Plasmablastic Lymphoma in an Immunocompetent Patient: A Case Report and Literature Review.

Plasmablastic lymphoma (PBL) is considered an aggressive rare variant of diffuse large B-cell lymphoma that has a predilection to develop in immunocompromised patients, particularly HIV-positive individuals. This report highlights the development of such a rare and aggressive malignancy in a 55-year-old immunocompetent male. It outlines the atypical clinical presentation and pathological features of this disease entity. Overall prognosis and response to chemotherapy differ in the absence or presence of immunosuppression. This report includes a summary of the epidemiologic, clinical, and immunohistochemical characteristics of PBL based on a comprehensive review of the reported cases occurring in immunocompetent individuals.

The Epidemiology of Primary Central Nervous System Tumors at the National Neurologic Institute in Saudi Arabia: A Ten-Year Single-Institution Study.

OBJECTIVES: This study is aimed at describing the epidemiological trends of primary CNS tumors in children and adults at the National Neurologic Institute in Saudi Arabia. METHODS: A retrospective epidemiological approach was used where data was obtained from the department of pathology registry files and pathology reports. The records of all patients registered from January 2005 to December 2014 with a diagnosis of primary CNS tumor (brain and spinal cord) were selected. Data about sex, age, tumor location, and histologic type were collected. The classification was based on the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3). RESULTS: Nine hundred and ninety-two (992) cases of primary CNS tumors throughout the ten years (2005 to 2014) were reviewed. There were 714 (71.97%) adults and 278 (28.02%) in the pediatric age group. Nonmalignant tumors dominated the adult population (60.08%) while malignant tumors were more frequent in the pediatric population. Gliomas constituted the most common neoplastic category in children and adults. The most common single tumor entity was meningioma (26.99%, ICD-O-3 histology codes 9530/0, 9539/1, and 9530/3). Medulloblastomas (ICD-O-3 histology codes 9470, 9471, and 9474) were the most common single tumor entity in the pediatric age group (26.62%). CONCLUSIONS: This is an institution-based, detailed, and descriptive epidemiological study of patients with primary CNS tumors in Saudi Arabia. In contrast to other regional and international studies, the medulloblastomas in our institution are more frequent than pilocytic astrocytomas. Limitations to our study included the referral bias and histology-based methodology.

Brain metastasis from large cell neuroendocrine carcinoma of the prostate: A case report and literature review.

INTRODUCTION: Large-cell neuroendocrine carcinoma (LCNEC) of the prostate is a rare type of prostate cancer. Only eighteen case reports have been published in the literature to date. The present case report is the first case in the literature to describe brain metastasis of LCNEC of the prostate with neuroimaging, gross, and microscopic evaluation with immunohistochemistry CASE PRESENTATION: A 79-year old male with a history of high-grade prostatic adenocarcinoma treated with androgen deprivation therapy (ADT) who presented after remission with a severe headache and limbs weakness. Neuroimaging showed large right frontal lesion that caused a mass effect. Tumor resection was done, and the biopsy showed LCNEC of prostatic origin. The patient survived for 40 days after the diagnosis and tumor removal. DISCUSSION: We discuss the spectrum of neuroendocrine differentiation in prostate carcinomas and the possible pathological pathways leading to the development of LCNEC of the prostate, and how it affects the presentation and the pattern of metastasis. CONCLUSION: This case report describes a brain metastasis of a rare aggressive type of prostate cancer with poor prognosis. With metastatic lesions of prostatic adenocarcinoma, the probability of NE transdifferentiation increases. LCNEC has a poor prognosis attributed to its nature and late diagnosis. Thus, reporting and investigating such tumor will positively contribute to better management for future patients.

Steroid-resistant extranodal rosai-dorfman disease of cheek mass and ptosis treated with radiation therapy.

Background. Rosai-Dorfman Disease (RDD) is rare benign hematologic disorder of histiocytes, which usually manifests as painless lymphadenopathy, fever, leukocytosis and hypergammaglobulinemia. Extranodal RDD has been reported in 43% of cases, with skin as commonly involved site followed by head and neck region. However, soft tissue cheek mass is rare presentation of extra-nodal RDD. Case Presentation. A 26-year-old Saudi man presented with a six-month history of right cheek swelling and left upper eyelid swelling. Physical examination revealed right cheek mass of size 3 × 3 cm and left upper eyelid mass of size 1 × 2 cm and no palpable cervical lymphadenopathy. Incisional biopsy of cheek mass showed positivity for S100 and negativity for CD1a, consistent with extra-nodal RDD. Patient did not respond to systemic steroids and was given radiation therapy to left orbit with minimal response. Then, he was started on chemotherapy Rituximab, cyclophosphamide, vincristine, and prednisolone (RCVP) 8 cycles followed by reirradiation 10 Gy in 10 fractions with 6 MeV electron with complete response. After 12 months of followup, patient had recurrence in right cheek and was started on radiotherapy to the cheek mass. Conclusion. Extra-nodal RDD with involvement of cheek is a rare presentation. Incorporation of S100 and CD1a is helpful in diagnoses of RDD and differentiating it from other benign histiocytosis. Treatment consists of surgery, steroids, chemotherapy, and radiation therapy.