Uterine endometrioid adenocarcinoma with extensive pilomatrixoma-like areas. A case report.

Shadow cells are typical features of pilomatrixoma, although they have been described in other benign cutaneous tumours with characteristics of differentiation toward the hair matrix. The finding of extensive shadow cell differentiation in visceral carcinomas is otherwise unusual. We report herein a case of uterine adenocarcinoma with extensive pilomatrixoma-like areas in a 74-year-old woman. The endometrial tumour showed an invasive poorly differentiated growth with squamous differentiation deeply extending into the myometrium intermixed with lobules of empty squamoid polyhedral cells with clear shadow like nuclei, focally exhibiting a 'ghost' appearance. The cervix, salpinges, ovaries and pelvic lymph nodes were free of disease and, taking all evidence into account, the tumour was diagnosed as poorly differentiated endometrial endometrioid adenocarcinoma (FIGO stage IB). The recognition of an extensive pilomatrixoma-like component in a high- grade endometrioid adenocarcinoma may be important to avoid diagnostic misinterpretation with uterine metastases of malignant cutaneous pilomatrical tumours, such as pilomatrix carcinomas.

Association between multiple cutaneous melanoma and other primary neoplasms.

BACKGROUND: The risk of a subsequent cancer is an important issue for patients with melanoma. The development of a second primary cancer in patients with a solitary melanoma has been discussed in several studies. However, to our knowledge, the incidence of second primary cancer (SPC) in patients with multiple primary melanoma (MPM) has not been thoroughly investigated. AIM: To quantify the incidence of SPC in patients with MPM, with the aim of possibly developing further preventive measures. METHODS: In a retrospective study, 76 patients with MPM were identified from 2155 patients being followed up at our unit. RESULTS: Of the 76 patients, 12 (16%) developed another neoplasm, with 59% of them having nonmelanoma skin cancer (NMSC), and 41% other noncutaneous cancers. By contrast, only 8% of those with single primary melanoma had other neoplasms (21% of whom had NMSC). CONCLUSIONS: Patients with MPM, especially men with skin phototype II, have a significantly increased incidence of developing SPC, particularly NMSC. Thus, careful monitoring is essential not only to detect recurrence of the original cancer or development of another primary melanoma, but also development of new malignancies of different types, particularly NMSC.