A locally destructive, completely asymptomatic, C1-root schwannoma with base of skull invasion: a case report.

Patients with C1 nerve root schwannomas usually present with signs relating to nerve root compression. However, asymptomatic presentations have never been reported. A healthy, 37-year-old female was referred in view of a slow-growing lump in the left posterosuperior aspect of the neck. The lump was asymptomatic and neurological examination was normal. Magnetic resonance imaging revealed a left C1 nerve root tumour, extending around the C1 vertebra and compressing the thecal sac. The tumour had invaded the basiocciput and was impinging on the left cerebellar hemispheric dura. Stereotactic biopsies of the lesion showed a spindle-cell tumour exhibiting an immunoprofile consistent with a schwannoma. The lesion was surgically excised by blunt dissection using a posterior midline approach. The case report adds to the diverse modes of presentation of C1 nerve root schwannomas, in that such lesions must be included in the differential diagnosis of asymptomatic posterior neck lumps.

[Inadequate burials as an important factor in plague epidemic amongst Serbs in the Habsburg monarchy by the end of the 18th century: a historical analysis].

Analysis of the archaic customs of burying the deceased in Srem, primarily amongst Serbs, in the second half of the 18th century is the essential part of the paper that aims at clarifying the consequences of this negative habit onto the spreading of plague epidemic. The Austrian Empire tried to stop and prevent the epidemic with an array of legal norms, but in practice, these orders were often not upheld. Serbian Metropolitans Pavle Nenadovic and Stefan Stratimirovic insisted on eradicating superstition and retrograde, often uncivilized actions in burial rituals, and they partially succeeded. The example of plague in Irig and the surroundings in 1795-1796 explicitly shows the hazardous effects of the inadequate attitude towards the deceased as one of the factors in spreading the epidemic. Using primary archives, and published sources, with adequate literature, authors depict this complex historical process.

Squamous cell carcinoma in mature cystic teratoma of the ovary.

INTRODUCTION: Malignant transformation is a rare complication of mature cystic teratoma, with squamous cell carcinoma as the most common malignancy (in 75% of cases). In this article we present a case of a well-differentiated squamous cell carcinoma arising in a mature cystic teratoma and discuss the morphological and clinico-pathological features of malignant transformation in teratoma. CASE REPORT: An 80-year-old woman with symptoms of acute abdomen underwent left salpingo-oophorectomy. Gross examination showed a cystic mass measuring 20 cm in diameter, with papillary formation on its internal surface. Histology revealed a well-differentiated squamous cell carcinoma arising in mature cystic teratoma. Squamous epithelium surrounding the tumor was dysplastic. CONCLUSION: Squamous cell carcinoma in mature cystic teratoma is a rare pathologic event and in most cases it is an accidental pathohistological finding.

[Morphology and immunohistochemical studies of ovarian strumal carcinoid].

INTRODUCTION: Teratomas are tumors derived from pluripotent germ cells, and they appear most frequently in ovaries. Strumal carcinoid belongs to the group of monodermal teratomas. Strumal carcinoid is characterized by the presence of carcinoid tumor, intermingled with thyroid tissue. CASE REPORT: A 52-year-old postmenopausal woman was referred to the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad with complex right adnexal mass for surgery. Laparotomy revealed tumor arising from the right ovary, of firm consistency and intact capsule. On gross examination, yellowish brown tumor was 26 x 17 x 10 cm, with vague nodularity. The cut sections revealed predominantly solid mass with two cystic areas, and one of the cysts showed a tuft of hair. On histopathological examination, the cystic spaces were lined with skin and mucinous epithelium. The solid areas showed a population of monomorphic cells with eosinophilic cytoplasm and nuclei with "salt and pepper" chromatin, arranged in acinar and trabecular patterns, respectively. In addition, focally follicular structures with central eosinophilic colloid-like material were seen. Based on the presence of these two components, a diagnosis of Strumal Carcinoid was made and confirmed on immunohistochemistry. The tumor cells were diffusely immunopositive for synaptophysin, chromogranin, and the follicles including the central coIloid were immunopositive for thyroglobulin and Thyroid transcription factor-1. Neither proliferative or mitotic activity nor capsular or angiolymphatic invasion were noticed. At 3 year follow up the patient was disease free. CONCLUSION: In order to diagnose this rare tumor a team, consisting of a pathologist, surgeon and radiologist, is needed. Diagnosis of strumal carcinoid has to be confirmed on immunohistochemistry.

Age-related skin changes.

Age-related skin changes can be induced by chronological ageing, manifested in subcutaneous fat reduction, and photo-ageing eliciting increased elastotic substance in the upper dermis, destruction of its fibrilar structure, augmented intercellular substance and moderate inflammatory infiltrate. Forty-five biopsy skin samples of the sun-exposed and sun-protected skin were analyzed. The patients were both males and females, aged from 17 to 81 years. The thickness of the epidermal layers and the number of cellular living layers is greater in younger skin. The amount of keratohyaline granules is enlarged in older skin. Dermoepidermal junction is flattened and the presence of elastotic material in the dermis is pronounced with age. The amount of inflammatory infiltrate is increased, the fibrous trabeculae are thickened in older skin and the atrophy of the hypodermis is observed. Chronological ageing alters the fibroblasts metabolism by reducing their life span, capacity to divide and produce collagen. During ageing, the enlargement of collagen fibrils diminishes the skin elasticity.

Xanthomas of the stomach: a report of two cases.

Gastrointestinal tract xanthomas are non tumor, well demarcated mucosal lesions that consist of foamy histiocytes, most commonly diagnosed in the stomach. The histologic appearance of xanthomas can resemble certain malignant lesions. After retrospective data base search, we have encountered only 2 cases of xanthomas, both in the antral part of the stomach. Lamina propria of the mucosa contained rare, chronic inflammatory infiltrate and clusters of oval and polygonal cells with abundant, foamy cytoplasm. The cytoplasm of described cells did not show the presence of mucin (Periodic acid-Schiff (PAS) and Alcian blue staining). The cells showed distinct cytoplasmic CD68 positivity and CKMNF116 negativity, which confirmed the diagnosis of xanthoma. Given the frequent association of xanthomas and known precancerous lesions of gastric mucosa, and occasional coexistence of malignant change, we need to pay attention to its diagnosis, and it is advisable to use both histochemical and immunohistochemical methods.