Juvenile psammomatoid ossifying fibroma of maxilla: A case report

Juvenile psammomatoid ossifying fibroma is histological variant of juvenile ossifying fibroma, a fibro-osseous tumor of craniofacial bones with benign but potentially aggressive nature. Complete excision of tumor is essential as it is associated with very high recurrence rate. We have reported here a case of juvenile ossifying fibroma- a psammomatoid variety present in right maxilla in a 13-year old male child. Complete excision of tumor was done through intra-oral approach with the 2.5 years of follow up shows no recurrence.Juvenile psammomatoid ossifying fibroma is fibro-osseous tumor of craniofacial bones with benign but potentially aggressive nature. Complete excision of tumor is essential as it is associated with very high recurrence rate.

Basal cell carcinoma trends in Thailand: a 10-year retrospective study of demographic, clinical and histopathological features

Background: Basal cell carcinoma (BCC) is the most common skin cancer with globally increasing incidence. To date, the information regarding BCC in Thailand is limited.Objective: To evaluate the demographic, clinical, histopathological trends of BCC and other contributing factors.Methods: We retrospectively reviewed the demographic, clinical and histological data of all BCC outpatients from January 2009 to December 2018.Results: From 278 BCC patients recruited to this study, most of them (71.6%) were older than 60 years old. The most common histological subtype was nodular BCC (63.3%). A statistically significant association was observed between histological variant and location of the tumor; H and M area were associated with nodular BCC, L area was related to superficial subtype (p-value < 0.001). Misdiagnosis of BCC was observed in 53 cases, mostly as melanocytic nevus (30.2%), and about quarter (26.4%) was made by board-certified dermatologists.Conclusions: Nodular BCC is significantly associated with H and M area, while superficial subtype is related to L location. Quarter of the patients already have large tumors at their first presentation. Misdiagnosis of BCC is not uncommon.

Papillary craniopharyngioma: a type of tumor primarily impairing the hypothalamus. A comprehensive anatomo-clinical characterization of 350 well-described cases

Objective: Papillary craniopharyngiomas (PCPs) represent a rare histological variant of craniopharyngiomas (CPs) usually involving the hypothalamus. This study systematically analyzes the clinical-anatomical correlation between tumor topography and symptoms related to hypothalamic dysfunction in the largest series of PCPs ever gathered. Methods: From 5,346 CP reports published from 1856 to 2021, we selected 350 well-described cases of the squamous-papillary type. Clinical presentation, tumor topography, severity of hypothalamic adhesion, patient outcome and tumor recurrence were thoroughly analyzed. Results: PCPs predominantly occur in adult (96.3%), male (61.7%) patients presenting with headache (63.4%), visual alterations (56.2%) and psychiatric disturbances (50.4%). Most PCPs are solid (50%), round (50%) lesions that occupy the third ventricle (3V, 94.8%) and show low-risk severity adhesions to the hypothalamus (66.8%). Two major topographical categories can be found: strictly 3V (57.5%), growing above an intact 3V floor (3VF) and not-strictly or infundibulo-tuberal (32.9%), expanding at the infundibulum and/or tuber cinereum. The hypothalamic syndrome predominated among strictly 3V PCPs (p<0.001). Psychiatric symptoms (p<0.001) and high-risk hypothalamic attachments (p=0.031) related to unfavorable postoperative outcomes among patients treated from 2006 onwards. The not-strictly 3V topography was identified as the major predictor of high-risk hypothalamic attachments (71.2% correctly predicted), which, along with incomplete tumor removal (p=0.018), underlies the higher tumor recurrence of this topography (p=0.001). Conclusions: This systematic review evidences that PCP topography is a major determinant of hypothalamic-related symptoms, type of hypothalamic attachments and tumor recurrence rate. Accurate preoperative definition of PCP-hypothalamus relationships is essential for the judicious, safe management of these complex lesions.

P16 expression and clinicopathological features of oral and oropharyngeal squamous cell carcinoma

Background: There is an epidemiological shift in head and neck squamous cell carcinoma (HNSCC) attributable to HPV infection. HPV positive HNSCC has unique biology, risk factors, clinicopathological characteristics and outcome. There is a large variation in the published prevalence of HPV-related HNSCCs in India ranging from 7 to 78.7%. This study aims to find the P16 expression in the oral cavity and oropharyngeal SCC, thereby prevalence of HPV in our setting and to define the clinicopathological characteristics of HPV positive tumours in our setting.Methods: 210 specimens of primary Oral squamous cell carcinoma (OSCC) and Oropharyngeal Squamous cell carcinoma (OPSCC) were included. Immunohistochemistry was done using monoclonal mouse p16 antibody. Clinical details of each case were collected. Analysis was done using SPSS software and the association of P16 and clinicopathological variables were calculated using Fishers exact test.Results: P16 positive expression is observed only in 1/122 (0.82%) of OSCC and 8/88 (9%) of OPSCC. P16 positivity showed significant association with Grade of tumor (p= 0.008) and histological variant of SCC (p=0.00). 77.7% of P16 positive tumours are Grade 2 and 66.6% of Basaloid SCC was P16 positive. There is no significant association between p16 expression and other variables (subsite, age, gender, alcoholism, smoking, betel chewing and stage).Conclusions: P16 positivity was higher in oropharyngeal than in oral cancer. However, the HPV positivity rates are lower than other parts of India.

Giant cell angioblastoma

Giant cell angioblastoma is an extremely rare tumor of vascular origin, described at the end of the 20th century. It belongs to tumors with intermediate malignant potential and is characterized by locally infiltrative growth. The tumor doesn’t have any clear distinctive clinical characteristics. The diagnosis is established on the basis of histological examination. Two main treatment options for this pathology are discussed in the literature: radical removal of the tumor and therapy with low doses of interferon alpha. As a rule, this is a combination treatment. This article describes our own clinical case. The patient’s parents gave their consent to the use of their child’s data, including photographs, for research purposes and in publications. Interest is in the rarity of the disease and the features of the clinical characteristics of this case, specifically the extremely unfavorable localization in the oropharynx region and, accordingly, the impossibility of carrying out not only a radical removal of the tumor, but also its resection. The high probability of developing irreversible neurological complications in this age group associated with interferon alpha therapy questioned the possibility of its use. For the first time in this histological variant of a vascular tumor, chemotherapy was applied, including metronomic therapy with cyclophosphamide and vinblastine in combination with a liposomal form of doxorubicin. After 8 courses of chemotherapy, a complete clinical response was obtained with the restoration of the patency of the respiratory and digestive tracts. The observation period at the time writing of this article was 36 months.

Xanthomatous meningioma, a rare histological variant: Case report

Xanthomatous meningioma is a WHO grade I metaplastic meningioma where neoplastic cells contain lipid-filled vacuolated cytoplasm. The origin of xanthomatous meningiomas is believed to be from meningothelial cells but diagnosis remains difficult because of their close resemblance with the histiocytes. Peculiar radiographic features may aid in diagnosis, however, definitive diagnosis requires immunohistochemical staining. We report a case of 43-year-old male with sphenoid wing meningioma revealing xanthomatous changes and received treatment as grade 1 meningioma. Though the exact pathophysiology remains unknown, we believe focal or gross metaplastic changes lead to transformation of tumor cells into the xanthomatous subtype. Authors discuss this interesting a rare histologic variant with discussion of the relevant literature.

Intramedullary Sclerosing Meningioma in Meningiomatosis: Case Report and Review of the Literature

Sclerosing meningioma is a rare histological variant of meningioma, first described in the literature by Davidson and Hope in 1989 as an invasive bulking mass consisted of whorling collagen bundles with a minimum percentage of meningothelial resembling cells [1]. The literature showed very rare cases of the intramedullary location of sclerosing meningiomas: in our opinion, it is mandatory to describe its clinical, surgical, histological and immunohistochemical features in order to reach the best final outcome. Sclerosing meningiomas are often misdiagnosed because of their invasive behaviour: it does require a correct diagnosis in order to prevent unnecessary postoperative treatment. Literature reports only 30 cases of sclerosing meningiomas and only 2 of them are intramedullary. We present the case of a cervical intramedullary sclerosing meningioma presenting with gait disturbances, sensory deficits, four extremities weakness and hypereflexia in a patient with the history of meningiomatosis.

CLINICAL AND EPIDEMIOLOGICAL FEATURES OF OVARIAN NEOPLASMS IN GRODNO REGION

Background. When providing specialized medical care and planning preventive measures, analysis of epidemiological data is instrumental in determining what should be done to reduce morbidity and mortality from ovarian malignant neoplasms (OMNs) within the given scenario. Purpose of research. To study the epidemiological situation with OMNs in the Grodno region. Material and methods. The OMN incidence and indicators of the quality of oncological care in the Grodno region were analyzed according to the data obtained from the Belarusian cancer registry. Results. Since 2007, the OMN morbidity and mortality rates have been relatively stable. In most cases, the diagnosis of malignant ovarian pathology has been based on the results of a pathomorphological investigation. The histological variant of the neoplasm significantly affects the prognosis for life. The most common neoplasms are serous ovarian carcinomas (69%). Neoplasms of non-epithelial origin occur in 8% of all cases. About 16% of women have multiple primary neoplasms with ovarian involvement. In most cases of metachronous development of polyneoplasia the ovarian neoplasm occurs last. The analysis of the age-specific morbidity showed that OMN was most often (52%) diagnosed at the age of 46-65 years. During the study period, about 70% of neoplasms were diagnosed at a later stage, 10% of patients were incurable and received only symptomatic therapy. The indicators of the quality of oncological care demonstrate an increase in the number of cases diagnosed at an early stage. In 2019, in the Grodno region, OMNs of stage I-II were diagnosed in 42% of patients. Conclusion. To improve oncological care for the population and reduce morbidity and mortality from OMNs, it is necessary to develop and implement a set of measures aimed primarily at early diagnosis of the disease and prevention of neoplasm development in the case of primary multiple forms.

Primary Epithelioid Rhabdomyosarcoma of the Liver: Case Report of an Unusual Histological Variant

Rhabdomyosarcoma (RMS) is a soft tissue tumor with striated muscle cell differentiation. It mostly occurs in children. While it can affect any part of the body, it commonly involves the urogenital organs, head and neck including the parameninges and orbit, and limbs. We describe an adult case of primary epithelioid RMS of the liver. A 71-year-old man presented with a 5.6 cm liver mass. Tumor histology revealed diffuse proliferation of small epithelioid cells and focal spindle cells. The tumor cells were immunohistochemically positive for myogenin (positive ratio 30%), desmin, Myo D1, and CD56. The tumor weakly expressed MDM2 and did not express CDK4. This suggested that dedifferentiated liposarcoma with a rhabdomyosarcomatous component was unlikely. There was no fusion gene of PAX3-FKHR or PAX7- FKHR to indicate alveolar RMS by RT-PCR. Subsequently, RNA Pan-Cancer Targeted sequencing was performed for 1385 genes revealed a single base substitution (c.742C>T) in TP53 that changes an amino acid (p.Arg248Trp). No fusion gene was found. No other primary RMS lesions were detected aside from the liver lesion. The tumor was diagnosed as a primary epithelioid RMS of the liver. His RMS already metastasized to the lymph nodes of the entire body. The patient declined further therapy and died one year later. This was the first case report of a primary epithelioid RMS of the liver.

Medullary Carcinoma of the Gastrointestinal Tract: Report on Two Cases with Immunohistochemical and Molecular Features

Medullary carcinoma of the colon is a rare histological variant characterized by a poorly differentiated morphology, an aberrant immunophenotype, and microsatellite instability. Despite the lack of glandular differentiation, medullary carcinoma is reported to have a good prognosis. It is typically located in the right colon and frequently affects older women. Due to its clinical, histological, biological, and genetic peculiarity, medullary carcinoma requires an accurate diagnosis and the awareness of this diagnostic possibility. We describe the morphological, immunohistochemical, and molecular findings of two interesting cases, the first one in the right colon of a patient and the second one in the terminal ileum of a patient with Crohn’s disease. Deeper knowledge of all the biological and clinical features will allow appropriate and specific treatment of this tumor in the future.