Facial Nerve Schwannoma: The Rare/Great Mimicker of Vestibular Schwannoma/Neuroma.

Schwannomas are benign tumors arising from Schwann cells which are a protective casing of nerves, composing myelin sheath and can develop in any nerve where Schwann cells are present. Most common are vestibulocochlear nerve schwannomas. Facial nerve schwannomas (FNSs) are uncommon tumors involving seventh nerve of which geniculate ganglion involvement is most common. Clinical presentations and the imaging appearances of FNSs are influenced by the topographical anatomy of the facial nerve and vary according to the segments involved. We report a case of 73-year-old man presenting with right side facial weakness of lower motor neuron type involvement. Computed tomography and magnetic resonance imaging are clinching the diagnosis. An early diagnosis is important in containing the disease facilitating early surgical intervention.

Clinicopathological profile of lung cancer at a tertiary care center.

BACKGROUND: Lung cancer is one of the most common malignancies with high morbidity and mortality. Nonsmall cell lung cancer (NSCLC) accounts for majority of cases. AIMS: This study aims to study the clinical and pathological features of lung cancer patients treated at our institute between January 2011 and December 2016. SUBJECTS AND METHODS: It is a retrospective study. 446 patients of lung cancer were retrospectively analyzed for demographic data, history of smoking, histological type, and presence of epidermal growth factor receptor (EGFR) mutation/anaplastic lymphoma kinase (ALK) mutations. RESULTS: Of the 446 patients analyzed, 304 (68%) were males and 142 (32%) were females, with the ratio being 2:1. Most of our patients had a lesion localizing to the right side (45.7%) than left (37.8%). NSCLC was reported in 81.1% of our patients. EGFR mutation was found in 60 (24%) patients, the most common mutation being the deletion of exon 19 (73%) followed by L858R mutation (21.6%). CONCLUSIONS: EGFR and ALK mutation testing of all the lung cancer patients is to be encouraged as these mutations form druggable targets.

Granulosa cell tumor induced massive recurrence of post hysterectomy leiomyoma.

The authors report a very unusual occurrence of a massive recurrence of leiomyoma from post hysterectomy stump diagnosed on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT). The case also has an additional complexity of granulosa cell tumor (GCT) of ovary probably contributing to the recurrence and massive size.

Metastatic squamous cell carcinoma thyroid from functionally cured cancer cervix.

The authors report a very unusual occurrence of a metastatic squamous carcinoma to thyroid gland from a treated squamous cell carcinoma cervix 12 years before with no recurrence at the primary site. The case also has an additional complexity of rapid progression of the metastatic thyroid carcinoma to wide spread dissemination to lungs and bones while on concurrent chemo radio therapy confirming the aggressiveness of the entity.

F18 FDG positron emission tomography revelation of primary testicular lymphoma with concurrent multiple extra nodal involvement.

Primary testicular lymphoma (PTL) a relatively rare disease of non-Hodgkin's lymphomas occurring with a lesser incidence of 1-2% has a propensity to occur at later ages above 50 years. PTL spreads to extra nodal sites due to deficiency of extra cellular adhesion molecules. We present detection of multiple sites of extra nodal involvement of PTL by F-18 positron emission tomography/computed tomography study aiding early detection of the dissemination thus aiding in staging and management.

Assessment of HER2/Neu status by fluorescence in situ hybridization in immunohistochemistry-equivocal cases of invasive ductal carcinoma and aberrant signal patterns: a study at a tertiary cancer center.

INTRODUCTION: HER-2/neu status determines the eligibility for targeted therapy with trastuzumab in breast carcinoma. Evaluation for HER-2/neu protein expression by immunohistochemistry (IHC) and gene amplification by fluorescence in situ hybridization (FISH) has become the gold standard. AIMS: Since data on HER-2/neu assessment by IHC and FISH and studies regarding concordance between the results of the two techniques are limited, especially from India, we sought to study HER-2 gene amplification status by FISH in equivocal (2+) cases by IHC and also study aberrant signal patterns. SETTINGS AND DESIGN: Mastectomies and breast core biopsies, equivocal for HER-2/neu protein expression, were analyzed for HER-2 amplification by FISH. MATERIALS AND METHODS: IHC (DAKO) and FISH (PathVysion dual-probe system) tests were performed on 68 of 112 (after exclusion) 10% neutral buffered formalin (NBF)-fixed paraffin-embedded tissues and evaluated according to American Society of Clinical Oncology ASCO guidelines. STATISTICAL ANALYSIS USED: Chi-square (χ2) test and the two-tailed P value were applied using Graphpad Quickcels software, version 2006. RESULTS: It was found that 73.5% of the IHC 2+ patients were negative for HER-2/neu amplification, 25% were positive (ratios ranging from 2.3 to 5.6) and 1 patient was equivocal (2.2). Retesting FISH HER-2 equivocal case on another tumor block by IHC demonstrated HER-2 overexpression of protein 3+, thus resolving the equivocal status. Polysomy and HER-2 genetic heterogeneity were seen frequently. CONCLUSIONS: The findings reiterate that IHC HER-2 equivocal cases are a heterogeneous group and need FISH for further categorization. Low concurrence (25%) rate between both IHC and FISH results in the equivocal scenario can be attributed to tumors with polysomy 17 and HER-2/neu genetic heterogeneity.