Polymorphous low-grade adenocarcinoma: a case report.
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ABSTRACT:
SUBMITTER: Potluri A
PROVIDER: S-EPMC3699016 | biostudies-other | 2013
REPOSITORIES: biostudies-other
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Project description:Salivary adenocarcinoma, not otherwise specified (AdCaNOS) is a rare malignant tumor with potential diagnostic challenge, which mainly affects the parotid glands; however, the minor salivary glands can also be involved by AdCaNOS. This paper reports a case of a 45-year-old Afro-descendant woman complaining of a slow-growing mass with 6 months of evolution in the left superior vestibular fornix. Microscopic examination revealed an infiltrative epithelial neoplasm composed of predominantly solid growth pattern, arranged in a lobular configuration, admixed with glandular or ductal structures. Perineural invasion was evident. The tumor cells were polygonal or oval showing focally mild nuclear pleomorphism, and eosinophilic or clear cytoplasm. Notably, some areas exhibited intracytoplasmic pigment granules mainly in non-luminal cells, as well as sebaceous-like cells, discrete hyaline material deposition and foci of infiltration of residual salivary gland parenchyma. Tumor cells were negative for PAS, mucicarmine and Alcian blue stains. By immunohistochemistry, the tumor cells were diffuse and strongly positive for pan-cytokeratin (CK) AE1/AE3, 34betaE12 CK, vimentin, p63 and S100. CK7 and EMA strongly highlighted the ductal structures. Solid areas also showed diffuse and moderate expression of CD56. Podoplanin (D2-40), GFAP and Calponin, followed by DOG-1, were focally positive; whereas CK20, α-SMA, h-Caldesmon, CD57, ERBB2/HER2 and p53 were negative. Ki-67 was < 2%. Consecutive serial tissue sections using CD57 confirmed the perineural invasion. Positivity for HMB-45 and MART-1/Melan-A, as well as Fontana-Masson stain (and potassium permanganate bleaching-sensitive), identified the pigment granules as melanin. To the best of our knowledge, this is the first case of intraoral low-grade AdCaNOS with intracytoplasmic melanin granules.
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Project description:Fetal adenocarcinoma of the lung (FLAC) is an extremely rare subtype of lung cancer, accounting for only 0.1% to 0.5% of primary pulmonary malignancy. In 2011, international multidisciplinary classification of lung adenocarcinoma developed by the International Association for the Study of Lung Cancer (IALSC), the American Thoracic Society (ATS) and the European Respiratory Society (ERS) classified FLAC as a variant of invasive adenocarcinoma. FLAC has been further divided into low-grade fetal adenocarcinoma (L-FLAC) and high-grade fetal adenocarcinoma (H-FLAC) as these two categories exhibit different clinicopathological features and biological behaviors. Here we report a case of high-grade fetal adenocarcinoma and summarize clinicopathologic features of fetal lung adenocarcinoma.?.
| S-EPMC6441118 | biostudies-literature
Project description:•We present a case of uterine carcinoma with low-grade carcinomatous and sarcomatous components.•The tumor is likely a rare biphasic form of carcinosarcoma.•Molecular profiling suggests that it is a Type I endometrial cancer.•The tumor was extremely chemotherapy-resistant.
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Project description:Background Although germ cell tumors and pineal cell tumors account for most of the histologic tumor subtypes, > 17 different tumors can arise in this location. We report a rare case of a low-grade oligodendroglioma that arose in the pineal region. Clinical Presentation A young woman complaining of a headache underwent magnetic resonance imaging that showed a mass in the pineal region and mild hydrocephalus. A ventriculoperitoneal shunt was performed followed by a near-total tumor removal, due to tumor invasion of the tectal plate and thalamus. The histologic examination confirmed the diagnosis of a low-grade oligodendroglioma. The patient then underwent chemotherapy and radiotherapy as adjuvant therapies. Conclusion Although the pineal region is a common place for a large number of tumoral lesions, low-grade oligodendrogliomas are extremely rare in this location. This case is only the second account of a benign oligodendroglioma of the pineal region reported in the literature.
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Project description:BackgroundAmong the malignant tumors that occur in the nasopharynx, nasopharyngeal carcinoma is the most common. Nasopharyngeal carcinoma (NPC) is commonly diagnosed in Southeastern Asia, particularly in southern China. It originates from the epithelial lining of the nasopharynx and has a variety of pathological subtypes. The vast majority of NPC cases are keratinizing or nonkeratinizing squamous cell carcinoma. Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is an extremely rare malignant tumor. Most reports regarding this disease mainly focus on clinical diagnosis and pathology; however, reports regarding therapy and follow-up are relatively limited. The case in the study presents a female patient with LGNPPA. The patient underwent endoscopic resection and adjuvant radiotherapy. Following-up 6 years, the patient was free of local recurrence and distant metastasis. Because of the very low incidence, there are no guidelines or protocols developed for proper, standardized therapy, we aim to provide useful recommendations regarding optimal treatment strategies by exploring the therapeutic expectancies of the rare disease.Case descriptionA 45-year-old female of Han ethnicity visited a local hospital for over 2 years of recurrent nasal congestion. The patient had no previous medical history, had a history of smoking (6 years, 20 cigarettes per day) and drank occasionally. but had no family history of cancer. Epstein-Barr virus (EBV) DNA was <500×102 IU/mL. Based on findings from computed tomography (CT) scans of the nasal cavity and paranasal sinuses, nasal endoscopy, and postoperative pathology, the diagnosis was low-grade papillary adenocarcinoma located at the upper nasopharynx (T1N0M0, stage I). This patient underwent endoscopic resection. After the endoscopic resection, she received intensity-modulated radiotherapy. After radiotherapy, there was no residual by nasopharyngo-fiberoscope. And she was free of local recurrence and distant metastasis at 6 years of follow-up.ConclusionsAlthough primary nasopharyngeal adenocarcinomas (NPACs) are very rare, they also should be pay attention to. As far as treatment policy, no standard treatment exists for the tumors. So through this case report, we want to provide a possible useful recommendations regarding optimal treatment strategies by exploring the therapeutic expectations of this rare disease.
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Project description:Objectives/hypothesisInformation on polymorphous low-grade adenocarcinoma (PLGA) consists primarily of case reports and small institutional series with varying recurrence rates. In this report, we describe our institutional experience and conduct a review of the literature to assess the overall incidence of PLGA among oral salivary gland tumors and determine recurrence rates.Study designA retrospective case series and literature-based review was performed.MethodsRetrospective case series at an academic tertiary referral center. Review of clinical records and pathological analysis of tissue specimens from 20 patients treated for PLGA from July 1, 1990 to July 1, 2011. A literature-based review on PLGA was also performed.ResultsTwenty patients (mean age, 54 years; eight males) with PLGA based on pathologic diagnosis were included. The most common initial presentation was an asymptomatic mass (45%), and the most frequent site was the palate (60%). Our literature review identified 54 case reports, eight case series, and 17 large series. In total, 456 cases of PLGA were identified, with an overall recurrence rate of 19%. Half of the recurrences occurred by 36 months; however, recurrences were reported up to 24 years after initial resection.ConclusionsPLGA arises from minor salivary glands and is characteristically slow growing and indolent. Although these tumors may be histologically low-grade, our review highlights the high rates of recurrence of these tumors as well as the ability to metastasize to local lymph nodes and distant organs. The mainstay of treatment should be wide surgical excision with long-term oncologic follow-up.Level of evidence4.
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Project description:IntroductionLow-grade adenosquamous carcinoma (LGASC) is categorized as a metaplastic carcinoma but differs from other types of metaplastic carcinoma in having a more favorable prognosis. Due to its rarity and unusual and inconsistent presentation, there is little information available regarding its characteristics, making correct diagnosis a challenge.Case presentationWe report herein the case of a 54-year-old Japanese woman who presented with a lump in her left breast. She was found to have a benign lesion which continually relapsed, necessitating repeated excisions, ultimately leading to the diagnosis of LGASC after the third excision. Guidelines for the treatment of LGASC emphasize complete tumor excision, with adjuvant therapies only considered in cases with positive lymph node metastasis. Consequently, the patient underwent total mastectomy but postoperative chemotherapy was not administered, and the patient was followed up with regular observation. By 20 months postoperatively, there was no sign of recurrence.ConclusionLGASC has distinctive pathological features of the intimate admixture of well-developed glands and solid squamous cell nests within a fibrotic or cellular spindle stroma. It is difficult to determine preoperatively with cytology or needle biopsy because LGASC mimics benign tumors. It is typically triple-negative, but it has an indolent behavior. Adjuvant therapy after surgery is considered unnecessary for triple-negative status, but there is no clear evidence. We aimed to provide more data on the disease characteristics, presentation, and treatment outcome. Accumulation of further evidence is warranted to refine diagnostic and therapeutic strategies of LGASC.
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Project description:Low-grade myofibroblastic sarcoma (LGMS) is a rare malignant mesenchymal tumor derived from myofibroblasts. It is commonly identified in the head and neck, and particularly in the oral cavity, but rarely in the larynx. In this case report, we describe a patient who presented with hoarseness and underwent electronic fiber laryngoscopy, which revealed a neoplasm on the surface of his left vocal cord. The vocal cord tumor was resected under general anesthesia, and a malignant LGMS was diagnosed on postoperative pathologic examination. The results of immunohistochemical staining of the sections for vimentin (diffuse +), actin (partial +), and desmin (-) were consistent with this diagnosis. The patient recovered well after the surgery, and there was no recurrence of the neoplasm.
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