A patient with pilomatricoma in the parotid region: case report and review of the literature.

Pilomatricoma is a benign skin tumor originating from the matrix cells of the hair follicles. Sometimes, its diagnosis can be difficult, especially in the preauricular region, where in the differential diagnosis, in addition to other dermal and subcutaneous masses, primary and secondary parotid gland tumor lesions must be also considered. A 34-year-old female was referred to our Institution with a right preauricular swelling over 12 months, which enlarged in the last two months. The ultrasonography confirms the origin of the tumoral mass in the skin of the preauricular region and not from the superficial lobe of the right parotid gland. The patient underwent complete tumor excision and the histopathology and immunohistochemical exams confirmed the diagnosis of a conventional pilomatricoma evolving to a late regressive lesion. She was discharged considered as cured and no recurrences were reported within a period of eight months of follow-up. This is the first reported case in the last 30 years, in this location, in the Department of Oral and Maxillofacial Surgery our Institution. Regarding the rarity of these tumors, especially in this location, we must keep in mind to consider a broader differential diagnosis that includes both tumoral and non-tumoral skin lesion and also parotid gland lesions.

Parotid sclerosing mucoepidermoid carcinoma: a case report and immunohistochemical study.

Here we report the case of a 63-year-old female with a parotid sclerosing mucoepidermoid carcinoma diagnosed and treated at the Department of Oral and Maxillofacial Surgery, Emergency County Hospital of Craiova, Romania. The clinical and imaging investigation revealed a parotid malignant tumor with central fluid-filled cystic formation. Histopathology found an intermediate grade sclerosing mucoepidermoid carcinoma that invaded the adjacent adipose and striated muscle tissues, but without perineural and lymphovascular invasion. The immunohistochemistry investigated mainly biomarkers involved in the induction of a local aggressive behavior. This case report describes a rare parotid sclerosing mucoepidermoid carcinoma with peculiar clinical and morphological characteristic features. The immunohistochemical study sustained its intermediate grade malignancy highlighting the prognostic value of some of the used biomarkers.

Fronto-parietal pial extension of a basal cell carcinoma of the scalp - case report.

Basal cell carcinoma is the most common malignant tumor of the skin, and it develops most frequently on the head and neck regions. Although most of these tumors are slow growing and with a limited evolution, the existence of some aggressive variants accompanied by a complete neglect from the patient may occasionally lead to invasion of the face and organs of the head and neck. Even though, intracranial invasion of basal cell carcinoma of the scalp is a rare presentation. We describe here the case of a woman who developed an aggressive and neglected morpheiform basal cell carcinoma (ulcus terebrans), which showed a complete invasion through the skull, but with an apparent self-limitation to the pia mater.

The immunohistochemical investigations of cadherin "switch" during epithelial-mesenchymal transition of tongue squamous cell carcinoma.

Oral cancer was ranked as the sixth worldwide most common cancer, but recent studies noticed an overall downward trend in its incidence. However, for tumors localized on the tongue, the incidence seems to increase. The malignant transformation of many carcinomas is associated with loss of epithelial differentiation and gain of a mesenchymal phenotype, a process known as epithelial-mesenchymal transition (EMT) which for oral squamous cell carcinomas (OSCC) could be a predictor and a prognostic factor. The aim of our study was to investigate immunohistochemically the E-cadherin/N-cadherin "switch" and vimentin expression as markers of EMT process in tongue OSCC. Thus, we analyzed 15 cases of tongue OSCC by enzymatic double immunohistochemistry using the following double pairs of antibodies: E-cadherin/vimentin and N-cadherin/E-cadherin. E-cadherin reactivity was recorded in all the investigated cases, the pattern of expression being both membranous and cytoplasmic, with the membrane pattern decreasing simultaneously with the decrease of the differentiation degree and with the increase of invasion phenotype, while the cytoplasmic pattern had an opposite behavior. Tumor parenchyma reactivity for vimentin was noticed in 73.3% and its expression was more obvious in tumor cells from the periphery of proliferative islands and in acantholytic carcinomatous cells. N-cadherin reactivity was restricted to only 33.33% of the investigated cases and its expression was prevalent in poorly differentiated forms. In conclusion, in tongue squamous cell carcinomas at the invasion front the E-cadherin reactivity decreases while vimentin expression increases, with a cytoplasmic N-cadherin reactivity in a few of the observed cases. This EMT phenotype was correlated with the decrease of differentiation degree, with the increase of the type of invasion pattern and with increasing disease' stages and thus these EMT markers could be used for prognostic stratification of such patients.

The role of immunohistochemistry in diagnosing a synchronous colon tumor.

Simultaneous presence of an epithelial and lymphoid tumor of the digestive tract is quite rarely met in literature. In this paper, we describe a case which presented such an association. Diagnosis was established by histological study, followed by immunohistochemistry. It is a synchronous colon tumor, associating a non-Hodgkin's lymphoma to a colon adenocarcinoma. The 57-year-old male patient has been clinically diagnosed with a tumor of the left abdominal quadrant and paraclinically (imaging and endoscopic) with colon neoplasm. Exploratory laparotomy revealed two tumors: one tumor of five centimeters in the sigmoid, with firm consistency, mobile on lower plans and the second tumor in the ceco-ascending colon, measuring about 7 cm, irregular, with firm consistency, mobile on lower plans, with lymph nodes extending to retroperitoneal space. The urinary bladder, kidneys, liver and stomach were of normal aspect. Subtotal colectomy was performed with latero-lateral ileo-sigmoid anastomosis. Microscopic examination revealed sigmoid tumor as G1 adenocarcinoma and cecal tumor as B-cell type lymphoma. Immunohistochemistry established the final diagnosis of cecal localization being a diffuse immunoblastic large B-cell non-Hodgkin's malignant lymphoma. The final diagnosis of this patient was actually a synchronous manifestation of a colon adenocarcinoma and non-Hodgkin's lymphoma. This association puts into question synchronous tumors etiopathogeny matter.