Tall cell carcinoma with reversed polarity (TCCRP) is a very rare variant of carcinoma of the breast, resembling the tall cell variant of papillary thyroid carcinoma, first described in 2003, recently recognized as a separate entity in the 5th edition of the WHO (World Health Organization) Blue Book Classification of breast tumors with alternative terminology of tall cell variant of papillary breast carcinoma and solid papillary carcinoma with reversed polarity. Here, we report an additional case of this rare tumor in a 71‐year‐old woman, and the problems correlating with its diagnosis.
Background: Hepatoblastoma is a primary malignant tumor of the liver usually occurring in children, whereas it is very rare in adults, affecting males slightly more.
Case Presentation: We report a case of a 20-year old female patient with a palpable liver mass and significantly elevated alphafetoprotein (AFP), Serum Glutamic Oxaloacetic Transaminase, and Serum Glutamic-Pyruvic Transaminase values. The microscopic examination revealed a mixed cell population of small cells with an oval-shaped nucleus and scant relatively basophilic cytoplasm co-existing with larger cells with eosinophilic or clear cytoplasm, round nuclei, arranged in trabeculae of six or more cells separated by thin fibrous septa. The immunohistochemical assessment of the tumor cells revealed positivity for AFP, Glypican-3, Glutamate Synthetase, polyclonal Carcinoembryonic antigen, Cytokeratin (CK8/18), and Epithelial Specific Antigen/Ep-CAM, membranous and focally nuclear positivity for b-catenin, focal positivity for CK19 and vimentin and faintly focal positivity for Sallike protein-4 and Cluster Differentiation 99. The cell proliferation rate Ki-67 was high, at about 85% and concerning the prognostic markers, there was a positive expression of Cyclin D1 at approximately 80% of the tumor cells, whereas c-myc was negative. These findings drove us to the diagnosis of hepatoblastoma, macrotrabecular subtype.
Conclusion: Although the age, medical history, clinical findings, and the laboratory investigations of the patient suggested hepatocellular carcinoma, on the histological examination the mixed blastematous morphology of the tumor combined with the results of the immunohistochemical assay, lead to the diagnosis of hepatoblastoma.
Sarcomas of the breast constitute less than 1% of all malignant breast tumors and primary rhabdomyosarcoma (RMS) is a very rare entity with limited case reports in the literature. RMS is common in children and adolescents and rare in adults. Primary RMS arising from the breast is exceedingly rare in adults. We report a case of a primary RMS of the breast in a 60-year-old woman, who presented in an early stage, mimicking invasive ductal carcinoma clinically and is in complete remission after three years of diagnosis and one year of treatment.
Idiopathic noncirrhotic portal hypertension is a rare clinical entity. Even rarer is the littoral cell angioma of the spleen. The almost simultaneous appearance of the two disorders in a 64-year-old Greek woman was a tempting stimulus for us to attempt to identify a common denominator between these two, apparently distinct, entities.
Background: Silicone lymphadenopathy is a recognized complication of silicone implant rupture. It occurs when silicone droplets migrate from breast implants to lymph nodes, resulting in the formation of granulomas (known as siliconoma) and lymph node enlargement. The ipsilateral axillary lymph nodes are most commonly involved but it can also affect contralateral axillary, supraclavicular, internal mammary and mediastinal lymph nodes.Case presentation: A 60-year-old woman with a history of left breast cancer who had undergone modified radical mastectomy (MRM) followed by left breast reconstruction with implant (30 years ago) presented with right axillary lymph nodes enlargement. An excisional biopsy of the two larger lymph nodes was performed to rule out malignancy. Pathologic examination showed features of silicone lymphadenopathy. Further examination with Ultrasound and MRI confirmed breast implant rupture. Conclusion: Silicone lymphadenopathy following breast augmentation and reconstruction primarily affects the ipsilateral axillary nodes. Contralateral lymph node involvement is rare and may occur several years after breast cancer diagnosis and can be the first sign of breast implant rupture. Although, the need to exclude malignancy in such cases is of outmost importance, silicone lymphadenopathy should also be considered in the differential diagnosis.
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