A primary intraosseous cystic meningioma: Case report.

INTRODUCTION: This is a very rare case of intraosseous cystic meningioma. There have been no reports of similar cases in the last 30 years. PRESENTATION OF CASE: A 62-year-old man, suffering from a swelling of the lateral wall of the left orbit was admitted to our hospital. MRI and CT scan showed a large intradiploic lesion involving the lateral wall of the orbit and the greater wing of the sphenoid. The lesion was cystic with a mural nodule. We operated the patient and removed completely the mural nodule and the fibrous wall of cyst. Histological examination showed that the mural nodule was a benign meningothelial meningioma. DISCUSSION: Primary intraosseous meningiomas represent a subtype of primary extradural meningiomas; they comprise about 2% of all meningiomas and are therefore rare entities. Cystic meningiomas are rare, their incidence compared to all other types of meningiomas is of 2-4%. The presence of a meningioma with both characteristics: cystic and intraosseous, like in our case, is an exceptional occurrence. CONCLUSION: The surgical management of tumor was easy; its rarity means that the case is interesting.

External Quality Assessment (EQA) program for the preanalytical and analytical immunohistochemical determination of HER2 in breast cancer: an experience on a regional scale.

BACKGROUND: An External Quality Assessment (EQA) program was developed to investigate the state of the art of HER2 immunohistochemical determination in breast cancer (BC) in 16 Pathology Departments in the Lazio Region (Italy). This program was implemented through two specific steps to evaluate HER2 staining (step 1) and interpretation (step 2) reproducibility among participants. METHODS: The management activities of this EQA program were assigned to the Coordinating Center (CC), the Revising Centers (RCs) and the Participating Centers (PCs). In step 1, 4 BC sections, selected by RCs, were stained by each PC using their own procedures. In step 2, each PC interpreted HER2 score in 10 BC sections stained by the CC. The concordance pattern was evaluated by using the kappa category-specific statistic and/or the weighted kappa statistic with the corresponding 95% Jackknife confidence interval. RESULTS: In step 1, a substantial/almost perfect agreement was reached between the PCs for scores 0 and 3+ whereas a moderate and fair agreement was observed for scores 1+ and 2+, respectively.In step 2, a fully satisfactory agreement was observed for 6 out of the 16 PCs and a quite satisfactory agreement was obtained for the remaining 10 PCs. CONCLUSIONS: Our findings highlight that in the whole HER2 evaluation process the two intermediate categories, scores 1+ and 2+, are less reproducible than scores 0 and 3+. These findings are relevant in clinical practice where the choice of treatment is based on HER2 positivity, suggesting the need to share evaluation procedures within laboratories and implement educational programs.

Central chorioretinopathy associated with topical use of minoxidil 2% for treatment of baldness.

PURPOSE: Minoxidil is one of the drugs approved for the treatment of androgenetic alopecia. This article presents a case of central serous chorioretinopathy after application of topical minoxidil solution. METHODS: We examined a 37-year-old man who complained of a positive relative scotoma, metamorphopsia and impaired dark adaptation involving the right eye. The patient reported an 8 month history of daily topical use but denied previous treatment with other drugs. Dilated fundus examination of right eye revealed central swelling located over the macula. Optical coherence tomography showed the presence of subretinal fluid. Fluorescein angiography disclosed one focal hyperfluorescent spot in the foveal area with minimal pigmentary changes limitated to that area. The patient was diagnosed with central serous chorioretinopathy (CSC) potentially related to an 8 month topical minoxidil solution administration. One month after the drug was discontinued, normal findings were found upon reexamination. The patient reported no previous episode of CSC. CONCLUSION: Major systemic side effects from topical solution of minoxidil are rare. To our knowledge, this is the first reported case of a central serous chorioretinopathy associated with long-term use of this drug.

Mucosal Schwann cell "Hamartoma": a new entity?

Schwannoma is a well-described, benign nerve sheath tumor of the soft tissue, but is rare in the gastrointestinal tract. Gastrointestinal schwannomas are often incidentally discovered as small polypoid intraluminal lesions. In this report, we describe the clinicopathologic and immunohistochemical features of a distinctive neural mucosal polyp composed of a diffuse cellular proliferation of uniform bland spindled cells in the lamina propria that entraps the colonic crypts. Immunohistochemical analysis revealed strong and diffuse positivity for the S-100 protein. To avoid confusion of these solitary colorectal polyps containing pure spindled Schwann cell proliferation in the lamina propria with neural lesions that have significant association with inherited syndromes, it is better to use the designation "mucosal Schwann hamartoma".

Giant fibrolipoma in the leg--a case report.

Lipomas are the most common benign tumors of the mesenchyme; they are composed of mature lipocytes. Benign fatty tumours can arise in any location in which fat is present. Most patients affected by such tumours are in their fifth or sixth decade of life. Only rarely are children affected. Lipomas may be single or multiple. Multiple lipomas are more common in women; many are seen in a familial setting. For a lipoma to be referred to as "giant", the lesion should be at least 10 cm in diameter or weigh a minimum of 1000 g. When very close to vital structures, giant lipomas may, on account of their excessive size, cause functional limitations, such as lymphedema, pain or nerve compression syndromes. Owing to the peculiarity of this condition and the difficulties encountered in its diagnosis and treatment, a case of a giant fibrolipoma in the leg is reported. A 48-year-old woman presented with an enlarging, soft, noduled mass on the right ankle and in the lower third of the right leg and heel; it was decided to remove the mass with all the overlying epidermis and to repair the resulting lesion first with fibroblast culture and subsequently with a meshed dermo-epidermal graft. One year after surgery, both the local and the general condition of the patient were good and there were no signs of recurrence.