Pleomorphic hyalinizing angiectatic tumor of the mesorectum: a rare case and review of literature

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare tumor of uncertain tissue origin. Although it has been classified as a benign tumor under the WHO classification, it is locally aggressive, and multiple recurrences have been reported. PHAT commonly involves the lower extremities; however, various unusual sites of origin have been reported. We present the case of a 30-year-old female with dysmenorrhea, who presented a presacral mass on imaging. The core biopsy confirmed the diagnosis of PHAT. She underwent laparotomy and excision. Histopathology confirmed the presence of a tumor comprised of aggregates of ectatic vessels with perivascular hyalinization. An immunohistochemical study showed diffuse CD34 positivity, but S100, MDM2, and smooth muscle actin negativity. After surgical procedures, the patient is disease free as at the 12-month follow-up. Only 120 cases have been published in the English literature to date. Our study is only the third case of PHAT arising from the pelvis to be reported. Though considered to be a rare condition, the diagnosis of PHAT should always be considered in the differential diagnosis of well-defined hypervascular soft tissue mass in the pelvis. The typical histopathological findings along with immunohistochemistry should clinch the diagnosis

Elastosis Perforans Serpiginosa: a D-penicillamine induced dermatoses in a patient with Wilson’s disease

Long term use of D-penicillamine for Wilson’s disease can be associated with many adverse reactions and systemic side effects. We report the case of a 28-year-old male patient diagnosed with Wilson’s disease presenting with a serpiginous raised violaceous skin lesion in the anterior aspect of the neck over the last six months and two small papules with central umbilication during the last month. Histopathological examination of skin lesions demonstrated transepidermal perforating channel, and the Verhoeff’s-van Gieson stain showed marked increase number of irregular serrated elastic fibers suggesting the diagnosis of D- penicillamine induced elastosis perforans serpiginosa

Rhinosporidiosis of the lacrimal sac masquerading as chronic dacryocystitis: a rare presentation

Rhinosporidiosis is a chronic infection of the mucous membrane caused by the Rhinosporiduim seeberi, which infects through transepithelial penetration. Although described worldwide, this entity is mostly found in the western hemisphere, afflicting young people, predominantly males, associated in many cases with recreational or professional contact with bath in ponds, rivers, or stagnant waters. The clinical features are varied depending on the affected membrane, in some cases mimicking other diseases postponing the correct diagnosis. Although nasal obstruction and epistaxis are the common clinical presentations in sinonasal rhinosporidiosis, patients with epiphora without a nasal mass often challenge the diagnosis. In the present case, we have documented a case of isolated lacrimal sac rhinosporidiosis masquerading as chronic dacryocystitis, which was successfully managed by endoscopic excision, accompanied by a literature review

Giant epidermal inclusion cyst of the thyroid: a rare occurrence

Epidermal inclusion cyst (EIC) of the thyroid is extremely rare in the clinical practice. A handful of cases have been documented in the past in the world literature. A giant EIC of the thyroid is hitherto unreported. This lesion may arise from the squamous metaplasia of the thyroid follicular cells. Though non-neoplastic, giant forms can cause compression of the vital structures of the neck. In the present case, we have described a giant epidermal inclusion cyst successfully managed with surgical management

Intraconal orbital dermoid cyst: a rare location

Intraconal dermoid cysts are very unusual in routine clinical practice. Clinical symptoms depend upon the site and extension of the lesion. Though rare, proptosis, diplopia, and orbital pain are the presenting symptoms encountered in patients with an intraorbital dermoid cyst. Although radiology can be diagnostic, a complete correlation with the final histopathology is always mandatory for its confirmation. Endoscopic excision of the cyst ensures a complete cure for the disease without any intraoperative/postoperative complications

Non-Hodgkin's lymphoma-associated pleural effusion misdiagnosed as tubercular pleural effusion

Adenosine deaminase (ADA) in the pleural fluid has high sensitivity and specificity for diagnosing tubercular pleuritis. ADA level of more than 40 IU/L in a lymphocytic and exudative effusion is suggestive of tubercular etiology in clinical practice. Antitubercular chemotherapy is often instituted without further histopathological or microbiological confirmation, especially in tuberculosis (TB)-endemic countries. Lymphoma is another important cause of elevated ADA levels in pleural fluid. Hence, in the absence of tissue diagnosis, lymphoma is often wrongly labeled as TB based on fluid characteristics. Here, we present a case of non-Hodgkin lymphoma with right-side pleural effusion who was initially misdiagnosed to have TB based on pleural fluid analysis

Necrotizing sialometaplasia: Manifestation of a localized unclassified vasculitis

Necrotizing sialometaplasia is a rare benign and self-limiting disease, which commonly affects the minor salivary glands. Typically, it involves the seromucinous glands located at palate, buccal mucosa, tongue, tonsil, nasal cavity, trachea, larynx, maxillary sinus, and retromolar trigone. We report two such cases of necrotizing sialometaplasia to create awareness among the pathologists and surgeons because of its close morphological and clinical resemblance to squamous cell carcinoma. We have also documented that, the ischemic necrosis of salivary gland is the result of a vasculitic process

Multiple familial trichoepithelioma with an adjacent basal cell carcinoma, transformation or collision - A case report and review of literature

Trichoepithelioma is a benign tumor of follicular origin that presents as small, skin-colored papules predominantly on the face. When more than one family member is affected, the disease is known as multiple familial trichoepithelioma (MFT). It is a rare autosomal dominant skin disease. Malignant transformation is very rare. We describe here a case that developed malignant neoplasm in a setting of multiple trichoepithelioma