A dedifferentiated rare primary breast liposarcoma - case report and literature review.

Liposarcoma of the breast is a very rare soft tissue malignant tumor arising in the fat cells, with a prevalence of 0.3% of all malignant breast tumors, clinically manifested as a palpable breast mass mimicking a primary breast cancer. In the present paper, we had two objectives: (i) to report the first liposarcoma case in our Clinic and (ii) to screen the scientific literature on the topic. Our report presents an unusual case of a 56-year-old female with symptomatic left breast mass initially histopathologically diagnosed as a mesenchymal lesion. Four months later, the tumor was histopathologically identified as a grade 3 dedifferentiated liposarcoma (DDLPS) Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC; French Federation of Cancer Centers). We present the histopathological, immunohistochemical, and radiological features of the case and outcomes. Secondly, we performed a systematic search on liposarcoma on the PubMed®∕Medline® and Web of Science® databases, using the keyword "primary breast liposarcoma" (all-time topic). Due to the small number of cases found in the literature, the best treatment choice and determination of prognosis are difficult to make. Our patient underwent breast radical surgery, received adjuvant treatment, continuously monitored, being disease-free after five years of follow-up.

Giant abdominal tumor - would you think adrenal?

Adrenal cavernomas are rare benign tumors, and those of giant dimensions are exceptional. Usually, they are symptomless or they induce symptoms and signs due to compression over nearby organs. We present the case of a 68-year-old woman, who complained of abdominal enlargement and abdominal pain in the left part of the abdomen. Imagistic investigations (native and contrast abdominal computed tomography) revealed an inhomogeneous retroperitoneal mass of 210∕182∕200 mm, containing calcifications. Laboratory findings were not relevant, just a slight and non-significant elevation of carcinoembryonic antigen and a slight elevation of C-reactive protein. Diagnosis of cancer of undetermined origin was considered, and surgery was performed. During surgery, a giant encapsulated inhomogeneous tumor of 330 mm, with cystic areas, was removed, without assessing the origin. Primary or secondary tumors (metastasis from breast, intestinal, lung, renal or skin cancer) were taken into account. Only histopathology and immunohistochemistry revealed the diagnosis of adrenal cavernoma. Until this moment, we found only one published article in the medical literature with similar dimensions of an adrenal cavernoma as in our case. Even if rare, hemangioma of the adrenal gland must be considered during the differential diagnosis of an adrenal tumor.

Giant basal cell carcinoma of the nasal pyramid - case report.

Basal cell carcinoma (BCC) is a frequent form of skin cancer, which usually affects people that have been exposed to the sunlight for longer periods of time. The cells of the lower part of the epidermis are called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skin's surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells. Therefore, the BCC develops from these cells. Most BCCs have indolent behavior, with cure rates very high after low-complexity treatment. However, some lesions are very aggressive and there are only a few papers focusing on the subtype of this skin cancer known with the name ulcus rodens or giant BCC. In this study, we evaluate a case of ulcus rodens or giant BCC, subtype of the BCC skin cancer located in the area of the nasal pyramid, stage III, TxNxMx, with lymphatic and vascular invasion present.

Prevalence of abnormal Pap smears in a consecutive and previously unscreened population in Romania.

OBJECTIVE: To determine the prevalence of abnormal cervical smears in a previously unscreened and asymptomatic population in Romania and to compare the data with those from other countries in Europe. METHODS: In a retrospective study, data were reviewed from smears obtained from women in Romania who had been referred to the gynecologist between January 2006 and December 2011. The smears were collected through 3 regional opportunistic programs of cervical screening and were classified according to the Bethesda system. RESULTS: During the study period, 50536 smear tests were carried out. Of these, 100 smears (0.2%) were unsatisfactory and excluded from the study. Among the remaining 50436 smears, 2965 patients (5.9%) had abnormal epithelial changes. Most of the abnormal smears were represented by atypical squamous cells of undetermined significance (2.6% of all smears). The data confirmed that there is a high prevalence of high-grade intraepithelial squamous-type lesions (0.9% of all smears) in Romania, and of abnormal smears in women younger than 25years of age (14.0% of all abnormal smears). CONCLUSION: The data show that there is a high prevalence of epithelial abnormalities among cervical smears in Romania compared with other European countries that run a national screening program.

Asymptomatic abdominal wall endometrioma 15 years after cesarean section.

Abdominal wall endometriosis is rare and its diagnosis is difficult. However, the consequences may be serious, like recurrences or even malignant transformation. We report a rarer case of asymptomatic abdominal wall endometrioma, accidentally found during a surgical procedure for a second cesarean section, in a 39-years old patient, without any relevant history of endometriosis. The tumor was subcutaneous, 3/3 cm in size, located in the left angle of the incision from the 15 years previously performed cesarean section and freely mobile in relation with the skin and the fascia. It was excised, with clear margins (to prevent recurrences), during the procedure. The patient was discharged after five days. The postoperative period and the follow-up at one and three months were uneventful. The pathological examination clarified the diagnosis by revealing an endometrioma with decidual reaction. Such a condition may be, therefore, evoked before an abdominal wall tumor, even without specific symptoms, even in a 39-years old woman and longtime after the possible causal surgery. Pathological examination remains the ultimate diagnostic tool. Relevant prophylactic attitude at the end of the cesarean section may be considered.