Multimodality Imaging Evaluation of Nasal Rhabdomyosarcoma in Adults: A Case Report and Literature Review.

BACKGROUND: Alveolar rhabdomyosarcoma (ARMS) predominantly affects adolescents aged 10-15 years and is distinguished by its high aggressiveness and adverse prognosis compared with other sarcomas. It exhibits a pronounced tendency for lymphatic and hematogenous metastases at early stages. ARMS commonly manifests in the limbs and genitourinary system, with occurrences in the head and neck region being relatively uncommon. The role of CT, MRI, and 18F-FDG positron emission tomography combined with computed tomography (PET/CT) in the diagnostic process of ARMS is yet to be fully established. CASE REPORT: We report the case of a 49-year-old woman who presented with hematological nasal discharge for one month. CT imaging revealed a soft tissue mass in the left nasal cavity. MRI demonstrated a marginally hypo- to isointense signal on T1-weighted images, a hyperintense signal on T2-weighted images, and heterogeneous enhancement post-contrast. 18F-FDG PET/CT identified a hypermetabolic lesion located within the left nasal cavity. Surgical intervention entailed the excision of the left intranasal mass and the skull base lesion. Postoperative pathological analysis indicated ARMS. CONCLUSION: Sinus ARMS is notably malignant and associated with a dismal prognosis. Accurate diagnosis depends on histopathological and immunohistochemical evaluation, complemented by genetic analysis for specific chromosomal translocations and fusion genes. Imaging techniques, including CT, MRI, and PET/CT, are crucial for assessing lesion extent and metastasis, supporting disease diagnosis, informing treatment choices, facilitating surgical planning, and monitoring response to therapy.

Potential missed opportunities for diagnosis of lymphoepithelioma-like intrahepatic cholangiocarcinoma: report of a rare case.

Lymphoepithelioma-like intrahepatic cholangiocarcinoma (LEL-ICC) is a rare distinctive variant of liver cancer with unique epidemiological and pathological characteristics, including dense lymphocyte infiltration. We herein describe a 67-year-old Chinese man with LEL-ICC. The patient had undergone endoscopic extraction of a bile duct stone 1 month prior. Contrast-enhanced abdominal computed tomography (CT) revealed a 2.5- × 2.5- × 1.5-cm low-density mass located in a covert part of the left lateral segment of the liver. Contrast-enhanced magnetic resonance imaging revealed a hyperintense lesion on T2-weighted and diffusion-weighted images of the left lateral liver, with similar size and signal characteristics in the arterial and portal venous phases. The patient subsequently underwent left lateral laparoscopic hepatectomy. The results of postoperative pathology and immunohistochemistry allowed for the definitive diagnosis. In situ hybridization using an Epstein-Barr virus-encoded RNA probe revealed extensive reactivity in the tumor cell nuclei, supporting a diagnosis of LEL-ICC. The patient was recurrence-free at 12 months postoperatively as shown by CT. A literature review indicated that in middle-aged patients with Epstein-Barr virus infection, a liver mass with a well-defined margin and a combination of hypervascularity and delayed intratumoral enhancement on CT and magnetic resonance imaging may suggest a diagnosis of LEL-ICC.

Collision tumor of meningioma and metastatic renal clear cell carcinoma: a case report.

Distinct tumors in direct contact with one another are known as collision tumors and collision tumors of meningioma and metastatic renal cell carcinoma have not been previously reported. We report a 71-year-old female with a history of renal cell carcinoma who was presented with slow response and gait imbalance for 4 months. Brain MRI showed a mass in the base of right middle cranial fossa. The mass was completely removed. Histopathologic and radiographic findings provided evidence for a collision composed of meningioma and metastatic renal clear cell carcinoma.

Familial aggregation of subcutaneous panniculitis-like T cell lymphoma: A case report of monozygotic twin brothers.

RATIONALE: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous lymphoma, which was first defined as a clinical entity in 1991 as a cytotoxic T-cell lymphoma preferentially infiltrating subcutaneous tissue. Herein, we report 2 patients of SPTCL who are a pair of twin brothers. PATIENT CONCERNS: The disease afflicted the monozygotic twin brothers at different time with an interval period of 5 years. The older twin brother had disease onset at 27 years of age. In June 2012, he developed prolonged fever accompanied by subcutaneous nodules in the left upper arm and left chest due to unknown origin. The younger twin brother had disease onset at 32 years of age. In June 2017, the younger brother presented with repeated high fever for more than 10 days, accompanied by head distension. DIAGNOSIS: On August 7, 2012, skin biopsy was performed on the lesion of left upper arm of the older twin brother, and then, a diagnosis of subcutaneous panniculitis-like T cell lymphoma (SPTCL) was made. On June 19, 2017, the younger twin brother underwent whole-body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography for diagnosis. Soon afterwards, abdominal subcutaneous nodule resection and biopsy was performed on June 28, 2018, and the specimen was diagnosed as SPTCL. INTERVENTIONS: For the older brother, a total of 14 systemic chemotherapy sessions were performed from August 16, 2012, to September 21, 2014. For the younger brother, a total of 9 systemic chemotherapy sessions were performed from July 14, 2017, to March 8, 2018, then he was switched to oral chemotherapy with chidamide twice a week for 6 months. OUTCOMES: The older twin brother died in March 2015, the younger brother has recovered well and is no longer receiving any treatment LESSONS:: To the best of our knowledge, twin brothers both having this disease has never been previously reported. Moreover, some of the involved areas are also extremely rare detected by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography at initial stage. It is beneficial to people to gain some new understanding for SPTCL by this special case and some extremely unusual involved sites in the younger twin brother.

Lymphoepithelioma-like hepatocellular carcinoma without Epstein-Barr virus infection: A case report and a review of the literature.

Lymphoepithelioma-like carcinoma (LELC) of the liver is uncommon, only 20 cases have been reported in the English-language literature so far, and the majority has been identified as cholangiocarcinomas, only four cases were hepatocellular LELC. Here we described a rare case of lymphoepithelioma-like hepatocellular carcinoma (HCC). A 42-year-old Chinese female who was incidentally found to have a liver-occupying lesion during a routine medical examination. Ultrasonography revealed a 47 mm × 33 mm × 36 mm hypoechoic mass in the left lobe. Computed tomography and magnetic resonance imaging displayed a nodular lesions in the left liver lobe. The patient underwent a left-side hepatectomy. Histopathological examination of the resected specimen revealed an undifferentiated carcinoma with a dense lymphocytic infiltrate, predominantly composed of CD3(+) T cells, morphologically similar to nasopharyngeal carcinoma. Immunohistochemically, the tumor cells were positive for CK, EMA, Glypican-3 and hepatocyte, but negative for alpha-fetoprotein, CK19, CK7 and CK20. Epstein-Barr virus (EBV) in situ hybridization was negative. The final histopathological diagnosis was lymphoepithelioma-like HCC without EBV infection.