RESUMEN
We present the first reported case of clear cell carcinoma associated with a midurethral tape (MUT), the possible hypotheses and the management pitfalls we encountered. We report a 58-year-old woman who presented with symptoms of urinary tract infection and acute retention of urine associated with vaginal tape exposure 10 years after placement of an inside-out transobturator tape. She subsequently had a partial transobturator tape excision and a diagnostic cystoscopy, which revealed inflammatory changes within the urethra. Postoperatively, her symptoms persisted and the vaginal epithelium healed poorly. A biopsy of the friable tissue reported clear cell carcinoma. Imaging showed a locally invasive periurethral mass and bony and lymphatic metastases. This was treated with palliative radiation therapy. She was still receiving palliative care 5 months after the initial surgery.
Asunto(s)
Adenocarcinoma de Células Claras/etiología , Cabestrillo Suburetral/efectos adversos , Neoplasias Vaginales/etiología , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Solitary fibrous tumour (SFT) is uncommonly found in the salivary glands and is a rare group of spindle-cell tumours. A review of literature revealed only 40 reported cases of SFT of major salivary glands over a 15-year period from 2004 to 2018. SFTs of the salivary glands are usually benign, although rarely, can be aggressive and may sometimes recur after initial resection. Histology and Immunohistochemistry are the most important criteria to distinguish SFT from other head and neck tumours. SFTs strongly stain for CD34 and hence is the most frequently used stain for diagnosis. All reported SFT cases with available information on immunohistochemical stains were positive for CD34. Recently, immunohistochemistry for STAT6 has been introduced as a surrogate diagnostic marker for SFT that is highly sensitive and specific. We report a case of a 51-year-old Chinese gentleman who presents with a 3-month history of a left parotid tumour that required a subtotal parotidectomy for complete excision. It was diagnosed as SFT based on histology and immunohistochemical features. He was followed-up for 3 months post-operatively with no clinical evidence of recurrence. This case proposes that, although rare, SFT should be considered in the differential diagnosis of soft-tissue tumors in the major salivary glands. An awareness of this rare entity will help clinicians and pathologists better manage similar patients in the future.
Asunto(s)
Mutación , Cavidad Nasal/patología , Neoplasias Nasales/genética , Tumores Fibrosos Solitarios/genética , Proteína p53 Supresora de Tumor/genética , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Cavidad Nasal/metabolismo , Neoplasias Nasales/metabolismo , Neoplasias Nasales/patología , Tumores Fibrosos Solitarios/metabolismo , Tumores Fibrosos Solitarios/patologíaRESUMEN
Carcinoma cuniculatum (CC) is a rare variant of extremely well differentiated squamous cell carcinoma. We present the clinicopathological features of two cases of CC; one lingual and one esophageal case with a molecular genetic study regarding the TP53 gene mutational status. Case 1 was a 62 year old male with enlarging chronic ulcer in the tongue. Case 2 was a 77 year old male with progressive dysphagia and odynophagia. Both patients were treated surgically. Both tumors showed deeply invaginating, keratin-filled, burrowing crypts lined by very well differentiated squamous epithelium. The esophageal tumor showed varying degrees of reactive nuclear atypia largely limited to the areas with dense intratumoral infiltration of neutrophils. No mutation of TP53 was identified in the esophageal case. Cytologic atypia limited to areas of significant acute inflammation may occur in CC and should, in the absence of aggressive stromal invasion, not preclude a diagnosis of CC.
Asunto(s)
Carcinoma de Células Escamosas/patología , Neoplasias Esofágicas/patología , Neoplasias de la Lengua/patología , Proteína p53 Supresora de Tumor/genética , Anciano , Carcinoma de Células Escamosas/genética , Análisis Mutacional de ADN , Neoplasias Esofágicas/genética , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Neoplasias de la Lengua/genética , Proteína p53 Supresora de Tumor/análisisRESUMEN
INTRODUCTION: Gallbladder carcinoma has been associated with various paraneoplastic syndromes. These may be the presenting manifestations that lead the clinician to a diagnosis. CASE REPORT: We report a case of small cell gallbladder carcinoma complicated by paraneoplastic hyponatremia. The hyponatremia was further exacerbated by platinum-based chemotherapy. DISCUSSION: There have previously been no reports of paraneoplastic hyponatremia in gallbladder carcinoma. We discuss the management of this problem and also provide a short literature review on the other paraneoplastic syndromes associated with gallbladder carcinoma. CONCLUSION: Symptoms and signs of gallbladder cancer may be insidious. Thorough workup is needed if the patient presents with symptoms and signs of a paraneoplastic syndrome.