A Case of Malignant Mixed Ovarian Tumor (OMMMT) with synchronous mesenteric localization presenting heterologous expression of neuroendocrine markers, mesothelin and TTFI is studied. The peculiarity of this case is that of presenting immunophenotypic characters not yet reported in the literature in OMMMT.
{"title":"On a Complex Biphasic Neoplasm Involving the Ovary and Omentum Expressing Neuroendocrine Markers, HBME1 and TTF1: A Case Report and the Literature Review","authors":"Giuseppe Albonico, Marcello Filotico","doi":"10.5430/crcp.v10n1p1","DOIUrl":"https://doi.org/10.5430/crcp.v10n1p1","url":null,"abstract":"A Case of Malignant Mixed Ovarian Tumor (OMMMT) with synchronous mesenteric localization presenting heterologous expression of neuroendocrine markers, mesothelin and TTFI is studied. The peculiarity of this case is that of presenting immunophenotypic characters not yet reported in the literature in OMMMT.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135925965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zehra Kazmi, Fatima Ambreen, U. Tahir, S. Zafar Zaidi
Inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue neoplasm which has been described in a variety of locations. In the urogenital system, it occurs mainly in the bladder and the kidney. IMT arising from the ureter is exceedingly rare. We report an exceptional case of IMT arising from the ureteric submucosa in a three-year-old female child. The patient presented with pan-hematuria and no other symptoms. Urinalysis revealed numerous red blood cells, culture was negative for infection. A CT Urogram showed the lesion was involving most of the ureter. A left radical nephroureterectomy was performed, and she has remained well to date. Ureteral IMT is extremely rare and often asymptomatic, which can result in a delayed diagnosis. Radical excision is the best therapeutic approach with excellent survival outcomes.
{"title":"Inflammatory myofibroblastic tumor of the ureter in a paediatric patient","authors":"Zehra Kazmi, Fatima Ambreen, U. Tahir, S. Zafar Zaidi","doi":"10.5430/crcp.v9n1p27","DOIUrl":"https://doi.org/10.5430/crcp.v9n1p27","url":null,"abstract":"Inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue neoplasm which has been described in a variety of locations. In the urogenital system, it occurs mainly in the bladder and the kidney. IMT arising from the ureter is exceedingly rare. We report an exceptional case of IMT arising from the ureteric submucosa in a three-year-old female child. The patient presented with pan-hematuria and no other symptoms. Urinalysis revealed numerous red blood cells, culture was negative for infection. A CT Urogram showed the lesion was involving most of the ureter. A left radical nephroureterectomy was performed, and she has remained well to date. Ureteral IMT is extremely rare and often asymptomatic, which can result in a delayed diagnosis. Radical excision is the best therapeutic approach with excellent survival outcomes.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48959895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivan Franin, Sanda Bubanović, I. Milas, K. Čulo, M. Kirigin
We report a patient with polymorphous adenocarcinoma of the breast. Polymorphous adenocarcinoma of the breast is a rare tumour that corresponds to polymorphous adenocarcinoma in the salivary gland. The tumour consisted of a unimorphous population of one type of neoplastic cells with hyperchromatic, pleomorphic nuclei. Neoplastic cells were arranged in various architectural patterns including solid pattern, trabecular pattern and single “Indian-file“ arrangement with myxoid stroma in between. Tumour cells were negative for Estrogen, Progesterone, Her-2/neu, Smooth Muscle Actin, Cytokeratin 5/6, Cytokeratin 7, Synaptophysin and Chromogranin, while Cytokeratin AE1/AE3 (Pankeratin), BCL2 and E-cadherin were positive and p63 partially positive. Polymorphous adenocarcinoma is a rare and salivary gland-type tumour with only three cases reported up to date. To the best of our knowledge this is the fourth case of a polymorphous adenocarcinoma of the breast reported in the english literature.
{"title":"Polymorphous adenocarcinoma of the breast: A case report","authors":"Ivan Franin, Sanda Bubanović, I. Milas, K. Čulo, M. Kirigin","doi":"10.5430/crcp.v9n1p24","DOIUrl":"https://doi.org/10.5430/crcp.v9n1p24","url":null,"abstract":"We report a patient with polymorphous adenocarcinoma of the breast. Polymorphous adenocarcinoma of the breast is a rare tumour that corresponds to polymorphous adenocarcinoma in the salivary gland. The tumour consisted of a unimorphous population of one type of neoplastic cells with hyperchromatic, pleomorphic nuclei. Neoplastic cells were arranged in various architectural patterns including solid pattern, trabecular pattern and single “Indian-file“ arrangement with myxoid stroma in between. Tumour cells were negative for Estrogen, Progesterone, Her-2/neu, Smooth Muscle Actin, Cytokeratin 5/6, Cytokeratin 7, Synaptophysin and Chromogranin, while Cytokeratin AE1/AE3 (Pankeratin), BCL2 and E-cadherin were positive and p63 partially positive. Polymorphous adenocarcinoma is a rare and salivary gland-type tumour with only three cases reported up to date. To the best of our knowledge this is the fourth case of a polymorphous adenocarcinoma of the breast reported in the english literature.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48386703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cystic lymphangiomas are extremely rare benign vascular neoplasms generally found in childhood. Thought to arise from obstructed lymphatic channels during development, but may also arise secondary to trauma, inflammation, malignancy, and surgery or radiation exposure. They are usually seen in the head and neck or axillary region, and rarely in the abdominal cavity with only 1% occurring in the retroperitoneum. These are typically asymptomatic lesions incidentally identified by computer tomography, magnetic resonance imaging or ultrasound. Complete surgical resection with histologic confirmation of the diagnosis is the treatment of choice.We present a case of a 27-year-old woman with multiple cystic lymphangiomas in retroperitoneum, discovered incidentally by ultrasound during pregnancy.
{"title":"Multiple retroperitoneal cystic lymphangiomas in a pregnant woman: A case report","authors":"Janriette Isabelle Vizuete Yépez, Marcelo Xavier Carpio Ayora, A. Robin, Evelyn Carolina Polanco Jacome","doi":"10.5430/crcp.v9n1p20","DOIUrl":"https://doi.org/10.5430/crcp.v9n1p20","url":null,"abstract":"Cystic lymphangiomas are extremely rare benign vascular neoplasms generally found in childhood. Thought to arise from obstructed lymphatic channels during development, but may also arise secondary to trauma, inflammation, malignancy, and surgery or radiation exposure. They are usually seen in the head and neck or axillary region, and rarely in the abdominal cavity with only 1% occurring in the retroperitoneum. These are typically asymptomatic lesions incidentally identified by computer tomography, magnetic resonance imaging or ultrasound. Complete surgical resection with histologic confirmation of the diagnosis is the treatment of choice.We present a case of a 27-year-old woman with multiple cystic lymphangiomas in retroperitoneum, discovered incidentally by ultrasound during pregnancy.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46249248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This report presents the case of primary Mucoepidermoid Carcinoma of the skin on the leg of a 74-year-old man. The epidemiological data of the neoplasm are examined, and the morphological picture and immunophenotypic profile are compared with those of the homologous tumor of the salivary glands. According to the scoring system of this type of tumor, our case is classified as low-grade.
{"title":"A rare case of mucoepidermoid carcinoma of the skin: A case report and a literature review","authors":"M. Filotico, Francesca Mazzeo","doi":"10.5430/crcp.v9n1p1","DOIUrl":"https://doi.org/10.5430/crcp.v9n1p1","url":null,"abstract":"This report presents the case of primary Mucoepidermoid Carcinoma of the skin on the leg of a 74-year-old man. The epidemiological data of the neoplasm are examined, and the morphological picture and immunophenotypic profile are compared with those of the homologous tumor of the salivary glands. According to the scoring system of this type of tumor, our case is classified as low-grade.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44305657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vivek Somasundaram, M. Hernandez, Blake A Ebner, A. Folpe, Joaquín J. García, T. Mckenzie
Adrenal masses are frequently discovered incidentally and warrant further workup to explore the etiology of the mass. We present the case of a patient who had an incidentally discovered nonfunctional adrenal mass, which was determined to be a perineurioma. This is the first case report, to our knowledge of a perineurioma occurring in this location. Additionally, we report an episode of post sedation excitation, or “propofol frenzy” in the same patient to add to the clinical spectrum of presentation of this phenomenon.
{"title":"A confluence of rarities: post sedation neuroexcitation following adrenal perineurioma resection","authors":"Vivek Somasundaram, M. Hernandez, Blake A Ebner, A. Folpe, Joaquín J. García, T. Mckenzie","doi":"10.5430/crcp.v8n1p40","DOIUrl":"https://doi.org/10.5430/crcp.v8n1p40","url":null,"abstract":"Adrenal masses are frequently discovered incidentally and warrant further workup to explore the etiology of the mass. We present the case of a patient who had an incidentally discovered nonfunctional adrenal mass, which was determined to be a perineurioma. This is the first case report, to our knowledge of a perineurioma occurring in this location. Additionally, we report an episode of post sedation excitation, or “propofol frenzy” in the same patient to add to the clinical spectrum of presentation of this phenomenon.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48168193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Inflammatory pseudotumor (IPT) is a rare benign mass forming lesion that has been reported in virtually every organ, and can closely mimic spindle cell neoplasms. Mycobacterial spindle cell pseudotumor (MSP) represents a small proportion of IPT of the lymph node, which occur in immunocompromised patients, posing a diagnostic challenge. We report three cases of MSP involving two AIDS patients who presented with generalized lymphadenopathy, and one immunosuppressed patient with a mediastinal mass. Biopsy in these cases revealed effaced architecture replaced by proliferating fibrohistiocytic spindle cells, fibrosis and polymorphic inflammatory infiltrate. Inflammatory pseudotumors and other spindle cell neoplasms of the lymph node can show overlapping morphologic features, resulting in diagnostic confusion. A differential diagnosis of Mycobacterial spindle cell pseudotumor should be kept in mind when approaching localized or generalized lymphadenopathy in an immunocompromised patient.
{"title":"Nodal mycobacterial spindle cell pseudotumor: A diagnostic pitfall","authors":"Daniel Christensen, E. Gnass, G. Uppal","doi":"10.5430/crcp.v8n1p33","DOIUrl":"https://doi.org/10.5430/crcp.v8n1p33","url":null,"abstract":"Inflammatory pseudotumor (IPT) is a rare benign mass forming lesion that has been reported in virtually every organ, and can closely mimic spindle cell neoplasms. Mycobacterial spindle cell pseudotumor (MSP) represents a small proportion of IPT of the lymph node, which occur in immunocompromised patients, posing a diagnostic challenge. We report three cases of MSP involving two AIDS patients who presented with generalized lymphadenopathy, and one immunosuppressed patient with a mediastinal mass. Biopsy in these cases revealed effaced architecture replaced by proliferating fibrohistiocytic spindle cells, fibrosis and polymorphic inflammatory infiltrate. Inflammatory pseudotumors and other spindle cell neoplasms of the lymph node can show overlapping morphologic features, resulting in diagnostic confusion. A differential diagnosis of Mycobacterial spindle cell pseudotumor should be kept in mind when approaching localized or generalized lymphadenopathy in an immunocompromised patient.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44665488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Oeng, Lath Sokun, Veasna Tan, N. Townell, E. Baron, J. Letchford
Background: In most countries with full-service microbiology services, streptococcus-like organisms visualized in a gram-stained smear of cerebrospinal fluid (CSF) from patients presenting with meningitis syndrome would be assumed to be Streptococcus pneumoniae . However, in many areas of the world, predominantly in Southeast Asia, the organism may be Streptococcus suis . Although initial antimicrobial treatment is similar, additional treatment for specific co-morbidities, such as hearing loss, may be needed. This case, involving an adult male who presented with signs and symptoms of meningitis, describes the appropriate laboratory test procedures used to make the diagnosis and the subsequent patient management strategy. Case presentation : A previously healthy 69-year old rice farmer was admitted to the hospital with a one day history of fever, headache, neck stiffness, and altered consciousness. Initial laboratory studies were consistent with meningitis but the CSF Gram stain did not reveal any organisms. Blood cultures obtained at admission grew alpha-hemolytic, optochin-resistant colonies consistent with Streptococcus suis, and the identification was confirmed by MALDI-TOF performed at another laboratory. Unusually, the isolate was penicillin resistant. The patient received 4 mg/day ceftriaxone and dexamethasone (to mitigate deafness) for 10 days and was discharged to home with moderate deafness but no residual infection. Conclusion: Diagnosis of meningitis should include both blood cultures and CSF cultures obtained before any antibiotics are administered. In some patient populations such as those in Southeast Asia or if there is history of contact with pigs or raw pork, S. suis should be considered.
{"title":"Meningitis caused by Streptococcus suis","authors":"S. Oeng, Lath Sokun, Veasna Tan, N. Townell, E. Baron, J. Letchford","doi":"10.5430/CRCP.V8N1P23","DOIUrl":"https://doi.org/10.5430/CRCP.V8N1P23","url":null,"abstract":"Background: In most countries with full-service microbiology services, streptococcus-like organisms visualized in a gram-stained smear of cerebrospinal fluid (CSF) from patients presenting with meningitis syndrome would be assumed to be Streptococcus pneumoniae . However, in many areas of the world, predominantly in Southeast Asia, the organism may be Streptococcus suis . Although initial antimicrobial treatment is similar, additional treatment for specific co-morbidities, such as hearing loss, may be needed. This case, involving an adult male who presented with signs and symptoms of meningitis, describes the appropriate laboratory test procedures used to make the diagnosis and the subsequent patient management strategy. Case presentation : A previously healthy 69-year old rice farmer was admitted to the hospital with a one day history of fever, headache, neck stiffness, and altered consciousness. Initial laboratory studies were consistent with meningitis but the CSF Gram stain did not reveal any organisms. Blood cultures obtained at admission grew alpha-hemolytic, optochin-resistant colonies consistent with Streptococcus suis, and the identification was confirmed by MALDI-TOF performed at another laboratory. Unusually, the isolate was penicillin resistant. The patient received 4 mg/day ceftriaxone and dexamethasone (to mitigate deafness) for 10 days and was discharged to home with moderate deafness but no residual infection. Conclusion: Diagnosis of meningitis should include both blood cultures and CSF cultures obtained before any antibiotics are administered. In some patient populations such as those in Southeast Asia or if there is history of contact with pigs or raw pork, S. suis should be considered.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":"8 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2021-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42179409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Onyenekwu, Reena Singh, J. A. Miller, M. Mostafa
Introduction: Angiosarcoma of the gastrointestinal tract is a rare, aggressive malignant neoplasm of vascular origin. Commonly, this tumor occurs due to metastases from other sites like the head and neck region and the soft tissue. When occurring as a primary tumor of the intestines, this entity poses a diagnostic dilemma due to its non-specific clinical presentation, coupled to its infiltrative features that may occur without an obvious lesion amenable to routine gastrointestinal interventions. The findings from an autopsy and surgical case with a brief review of its diagnostic features and relevant literature are discussed.Methods: We present a 73-year-old male with a history of a recent onset of gastrointestinal bleeding who was referred to our facility for persisting bleeding. He underwent endoscopy without an identifiable source of bleeding and subsequently received a colectomy at our facility, with repeated blood transfusions for persisting gastrointestinal bleeding. He was eventually transitioned to hospice and died shortly after presentation. A complete autopsy was performed.Results: There was anasarca with hemoperitoneum and intestinal intraluminal blood. Present in the small intestinal mucosa were three hemorrhagic nodules. Histologically, the nodules demonstrated medium to large epithelioid vasoformative neoplastic cells infiltrating through the wall of the small intestine and extending to the omentum. The findings from the gross and histology examination, as well as the immunohistochemical stains were consistent with an epithelioid angiosarcoma.Conclusion: Primary epithelioid angiosarcoma of the intestine is an uncommon aggressive tumor that poses a diagnostic challenge. Although rare, this diagnosis needs to be considered in patients with intractable gastrointestinal bleeding. Due to its morphologic overlap with other benign and malignant neoplasms, the use of ancillary testing during histologic examination is key in arriving at an accurate diagnosis.
{"title":"Epithelioid angiosarcoma of the small intestine presenting with intractable gastrointestinal bleeding: An uncommon tumor with diagnostic challenge and poor prognosis","authors":"C. Onyenekwu, Reena Singh, J. A. Miller, M. Mostafa","doi":"10.5430/CRCP.V8N1P17","DOIUrl":"https://doi.org/10.5430/CRCP.V8N1P17","url":null,"abstract":"Introduction: Angiosarcoma of the gastrointestinal tract is a rare, aggressive malignant neoplasm of vascular origin. Commonly, this tumor occurs due to metastases from other sites like the head and neck region and the soft tissue. When occurring as a primary tumor of the intestines, this entity poses a diagnostic dilemma due to its non-specific clinical presentation, coupled to its infiltrative features that may occur without an obvious lesion amenable to routine gastrointestinal interventions. The findings from an autopsy and surgical case with a brief review of its diagnostic features and relevant literature are discussed.Methods: We present a 73-year-old male with a history of a recent onset of gastrointestinal bleeding who was referred to our facility for persisting bleeding. He underwent endoscopy without an identifiable source of bleeding and subsequently received a colectomy at our facility, with repeated blood transfusions for persisting gastrointestinal bleeding. He was eventually transitioned to hospice and died shortly after presentation. A complete autopsy was performed.Results: There was anasarca with hemoperitoneum and intestinal intraluminal blood. Present in the small intestinal mucosa were three hemorrhagic nodules. Histologically, the nodules demonstrated medium to large epithelioid vasoformative neoplastic cells infiltrating through the wall of the small intestine and extending to the omentum. The findings from the gross and histology examination, as well as the immunohistochemical stains were consistent with an epithelioid angiosarcoma.Conclusion: Primary epithelioid angiosarcoma of the intestine is an uncommon aggressive tumor that poses a diagnostic challenge. Although rare, this diagnosis needs to be considered in patients with intractable gastrointestinal bleeding. Due to its morphologic overlap with other benign and malignant neoplasms, the use of ancillary testing during histologic examination is key in arriving at an accurate diagnosis.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42427794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jared Sweeney, Vaibhav Chumbalkar, Michael D. Staudt, P. Entezami, J. Qian, V. Sukul
Due to its rarity, a complete understanding of the clinical behavior, pathogenesis, and diagnostic definition of anaplastic pilocytic astrocytoma (APA) is currently lacking. The optimal clinical management and use of adjuvant therapies has yet to be defined. We present a 64 year-old-female with progressive headaches, dysarthria, and ataxia, who was found to have right cerebellar mass. A gross total resection was achieved through two staged operations. Pathology demonstrated focal areas of necrosis, tumor infiltration, and increased mitotic activity most consistent with APA. Adjuvant chemotherapy and stereotactic radiosurgery were administered. Approximately two years later, the patient presented with symptoms of cauda equina syndrome, and lumbar spine imaging demonstrated a large intradural mass at the conus medullaris with diffuse leptomeningeal enhancement. A biopsy was performed and was consistent with metastatic APA. APA may rarely progress to metastatic disease, most frequently involving the leptomeninges of the posterior fossa and cervical spine. This report represents the first case of metastases distal to the cervicomedullary junction.
{"title":"Anaplastic pilocytic astrocytoma of the cerebellum presenting with conus medullaris drop metastasis","authors":"Jared Sweeney, Vaibhav Chumbalkar, Michael D. Staudt, P. Entezami, J. Qian, V. Sukul","doi":"10.5430/CRCP.V8N1P10","DOIUrl":"https://doi.org/10.5430/CRCP.V8N1P10","url":null,"abstract":"Due to its rarity, a complete understanding of the clinical behavior, pathogenesis, and diagnostic definition of anaplastic pilocytic astrocytoma (APA) is currently lacking. The optimal clinical management and use of adjuvant therapies has yet to be defined. We present a 64 year-old-female with progressive headaches, dysarthria, and ataxia, who was found to have right cerebellar mass. A gross total resection was achieved through two staged operations. Pathology demonstrated focal areas of necrosis, tumor infiltration, and increased mitotic activity most consistent with APA. Adjuvant chemotherapy and stereotactic radiosurgery were administered. Approximately two years later, the patient presented with symptoms of cauda equina syndrome, and lumbar spine imaging demonstrated a large intradural mass at the conus medullaris with diffuse leptomeningeal enhancement. A biopsy was performed and was consistent with metastatic APA. APA may rarely progress to metastatic disease, most frequently involving the leptomeninges of the posterior fossa and cervical spine. This report represents the first case of metastases distal to the cervicomedullary junction.","PeriodicalId":90463,"journal":{"name":"Case reports in clinical pathology","volume":"8 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46527231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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