Metastatic choroidal melanoma in the breast: a case report and review of the literature.

The breast is an unusual site for metastases, accounting for less than 2% of malignant breast lesions but include those from malignant melanomas, carcinomas, sarcomas, and lymphomas from various organs. We diagnosed a very rare case of metastatic choroidal melanoma for a 67-year-old female who presented with a right breast lump and who had been previously diagnosed with choroidal melanoma-monosomy 3 in 2017. To the best of our knowledge, only five such cases have been published so far, with one in a male patient.

A Rare Case of Intestinal Low-Grade Endometrial Stromal Sarcoma With Glandular Differentiation and Associated Endometriosis.

Endometrial stromal sarcoma is a rare tumour. It is even rarer to find it arising in the background of endometriosis in an extrauterine location. This case report describes a case of missed diagnosis of intestinal extra-uterine endometrial stromal sarcoma associated with endometriosis, and the subsequent presentation with distant metastases. The potential pitfalls are highlighted and differential diagnoses are discussed.

Primary fibrosarcoma of the thyroid gland--a case report.

A 54-year-old woman, a teacher with a two-year history of a thyroid gland enlargement was referred to the Surgeon Ward with a preliminary cytological diagnosis of schwannoma. Histological examination of the resected tumour revealed a malignant mesenchymal tumor and a primary fibrosarcoma of the thyroid gland was ultimately confirmed. Currently, a follow-up, with further clinical investigations has been recommended.

Intestinal schistosomiasis--a case report.

A 61-year old male, an ex-pilot of an agricultural aeroduster, with a history of a Schistosoma mansoni infection following an accident in Sudan in 1986 (an exposure to the contents of a polluted water reservoir) was diagnosed three times due to abdominal complaints. The primary diagnosis was Lesniowski-Crohn's disease. Only three years later was an appropriate diagnosis made based on histopathology of sections of the colon.

Sarcomatoid variant of urothelial carcinoma (carcinosarcoma, spindle cell carcinoma): a review of the literature.

Background. Sarcomatoid variant of urothelial carcinoma (SVUC) was added to the WHO classification in 2004. Aims. To review the literature. Materials and Method. Various internet databases were used. Result. SVUCs are rare biphasic malignant neoplasms exhibiting morphologic/immunohistochemical evidence of epithelial and mesenchymal differentiation with the presence or absence of heterologous elements. Some cases of SVUC have been associated with radiation therapy and cyclophosphamide treatment. Patients' ages range from 50 to 77 years (mean age 66). Patients tend to be younger and they more commonly presented with high-grade histology and advanced stage disease, in comparison with patients who had conventional urothelial carcinoma (CUC). Results of molecular/genetic studies strongly argue for a common monoclonal cell origin of both the epithelial and mesenchymal components in SUVC. The cancer specific survival of SVUC is poor in comparison with CUC. Radical surgical excision and chemoradiation may be associated with improved prognosis; chemoradiation as an organ preserving alternative to radical excision may be associated with improved outcome. There is no consensus opinion on the best treatment modalities for SUVC. Conclusions. SVUC is rare and is associated with inferior outcome compared with CUC. A multicentre trial of various treatment options is required. Cases of SVUC should be reported.

Unilateral Pigmented Extramammary Paget's Disease of the Axilla Associated with a Benign Mole: A Case Study and a Review of Literature.

Pigmented extramammary Paget's disease (PEMPD) is an uncommon intraepithelial adenocarcinoma and a rare variant of Paget's disease affecting skin that is rich in apocrine sweat glands such as the axilla, perianal region and vulva. It most commonly occurs in postmenopausal women and presents as a superficial pigmented scaly macule, mimicking a melanocytic lesion. The histological presentation is adenocarcinoma in situ with an increased number of melanocytes scattered between the Paget's cells. Therefore, PEMPD may be misdiagnosed as a melanocytic tumour both clinically and histologically. The tumour cells are usually positive for cytokeratin 7, epithelial membrane antigen, Cam 5.2, HER2, and mucicarmine stain while S100 and human melanoma black-45 highlight the processes of reactive dendritic cells. The association between Paget's cells and intratumoural reactive melanocytes is still unclear. We report our first case of PEMPD associated with an intradermal naevus involving the axilla in a 63-year-old woman.

Primary sigmoid adenocarcinoma metastasis to the breast in a 28-year-old female: a case study and a review of literature.

Metastasis to the breast from colorectal carcinoma is rare, only a few cases have been reported in the literature, and no cases have been reported in a young, 28-year-old patient. This report confirms the occurrence of the disease in a younger age group. The patient was referred to the Breast Clinic with a history of a gradually increasing lump in her right breast for two weeks' duration. On clinical examination, a 2-cm firm lump was noted in the upper inner quadrant of the right breast, which was clinically benign; however, histological examination of the breast core biopsy together with immunohistochemistry confirmed metastatic colorectal adenocarcinoma. The primary colorectal carcinoma was later confirmed to be a stage pT4N2M1 tumor, and the Duke stage was C1. Histology with immunohistochemistry is very important in the diagnosis of cases of this nature, but the clinical correlation should be taken into consideration at multidisciplinary team meetings to decide the final management of the patient.

[Her-2 amplification and p185 expression in invasive breast cancer cells in women]. / Amplifikacja HER-2 I ekspresja p185 w komórkach inwazyjnych raków sutka u kobiet.

INTRODUCTION: The objective of the investigation was to describe p185 protein expression using immunohistochemistry (IHC) and HER-2 gene amplification by fluorescence in situ hybridization (FISH), assessment being semi-quantitative and with the more precise computer image analysis, and to determine whether p185 overexpression is associated with some clinical and morphological parameters such as histological type, histological grade, axillary lymph node status, tumor size, estrogen receptor expression, proliferative index, and age in females with invasive breast carcinoma. MATERIAL AND METHODS: Histological preparations from 390 breast carcinomas were studied with the IHC reaction (HercepTest) based on a polyclonal anti-p185 antibody. HercepTest results classified semi-quantitatively as 2+ and 3+ were evaluated using a computer image analyzer and the p185 index was calculated. HER-2 amplification was carried out with FISH using a unique probe (HER-2) with a satellite probe (CEP17). The FISH reaction was assessed routinely by counting red fluorescence signals emitted by the HER-2 gene and additionally with AnalySIS software (AS). The latter method showed that the mean HER-2 amplification index in carcinomas determined as 2+ was significantly lower as compared to carcinomas defined as 3+ (p < 0.0001). On the other hand, the mean amplification indices of carcinomas classified as 3+ and of 2+ cancers which manifested HER-2 amplification did not differ significantly. High HER-2 amplification values (HER-2/CEP17 > 5) were noted in a similar percentage of carcinomas classified by IHC as 2+ (45.5%) or 3+ (55.5%). No correlation was observed between the intensity of the immunohistochemical reaction to p185 as assessed by computer image analysis and the HER-2 amplification index either in breast carcinomas classified semi-quantitatively as 2+ or 3+. The p185 index in 2+ carcinomas without HER-2 amplification might be higher than in some cancers with HER-2 amplification or even higher than in some carcinomas with HER-2 amplification belonging to the 3+ class. Significant differences were noted in p185 expression between ductal and lobular carcinomas (p = 0.0001) and between lobular and medullar carcinomas (p = 0.003). Invasive ductal carcinomas revealed significant differences in p185 expression depending on histological grade (I degree vs III degree p = 0.02; II degree vs III degree p = 0.02), estrogen receptor expression (p = 0.01), and proliferative index (p = 0.02).