Primary Epithelioid Angiosarcoma of the Uterus: A Rare Tumor with Very Aggressive BehaviorRead the full article
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Leiomyoma of the Cheek
Leiomyomas are rare benign tumors that grow in the tunica media of smooth muscle cells. Leiomyomas occur most frequently in the uterus or gastrointestinal tract and only very rarely in the area of the cheek. This study reports on a rare case of a leiomyoma in the cheek of a 43-year-old woman, who presented with a well-circumscribed, asymptomatic, mobile swelling in the right cheek. This swelling was slightly purplish in color and measured approximately . Surgical excision was the treatment of choice, and the diagnosis was based on histopathological and immunohistochemical stains, which were positive for actin and desmin and negative for AE1/AE3, CD34, and S100. The patient’s follow-up, two years later, showed no recurrence, and she has been asymptomatic since the surgery.
Late Recurrence in Ovarian Dysgerminoma Presenting as a Primary Retroperitoneal Tumor: A Case Report and Review of the Literature
Ovarian dysgerminoma is a rare type of germ cell tumor. The majority of patient relapses occur within 2 years of diagnosis. Here, we report the case of a 74-year-old woman with a history of ovarian dysgerminoma 39 years earlier. The patient visited the hospital presenting with heartburn. An abdominal computed tomography (CT) revealed a right retroperitoneal mass, and a primary retroperitoneal tumor was suspected. She underwent surgical resection of the retroperitoneal tumor. Histological examination confirmed a metastatic dysgerminoma to the retroperitoneum. Postoperative CT showed paraaortic and cervical lymph node metastases. The patient was treated with bleomycin, etoposide, and cisplatin chemotherapy. This case demonstrates the difficulties that may be encountered in the differential diagnosis of a retroperitoneal mass and underlines the necessity for understanding a patient’s clinical history.
Cholangiolytic Changes in Statin-Induced Liver Injury
Atorvastatin is a commonly used oral cholesterol-lowering agent. Side effects associated with statin therapy include arthralgia, myalgia, dyspepsia, weakness, and headache. Prospective and retrospective studies of drug-induced liver injury have identified statin-induced hepatotoxicity, with atorvastatin being the most commonly cited. Associated liver function test elevations have varied from hepatocellular to cholestatic/mixed pattern. We report a case of a 58-year-old woman that illustrates unusual histologic findings associated with a mixed pattern of statin-induced liver injury. While being treated with atorvastatin, the patient exhibited repeated bouts of abdominal pain over a year associated with biliary tree dilation, variably attributed to postcholecystectomy dilation and stenosis of the ampulla of Vater. Following sphincterotomy, the patient’s bilirubin normalized but the other liver function tests remained elevated. Liver biopsy revealed portal and lobular inflammation with cholangiolysis. The patient’s liver function tests normalized following cessation of atorvastatin therapy.
Collision Glial Neoplasms Arising in an Ovarian Mature Cystic Teratoma: A Rare Event
Germ cell neoplasms represent around 20% of all ovarian tumors. They most frequently affect children and young adults. Mature cystic teratoma is a common benign ovarian neoplasm comprising about 95% and is made up of all three germ cell embryonic layers. By definition, mature cystic teratoma may be derived from any of the three germ cell lines. On the other hand, immature teratomas contain primitive neuroepithelial elements. However, it is quite uncommon in the English literature to have a neuroepithelial glial neoplasm arising in a mature cystic teratoma of an adolescent. Interestingly enough, all published cases described a single type of glial neoplasm arising in mature ovarian teratoma. Herein, the authors discuss a unique case of concomitant occurrence of two different glial neoplasms, namely pilocytic astrocytoma and subependymoma arising in an ovarian mature cystic teratoma. To the best of our knowledge, this is the first reported case with such a distinctive histopathologic finding.
Neurotrophic Receptor Tyrosine Kinase 2 (NTRK2) Alterations in Low-Grade Gliomas: Report of a Novel Gene Fusion Partner in a Pilocytic Astrocytoma and Review of the Literature
Pilocytic astrocytoma is a low-grade glial neoplasm of the central nervous system (CNS) that tends to occur in the pediatric population and less commonly presents in adults. Hereditary pilocytic astrocytoma is often associated with germline genetic alterations in the tumor suppressor NF1, the gene responsible for the syndrome neurofibromatosis type 1. Sporadic pilocytic astrocytoma frequently harbors somatic alterations in BRAF, with rare pilocytic astrocytomas containing alterations in FGFR1 and NTRK2. NTRK2 encodes for the protein tropomyosin receptor kinase B (TrkB), which is a neurotrophin receptor with high affinity for Brain-Derived Neurotrophic Factor (BDNF), and plays a role in several physiological functions of neurons, including cell survival and differentiation. In this report, we describe a novel PML-NTRK2 gene fusion occurring in an adult sporadic pilocytic astrocytoma and review the biology and implications of specific NTRK2 mutations occurring in CNS neoplasms.
Histopathological Findings Related to ORISE™ Injectable Submucosa Lifting Agent Used in the Endoscopic Mucosal Resection of Bowel Neoplasms: A Review of Three Cases
The use of nonsaline injectable lifting agents is now routine in the performance of endoscopic mucosal resection of bowel neoplasms (EMR). These agents are used to elevate the mucosa from the muscularis propria and permit more a complete resection of the lesion while mitigating risk of possible thermal injury to the bowel wall and thus preventing perforation. After injection, these new agents, which are replacing normal saline, often remain present in the tissues for some time following the procedure and may be identified in the resection specimens where they may mimic a number of other conditions such as mucin pools, lymphangiomas, granulomatous inflammation, and amyloid deposition. We describe the histological findings associated with the use of nonsaline injectable mucosal lifting agents. Awareness of these agents and their associated artefact may reduce misdiagnosis or the use of unnecessary ancillary studies and highlights the importance of proving relevant clinical information on submission of specimens for pathological examination.