scholarly journals Unique case of inverted papilloma of septum with nasopharyngeal carcinoma: Is it a metachronous tumour?

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092203
Author(s):  
Susanne Flach ◽  
Aaron SJ Ferguson ◽  
Sharon White ◽  
Paul S White ◽  
Jaiganesh Manickavasagam
Keyword(s):  
Malignant Transformation ◽  
Inverted Papilloma ◽  
High Rate ◽  
Unique Case ◽  
Solitary Lesion ◽  
Poorly Differentiated Carcinoma ◽  
Nasopharyngeal Biopsy ◽  
Poorly Differentiated ◽  
The Right

Inverted papilloma is a rare and benign tumour. It affects the nasal cavity and paranasal sinuses, has a high rate of recurrence and is associated with malignant transformation. Only few cases of a poorly differentiated carcinoma arising from inverted papilloma have been reported, none of which in the nasopharynx. We report a case of a 37-year-old female, who presented originally in 2012 with inverted papilloma of the nasal septum which was surgically resected. Nasopharyngeal biopsy from 2014 was reported as carcinoma in situ and treated with local endoscopic resection. Three years later she presented with a solitary lesion of the right Eustachian tube opening, confirmed as invasive poorly differentiated carcinoma. Imaging revealed T4 N2b M0 malignancy with skull base and prevertebral space invasion, likely extension into right temporal lobe and malignant adenopathy. Although rare, malignant transformation of inverted papilloma in unusual places should be considered during workup and monitoring of patients.

scholarly journals Challenging Diagnosis in NUT Carcinoma

2021 ◽  
pp. 106689692110195
Author(s):  
Grosse Claudia ◽  
Grosse Alexandra
Keyword(s):  
Nuclear Protein ◽  
Hematological Malignancy ◽  
Undifferentiated Carcinoma ◽  
Squamous Differentiation ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Nut Carcinoma ◽  
Disseminated Disease ◽  
Generation Sequencing

Nuclear protein in testis (NUT) carcinoma represents a highly aggressive, poorly differentiated carcinoma that is genetically defined by rearrangement of NUT gene. The histomorphological appearance ranges from entirely undifferentiated carcinoma to carcinoma with prominent squamous differentiation. NUT carcinoma can display neuroendocrine features. Although it is typically distributed along the midline axis, it may manifest in nonmidline locations. The majority of patients develop rapidly disseminated disease. We illustrate 2 cases of NUT carcinoma, one located in the lung, which closely resembled a neuroendocrine carcinoma, and the other one with assumed lung origin demonstrating metastatic dissemination with diffuse bone involvement, which was clinically first suspected to be a hematological malignancy. Due to its undifferentiated nature, NUT carcinoma may be confused with many entities. NUT immunohistochemistry is considered to be sufficient for the diagnosis. Fluorescence in-situ hybridization analysis and next-generation sequencing are currently used to confirm the diagnosis.

Clinical Implications of Carcinoma In Situ in Sinonasal Inverted Papilloma

2019 ◽  
Vol 161 (6) ◽  
pp. 1036-1042 ◽  
Author(s):  
Ivy W. Maina ◽  
Charles C. L. Tong ◽  
Esther Baranov ◽  
Neil N. Patel ◽  
Vasiliki Triantafillou ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Recurrence Rate ◽  
Carcinoma In Situ ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Definitive Surgery ◽  
Severe Degree ◽  
Multiple Recurrences

Objective Sinonasal inverted papilloma (IP) is a typically benign sinonasal tumor with a tendency to recur and the potential for malignant transformation. Varying degrees of dysplasia may be present, of which carcinoma in situ (CIS) is most advanced. We hereby describe the biological and clinical behavior of IP with CIS (IPwCIS). Study Design Retrospective cohort. Setting Tertiary academic referral center. Subjects and Methods Patients who underwent surgical resection for IP between 2002 and 2017. Pertinent clinical data were obtained, and all IPwCIS cases were histologically confirmed. Results In total, 37 of 215 cases (17.2%) were identified with IPwCIS. Mean age was 57 years and 86.5% of patients were male. Median follow-up was 82 months, and the recurrence rate was 27%. The maxillary sinus was the most common primary site (37.8%) and 14 tumors (37.8%) demonstrated multifocal attachment, which was associated with recurrence (odds ratio [OR], 9.7; 95% confidence interval [CI], 1.4-112.8; P = .028). IPwCIS was also associated with multiple recurrences (OR, 2.71; 95% CI, 1.246-5.814; P = .021). Most patients were treated with surgery alone (89.1%) and 4 patients received adjuvant radiotherapy (8.1%). Only 1 patient (2.7%) demonstrated malignant transformation after definitive surgery. Conclusions IPwCIS represents the most severe degree of dysplasia prior to malignant transformation and is associated with higher recurrence rate and multifocal involvement but low rate of conversion to invasive carcinoma. The need for adjuvant therapy remains controversial, and further research into the etiology of the disease is warranted.

scholarly journals Rare Leiomyoma of the Tunica Dartos: A Case Report with Clinical Relevance for Malignant Transformation and HLRCC

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Robert C. Bell ◽  
Evan T. Austin ◽  
Stacy J. Arnold ◽  
Frank C. Lin ◽  
Jonathan R. Walker ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Renal Cell ◽  
Cell Cancer ◽  
Surgical Excision ◽  
High Rate ◽  
Case Presentation ◽  
Increased Risk ◽  
The Right ◽  
Cutaneous Leiomyomas

Background. Genital leiomyomas fall under the broader category of cutaneous leiomyomas, which are rare smooth muscle neoplasms accounting for 5% of all leiomyomas. Genital leiomyomas arising from the dartos muscle are exceedingly rare with fewer than 30 cases reported in the literature. They are typically benign and adequately treated with simple surgical excision; however, previously reported cases of malignant transformation and a possible link to the hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome warrant closer follow-up.Case Presentation. We report a case of a 47-year-old male refugee from Rwanda found to have a mobile, pea-sized, mildly painful scrotal lesion near the left penoscrotal junction and 1.5 cm indeterminate vascular mass in the right kidney. Surgical excision of the scrotal nodule was performed and the diagnosis of a dartoic leiomyoma was rendered. The presence of moderate nuclear atypia, rare mitotic activity, and close surgical margins prompted a wide reexcision. We report the surgical approach, pathologic findings, and clinical follow-up related to this scrotal lesion.Conclusion. Scrotal leiomyomas demonstrate a high rate of recurrence and pose a risk for malignant transformation. They may also indicate an underlying autosomal dominant syndrome associated with increased risk for development of an aggressive form of renal cell carcinoma. When discovered, management should include surgical excision, screening for syndromic features, and routine follow-up.

Recurrent malignant proliferating trichilemmal tumour of the scalp: a case report

2015 ◽  
pp. 1-4
Author(s):  
Lohith G. Reddy ◽  
Vijetha Jayakumar ◽  
Sudhan Rajan ◽  
Ramesh S. Bilimagga ◽  
V. Priyadarshini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Malignant Transformation ◽  
Distant Metastases ◽  
Outer Root Sheath ◽  
Solitary Lesion ◽  
Electron Therapy ◽  
Root Sheath ◽  
The Right ◽  
Disease Free

AbstractIntroductionProliferating trichilemmal tumour (PTT) is a benign tumour originating from the outer root sheath of a hair follicle. In rare instances, malignant transformation has been reported, evidenced by regional or distant metastases. Malignant transformation of PTT is often confused with squamous cell carcinoma. PTT usually occur as a solitary lesion on the scalp. It was first described as a proliferating epidermoid cyst by Wilson-Jones in 1966.Case descriptionA female patient presented with a growing lesion on scalp in the right parietal region. She had already undergone excision for the same 8 months ago. The cyst was surgically removed and scalp was treated with electron therapy using a field dimension of 8×8 cm in 2011. Now, the patient is disease free with good quality of life.ConclusionOncologists can consider electron therapy in management of PTT. This can improve cosmesis and quality of life of these patients.

Tumor-to-tumor metastasis: esophageal carcinoma metastatic to an intracranial paraganglioma

2009 ◽  
Vol 110 (4) ◽  
pp. 744-748 ◽  
Author(s):  
Jian-Qiang Lu ◽  
Moosa Khalil ◽  
William Hu ◽  
Garnette R. Sutherland ◽  
Arthur W. Clark
Keyword(s):  
Esophageal Carcinoma ◽  
Tumor Metastasis ◽  
Histopathological Examination ◽  
Unique Case ◽  
Blurred Vision ◽  
Poorly Differentiated Carcinoma ◽  
History Of ◽  
Poorly Differentiated ◽  
Tumor To Tumor Metastasis ◽  
Upper Gastrointestinal

Tumor-to-tumor metastasis (TTM) is a relatively rare but well-documented phenomenon. The authors report a unique case of esophageal carcinoma metastatic to an intracranial paraganglioma. A sellar and suprasellar tumor was found using MR imaging in an 81-year-old man who presented with a 3-week history of progressive headache and blurred vision. A subtotal excision of the tumor was achieved. Histopathological examination of the tumor disclosed a neoplasm with two distinct components: one showing the classic Zellballen pattern of a paraganglioma, the other exhibiting malignant features leading to the diagnosis of a poorly differentiated carcinoma metastatic to a sellar/suprasellar paraganglioma. The primary esophageal carcinoma was not uncovered until 2 months later, after the patient presented with upper gastrointestinal bleeding. The patient died 4 months after initial presentation. This case expands the spectrum of TTM, and emphasizes the importance of TTM in the practice of pathology.

scholarly journals Carcinoma with Triphasic Differentiation Arising from Inverted Papilloma in Sinonasal Sinus: A Rare Case with Molecular Characterization

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1827
Author(s):  
So-Woon Kim ◽  
Kiyong Na
Keyword(s):  
Sarcomatoid Carcinoma ◽  
Excisional Biopsy ◽  
Inverted Papilloma ◽  
Molecular Characteristics ◽  
Rare Presentation ◽  
Oncogenic Mutations ◽  
Spindle Cell Proliferation ◽  
The Right ◽  
Maxillary Sinuses

Small cell neuroendocrine carcinoma (SNEC) is a rare subset of tumors in the sinonasal sinus. Combined tumors are exceedingly rare. Here, we describe a 65-year-old male with a mixed tumor of SNEC and sarcomatoid carcinoma arising in an inverted papilloma, containing squamous cell carcinoma in situ (SqCCis) in the sinonasal sinus. We evaluated the molecular characteristics of the two separate carcinoma components using next-generation sequencing. The patient presented with a nasal obstruction. Computed tomography showed a mass infiltrating the right ethmoid and maxillary sinuses. An excisional biopsy was performed. The tumor was found to have three morphologically distinct components. The first was SqCCis arising in an inverted papilloma, which was positive for cytokeratin and P40. The second consisted of nests of densely packed small round cells representing SNEC-positive neuroendocrine markers. The third was a solid sheet of anaplastic spindle cell proliferation, which was negative for the above markers. Oncogenic mutations such as FBXW7, TP53, and EGFR were detected in both SNEC and sarcomatoid carcinoma, and MYCL amplification was observed only in the SNEC component. This case highlights an extremely rare presentation of combined SNEC and sarcomatoid carcinoma arising from an inverted papilloma in the sinonasal sinus.

Epiphora as a sign of unexpected underlying squamous cell carcinoma within sinonasal inverted papilloma

2020 ◽  
Vol 4 (5) ◽  
pp. 01-04
Author(s):  
Filippo Confalonieri
Keyword(s):  
Squamous Cell Carcinoma ◽  
Nasal Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Inverted Papilloma ◽  
High Rate ◽  
Sinonasal Inverted Papilloma ◽  
The Right

Backgorund: Sinonasal inverted papilloma (SIP) is a benign tumor of the nasal cavity and sinus. It is characterized by aggressive malignant transformation and a high rate of recurrence. Inadequate removal of the tumor during surgery is one of the most significant contributors to recurrence. SIP has been reported to rarely occur in conjunction with Squamous Cell Carcinoma (SCC) invading the lacrimal drainage system and the orbit. The mechanism of this secondary SCC transformation has yet to be explained. Case presentation: Herein, the authors present the case of a 66-year-old woman with a rapidly enlarging sinonasal inverted papilloma with secondary squamous cell carcinoma of the right nasal cavity presenting with epiphora. Conclusions: Nasolacrimal duct obstructions require a thorough examination as it may hide a malignant pathology.

scholarly journals Adrenocortical sarcomatoid carcinoma: a case report and review of the literature

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Derqaoui Sabrine ◽  
Bernoussi Zakia ◽  
Znati Kaoutar
Keyword(s):  
Poor Prognosis ◽  
Sarcomatoid Carcinoma ◽  
Rare Entity ◽  
Rare Cancer ◽  
Review Of The Literature ◽  
Epithelioid Cells ◽  
Poorly Differentiated Carcinoma ◽  
S 100 ◽  
Poorly Differentiated ◽  
The Right

Abstract Adrenal sarcomatoid carcinoma (ASC) is a very rare aggressive variant of adrenocortical carcinoma showing carcinomatous and sarcomatous differentiation. It is a poorly differentiated carcinoma with poor prognosis. The diagnosis requires careful histological and immunohistochemical investigation. We describe a new case of ASC to raise awareness on this extremely rare entity. A 27-year-old woman presented with a right flank pain. Imaging revealed a tissular mass of the right adrenal gland without metastases. After adrenalectomy, histology revealed sheets of epithelioid cells that stained for synaptophysin and Melan-A; and spindled cells staining for S-100. We have reported the clinical and histopathological features of ACS’s case; as it is an extremely rare cancer with a challenging diagnosis. There is a need for a further understanding of ASC’s biology to improve it poor prognosis.

Phase I/II study of the CAPABLE regimen for patients with poorly differentiated carcinoma of the nasopharynx.

1998 ◽  
Vol 16 (7) ◽  
pp. 2514-2521 ◽  
Author(s):  
L L Siu ◽  
P M Czaykowski ◽  
I F Tannock
Keyword(s):  
Phase I ◽  
Metastatic Disease ◽  
Response Rate ◽  
Complete Response ◽  
High Rate ◽  
Similar Response ◽  
Poorly Differentiated Carcinoma ◽  
Local Disease ◽  
Prospective Phase ◽  
Poorly Differentiated

PURPOSE To evaluate the role of aggressive combination chemotherapy in patients with poorly differentiated carcinoma of the nasopharynx (NPC). PATIENTS AND METHODS In a prospective phase I/II study, 90 chemotherapy-naive patients with NPC (21 with very advanced locoregional disease, 18 with locoregional persistent and/or recurrent disease postradiotherapy, and 51 with metastatic disease) were treated with cyclophosphamide, doxorubicin, cisplatin, methotrexate, and bleomycin (CAPABLE). Two schedules of this regimen were used over a 9-year period, with the second schedule being a modification of the first in an attempt to minimize treatment-related toxicity. RESULTS Of 21 patients with very advanced local disease, one had a complete response (CR) and 17 had partial responses (PRs) (response rate, 86%). Seventeen of these 21 patients had subsequent radiotherapy. Of 17 patients with measurable locoregional disease either persistent and/or recurrent postradiotherapy, there were four CRs and three PRs (response rate, 41%). Of 44 patients with measurable metastatic disease, there were three CRs and 32 PRs (response rate, 80%). The median survival durations for these three groups of patients were 47, 16, and 14 months, respectively. The two chemotherapy schedules had similar received dose-intensities (RDIs) and produced similar response rates and survival. Toxicity was severe with frequent mucositis and myelosuppression. Overall, 37 patients required at least one hospital admission for management of toxic side effects and there were seven drug-related deaths. Three of the deaths were due to fulminant hepatitis, likely from reactivation of hepatitis B. CONCLUSION This aggressive regimen provides a high rate of tumor response, but limited palliation for most patients with recurrent or metastatic NPC. The results with chemotherapy followed by radiotherapy for patients with very advanced local disease are encouraging, but proof of benefit would require evaluation in a randomized trial.

scholarly journals Melan-A Expression in Poorly Differentiated Carcinoma of Lung: A Potential Diagnostic Pitfall

2021 ◽  
Author(s):  
wenyong huang ◽  
Shuixian Li ◽  
Guofeng Zhu ◽  
Lei Zeng ◽  
Yueer Zheng ◽  
...  
Keyword(s):  
Diagnostic Marker ◽  
Large Mass ◽  
Melanocytic Tumors ◽  
Diagnostic Pitfall ◽  
Poorly Differentiated Carcinoma ◽  
First Case ◽  
Poorly Differentiated ◽  
Differentiation Marker ◽  
The Right ◽  
Melanocytic Differentiation

Abstract BackgroundMelan-A/MART-1 is a melanocytic differentiation marker, which is recognized as an antigen on melanoma cells. It is relevant for pathologists as a useful diagnostic marker in the diagnosis of melanocytic tumors. However, the expressional pattern of Melan-A in poorly differentiated carcinoma of lung has never been reported so far.Case presentationHere, we report a 77-year-old female patient who presented with a large mass in the right lung and was subsequently diagnosed with a poorly differentiated carcinoma of lung. We unexpectedly found that the carcinoma in this patient exhibited diffuse Melan-A expression. ConclusionThis is the first case reported of a poorly differentiated carcinoma of lung with Melan-A expression. This report shows that Melan-A can express in poorly differentiated carcinoma, and highlights a potential diagnostic pitfall in the diagnosis of carcinoma, which urges pathologists to exercise caution in cases where Melan-A positivity and illustrates the need for further immunohistochemical or molecular examination to avoid misdiagnosis.

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