Adult Wilms' tumour: a case report with review of literature

BACKGROUND: Wilms' tumor is the commonest primary malignant renal tumor in childhood. Rarely, it may present in the adult age group. CASE PRESENTATION: We report a 48-year-old male presenting with flank pain and haematuria. Abdominal ultrasound revealed a right renal mass measuring 11 × 10 cms, and a clinical diagnosis of renal cell carcinoma was made. Nephrectomy was performed, and a final diagnosis of adult Wilms' tumor was made based on the criteria proposed by Kilton et al. CONCLUSION: The possibility of an adult Wilms' tumor should be considered when a patient presents with pain in the flank and a renal mass. Rarity of the tumor favors documentation in literature

Amelanotic melanoma masquerading as a superficial small round cell tumor: A diagnostic challenge

Malignant melanoma poses a remarkable capacity for morphological diversity and often presents as a diagnostic challenge due to its wide clinical presentation. We present a case of a 73-year-old lady, with a large superficial ulcerative nodular mass on the flexor aspect of the right upper arm. On fine needle aspiration poorly differentiated round cell tumor was suggested, with histopathology also supporting the same diagnosis. A final diagnosis of amelanotic melanoma was given following immunohistochemical work-up using a panel of relevant markers. We are presenting this case, not only for its rare clinical presentation, but also for the diagnostic difficulties encountered by us in cytology and histopathology to reach the final diagnosis

Malignant myoepithelioma of the breast: Case report with review of literature

Myoepithelial lesions of the breast are extremely rare and can present with a diverse morphology. We report a case of malignant myoepithelioma characterized by proliferation of atypical oval to polygonal cells expressing typical myoepithelial markers. A 45-year-old lady presented with a mass in the left breast. Fine needle aspiration yielded a cellular smear with large papillae-like clusters of monomorphic cells with naked nuclei in the background. A diagnosis of sub-areolar sclerosing duct hyperplasia was made on cytology and the patient underwent excision. The surgical specimen showed a grey-white 5x3 cm mass on cut surface. Histopathology revealed mitotically active (5-6 per 10hpf) oval to polygonal cells tumor cells with clear to eosinophilic cytoplasm arranged in the form of nodules separated by dense sclerotic stroma mimicking clear cell or adenoid-cystic carcinoma. A diagnosis of malignant myoepithelioma was made as the cells were CK14 and SMA positive, and negative for ER and PR on immunohistochemistry. We discuss the unusual morphological features of malignant myoepithelioma, cytological fi ndings and the important differential diagnoses of malignant myoepthelial lesions. A high degree of suspicion with a keen eye for morphological details coupled with relevant immunohistochemistry will aid in arriving at the diagnosis

Type II First Branchial Cleft Cyst: A Case Report with Review of Literature

We report a rare case of type II first branchial cleft cyst that presented as an intraparotid cyst. Rarity and varied presentations of the first branchial cleft cysts have led to frequent misdiagnosis. High index of suspicion is required. Complete excision is the main treatment