SYNCHRONOUS DIAGNOSIS OF TESTICULAR AND THYROID CANCER IN A YOUNG MALE.

Testicular cancer is the most common neoplasm in young males. The early diagnosis and the appropriate treatment make it a curable malignancy in over 90% of the patients, but 6% of the patients with testicular cancer develop a second, mostly treatment-related, malignancy in another primary site many years after the first diagnosis. The simultaneous appearance of a testicular tumor with another primary neoplasm is rarely described in the literature. Here is presented an interesting case of a coexisting non-seminomatous germ cell testicular tumor with a papillary thyroid carcinoma, which was detected early during post-treatment restaging of the testicular tumor. The synchronous presence of these two neoplasms might indicate a probable common pathogenetic background. As treatment-related oncogenesis is highly improbable in this case and the common environmental factors are not known yet, the interest is focused on genetic predisposition. Recent discoveries in molecular genetics show that the two neoplasms share common genetic alterations in the RAS and BRAF genes, which affect the significant signaling pathways. Interestingly, BRAF-V600E was positive in both primary malignancies in our individual.

Laryngeal solitary fibrous tumour: diagnostic challenge in a rare presentation.

Solitary fibrous tumours (SFT) are rare spindle cell mesenchymal neoplasms, most commonly appearing as well-circumscribed localised lesions arising from the abdominal or pelvic peritoneum. Their presence in the head and neck region is very rare; even more so in the post-cricoid region, with only one case described in the literature to date. The clinical behaviour of SFT may vary from benign to malignant, but only 10-15% of SFT demonstrate local recurrence or distant metastasis. The usual presenting symptoms of dysphagia and weight loss are very vague to give a definite diagnosis, and examination, even under general anaesthesia, combined with biopsies can sometimes be misleading, as in our case. Here, we describe a very challenging case of supraglottic SFT originating from the post-cricoid area. Our 73-year-old patient presented with dysphagia and upon examination a large supraglottic mass was revealed. Biopsies from the mass pointed to malignancy and the patient underwent total laryngectomy. The laryngeal specimen contradicted the biopsy and revealed a rare solitary fibrous tumour with benign features and thus adjuvant treatment was not necessary. Ever since the patient has been attending regular follow-up sessions and remains disease-free 18 months after surgery.

Desmoplastic small round-cell tumour of the peritoneal cavity: case report and literature review.

Desmoplastic small round-cell tumour is a very rare neoplasm, which usually arises from the abdominal or pelvic peritoneum of adolescents and young adults. Early diagnosis is difficult, because most tumours present with non-specific gastrointestinal symptoms after a long asymptomatic period. It is generally a very aggressive tumour, which grows rapidly with poor prognosis and an overall five-year survival rate of 15% despite multimodal treatment. Despite multiple treatment strategies, the management of desmoplastic small round-cell tumour still remains a clinical challenge and no consensus about a therapeutic protocol has been established. A 35-year-old man presented with mild abdominal pain, constipation and weight gain, and was eventually diagnosed with desmoplastic small round-cell tumour, which was shown to be limited to the abdomen. After incomplete debulking surgery, radiotherapy and chemotherapy, he developed multiple metastatic nodular foci in chest and the pleura and, unfortunately, he died due to disease progression.

Mucinous breast carcinoma with tall columnar cells.

Mucinous carcinoma of the breast represents 1%-4% of all breast cancers. The World Health Organization classification divides this type of tumour into three different subtypes: mucinous carcinoma, mucinous carcinoma with tall columnar cells (mucinous cystadenocarcinoma and columnar cell mucinous carcinoma) and signet ring cell carcinoma. A 74-year-old woman presented a tumour with inflammatory features in the upper outer quadrant of her left breast, 7 cm in diameter. The core biopsy showed infiltrating ductal carcinoma of no specific type. The tumour-node-metastasis clinical staging was T4cN3M0 (Stage IIIC). She received neoadjuvant chemotherapy, underwent left mastectomy with radical axillary resection and subsequently received radiotherapy and chemotherapy. The histological examination of the surgical specimen revealed two solid tumors in the tail of Spence, which corresponded to adenocarcinoma with high columnar cells. The patient died 16 months after the diagnosis, suffering from pulmonary metastases and anterior chest wall infiltration. A review of the literature revealed only 21 reports of mucinous carcinoma of the breast with tall columnar cells, including our case. This is only the third time that the specific histological type of columnar cell mucinous carcinoma has been reported in the literature.