ABSTRACT
The small cell carcinoma of ovaries co-occurring with mucinous ovarian cancer is a rare event. We report a 21-years-old lady with a composite tumour comprising small cell carcinoma and mucinous carcinoma of ovaries. The incidental finding of the left ovarian cyst led to further workup and revealed a solid cystic mass in the left adnexal area pathologically proven to be mucinous ovarian carcinoma. The initial surgery was deferred upon the patient's request. After a few more cycles of chemotherapy, at the completion of surgery as per ovarian protocol, the pathological evaluation showed small cell carcinoma in the left ovary with a residual focus of mucinous carcinoma. In contrast, the right ovary also showed surface deposits of small cell carcinoma. The patient's clinical condition deteriorated very rapidly after that, and she passed away. Early recognition of small cell carcinoma in a composite tumour is critically essential for timely intervention.
ABSTRACT
Suprasellar meningiomas make a relevant differential when it comes to sellar/suprasellar masses. The most common pathology in this location is pituitary adenomas. It is imperative to differentiate the two entities based on imaging as the clinical picture, and sometimes the biochemical profile can show significant overlap. It is also essential for the neurosurgeons to have a preoperative diagnosis as the behavior of both tumors is different. This piece will give a pictorial review of the imaging features of suprasellar meningiomas, in patients who presented to us with sellar/suprasellar masses. The aim is to help the radiologists as well as fellow clinicians to diagnose this entity with confidence based on imaging.
ABSTRACT
Introduction: Head-and-neck sarcomas result in high mortality rates. A lot of new cases of sarcomas are diagnosed every year constituting about 1 % of all head-and-neck malignancies. Undifferentiated pleomorphic sarcomas (UPSs) are high-grade soft-tissue malignant tumours which occur primarily in limbs and retroperitoneal cavities. These tumours can often metastasize to the central nervous system. However, in rare instances, soft-tissue sarcomas may develop as a primary lesion within the intracranial compartments. Case Description: A young male presented to the clinic with occipital headache and blurring of vision. Initial workup included brain contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). The CECT suggested that there was an extra-axial mass present which was pressing against the adjacent left frontal lobe. Overlying frontal bone of the left side showed remodelling effect and associated mild periosteal reaction. MRI scan showed intracranial extra-axial lobulated mass with T1 intermediate to low-signal intensity and intermediate to high signals on T2 sequences. Heterogeneous enhancement on post-contrast sequences was also seen. The lesion had a broad-based attachment with dura mater and was closely applied to the orbital roof without orbital invasion. Staging positron emission tomography-CT scan showed a solitary site of disease in an intracranial location. Final diagnosis was confirmed by histopathology following excision of mass as UPS. Post-surgery MRI brain showed satisfactory post-operative appearance without any residual disease. The patient remained asymptomatic for 2 years and 6 months following the resection of the tumour. Practical Implications: Most of the extra-axial intracranial soft-tissue tumours arise from the meninges with meningiomas making the substantial bulk; however, possibility of other relatively rare tumours of meningeal origin must not be ignored. Intracranial soft-tissue sarcomas mostly arise from meninges thus require a good understanding of clinical presentation as well as acquaintance with morphological features on radiological imaging to differentiate from other tumours. These can be treated with excision and radiotherapy along with sequential follow-ups to look for recurrence. Tissue sampling is mandatory followed by complete staging scan in case of sarcomas to rule out possible primary or secondary disease.
