Primary squamous cell carcinoma of the thyroid--a case report

A rare case of primary squamous cell carcinoma of the thyroid is reported herein. A 64-year-old Malay lady presented with a gradually enlarging thyroid nodule for the past 6 months and underwent total thyroidectomy. Histopathology revealed a squamous cell carcinoma of the thyroid with complete resection. Possible primary tumour elsewhere was excluded. Postoperative irradiation was given and patient is still alive after 2 years of follow-up.     

Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid--a case report

We report a 55-year old female who presented with thyroid swelling for six months. She was clinically asymptomatic with normal thyroid functions. Thyroidectomy revealed the left lobe totally replaced by a well-circumscribed grey white homogenous tumor. Microscopically, the tumor comprised of cells arranged in adenoid pattern along with nests of cohesive intermediate cells, some also forming keratin pearls in a sclerotic and inflammatory background. The thin rim of thyroid at the periphery showed features of lymphocytic thyroiditis. No other associated malignancy was seen on thorough screening. The tumor cells were negative for thyroglobulin and calcitonin. The patient was thus diagnosed with Sclerosing mucoepidermoid carcinoma with eosinophilia, thyroid.     

Insular carcinoma of the thyroid: report of a case with intact insulae and microfollicular structures

A case of insular carcinoma of the thyroid is presented, in which a prominence of microfollicular structures resulted in difficulty in distinguishing it from a follicular neoplasm of the thyroid. The patient presented with a single discrete thyroid nodule, aspiration of which yielded markedly cellular smears containing cells lying singly, in tight clusters and microfollicles. Criteria for separation of insular carcinoma of the thyroid from follicular neoplasms include the presence of intact insulae, high cellularity, and the presence of small amounts of necrotic debris.     

Insular component as a risk factor of thyroid carcinoma

Forty-four thyroid carcinomas with an Insular component (JC) were reviewed from 2457 tumors diagnosed as papillary (PC) or follicular carcinoma (FC). These tumors were classified as FC with an IC (FCIC; 30 cases) and PC with an IC (PCIC; 14 cases). Both tumors were composed of solid cell nests in some areas and had a tendency toward a characteristic nuclear size: FCIC had a small nucleus and PCIC contained a nucleus of an Intermediate type or a large nucleus similar to that of PC, although there were numerous tumors with an exceptional nuclear size. The mean age and tumor diameter were the highest and largest in FCIC, respectively, followed by PCIC. Among the 44 cases, 17 patients died of the disease, two were alive with the disease and 18 were alive without the disease. From 13 clinicopathological factors, the presence of an IC, age, non-encapsulation, tumor size, vascular invasion and necrosis were found to be independent variables for actual prognosis of FC and PC based on univariate analysis followed by multtvariate analysis. The results of the present study indicate that the presence of an IC is an independent aggressive prognostic factor for patients with PC and FC.     

Primary mucinous carcinoma of urachus--a case report

The authors describe a case of primary mucinous carcinoma of urachus in 65 years old male. Patient presented with hematuria with suprapubic mass. The patient underwent total cystectomy with en bloc excision of the tumor mass and umbilicus. Histological examination showed features of mucinous carcinoma of urachus. A clinicopathological study and brief review of literature is presented.     

Merkel cell carcinoma: a case report

Merkel cell carcinoma is an uncommon, highly malignant, primary cutaneous neuroendocrine tumour mostly occurring as a solitary nodule on the head or on the extremities. It has high recurrence rate. We hereby report a case of Merkel cell carcinoma in a young woman.     

Hypopharyngeal sebaceous carcinoma: a case report

A hypopharyngeal squamous-cell carcinoma with sebaceous differentiation is reported. In the primary as well as the metastatic lymph nodes, the tumor showed basaloid, squamous, and sebaceous cells. In addition, immunostaining for S-100 protein and vimentin manifested scattered cells showing cytoplasmic processes suggesting myoepithelial cells. An exhaustive review of the literature revealed only one similar case previously reported. The probable origin from the minor salivary glands is discussed.     

Microcystic urothelial carcinoma: a case report

Microcystic urothelial carcinoma (MUC) is a rare variant of urothelial carcinoma that is highly aggressive with poor prognosis. Due to the scarcity of cases, its histologic morphology and immunohistochemical characteristics are still not clear. This paper reports a 71-year old female patient with gross hematuria and abdominal pain. Imaging examination showed that the bladder wall was thickened, and rough. A soft tissue mass was seen in the bladder and the left lower ureter, and the boundary between the bladder and the uterus and bilateral adnexa was not clear. Multiple enlarged lymph nodes were seen around the abdominal aorta and left iliac artery. Cystoscopy showed diffuse thickening and edema of the left wall of the bladder, local rough bleeding, and histopathologic results showed that the lesions were consistent with high-grade invasive urothelial carcinoma. Radical cystectomy and bilateral ovariectomy were performed. By microscopic observation the tumor showed infiltrative growth with cystic structures of different sizes. Mitotic figures were frequent and a large amount of mucus was in the stroma. The same type of cancer was found in the left ovary. Immunohistochemistry showed CK5/6 +, p63 +, Pax-8, MUC5AC, CK7, and Ki67 was 50%. Postoperative pathology confirmed that MUC involved the left ureter with ovarian metastasis. Two months after the operation, the patient died of vascular invasion. Because tumor cells were bland in morphology and had no specific immunohistochemical markers, they were easily missed and misdiagnosed by pathologists. Here, we describe this case and analyze it with relevant literature to deepen understanding of MUC.     

Fibrolamellar hepatocellular carcinoma: a case report

A 6-year-old Malay boy presented with fever and abdominal pain for 2 months. Computerised tomography showed a nodular mass in the left lobe of the liver. There was also portal vein thrombosis on the left side. Serum alpha-fetoprotein was not elevated and Hepatitis B antigen was negative. Biopsy of the liver mass led to a histological diagnosis of fibrolamellar hepatocellular carcinoma. In view of extensive tumour involvement, he could not be operated on but was treated with chemotherapy. However, the tumour did not respond. While this is expected for fibrolamellar hepatocellular carcinoma, the possibility of the tumour having a component of ordinary hepatocellular carcinoma could not be excluded as the tumour was not resected. Fibrolamellar hepatocellular carcinoma is a rare histological subtype of hepatocellular carcinoma, associated with a better prognosis. It affects the younger age group and has no association with cirrhosis, hepatitis B virus infection or exposure to oral contraceptives, all of which are implicated in ordinary hepatocellular carcinoma. Serum alpha-fetoprotein level is usually within normal limits and other laboratory values are not contributory to the diagnosis. The diagnosis is usually suggested by radiographic studies viz. CT scan of the abdomen, which would show an irregular non-homogenous mass in the liver, and confirmed by histological examination. The most characteristic microscopical feature is fibrosis arranged in a lamellar fashion around polygonal and deeply eosinophilic neoplastic hepatocytes.     

Small cell neuroendocrine carcinoma of cervix--a case report

Small cell neuroendocrine carcinoma of uterine cervix is a rare variant of cervical carcinoma with features of high aggressiveness. It is difficult to manage these tumors. It is often diagnosed at an advanced stage and its prognosis is generally poor. The present report describes a 65 year old woman who presented with postmenopausal bleeding and had a friable polypoidal growth hanging from the cervix. Microscopic examination of the growth showed features of small cell carcinoma. Neuroendocrine cellular characteristics were assessed by using antibodies against neuron specific enolase. The case is being reported to create awareness of this rare entity     

Invasive lobular carcinoma of male breast--a case report

A 56 year old male presented with painless subareolar lump in the left breast was subsequently diagnosed as invasive lobular carcinoma. This case is reported in view of its rarity.     

左下颌骨牙源性硬化性癌一例

报道1例发生于左下颌骨的牙源性硬化性癌。患者女,54岁。左下后牙疼痛不适3个月伴下唇麻木1个月。临床表现为下颌骨膨隆明显。镜下观察见条索或小巢团状的肿瘤细胞浸润于密集硬化的基质中,可见神经周侵犯。免疫组织化学中细胞角蛋白(CK)5/6、p63、CD56、CD99阳性,Ki-67阳性指数多在10%或以下。荧光原位杂交检测表现为EWSR1基因重排阴性。术后随访30个月,恢复良好,无复发。     

Mucoepidermoid carcinoma of lung: a case report

Mucoepidermoid lung tumours are uncommon neoplasms comprising of 0.2% of all the lung tumours and historically included under the term bronchial adenomas. This is a case report of a bronchial tumour in the hilar region present since 3 years. The neoplasm could be easily classified as a mucoepidermoid tumour of low malignant potential, as it resembled the histologically identical lesion in the main salivary glands. The case is reported for its rarity and for the histological evaluation of the malignant potential in an apparently clinically benign neoplasm.     

皮肤淋巴上皮瘤样癌一例

患者男,80岁.左颧部皮肤新生物1年,逐渐长大,无明显自觉症状,发现肿物逐渐明显于2010年2月27日就诊.超声检查:真皮及皮下见一实性结节,界限清,直径0.4 cm,回声均匀.CT检查鼻咽等其他部位未见占位.     

Medullary thyroid carcinoma with melanin production--a case report

Melanin production in medullary thyroid carcinomas is rare. The present case illustrates melanin and other atypical features of medullary carcinoma of the thyroid in a fifty year old female. The diagnosis was suggested on the cytomorphological features seen on fine needle aspiration cytology smears. On histo-pathological examination the tumor was extensively pigmented with frequent mitosis. Amyloid was conspicuously scarce. Confirmation of diagnosis was done by immunohistochemical positivity for calcitonin and HMB-45 on tissue sections. The case is being presented in view of its rarity and distinct immunoreactivity. Review of literature is done and the implications of such dual positivity in the histogenesis and divergent phenotype of this tumor are discussed.     

Vaginal adenoid cystic carcinoma: a case report

Adenoid cystic carcinoma generally arises from the salivary glands and is rarely found in the female genital tract. Infection with HPV is implicated in this cervical lesion. Differential diagnosis includes adenoid basal carcinoma, polymorphous low-grade adenocarcinoma and basaloid squamous cell carcinoma. Only one case of vaginal localisation was previously described. We report a case of adenoid cystic carcinoma in a 48-year-old woman with previous cervical HPV infection. Histological examination revealed nests of cells with peripheral palisading organisation and glandular lumina containing material produced by the tumor cells.