Altered clinical course of glomus tympanicum — a case report

Glomus tumours of temporal bone are rare and usually present with symptoms of hearing loss and tinnitus. Diagnosis is often delayed due to the slow growth of the tumour. Here we present a case report of a patient diagnosed as glomus tympanicum who presented only with unilateral progressive hearing loss for the past one year and rapidly detoriating hearing loss since two months who was managed successfully.     

Hemangioendothelioma of bone with pulmonary metastases: a 25-year course: report of a case.

A unique case of hemangioendothelioma of bone arising in the right scapula of a 15-year-old boy is reported. The patient has been followed for over 25 years. After a symptom-free interval of 15 years, he developed a solitary pulmonary metastasis which was removed by left lower lobectomy. Five years later another metastasis was resected from his left upper lobe. During the subsequent five year period he has remained free of further evidence of metastases, attesting to the indolent course which may be taken occasionally by these malignant vascular tumors.     

Parachordoma: a case report

Parachordoma is a very rare soft tissue tumor with histological features similar to chordoma and chondrosarcoma. It should be distinguished from metastatic chordoma and extraskeletal myxoid chondrosarcoma because of its different treatment and prognosis. In this paper we report one case of parachordoma in a 20-year-old female patient. The tumor occurred in the subcutaneous tissue of the left hand as a painless, fixed, slow-growing mass. Pathologic analysis revealed a tumor composed of lobules of cells with variably vacuolated cytoplasm (physaliphorous cells) separated by fibrous septa, predominantly arranged in peculiar small or large alveolar structures. Immunohistochemistry showed positive staining of the tumor cells with cytokeratin 8/18, S-100 protein and vimentin. The patient is well and without recurrence 20 months after surgery.     

Solitary iris metastasis from breast cancer with dramatic course: case report

Intraocular metastases are the most common malignancy of eye. Breast cancer is more frequently a cause of intraocular metastases. As a first metastatic site, iris and ciliary body are relatively rare. We report a case of 52-year-old women, operated for breast cancer 16 months ago and diagnosed multiple brain metastases 1 month ago. After first course of chemotherapy she was admitted to hospital with the complaints of eye pain and she recognized a solid mass on iris. Iris and ciliary metastases were diagnosed by ophtalmological examination. Because of the patient’s poor general condition, diagnostic aspiration from eye metastasis cannot be performed. Intramedullary mass was determined 1 month later and she died 2 months later. Ciliary body and iris metastases of breast cancer must be considered as a manifestation of aggressive clinical course and poor prognosis. The eye metastases of breast cancer are a part of systemic illness and must be treated by systemic chemotherapy.     

Aggressive clinical course of primary invasive vaginal carcinoma associated with type 61 HPV: a case report

Primary invasive vaginal cancer is one of the rarest malignant processes in the female genital tract. The etiology has not been identified, but the strongest association is with HPV infection and subtypes 16 and 18 have the highest oncogenic potential. We present the case of a young woman diagnosed with metastatic squamous cell carcinoma of the vagina associated with HPV type 61, a non-oncogenic HPV type. We report the propensity of a primary vaginal neoplasm to spread to lymphatic vessels early and the unresponsive aggressive behavior to multimodal therapy.     

Muir-Torre syndrome: a case report

The authors present a case of Muir-Torre syndrome, the "sporadic" form, with a review of the literature. The importance of the close scrutiny of these patients and their relatives is stressed.     

Askin 瘤1例报告

1 临床资料 患者,女,9岁,因“双侧胸壁肿物溃疡不愈2个月”于2013年8月入院.入院查体:左锁骨上、双腋窝淋巴结肿大,最大约2 cm×2 cm,部分融合,双侧上胸壁见2处肿物,溃疡不愈,表面黑痂渗液,边界各约3 cm×3 cm,硬质,轻压痛,心肺腹部未发现明显异常.CT检查:左前下胸壁肿瘤,2.8 cm×3.0 cm肿物,与肋骨边界清,左锁骨上、双腋窝、腹膜后多发淋巴结肿大,右侧胸壁活检切除术后改变(图A-B).骨髓穿刺活检:未发现明显异常.病理检查:IHC:Vimetin(+),NSE(+),CD99(+),CD45(+),CD3(-),CD20(-),CK20(-),CD34(-),Syn(-),S-100(-),desmin(-),Ki-67(+),约50％)(图2).临床诊断:Askin瘤(胸壁),左锁骨上、双腋窝、腹膜后多发淋巴结转移(Ⅳ期).     

Dedifferentiated chordoma: a case report

Dedifferentiated chordoma, i.e. chordoma with a sarcomatous component, is a rare bone tumor. This case report is of a dedifferentiated chordoma in the sacrococcygeal region in a 50-year-old male. The patient was initially diagnosed as having a leiomyosarcoma at the first medical consultation, but after the tumor recurred it was proven to be a dedifferentiated chordoma. The primary tumor, which measured 7 x 5 cm, was located in front of the sacrum so as to compress the rectum forward. The resected specimen showed histological features of chordoma, but the presence in some parts of the tumor of spindle-shaped epithelial cells led to a misdiagnosis of leiomyosarcoma. Thirty-six months later, a local recurrent tumor measuring 24 x 17 cm was identified and promptly resected. The recurrent tumor showed features of pleomorphic cell sarcoma mimicking malignant fibrous histiocytoma. In the pleomorphic sarcomatous area, many mitotic figures were seen, and the MIB-1 labeling index was greater than 40%, which was higher than that of the conventional chordoma area. From histological and immunohistochemical examination, the resected tumor was proven to be a dedifferentiated chordoma. This case highlights the importance of careful study of suspected chordoma to allow early identification of sarcomatous components. When we encounter a chordoma with a spindled epithelial component, we need to distinguish this tumor from a dedifferentiated chordoma and other spindle cell sarcomas such as leiomyosarcoma.      

Epithelioid glioblastoma: a case report

A 43-year-old woman who had undergone breast cancer surgery 1 year previously complained of headache and nausea. Her brain computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a well-circumscribed, heterogeneously enhanced tumor in the right thalamus. She underwent gross total resection of the tumor followed by radiochemotherapy, and her clinical course was uneventful after surgery. Histological examination revealed a moderate number of tumor cells with fine bipolar processes in a mucoid matrix, which suggested pilocytic astrocytoma. The tumor was associated with microvascular proliferation but did not show significant mitosis or necrosis. In some areas, it had an epithelioid appearance, with ribbon-like, cribriform, and pseudoglandular patterns involving cuboid-shaped cells showing nuclear atypia and mitotic figures. Immunohistochemically, the tumor cells were positive for glial fibrillary acidic protein (GFAP) and vimentin in the area resembling pilocytic astrocytoma, but in the epithelioid area they were negative for GFAP and vimentin as well as for breast cancer markers, including AE1/AE3. The proliferating potential, represented by the MIB-1 labeling index, was high (82.5%) in the area of epithelioid appearance, compared to only 3% in the area of pilocytic astrocytoma-like appearance. As a rare histoarchitectural variant of glioblastoma, the epithelioid pattern may represent a very primitive tumor cell phenotype. Typically, this pattern is characterized by well-circumscribed masses, although its clinical significance is unknown.     

Pseudomixoma peritonei: a case report

Pseudomixoma Peritonei (PMP) is an uncommon neoplasm characterised by mucinous ascites and multifocal amorphous mucous substances involving the peritoneal surface, omentum and bowel loops. Although the origin of the Pseudomixoma Peritonei is still unclear, it could be due to the perforation of an ovarian mucinous cystoadenoma or an appendiceal mucocele. The further pelvic dissemination of the endotumor material, which adhere itself into the peritoneal surface, may induce an intra-abdominal transformation of the peritoneal mesothelium into mucin-producing tissue. A case of Pseudomyxoma Peritonei (PMP) which occurred in a young woman is reported.     

Kaposiform Hemangioendothelioma： a Case Reporl

Case Report A 36-year-old man with a neoplasm in his right-leg had undergone surgical removal of this neoplasm at an out-patient clinic (OPD). The tumor size was about 1 cm× 1 cm× 0.5 cm. It was knotty and nonencapsulated. Its cross-section was kermesinus and its texture was moderate. The pathological examination confirmed a diagnosis of Kaposiform hemangioendothelioma.     

Epithelioid angiomyolipoma: a case report

Epithelioid angiomyolipoma is a recently recognized tumor entity. We report a case of epithelioid angiomyolipoma of the kidney that occurred in a 70-year-old female. The patient presented with massive abdominal hemorrhage and shock. There was no history of tuberous sclerosis complex. The tumor consisted of smooth muscle, adipocytes, small-to-medium-sized hyalinized blood vessels and numerous pleomorphic epithelioid cells with clear to eosinophilic cytoplasm. Mitosis was exceptional and no glandular pattern was recognizable. Immunohistochemically the epithelioid cells were strongly positive for HMB45 and CD68, focally positive for S-100, actin and vimentin, and negative for epithelial markers including epithelial membrane antigen and cytokeratins. Previous reports in the English literature suggest that epithelioid angiomyolipoma may have malignant potential. In our case, at six months from surgery the patient is alive and well without evidence of relapse or metastasis.     

Bronchial cast: a case report

We present a case of a child who presented with respiratory distress mimicking foreign body aspiration which was treated by bronchoscopic extraction of bronchial cast. Early interventional bronchoscopy in management of plastic bronchitis, though difficult, provides an immediate benefit and good prognosis especially in patients with no underlying cardiopulmonary morbidity.     

Ifosfamide encephalopathy: a case report

The aim of this short communication is to discuss the mechanism, modality and treatment of ifosfamide encephalopathy. We present the case of a 52-year-old woman treated with this alkylating agent who developed severe neurotoxicity. It was resolved with administration of Methylene blue, abundant intravenous hydration and interruption of ifosfamide.     

小汗腺螺旋腺瘤1例报告

报告1例小汗腺螺旋腺瘤。患者,女,60岁。因发现右上臂肿块一年余就诊。皮肤科检查:肿块位于皮下,直径0.5cm,质地中等,活动度可。组织病理检查:肿瘤呈分叶状,与周围组织界限清楚。瘤细胞内毛细血管丰富,瘤细胞围绕毛细血管排列呈片状、实性条索状、花瓣样及腺管样,部分区域似玫瑰花样排列。肿瘤主要由两种瘤细胞组成:一种瘤细胞体积稍大,呈卵圆形及立方形,细胞核呈类圆形,淡染;另一种瘤细胞形态似基底细胞样,体积较小,卵圆形,细胞核深染。免疫组化:肿瘤细胞SMA(+),CK5/6(+),CK(+),EMA(+)。结合临床和组织病理表现,诊断为小汗腺螺旋腺瘤。     

双重打击淋巴瘤一例

患者 男性,48岁.因腹部发现肿物10d余,于2014年2月入我院.无发热、盗汗、体质量下降、中枢神经系统等症状.既往体健.查体：一般情况尚好,肝、脾、浅表淋巴结不大.白细胞计数8.5×109/L,血红蛋白154 g/L,血小板计数232×109/L,肝肾功能、心电图（ECG）正常,乳酸脱氢酶（LDH）225 U/L,β2微球蛋白（β2-MG） 1.5 mg/L.腹部彩色超声示：腹腔及腹膜后肿物直径＞ 10 cm.外科行剖腹探查术,术中见肿块巨大,与胃壁、胰腺、腹主动脉、下腔静脉等重要脏器联系紧密,取部分组织送检.     

复杂的原发性小肠淋巴瘤1例报道并文献复习

原发性小肠淋巴瘤在消化道肿瘤中相对少见。由于其起病隐匿、无典型的临床表现、目前缺乏有效的小肠检查手段,致使此病的漏诊率和误诊率大大增加。原发性小肠淋巴瘤伴全小肠、十二指肠息肉样改变的病例尚未见报道。本文就1例原发性小肠淋巴瘤伴全小肠、十二指肠息肉样改变进行分析讨论。