Local recurrence of sinonasal renal cell-like adenocarcinoma: A CARE compliant case report.

RATIONALE: Sinonasal renal cell-like adenocarcinoma (SNRCLA) is a very rare sino-nasal carcinoma. Because SNRCLA has the same morphological features as other clear cell carcinomas, and some of them also occurred in sinonasal part, it is necessary to differentiate SNRCLA from these tumors. PATIENT CONCERNS: A 42-year-old man presented with complaints of epistaxis for 1 day. The patient had undergone endoscopic resection of a neoplasm in the right nasal passage at another hospital 35 months before and was diagnosed with SNRCLA at that time, and did not receive any other adjuvant therapy. DIAGNOSES: The postoperative histopathological examination revealed a diagnosis of recurrent SNRCLA. INTERVENTIONS: The tumor was removed under nasal endoscopy. OUTCOMES: The patient was followed up for 2 months and recovered well without any complications. LESSONS: NSRCLA is a very rare tumor, and should be differentiated from other clear cell tumors including some salivary tumors and metastatic tumors of renal and thyroid.

Ovarian granulocytic sarcoma as the primary manifestation of acute myelogenous leukemia.

Granulocytic sarcoma (GS) usually occurs concomitantly with or after the onset of acute myeloid leukemia (AML) or other myeloproliferative disorders, however, GS of the ovary as the primary manifestation of AML is exceedingly rare. To the best of our knowledge, eight cases of ovarian GS as the first sign of AML have been reported in the literature. Here, we report the ninth case: a 27-year-old female who presented with an ovarian mass without any underlying hematologic disorder. A high index of suspicion aided by immunohistochemistry established the correct diagnosis of undifferentiated GS that involved the ovary. Simultaneously, laboratory findings indicated that the blood counts continually increased after surgery. Five days after the surgery, bone marrow biopsy confirmed the presence of AML. After establishing the diagnosis, the patient was sent to the hematology department to receive cytosine arabinoside and idarubicin chemotherapy. This report outlines an exceedingly rare case of AML that initially manifested as an ovarian GS. Awareness of this entity will enable earlier diagnosis and appropriate treatment.

Synchronous poorly-differentiated neuroendocrine carcinoma and gastrointestinal stromal tumor of the stomach: a case report with immunohistochemical and molecular genetic analyses of KIT and PDGFRA.

Although the stomach is the most common location for gastrointestinal stromal tumor (GIST) with co-primary tumors, the synchronous appearance of a poorly differentiated neuroendocrine carcinoma (NEC) and GIST in the stomach is extremely rare. To the best of our knowledge, this is the first case of gastric GIST coexisting with gastric NEC to be reported in the literature. The current study reports the case of a 71-year-old male with gastric poorly differentiated NEC and GIST discovered incidentally during surgical treatment of the NEC. Immunohistochemistry analysis showed that the NEC tumor cells were positive for CK (cytokeratin), CD57, synaptophysin, chromogranin, CD117 (KIT protein), Dog-1 (discovered on GIST-1 protein) and CD34. The synchronous GIST immunophenotype showed positivity for CD117, Dog-1 and CD34 (100%), whereas staining for CK, SMA, desmin and S100 was negative. Ki-67 labeling of proliferating cells was 90% in NEC and 1% in GIST. An accurate diagnosis was confirmed by immunohistochemical findings. Furthermore, genetic analysis using PCR direct sequencing identified no mutations in the KIT (exons 9, 11, 13 and 17) and PDGFRA (exons 12 and 18) genes. The patient developed lymph node metastases and underwent cisplatin-based chemotherapy after the operation. This is the first documented case of synchronous gastric GIST and NEC with the examination of protein expression and gene mutations in KIT and PDGFRA, which will help to further understand the etiology and pathogenesis of NEC coexisting with GIST in a gastric location.