Metastatic prostate tumor to testes: Sign of advance disease.

Prostate cancer is the second most common cause of mortality for males in the United States. Metastases may be present, typically in the axial skeletal region. To date, few patients have presented with metastases to the testicles. We present the case of an adult male with diagnosed prostate cancer who presented and subsequently diagnosed bilateral testicular metastases. Testicular metastases secondary to diagnosed prostate cancer are very rare. Patients present with these metastases may have unfavorable prognosis. This case demonstrates that prostate cancer may metastasize to rare locations such as the testes, requiring further surgical intervention.

Grading Intraductal Carcinoma of the Prostate; ISUP versus GUPS Recommendations.

OBJECTIVE:  To evaluate the frequency of intraductal component (IDC-P) in prostatic adenocarcinoma and its effect on the final grade using the ISUP and GUPS grading system. STUDY DESIGN:  Descriptive study. Place and Duration of the Study: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, between June 2021 and June 2022. METHODOLOGY: The study included 250 cases of prostatic adenocarcinoma. The presence of the intraductal carcinoma prostate (IDC-P) was confirmed by patchy or complete staining of the basal cell layer by p63 immunohistochemical stain. Cases with IDC-P were then graded using two different methods, first using the grading criteria based on the ISUP recommendations and then by the grading criteria based on the GUPS recommendations. RESULTS: Two hundred and fifty cases showed invasive prostatic carcinoma ranging from Gleason grade group 2-5. IDC-P was identified in 5 of the 250 biopsies (2%). The final Gleason grade remained unchanged in these cases, when they were graded using the ISUP and GUPS recommendations. CONCLUSION:  Although the present results are based on a relatively small sample size, IDC-P was not frequently present in biopsies of patients with adenocarcinoma in the studied population. Grading IDC-P in invasive prostate cancer led to only a minor change in grade group assignment of prostate cancer biopsies. KEY WORDS:  Prostatic adenocarcinoma, Intraductal carcinoma, IDC-P, ISUP, GUPS, Gleason Grade group.

Angiomatoid Fibrous Histiocytoma: A Tumor With Uncertain Behavior and Various Clinicopathological Presentations.

Background Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue neoplasm of uncertain differentiation, which has various clinical and morphological presentations. Although it behaves in a benign manner, it has malignant potential. Aim To share various histological patterns and survival data in our population of this rare entity. Materials and methods We studied 25 patients who reported AFH from January 2011 to December 2021. Clinical information, gross and histological features, immunohistochemical results, and survival data were compiled and analyzed. Results Among 25 cases reported as AFH, the majority (68%) were males with a mean age of 31.8 years at the time of diagnosis. The most common location was the lower extremity, especially the thigh (56%), and the mean size of the lesion was 55 mm. Most of the lesions were superficial (84%). Grossly, the majority of lesions (76%) had a solid appearance. Microscopically, classic spindle cell morphology was the most common (76%) with a lymphoid cuff and intralesional hemorrhage. Mild cellular atypia was seen in most (92%) of the cases, while some biopsies (8%) had a high-grade morphology. The majority of patients were alive, while one patient died of the disease. Conclusion AFH is an under-recognized entity with various clinical and histological presentations and a low malignant potential.

Bronchogenic Cyst in the Cervical Region: A Rare Entity - A Case Report and Review of the Literature.

Bronchogenic cysts originate from the tracheobronchial bud, which arises from the embryonic foregut. Congenital bronchogenic cysts in the cervical region, especially in the thyroid or perithyroidal area, are extremely rare. Moreover, distinguishing them from other cervical cystic lesions such as thyroglossal duct and branchial cleft cysts and metastatic cervical lymph nodes is difficult preoperatively. In this report, we discuss a case of a 41-year-old woman who presented to us with a history of anterior neck swelling for two weeks with occasional palpitations and bilateral flank pain. On workup, she was diagnosed as a case of multiple neuroendocrine neoplasm type 2A for which she underwent adrenalectomy first followed by total thyroidectomy with central neck dissection and parathyroidectomy. On the final histopathology specimen, an incidental bronchogenic cyst was diagnosed. A bronchogenic cyst is a rare entity, especially in the head and neck region, and can be confused with a metastatic lymph node. Diagnosis is made based on the histopathological examination, which requires surgical excision. The bronchogenic cyst should be considered in the differential diagnosis for midline and lateral neck masses.

Diagnostic Utility Of Fish For MDM2 In Adipocytic Neoplasms.

BACKGROUND: The 2013 World Health Organization (WHO) classification of soft tissue and bone tumours recognizes benign entities such as lipoma and four major liposarcoma subtypes: atypical lipomatous tumour/well differentiated liposarcomas (ALT/WDL), dedifferentiated liposarcomas (DDL), myxoid liposarcoma and pleomorphic liposarcoma. This classification of atypical and malignant adipocytic tumours has evolved significantly over the past few decades owing to contributions from cytogenetics, molecular genetics and Immunohistochemical correlates. Most ALT/WDLs can be diagnosed on histology; however, some of the biopsies may be underdiagnosed due to focal atypia or limited nature of tissue for the biopsy. Fluorescence in situ hybridization (FISH) for MDM2 (located at 12q14-15) gene amplification has emerged as gold standard for diagnosis in cases with limiting histological factors. METHODS: We studied MDM2 amplification by FISH in 55 such problematic adipocytic tumours with overlapping morphological features and a retrospective analysis was made against their corresponding histological features. RESULTS: MDM2 amplification correctly identified 11 of 17 ALT/WDLs (64.71% concordance) and 8 of 10 Lipomas (80% concordance). We were able to differentiate liposarcomas from other high grade sarcomatous lesions and sub-classified these lesions into pleomorphic and dedifferentiated types. CONCLUSIONS: FISH for MDM2 amplification should be used as a gold standard in adjunction with morphology and immunohistochemistry for problematic adipocytic neoplasms.