Although it is not uncommon to find occult carcinomas in the prophylactic breast, it is rare for the occult carcinoma to spread to the lymph nodes. Therefore, routine prophylactic SLNB is not indicated in patients undergoing PM.
Primary carcinoma of the gallbladder is an uncommon malignancy with a variable incidence among different geographic locales and ethnic groups. Women are affected generally 3 times as often as men. Choleliths are a significant risk factor. Other risk factors include abnormal union of the choledochopancreatic ducts, obesity, multiparity, chronic infection with certain bacteria, and genetics. The signet ring cell subtype of adenocarcinoma is a rare entity. The behavior of this subtype is not well described in the literature. The authors present a case of signet ring cell carcinoma of the gallbladder, unusual in their case because of the patient's young age, male gender, African American ethnicity, and lack of choleliths or any other risk factors. They review the literature in English to characterize this rare subtype.
We report a case of an intraventricular tumor with features of atypical central neurocytoma with a sarcomatous component in a 44-year-old woman who presented with headaches and vomiting. Magnetic resonance imaging revealed a 3.4-cm lobulated enhancing mass in the occipital horn of the left lateral ventricle, and the patient subsequently underwent a left occipital-parietal craniotomy for debulking. The tumor contained 2 cell populations: round cells with perinuclear halos in a fibrillary background, and spindle cells with oval nuclei arranged in interlacing fascicles with focal necrosis. The round cells had diffuse synaptophysin immunopositivity, while the spindle cells were diffusely immunopositive for vimentin and had intercellular reticulin. The mitotic activity (8 mitotic figures per 10 high-power fields) and the high Ki-67 proliferation index (15.0%) were consistent with atypical central neurocytoma with a sarcomatous component. Although different histologic variants have been described, this is the first reported case, to our knowledge, of central neurocytoma with spindle cell sarcomatous features.
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