1/21. Winer's dilated pore, rare presentation in the external ear canal.A 51-year-old female patient was admitted to our outpatient department with a discharging right ear of six months duration and not responding to aural toilet and topical antibiotics. Microscopic examination showed a collection of soggy keratin in the floor of the ear canal. suction cleaning showed a skin defect of about 7 mm in diameter. A CT scan showed rarefaction in the bony canal. Histological diagnosis following an excision biopsy under general anaesthetic showed Winer's dilated pore. Winer's dilated pore is a hair follicle tumour arising from the pilosebaceous apparatus. hair follicle tumours are relatively rare and their clinical appearance is commonly non-specific. In spite of their non-specific features, they show a keratotic plug grossly which when removed reveals a skin defect and may show bone erosion occasionally if the underlying structure is bone. These features can be misinterpreted for more serious lesions such as squamous cell carcinoma or basal cell carcinoma of the ear canal that can lead to pursuing a more aggressive line of management for a benign lesion. We present this rare lesion illustrating the pathological features, differential diagnosis and management.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/21. adamantinoma and meningioma occurring synchronously in a patient with breast cancer: a case report.Screening mammography of a woman with no symptoms led to the diagnosis of carcinoma of the breast, an intracranial meningioma, and adamantinoma of the right tibia. This is the first reported case of three synchronous primary tumors of different tissue origins. biopsy is essential for diagnosing or excluding primary tumor(s) in cases of suspected metastases occurring at a limited number of sites.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
3/21. Glandular patterns in a thyroid carcinoma with insular and anaplastic features: a case with possible implications for the classification of thyroid carcinomas.We describe the case of a 33-year-old woman with a thyroid carcinoma showing poorly differentiated (insular), anaplastic, and glandular features, the latter with extensive clear cell changes. Grossly, the well-circumscribed tumor nodule measured 3.6 cm in maximum dimension and was confined to the thyroid. Microscopically, the majority of the tumor was composed of well-defined "insular" nests showing microfollicular formation, high mitotic activity, and areas of necrosis. Other regions, as well as the intervening stroma of the insular nests, were characterized by highly atypical and pleomorphic stromal cells, extensive necrosis, and malignant cartilaginous nodules. Approximately 30% of the tumor was composed of diffuse glandular formations, each of which were lined by elongated, simple columnar cells with basally situated, mildly pleomorphic nuclei, clear supranuclear, periodic acid-Schiff (and diastase sensitive) cytoplasm, empty lumens, and no myoepithelia or basement membranes. Immunohistochemically, the glandular elements displayed diffuse and strong positivity for thyroid transcription factor-1, bcl-2, and CAM 5.2, sparse positivity for thyroglobulin and Ki67, and diffuse but weak positivity for p53. calcitonin was negative throughout the tumor. Karyotypic analysis of a primary culture showed a complex hypertriploid karyotype including structural abnormalities of chromosomes X, 1, 4, 6, 9, 13, and 14 in the majority of cells examined. This composite of histologic findings, especially the glandular patterns, is unusual and their prognostic significance is unclear. The patient is alive with no evidence of tumor recurrence or metastasis at 5 months follow-up. overall, the morphologic and immunohistochemical properties of the glandular component suggests that they are less differentiated than well-differentiated carcinomas and are probably more differentiated than the insular component. This case supports the theory that the various primary carcinomas of the thyroid may represent points along a spectrum rather than distinct entities.- - - - - - - - - - ranking = 5.5keywords = carcinoma (Clic here for more details about this article) |
4/21. Epithelial-myoepithelial carcinoma of the lung. A case report and review of the literature.Primary lung tumors mimicking the salivary gland-type neoplasms are extremely rare. These types of tumors originate from submucosal bronchial glands. Epithelial-myoepithelial carcinoma is an uncommon tumor in this group, and only 7 cases have been reported. It is considered to be a low-grade malignant neoplasm. We report a case of epithelial-myoepithelial carcinoma of bronchial gland origin in a 73-year-old man who presented with coughing and dyspnea. The bronchus of the left lower lobe contained a tumor mass that had a polypoid growth pattern. The tumor also extended into the pulmonary parenchyma, forming a well-circumscribed mass with a pushing margin. The tumor consisted of epithelial and myoepithelial cells. The epithelial cells were positive for cytokeratins and epithelial membrane antigen, while the myoepithelial cells were positive for S100 protein and muscle-specific actin. According to these findings, we diagnosed epithelial-myoepithelial carcinoma. After undergoing pneumonectomy, the patient has been disease free for 34 months.- - - - - - - - - - ranking = 3.5keywords = carcinoma (Clic here for more details about this article) |
5/21. A case of porocarcinoma from pre-existing hidroacanthoma simplex: need of early excision for hidroacanthoma simplex?BACKGROUND: Hidroacanthoma simplex (HAS) is an uncommon eccrine neoplasm of the skin. It is a benign neoplasm, but some cases of malignant change were reported in the literature. OBJECTIVE: To describe a rare case of porocarcinoma in a relatively short period from pre-existing HAS on the abdomen. methods: Wide local excision was performed on this neoplasm. RESULTS: There was no recurrence for 72 months after wide excision. CONCLUSION. : We recommend an early excision and careful attention in the case of HAS because of its potential malignant change.- - - - - - - - - - ranking = 2.5keywords = carcinoma (Clic here for more details about this article) |
6/21. Extraorbital sebaceous carcinoma with rapidly developing visceral metastases.BACKGROUND: Extraorbital sebaceous carcinoma (SC) is a rare carcinoma of the skin but is known to have a good prognosis in terms of metastasis and survival. OBJECTIVE: To discuss and emphasize through the clinical and histopathologic findings and the aggressive potential of extraorbital SC and to review the corresponding literature. methods: We present an unusual form of extraorbital SC that has followed an aggressive course and that has metastasized rapidly. RESULTS: Local excision of the primary cutaneous tumor with negative margins did not prevent the rapid and fatal internal organ metastases. The patient did not benefit from the docetaxel chemotherapy regimen applied after the distant metastases were developed. CONCLUSION: Extraorbital SC may show a poor prognosis. Both the dermatologic surgeon and the dermatologist should be cautious of the risk of local recurrence and distant metastasis when dealing with extraorbital SC.- - - - - - - - - - ranking = 3keywords = carcinoma (Clic here for more details about this article) |
7/21. Imprint cytology of metastatic sialoblastoma. A case report.BACKGROUND: Sialoblastoma is a rare, aggressive and potentially malignant perinatal/congenital tumor that recapitulates the developing salivary gland. There is only 1 brief description of the cytologic findings of metastatic sialoblastoma and 1 poorly documented case of lung metastasis in the literature. CASE: A 75-month-old girl with a history of recurrent sialoblastoma initially diagnosed at 21 months and treated with multiple incomplete surgical excisions, chemotherapy and radiation presented with a solitary lung nodule. Imprint smears and frozen section of the mass were diagnostic of metastatic sialoblastoma. CONCLUSION: Cytologic features of sialoblastoma showed complete concordance with histology and included the presence of variably arranged, tight, solid clusters of atypical-appearing, basaloidlike cells in a background of dispersed epithelial and myoepithelial cells. The clusters contained admixed benign ductal cells and dense, metachromatic, magenta hyaline globular material with smooth, rounded outlines. The differential diagnoses include neoplasms composed of either basaloid cells and/or admixed hyaline matrix material and included pleomorphic adenoma, basal cell adenoma and adenoid cystic carcinoma. All these neoplasms affect patients in the first 2 years of life, whereas sialoblastoma usually occurs in the first 2 decades of life.- - - - - - - - - - ranking = 0.5keywords = carcinoma (Clic here for more details about this article) |
8/21. adoptive transfer of allogeneic Epstein-Barr virus (EBV)-specific cytotoxic T cells with in vitro antitumor activity boosts LMP2-specific immune response in a patient with EBV-related nasopharyngeal carcinoma.BACKGROUND: The outcome of patients with nasopharyngeal carcinoma (NPC) presenting as advanced-stage disease or failing conventional radio-chemotherapy is poor. Thus, additional forms of effective, low-toxicity treatment are warranted to improve NPC prognosis. Since NPC is almost universally associated with Epstein-Barr virus (EBV), cellular immunotherapy with EBV-specific cytotoxic T lymphocytes (CTLs) may prove a successful treatment strategy. Patient and methods A patient with relapsed NPC, refractory to conventional treatments, received salvage adoptive immunotherapy with EBV-specific CTLs reactivated ex vivo from a human leukocyte antigen-identical sibling. EBV-specific immunity, as well as T-cell repertoire in the tumor, before and after immunotherapy, was evaluated. RESULTS: CTL transfer was well tolerated, and a temporary stabilization of disease was obtained. Moreover, notwithstanding the short in-vivo duration of allogeneic CTLs, immunotherapy induced a marked increase of endogenous tumor-infiltrating CD8 T lymphocytes, and a long-term increase of latent membrane protein 2-specific immunity. CONCLUSIONS: Preliminary data obtained in this patient indicate that EBV-specific CTLs are safe, may exert specific killing of NPC tumor cells in vitro, and induce antitumor effect in vivo.- - - - - - - - - - ranking = 2.5keywords = carcinoma (Clic here for more details about this article) |
9/21. Cytopathological features of an epithelial-myoepithelial carcinoma with predominant clear myoepithelial cells in the parotid gland.Epithelial-myoepithelial carcinoma (EMC) is a rare low-grade carcinoma occurring most frequently in the parotid gland. Most EMCs consist of two cell types that typically form double-layered ductal structures. However, occasionally EMC presents predominantly clear myoepithelial cells. A 34-year-old man visited in August 1993 and was diagnosed as having clear-cell carcinoma. The tumor was curatively resected. However, in the following 5 years, recurrence developed a total of five times. The imprint cytological feature of the recurrence at the third time showed monophasic clear cells in sheet clusters with overlapping. Most of the clear tumor cells presented an expression to alpha-smooth muscle actin (SMA). The imprint cytological feature of the recurrence at the fifth time showed increase of nuclear atypia with coarse chromatin patterns and large nucleoli. In addition to cytological findings, the cytological diagnosis of EMC with predominant clear myoepithelial cells requires a definite expression to SMA.- - - - - - - - - - ranking = 3.5keywords = carcinoma (Clic here for more details about this article) |
10/21. A hybrid carcinoma of epithelial-myoepithelial carcinoma and adenoid cystic carcinoma in maxillary sinus.Hybrid carcinoma of the salivary gland is a very rare entity that has been described only in the parotid and palate. The occurrence of a hybrid carcinoma of maxillary sinus has not been reported. The diagnosis of hybrid carcinoma is important particularly when the components of tumor have different biologic behaviors. diagnosis and treatment require a high index of suspicion, especially when the tumor is an epithelial-myoepithelial carcinoma, pathological effort to look for a more aggressive accompanying tumor, and proper oncologic treatment. We describe a case of 26-yr-old woman with a hybrid carcinoma composed of epithelial-myoepithelial carcinoma with an adenoid cystic carcinoma component (cribriform pattern) in the right maxillary sinus with a brief review of the relevant literature.- - - - - - - - - - ranking = 9.5keywords = carcinoma (Clic here for more details about this article) |
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