Oncocytic sialolipoma of parotid gland: Case report and literature review

Neoplastic lipomatous lesions of the salivary glands constitute ?0.5% of all the salivary gland tumors. Oncocytic sialolipoma of the parotid glands is extremely uncommon. We report a case of oncocytic sialolipoma of the parotid gland in a 59-year-old male who presented with a gradually increasing swelling of the right parotid. Excisional parotid biopsy performed in view of possible pleomorphic adenoma as suggested on ultrasonography showed histological features consistent with oncocytic sialolipoma. We also described the characteristics of 24 previously reported cases of oncocytic sialolipoma of the parotid gland. The median age of the patients including the present case was 56 years (range 7–89), and 14 were male. The largest and the least reported sizes of the tumor were 7.0 and 1.4 cm, respectively. The left-sided parotid gland was more commonly involved (14/23). Despite its rarity, oncocytic sialolipoma should be considered in lipomatous parotid lesions showing epithelial components with oncocytic changes.

Clinicopathological and molecular features of 25 cases of the oncocytic carcinoma of the thyroid / 临床与实验病理学杂志

Purpose To investigate the clinicopathological and molecular genetic features of oncocytic carcinoma of the thy-roid(OCA).Methods The clinicopathological and immuno-histochemical data of 25 patients with oncocytic carcinoma of the thyroid were retrospectively reviewed.Genetic features were determined by fluorescence quantitative PCR.Results The male to female ratio of the 25 patients was 1 ∶ 1.8,and the aver-age age was 49 years.The tumor was confined to the thyroid gland.Of the 22 cases with a single nodule,5 cases were ill-de-marcated and 3 cases were multiple nodular lesions.The average size was 2.7 centimeter in diameter.Cytologically,the tumor cells were arranged in detached clusters with abundant eosino-philic and granular cytoplasm and hyperchromatic nuclei with prominent nucleoli.Histologically,the oncocytic tumor cells mainly arranged in trabecular and solid architecture.Capsular,blood and lymphoid vascular invasion could be observed in a cer-tain extent.Among 25 cases of OCA,8 cases were minimally in-vasive,14 cases were encapsulated angio-invasive and 3 cases were widely invasive.Positive immunoreaction with TTF-1,thy-roglobulin and CD56 supported the thyroid epithelial origination of the tumour.One recurrent case was found to have cervical lymph node metastasis,and another case was presented with bone metastasis,which was determined to harbor TERT promoter mu-tation(C228T)in each case.Different point mutation of RAS gene was determined in 2 cases(8%),respectively.Conclu-sion Oncocytic carcinoma of the thyroid shows typical eosino-philic and granular cytoplasm,immunohistochemical staining is helpful in differential diagnosis with other oncocytic lesions.It lacks BRAF-like mutation.Low frequency of RAS mutations could be found.Rare TERT promoter mutation has significant mutation with clinical behavior of OCA.

Oncocytic adrenal cortical neoplasm of uncertain malignant potential – A rare case report

Adrenal oncocytic tumors are rarely encountered. Most of the oncocytic tumors are benign and rarely malignant. Here we report a case of a 10-year-old male child presented with abdominal mass whose Contrast-Enhanced Computed Tomography (CECT) shows well-circumscribed tumor. Right adrenalectomy was carried out. Histopathologically, it was diagnosed as adrenal cortical oncocytic neoplasm of uncertain malignant potential (AONUMP). This case highlights that although adrenal oncoytic tumors are rare, we should consider this as a differential diagnosis while evaluating the patient for adrenal masses. The case is presented in view of its rarity, and distinguishing gross and microscopy appearance, the diagnosis of which was further confirmed with immunohistochemistry markers.

Analysis of clinical and imaging features of 12 cases of pancreatic intraductal oncocytic papillary neoplasm / 中华消化杂志

Objective:To investigate the clinical and imaging features of pancreatic intraductal oncocytic papillary neoplasm (IOPN).Methods:From January 2011 to August 2021, at the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, 12 patients pathologically diagnosed with pancreatic IOPN after surgical resection were enrolled. Before operation, all patients underwent plain and enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The clinical data (general conditions, main complaints, tumor related indicators and past medical history), CT and MRI features, surgical methods and pathologic results of the 12 patients with pancreatic IOPN were retrospectively analyzed. Descriptive method was used for statistical analysis.Results:Among 12 pancreatic IOPN patients, there were 7 males and 5 females, aged (54.0±13.0) years old (ranged from 31 to 75 years old). The symptoms were abdominal pain in 3 cases, jaundice in 1 case and 8 cases were detected during regular health checkups. Serum carbohydrate antigen 19-9 increased in 3 cases and carcinoembryonic antigen increased in 2 cases. One pancreatic IOPN patient with pancreatitis history and 3 pancreatic IOPN patients with diabetes history. Six cases were with the lesions located in the head of pancreas, 5 cases were located in the body and tail of pancreas and 1 case were diffused in the all the pancreas. Five cases were branch duct type, 2 cases were main duct type and 5 cases were mixed duct type. Ten pancreatic IOPN patients presented cystic or cystic-solid tumor, the maximum diameter (range) of the tumor was (50.3±31.1) mm (28 to 127 mm). The cyst walls of 6 patients were thickened and those of 9 patients were found with enhanced mural nodule or solid component, and none of them were growing outside the cystic wall. Two patients presented solid tumor located in the dilated pancreatic duct, and the maximum diameter (range) of the tumor was (25.5±0.5) mm (25 to 26 mm). The solid tumor demonstrated as slightly lower density on plain CT scan, lower signal on T1-weighted MRI imaging, high signal on T2-weighted MRI imaging, and limited diffusion on diffusion weighted imaging, and mild enhancement after CT and MRI enhanced scan. The main pancreatic duct dilated in 11 cases, and the inner diameter (range) was (10.5±8.1) mm (3 to 28 mm). The pancreatic parenchymal of 4 pancreatic IOPN patients was atrophy, 4 patients with calcification and 1 patient with lymphadenopathy. None of the 12 pancreatic IPON patients had peripheral blood vessel and tissue invasion. Six cases were received pancreaticoduodenectomy, 4 cases were underwent distal pancreatectomy, 2 cases underwent total pancreatectomy. The pathological classification of 7 pancreatic IOPN patients was invasive carcinoma, 4 cases were with high-grade dysplasia and 1 case with low-grade dysplasia.Conclusion:The clinical features of pancreatic IOPN are atypical and the imaging findings are mostly solid or cystic-solid tumor, pancreatic duct dilation, solid component of tumor located in the dilated pancreatic duct, and no peripheral tissue invasion.

Molecular genetic analysis of primary renal epithelial tumours with granular oncocytic cytoplasms / Análisis genético molecular de tumores epiteliales renales primarios con citoplasma oncocítico granular

SUMMARY: The group of primary renal tumours with granular-oncocytic cytoplasm is a very heterogeneous group, in its histological origin and biological behavior resulting in many diagnostic problems. In this study 57 renal epithelial tumours with granular oncocytic cells were analyzed using fluorescence in situ hybridisation (FISH), array comparative genomic hybridisation (aCGH) and polymerase chain reaction (PCR). The results of analysis in renal oncocytoma (RO) did not indicate the presence of the gene mutations or chromosomal abnormalities. Sporadic renal hybrid oncocytic/chromophobe tumours (HOCT) had multiple numerical aberrations of chromosomes 1, 2, 6, 9, 10, 13, 17, 20, 21 and 22. This type of tumour had no mutations in the VHL, c-kit, PDGFRA, and FLCN genes. Oncocytic papillary renal cell carcinoma (O-PRCC) had numerical abnormalities of chromosomes 7 and 17 and the loss of the Y chromosome. Cytogenetic analysis of 20 pigmented microcystic chromophobe renal cell carcinomas (PMChRCC) showed monosomy as the most frequent aberration in all analyzed chromosomes 1, 2, 5, 10, 13, 17 and 21. One case of chromophobe renal cell carcinoma (ChRCC) with hyaline globules had a mutation in the distal part of exon 3 of the VHL gene. Absence of genetic disorders in usual RO is common result, but we have established absence of genetic disorders even in rare variants. Variety of genetic alterations detected in sporadic renal HOCT proves it to be a separate entity, not a variant of ChRCC, while PMChRCC is an uncommon variant of ChRCC. O-PRCC is a subtype of papillary renal cell carcinoma.

RESUMEN: El grupo de tumores renales primarios con citoplasma granular-oncocítico es un grupo muy heterogéneo, en su origen histológico y comportamiento biológico, resultando en problemas de diagnóstico. En el estudio se analizaron 57 tumores epiteliales renales con citoplasma oncocítico granular mediante hibridación fluorescente in situ (FISH), hibridación genómica comparativa de matriz (aCGH) y reacción en cadena de la polimerasa (PCR). Los resultados del análisis en oncocitoma renal (RO) no indicaron la presencia de mutaciones genéticas ni anomalías cromosómicas. Los tumores oncocíticos / cromófobos híbridos renales esporádicos (HOCT) tenían múltiples aberraciones numéricas de los cromosomas 1, 2, 6, 9, 10, 13, 17, 20, 21 y 22. No se observaron mutaciones en este tipo de tumor en el VHL, c-kit, PDGFRA y genes FLCN. El carcinoma de células renales papilar oncocítico (O-PRCC) tenía anomalías numéricas de los cromosomas 7 y 17 y la pérdida del cromosoma Y. El análisis citogenético de 20 carcinomas de células renales cromófobos microquísticos pigmentados (PMChRCC) mostró que la monosomía era la aberración más frecuente en todos los cromosomas analizados 1, 2, 5, 10, 13, 17 y 21. Un caso de carcinoma de células renales cromófobo (CCRc) hialino tenía una mutación en la parte distal del exón 3 del gen VHL. La ausencia de trastornos genéticos en la OI habitual es un resultado común, pero hemos establecido la ausencia de trastornos genéticos incluso en variantes raras. Varias alteraciones genéticas detectadas en esporádica HOCT renal demuestran que es una entidad separada, no una variante de ChRCC, mientras que PMChRCC es una variante poco común de ChRCC. O-PRCC es un subtipo de carcinoma papilar de células renales.

Oncocytic Carcinoma of Parotid Gland: A Case Report

Introduction: Oncocytic carcinoma (OC) of salivary glandorigin is an extremely rare proliferation of malignant oncocyteswith adenocarcinomatous architectural phenotypes, includinginfiltrative qualities. To help clarify the clinicopathologicfeature of this tumor group, herein, we report a case ofoncocytic carcinoma arising from the salivary glands, togetherwith radiological and immunohistochemical observations.Case report: The tumor was reported in the parotid regionof a 50 year old female. The tumors were unencapsulatedand was seen invading into the nearby lymphatic tissues. Theneoplastic cells had eosinophilic granular cytoplasm and roundvesicular nuclei with prominent red nucleoli. Cellular atypiaand pleomorphism was mild. Immunohistochemistry reveleadDOG1 and p63 positivity. In summary, OC of salivary glandorigin is a high-grade tumor, often with local recurrence,regional or distant metastasis, diagnosis of which is based ona combination of clinical and histopathological features.Conclusion: Complete surgical excision is the treatment ofchoice while the role of radiotherapy or chemotherapy iscontroversial, and careful follow-up is necessary.

Parotid gland oncocytic carcinoma: A rare entity in head and neck region

@#Oncocytic carcinoma of the salivary gland is an uncommon tumour in the head and neck region. Owing to its rarity, identifying the histopathological features of a malignant tumour can be difficult and challenging. We report a case of a 70-year-old man who presented with a left facial weakness for six months in a background history of left parotid swelling over the past 10 years. Clinical examination revealed a 3x3cm left parotid mass and grade 4 facial nerve palsy. Fine needle aspiration of the mass showed scattered cohesive, monolayered sheets of uniform oncocytic cells. Subsequently, a left total parotidectomy and selective neck dissection were performed. Histological examination showed sheets of small oncocytes with minimal nuclear atypia. Evidence of nerve entrapment, capsular invasion and perivascular permeation were identified in focal areas. Thus, a final diagnosis of oncocytic carcinoma was rendered.

Oncocitoma suprarrenal / Oncocytic adrenocortical carcinoma

El oncocitoma suprarrenal es un tumor extremadamente infrecuente, con apenas unos 150 casos descriptos. Paciente de sexo masculino, de 48 años, con adrenalectomía derecha por incidentaloma suprarrenal de 7 cm, no funcionante. El oncocitoma suprarrenal no puede distinguirse desde el punto de vista clínico-imagenológico de otros tumores adrenales más frecuentes, por lo que su confirmación es histológica. Rara vez son malignos, y el tratamiento aceptado es la suprarrenalectomía, idealmente por vía laparoscópica. En nuestro caso, la presencia de dos criterios histológicos menores lo clasifican como un tumor con potencial maligno.

Oncocytic adrenocortical carcinoma is an extremely rare tumor, with only 150 cases reported in the literature. A 48-year-old male patient, with right adrenalectomy due to a 7-cm non-functional adrenal incidentaloma. From a clinical imaging point of view, oncocytic adrenocortical carcinoma cannot be distinguished from other more common adrenal tumors; therefore, the diagnostic confirmation is histological. It is rarely malignant, and the accepted treatment is laparoscopic adrenalectomy. In our case, two minor histological criteria classify it as a potentially malignant tumor.

Proliferaciones Oncocíticas de Glándulas Salivales: Estudio Estructural e Inmunohistoquímico de 7 Casos / Oncocytic Proliferations of Salivary Glands: Structural and Immunohistochemical Study of 7 Cases

RESUMEN: Los oncocitos son células originadas probablemente por transformación metaplásica del epitelio ductal o acinar de parótida y submandibular. Su proliferación puede originar condiciones patológicas que incluyen hiperplasias oncocíticas adenomatosas multinodulares (HOAM), oncocitomas y carcinomas oncocíticos. Los tumores oncocíticos constituyen el 1 % de todos los tumores salivales y entre el 82 y 90 % se desarrollan en la parótida; el resto se divide entre la glándula submandibular y las glándulas salivales menores. Las hiperplasias oncocíticas multinodulares son extremadamente raras. En el presente trabajo se analizaron 5 casos de oncocitomas de parótida y dos casos de HOAM, uno de parótida y otro de submandibular y se describieron las características estructurales e inmunohistoquímicas de los oncocitos. Cortes seriados de las biopsias incluidas en parafina se colorearon con Hematoxilina - Eosina, Hematoxilina/ácido fosfotúngstico (PTA/H), PAS y se marcaron con AC antimitocondrial, CK 5/6, CK 20 y EMA. Los tumores mostraron un crecimiento nodular encapsulado por tejido conectivo denso. En los cortes histológicos se identificaron oncocitos eosinófilos (oscuros) y granulaciones violáceas con PTA/H. En dos casos de parótida y el caso de HOAM de submandibular presentaron además oncocitos claros PAS positivos. La inmunomarcación fue positiva en todas las células siendo la marcación para mitocondrias periférica en los oncocitos claros. Las células eosinofílicas PTA/H positivas y con fuerte marcación con AC antimitocondrial, CKs y EMA confirman el diagnóstico de patología oncocítica. En tres casos coexisten oncocitos claros y oscuros. Las células claras son oncocitos que acumulan glucógeno en su citoplasma desplazando a las mitocondrias hacia la periferia. En el diagnóstico diferencial de este tumor debemos considerar los tumores salivales con células claras, el carcinoma renal metastásico, el tumor de Whartin, la variante de células claras del carcinoma epitelial/mioepitelial y el carcinoma mucoepidermoide con metaplasia oncocítica.

ABSTRACT: Oncocytes are cells probably originated by metaplastic transformation of the ductal or acinar epithelium of parotid and submandibular. Its proliferation can cause pathological conditions that include multinodular adenomatous oncocytic hiperplasia (HOAM), oncocytomas and oncocytic carcinomas. Oncocytic tumors make up 1 % of all salivary tumors and between 82 and 90 % develop in the parotid; the rest of the tumors are divided between the submandibular gland and the minor salivary glands. Multinodular oncocytic hyperplasias are extremely rare. In the present work we analyzed five cases of parotid oncocytomas and two cases of HOAM, one of parotid and the other of submandibular; structural and immunohistochemical characteristics of the oncocytes were described. Biopsies were included in paraffin, serial cuts were stained with H&E, Hematoxylin / phosphotungstic acid (PTA / H), PAS and were marked with antimitochondrial AC, CK 5/6, CKs 20 and EMA. The tumors showed a nodular growth encapsulated by dense connective tissue. The histological cuts showed dark eosinophilic oncocytes and violaceous granulations with PTA / H. In two cases of parotid and the case of submandibular HOAM, PAS positive clear oncocytes were also present. The immunostaining was positive in all the cells, being the labeling for peripheral mitochondria in the clear oncocytes. Eosinophilic cells PTA / H positive with strongly marked with antimitochondrial AC, CKs and EMA confirm the diagnosis of oncocytic pathology. In three cases, light and dark oncocytes coexist. Clear cells are oncocytes that accumulate glycogen in their cytoplasm, displacing the mitochondria to the periphery. In the differential diagnosis we should consider salivary tumors with clear cells, metastatic renal carcinoma, Whartin's tumor, the clear cell variant of epithelial / myoepithelial carcinoma and mucoepidermoid carcinoma with oncocytic metaplasia.

A Case of Oncocytic Lipoadenoma Arising in the Submandibular Gland / 대한두경부종양학회지

Oncocytic lipoadenoma is a rare salivary gland tumor composed of adipose tissue and oncocytic epithelial cells in varied proportions. We report a case of an oncocytic lipoadenoma of the submandibular gland, which presented as a submandibular gland mass. The patient was a 65-year-old woman with a right submandibular mass measuring 2 × 2 × 1.6 cm. As a sonographic evaluation and computed tomograph scan gave us the impression of benign submandibular gland tumor such as pleomorphic adenoma, we resected the right side submandibular gland. Grossly, the tumor was well circumscribed with yellow to brown cut surface. Microscopically, the tumor was surrounded by a thin, fibrous capsule and composed of oncocytic epithelial cells admixed with mature adipose tissue. Final diagnosis was an oncocytic lipoadenoma. We discussed here radiologic and pathologic finding of this rare salivary gland tumor.

Carcinoma adrenocortical oncocítico virilizante / Adrenal oncocytic virilizing carcinoma

Las neoplasias oncocíticas se encuentran raramente en la glándula suprarrenal. Suelen ser benignos y no funcionales. Existen informes extremadamente limitados de neoplasias oncocíticas suprarrenales. Alrededor del 20% de las neoplasias oncocíticas adrenocorticales muestran componentes malignos y el 10-20% produce hormonas que pueden causar desbalances hormonales. Se presenta un carcinoma adrenocortical oncocítico virilizante en mujer de 35 años de edad quien acudió a consulta por presentar hipomenorrea secundaria de seis meses de duración acompañada de hirsutismo y agravamiento del acné que afectaba principalmente la cara. El examen de laboratorio revela niveles elevados de testosterona libre. La tomografía computada mostró tumor multinodular en la glándula suprarrenal derecha con necrosis central y sin evidencia de linfadenopatía o invasión de estructuras que la rodeaban. Se programó la adrenalectomía derecha lográndose resección completa del tumor. Después de la cirugía, se normalizaron los ciclos menstruales, el hirsutismo, el acné y el resto de las pruebas. El examen histopatológico del tumor fue compatible con carcinoma adrenocortical oncocítico(AU)

Oncocytic neoplasms are found more rarely in the adrenal gland. They are usually benign and nonfunctional. There are limited reports of adrenal oncocytic neoplasms. About 20% of adrenocortical oncocytic neoplasms show malignant components and 10-20% produce hormones that can cause hormonal imbalances. We present a virilizing oncocytic adrenocortical carcinoma in a 35-year-old woman who consulted for hypomenorrhea accompanied by hirsutism and face acne worsening. Laboratory test revealed high levels of free testosterone. Computed tomography showed multinodular tumor of the right adrenal gland with central necrosis and without evidence of lymphadenopathy or invasion of surrounding structures. A right adrenalectomy was performed. After surgery, menstrual cycle, hirsutism and acne, as well as hormonal tests were normal. Histopathological examination of tumor showed an oncocytic adrenocortical carcinoma(AU)

Dedifferentiation of oncocytic epithelial–myoepithelial carcinoma to mucoepidermoid carcinoma in parotid gland: A rare case report

Epithelial–myoepithelial carcinomas (EMCs) account for <1% of all salivary gland malignancies. Till now, 23 cases of dedifferentiated EMC have been reported to the best of our knowledge. However, dedifferentiation of oncocytic EMC to mucoepidermoid carcinoma is extremely rare. A 38-year-old female presented with right post aural swelling 4 cm × 2 cm in size for 6 months. Surgical excision was carried out, and we received partly skin-covered tissue 5 cm × 2 cm in size. Sections examined showed features of oncocytic EMC dedifferentiating into mucoepidermoid carcinoma. Myoepithelial component showed oncocytic change which was highlighted by p63.

Cistoadenoma papilar oncocítico de glándula parótida: caso clínico / Papillary oncocytic cystoadenoma of the parotid gland: case report

RESUMEN El cistoadenoma es un tumor epitelial benigno raro de glándulas salivales, de crecimiento lento y asintomático, que forma grandes masas uni o multiloculares con desarrollo papilar intraluminal. Si bien es más frecuente en glándulas salivales menores, se ha destacado lo inusual de la lesión en glándulas salivales mayores. Se presenta el caso de una mujer de 60 años, quien consultó por una masa indolora, blanda y de consistencia quistica en glándula parótida derecha, de crecimiento lento y progresivo. Su evolución fue de varios meses con piel de la zona intacta. Se realizó parotidectomia superficial. El examen histopatológico demostró cistoadenoma papilar oncocitico, tumor que ha sido destacado por su infrecuencia, y con una manifestación en parótida sumamente rara y de variados patrones histológicos. Su reconocimiento es trascendente para el profesional en casos como el que se presenta, pues su diagnóstico diferencial incluye lesiones con aspecto clínico similar y en algunos casos comportamiento agresivo.

ABSTRACT The cystadenoma is a rare benign epithelial tumor of salivary glands, characterized by slow growing and asymptomatic presentation, forming large uni or multilocular masses with intraluminal papillary development. Although it is more frequent in minor salivary glands, it has been emphasized the unusual of the major salivary glands affection. We present the case of a 60-year-old woman consulting for a painless, soft mass with cystic consistency in the right parotid gland, slow and progressive growing. The tumor evolved for several months keeping the skin of the area intact. A superficial parotidectomy was performed. Histopathological examination demonstrated a papillary oncocytic cystadenoma, a tumor that has been noted for its low frequency, and with extremely rare parotid manifestation and varied histological patterns. Its recognition is relevant for the professional in cases such as the one presented, since its differential diagnosis includes lesions with similar clinical appearance and in some cases aggressive behavior.

Tratamiento del papiloma oncocítico nasosinusal avanzado sin malignización asociada, con resección endoscópica y radioterapia en arcos de volumen modulado (RAVM). Reporte de un caso / Management of advanced sinonasal non-malignant oncocytic papilloma with endoscopic resection and volumetric modulated arc radiotherapy (VMAR). Case report / Gestão do Papiloma Oncocítico Nasossinusal avançado sem malignidade associada, com ressecção endoscópica e Radioterapia em Volume de Arcos de Modulado. Relato de caso

RESUMEN El papiloma oncocítico (PO) es una neoplasia rara de la cavidad nasal y los senos paranasales y es el subtipo histológico menos frecuente del papiloma rinosinusal. Al igual que el papiloma invertido (PI), se lo considera un tumor benigno, pero su comportamiento biológico no lo es tanto por su crecimiento local agresivo, su tasa alta de recurrencia y el riesgo de transformación maligna con asociación a carcinoma. El tratamiento de elección es la resección endoscópica. Se ha usado exitosamente la radioterapia para el tratamiento de los PI extensos, pero no se conocen informes documentados de su uso en pacientes con PO avanzado o con extensión extrasinusal y sin malignización asociada. Se presenta un caso de PO unilateral izquierdo con enfermedad extensa que comprometía la pared nasal lateral y los senos maxilar, etmoidal y frontal del mismo lado, tratado con radioterapia en arcos de volumen modulado.

SUMMARY Oncocytic papiloma (OP) is a rare neoplasm of the nasal cavity and paranasal sinuses. It is the least common histological subtype of sinonasal papilloma. OP is regarded as a benign tumor like inverted papilloma (IP), but its biological behavior is not so benign due to its aggressive local growth, the high rate of recurrences and the risk of malignant transformation with associated carcinoma. Endoscopic resection is the treatment of choice for OP. No relevant reports on the use of radiotherapy are known in patients with OP with advanced disease or extrasinonasal extension without associated malignancy, although its application in advanced IP has been successfull. We report a case of unilateral left OP with advanced disease that involved lateral nasal wall, maxillary, ethmoidal and frontal sinus on the same side, treated with volumetric modulated arc radiotherapy.

RESUMO O Papiloma Oncocítico (PO) é uma neoplasia rara da cavidade nasal e os Seios Parinasais menos comum e representa o subtipo histológicos menos frequente dos Papilomas Nasossinusais (PNS). Assim como o Papiloma Invertido (PI), o PO é considerado um tumor benigno, mas o seu comportamento biológico não é tão benigno devido a seu crescimento local agressivo, a sua elevada taxa de recorrência e o risco potencial de transformação maligna com carcinoma associado. A ressecção endoscópica é o tratamento de preferência do PO. Em pacientes com doença avançada ou extensão extrassinusal sem malignidade associada, não há relatórios relevantes do uso de radioterapia (RT), embora a sua aplicação no caso dos PI avançados, em que tem sido utilizado com sucesso. Um caso de PO unilateral é apresentado com doença extensa que comprometeu a parede lateral nasal e os seios maxilar, etmoidal e frontal do mesmo lado, que foi tratado com sucesso com cirurgia endoscópica e radioterapia em arco volumetricamente modulada (RAVM).

Clinicopathological features of oncocytic mucoepidermoid carcinoma / 局解手术学杂志

Objective To investigate the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of oncocytic mucoepidermoid carcinoma(OMEC).Methods A case of OMEC was studied for clinicopathological and immunohistochemical features,the available literature on this subject was reviewed as well.Results Magnetic resonance imaging revealed a well-defined mass,measured 1 cm×1 cm,within the right submandibular gland.The patient was underwent the total mass and the right submandibular gland resections.On macroscopic examination,the well-defined tumor was gray-yellowish on cut surface with hard consistence and was sized 1 cm×1 cm×0.8 cm.The uncapsulated tumor was mainly solid with focal microcysts on cut surface.Microscopically,the tumor consisted of nests,sheets,and occasional microcysts of oncocytic cells.Focally,intermediate cells,mucilage cell and epidermoid cell were also present.Immunohistochemically,the oncocytic cells were diffusely and intensely positive for CK(AE1/AE3),EMA and P63.By histochemical staining,the oncocytic cells were positive for PTAH staining,and mucilage cell were positive for PAS staining.Conclusion The OMEC is an exceedingly rare variant of mucoepidermoid carcinoma with a good prognosis and should be differentiated from oncocytoma,oncocytic carcinoma,Warthin's tumor with mucinous metaplasia,pleomorphic adenoma,oncocytic myoepithelioma and myoepithelial carcinoma,et al.

Oncocytic variant of medullary thyroid carcinoma: 3 cases report with review of literatures / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic features and differential diagnosis of oncocytic variant of medullary thyroid carcinoma (MTC).Methods Morphological,immunohistochemical findings on 3 oncocytic variant of MTC cases and electron microscopic findings on 2 of these 3 cases were studied,with review of the relevant literatures.Results The cytoplasm was abundant,eosinophilic and granular with defined margins.The nuclei were enlarged,round to oval.Prominent nucleoli were identified in some cells.Tumor cells formed sheets,trabeculae or follicles with infiltrative pattern.Immunohistochemically,thyroglobulin (TG) was negative in all 3 cases.Calcitonin was positive in 2 cases and negative in 1 case.Ultrastructurally,a large number of mitochondria and various neuroendocrine granules were found in the 2nd and 3rd cases.Conclusion Oncocytic variant of MTC is very rare with variable histopathologic appearances.It should be considered in diagnosing oncocytic lesions of thyroid.A definite diagnosis can be rendered based on comprehensive findings of the immunohistochemistry,serology study and electron microscopy.It needs to avoid misdiagnosis and missed diagnosis.

Oncocitoma: caso clínico / Oncocytoma: a clinical case

El oncocitoma es un tumor benigno que afecta varios órganos como tiroides, paratiroides, riñón y glándulas salivales, que consiste en la proliferación de células oncocíticas producidas por una gran hiperplasia mitocondrial. El oncocitoma representa menos del 1 por ciento de todos lostumores de las gandulas salivales. Cuando en estudios por imágenes de glándula parótida se observen múltiples pequeños nódulos con unamasa sólida o quística, el diagnóstico de oncocitoma debe ser considerado, especialmente en pacientes de sesenta o más años. El objetivo de este artículo es la presentación de un caso de oncocitoma y analizar el estado de arte de los casos reportados en la temática.

The oncocytoma is a benign neoplastic tumor that occurs in several organs, including the thyroid gland, parathyroid gland, kidneys, and salivary glands consisting of a proliferation of oncocytic cells produced by a large mitochondrial hyperplasia. The oncocytoma accounts for less than 1% of the whole salivary gland tumors.When multiple small nodules are found in the parotid gland with a large solid or cystic mass that is evident on imaging, a diagnosis of oncocytoma should be considered, particularly in patients of sixty years of age or older. The objective of this article is the presentation of a case of oncocytoma and the state of art of reported cases in this field.

Oncocytic variant of mucoepidermoid carcinoma: A diagnostic challenge for the pathologist.

Oncocytic mucoepidermoid carcinoma of the salivary gland is rare. We report a 48-year-old man who presented with a slowly growing right parotid mass. A preoperative fi ne needle aspiration showed exclusively oncocytic cells and cellular debris. A fi rst diagnosis of Warthin tumor or myoepithelioma was made. The patient underwent a superfi cial parotidectomy, and her postoperative course was uneventful. Histologically, the tumor was composed of solid nests and cystic gland containing clear mucoid material, lined predominantly with oncocytes and few mucous goblet cells. A fi nal diagnosis of oncocytic variant of mucoepidermoid low-grade carcinoma was made. The recognition of this variant is important, because may be easy confused with most frequent benign tumor with oncocytic cells; in this case a complete surgical excision and long-term clinical follow-up are an adequate management.

Oncocytic Lipoadenoma: A Rare Case of Parotid Gland Tumor and Review of the Literature

Oncocytic lipoadenoma is a rare tumor, with only 18 cases having been reported since the first in 1998. We encountered a case of oncocytic lipoadenoma presenting as a slowly growing parotid mass in a 71-year-old man. This tumor is characteristically comprised of a mixture of oncocytes and adipocytes. The present case is one of five reported cases of oncocytic lipoadenoma showing sebaceous differentiation. The results of immunohistochemical study with DOG1 antibody supported the origination of this tumor in the striated duct.

Adenocarcinoma oncocítico oxifílico de endometrio: reporte de caso / Endometrial oncocytic carcinoma: a case report

El cáncer de endometrio es la patología maligna más frecuente del tracto genital femenino, con una incidencia del 3,2 por ciento en Latinoamérica, y que según sus características histológicas permite clasificar las lesiones en tipo I o II. Entre las variantes de esta última se encuentra el adenocarcinoma oxifílico. Se presenta caso de una paciente de 77 años con cuadro de hemorragia uterina anormal y dolor pélvico crónico, que posterior a estudios complementarios es llevada a histerectomía ampliada, en su estudio histopatológico final se encuentra lesión compuesta por células epiteliales con abundante citoplasma intensamente acidofílico con núcleos pleomórficos e hipercromáticos dispuestos en un patrón arquitectural de predominio sólido, positivo para CK7, CK14 y parcialmente positivo para Bcl2, diagnosticándose adenocarcinoma oxifílico de endometrio. Este caso resulta importante debido al poco número de reportes a nivel mundial y por ser el primero encontrado en Colombia.

Endometrial cancer is the most frequent malignant pathology of the female genital tract, with an incidence of 3.2 percent in Latin America. Histological characteristics lead to classify this lesions in type I or II where oxyphilic adenocarcinoma is included as a variant of the last group. This is a case report of a 77 years old patient with clinical symptoms of abnormal uterine bleeding and chronic pelvic pain thatafter complementary studies is carried to extended hysterectomy; further histopathological study showed a lesion formed by epithelial cells with abundant intensely acidophilic cytoplasm with pleomorphic and hyperchromatic nuclei arranged in a predominantly solid architectural pattern, positive for CK14, CK7 and partially positive for Bcl2, diagnosing endometrial oxyphilic adenocarcinoma. This case is remarkable important because of the small number of reports worldwide and being the first found in Colombia.