Leiomyosarcoma of the bone: Unveiling the mystery of a spindly ossein.

ABSTRACT: Leiomyosarcoma (LMS) represents one of the most common soft tissue sarcomas, involving various anatomical sites like the retroperitoneum, genitourinary tract, and extremities. LMS of the bone is extremely rare, with a 0.7% incidence of all primary malignant bone tumors. They are histologically identical to the leiomyosarcomas of other sites but pose a diagnostic dilemma due to their rarity and varied presentation when it manifests as a bony lesion.

Ovarian Plasmablastic Lymphoma Posing Diagnostic Dilemma: A Rare Case Report.

Plasmablastic lymphoma (PBL) is a rare, aggressive lymphoma with no definite standard of care with a poor outcome. It occurs predominantly in HIV-infected individuals and is frequently seen in extranodal sites. The important differential diagnosis for this PBL is plasmablastic myeloma, where clinical and histopathological features are often ambiguous, rendering the correct diagnosis difficult without complete integration of clinical, morphological, phenotypic, and molecular features. Here, we report a rare case of plasmablastic lymphoma of the ovary with a diagnostic dilemma and the approach to the diagnosis and its management.

Neuroendocrine Carcinoma of Duodenum-an Uncommon Tumour at an Unusual Site.

Neuroendocrine carcinoma rarely occurs in the duodenum, and most cases of neuroendocrine carcinoma in the duodenum show rapid progression of the disease. Such cases have poor prognosis even with radical surgery with or without chemotherapy with low 5-year survival rate. We present a case of a 52-year-old man who presented with abdominal pain of 1-month duration and one episode of vomiting. Upper gastrointestinal endoscopy revealed polypoidal lesions in the first and second part of the duodenum. Whipple's procedure was performed. Diagnosis of poorly differentiated neuroendocrine carcinoma was made with extension to pancreas with peripancreatic lymph node metastases. The patient expired on post operative day 17 following cardiac arrest.

Urachal cyst with xanthogranulomatous cystitis: A rare case report.

An urachal cyst is a sinus remaining from the allantois during embryogenesis which is rarely manifested in adults. The urachus is an embryologic remnant which degenerates after the birth. Defective obliteration of the urachus leads to urachal abnormalities. Urachal cyst is a rare pathology in adult women, and this pathology should be considered in the differential diagnosis of acute abdomen. Xanthogranulomatous cystitis (XC) is a benign disease of unknown etiology. The clinical manifestations of these are nonspecific such as lower abdominal pain, umbilical discharge with occasional hematuria. Urachal lesions present with persistent umbilical drainage in infants and newborn. However, in 35% cases, enclosed urachal cyst or infected urachal cyst (abscess) manifests without having umbilical discharge. Computed tomography scan and magnetic resonance imaging are of little help to the identification of these preoperatively. Here, we present a rare case of urachal cyst with XC in 30-year-old female which has produced diagnostic dilemma.

Unusual presentation of immature teratoma of the neck: A rare case report.

Cervical region teratoma is a rare disease, accounting for 3-5% of all teratomas in the children. Teratomas of the head and neck due to their obscure origin, unpredictable behavior, and often manifest as a clinical surprise. Airway obstruction is the most serious postnatal complication of cervical teratoma. Prenatal diagnosis is crucial for early recognition of the neck masses that could obstruct the airway. We present a case of 4-month-old female child at age of 4 th month with right submandibular region swelling. Computed tomography neck showed ill-defined, multiloculated cystic lesion with enhancing thick septations in the right side of the neck. Excision biopsy revealed Grade I--immature teratoma--cervical region. On 1-year of close follow-up, no evidence of local recurrence or metastasis was seen. Unlike adults, teratomas in children are often congenital and very rarely turn malignant. The treating consultant should be aware of their natural history, clinical features, pathology, and principles of management.

Subcutaneous rhinosporidiosis masquerading as soft tissue tumor: diagnosed by fine-needle aspiration cytology.

Rhinosporidiosis is a chronic granulomatous lesion caused by Rhinosporidium seeberi. It frequently involves nasopharynx and ocular region. Presenting as cutaneous and subcutaneous mass is extremely rare. This report describes the FNA cytology of rhinosporidiosis occurring as a soft tissue mass in the right mid thigh region. We present a rare case of a 71-year-old male, who presented with multiple subcutaneous soft tissue mass lesions in the posteromedial aspect of mid right thigh region since 2 weeks. Local examination revealed multiple firm to hard mass with skin over the swelling was unremarkable. CT of the right thigh showed a heterogeneous lesion with infiltrative margins in the thigh. Clinically soft tissue sarcoma was considered. Diagnostic FNAC was performed showing numerous mature and immature sporangias with giant cell reaction. Hence, an excision biopsy confirmed the rhinosporidiosis. To conclude, the FNAC diagnosis of rhinosporidiosis is specific. Preoperative diagnosis is possible even in cases with unusual clinical presentations.

Solid pseudopapillary tumor of pancreas with sickle cell trait: a rare case report.

Solid pseudopapillary tumor of pancreas is a rare pancreatic neoplasm affecting young women, has low malignant potential and amenable for surgical excision with good long-term survival. Sickle cell trait is benign condition, which involves one normal beta-globin chain and one HbS chain. Although it is a benign condition, individuals are prone to have rare complications that may predispose to death under certain circumstances. We report a rare coexistence of solid pseudopapillary tumor of pancreas with sickle cell trait in an 18-year-old female who underwent distal pancreatectomy with splenectomy. Histopathological examination and haemoglobin electrophoresis confirmed the diagnosis.

Morphological profile and receptor status in breast carcinoma: an institutional study.

CONTEXT: The data on histological and receptor status in breast cancer in an Indian population is limited as receptor status is not routinely carried out for these patients. In the present study, receptor status was analyzed and it was correlated with morphological prognostic parameters. OBJECTIVE: To analyze the morphological prognostic parameters and its correlation with receptor status in Indian women. DESIGN: The sample consisted of 126 specimens of invasive breast cancer received in department of pathology of our institution with teaching hospital attached to it, situated in South Canara district of, Karnataka, South India between year 2009 and 2011. RESULT: Sixty-seven percent of patients were 50 years or younger. Histological types were invasive ductal carcinoma, not otherwise specified (58.7%), and overall (15.9%) were grade 3. Estrogen receptor was positive in 36.5%, HER/neu was overexpressed in only three cases; 50.0% were "triple" negative (estrogen receptor, progesterone receptor, HER/neu negative). Estrogen receptor (ER) and progesterone receptor (PR) positivity decreased with increase in tumor grade. There was significant association between tumor size and ER positivity. CONCLUSIONS: Breast carcinoma in our population presents at younger age than Western population. Our results showed very high proportion of triple-negative breast cancers. The tumor size and grade is related to expression of only ER. The findings suggest that women in our population more often have histologically aggressive breast carcinoma at young age, likely to be less susceptible to conventional hormonal and targeted antibody treatment. Detecting and treating this increasing important cause of mortality will be an enormous challenge.

Synchronous bilateral medullary carcinoma of breast: is it metastasis or second primary?

Bilateral breast cancer is a rare event accounting for 2-5% of all breast malignancies. A second tumor in contralateral breast may be either synchronous or metachronous lesion. Synchronous bilateral invasive ductal carcinoma is known but medullary carcinoma is rare. The etiology of bilateral breast cancer is uncertain and prognosis in these cases once thought to be poor but recent data suggest a similar survival compared to unilateral disease. We report a case of triple negative synchronous bilateral medullary carcinoma in a 38-year-old female who presented with lump in both the breasts for three months. Multidetector computed tomography breast scan revealed bilateral heterogeneously enhancing well-defined lesion in both the breasts. Fine needle aspiration cytology from both the breast lump was suggestive of malignancy. Patient underwent bilateral modified radical mastectomy with axillary clearance in a single sitting. Histopathology showed synchronous bilateral medullary carcinoma of breast with ER, PR and HER- 2/ neu negativity. Patient was treated with chemoradiation and she is on regular follow up for one year without any recurrence or metastasis.

A Rare Case of Fungal Maxillary Sinusitis due to Paecilomyces lilacinus in an Immunocompetent Host, Presenting as a Subcutaneous Swelling.

Paecilomyces is a colonizing fungal species which usually causes keratitis, endocarditis, sinusitis, nephritis, fungemia, cutaneous, and subcutaneous infections in immunocompromised host. Very rarely, it causes similar infection in immunocompetent host without any risk factors. We report a case of maxillary sinusitis due to Paecilomyces lilacinus in a 65-year-old immunocompetent male, who presented with a subcutaneous swelling below the left eye. The lesion was excised by surgery and treated with itraconazole for 6 months based on culture and sensitivity. After 1 year of follow up, he is free of symptoms with no evidence of recurrence.