1/28. Maxillary giant cell granuloma, pheochromocytoma, and hyperparathyroidism without medullary thyroid carcinoma.We examined a young man who had a benign giant cell granuloma of the maxilla, which we subsequently diagnosed as a brown tumor associated with hyperparathyroidism. During surgery for the granuloma, the patient developed severe hypertension and was discovered to have an extra-adrenal pheochromocytoma. Oncogene and calcitonin testing for medullary carcinoma of the thyroid was negative. Therefore, despite the presence of both pheochromocytoma and hyperparathyroidism, we concluded that this patient did not have multiple endocrine neoplasia type 2a.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/28. Unusual retrovesical masses in men.Retrovesical masses in men not related to prostatic carcinoma or hyperplasia is an uncommon pathology. Rare masses or unusual manifestations of those common diseases are a diagnostic dilemma. We review our experience in three unusual retrovesical masses in men: carcinosarcoma filling a giant bladder diverticulum; cystic prostatic carcinoma; and acquired cystic dilatation of the seminal vesicle associated with a prostatic carcinoma that obstructed and invaded the vesicle. We report the imaging findings and review the literature. In our experience, the imaging findings are usually not specific for doing a precise diagnosis and biopsy procedures are necessary.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
3/28. Unusual bladder masses in children.Benign and malignant bladder masses in children are extremely rare pathologic lesions. The presentation can include gross hematuria, irritable or obstructive voiding symptoms, and urinary infection. We present 2 cases in which large bladder masses suspicious for malignancy were diagnosed as benign lesions. One patient presented with abdominal pain and frequency 2 weeks after a minor bicycle accident and had a bladder wall abscess with sterile urine. Another child presented with gross hematuria and was found to have a giant cystitis glandularis lesion with no precipitating event or infection. The evaluation and differential diagnosis are discussed, and a review of the literature is presented.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
4/28. Bladder leiomyoma: rare presentation as a pelvic mass.Bladder leiomyomas are rare tumors. They very rarely present as a pelvic mass. We present an interesting case where a giant bladder leiomyoma was mistaken to be an ovarian mass. A bladder preserving surgery was performed. The literature is reviewed and the management is discussed.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
5/28. Fine-needle aspiration biopsy as an adjunct to the diagnosis of a rare adnexal tumor of hair follicle origin: trichoblastoma.Fine-needle aspiration biopsy (FNAB) is a technique used increasingly for the investigation of primary and metastatic cutaneous tumors. Trichoblastoma is a rare benign skin appendage tumor of hair germ origin. We report the diagnosis by FNAB of a rare giant subcutaneous tumor, trichoblastoma, from an 81-yr-old woman with a subcutaneous mass in the interscapular area of her back. The cytologic characteristics of the tumor are discussed in detail in this report. The findings have been compared with the histologic features of the tumor after surgical excision. We have characterized several distinctive cytologic features that may aid in the diagnosis of this rare neoplasm. While most reported cases have been diagnosed from surgical excisional biopsy specimens, FNAB may also be a valuable tool for the accurate diagnosis of trichoblastoma in the proper clinical context.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
6/28. Large cell neuroendocrine carcinoma of the urinary bladder with lymphoepithelioma-like features.The group of undifferentiated carcinomas of the urinary bladder encompasses small cell undifferentiated carcinoma, giant cell carcinoma, lymphoepithelioma-like carcinoma (LELC), and large cell neuroendocrine carcinoma (LCNEC). These tumors are either pure or can be associated with other components, such as transitional cell carcinoma, squamous cell carcinoma, and adenocarcinoma. We report a case of LCNEC of the urinary bladder in a 54-year-old woman. Histologically, the tumor showed features of LELC; immunohistochemically, the tumor cells reacted to chromogranin a, NSE, and synaptophysin. In addition to these neuroendocrine markers, tumor cells were positive for cytokeratin CAM 5.2 and AE1/AE3, and there was focal positivity for vimentin. in situ hybridization for the detection of Epstein-Barr virus was negative. Despite radical cystourethrectomy and six courses of chemotherapy, the patient developed metastases invading the left inguinal lymph nodes 11 months postoperatively. Currently, 16 months postoperatively, the patient has developed metastases spreading into the lymph nodes of the right ischiorectal fossa; therefore, she is receiving a new cyclus of chemotherapy. There are only three previously reported cases of LCNEC of the urinary bladder, and the significance of neuroendocrine differentiation in non-small cell carcinomas at this location remains to be established. However, LELC appears to be a separate clinicopathological entity with sensitivity to chemotherapy and a relatively favorable prognosis. The differentiation between LELC and LCNEC with prominent inflammatory reaction could be of therapeutic relevance. However, in our case, this was possible using immunohistochemistry only.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
7/28. Primary and metaplastic choriocarcinoma of the bladder. A report of two cases.Two cases of primary choriocarcinoma arose in the urinary bladder in males aged 72 and 70 years. Human chorionic gonadotropin (hCG) in serum and urine was significantly elevated in both cases. Cytologic features consisted of bizarre mononucleate and multinucleate giant cells with numerous erythrocytes, necrotic cells and neutrophils, indicating the possibility of choriocarcinoma. Histologically, one tumor consisted of an admixture of choriocarcinomatous areas and transitional cell carcinoma (TCC) with or without syncytiotrophoblastic differentiation, and the other was composed of pure choriocarcinoma. Immunohistochemical examination revealed that syncytiotrophoblasts and a small number of TCC cells were intensely positive for hCG in their cytoplasm. The histogenesis of choriocarcinoma arising in the bladder is considered to be metaplasia or retro-differentiation from TCC to trophoblasts because of TCC's differentiating to hCG-positive trophoblasts, as seen in one of the present cases.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
8/28. Urothelial carcinoma of the bladder with trophoblastic differentiation: a case report.We report a case of a urothelial carcinoma with trophoblastic differentiation of the bladder that occured in a 23-year-old man. The patient presented with hematuria. Multiple papillary masses were resected transurethrally. Histopathologically, grade III urothelial cell carcinoma contained giant cells that were positive for human chorionic gonadotrophin (HCG), placental alkalen phosphatase, and human placental lactogen. HCG secreting tumors are reported to be highly aggressive. The patient is alive and well without evidence of recurrent disease or metastasis at 10 months from transurethral resection. To our knowledge, this case is the youngest patient in the literature so far.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
9/28. Papillary urothelial bladder carcinoma associated with osteoclast-like giant cells.We report the case of a papillary urothelial carcinoma associated with osteoclast-like giant cells. A 60-year old woman presented with hematuria. A papillary neoplasm was detected by cystoscopy and removed transurethrally. Histological examination revealed a papillary urothelial carcinoma (grade I) associated with multiple stromal giant cells, which displayed morphological, ultrastructural and immunohistochemical characteristics of osteoclast-like giant cells. The formation of osteoclast-like giant cells in association with urothelial bladder carcinoma is a rare event, of which only six cases have been reported in the Anglo-American literature. It may cause diagnostic problems because primary giant cell tumor, giant cell carcinoma and foreign body stromal reaction have to be considered. immunohistochemistry and electron microscopy may help to rule out these differential diagnoses.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
10/28. Osteoclast-rich undifferentiated carcinomas of the urinary tract.Osteoclast-like giant-cell neoplasms of the urinary tract are rare. They are composed of ovoid or spindle-shaped mononuclear cells with evenly spaced osteoclast-like giant cells. terminology, histogenesis, and biologic behavior of these tumors remain controversial. Six cases of osteoclast-like giant-cell neoplasms of the urinary tract were identified from the consultation files of two of the authors. patients were all male and elderly (range 65-82), with the exception of one 39-year-old male. In all, 3/6 tumors developed in the bladder and 3/6 in the renal pelvis. Size ranged from 5 to 11 cm. One bladder and three renal pelvis tumors were high stage (pT3) at time of presentation. Adjacent to the osteoclast-like giant-cell neoplasm in the same specimen, all patients had urothelial carcinoma in situ and/or high-grade papillary urothelial carcinoma. Multinucleated cells had identical morphological and immunohistochemical properties of osteoclasts; positive for CD-68, LCA, CD51 and CD54, and negative for cytokeratins and EMA. Varying percentages of mononuclear cells expressed alpha-smooth muscle actin (4/6), desmin (1/6), S-100 (4/6), LCA (2/6) and CD68 (6/6). However, mononuclear cells were also positive for epithelial markers in 4/6 tumors (cytokeratins AE-1/AE-3, Cam 5.2, CK7 and/or EMA). p53 stained mononuclear tumor cells in three cases, paralleling the staining on the accompanying urothelial carcinoma. Ki-67 stained mononuclear tumor cells, but not osteoclast-like giant cells. Follow-up data were available in five cases. One patient developed recurrence of noninvasive urothelial carcinoma and is still alive. Four patients were dead due to disease within 15 months, three with distant metastases. The intimate association of these tumors with urothelial carcinoma along with their immunohistochemical profile supports an epithelial origin for the mononuclear cells and non-neoplastic reactive histiocytic lineage for the osteoclast-like giant cells.- - - - - - - - - - ranking = 1.2keywords = giant (Clic here for more details about this article) |
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