Ewing sarcoma of the mandible: A rare case report and literature review.

Ewing sarcoma (ES) usually arises from long bones and affects the head and neck region in only 1%-4% of cases. We reported clinical, radiographic, cytomorphologic, and histomorphologic findings of the ES in the mandible, because of its rarity and radiologically misinterpreted as a parotid gland tumor. A 26-year-old male patient presented with a history of painfull cheek swelling. On magnetic resonance imaging, a mass measuring 50 × 48 × 45 mm was found eroding mandible and pushing back the parotid gland. Aspiration cytology was performed with suspicion of parotid gland tumor. Small, nucleated cells with nuclear indentation, inconspicuous nucleoli, and occasionally rosette-like arrangement were observed. Neuroendocrine immune markers were positive on cell block. It was diagnosed as small round cell neoplasm with neuroendocrine differentiation and biopsy was suggested. The differential diagnosis considered soft tissue and parotid gland tumors. The small round cell tumor morphology was seen on biopsy specimen and immunostaining was applied. The diagnosis for this case was ES of the mandible. ES of the mandible is unusual. Although the histogenesis is still unknown, various cells have been proposed as cells of origin namely, endothelial, hematopoietic, fibroblastic, mesenchymal stem cells or neural derived mesenchymal stem cells. Small cell morphology, CD99, CD56, neuron specific enolase, and synaptophysin expressions confirmed the diagnosis of ES. The differentiation of the ES from other small cell tumors may be difficult and requires awareness for histological and immunohistochemical features. It should be kept in mind that the diagnosis can be challenging due to uncommon locations and radiological misinterpreted.

Correlation between breast and axillary pathologic complete response after neoadjuvant chemotherapy in breast cancer.

AIM: The aim of this study was to evaluate the correlation of the pathological response in breast tissue and the axilla of patients with breast cancer who underwent surgery following neoadjuvant chemotherapy. METHOD: This retrospective cohort study included patients with T1-4, N1-3, M0 breast cancer who underwent surgery following neoadjuvant chemotherapy at Gaziosmanpasa Training and Research Hospital between 2013 and 2022. The response of the breast tissue to chemotherapy was evaluated with the Miller-Payne grading system, and the response of the axillary lymph nodes to chemotherapy was evaluated with the Pinder grading system. The patients were grouped histopathologically as luminal A, luminal B, Her-2 enriched, or triple negative breast cancer (TNBC). RESULTS: The study was completed with 140 patients. Pathological complete response (pCR) was seen in the breast in 40 patients and in the axilla in 34. Of the patients with pCR in the breast, pCR was also determined in the axilla in 45%. In the patients with pCR in both the breast and axilla, Her-2 enriched subtype, estrogen receptor negativity, progesterone receptor negativity, Her-2 neu positivity, and Ki-67 level >25% were determined to be effective (p<0.05). Her-2 neu positivity was evaluated as statistically significant in the development of pCR in both the breast and axilla (OR: 4.06, 95% CI:1.2-13.6, p=0.023). CONCLUSION: The development of pCR in the breast, especially in the Her-2 enriched subgroup, can be accepted as a predictive factor for the evaluation of axillary response in patients with breast cancer. The least compatibility was seen in the luminal A subgroup. KEY WORDS: Breast cancer, Miller-Payne, Neoadjuvant chemotherapy Pathological complete response, Pinder.

The relationship of tumor budding with GOLPH3 expression and histopathological prognostic parameters in colorectal adenocarcinoma.

OBJECTIVE: Tumor budding is an independent poor prognostic parameter in colorectal carcinoma (CRC). Golgi phosphoprotein 3 (GOLPH3) has been investigated in many solid organ tumors and has been associated with poor prognosis. In this study, the relationship of tumor budding and GOLPH3 and histopathological prognostic markers was investigated. MATERIALS AND METHODS: 140 colon resection materials diagnosed with adenocarcinoma between 2011 and 2018 were included in this study. Cases were reanalysed for their age, gender, tumor localization and size, histological grade, mucinous and signet ring cell differentiation, depth of invasion, lymphovascular and perineural invasion, stromal and intraepithelial tumor infiltrating lymphocyte (TIL), Crohn-like lymphoid reaction, peritumoral lymphocytic response, overall lympocytic score and lymph node metastasis. GOLPH3 antibody was applied to the sections containing the most dense tumor budding. The relationship between tumor budding and GOLPH3 expression, histopathological parameters and overall survival time was evaluated. RESULTS: Tumor budding was detected in 72 (51.4%) of 140 tumors. There was correlation between tumor budding and localization, size, histological type and grade, lymphovascular and perineural invasion, there was no relation with GOLPH3 expression. GOLPH3 expression was positive in 106 (75.7%) of tumors. Significant correlations were found between GOLPH3 expression and signet ring cell differentiation, stromal TIL, peritumoral lymphocytic response and overall lymphocytic score. CONCLUSION: Tumor budding and GOLPH3 expression are not correlated in CRC, but both are correlated to important prognostic histopathological parameters. In addition, tumor budding and GOLPH3 expression were not effective in overall survival, however, both parameters should be evaluated in a larger series.

Evaluation of appendiceal mucinous neoplasms with a new classification system and literature review.

Appendiceal mucinous neoplasms constitute a diagnostic spectrum ranging from adenoma to mucinous adenocarcinoma. To date, many classification systems have been proposed to reflect the histomorphological diversity of neoplasms in this range and their clinical correspondence, and also to form a common terminology between the pathologist and clinicians. The aim of this review is to provide an updated perspective on the pathological features of appendiceal mucinous neoplasms. Using the 2016 Modified Delphi Consensus Protocol (Delphi) and the Eighth Edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 19 cases presented from June 2011 to December 2016 were evaluated and diagnosed with appendiceal mucinous neoplasia. According to the Delphi, non-carcinoid epithelial tumours of the appendix were categorized in eight histomorphological architectural groups. These groups are adenoma, serrated polyp, low-grade appendiceal mucinous neoplasm, high-grade appendiceal mucinous neoplasm, mucinous adenocarcinoma, poorly-differentiated adenocarcinoma with signet-ring, signet-ring cell carcinoma and adenocarcinoma. The most common symptom was right lower quadrant pain. The median age of these cases was 60±15 years. There was a preponderance of females (F/M: 15/4). In our re-evaluation, six cases were diagnosed as serrated polyp. There were 11 cases in the LAMN group and two cases in the mucinous adenocarcinoma group. Using the Delphi and the AJCC manual, there were many changes in the classification, evaluation and treatment of appendiceal mucinous neoplasms. These classification systems have facilitated the compatibility and communication of clinicians and pathologists and have guided clinicians on treatment methods.