Acral Nodular Melanoma Presenting With Rapid Progression.

Melanoma is a malignant tumor that is derived from melanocytes of the skin and other sites. Melanoma accounts for 1% to 3% of all malignancies and 1% to 2% of all cancer deaths worldwide. We are presenting a case of a 42-year-old female who presented to the surgery department with a growth over the right heel since 18 months, with a history of trauma to the site. The lesion showed rapid progression with a large mass and secondary skin ulceration and sloughing. A PET scan showed an enhancing lesion on the right heel measuring 11 mm in thickness. There was no evidence of any systemic organ or any lymph node metastasis. Surgical excision and reconstruction on the part of the heel by a local flap with sural graft with split-thickness skin grafting was done. The excised growth was sent for histopathology. The histopathological diagnosis of nodular melanoma (NM) of the heel was given. We are presenting this case for its clinical, histopathological, and surgical management.

Gestational Trophoblastic Disease - Clinicopathological Study at Tertiary Care Hospital.

INTRODUCTION: Gestational Trophoblastic Disease (GTD) is a term used for a group of pregnancy-related tumours. These consist of various tumours and tumour like lesions characterized by proliferation of trophoblastic tissue. Amongst GTD, hydatidiform moles are the most common form. These lesions sometimes may develop into invasive moles, or, in rare cases, into choriocarcinoma. AIM: To study the clinicopathologic characteristics and prevalence of different forms of gestational trophoblastic disease in a tertiary care hospital. MATERIALS AND METHODS: The present study was descriptive, observational, analytical type done in Department of Pathology at tertiary care hospital from May 2012 to April 2016. All cases clinically suspected of GTD were included and confirmation was done by histopathological study on H&E stained slides. The cases of GTD were classified according to WHO classification. Detailed histomorphological features and beta human Chorionic Gonadotropin (hCG) levels were correlated. RESULTS: During study period, 18345 deliveries were reported; out of which 77 cases were diagnosed as GTD. Almost 97.40% cases were of hydatidiform moles, 1.30% cases of choriocarcinoma and 1.30% cases of Placental Site Trophoblastic Tumour (PSTT). Among the cases of hydatidiform mole 57.34% were complete mole and 41.33% cases were of partial mole. The common clinical presentation was per vaginal bleeding and amenorrhea. The blood group A was most commonly observed in patient (49.35%). In majority of cases beta hCG levels were between 50,000 to 100000 mIU/ml. The correlation between beta hCG level and GTD were done. CONCLUSION: Pregnant females clinically presenting with abnormal vaginal bleeding must be evaluated for GTD. Histopathological examination is helpful for confirmatory diagnosis. Follow up of such patients is essential for early detection of malignant trophoblastic tumours.

Primary Squamous Cell Carcinoma of Urinary Bladder - A Rare Histological Variant.

Primary squamous cell carcinoma of urinary bladder is a rare histological variant of epithelial bladder tumours. Histopathological types are associated with significant disease outcome, so it is essential to find, on microscopy the exact type of urothelial carcinoma. Herewith, we present a 70-year-old male having 3 months history of difficulty in micturition, reduced frequency of urine and associated pain. On Contrast Enhanced CT scan abdomen pelvis, showed irregular large urinary bladder mass with hydroureter and hydronephrosis. Internal iliac group of lymphnodes was enlarged. On histopathology diagnosed as pure squamous cell carcinoma of urinary bladder grade II with muscle invasion. We are presenting this case for its clinical, radiological and histopathological findings.

Primary Angiosarcoma of the Breast: An Uncommon Histopathological Subtype.

Primary angiosarcoma of the breast is extremely rare malignant tumour of the breast. The cytological and radiological findings are often non specific for diagnosis. Histopathology plays an important role in diagnosis and grading of tumour. Herewith we present a case of 55-year-old postmenopausal woman having history of rapidly enlarging right breast lump with prominent vascularity and associated bluish discolouration of overlying skin. Mammography shows ill defined mass lesion. Fine needle aspiration cytology was done which showed haemorrhagic aspirate with few clusters of highly pleomorphic neoplastic cells. Patient underwent modified radical mastectomy. On histopathological evaluation it showed primary angiosarcoma of the breast, poorly differentiated, grade-III. We are presenting this extremely rare malignancy of breast for its clinical, cytological and histopathological findings.

Male breast cancer: presenting as synchronous, large, bilateral masses.

Male breast cancer is a very rare neoplasm which accounts for 1% of all breast cancers. A 70-year-old male presented with a rapidly growing, bilateral breast masses with large size, surface ulceration and bloody discharge. Synchronous bilateral breast cancer was diagnosed by using fine needle aspiration cytology, mammography, ultrasonography and incisional biopsy. Histopathological studies revealed invasive ductal carcinoma (not otherwise specified), which was of grade III in left breast and of grade II in right breast. We are presenting this case with its clinico-pathological findings, as synchronous bilateral breast cancer occurs extremely rarely in males.