Pleomorphic Adenoma of the Nasal Vestibule: An Atypical Presentation.

Introduction: We introduce the third case reported in the literature of an atypical presentation of pleomorphic adenoma located in the nasal vestibule of a young patient who assisted at our clinic. Case Report: A young man with no important medical history consulted due to a painless mass-type slow-growth lesion associated with right nasal obstruction. He underwent surgical management and complete resection of the mass. The pathological study revealed a pleomorphic adenoma, confirmed by immunohistochemistry. Conclusion: This case confirms that pleomorphic adenomas can occur anywhere in the head and neck, even in areas without upper air-digestive tract mucosa.

Commonly Misdiagnosed Facial Lesion: Pilomatricoma.

Pilomatricoma, also known as Pilamatrixoma or Malherbe's calcifying epithelioma, is a benign skin tumour with a bimodal age distribution between the paediatric and elderly age groups. Although it was previously thought to be rare, recent studies have revealed that it is quite common. Typically, pilomatricoma is diagnosed following histopathological examination of the lesion as it is frequently misdiagnosed with other types of skin pathology. In our case, the child presented with painless swelling of the left infraauricular region. The initial cytology and imaging were unable to provide a definite diagnosis. An excision biopsy was done, and a histopathological examination was suggestive of Pilomatricoma. Therefore, Pilomatricoma ought to be considered in the differential diagnosis of head and neck lesions in hopes of providing a better understanding on this pathological lesion.

Combined Use of Texture Features and Morphological Classification Based on Dynamic Contrast-enhanced MR Imaging: Differentiating Benign and Malignant Breast Masses with High Negative Predictive Value.

PURPOSE: We evaluated the diagnostic performance of the texture features of dynamic contrast-enhanced (DCE) MRI for breast cancer diagnosis in which the discriminator was optimized, so that the specificity was maximized via the restriction of the negative predictive value (NPV) to greater than 98%. METHODS: Histologically proven benign and malignant mass lesions of DCE MRI were enrolled retrospectively. Training and testing sets consist of 166 masses (49 benign, 117 malignant) and 50 masses (15 benign, 35 malignant), respectively. Lesions were classified via MRI review by a radiologist into 4 shape types: smooth (S-type, 34 masses in training set and 8 masses in testing set), irregular without rim-enhancement (I-type, 60 in training and 14 in testing), irregular with rim-enhancement (R-type, 56 in training and 22 in testing), and spicula (16 in training and 6 in testing). Spicula were immediately classified as malignant. For the remaining masses, 298 texture features were calculated using a parametric map of DCE MRI in 3D mass regions. Masses were classified into malignant or benign using two thresholds on a feature pair. On the training set, several feature pairs and their thresholds were selected and optimized for each mass shape type to maximize specificity with the restriction of NPV > 98%. NPV and specificity were computed using the testing set by comparison with histopathologic results and averaged on the selected feature pairs. RESULTS: In the training set, 27, 12, and 15 texture feature pairs are selected for S-type, I-type, and R-type masses, respectively, and thresholds are determined. In the testing set, average NPV and specificity using the selected texture features were 99.0% and 45.2%, respectively, compared to the NPV (85.7%) and specificity (40.0%) in visually assessed MRI category-based diagnosis. CONCLUSION: We, therefore, suggest that the NPV of our texture-based features method described performs similarly to or greater than the NPV of the MRI category-based diagnosis.

Diagnosis and treatment analysis of renal pelvic hemangioma / 中华泌尿外科杂志

Renal pelvic hemangioma is a rare benign tumor, presenting with intermittent, total, painless, gross hematuria, accompanied by low back pain, abdominal pain or other symptoms in some cases. Four cases of pyelonephric hemangioma were treated, which were misdiagnosed as malignancy before surgery. For middle-aged patients with intermittent hematuria, if the imaging data cannot rule out renal pelvic hemangioma, it is recommended to perform renoscopy, renal artery angiography or renal puncture biopsy. For patients diagnosed with renal pelvic hemangioma, either partial nephrectomy, ureteroscopic cauterization, or selective renal artery embolization can achieve good results.

A rare case of hepatic myxoma: Case Report.

Myxomas are benign tumours occurring commonly, but not limited to the heart. Myxomas can also occur in various locations such as the skeletal muscles, skin, urogenital tract, subcutaneous tissue and even in bone. They are quite rare; are tumours of mesenchymal origin and usually produce mucinous type fluid. About 1 in 10 are hereditary and tend to occur more commonly in women. Common benign hepatic masses are of epithelial origin and majority are discovered incidentally on radiological abdominal or chest screening. We present a case of an intrahepatic myxoma. Clinical and radiological features in keeping with a simple hepatic cyst. The elective surgical intervention planned was that of an open cystectomy. Progression of the case led to emergency laparotomy after trauma to the patient's abdomen and the patient presenting with an acute abdomen and clinical features of cyst rupture. Aspiration of the seemingly mixed solid-cystic mass revealed a very thick non purulent turbid fluid which was sent together with the excised mass for cytology and histopathology. Histology reported features of an intrahepatic myxoma.

Breast adenomyoepithelioma, a case report.

BACKGROUND: Adenomyoepithelioma is a rare tumor of the breast characterized by a dual/biphasic proliferation of two cell populations: the epithelial cells and the myoepithelial cells. The first case was reported in 1970. The majority of the cases are benign, but few malignant cases were reported in literature. CASE PRESENTATION: A case of a 66-year-old lady presenting with an asymptomatic breast mass, of 18 × 17 × 15 mm size with irregular borders and negative metastatic workup. The patient was operated for wide local excision of the tumor, with a confirmed negative margins intraoperatively. The final pathology was Adenomyoepithelioma. CONCLUSION: We report this rare case to encourage physicians to keep this etiology in mind as part of the differential diagnosis of breast mass.

A case report of spermatic neuroblastoma / 中华泌尿外科杂志

The purpose of this study is to study the clinical characteristics of spermatic cord tumor.The clinical data of a case of varicocele in our hospital were analyzed retrospectively.In this case,the patients with varicocele had a good recovery after operation.Varicocele is a rare case.The best mode of treatment is surgical resection and follow-up after operation.

An "accidental" discovery: Incidentally found metanephric adenofibroma in a 5-year-old male trauma patient.

Metanephric adenofibroma is a rare pediatric renal tumor, which should be considered in cases of solid renal lesions that mimic Wilms tumor on both imaging and histology. We present a case of an incidentally found left renal lesion on a trauma computed tomography scan in a 5-year-old male patient. The patient underwent total nephrectomy, and the diagnosis of metanephric adenofibroma was made on histology. Radiologists should consider this entity in the differential for an incidentally found solitary renal mass in a pediatric patient. Prompting the pathologic diagnosis of this entity can spare patients from unnecessary chemotherapy and allow for nephron-sparing surgery.

Characterization of microbiome in bronchoalveolar lavage fluid of patients with lung cancer comparing with benign mass like lesions.

OBJECTIVES: Disruption in the stability of respiratory microbiota is known to be associated with many chronic respiratory diseases. However, only few studies have examined microbiomes in lung cancer. Therefore, we characterized and compared the microbiomes of patients with lung cancer and those with benign mass-like lesions. MATERIALS AND METHODS: Bronchoalveolar fluid was collected prospectively to evaluate lung masses in patients who had undergone bronchoscopies from May to September 2015. Twenty-eight patients (20 male, 8 female) were enrolled: 20 diagnosed with lung cancer and 8 diagnosed with benign diseases. Samples were analysed by 16S rRNA-based next-generation sequencing. RESULTS: The participants' mean age was 64±11years. Bacterial operational taxonomic units were classified into 26 phyla, 44 classes, 81 orders, 153 families, 288 genera, and 797 species. The relative abundance of two phyla (Firmicutes and TM7) was significantly increased in patients with lung cancer (p=0.037 and 0.035, respectively). Furthermore, two genera (Veillonella and Megasphaera) were relatively more abundant in lung cancer patients (p=0.003 and 0.022, respectively). The area under the curve of a combination of these two genera used to predict lung cancer was 0.888 (sensitivity=95.0%, specificity=75.0% and sensitivity=70.0%, specificity=100.0%; p=0.002). CONCLUSION: The results indicate that differences exist in the bacterial communities of patients with lung cancer and those with benign mass-like lesions. The genera Veillonella and Megasphaera showed the potential to serve as biomarkers to predict lung cancer. Thus, the lung microbiota may change the environment in patients with lung cancer.

Development of Thyroid-Associated Ophthalmopathy in Patients Who Underwent Total Thyroidectomy.

PURPOSE: To report clinical characteristics of thyroid-associated ophthalmopathy (TAO) in patients who previously underwent total thyroidectomy for thyroid cancer or a benign mass of the thyroid. MATERIALS AND METHODS: Of the patients who were diagnosed with TAO from March 2008 to March 2012, we performed a retrospective chart review on those who had undergone total thyroidectomy for thyroid cancer or a benign mass of the thyroid before the occurrence of ophthalmopathy. RESULTS: Of the 206 patients diagnosed with TAO, seven (3.4%) met the inclusion criteria. The mean age of the subjects was 47.4 years, and all were female. Six patients were diagnosed with papillary thyroid cancer, and one was diagnosed with a benign mass. The duration between total thyroidectomy and onset of TAO ranged from 3-120 months (median 48 months). Ophthalmic manifestations varied among cases. Except for the patient who was diagnosed with a benign mass, all patients showed hyperthyroid status and were under Synthroid hormone treatment at the time of TAO development. Five of these six patients had positive levels of thyroid-stimulating hormone (TSH) receptor autoantibodies. CONCLUSION: TAO rarely develops after total thyroidectomy, and the mechanism of TAO occurrence is unclear. However, most patients showed abnormalities in thyroid function and TSH receptor autoantibodies.

Development of Thyroid-Associated Ophthalmopathy in Patients Who Underwent Total Thyroidectomy

PURPOSE: To report clinical characteristics of thyroid-associated ophthalmopathy (TAO) in patients who previously underwent total thyroidectomy for thyroid cancer or a benign mass of the thyroid. MATERIALS AND METHODS: Of the patients who were diagnosed with TAO from March 2008 to March 2012, we performed a retrospective chart review on those who had undergone total thyroidectomy for thyroid cancer or a benign mass of the thyroid before the occurrence of ophthalmopathy. RESULTS: Of the 206 patients diagnosed with TAO, seven (3.4%) met the inclusion criteria. The mean age of the subjects was 47.4 years, and all were female. Six patients were diagnosed with papillary thyroid cancer, and one was diagnosed with a benign mass. The duration between total thyroidectomy and onset of TAO ranged from 3-120 months (median 48 months). Ophthalmic manifestations varied among cases. Except for the patient who was diagnosed with a benign mass, all patients showed hyperthyroid status and were under Synthroid hormone treatment at the time of TAO development. Five of these six patients had positive levels of thyroid-stimulating hormone (TSH) receptor autoantibodies. CONCLUSION: TAO rarely develops after total thyroidectomy, and the mechanism of TAO occurrence is unclear. However, most patients showed abnormalities in thyroid function and TSH receptor autoantibodies.

Nodular fasciitis of the breast: two cases with a review of imaging findings.

Nodular fasciitis of the breast is a rare, benign, proliferative disease characterized by sudden onset and rapid growth. It can clinically and radiologically mimic breast cancer. We present imaging findings from two cases of nodular fasciitis that initially manifested as palpable masses. Sonographically, they appeared as irregular, not-circumscribed hypoechoic nodules. The diagnosis of nodular fasciitis was made by US-guided core needle biopsies. US-guided vacuum-assisted excision was subsequently performed in the first case, while the second resolved via spontaneous regression.

Endoscopic Management of Benign Tumors of the Nose and Paranasal Sinuses / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In this presentation, we tried to discuss in detail the reasons why the endoscopic technique is useful when applied to diagnosis, treatment and follow up of benign masses in these areas. MATERIALS AND METHODS: We reviewed retrospectively the records of 24 patients with benign nasal tumors treated with endoscopic resection between January 1995 and July 1997 at Samsung Medical Center. RESULTS: The clinical symptoms were nasal obstruction, rhinorrhea, epistaxis, hyposmia, postnasal drip, and cough in the descending order. Among the benign tumors, inverting papilloma was most common, followed by granuloma pyogenicum, hemangioma, fibrous dysplasia, osteoma, papilloma, and oncocytic schneiderian papilloma. No recurrence was found at mean follow-up of 23 months except one case of fibrous dysplasia. CONCLUSION: This technique can be used to remove benign tumors with excellent result, thereby avoiding the disadvantages of external approaches.