Background/Aim: Some metastatic tumors that involve the fallopian tube show intraepithelial spread, mimicking primary tubal neoplasm and representing a potential diagnostic pitfall. In this study, we aimed to investigate the clinicopathological characteristics of tubal intraepithelial metastasis (IEM) from cervical carcinoma. Patients and Methods: We analyzed the clinical features, histological features, and immunophenotypes of IEMs in five patients with cervical carcinoma. Results: This study included usual-type (1/5), mucinous-type (1/5), and gastrictype (2/5) endocervical adenocarcinomas and small cell neuroendocrine carcinoma (1/5) cases. None of the patients had ovarian metastasis, but metastatic tumor cells spread along the tubal mucosal surface and partially replaced the lining epithelium. Histological features of metastatic tumors closely resembled those of the primary tumors in all cases. Conclusion: Tubal IEM can mimic various tubal lesions including serous tubal intraepithelial carcinoma. Morphological consistency between the primary and metastatic tumors and immunostaining help guide the differential diagnosis of challenging intraepithelial lesions of the fallopian tube.Cervical carcinoma is one of the commonest causes of carcinoma-related mortality among women worldwide. The incidence and mortality rates of cervical carcinoma have decreased significantly in developed countries since the introduction of the cervicovaginal cytology screening program, which has facilitated the detection and treatment of precursor lesions (i.e. high-grade squamous intraepithelial lesion and adenocarcinoma in situ) (1). Despite the high efficacy of local treatment for the precursor lesions, treated women continue to represent a high-risk group, with high recurrence rates of 5-10% (2). Furthermore, despite increased surveillance, for several years after treatment, these women have a higher risk of invasive carcinoma than women in the general population (3). In 2018, approximately 570,000 women developed cervical carcinoma and 311,000 women died from it (4, 5).Squamous cell carcinoma is the commonest histological subtype arising in the uterine cervix, which accounts for 70% of all cervical carcinoma cases (6). Endocervical adenocarcinoma and high-grade neuroendocrine carcinoma comprise approximately 25% and 2%, respectively (6, 7). A recent large-scale study revealed that the most frequent anatomic site of metastatic cervical carcinoma was the lungs (37.9%), followed by the bone (16.7%), liver (12.5%), and brain (1.6%) (8). Adnexal metastasis of cervical carcinoma is relatively uncommon. The incidence of ovarian metastases ranges 2.0-28.6% and 0-17.4% for endocervical adenocarcinomas and squamous cell carcinomas, respectively. The clinicopathological characteristics of cervical carcinoma that involves the ovaries have been well documented (9), whereas only a few studies have investigated metastatic cervical carcinoma to the fallopian tube (10).Most of the tubal metastases from gynecological malignancies are associated with ...
Metastatic leiomyosarcoma to the thyroid is an extremely rare occurrence, and only 18 cases have been reported. Here, we report a case of a 37-year-old woman who presented with multiple masses on the scalp. Excisional biopsy was done and the mass revealed fascicles of smooth muscle fibers which showed positive staining for smooth muscle actin, thus confirming the diagnosis of leiomyosarcoma. The patient was also found to have a 0.9 cm mass within the left thyroid. Fine-needle aspiration was done and the cytological smear showed hypercellular spindle cell clusters with hyperchromatic and large nuclei. Normal thyroid follicular cells were found within or around tumor cells. In this report, we present the cytologic findings of metastatic leiomyosarcoma to the thyroid and offer differential diagnoses of the aspirated spindle cells.
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