Benign paravertebral cyst of Hattori: A case report and review of literature

Hideo Hattori reported the first case of a mediastinal cyst with features characteristic of a Mullerian cyst in 2005. He presented a case of an 18-year-old woman who presented with an abnormal shadow on chest X-ray film during medical examination and who had no other anatomic abnormalities or clinical problems. We present a case of benign cyst within the mediastinum in the left paravertebral space at the level of the aortic arch in a 56-year-old woman. This patient was being investigated for unexplained shortness of breath and dry cough. As at the time writing this report, to our knowledge, this is the first case report of Hattori cyst in the United Kingdom (UK) following literature search

Ki-67 proliferative index correlation to the immunohistochemistry profile in early female breast cancer: a review of 515 cases

Introduction: Many biological markers are used as prognostic and predictive indicators in invasive breastcancers management. Among them, tumour size, grade, patho-morphological subtype, hormone receptorsstatus and HER2 receptor expression in addition to Ki-67 proliferative index. Also, they play a key role inadjuvant treatment decision making. Our aim was to evaluate the association between Ki-67 proliferativeindex and breast cancer immunological subtype.Material and methods: A total of 515 early invasive patients were enrolled, tumour biological characteristicsas histopathological subtype, immune-histo-chemistry (ER,PR,HER2) status and Ki-67 proliferation indexvalues have been collected. The Ki-67 index level of 20%, was used as the cut-off point to differentiatebetween low and high Ki-67 expression levels. Statistical analysis has been performed using the Chisquare test online tool.Results: In this cohort, about 42%, 33%, 7%, and 18% of the cases were grouped as luminal A-like, luminalB-like, HER2 enriched subtype, and triple-negative, respectively. All luminal A-like patients had Ki-67 levelless than 20%. About 3% of the cohort, are luminal B-like tumours with Ki-67 level less than 20%, where30.3% of the patients were luminal B-like tumours with Ki-67 level ≥ 20%. In HER2 enriched subtype, Ki-67 of < 20% level seen in 1.9% of cases, and Ki-67 levels ≥ 20% was observed in 5.2% of the cases. Inthe triple-negative group, Ki-67 was 20% or higher in 16% of cases, and only 1.7% of patients had Ki-67level less than 20%.Conclusion: Luminal A-like tumours were the most frequently encountered subtype, they have low Ki-67levels and are known to be of a low histological grade tumour, and usually associated with a good prognosis.Also, data indicates that high Ki-67 levels are seen more often in Luminal B-Like breast cancers aswell as in triple-negative breast cancers and HER2 enriched tumours

Primary lung cancer with metastasis to the ipsilateral breast-a case report

The metastasis of extra-mammary malignancy to breast is extremely rare; literature reports the incidence between 0.4-1.3%. Primary sites include the contralateral breast, leukaemia, lymphoma, malignant melanoma, sarcoma, lung, prostate, ovary, colon and the stomach. Here we present a rare case in which lung cancer was found to metastasise to the breast. Initially the patient presented with chest symptoms and a left breast lump was detected clinically. The radiological and histological investigations confirmed the diagnosis of primary lung cancer with breast metastases. Prognosis of such cases is generally poor

The Rare Diagnosis of Synchronous Breast and Colonic Cancers: A Case Report and Review of Literature

Any two or more primary malignant tumors, in which each tumor is not an extension, recurrence, or metastasis of the other lesion, are defined or described as multiple primary malignant neoplasms (MPMN). These tumors are increasingly diagnosed despite their rare occurrence rate. The term synchronous tumors is applied if two different tumors originating in the same patient are detected at the same time or within six months; if the second tumor is detected beyond six months, it is called metachronous. Aetiological factors that may predispose patients to MPMNs have been grouped into three broad categories: familial cancer syndromes and other genetic susceptibility factors, common exposures (e.g. tobacco), and carcinogenic effects of cancer treatment. The likelihood of missing asymptomatic synchronous tumors at the time of diagnosis is due to a lack of definitively set guidelines for synchronous tumors. Studying every individual case may aid us in understanding disease biology, developing diagnostic guidelines, and establishing patient-specific management strategies. We present a case report of synchronous breast and colonic cancer in a female patient

Incidental Malignant Colonic Polyp Detected in a Resected Ischaemic Large Bowel: A Case Report and Literature Review

Most patients with bowel cancer are symptomatic at the time of the diagnosis. They may present with a change in bowel habit, bleeding per rectum, abdominal pain, anaemia, weight loss or bowel obstruction. Colonic carcinoma can also be diagnosed incidentally during screening programs. Moreover, it may be incidentally detected in CT scans being performed for other indications or encountered during surgery for other causes. Some patients with colonic bowel ischaemia have associated large bowel cancer, where the ischaemic segment is usually proximal to the tumour and not necessarily associated with bowel obstruction. We are presenting a rare case of incidental malignant colonic polyp detected in a resected ischaemic large bowel in an 88-year-old gentleman. This was a very small tumour that was not visible macroscopically or detectable by imaging. Pathological examination of non-tumour colorectal resection specimens, as in this case, should include careful macroscopic examination and sequential block selection along the length of the colon, and where there is diffuse mucosal abnormality, block selection at 100mm interval is also advised. Attention to and block selection from any suspicious-looking area is warranted in all cases of non-tumour colorectal resections if such microscopic-sized malignancies of the type seen in our patient are to be picked up

Breast Atypical Apocrine Adenosis: A Case Report and Literature Review

Atypical apocrine adenosis (AAA) is a benign lesion of the breast that is identified more frequently today than in the past when it was considered a rare diagnosis and commonly misdiagnosed as other malignant lesions of the breast. AAA is defined as the presence of apocrine cytology in a recognisable lobular unit associated with sclerosing adenosis. We present a case of an incidental finding of AAA and discuss diagnostic challenges and their implications on clinical management

Posterior Mediastinal Paravertebral Müllerian cyst (cyst of Hattori): literature review

Mediastinal cysts are typically of bronchogenic, thymic or neurenteric origin, but may also represent oesophageal duplication. Posterior paravertebral mediastinal Müllerian cysts of undetermined pathogenesis are very rare occurrences. The first case of a ciliated cyst arising in the mediastinum, of probable Müllerian origin, was reported by Hattori in 2005, which gave rise to the name cyst of Hatorri (COH) The number of reported cases in literature of a similar nature have since then increased significantly.  One of the main concerns about this pathology is the possibility of malignant transformation of the Müllerian tissue. Over the course of this paper we will discuss the pathogenesis, immunohistochemistry and its role in differential diagnosis as well as optimal treatment of such cysts

Breast apocrine carcinoma: a case report and review of literature

Breast cancer is known to be the most common malignancy in women worldwide, the spectrum of thehistological type varies from common types as invasive ductal carcinoma, of no special type to a rarevariety as apocrine breast carcinoma. This study reports a case of apocrine carcinoma in a 60-year-oldfemale patient, exploring the diagnosis strategies and management of this case

RECURRENT PRIMARY BILATERAL BREAST ANGIOSARCOMA - CASE REPORT AND LITERATURE REVIEW

Primary angiosarcoma of the breast is a rare entity. They arise in the vascular endothelium and represent only 0.04% of all malignant breast tumours. This paper reports a case of previous primary bilateral breast angiosarcoma, with a unilateral recurrence in a 48 years old femal

Evaluation of the correlation between Ki-67 proliferative index and the histopathological grade of invasive neoplasms in early breast cancer aged < 70 years of age: a review of 300 cases

Background and objectives: according to the WHO 2018 reports, breast cancer is the fourth most common cause of cancer deaths worldwide. The breast cancer is recognized as the most common malignancy in the UK, it accounts for about 15% of all newly diagnosed malignancies, followed by prostate (13%), lung (13%), and bowel (11%). Ki-67 proliferative index became a key element in the diagnostic process of breast cancer, in addition to its role as a predictive tool and prognostic marker during the planning of adjuvant therapy as hormonal manipulation of systemic chemotherapy. The study aims to present the correlation analysis between Ki-67 and the different histological grade in breast cancer tumours. Material and methods: a cohort of 300 patients treated for early breast cancer was included in the study. The demographic data, histopathological subtype, hormonal and HER2 (Human epidermal growth factor receptor-2) receptor status and Ki-67 were analysed. The cut-off point was set at 20% to distinguish “high Ki-67” from “low Ki-67”. Results: about 35% (n = 106) of the cases were grade II with low Ki-67 , 26% (n = 79) grade III with high Ki-67, 19% (n = 56) grade II with high Ki-67, 11% (n = 34) grade I with low Ki-67. The high Ki-67 seen in 135 patients who belong to grade II and III groups (45%), where low Ki-67 in 42% of those cases, however, grade III alone contained more cases of high Ki-67 than any other histological grade group. Conclusions: a higher tumour histopathologic grade was correlated with higher Ki-67 values (OR = 7.12, 95% CI 16.75–3.03; p &lt; 0.0001)