1/64. Esophageal mucoepidermoid carcinoma containing signet-ring cells: three case reports and a literature review.We report 3 cases of esophageal signet-ring cell carcinoma which were found in a set of 505 resected esophageal tumors. The incidence of esophageal signet-ring cell carcinoma was 0.6%. All of the signet-ring cell carcinomas were histologically mixed with squamous cell carcinoma (mucoepidermoid carcinoma). The signet-ring cells had intracellular mucin, which was positive for both periodic acid-Schiff (PAS) and alcian blue at pH 2.5. At the time of presentation, extensive extraesophageal tumor spread and local extension were found in all cases. All of the patients died within 2 years after the esophagectomy irrespective of whether they received chemotherapy or radiotherapy. Our results, and those previously reported, suggest that most esophageal carcinomas containing signet-ring cell carcinoma are aggressive neoplasms associated with a poor prognosis after esophagectomy.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/64. Sclerosing Mucoepidermoid carcinoma with eosinophilia of the thyroid glands: a case report with clinical manifestation of recurrent neck mass.Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectomy was performed under the impression of thyroid carcinoma. The resected thyroid gland showed a poorly circumscribed hard mass. Histologically, the tumor consisted of solid nests of large atypical cells with dense fibrous stroma. The tumor cells showed squamoid appearance with abundant eosinophilic cytoplasm. There were also rare mucin-containing cells within the nests. Within the hyalinized stroma, numerous eosinophils were found. The surrounding thyroid parenchyma displayed Hashimoto's thyroiditis. There was metastasis in a regional lymph node. Two years after initial surgery, she underwent a modified radical neck dissection due to recurrent neck mass. After the radiation therapy for eight weeks, laryngectomy and esophagectomy were performed due to a recurrent carcinoma in the esophageal wall. We report an additional case of SMECE, with metastasis to regional lymph nodes and esophagus. The tumor appears to be more aggressive than previously reported and a correct diagnosis can be rendered by just examining the metastatic lesions.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/64. Hybrid carcinomas of salivary glands. Report of 4 cases and review of the literature.OBJECTIVE: To report 4 cases of hybrid carcinoma and to review the literature on these rare neoplasms of the salivary gland. methods: hematoxylin-eosin-stained, formalin-fixed, paraffin-embedded tissue sections from 3 parotid tumors and 1 palate tumor were examined. RESULTS: The cases were classified as adenoid cystic and mucoepidermoid carcinoma, adenoid cystic and epithelial-myoepithelial carcinoma, epithelial-myoepithelial and salivary duct carcinoma, and adenoid cystic and salivary duct carcinoma. All patients were men, 28 to 71 years old; 3 patients presented with parotid mass, and 1 patient presented with palatal mass. One patient presented with facial nerve paralysis and pain. The soft palatal tumor was a slowly growing mass with maxillary sinus involvement at the time of the diagnosis. All patients were treated with surgery and radiotherapy. CONCLUSIONS: Correct identification of 2 or more neoplastic entities will help assess the aggressiveness and metastatic potential of the tumor and influence the clinical course and treatment.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
4/64. Cytology of primary pulmonary mucoepidermoid and adenoid cystic carcinoma. A report of four cases.BACKGROUND: Mucoepidermoid and adenoid cystic carcinomas are very rare primary pulmonary neoplasms that can be classified under the broader heading of salivary gland-like neoplasms (SGN). Both entities need to be considered in the cytologic differential diagnosis of lung tumors. We reviewed cytologic findings in primary pulmonary neoplasms diagnosed at our institution during the time period 1981 to the present along with outside consultation cases. CASES: Three cases of primary mucoepidermoid carcinoma and one case of primary adenoid cystic carcinoma of the lung were diagnosed based on cytology during the period examined. Patient ages were 16, 25, 47 and 78 years, respectively. The mucoepidermoid cytology specimens were composed of three cell types, mucinous, squamous and intermediate cells, at times associated with extracellular mucin. The adenoid cystic carcinoma consisted of small, uniform cells with dark nuclei, scant cytoplasm and associated, acellular balls of basement membrane material. CONCLUSION: The differential diagnosis for primary pulmonary neoplasms needs to include the rare SGN. Cytologic features of adenoid cystic carcinoma are diagnostic; those of mucoepidermoid carcinoma are at least suggestive.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
5/64. Parotid carcinoma as a second malignancy after treatment of childhood acute lymphoblastic leukemia.The occurrence of second malignant neoplasms (SMN) in children who survive their primary malignancy is a major cause for concern. Two children with diagnoses of intermediate-risk acute lymphoblastic leukemia (ALL) at 22 months and 2 years of age were treated with multiagent chemotherapy and prophylactic cranial irradiation. They experienced painless parotid swelling 6 and 7 years after successful treatment of the ALL. The patients underwent total parotidectomy, and a diagnosis of mucoepidermoid carcinoma was made. Both patients experienced transient facial nerve paresis. The incidence of SMN in children successfully treated for primary malignancies is 3% to 12%. Salivary gland tumors are being increasingly described in this setting. Long-term follow-up for survivors of childhood ALL is recommended with prompt assessment and resection of parotid swellings, particularly in children who have received cranial irradiation.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
6/64. Mucoepidermoid carcinoma arising in the glans penis.Mixed carcinoma (squamous and glandular) of the penis is a rare neoplasm with an unknown origin and a poorly defined prognosis. The mucoepidermoid carcinoma described herein has not been previously reported to our knowledge. The present carcinoma arose from and extensively ulcerated the squamous epithelium of the glans penis, including that surrounding the urethral meatus. The neoplasm was composed of well-differentiated nonkeratinizing squamous cell carcinoma associated with large areas of carcinoma formed by cell nests that contained poorly differentiated squamous elements and large eosinophilic to pale granular cells. Mucin stains revealed approximately one quarter of the pale cells contained mucous substances. These findings are virtually identical to the mucoepidermoid type of carcinoma seen in the cervix. The 3 previously reported cases of adenosquamous carcinoma of the penis demonstrated a relatively indolent course, with only one being associated with a single inguinal lymph node metastasis. That patient was alive and well 9 years following diagnosis. Our example of mucoepidermoid carcinoma appears to demonstrate a more aggressive course than those reported previously.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
7/64. Thyroid sclerosing mucoepidermoid carcinoma with eosinophilia: mimic of hodgkin disease in nodal metastases.We present the clinical and pathologic findings of a case of sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid in a 39-year-old woman. This particular case is notable because it initially presented as a cervical lymph node metastasis, and the initial clinical and histologic impression was hodgkin disease, nodular sclerosis type. Sclerosing mucoepidermoid carcinoma with eosinophilia is a differentiated malignant neoplasm of the thyroid that can be confused with anaplastic carcinoma, medullary carcinoma, squamous cell carcinoma, or, as in this case, hodgkin disease. A correct diagnosis of sclerosing mucoepidermoid carcinoma with eosinophilia involves awareness of this entity and appropriate immunohistochemical analysis. In this article, we briefly review the literature and stress the histologic and cytologic findings characteristic of sclerosing mucoepidermoid with eosinophilia of the thyroid.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
8/64. Primary mucoepidermoid carcinoma of the intrahepatic bile duct: a case report with review of literature.A 64-year-old Thai man had a primary mucoepidermoid carcinoma, a variant of the cholangiocarcinoma, of the left lobe of the liver. A 5 x 4 x 3 cm tumor metastasized within the liver and to the porta hepatic and parapancreatic lymph nodes with compression of the head of pancreas and distal part of the common bile duct resulting in obstructive janudice. The patient died within 7 months from massive hemorrhage of a chronic peptic ulcer of the duodenum. review of the medical literature in the English language disclosed 11 primary mucoepidermoid carcinomas of the bile ducts, including the present instance. Nine tumors were intrahepatic; three were in the right lobe and six in the left lobe. Two neoplasms were extrahepatic; they arose in the common hepatic ducts. There were 6 men and 5 women of 44 to 78 years old; the mean age was 60 years. The size of the tumor ranged from 1.5 to 18 cm in greatest dimension; the average size was 8.4 cm. The tumor metastasized frequently to the regional lymph nodes. Invasion of the portal vein and hepatic artery has also occurred. Ten patients having primary mucoepidermoid carcinoma of the bile duct died within 11 months regardless of treatments. Only one patient was well, 10 months after extensive resection of a 1.5 cm tumor of the common hepatic duct. It is concluded that the prognosis is generally poor for the patient having primary mucoepidermoid carcinoma of the bile duct.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/64. Fine needle aspiration cytology of high grade mucoepidermoid carcinoma of the thyroid. A case report.BACKGROUND: Although mucoepidermoid carcinoma is considered a very rare, low grade thyroid neoplasm, in two patients a very rapid and aggressive outcome occurred. We describe the cytologic, histologic and immunohistochemical findings of a high grade mucoepidermoid carcinoma that evolved into an anaplastic carcinoma. CASE: A 57-year-old man was admitted with dysphagia, dysphonia and odynophagia. The patient had begun to develop symptoms over the previous two months. Ultrasound and computed tomography revealed diffuse enlargement of the thyroid gland with multiple, bilateral, palpable lymph nodes in the cervical, supraclavicular, paratracheal and retrocaval chains. The patient died four weeks after receiving the first cycle of treatment with adriamycin and cisplatin. The smears were highly cellular, with a background rich in neutrophilic, inflammatory infiltrate and necrotic debris. Two main types of tumor cell were identified: squamoid and mucus secreting. Squamoid cells were polygonal, with well-defined borders and dense cytoplasm. Nuclei varied greatly in shape and size and displayed clumped chromatin and prominent nucleoli. Mucussecreting cells were ring shaped and dispersed among the squamoid cells; they contained a large vacuole, with condensed acid and neutral mucins, that peripherally displaced the nucleus. Small and large clusters of large, polygonal cells with single or multiple bizarre nuclei and less-dense cytoplasm were also present. histology revealed tumor cells distributed in irregular nests, with necrosis surrounded by a fibrous stroma. The predominant cells were squamoid, but dispersed mucus-secreting cells were frequently seen in the better-differentiated areas. Sparse anaplastic spindle cells were observed adjacent to the squamoid focus. immunohistochemistry revealed a reaction positive for cytokeratin (AE3/AE1) in tumor nests and negative staining for thyroglobulin and neuroendocrine markers. CONCLUSION: Although mucoepidermoid carcinoma of the thyroid is a very rare neoplasm, its peculiar cytomorphologic features in fine needle aspiration cytology may contribute to its correct diagnosis.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
10/64. Mucoepidermoid carcinoma of the conjunctiva: a series of three cases.OBJECTIVE: To detail the clinical presentation and outcomes of currently available treatments for mucoepidermoid carcinoma of the conjunctiva (MCC). DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Three patients ranging from 40 to 63 years of age with MCC participated. INTERVENTION: Excisional biopsies and various therapies were performed. MAIN OUTCOME MEASURES: Clinical and surgical outcomes were measured. RESULTS: Patient 1 is a 55-year-old man with right temporal MCC. He underwent two local excisions with adjuvant cryotherapy and has had no recurrence at 31 months follow-up. Patient 2 is a 63-year-old man with right temporal MCC who underwent fractionated iodine 125 plaque radiotherapy. He had a recurrence approximately 8 months after plaque treatment and subsequently underwent enucleation of the right eye. Clinical follow-up examinations revealed no further recurrence at 17 months. Patient 3 is a 40-year-old woman treated for right MCC with carbon dioxide laser with recurrence at 3 weeks. She subsequently underwent radiation treatment with the development of regional lymph node metastases 16 months later. CONCLUSIONS: MCC is a rare neoplasm that displays an extraordinary capacity for aggressive local invasion. This series of three case reports demonstrates the high recurrence rate of MCC and the response of this tumor to different current modalities of treatment. Extended follow-up is required with this tumor because distant metastases can occur very late.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
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