Intracranial tumor-to-tumor metastasis in an elderly female: An unusual case report.

Tumor-to-tumor metastasis is an extremely rare event, with only 150 reported cases in the literature. Meningioma, renal carcinoma, and tumors of the thyroid are the commonest sites of metastasis. Lung, breast, and GI-tract cancers are the most common types that undergo metastasis. Meningioma is the most common intracranial tumor as recipient of the tumor-to-tumor metastasis. Although breast carcinoma is the most common tumor to metastasize, adenocarcinoma from other organs can also spread to meningiomas, like the ovary and upper gastrointestinal (GI). We report a case of adenocarcinoma metastasis to meningioma with the possibility of primary involvement of the ovary or upper GI. A 77-year-old female patient presented to neurosurgery with episodes of multiple seizures and loss of consciousness. An MRI suggested a left frontotemporal meningioma. The patient underwent craniotomy with mass dissection. Microscopic examinations showed a dual tumor containing both components of meningioma with a metastatic adenocarcinomatous component. The tumor cells were positive for cytokeratin (CK7). Thus, the final diagnosis was made as meningothelial meningiomas (WHO grade I) with metastatic mucinous adenocarcinoma, possible primaries of the ovary or upper GI tract. The patient could not be followed up as we lost the patient a few days after surgery.

Immunohistochemical Expression of the Stem Cell Marker CD133 in Colorectal Carcinoma.

Background Colorectal carcinoma (CRC) is the second-leading cause of cancer-related death. Despite the combined (surgery, chemotherapy, radiotherapy, and immunotherapy) modalities of treatment, the prognosis remains poor, mostly because of recurrence and distant metastasis. Cancer stem cells (CSC) are thought to be responsible for the development and spread of tumors. Hence, targeted therapy against these cells hopes to reduce the chance of recurrence and metastasis and improve the prognosis. Many immune markers have been identified to detect CSC in CRC. Here, we tried to assess the immunohistochemical expression of the stem cell marker CD133 in colorectal carcinoma and its correlation with various pathological parameters. Methodology A total of 51 cases of CRC were analyzed. Immunohistochemistry for CD133 was done after standardization in our laboratory. Expression status was decided based on the total score obtained by multiplying the intensity score by the percentage score. CD133 expression was correlated with the age and gender of the patient, tumor location, histological grade, extent of invasion, lymphovascular invasion (LVI), perineural invasion (PNI), and nodal status. Results High CD133 expression was seen in 21 (41.17%) cases. There was no significant association between CD133 expression and the pathological parameters except the tumor site. CD133 expression was significantly higher as we moved from the proximal colon to the rectum. Conclusions CD133 expression was significantly higher in the distal part of the large intestine as compared to the proximal part. But there was no linear correlation between CD133 expression and histological grade, extent of invasion, or nodal status.

Expression of TP53 in oral squamous cell carcinoma and its correlation with adverse histopathological features.

Background: This study aimed to evaluate the expression of TP53 in oral squamous cell carcinoma (OSCC) and to correlate its expressions with adverse histopathological features like depth of invasion (DOI), lymphovascular invasion (LVI), perineural invasion (PNI), extranodal extension (ENE), and margin status which significantly affect the prognosis. Methodology: This cross-sectional study included 48 patients of OSCC who underwent surgical resection. All the histopathological adverse features such as DOI, LVI, PNI, ENE, margin status were noted. Immunohistochemical expression of TP53 was noted and a correlation of TP53 with histopathological adverse features was done. Statistical analysis was performed using SPSS software. Results: TP53 immunopositivity was seen in 45.83% (22/48) of cases. TP53 has a statistically significant correlation with margin status (P = 0.002). Similarly, TP53 expression is more in cases with LVI (100% cases) though the value is not statistically significant. TP53 expressions are more in positive margin cases and less if the margin is >5 mm. Similarly, TP53 expression is more in cases with LVI (100% cases) though the value is not statistically significant. Conclusion: Few parameters that did not show the correlation of TP53 with adverse histopathological features could be attributed to a small sample size. Further studies with a large number of cases and using other ancillary molecular diagnostic techniques would throw further light on the exact alteration of TP53 in our population and their association with histopathological prognostic features.

Diagnostic Utility of Ultrasound-Guided Fine-Needle Aspiration Cytology in Gall Bladder Lesions: An Experience from a Tertiary Care Cancer Center in Eastern India.

INTRODUCTION: Gallbladder cancer (GBC) is the most common malignancy, representing 80-95% of biliary tract cancers. Although ultrasonography-guided fine-needle aspiration cytology (USG-FNAC) has emerged as an effective diagnostic the tool for the precise diagnosis of gallbladder lesions, data on its diagnostic utility and cytomorphological categorization of gallbladder lesions are lacking. AIMS: To study the diagnostic utility of USG-FNAC in gallbladder lesions. MATERIALS AND METHODS: This study was the conducted prospectively on patients who came with clinical and radiological evidence of gallbladder space-occupying lesion and then advised to USG-FNAC over 2 years and 6 months from January 2018 to June 2020. RESULTS: A total of 314 cases were included. The mean age was 56 years, with a range of 17-88 years. Women predominated over men (Male:Female = 1:2.3). Primary adenocarcinoma of the gallbladder was most common. On cyto-histological correlation, the sensitivity, specificity, and diagnostic accuracy of USG-FNAC of gallbladder lesions were found to be 98.82, 87.23, and 96.3%, respectively. CONCLUSION: The USG-FNAC of gallbladder lesion was found to be an easy, quick, cost-effective, and presumptive diagnostic procedure. It should be opted as an initial preoperative diagnostic modality in high incidence areas to avoid inappropriate management with unnecessary morbidity and cost. Moreover, a close cytological examination of the architectural pattern and the cytomorphological features would help in the sub-typing and prognosticating the tumor.

Salivary amylase crystalloids in Warthin's tumor: An aspiration cytodiagnosis.

Crystalloids may be seen in a variety of salivary gland lesions, but their presence is not common. Among various types of crystalloids, amylase crystalloids are usually found in benign lesions of the salivary gland. Here, we report a case of a 76-year-old male with swelling on the angle of the mandible left side for 15 days. Local examination showed a solitary soft-to-firm swelling of size 4.7 cm × 4.1 cm × 2.8 cm. Ultrasonography (USG) showed a well-defined cystic lesion with the solid component. Fine-needle aspiration cytology cytosmears showed predominantly mixed inflammatory cells; few epithelial cell clusters with numerous crystalloids which are rectangular to rhomboid shape with nonparallel sides. Cytological features are suggestive of benign cystic sialadenitis with amylase crystalloids. However, after 3 months of follow-up, as the swelling did not subside, excisional biopsy was done and histopathology showed features of Warthin's tumor with crystalloids. The presence of amylase crystalloids in any type of salivary gland lesion with cystic change; multiple aspirations followed by histopathological examination should be done to rule out neoplastic etiology.