Intranodal palisaded myofibroblastoma: a case report from an unusual site

Intranodal palisaded myofibroblastoma is a rare lymph node benign tumor, of unknown pathogenesis. Although benign, this lesion is frequently confused with metastatic lesions, especially in atypical sites. We report a  39-year-old man with a history of testicular malignant mixed germ cell tumor, presented with abdominal  painless mass. The computed tomography of the abdomen confirmed the presence of 180 × 140 mm2 mass in the retroperitoneum with  lympadenopathy on the right measuring 20 x 15 mm. The patient underwent  exploratory laparotomy, and a surgical exerese of the retroperitoneeum lymph node  was made. Histological and immunohistochemical examination confirmed the diagnosis of intranodal palissaded myofibroblastoma. This entity has been previously, only once, in retroperitoneal region. Despite to the rarity of this  neoplasm, we discuss clinicopathologic features and differential diagnosis.Key words: Intranodal palisaded myofibroblastoma, retroperitoneum, lymph nod

Epidermoid cyst discovered concomitant with torsion of the spermatic cord: A case report

Testicular epidermoid cysts, accounting for 1%–2% of all testicular masses, present a diagnostic challenge often identified post-orchiectomy. Conservative surgery is recommended, emphasizing the need for accurate preoperative diagnosis. A 28-year-old patient with acute left scrotal pain, initially suggestive of testicular torsion, underwent intraoperative exploration revealing extra-vaginal torsion with an incidentally discovered 2-cm intra-testicular mass. Due to suspected malignancy, a total orchiectomy was performed. Pathological analysis confirmed an epidermoid cyst with normal postoperative tumor markers. The patient had a good postoperative outcome and underwent testicular prosthesis placement 3 months after the surgery. Epidermoid cysts, often identified incidentally during urgent scenarios, underscore the importance of accurate preoperative diagnosis. Conservative surgery remains the preferred approach, emphasizing the consideration of benign factors to prevent unnecessary orchiectomies

Retroperitoneal pelvic schwannoma: A rare case report and review of the literature

Schwannoma, typically a non-cancerous tumor originating from Schwann cells, seldom occurs in the retroperitoneal area. Its clinical manifestation varies, often remaining asymptomatic for an extended period until it enlarges, exerting pressure on neighboring organs. This article presents a unique instance of retroperitoneal pelvic schwannoma in a 75-year-old woman, initially presenting with unusual lower back discomfort. Imaging was used to characterize the tumor, and anatomopathological examination established the preoperative diagnosis of pelvic schwannoma and its benign nature. The clinical, imaging, and anatomopathological aspects of this pelvic schwannoma case are elucidated herein

Correlation between KRAS and NRAS mutational status and clinicopathological features in 414 cases of metastatic colorectal cancer in Morocco: the largest North African case series

Abstract Background Advances in molecular biology have improved understanding of the molecular features of carcinogenesis and progression of colorectal cancer. It is clear that the efficacy of anti-EGFR depends upon the RAS mutational status, since any mutation in RAS is associated with resistance to anti-EGFR therapy. The aim of this study is to report the largest North African description of KRAS and NRAS status in metastatic colorectal cancer and to describe the association of these mutations with clinicopathological characteristics. Methods This is a prospective study of all consecutive unselected metastatic colorectal cancer samples, collected from the Laboratory of Pathology at the National Institute of Oncology of Rabat, Morocco, from January 1st 2020 to December 31st 2021. The molecular analysis was performed on the Idylla™ platform (fully automated real-time polymerase chain reaction-based assay) for KRAS and NRAS mutations in exons 2, 3 and 4. These mutations were correlated to gender, primary tumor site, histological type and degree of differentiation of tumor using adequate statistical methods. Results Four hundred fourteen colorectal tumors were screened for KRAS and NRAS mutations. These mutations occurred in 51.7% of tumors for KRAS (mainly in exon 12) and in 3% of tumors for NRAS. There was a significant correlation between NRAS mutation and age of colorectal patients in this study. The low rate of invalid RAS tests (1.7% for KRAS and 3.1% for NRAS) was certainly obtained due to the strict respect of pre-analytical factors such as cold ischemia time and formalin fixation. Conclusion We report the largest North African analysis of NRAS and KRAS status in colorectal metastatic patients. This study showed the ability in low middle income countries to perform a high rate of valid tests and the unusual trend towards older patients for NRAS mutations

Neuroblastoma in an adult: a case report of a rare entity with a summary review

Neuroblastoma is a very uncommon neoplasm in adulthood. It occurs almost exclusively in children younger than 10 years (More than 90% of cases). We report the case of a healthy 40-year-old male who complained of a right flank pain in 2010. Clinical examination revealed an enormous abdominal mass involving the adrenal gland as showed at abdominal CT scan. The patient underwent a surgical en-bloc excision of the right adrenal mass, after a laborious dissection of the tumor. Histological and immunohistochemical findings were suggestive of a neuroblastoma. Adjuvant treatment was not indicated since the complete gross excision of the tumor was performed, and subsequently the patient was considered stage 1 disease and because of the unavailability of MYCN status, necessary for achieving risk group stratification and a risk-adapted strategy. The patient remained in good local control, until January 2015 when he accused a locoregional and metastatic relapse consisting of two new para-renal masses and magma of celiac adenomegalies extending into the mediastinum. As the mass was considered unresectable, therapeutic decision of administrating neoadjuvant chemotherapy, followed by local treatment (surgery and / or radiotherapy) based on tumor response was taken. Given the bad tumor response to systemic treatment, a palliative radiotherapy was instaured. Currently the patient is two months after the end of radiation with mild clinical improvement. The purpose of presenting this case is not only to report an uncommon malignancy in adulthood, but also to raise awareness among clinicians adding this clinical entity as a differential diagnosis when a retroperitoneal mass is identified. We also conducted a literature review to enhance clinicians’ acknowledgment about the management of this rare entity in adults