The most common histological type of urinary bladder cancer is urothelial carcinoma (UC). In contrast, the clear cell variant of urothelial carcinoma (CCUC) is quite a rare neoplasm. In this study, we report a case of an 81-year-old male, presenting with gross hematuria and acute urinary retention, which was subsequently diagnosed with CCUC at our pathology department. Furthermore, we provide a short systematic review of the literature (PubMed, Scopus, Science Citation Index) for this rare histopathological entity and a brief discussion about its morphological and immunohistochemical (IHC) characteristics.
CD56 has been proved to be a useful marker in the diagnosis of PTC, including FV-PTC. Its absence can help differentiate FV-PTC from other thyroid nodules with follicular patterns.
Embryonal-type differentiations in urothelial neoplasms are uncommon [1,2]. These frequently underdiagnosed phenomena may include either the presence of trophoblastic areas or, even more rarely, admixed yolk sac tumour patterns (YST) [2]. We present for the first time the association of both trophoblastic and malignant endodermal-type elements within an aggressive high-grade urothelial carcinoma (HGUC). Due to the presence of the endodermal component, which had cells with a prominent clear cytoplasm, a differential diagnosis with other papillary and clear cell renal neoplasms was necessary. Clinical historyA 47-year-old male presented with intense pain in the lumbar region. Seventeen years previously, he had been treated for a non-seminomatous testicular tumour with lung and liver metastases. He eventually underwent a right orchidectomy followed by platinum-based chemotherapy. Followup showed only residual mature teratomatous tissue in the biopsy material from the remaining testicle.On his recent admission, elevated levels of serum β-hCG of 9,897.06 mUI/ml (normal 0-2.6 mUI/ml) and a lactate dehydrogenase of 1,280 U/L (normal 0-480 U/l) were found. Serum α-foetoprotein (AFP) was negative. A CT scan showed a large, ill-defined retroperitoneal mass involving the left kidney and ureter. There was marked infiltration of the psoas, and lung and vertebral metastases were prominent. No lesions were detected in the left testicle after both clinical and ultrasonographical exploration. A left ureteronephrectomy with resection of the surrounding tissues was performed. Patient refused chemo-or radiotherapy and 18 months after diagnosis is alive but has a large residual mass and pulmonary metastases. Materials and methodsThe ureteronephrectomy specimen was bivalved and fixed overnight in 10% buffered formalin and routinely processed. Seven tissue blocks were taken, and H&E-stained sections were analysed. Immunohistochemistry was performed on representative sections with the antibodies shown in Table 1.
Differentiated thyroid carcinomas are heterogeneous diseases with clinical and morphological features insufficient to predict their clinical behavior. The expression of tissue-specific transcription factors that control differentiated phenotype can be an additional method in evaluating the aggressiveness of a tumor, when differentiation markers and malignant phenotype of tumor cells are inconclusive. The expression of thyroid transcription factor-1 (TTF-1) is limited to thyroid follicular cells; it is a nuclear protein expressed in the epithelial cells of the thyroid, lungs and diencephalon. Using the monoclonal mouse antibody, clone 8G7G3/1, we examined the immunohistochemical expression of TTF-1 protein in 26 thyroid carcinomas (22 papillary carcinomas � PTC, 2 follicular carcinomas � FTC, 2 anaplastic carcinomas - AC), 4 follicular adenomas � FA, 10 benign thyroid lesions as underlying diseases (multinodular goiter � 3, Hashimoto thyroiditis � 3, Graves Basedow disease - 4) and sections of normal thyroid tissue, assessing the possible correlations with clinical and morphological features, as well as patient outcomes.TTF-1 nuclear expression was identified in 75% of benign thyroid lesions and 18/26 (69.23%) carcinomas. We noted TTF-1 nuclear expression in 68.18% of PTC (10% being associated with recurrent disease) and the absence of immunoreaction in 31.82% of PTC without recurrent disease. In patients with PTC, the risk of recurrence was significantly associated with the presence of nuclear TTF-1 expression in the primary tumor (p[0.001), but was not influenced by the type of surgery performed (p]0.05) or patients� age. TTF-1 nuclear expression did not correlate with patients� gender, tumor size, extent of disease at the moment of diagnosis and multifocal tumors (p]0.05). TTF-1 nuclear reactivity can be elevated in differentiated thyroid tumors (PTC and FTC) with aggressive clinical behavior that will develop recurrent or persistent disease. In anaplastic thyroid carcinomas with fast growth rate, immunoreactivity for TTF-1 and Ki-67 can offer useful information for tumor cell differentiation, while in the case of a mixed thyroid tumor it helps in distinguishing between well differentiated and undifferentiated/anaplastic areas.
Giant cell tumor (GCT) is a locally aggressive tumor but with benignity features, representing approximately 18% of non-malignant bone tumors in European countries, with slight female predominance. Malignancy in GCT is rare, about <2% of cases and is more common at older ages. Is known that usually occurs at the epiphyses of long bones, but extremely rare may have another location, such as the pelvic bone. An atypical location -the posterior iliac bone, found at a 34-year-old male -, is the case report we studied and described. Starting from the patient's complains, like a mass in the left buttock region described as "recently appeared", firm, not-mobile, with no distinctive borders and no tenderness at palpation, and a recent history trauma, multiple investigations have been performed, which have highlighted an osteolytic lesion, close to the sacroiliac joint, only with infiltration of the gluteal, iliac and paravertebral muscles. The treatment of choice was hemipelvectomy, with wide tumoral resection, and selective embolization of the nutrient vessels 24 hours prior to the surgical procedure. At two years postoperative, we found a good functional result and the computed tomography (CT) scan revealed no signs of recurrence.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.