Epithelial-myoepithelial carcinoma on lower lip and microinvasive verrucous carcinoma in vocal cord: Case report.

Epithelial-myoepithelial carcinoma is a biphasic low-grade malignant tumor, which represents approximately 1% of all salivary gland tumors. This tumor occurs mostly in the parotid gland, followed by submandibular gland and minor salivary glands. Women, mostly fifth to the eighth decade of life, are commonly affected. Histopathologically, epithelial-myoepithelial carcinoma is composed of an inner single layer of eosinophilic cuboidal ductal cells and outer single or multiple layers of clear myoepithelial cells. We present a case of a 69 years old man who had a scar on lower the lip for 10 years and voice annoyance for three months. The biopsy for lower lip was reported "infiltrative clear cell epithelioid neoplasm" and vocal cord biopsy result was "verrucous carcinoma". After cordectomy and wedge resection of the lower lip, histopathology revealed Epithelial-Myoepithelial Carcinoma for the lower lip and microinvasive verrucous carcinoma for the left vocal cord. Our case has a very uncommon location and presentation for EMC. The tumor location was minor salivary glands of the lower lip and the clinical presentation was quite different. Coexistence with microinvasive verrucous carcinoma of the vocal cord is the other unique part of our case.

An incidental giant preperitoneal fibrolipoma diagnosed during laparoscopic cholecystectomy.

Preperitoneal lipomas are rare in clinical practice. Here we report an unexpected diagnosis of a giant preperitoneal fibrolipoma detected intraoperatively during laparoscopic cholecystectomy in a 56-year-old woman. The mass was excised and a histopathological examination confirmed fibrolipoma. No recurrence was found on follow-up. In the literature, there have been many cases with unexpected diagnoses during laparoscopy. Here, we present an incidental giant preperitoneal fibrolipoma, which was overlooked by ultrasound and physical examination, but was detected during laparoscopic cholecystectomy.

Pleomorphic adenoma of the larynx.

Pleomorphic adenoma (PA) is the most common benign neoplasm of the salivary glands. It usually occurs in major salivary glands, such as the parotid and submandibular glands. Occasionally, however, it occurs in the larynx. These lesions generally present as a slow-growing, painless mass. Malignant transformation is very rare, but it increases with time. The present report is the case of a 59-year-old male who presented with a complaint of hoarseness. Right vertical partial hemilaryngectomy revealed an intact, mucosa-covered, fleshy 2×1.5×1 cm mass in the supraglottic area of the larynx. Lesion had histological characteristics of a PA, and this was confirmed by immunohistochemical expression of cytokeratin, S100 protein, Glial fibrillary acidic protein (GFAP) and vimentin. Their histopathological identification is, however, not always straightforward; immunohistochemistry can contribute significantly to formulation of a definitive diagnosis and to the realization of appropriate follow-up.

A Rare Cause of Prepubertal Gynecomastia: Sertoli Cell Tumor.

Prepubertal gynecomastia due to testis tumors is a very rare condition. Nearly 5% of the patients with testicular mass present with gynecomastia. Sertoli cell tumors are sporadic in 60% of the reported cases, while the remaining is a component of multiple neoplasia syndromes such as Peutz-Jeghers syndrome and Carney complex. We present a 4-year-old boy with gynecomastia due to Sertoli cell tumor with no evidence of Peutz-Jeghers syndrome or Carney complex.

Classic Mediterranean type of epiglottic Kaposi sarcoma.

Kaposi sarcoma is a malignant, multifocal, vascular, and low-grade tumor that mostly occurs in mucocutaneous sites. Kaposi sarcoma is usually associated with acquired immunodeficiency syndrome and involves lymphatic nodes and visceral organs. In this report, an 81-year-old man with epiglottic Kaposi sarcoma who screened negative for human immunodeficiency virus is presented.

Clinical significance of benign endometrial cells found in papanicolaou tests of Turkish women aged 40 years and older.

BACKGROUND: Spontaneously exfoliated benign-appearing endometrial cells (BEC) on a Papanicolaou smear might indicate endometrial pathology in postmenopausal women, necessitating further investigation. A cut-off age of 40 years was included in the Bethesda System 2001 based on studies of clinical significance of endometrial cells in Pap smears in Western countries. AIMS: The purpose of this study was to determine the significance of age subgroup for women with a cytological diagnosis of BEC, regardless of menopausal status, in a retrospective cohort of Turkish women. MATERIALS AND METHODS: Between October 2006 and November 2011, 41 patients with a BEC diagnosis and 64 patients with a cytological diagnosis of normal smear (NS) were enrolled; regardless of menopausal status, these women were 40 years and older and for whom follow-up endometrial biopsies had been performed. RESULTS: On subsequent histopathologic evaluation, no malignant lesion was detected in women aged 40-50 years compared to three endometrioid-type adenocarcinomas in women older than 50 years with cytological diagnosis of BEC. There was a significant difference between women older than 50 years with cytologic diagnosis of BEC and NS in relation to premalignant lesions on histopathologic evaluation; however, this was not the case for women aged 40-50 years. CONCLUSIONS: According to our study, reporting BEC for women aged between 40 and 50 years has minor clinical significance but is significant for women older than 50 years, regardless of menopausal status. Larger sample size would be appropriate to confirm the results of the current study.

Amniotic membrane covering for facial nerve repair.

Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3(rd) and 8(th) weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair.

Endocervical glandular involvement, positive endocervical surgical margin and multicentricity are more often associated with high-grade than low-grade squamous intraepithelial lesion.

AIM: The aim of this study was to compare the relative frequencies of endocervical glandular involvement (EGI), multicentricity, positive endocervical surgical margins (ESM) and positive vaginal surgical margins (VSM), and adenocarcinoma in situ of the cervix (AIS) between high-grade and low-grade squamous intraepithelial lesions (HSIL and LSIL, respectively). MATERIAL AND METHODS: We identified 238 patients with squamous intraepithelial lesions/cervical intraepithelial neoplasia (CIN) who were treated by loop electrocautery excision (LEEP) or conventional cold-knife conization (CKC). A total of 223 (72 [32.3%] LSIL/CIN I; 85 [38.1%] HSIL/CIN II; 66 [29.6%] HSIL/CIN III; and 151 [67.7%], HSIL/CIN II + III) LEEP/CKC slides were histologically reviewed. RESULTS: The frequencies of EGI, positive ESM, and multicentricity were significantly higher in the HSIL/CIN II + III group than in the LSIL/CIN I group (P = 0.001, 0.001, and 0.025, respectively). Eighteen of the 72 (25%) LSIL/CIN I patients, 44 of the 85 (51.8%) HSIL/CIN II patients, and 60 of the 66 (90.9%) HSIL/CIN III patients (P = 0.001) showed EGI. In four of the 72 (5.6%) LSIL/CIN I patients, 18 of the 85 (21.2%) HSIL/CIN II patients, and 42 of the 66 (63.6%) HSIL/CIN III patients (P = 0.001), ESM was positive. Two of the 72 (2.8%) LSIL/CIN I patients, seven of the 85 (8.2%) HSIL/CIN II patients, and 11 of the 66 (16.7%) HSIL/CIN III patients (P = 0.016) were multicentric. CONCLUSION: The current study showed that EGI, positive ESM and multicentricity were more often associated with HSIL/CIN II + III than with LSIL/CIN I. Moreover, the frequencies of EGI, multicentricity, and positive ESM increased with increasing severity of the cervical lesion. This result may influence the preference for the type of surgical procedure used for patients with cytological diagnosis of HSIL.

Functional capacity of the thyroid autograft and heterograft: An experimental study.

BACKGROUND: The aim of this study was to investigate the functional capacity of thyroid autografts/heterografts in a guinea pig model. METHODS: A total of 24 guinea pigs were divided into 4 groups. Group A had only a thyroidectomy incision, and group B had total thyroidectomy. We performed autotransplantation in group C and heterotransplantation in group D. We monitored the guinea pigs for an 8-week period, with weekly measurements of free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH). At the final stage, the autografts/heterografts were histologically examined. RESULTS: In group B, fT3/fT4 showed a gradual decrease; however, an increase of TSH was noted. In groups C and D, fT3/fT4 showed a gradual decrease, followed by a gradual increase until euthyroid levels; an exact opposite was noted for TSH. In histologic examination, there were functional thyroid follicles in all animals of groups C and D. CONCLUSIONS: The autotransplanted/heterotransplanted guinea pig's thyroid tissue provides adequate thyroid function.