1/17. A case of giant extramammary Paget's disease of the genital area with squamous-cell carcinoma.Extramammary Paget's disease is a primary carcinoma with apocrine differentiation that begins within the epidermis. Extramammary Paget's disease and squamous-cell carcinoma (SCC) have different neoplastic origins and are different both clinically and histologically. Until now the concurrence of extramammary Paget's disease and SCC in the same area has not been reported to our knowledge. We report on a 76-year-old man with extramammary Paget's disease affecting a large region of the genital area with SCC within the same area. A skin biopsy specimen showed the coexistence of typical Paget's disease and highly differentiated SCC invading the dermis. Immunohistochemical staining of both cell types was completely different.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/17. Giant malignant mesenchymoma of the spermatic cord with bidirectional differentiation.BACKGROUND: spermatic cord neoplasms are a rare tumor entity and, moreover, of benign behavior. Malignant tumors of the spermatic cord are mostly of mesenchymal origin. We present the unusual case of a giant malignant mesenchymoma of the spermatic cord with bidirectional differentiation into a liposarcoma and a leiomyosarcoma. CASE REPORT: A 84-year-old male patient presented with a scrotal mass on the left side which was observed growing since 1 year and misdiagnosed as scrotal hernia or testicular hydrocele. Ultrasound and computed tomography demonstrated a solid tumor suggesting a spermatic cord tumor. The patient underwent hemiscrotectomy, and the histological examination of the 2,500-gram specimen revealed a malignant mesenchymoma originating from the spermatic cord with two distinct histopathological compartments of liposarcoma and leiomyosarcoma. Because an adjuvant therapy protocol is of questionable effect and because of the patient's age no further therapy was applied. The patient was closely followed and is now, 5 years after surgery, still free of disease. CONCLUSION: Even in older patients, scrotal masses should be considered malignant tumors as long as no benign diagnosis has been proven. Although malignant mesenchymomas are rare tumors with poor prognosis, in selected cases even large tumor masses, as presented, can be cured by surgery.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
3/17. Malignant fibrous histiocytoma of the spermatic cord: report of two cases and review of the literature.Malignant fibrous histiocytoma (MFH) of the spermatic cord is rare, and most published cases are single case reports that emphasize clinical presentation and management. We describe in detail the histopathologic features of 2 cases of high-grade storiform-pleomorphic MFH arising in the spermatic cord. Both tumors occurred in elderly men, 65 years and 70 years, and were 4 cm (Case 1) and 5 cm (Case 2) in greatest dimension. The tumor mass in Case 1 was associated with satellite tumor nodules. At last follow-up, in Case 1 the patient died of metastasis, and in Case 2, the patient is alive and well 46 months after diagnosis. review of the literature reveals 33 additional cases published in English (17 cases) or Japanese (16 cases) that include histologic description. Including the 2 cases in this report, most of the tumors occurred in older (than 50 years) patients (28 of 35 cases, 80%) and occurred as solitary masses that ranged in diameter from less than 1 cm to more than 20 cm. Nine patients presented with satellite tumor nodules. Twenty-nine (83%) tumors were of the storiform-pleomorphic type, with 3 giant cell type, 2 inflammatory type, and 1 myxoid type. These features do not differ significantly from MFH in other anatomic sites. Clinical follow-up is available in 33 cases (3-174 months; mean, 31.5 months). Twelve patients developed recurrence and metastasis; at least 4 patients died of the disease. Tumor size does not predict the clinical progression; however, patients with progressive tumors were commonly associated with satellite nodules at time of presentation, an indication of early local metastasis.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
4/17. Fine-needle aspiration cytology of giant cell fibroblastoma: case report and review of the literature.Giant cell fibroblastoma is an uncommon soft tissue neoplasm occurring in childhood. It appears to be the juvenile form of dermatofibrosarcoma protuberans, with which it shares some histologic, cytogenetic, and immunohistochemical features. We report, to our knowledge, the second description of the cytologic features of giant cell fibroblastoma. The present case represents a recurrent lesion in the soft tissues of the scrotum of a 17-yr-old male. The aspirate produced moderately cellular smears containing mononuclear cells, usually lying singly, but occasionally forming clusters. The majority of the individual cells possessed scanty bipolar cytoplasm or were devoid of cytoplasm. The nuclei were bland, with small nucleoli. Nuclear membranes frequently contained notches, creases, or folds. Small fragments of metachromatic stroma were present in the background and were often associated with small aggregates of cells. Rare multinucleated giant cells containing bland oval or basillary-shaped nuclei were admixed with the spindle-cell component. necrosis and mitotic figures were not a component of the smears. Surgical resection of the mass confirmed the diagnosis of giant cell fibroblastoma. We review the characteristic cytologic features of giant cell fibroblastoma and compare them with other soft tissue tumors in the differential diagnosis.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
5/17. Giant basal cell carcinoma affecting the lower abdominal, genital and bilateral inguinal regions.We describe a giant basal cell carcinoma, measuring 40 cm x 20 cm, of the lower abdominal, genital and bilateral inguinal regions. The rectus abdominis muscle and the adductor magnus muscle were exposed centrally, and the penis and scrotum were completely destroyed. Reconstruction was performed with a fillet thigh flap, and an excellent result was obtained 1 year after surgery.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
6/17. Extramammary Paget's disease with superimposed herpes simplex virus infection: immunohistochemical comparison with cases of the two respective diseases.We describe an extremely rare case of genital Paget's disease with superimposed herpes simplex virus (HSV) infection. We also describe immunohistochemical comparison of this lesion with 19 cases of genital Paget's disease and 12 cases of skin lesions caused by HSV or varicella-zoster virus. The Paget cells expressed simple epithelial keratins (CK7 and CK19) and carcinoembryonic antigen (CEA), but did not express stratified epithelial keratins (CK1, CK2e, CK10, CK5/8, CK14). Conversely, the virus-infected keratinocytes were positive for stratified epithelial keratins but negative for simple epithelial keratins and CEA. In the present case, simple epithelial keratins, stratified epithelial keratins, CEA and HSV were heterogeneously expressed in the ballooning and multinucleated giant cells. These results suggest that these cells were derived from keratinocytes and Paget cells and that the production of many multinucleated giant cells resulted from the virus-mediated cell fusion between Paget cells and neighbouring keratinocytes.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
7/17. Analysis of a giant marker chromosome in a well-differentiated liposarcoma using cytogenetics and fluorescence in situ hybridization.Well-differentiated liposarcomas (LPS) are cytogenetically very complex, characterized by giant marker chromosomes, ring chromosomes, and telomeric associations. We report a case of well-differentiated LPS in which the only cytogenetic anomaly was an additional giant marker. In an attempt to identify the origin of this marker, centromeric probes (chosen on the basis of the morphology of the marker) to chromosomes 1,2,3,4,6,7,8,9,10,11,12,16,17, and X and a shared satellite probe for chromosomes 1,5, and 19, were used with fluorescence in situ hybridization (FISH). This was successful at eliminating certain chromosomes as candidates for centromeric trisomy but could not identify the origin of the marker. This case is unusual in that it does not conform to the typical cytogenetic pattern for well-differentiated LPS and is the first known example with an apparently normal diploid karyotype with only one additional change.- - - - - - - - - - ranking = 1.5keywords = giant (Clic here for more details about this article) |
8/17. A rare case of epidermoid cyst of the scrotum with signs of malignization--clinical and morphological features.Proceeding from the fact that epidermoid cysts of the scrotum are rare and often histologically proven to display evidence of malignization in the underlining epithelium, the authors present a case of scrotal epidermoid cyst from their clinical practice. Epidermoid cysts are given a detailed pathohistologic assessment. The finding was a productive granulomatous inflammation containing multinucleated giant cells of foreign body type in the overlying dermis and intraepidermal "horn pearls" (keratin substance of Queyrat) showing unequivocally signs of malignization of the epidermoid cyst. The authors argue that a histological study should be a must after surgical removal of the cyst as it is the only method to prove beyond any doubt the malignant transformation of the epithelium.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
9/17. Haemorrhagic papillary cystadenoma of the seminal vesicle mimicking giant seminal vesicle cyst: MRI appearances.Papillary cystadenoma of the seminal vesicle is very rare. We describe such a case presenting in a 58 year old man with bladder outlet obstruction. Investigations included magnetic resonance imaging (MRI), the usefulness of which in pre-operative diagnosis is highlighted in this case. Seminal vesicle cysts can usually be identified by conventional radiological imaging techniques such as ultrasound and computed tomography; however, identification would be difficult if the cyst is very large, causing distortion of the adjacent anatomy. In such cases, MRI, through coronal and sagittal scanning, can be helpful in localising the lesion, as in this patient. The precise pathological nature of the cyst can only be confirmed by biopsy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/17. Malignant mesenchymoma of spermatic cord: a case report with intermediate filament typing.A malignant mesenchymoma arising in the spermatic cord of a 79-year-old patient is described. The radiologic appearance was that of a predominantly calcified mass. Histologically the tumor was composed primarily of malignant cartilage. In other areas there were spindle-shaped cells and large eosinophilic and multinucleated giant cells. Staining for intermediate filaments revealed vimentin throughout the neoplasm with some areas showing positive staining for desmin, the latter confirming the muscular origin of some of the neoplastic elements. No cytokeratins were identified, effectively ruling out the possibility of a malignant teratoma.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
| | Next -> |