A case report of atypical malignant melanotic neuroectodermal tumor of infancy

Melanotic neuroectodermal tumor of infancy is a rare neoplasm that predominantly involves cranial bones and tends to occur during the first year of life. About 500 cases have been described in the literature to date; 6% of them have been reported to be malignant. Treatment for these malignant tumors was not documented and often turned out to be ineffective.Here we report a case of a child aged 2 years and 4 months who presented with a rapidly growing mass in the maxillary region spreading through the orbit into the anterior cranial fossa. The patient’s parents gave consent to the use of their child’s data, including photographs, for research purposes and in publications. He was treated at the Russian Children’s Clinical Hospital from July 2018 to November 2019. The child underwent chemoradiation and staged surgical removal of the tumor. Treatment with ICE and radiation therapy led to a significant reduction of the tumor volume and enabled us to perform cytoreductive surgery with the removal of the mass in the maxilla. Further treatment according to the CWS 2009 guidance for high-risk patients with NRSTS (NonRhabdomyosarcoma Soft Tissue Sarcoma) and radiation therapy resulted in further regression of intraorbital and intracranial components of the tumor and we performed a radical resection of the residual tumor conglomerate. Investigations during the course of treatment revealed no signs of metastatic involvement. The behavior of malignant melanotic neuroectodermal tumors of infancy is unpredictable, that is why in case of the massive involvement of the facial bones when surgery is associated with a high risk of functional impairment or cosmetic deformity, one should consider preoperative chemotherapy to reduce tumor size and intraoperative blood loss. Moreover, chemotherapy in combination with resection makes it possible to minimize the risk of local relapse or metastasis.

Preventing Breast Cancer-Related Lymphedema: Feasibility of Axillary Reverse Mapping Technique

Introduction. Our study aimed to determine the feasibility of axillary reverse mapping (ARM) technique, the identification rate of ARM nodes and their metastatic involvement, as well as to identify the factors that influence the identification and metastatic involvement. Material and methods. In total, 30 breast cancer patients scheduled for axillary lymph node dissection were enrolled in our study. The lymphatic nodes that drain the arm were identified by injecting 1 mL of blue dye in the ipsilateral upper arm; then, the ARM nodes were resected along with the other lymph nodes and sent for histological evaluation. Results. Identification of ARM node was successful in 18 patients (60%) and 22.22% of the identified ARM lymph nodes had metastatic involvement. Patients with identified ARM nodes had a significant lower BMI and a statistically significant relationship between axillary lymph node status and ARM node metastases was proven. Most of ARM lymph nodes (96.3%) were found above the intercostobrachial nerve, under the axillary vein and lateral to the thoracodorsal bundle. Conclusions. The ARM procedure is easy to reproduce but might not be appropriate for patients with a high BMI. The rate of metastatic involvement of ARM nodes is significant and no factor can predict it, showing that the preservation of these nodes cannot be considered.

Metastasis to spermatic cord from carcinoma prostate: A case series

Despite the high incidence of secondaries to lymph nodes, bones, and lungs in carcinoma (CA) prostate, metastatic involvement of scrotal organs is rare and usually associated with a poor prognosis. Here, we report a case series of three cases of CA prostate with metastatic involvement of scrotal organs. All three patients had metastatic involvement of the spermatic cord, with involvement of epididymis in the first patient and testes in the third patient, revealed incidentally on orchiectomy. Two patients were also found to have coexisting lymphatic filariasis. To date as per the best of our knowledge, only one such case of CA prostate with metastasis to scrotal organs and associated filariasis has been reported. This highlights the need for histopathological evaluation of all orchiectomy specimens. Chronic infection and inflammation leading to lymphatic obstruction due to filariasis probably led to the unusual retrograde spread of the tumor.

“The Rhythm of Cancer” – Unexpected Autopsy Finding in a Patient with Gastric Ulceration

Malignant tumors of the heart are rare. Even rarer, however, are metastases to the heart from cancers originating from the gastrointestinal tract. This case report involves a 63-year-old patient who presented into the clinic with a gastric ulcer and subsequent haemorrhage, and who died after sudden cardiac arrest. Autopsy revealed a metastatic involvement of the heart muscle from low-grade carcinoma of the stomach, as well as many other organ metastases.

Multifocal Urinary Tract Metastasis of Colorectal Carcinoma

<b><i>Introduction:</i></b> Secondary urinary tract tumors are uncommon findings and mainly evolve by direct invasion from adjacent organs. Actual metastatic involvement often develops in the urinary bladder, while the upper urinary tract is infrequently affected. In addition, the lungs, breast, and prostate gland are the usual primary sites. Colorectal carcinoma (CRC) may spread to the ureter directly or seeds via vascular or lymphatic channels. It may pose struggles in the differential diagnosis because CRC shares standard pathologic features with the primary adenocarcinoma of the urinary tract. <b><i>Case Presentation:</i></b> We describe the case of an 81-year-old man who was referred to our hospital with a distal ureteral tumor that was treated by a ureteronephrectomy. The histopathological and genetic analysis established the diagnosis of metastatic CRC along with 3 metastases in the renal pelvis. <b><i>Conclusion:</i></b> This rare case highlights the limitations of conventional histological processing, including immunohistochemistry, and it underlines the role of molecular investigations in certain circumstances.

Axillary staging should be routine in primary rhabdomyosarcoma of breast: A rare case report and review of literature

INTRODUCTION: Primary rhabdomyosarcoma (RMS) of breast is an uncommon entity and axillary lymph node (ALN) involvement is exceedingly rare. METHODS: Herein, we are reporting a case of RMS of breast with ALN metastasis in an adolescent girl. We searched Pubmed and Cochrane databases with keywords rhabdomyosarcoma and breast. All studies published in English language literature were included. Articles describing metastatic involvement of breast with RMS were excluded. RESULT: The initial search yielded a total of 8468 studies, out of which 03 were found to be duplicate. 8420 studies were excluded based on title and abstract as they did not fulfill inclusion criteria. Full text of the remaining 48 studies was screened. After full text screening, 26 case reports describing primary breast RMS were included. Overall 21% patients had axillary lymph node metastasis. CONCLUSION: Axillary staging should be considered in every patient undergoing surgery for breast RMS. However, it’s impact on recurrence and survival could not be determined based on current review.

Melanoma and Sarcoidosis in Patients Receiving or Not Antineoplastic Therapy

Sarcoidosis and sarcoid-like reactions have been associated with many solid tumors including malignant melanoma. There are reports of melanoma patients who develop sarcoidosis without having received any antineoplastic treatment, but there are also melanoma patients who have received immunotherapy or targeted therapy and, therefore, develop drug-associated sarcoidosis. Herein, we describe 2 cases of thoracic sarcoidosis which occurred in asymptomatic patients with known malignant melanoma. The first patient had metastatic disease, and she was under melanoma treatment with BRAF/MEK inhibitors at the time of sarcoidosis diagnosis. The second case involves a patient with early stage melanoma who had received no antineoplastic treatment. In both cases, the thoracic lesions were suspicious for metastatic involvement, and it was the biopsy which gave the diagnosis of granulomatous disease. Sarcoidosis induced by immune checkpoint or BRAF/MEK inhibitors seems to be more frequent in real-world studies than in large phase 3 melanoma trials. Sarcoidosis can mimic metastasis, predominately in mediastinum, representing a diagnostic pitfall. Therefore, biopsies must always be performed to exclude the metastatic spread before initiation of any antineoplastic treatment.

Colon Cancer With Metastatic Involvement of the Thyroid Incidentally Found at Excision of Parathyroid Adenoma

Metastatic disease from primary colon cancer in the thyroid is rare. The authors have submitted such a case. What makes this case particularly unusual is that it was in a man. 80% of such cases are in women. It has been speculated that there may be a humoral component. What is even more unique in this case is that it was found during the workup of a symptomatic parathyroid adenoma. The diagnosis was confirmed with immunochemistry using markers Cytokeratin 20 (CK20), Cytokeratin 7 (CK7), and Thyroid Transcription Factor 1 (TTF-1) .