◽  
Stephen J Baines
Keyword(s):  
Smooth Muscle ◽  
Histopathological Examination ◽  
Smooth Muscle Actin ◽  
Correct Diagnosis ◽  
Cell Lineage ◽  
Cell Tumour ◽  
Temporal Region ◽  
Muscle Actin ◽  
Glomus Cell ◽  
Veterinary Surgeon

Case summary A solitary, sessile, non-ulcerated, freely mobile cutaneous mass approximately 1 cm in diameter on the left temporal region of a 7-year-old neutered female cat was examined. A fine-needle aspirate and wedge biopsy were performed by the referring veterinary surgeon and indicated a neoplasm of uncertain cell lineage. On histopathological examination, the deep dermis contained a discrete, non-encapsulated and vascular neoplasm with morphological and immunophenotypical features typical of a glomus cell tumour. Neoplastic cells were immunopositive for vimentin, muscle actin and smooth muscle actin, and immunonegative for cytokeratin, S100, desmin and von Willebrand factor (factor VIII-related antigen). Relevance and novel information Glomus cell tumours arise from modified smooth muscle cells and are rare in animals, particularly cats. Specific immunohistochemistry is of fundamental importance in the correct diagnosis of these tumours and should be considered for masses when cytology and histology results are inconclusive or uncertain.

scholarly journals Intra-abdominal Solitary Myofibroma in a Child: A Rare Case Report

2021 ◽  
Author(s):  
Smita Singh ◽  
Jyoti Garg ◽  
Kusha Sharma ◽  
Kiran Agarwal
Keyword(s):  
Histopathological Examination ◽  
Smooth Muscle Actin ◽  
Iliac Fossa ◽  
Correct Diagnosis ◽  
Neck Region ◽  
Abdominal Distension ◽  
Malignant Tumours ◽  
Rare Presentation ◽  
Anaplastic Lymphoma ◽  
Abdominal Masses

Intra-abdominal masses in children are usually malignant. Benign tumours at this location are not seen frequently. It is even rarer to find solitary myofibromas intra-abdominally as these tumours are known to have predilection for the head and neck region. We present an unusual case of solitary myofibroma with abdominal localisation in a six-year-old male child who presented with abdominal distension since six months. Computed Tomography (CT) abdomen revealed a complex solid-cystic mass extending from umbilicus to right iliac fossa and measuring 9×6×4 cm. Histopathological examination revealed a tumour displaying biphasic nodular pattern with the presence of lighter staining fascicles of mature myoid cells along with darker staining and more cellular areas of smaller primitive cells. On Immunohistochemistry (IHC), tumour cells were positive for vimentin and Smooth Muscle Actin (SMA) with variable reactivity for desmin while these were negative for CD34 and Anaplastic Lymphoma Kinase 1 (ALK). Based on the histopathological and immunohistochemical findings, final diagnosis of myofibroma was made. Recognition of these lesions is extremely challenging owing to their rare presentation intra-abdominally and also because of their close morphological overlap with other spindle cell tumours commonly found at this site. This case highlights the combined role played by histopathology and IHC in making a clear distinction between different entities. It is imperative for both clinicians and histopathologists to establish the correct diagnosis as excision of the solitary myofibroma is curative in most cases and offers better clinical course than the more commonly found malignant tumours at this site.

scholarly journals Epidermoid cyst of earlobe: a common cyst at an uncommon site

2019 ◽  
Vol 5 (5) ◽  
pp. 1400
Author(s):  
Jayendiran S. ◽  
Jinu Vadakkanethu Iype ◽  
Srinivasa V.
Keyword(s):  
Head And Neck ◽  
Malignant Transformation ◽  
Clinical Diagnosis ◽  
Epidermoid Cyst ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Neck Region ◽  
Head And Neck Region ◽  
Important Concern ◽  
Nylon 4

<p class="abstract">Epidermoid cysts are frequently encountered cutaneous cysts. They are mostly tiny and benign swellings. But rarely they can grow huge in size and malignant transformation can also occur occasionally. Cosmetic disfigurement is also another important concern especially in head and neck region. We report a case of earlobe epidermoid cyst, a location where very few cases have been described in the literature. The cyst was completely excised and the wound was closed with nylon 4/0. Histopathological examination confirmed the diagnosis of an epidermoid cyst. The patient did not have any signs of recurrence even after six months postoperatively. Due to the possibility of malignant transformation and to ensure correct diagnosis, we consider that histopathological examination is necessary for all cysts although the clinical diagnosis could be enough.</p>

Leiomyosarcoma of the auricle: case report and literature review

1998 ◽  
Vol 112 (2) ◽  
pp. 166-168 ◽  
Author(s):  
R. Murat Karasen ◽  
Yavuz Sutbeyaz ◽  
Cemal Gundogdu ◽  
Bulent Aktan
Keyword(s):  
Smooth Muscle ◽  
Case Report ◽  
Literature Review ◽  
Head And Neck ◽  
External Auditory Canal ◽  
Neck Region ◽  
Malignant Tumour ◽  
Head And Neck Region ◽  
Muscle Origin

AbstractLeiomyosarcoma is a malignant tumour of smooth muscle origin. These tumours are rarely encountered in the head and neck region. A case of leiomyosarcoma of the auricle is presented. There are two cases of external auditory canal leiomyosarcoma in the literature. To our knowledge the present case is the first example of leiomyosarcoma of the auricle.

Periosteal Chondrosarcoma of the Maxilla

1995 ◽  
Vol 9 (1) ◽  
pp. 37-42
Author(s):  
Marc M. Kerner ◽  
Marilene B. Wang ◽  
Frank DiGregorio ◽  
Marilyn Zimmerman
Keyword(s):  
Head And Neck ◽  
Treatment Options ◽  
Neck Region ◽  
Long Bones ◽  
Diagnostic Dilemma ◽  
Head And Neck Region ◽  
Unusual Lesion

Primary chondrosarcomas of the head and neck region are exceedingly rare neoplasms. These lesions have clinical and histologic characteristics that make them difficult to discern from benign chondromas. Additionally, they may arise from the periosteum, making it even more difficult to distinguish them from osteosarcomas. We present a patient with a periosteal chondrosarcoma of the maxilla. Characteristic radiologic and histologic findings associated with this lesion are described. This is the first reported case of such a lesion in the maxilla, as previous reports of periosteal chondrosarcomas have involved long bones. The diagnostic dilemma posed by this extremely unusual lesion is discussed, as well as treatment options.

scholarly journals The role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region

2019 ◽  
Vol 10 (1) ◽  
pp. 48-53
Author(s):  
Mohammad Sowkat Hossain ◽  
S M Mahbubul Alam ◽  
Sk Md Jaynul Islam ◽  
Wasim Selimul Haque ◽  
Shamoli Yasmin
Keyword(s):  
Head And Neck ◽  
Soft Tissues ◽  
Histopathological Examination ◽  
Malignant Neoplasm ◽  
Cervical Lymphadenopathy ◽  
Neck Region ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Head And Neck Region

Background: Undifferentiated tumours in the head and neck region are not uncommon. They can arise from different sites like in mucosa as well as in salivary glands, soft tissues or lymph nodes. Histopathological examination plays a central role in the diagnosis but difficulties arise with some tumours which are poorlydifferentiated due to their high inter- and intra-observer variability. In those cases, immunohistochemistry has greatly assisted to diagnose the tumours that cannot be accurately identified using routine histopathological procedures. The correct histopathological diagnosis is essential especially in case of malignant tumourwhere subsequent specific therapy is required. The aim of this study was to determine the role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region. Methods: This cross-sectional study was conducted during July 2014 to June 2015. A total of 35 Bangladeshi patient’s specimens of head and neck swelling were collected from two renowned laboratories in Dhaka city.These cases were diagnosed as undifferentiated tumour in histopathological examination.Standard protocol was followed for immunohistochemistry.Then primary immunohistochemical panel which included the markers for Epithelial CK (AE1/AE3),mesenchymal marker (Vimentin) and lymphoid marker (LCA) were used.The cases which were not resolved by primary immunohistochemistry panel, the second panel was applied for further sub classification (Desmin, Chromogranin, CK20, CEA, CD20, CD30, HMB45, NSE). Based on interpretation of immunohistochemical findings final diagnoses were made.Data analysis was performed using the Statistical Package for the Social Sciences for Windows version 22.0 (SPSS, Chicago, Illinois, USA). Results: A total of 35 undifferentiated tumorsof head-neck region were studied.The mean age was 46.3±17.6 years and male to female ratio was 4.8:1. The majority 13 (37.1%) patient had cervical lymphadenopathy, 11 (31.4%) had neck mass and 4(11.4%) had in nasal/sinonasal mass.Regarding histopathologicalcell types, round cell was 21 (60.0%), spindle cell 6 (17.1%), pleomorphic cells 6(17.1%) and epithelioid cells 2(5.7%). In initial histopathological examination, majority 25(71.4%) were undifferentiated malignant neoplasm, 8(22.8%) were metastatic undifferentiated carcinoma, 1(2.9%) was pleomorphic sarcoma and the remaining 1(2.9%) had malignant adnexal tumour. By application of immunohistochemistry, most (33, 94.3%) of the cases were resolved and the two cases remained unresolved. Among the resolved cases majority (15, 45.5%) were lymphoma, 4(12.1%) were metastatic carcinoma, 3(9.1%) were Ewing’s sarcoma and malignant melanoma were found in 3(9.1%) cases. Conclusion: This study supports that the immunohistochemical technique has a fundamental role in the investigation of undifferentiated tumour origin, to determine the correct guidance for treatment and improving the prognosis for head and neck tumour patients. Birdem Med J 2020; 10(1): 48-53

scholarly journals Lipoleiomyosarcoma an extremely unusual sarcoma of uterus: A case report

1970 ◽  
Vol 2 (1) ◽  
pp. 67-70 ◽  
Author(s):  
Abhimanyu Jha ◽  
Gita Sayami ◽  
Deepti Adhikari
Keyword(s):  
Smooth Muscle ◽  
Abdominal Pain ◽  
Case Report ◽  
Postmenopausal Woman ◽  
Unusual Case ◽  
Histopathological Examination ◽  
Abdominal Mass ◽  
Lower Abdominal Pain ◽  
First Case ◽  
Well Differentiated

Uterine lipoleiomyosarcoma is a heterologous sarcoma composed of variable proportions of malignant lipoblasts histologically corresponding to well differentiated liposarcoma and malignant smooth muscle cells corresponding to leiomyosarcoma. Finding of benign lipomatous component in a typical leiomyoma (lipoleiomyoma) is not an uncommon, however, lipoleiomyosarcoma is an extremely rare malignant tumor and only very few cases have been reported so far. We report a case of lipoleiomyosarcoma of uterine corpus in a postmenopausal woman presenting with lower abdominal pain and abdominal mass. Diagnosis of lipoleiomyosarcoma was confirmed by histopathological examination of hysterectomy specimen. This is the first case of lipoleiomyosarcoma of uterus reported from Nepal. Keywords: Lipoleiomyosarcoma, uterus, histopathology, unusual case.   doi:10.3126/njog.v2i1.1482    N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 67 - 70 May -June 2007

scholarly journals Tuberculosis in the head and neck: experience in India

2007 ◽  
Vol 121 (10) ◽  
pp. 979-985 ◽  
Author(s):  
Kishore C Prasad ◽  
S Sreedharan ◽  
Y Chakravarthy ◽  
Sampath C Prasad
Keyword(s):  
Head And Neck ◽  
Histopathological Examination ◽  
Neck Region ◽  
Needle Aspiration ◽  
Head And Neck Region ◽  
Mandibular Joint ◽  
Immunodeficiency Virus ◽  
Needle Aspiration Cytology ◽  
Anti Tubercular Therapy ◽  
Tubercular Lymphadenitis

Objective: With improvement in economic and social conditions and the use of effective anti-tubercular therapy, the developed nations, and most developing nations, have enjoyed a decline in tuberculosis for several decades. It is now seen that extra-pulmonary presentations form a major proportion of new cases, especially since the advent of the acquired immunodeficiency syndrome epidemic. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region and its varied manifestations. We report the increased incidence of isolated head and neck tuberculosis, its various presentations and clinical manifestations over a 10-year period.Materials and methods: A 10-year (1995–2004), retrospective study was undertaken by the department of otolaryngology and head and neck surgery, Kasturba Medical College, and its allied hospitals, Mangalore, South India, involving a group of 165 patients with head and neck tuberculosis. Each patient underwent a detailed clinical examination and a battery of investigations. Most patients were treated with anti-tubercular therapy alone; others required surgical intervention followed by Anti-tubercular therapy (ATT). In addition, those with human immunodeficiency virus infection or malignancy were treated with anti-retroviral therapy and radiotherapy, respectively.Results: Of the 165 cases, 121 (73.3 per cent) had isolated tubercular lymphadenitis, 24 (14.5 per cent) had laryngeal tuberculosis, four (2.4 per cent) had tubercular otitis media, three (1.8 per cent) had tuberculosis of the cervical spine, three (1.8 per cent) had tuberculosis of the parotid, eight (5 per cent) had tuberculosis of the oral cavity, one had tuberculosis of the temporo-mandibular joint and one had tuberculosis of the nose. Fine needle aspiration cytology was highly effective in the diagnosis of tubercular lymphadenitis (92 per cent) but not so for other sites. The purified protein derivative (PPD) test was positive in only 20 per cent of cases. Pus for culture and sensitivity was positive only in caries of the spine and mandibular tuberculosis. Excision biopsy and histopathological examination were required to make a diagnosis in tuberculosis of the oral and nasal cavities, salivary glands, ear, temporo-mandibular joint, and mandible. There were 40 cases (24.2 per cent) with coexisting pulmonary tuberculosis and five cases (3 per cent) with coexisting malignancy. Of the 65 patients who were tested, 30 per cent were found to have coexisting human immunodeficiency virus infection.Conclusion: In addition to cervical lymphadenitis, tuberculosis in the head and neck region can produce isolated disease in the oral cavity, ear, salivary glands, temporo-mandibular joint, nose and larynx. Seventy-five per cent of our head and neck tuberculosis patients did not have pulmonary involvement. Fine needle aspiration cytology was highly effective in the diagnosis of nodal tuberculosis, but histopathological examination was required to make the diagnosis in other head and neck sites. The PPD test was not effective as a diagnostic tool. If the otolaryngologist maintains a high index of suspicion, an early diagnosis can be made with the help of simple investigations. Successful outcome depends upon appropriate chemotherapy and timely surgical intervention when necessary.

scholarly journals Rosai-Dorfman Disease Originating from Nasal Septal Mucosa

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Abdulvahap Akyigit ◽  
Hadice Akyol ◽  
Oner Sakallioglu ◽  
Cahit Polat ◽  
Erol Keles ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Head And Neck ◽  
Nasal Obstruction ◽  
Histopathological Examination ◽  
Neck Region ◽  
Unknown Etiology ◽  
Extranodal Involvement ◽  
Head And Neck Region ◽  
Histiocytic Cell ◽  
Rosai Dorfman Disease

Rosai-Dorfman disease is a rarely seen disease with unknown etiology. Extranodal involvement is most commonly seen in the head and neck region. Histopathologically, it is characterized by histiocytic cell proliferation. This paper presents a case of a 15-year-old male patient who presented with nasal obstruction and was surgically treated for a mass filling in the left nasal meatus that was diagnosed to be Rosai-Dorfman disease by histopathological examination.

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