Inflammatory Myofibroblastic Pseudotumor of Ileum: A Rare Diagnosis

Inflammatory myofibroblastic pseudotumours are uncommon lesions of unknown etiology. Diverse nomenclature such as inflammatory pseudotumour, plasma cell granuloma, inflammatory myofibroblastoma and inflammatory myofibrohistioblastic proliferation have been used for this entity due to uncertainity regarding true biologic nature of these lesions. This tumour is composed of spindle cells with myofibroblastic proliferation accompanied by an inflammatory infiltrate of plasma cells. Since it was first described in 1937, the understanding of inflammatory myofibroblastic pseudotumour has evolved from a reactive inflammatory process to a neoplasm of intermediate biological potential. These are associated with nosologic, histogenetic and aetiopathogenetic controversy. They occur in all age groups and in diverse body sites, with equal propensity in males and females

Correlation between Modified Bloom Richardson Grade and Lymph Nodal Status in Infiltrating Ductal Type of Breast Carcinoma

Introduction: Breast cancer is one of the most common cancers in women. Among the various types, invasive ductal carcinomas (IDC), not otherwise specified (NOS) is the most common type. This study was conducted to describe the clinico-pathological parameters of breast cancer, and to find a correlation between two of the prognostic parameters, i.e., Bloom Richardson (BR) grade and lymph node metastasis. Materials and Methods: It was a cross-sectional study with a sample size of 100 cases. Routine clinical details and investigations of the patients were recorded, including age, TNM stage of tumour, etc. Further, the specimens were evaluated for the histological typing, histological grading, and status of lymph nodes. Also, statistical correlations were established between two of the prognostic parameters, i.e., BR grade and lymph node metastasis. Results: All the cases were NOS type of IDC. Majority of the cases belonged to pTNM stage III, followed by stage II. Maximum cases belonged to BR grade 2, followed by grade 3. Lymph node metastasis was present in 40% cases. A statistically significant correlation was seen between increasing BR grade and presence of lymph node metastasis in the tumour. Discussion and Conclusion: Majority of the cases in our study belong to high grade and stage. This is probably due to lack of awareness and late detection of breast carcinoma in Indian scenario. A statistically significant correlation was found between increasing BR grade and presence of lymph node metastasis in the tumour. Thus, these can be used along with other clinico-pathological parameters for prognostic and therapeutic planning in breast carcinoma cases

Primary pure non-gestational choriocarcinoma of ovary: a rare case report

Germ cell malignancies represent 15% of ovarian cancers. Choriocarcinoma is a malignant tumour with trophoblastic differentiation. It may be gestational or non-gestational and may be a primary tumour or metastatic from other organs. Pure non-gestational choriocarcinoma is an extremely rare neoplasm, with reports of only a few cases. This study reports a rare case of non-gestational pure choriocarcinoma in a postmenarcheal young female and describes details of the tumour, including the clinicopathological findings. A young female presented with sudden onset anxiety, abdominal distention, severe abdominal pain, and severe pallor. Clinically, she was diagnosed as a case of ruptured ectopic pregnancy, and was taken up for emergency laparotomy. A right ovarian mass of 5X7 cm was seen, which was ruptured and was bleeding profusely. Right salpingo-oophorectomy was done, and it was diagnosed histopathologically as primary pure non-gestational choriocarcinoma of ovary. This case report describes the histopathological and immunohistochemical findings of this rare entity, as well as the various methods to differentiate between cases of non-gestational and gestational choriocarcinoma of the ovary. This is important as non-gestational choriocarcinoma has a poorer prognosis in comparison with gestational. Also, the treatment regimen for the two differs

Synchronous mucinous cystadenoma ovary, leiomyoma uterus and mucinous adenocarcinoma cervix infiltrating into uterine leiomyoma: a rare case report

The overall incidence of synchronous female genital tract malignancies is 0.63%. The most frequently observed synchronous neoplasms are those of the ovary together with the endometrium. Cervical and ovarian malignancies are exceedingly rare. We present the case of a female patient who complained of abdominal distention and pain abdomen. A cervical pap smear was performed, and it showed inflammation and atrophic changes. USG abdomen revealed findings consistent with pyometra. Repeated dilatation and curretage for resolving the pyometra was attempted, but it yielded mucinous fluid only. Another USG abdomen was done, which showed a cervical growth. The patient was taken up for staging laparotomy. Per operatively, no growth could be identified in the cervix. However, dense adhesions of the cervix with the bladder were present. A bilateral salpingo-oophorectomy specimen was sent for intraoperative cytology, and showed mucinous cystadenoma, ovary. Further, the completion total hysterectomy specimen was sent for histopathology. Sections showed adenocarcinoma, cervix and leiomyoma, uterus. The cervical adenocarcinoma showed infiltration into the uterine leiomyoma. Thus, we document a very rare case involving a patient who presented with three coexistent tumours involving bilateral ovaries and uterus. To our knowledge, this is the first reported case of the combination. Accurate diagnosis as separate independent primary tumours or as primary tumour associated with its metastasis, and identification the site of origin in secondary tumours has important prognostic implications and is necessary for appropriate staging and treatment

Xanthogranulomatous Oophoritis Mimicking an Ovarian Neoplasm: A Rare Case Report

Xanthogranulomatous inflammation of female genital tract is uncommon and is usually seen in endometrium. Only a few cases involving the ovary have been reported. Its clinical manifestations, imaging modalities, and gross features can mimic ovarian malignancy. Thus, a preoperative diagnosis of this entity is important to avoid radical surgical treatment. We report a case of xanthogranulomatous oophoritis in a 24 years female, which was clinically and radiologically misdiagnosed as ovarian neoplasm. The approach to such a case and the differential diagnosis has also been discussed

Malignant peripheral nerve sheath tumor of the transverse colon with peritoneal metastasis: a case report

Abstract Background Malignant peripheral nerve sheath tumors are malignant tumors arising from a peripheral nerve or displaying nerve sheath differentiation. Gastrointestinal malignant peripheral nerve sheath tumors are rare and malignant peripheral nerve sheath tumor of the colon is even rarer. To date, only five cases have been reported as malignant peripheral nerve sheath tumor arising in the colon. This is probably the first case report of malignant peripheral nerve sheath tumor of the transverse colon associated with peritoneal metastasis. Case presentation A 25-year-old Indian man presented with a large abdominal mass. A computed tomography scan revealed a large 18 cm-sized mass in his transverse colon, suggestive of gastrointestinal stromal tumor. A wide local excision was performed. Histopathology showed sheets and fascicles of elongated to spindle-shaped tumor cells showing a moderate degree of pleomorphism and atypia. Based on morphology and immunohistochemistry, a final diagnosis of malignant peripheral nerve sheath tumor of the transverse colon was given. A peritoneal metastatic tumor deposit was identified grossly and confirmed on histopathology. Conclusion This is a rare case report discussing the detailed diagnostic approach along with an extensive review of the literature for malignant peripheral nerve sheath tumor arising in the colon

Metachronous extraskeletal (soft tissue) epithelioid osteogenic sarcoma: a case report

Abstract Background Metachronous osteosarcoma is a rare form of osteosarcoma. The occurrence of metachronous tumor in soft tissue is exceedingly rare. The pathogenesis of metachronous osteosarcoma, as to whether it represents multiple true primaries or metastatic disease, is still obscure. Case presentation A 49-year-old Indian man presented with progressively increasing swelling in his left hand of 2 months’ duration. An X-ray showed a soft tissue lesion. Contrast-enhanced computed tomography showed a soft tissue mass lesion, with peripheral enhancement and central necrotic areas in radial palmar soft tissue overlying second metacarpophalangeal region with no obvious bony osteolysis. Possibilities of acute abscess, resolving hematoma, or aggressive soft tissue mass lesion were suggested. An incision biopsy showed morphological features of epithelioid osteosarcoma, which was confirmed on immunohistochemistry. A detailed history revealed that our patient was diagnosed as having osteosarcoma of his right leg 3 years previously. Based on history, radiology, morphology, and immunohistochemistry, a final diagnosis of extraskeletal (soft tissue) epithelioid osteogenic sarcoma of the left hand occurring as a metachronous tumor 3 years after diagnosis of primary osteosarcoma in the right leg was given. Conclusion This is probably the first reported case of extraskeletal (soft tissue) epithelioid osteosarcoma occurring as a metachronous tumor 3 years after diagnosis of primary osteosarcoma in the right leg. The prognosis of metachronous skeletal osteosarcoma is poor as compared to that of relapse limited to lungs. In late metachronous osteosarcoma, combined-modality therapy comprising surgery and aggressive chemotherapy may affect long-term survival. Lifelong follow-up of surviving patients with osteosarcoma is necessary and if metachronous osteosarcoma is discovered, it should be treated with curative intent

Pseudocarcinomatous hyperplasia of the fallopian tube mimicking a tubal neoplasm: A rare entity

Pseudocarcinomatous hyperplasia of the fallopian tube is a rare, reactive response to an underlying inflammatory or neoplastic process. Only a few cases have been reported in literature. It is a benign condition that mimics a malignant neoplasm clinically and radiologically. Thus, a preoperative diagnosis of this entity is important to avoid radical surgical treatment. We report a case of pseudocarcinomatous hyperplasia of the fallopian tube in a 27-year-old female, which was clinically and radiologically thought to be a tubal neoplasm. The approach to such a case and the differentiating features from adenocarcinoma have also been discussed