Gastric calcifying fibrous tumor: a very rare case report.

Calcifying fibrous tumor is a very rare benign mesenchymal tumor which shows a predilection for soft tissue, mesentery and peritoneum. Up to date only 7 cases have been reported in the literature confined to the gastric wall. We report a rare case of a calcifying fibrous tumor of the stomach in a 60-year-old man who presented with dyspepsia, flatulence and feeling weight. A clinical and laboratory investigation was performed with normal results. Gastroscopy revealed a bulge in the gastric body measuring 1 cm with normal overlying mucosa, and mucosal biopsies showed chronic gastritis. Endoscopic ultrasound of the gastric bulge showed a 1 × 0.8 cm hypoechoic lesion involving the gastric wall. After the above finding a wedge resection of the stomach was performed. Microscopically the lesion consisted of well-circumscribed hypocellular hyalinized fibrosclerotic tissue with lympoplasmatic infiltrates, lymphoid aggregates and psammomatous calcifications. Lesional cells were positive for vimentin and factor XIII and negative for actin, desmin, S100p, CD117, CD34, CD31 and ALK-1. The lesion involved the muscularis propria with variable submucosal extension. Calcifying fibrous tumor has shown an excellent prognosis with recurrences being rare and showing the same morphology as the primary lesion.

Synchronous primary adenocarcinoma and ancient schwannoma in the colon: an unusual case report.

Gastrointestinal schwannomas are uncommon stromal tumors of the intestinal tract and colon schwannomas are extremely rare. We report a rare case of ascending colon schwannoma with associated synchronous adenocarcinoma of the sigmoid colon. A 68-year-old man presented with a 20-day history of bleeding per rectum. Colonoscopy revealed a mass of 4.2 cm in diameter with endoluminal protrusion in the sigmoid colon and a second submucosal tumor in the ascending colon. Surgical intervention was suggested and ileo-hemicolectomy was done. Microscopically, the submucosal tumor of 4 cm in diameter showed features of schwannoma with degenerative change (ancient schwannoma). Lesional cells were positive for S100p and negative for actin, desmin, CD34, CD117, and pankeratin. The mass showed features of an invasive moderately differentiated adenocarcinoma. Colon schwannoma is a rare submucosal tumor, and the incidental occurrence with adenocarcinoma has not been well described in the literature.

Borderline clear cell adenofibroma of the ovary associated with ovarian endometriosis: a case report.

Clear cell tumours of the ovary are relatively uncommon. Most of them are clear cell carcinomas. Benign and borderline clear cell tumours are extremely rare and almost always fibromatous. We report a case of a 34-year-old woman. Ultrasound and computed tomography showed a right ovarian mass 8 cm in diameter. The patient underwent right salpingo-oophorectomy. Microscopic examination revealed glands and cysts different in size and shape within an abundant stromal component without evidence of stromal invasion. Many cysts and glands were lined by a single layer of flattened, cuboidal or hobnail cells with mild to moderate cytologic atypia and prominent nucleoli. Psammomatous calcifications were occasionally indentified. Features of endometriosis were also present adjacent to the tumour. Lesional cells were positive for Ker 7 and CA125. Staining for p53 was focally positive. Based on the above characteristic morphologic and immunohistochemical findings a diagnosis of borderline clear cell adenofibroma was made. The patient was free of recurrence four years after surgery.

Primary cutaneous apocrine carcinoma of sweat glands: a rare case report.

Cutaneous apocrine gland carcinoma, a subtype of sweat gland carcinoma, is a very rare malignancy, and only few cases have been reported in the literature. Many of these carcinomas are indolent and slowly developing, but some are rapidly progressive. The treatment of choice is wide local excision with clear margins, with or without lymph node dissection. We report a case of a 67-year-old man who came to our hospital with an ulcerated nodule in the right axilla measuring 1 × 0.8 cm. Histological evaluation showed features of an apocrine gland carcinoma arising in an area of high apocrine gland density.

Primary malignant mixed müillerian tumour of the fallopian tube. Report of a case.

Malignant mixed müllerian tumour of the fallopian tube is an extremely rare lesion and to date only approximately 50 cases have been reported. The tumour is seldom distinguished preoperatively from other more common lesions or ovarian cancer. We report a case of a 60-year-old woman who presented to our hospital with pelvic pain. There was no clinical evidence of ascites or adenopathy. Ultrasound and abdominal and pelvic computed tomography showed a left adnexal mass. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were carried out. Grossly the left side of the fallopian tube was dilated and the cut surface revealed a solid mass filling the entire lumen. Histological examinations showed a malignant mixed müllerian tumour. The tumor was an admixture of both carcinomatous and sarcomatous elements. The carcinomatous element was composed of well to moderately differentiated squamous cell carcinoma and the sarcomatous component was made up of anaplastic spindle shaped cells with hyperchromatic nuclei. An immunohistochemical study was performed. The patient was admitted to the anticancer hospital for further treatment. The prognosis of a primary malignancy of the fallopian tube is poor and depends more on staging than on histologic type and grade.

Synchronous endometrioid carcinoma of the uterine corpus and ovary. A case report and review of the literature.

Synchronous endometrioid carcinoma of the uterine corpus and ovary is an uncommon but well recognized event. Diagnosis as either a separate independent primary or as a metastatic tumor requires careful consideration of a number of gross and histological features. These features illustrate the criteria helpful in distinguishing independent primaries from metastatic carcinomas which have a different therapeutic implication. The possible link between fertility drugs and carcinogenesis still remains controversial. We report a case of a 52-year-old woman who came to our hospital with a cystic left ovarian mass (8 cm). Hysterectomy and bilateral salpingo-oophorecromy were carried out. Histological examinations showed well differentiated endometrioid ovarian cancer and well differentiated endometrioid endometrial cancer. The endometrial tumor was intramucosal without myometrial or vascular invasion and was associated with atypical complex hyperplasia. The woman had not been previously treated with ovulation induction drugs. She was free of recurrence two years after surgery. Patients with synchronous endometrioid tumors of the endometrium and ovary are generally younger than reported for either endometrial adenocarcinomas or ovarian adenocarcinomas. They tend to be low grade and early stage and are frequently associated with endometriosis. The prognosis of endometrioid type carcinomas is better than other histological types of carcinoma.

Malignant adenomyoepithelioma of the breast--case report.

Malignant adenomyoepithelioma (MAME) of the breast is a rare tumor characterized on the basis of histologic, immunohistochemical and ultrastructural features by malignant proliferation of the epithelial and myoepithelial cells. We report a case of an 80-year-old woman with malignant adenomyoepithelioma of the breast, one of the oldest patients described up to today. A primary tumor in the left breast grew within a short period of time. A modified mastectomy with sampling of the axillary lymph nodes was performed. The lymph nodes did not include any metastatic lesions. In this case the malignancy was evidenced by the presence of a high mitotic rate, several nuclear atypia, necrosis, and local invasion. The tumor was associated with adenosis and in adjacent positions to the infiltrating portions a circumscribed nodule with histological features of benign adenomyoepithelioma was present. Reviewing the literature MAME has been reported in women aged between 26-76 years. The metastatic potential of this entity is not well studied. It appears to have hematogenous rather than lymphatic spread and usually occurs in primary tumors more than 2 cm in size.

Combined carcinoid and mixed (composite) glandular - endocrine cell carcinoma of the stomach in atrophic gastritis.

We describe a case of gastric carcinoid and inflammatory fibroid polyp concomitant with a composite tumor of the gastric antrum composed of poorly differentiated adenocarcinoma - endocrine carcinoma with immunohistochemical documentation of endocrine and non endocrine differentiation in a 67-year-old man with atrophic gastritis and intestinal metaplasia. When gastrectomy was carried out, two lymph nodes along the greater curvature harbored metastasis from carcinoid. The same occurrence is reported in several cases in the literature, which suggests that the association of gastric carcinoid to adenocarcinoma could point to the malignant nature of carcinoid. Furthermore, the findings in this patient reinforce the concept that the epithelial and neuroendocrine cells of the gastrointestinal tract both result from multidirectional differentiation of a primitive cell.

Glomus tumor of the stomach: a case report.

Glomus tumors are relatively uncommon benign neoplasms, most common in the skin and subcutaneous tissue, but can also occur in the viscera, most often in the stomach. Preoperative diagnosis, when the tumor occurs in the stomach, seems difficult but is important, since glomus tumors of the stomach are essentially benign and amenable to conservative excision, contrary to aggressive gastric neoplasms. We describe the case of a 75-year-old man presented to the emergency department with gastrointestinal bleeding and epigastric pain. Gastroscopy revealed a submucosal mass in the antrum of the stomach in correspondence to the lesser curvature. Biopsies taken from the lesion showed morphological and immunohistochemical [positivity for alphasmooth muscle actin (alpha-SMA) and vimentin, negativity for CD34, CD117, chromogranin, synaptophysin, desmin and S-100 protein] characteristics attributable to glomus tumor. The patient underwent a laparotomic antrotomy incision. Histological examination of the tumor confirmed the diagnosis of gastric glomus tumor.

Bilateral primary breast lymphoma--case report.

Primary lymphoma of the breast is an uncommon malignant breast tumor which is seldom distinguished preoperatively from other more common forms of breast cancer. Bilateral breast lymphoma affects younger women especially during pregnancy or postpartum. We report a case of a 55-year-old woman who was admitted to our hospital with painless bilateral breast enlargement. A bilateral radical mastectomy with bilateral axillary lymph node dissection was performed. The histology of the surgical specimen was non-Hodgkin's malignant lymphoma of the diffused large B cell type. Most of the neoplastic cells resembled large centrocytes and sometimes blast cells showing some degree of plasmacytoid differentiation. Foci with a sufficient number of immunoblasts were also noted. The patient was also found to have a bilateral axillary lymph node metastasis. After additional clinical and laboratory screening, there was no other evidence of lymphatic disease at other sites. The patient was submitted to the anticancer hospital for further treatment. She was free of recurrence two years after surgery. The rarity of the disease, lack of uniform classification and variable treatment modalities make prognostic predictions of breast lymphoma difficult.