Chondroid syringoma of an upper eyelid tumor: Unusual case report

We present the case report of a 58?year?old man with recurrent chondroid syringoma, which was histopathologically confirmed, who underwent exenteration surgery of the right eye. Furthermore, the patient was receiving postoperative radiation therapy, and presently there is no local and/or distant evidence of disease in the patient

Carcinosarcoma ovárico asociado a carcinoma seroso intraepitelial tubárico

El carcinosarcoma primario ovárico es una neoplasia de baja incidencia, que suele ser diagnosticado en estadios avanzados y cursa con un mal pronóstico. Se comunica el caso de una paciente de 64 años con una tumoración abdominopélvica de 15 cm. El examen histológico evidenció una neoplasia maligna bifásica ovárica asociada a un carcinoma seroso intraepitelial tubárico, hallazgo que estaría en relación con la patogénesis de esta neoplasia.

Primary ovarian carcinosarcoma is a low incidence neoplasm that is usually diagnosed in advanced stages and has a poor prognosis. We report the case of a 64-yearold female patient with a 15 cm abdominopelvic tumor. Histological examination revealed a malignant ovarian biphasic malignancy associated with a serous tubal intraepithelial carcinoma, a finding that would be related to the pathogenesis of this neoplasm.

Pleomorpic Adenoma of Infratemporal Fossa Co- Existing with Actinomycosis: A Rare Case Report with Review of Literature

Introduction: Salivary gland tumors account for about 3% of head and neck tumors and the majority are benign in nature. Among these, the most common pathological type is pleomorphic adenoma also called the mixed tumor. It is a kind of tumor containing glandular tissue, myxoid and cartilage-like tissue. As the structure of the tissue is diverse, it is called a “mixed tumor.” Actinomycosis is a chronic suppurative bacterial infection caused by Actinomyces israelii. In this case report, we are presenting a rare co-existence of pleomorphic adenoma and Actinomycosis in the infratemporal fossa. Case description: A 40-year-old female patient complains of pain over the upper left back tooth region for the past 6months. The patient had a past history of a small lesion in 28 region which resulted in constant irritation. The patient had consulted the dentist for the same and underwent extraction of 28 and 38 three years back, which was thought to be the cause of the swell- ing. Conclusion: The case highlights the importance of proper history taking, clinical examination, and histopathological examina- tion in arriving at a precise diagnosis of a lesion irrespective of size and clinical presentation.

Tumor mülleriano mixto maligno / Malignant mixed müllerian tumor

RESUMEN Introducción: El tumor mülleriano mixto maligno es una neoplasia uterina infrecuente, agresiva y se caracteriza por su histología por contener elementos malignos sarcomatosos y carcinomatosos. Objetivo: Describir un caso de tumor mülleriano mixto maligno y revisar la literatura sobre el tema. Caso clínico: Paciente femenina de 63 años de edad, color de la piel negra, obesa e hipertensa con tratamiento, antecedentes de mastectomía derecha seis meses atrás, acudió a consulta por presentar aumento de volumen abdominal, dolor en bajo vientre y sangramiento uterino. Con la administración de anestesia combinada (general orotraqueal y regional epidural continua) se resecó un fibroma uterino gigante y se confirmó el diagnóstico de un tumor mülleriano mixto maligno. Conclusiones: El tumor mülleriano mixto maligno se debe sospechar en mujeres de edad avanzada con sangrado genital acompañado de masa pélvica. El estudio anatomopatológico es de elección para el diagnóstico definitivo de esta neoplasia rara y muy agresiva. La cirugía, la radioterapia y la quimioterapia son las opciones terapéuticas más aceptadas, sin embargo, en mujeres con tumor en estadios avanzados, independiente del tratamiento proporcionado, la tasa de supervivencia es corta.

ABSTRACT Introduction: The malignant mixed müllerian tumor is an infrequent, aggressive uterine neoplasm and is histologically characterized by containing sarcomatous and carcinomatous malignant elements. Objective: To describe a case of a malignant mixed Müllerian tumor and to review the literature on the subject. Case report: A 63-year-old black female patient, obese and hypertensive under treatment, with a history of right mastectomy six months ago, who was consulted due to increased abdominal volume, lower abdominal pain and uterine bleeding. With the administration of combined anesthesia (general orotracheal and continuous epidural regional) a giant uterine fibroid was resected and the diagnosis of a malignant mixed Müllerian tumor was confirmed. Conclusions: Malignant mixed Müllerian tumor should be suspected in elderly women with genital bleeding accompanied by a pelvic mass. The pathological study is of choice for the definitive diagnosis of this rare and potentially aggressive neoplasm. Surgery, radiotherapy and chemotherapy are the most accepted therapeutic options, however, in women with advanced stage tumors, regardless of the treatment provided, the survival rate is short.

Relato de caso: adenoma pleomórfico nasal / Nasal pleomorphic adenoma: a case report

INTRODUÇÃO: O adenoma pleomórfico é o tumor misto glandular benigno mais comum das glândulas salivares, raramente encontrado na cavidade nasal. A apresentação clínica típica é de obstrução nasal unilateral associada à epistaxe e à presença de uma massa polipoide, lisa, lobulada e firme na fossa nasal. O diagnóstico é feito por exame anatomopatológico, e o tratamento de escolha é cirúrgico, com ressecção do tumor com margem de segurança. RELATO DE CASO: O caso relatado é de uma paciente de 49 anos, com adenoma pleomórfico nasal, diagnosticado e tratado cirurgicamente. CONCLUSÃO: A importância do caso relatado reside na raridade do tumor nessa localização, sendo um diagnóstico diferencial que deve ser lembrado para os tumores nasais

INTRODUCTION: The pleomorphic adenoma is the most common benign mixed tumor of salivary glands, rarely found in the nasal cavity. Its typical clinical presentation is a unilat-eral nasal obstruction associated with an epistaxis and a presence of a polypoid, smooth, lobulated, and firm mass in the nasal fossa. It is diagnosed by anatomopathological ex-amination, and the treatment of choice is surgical with tumor resection, keeping a safety margin. CASE REPORT: The case reported is a female 49-year-old patient, diagnosed with a nasal pleomorphic adenoma that was surgically treated. CONCLUSION: The importance of the case reported lies in the rarity of the pleomorphic adenoma located in this area. Therefore, this is a differential diagnosis that must be remembered for nasal tumors.

Giant pleomorphic adenoma of submandibular salivary gland: a case report

The most common benign salivary gland tumor is the pleomorphic adenoma (PA). They can attain grotesque proportions and weigh several kilograms. They can cause facial disfigurement and, if untreated, could lead to airway compromise. Authors report a case of a large PA arising from the right submandibular salivary gland in a 48-year-old male. The lesion measured 9cmx8cmx5cm.

Long-Term Results of Intraoral Excision for Submandibular Mixed Tumors / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Generally, the benign mixed tumors of the submandibular gland are successfully removed via transcervical approach. Recently, however, an alternative to the standard transcervical approach, such as an intraoral approach, has been reported. The surgical results of intraoral excisions for submandibular mixed tumors are discussed here. SUBJECTS AND METHOD: A retrospective review was carried out for 24 patients with submandibular mixed tumors who were past 3 years of follow-up. Surgical morbidities and benefits were studied using these data. RESULTS: All patients successfully received an excision of the submandibular gland with tumor via an intraoral approach. Early postoperative complications of temporary lingual sensory paresis were developed in 75% of patients, followed by 54% of patients with temporary limitation of tongue movement. In contrast, there were no permanent paresis. Late complications were developed in two cases of mild deviation of tongue due to scar contracture on the floor of mouth, whereas two cases of tumor recurrence and one case of post-gustatory sweating syndrome were observed after surgery. CONCLUSION: This approach might be safe, if used with proper expertise, for the treatment of submandibular mixed tumors. The main advantages of this approach are that no external scars nor permanent injury are incurred to the related nerves. However, disadvantages are temporary lingual paresis and temporary limitation of tongue movement. Unfortunately, there were two cases showing recurrence after surgery and thus required more follow-up.

A Case of Mucoepidermoid Carcinoma Mixed with Osteosarcoma of the Parotid Gland Extending to the Parapharyngeal Space / 대한이비인후과학회지

Carcinosarcomas, also known as true malignant mixed tumors, are rare tumors of the salivary gland and are composed of both malignant epithelial and malignant mesenchymal elements. They may occur in pre-existing pleomorphic adenomas or arise de novo. Here we report the first case of carcinosarcoma of the parotid gland composed of mucoepidermoid carcinoma and osteosarcoma. The tumor had originated from the parotid gland and extended into the parapharyngeal space. To the best of our knowledge, there have been no reports on mucoepidermoid carcinoma mixed with osteosarcoma ex pleomorphic adenoma in the parotid gland.

Uterine Malignant Mixed Müllerian Tumors Following Treatment with Selective Estrogen Receptor Modulators in Patients with Breast Cancer: A Report of 13 Cases and Their Clinicopathologic Characteristics

BACKGROUND: Breast cancer treatment with selective estrogen receptor modulators (SERMs) increases the incidence of uterine malignant mixed Müllerian tumors (uMMMTs). We examine clinicopathologic characteristics and prognosis of SERM-associated uMMMTs (S-uMMMTs) and discuss possible pathogenetic mechanisms. METHODS: Among 28,104 patients with breast cancer, clinicopathologic features and incidence of uMMMT were compared between patients who underwent SERM treatment and those who did not. Of 92 uMMMT cases that occurred during the same period, incidence, dose, and duration of SERM treatment, as well as overall survival rate, were compared for patients with breast cancer who underwent SERM treatment and those who did not (S-uMMMT vs NS-uMMMT) and for patients without breast cancer (de novo-uMMMT). Histopathological findings and immunophenotypes for myogenin, desmin, p53, WT-1, estrogen receptor (ER) α, ERβ, progesterone receptor, and GATA-3 were compared between S-uMMMT and de novo-uMMMT. RESULTS: The incidence of S-uMMMT was significantly higher than that of NS-uMMMT (6.35-fold). All patients with SERM were postmenopausal and received daily 20–40 mg SERM. Cumulative SERM dose ranged from 21.9 to 73.0 g (mean, 46.0) over 39–192 months (mean, 107). Clinicopathologic features, such as International Federation of Gynecology and Obstetrics stage and overall survival, were not significantly different between patients with S-uMMMT and NS-uMMMT or between patients with S-uMMMT and de novo-uMMMT. All 11 S-uMMMT cases available for immunostaining exhibited strong overexpression/null expression of p53 protein and significantly increased ERβ expression in carcinomatous and sarcomatous components. CONCLUSIONS: SERM therapy seemingly increases risk of S-uMMMT development; however, clinicopathologic features were similar in all uMMMTs from different backgrounds. p53 mutation and increased ERβ expression might be involved in the etiology of S-uMMMT.

A rare case of hyaline cell-rich atypical chondroid syringoma with divergent differentiation

Chondroid syringoma (CS) also known as mixed tumor of the skin, is a rare benign adnexal tumor accounting for < 0.098%. Epithelial cells arranged in cords and tubules set in myxoid or chondroid stroma. Differentiation such as osteoid, sebaceous or mature adipocytes can be seen rarely. Hyaline cell rich is a rare variant of CS composed of cells with eosinophilic hyaline cytoplasm and plasmacytoid features. CS can have benign, atypical and malignant variants. The term atypical mixed tumor is recommended for those tumors which have histological features of malignancy such as infiltrative margin, satellite tumor nodules and tumor necrosis but without proven metastasis. Very few case reports of hyaline cellrich benign CS have been reported in the past, but to the best of our knowledge, possibly it is the first case of atypical hyaline cellrich CS of the little finger in a 65 year-old female showing divergent differentiation.

Clinicopathologic characterization of malignant mixed tumor of the skin accompanied by eccrine porocarcinoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic features, immunophenotype, pathological diagnosis and treatment of malignant mixed tumor (MMT).@*Methods@#Clinical and pathological features including immunohistochemical phenotypes were analyzed in a case of MMT accompanied with eccrine porocarcinoma (EP) involving both hands, diagnosed definitely in January 2018 along with review of relevant literature.@*Results@#A 64-year-old man presented with multiple rash on both hands for 4 years. Three lesions of 0.5 to 2.2 cm were removed for pathological evaluation. The pathological changes on little finger of left and right hands were MMT with EP, whereas that removed from the right ring finger was EP. MMT showed infiltrative growth with vascular wall invasion and consisted of epithelial (glandular or tube differentiation) and mesenchymal components (mucinous and/or cartilage stroma). The endothelial cells showed moderate to severe cytological atypia, nuclear pleomorphism and increased mitotic activity. The glandular component had histological characteristics of syringocarcinoma with moderately atypical chondrocytes but without myoepithelium. EP was composed of basal cells with visible vacuoles in cytoplasm and the presence of tubular and squamous differentiation, along with obvious atypia. Immunohistochemically cavosurface epithelium of glandular differentiation of MMT showed positivity for CK7, EMA and CD117. Myoepithelium showed S-100, CK5/6 and p63 positivity and stromal cells were positive for S-100. Differential diagnoses included metaplastic carcinoma, malignant myoepithelioma and atypical mixed tumor of skin.@*Conclusions@#MMT with EP is extremely rare.The diagnosis of MMT depends on the morphologic features. Immunohistochemical staining is helpful for differential diagnosis. Surgical excision with safety margins is the treatment of choice. Complementary radiotherapy and/or chemotherapy is still controversial. The clinical course of MMT is deemed unpredictable and long-term follow-up is necessary.

A Case of Pleomorphic Adenoma Occurred on Philtrum / 대한피부과학회지

No abstract available.

Adenoma pleomórfico gigante en paladar. Reporte de caso y revisión de la literatura / Giant pleomorphic adenoma of the palate. Case report and literature review

Resumen: El adenoma pleomórfico es considerado el tumor benigno más frecuente de las glándulas salivales y se caracteriza histológicamente por presentar tanto elementos epiteliales como mesenquimales. El presente estudio tiene como objetivo reportar un caso clínico de adenoma pleomórfico en paladar de grandes dimensiones de un paciente masculino de 45 años de edad, tratado en la Unidad de Cirugía Buco-Maxilofacial del Hospital General del Este «Dr. Domingo Luciani¼ quien inicia enfermedad actual, hace 17 años aproximadamente presentando un aumento de volumen progresivo en paladar. Se planificó quirúrgicamente para una maxilectomía de Brown tipo II B y colocación de placa obturadora. En un control postoperatorio de 10 meses se evidenció formación de tejido en la región del lecho quirúrgico de aspecto similar a la mucosa circundante sin señales de recidiva con presencia de fístula oro-nasal de aproximadamente 2 cm de diámetro. Actualmente se encuentra en programación de cierre de la misma con colgajos locales y posterior rehabilitación protésica.

Abstract: Pleomorphic adenoma is considered the most frequent benign tumor found in the salivary glands. Histologically it is characterized by presenting epithelial as well as mesenchymal elements. The present study targets the report of a clinical case of a large size pleomorphic adenoma found in a 45 year old patient. The patient was treated at the Oral and Maxillofacial Surgery Unit of the Eastern General Hospital «Dr. Domingo Luciani¼. The patient reported onset of the disease approximately 17 years before, with a progressive volume increase in the palate. A surgical Brown type II B maxillectomy was planned, with placement of a shutter plate. At a 10 month post-surgery control, tissue formation was observed in the region of the surgical bed, this formation exhibited similar appearance to the surrounding mucosa, with no signs of recurrence and presence of an oral-nasal fistula measuring approximately 2 cm in diameter. Presently, the patient is programmed to receive a fistula closure procedure by means of local flaps as well as subsequent prosthetic rehabilitation.

Carcinosarcoma of parotid gland - A rare case report.

Carcinosarcoma (true malignant mixed tumor) is an extremely rare tumor of the salivary gland. It is a biphasic tumor and is composed of both malignant epithelial and malignant mesenchymal component. Commonly, squamous cell carcinoma and adenocarcinoma forms the epithelial component and chondrosarcoma forms the mesenchymal component. We, hereby, report a parotid lesion in a 47 year old female that contained adenocarcinoma as epithelial component and chondrosarcoma as mesenchymal component. We report this unusual case of carcinosarcoma of parotid gland due to its rarity. It mimics benign lesions on ultrasonographic examination. On fine needle aspiration, the diagnosis of carcinosarcoma can be missed, as was in our case where it was reported as pleomorphic adenoma with atypical features. Histopathology only gives confirmatory diagnosis. In addition, a short review of literature along with possible pathogenesis of malignant mixed tumor of salivary gland is also presented.

Siringoma condroide en el labio superior: reporte de un caso / Chondroid syringoma of the upper lip: report of a case

Paciente masculino de 81 años de edad que acudió a consulta con un cirujano dentista por presentar una lesión nodular, asintomática, firme y móvil en el labio superior del lado derecho. El sujeto refi rió tener la lesión desde la infancia, pero notó crecimiento lento en el último año. El diagnóstico clínico indicaba un adenoma pleomorfo, por lo que el individuo se sometió a biopsia escisional bajo anestesia local. El espécimen se envió a estudio histopatológico. La evolución del paciente fue satisfactoria, sin reincidencia de la lesión. El examen microscópico reveló la presencia de una neoplasia bien delimitada constituida pormúltiples estructuras ductales pequeñas en la dermis. Estos ductos se encontraban revestidos por dos hileras de células epiteliales planas y contenían cantidades variables de material amorfo en la luz. El estroma presentaba diferenciación condroide.

An 81-year-old male patient consulted a dental surgeon due to his presenting a fi rm, mobile, asymptomatic nodular lesion on the upper lip. The patient stated that he had had the mass since childhood but that it had grown slowly over the course of the previous year. The clinical diagnosis was pleomorphic adenoma, for which reason the patient underwent an excisional biopsy under local anesthesia. The specimen was sent for histopathological examination. The patient’s progress was satisfactory and there was no recurrence of the lesion. Micro-scopic examination revealed the presence of a well-defi ned neoplasm consisting of multiple small ductal structures located in the dermis. These ducts were lined with two rows of fl attened epithelial cells and contained varying amounts of amorphous material in the lumen. The stroma exhibited chondroid differentiation.

Mixed adenoneuroendocrine carcinoma of the gastric stump following Billroth II gastrectomy: case report and review of the literature / Adenocarcinoma neuroendócrino misto do coto gástrico após gastrectomia à Billroth II: relato de caso e revisão de literatura

CONTEXT: Gastric stump cancer after gastric resection is a well-known disease. It may be a newly developed cancer after resection due to benign disease, or recurrent or residual disease after oncological surgery. The predominant histological type is usually adenocarcinoma. This study aimed to report on a rare occurrence of a mixed adenoneuroendocrine carcinoma (MANEC) on the gastric stump. CASE REPORT: The case of an 83-year-old female who presented a locally aggressive gastric stump MANEC, 35 years after Billroth II gastrectomy to treat a peptic ulcer, is reported. The patient underwent resection and adjuvant therapy. She has been followed up for one year without signs of recurrence. CONCLUSION: MANEC is a rare type of gastrointestinal neoplasm. The classification, histopathology, clinical features, treatment issues and prognosis are discussed along with a brief review of the literature.

CONTEXTO: O câncer de coto gástrico após gastrectomia é uma condição extensamente documentada. Pode se tratar de doença desenvolvida após a ressecção por doença benigna, ou ainda doença recorrente ou residual após cirurgia oncológica. Geralmente, o tipo histológico predominante é o adenocarcinoma. Este estudo tem como propósito relatar a rara ocorrência de um adenocarcinoma neuroendócrino misto (MANEC) no coto gástrico. RELATO DE CASO: É relatado o caso de uma mulher de 83 anos que apresentou um MANEC localmente agressivo 35 anos após uma gastrectomia à Billroth II devido a úlcera péptica. Foi submetida a ressecção e terapia adjuvante e foi seguida por 12 meses sem sinais de recorrência. CONCLUSÃO: Os MANECs constituem raro tipo de neoplasia gastrointestinal. Sua classificação, histopatologia, aspectos clínicos, tratamento e prognóstico são discutidos junto com uma breve revisão de literatura.

Tumor mixto cutáneo apocrino, un desafío diagnóstico a considerar / A mixed cutaneous apocrine tumors, a diagnostic challenge to to consider

El tumor mixto cutáneo es una neoplasia se aparición inusual al que se ha denominado también siringoma condroide. Se reporta un caso de Tumor mixto benigno apocrino en una paciente de 63 años. Paciente mujer de 63 años, con lesión tumoral de un año de evolución en zona frontal, asintomática. La ecografía de partes blandas fue compatible con lesión quística y el estudio histológico mostró la presencia de una neoplasia mixta benigna epitelial estromal, correspondiente a un tumor mixto benigno apocrino. Los tumores mixtos benignos apocrinos son neoplasias poco frecuentes, localizadas en las glándulas sudoríparas. Se caracterizan por presentarse como un nódulo subcutáneo o intradérmico, solitario, que puede alcanzar hasta 3 cm. de diámetro. Son asintomáticos y de crecimiento lento. Su principal ubicación corresponde a la cabeza y cuello y predominan en pacientes de sexo masculino, de edad media. El diagnóstico de certeza es histopatológico, encontrándose a la microscopía un patrón epitelial compuesto por estructuras tubulares, ductales, túbulo-alveolares o áreas sólidas con diferenciación pilo-sebácea focal, en un estroma que puede ser mixoide o condroide Se presenta este caso por ser un tumor de baja frecuencia, cuyo diagnóstico es esencialmente histopatológico y cuya terapia resolutiva es la extirpación quirúrgica completa.

Apocrine mixed tumor of the skin: a diagnosis challenge to consider. Cutaneous mixed tumor is an uncommon, benign adnexal neoplasm arising from apocrine or eccrine glands of the dermis. Apocrine mixed tumors often exhibit decapitation secretion, a feature of apocrine epithelium, but they may exhibit a wide range of metaplastic changes and differentiation in the epithelial, the myoepithelial, and the stromal components. We present two clinical cases of Apocrine mixed tumour of the skin in two different patients who have seen in our Department.

Pleomorphic Adenoma of Hard Palate: A Case Report and Review of Literature.

Pleomorphic adenoma is a benign mixed tumor, which is composed of myoepithelial and epithelial cells. A fibrous capsule separates these cells from the surrounding tissues. Pleomorphic adenoma has unusual histopathologic features. It is the most common benign tumor affecting both major and minor salivary glands. Parotid salivary gland is affected mostly in the major group, and palate is the most common site affected in minor salivary glands. The upper lip is the second most common site followed by buccal mucosa. Less than 3% of the salivary gland tumors account for head and neck tumors. In few cases, benign pleomorphic adenoma may turn malignant also. In this case report, a female patient aged 32 years who reported with a complaint of painless swelling in the palate is presented.

Benign mixed tumor of the lacrimal sac.

Neoplasms of the lacrimal drainage system are uncommon, but potentially life‑threatening and are often difficult to diagnose Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

Pleomorphic Adenoma with Sarcomatous Change in a Lacrimal Gland

A 69-year-old man was referred with left exophthalmos. Computed tomographic (CT) findings detected a well-circumscribed mass in the left side of the intraorbital cavity. At that time, he refused the further evaluation and treatment. About three years later, the size of the mass had enlarged, and the patient's symptoms were getting worse. The mass was completely removed with frontotemporal craniotomy and superolateral orbitotomy. In operative findings, the mass had originated in the lacrimal gland and was well-encapsulated without invasion to the surrounding tissue. In the pathologic findings, the tumor consisted of pleomorphic adenoma with osteosarcomatous change of stromal components. Postoperatively, the adjuvant radiotherapy was done four weeks later. The patient's symptoms were improved. The pleomorphic adenoma with osteosarcomatous change is extremely rare and appropriate treatment is not clearly established. We would like to report this rare case with a review of the literature.