Morphological predictors for microsatellite instability in urothelial carcinoma.

Introduction Microsatellite instability occurs due to a series of mutations in the DNA pairing error repair (Mismatch repair; MMR) genes, which can affect germ cells as occurs in Lynch syndrome, whose patients are at high risk of developing multiple cancers. The loss of MMR protein is commonly determined by immunohistochemical studies. Although the relation between microsatellite instability and urothelial carcinomas has been widely studied, its evaluation is not currently performed in the analysis of urothelial carcinomas. Methods In this study, the microsatellite status of 139 urothelial carcinomas was analyzed and their clinicopathological characteristics were evaluated. We identified that 10.3% (13 patients) of urothelial carcinomas had loss of MMR protein expression (9 MLH1; 5 MSH2; 2 PMS2; 2 PSH6; n = 139). Results Results suggest that these tumors occur more frequently in males, are more frequently located in the bladder or ureters, and present a high tumor grade with a papillary histological pattern that does not infiltrate the lamina propria or, in the case of infiltrating tumors, that grows into perivesical tissues. Conclusions We identified patients with the aforementioned tumor characteristics as patients with a high probability of presenting loss of MMR protein expression, and consider that only these patients should undergo further immunohistochemical and molecular techniques for proper diagnosis. Therefore, we propose that the clinicopathological characteristics found in the present study could become possible markers to determine which cases should undergo additional tests.post-print1010 K

Prominent Cutaneous Manifestation of COVID-19: A Case Report

The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogen and the subsequent coronavirus disease (COVID-19) mainly affect the lung.1 Respiratory symptoms are key for diagnosis, however, increasing knowledge has led to the understanding that COVID-19 induces multiorgan pathology. The first descriptions of clinical symptoms reported that 0.2% of patients admitted to hospitals in China presented with a skin rash.1 Following this, in Italy 20.4% of 88 admitted patients treated by dermatologists presented with symptoms of the skin.2 In April 2020, the first comprehensive classification of skin manifestations in patients within the full spectrum of COVID-19 severity, from intensive care, hospital wards, and home care, as well as those without symptoms, was published.3 The study analysed 375 patients with PCR-confirmed diagnosis or with suspected diagnosis, meeting the European Centre for Disease Prevention and Control (ECDC) clinical criteria. Although following certain patterns, skin manifestations showed extreme variability. Five skin patterns were defined: pseudo-chilblain, vesicular, urticarial, maculopapular, and livedo/necrosis. Each pattern usually associated with a different age category, evolutionary moment of the process, and systemic severity.3 The majority of these manifestations were non-specific and their cause–effect relationship with the virus is not fully established. The limited access to confirmatory tests and concurrence of different drugs to treat the disease make it difficult to reach any conclusions. The authors present the case of a patient in whom the most striking COVID-19 manifestation was dermatological

Multicentric myxoid liposarcoma: report of two cases

<p>Abstract</p> <p>Background</p> <p>Multicentric myxoid liposarcoma is a rather infrequent tumour that tends to behave aggressively.</p> <p>Case presentation</p> <p>We herein report two further cases of this tumour that have been managed in our Hospital. Both were young men with multiple sites of involvement at the moment of diagnosis and both have shown a bad prognosis with frequent recurrences after treatment and rapid death in one case.</p> <p>Conclusion</p> <p>We comment on the diagnosis of this entity and on the therapeutic options available for these patients.</p