We present a 6-year-old child with intraocular and extraocular mass and high intraocular pressure. The tumor mass involved a disorganized anterior segment and extended through the medial cornea and sclera. A preliminary diagnosis of retinoblastoma with extraocular extension was made. An exenteration of the left globe and orbital tissue was performed. Histological examination showed that the lesion, which occupied the posterior chamber, involved the ciliary body, extending into the iris, sclera and cornea, projecting beyond the cornea anteriorly and extending to the retina posteriorly. The tumor cells were diffusely immunoreactive to vimentin, neuron specific enolase and CD 138. The medulloepithelioma cells were focally positive to cytokeratin (AE1/AE3), cytokeratin 18, CD56,CD57, S100, HMB-45 and bcl2 while areas of retinoblastic differentiation showed diffuse immunoreactivity to synaptophysin, neurofilament and CD138 with focal immunoreactivity to calretinin. All tumor cells showed no immunoreactivity to cytokeratin 7, cytokeratin 20, epithelial membrane antigen, carcinoembryonic antigen, desmin, GFAP, and chromogranin. Nuclear staining for P53 was seen in 80% of tumor cells. The ki-67 index was 90%. The tumor was described as malignant intraocular non-teratoid medulloepithelioma with retinoblastic differentiation arising from the ciliary body. Tumor satellites were seen in the adjacent periocular soft tissue. The treatment involved exenteration of the left globe and orbital tissue with secondary skin graft following chemotherapy. The patient is well and has no recurrence after 1 year of treatment. We report that medulloepithelioma can present as a case of infantile glaucoma, can show signs of intraocular calcifications and can show retinoblastic differentiation.
A 2-year-old boy presented with an abdominal mass and was diagnosed as Churg-Strauss syndrome (CSS). There was no history of asthma. He developed fatal gastro-intestinal disease, despite treatment with corticosteroids and cyclophosphamide. CSS is extremely rare in young children and gastro-intestinal involvement might carry a worse prognosis than in adults.
Bronchioloalveolar carcinoma (BAC) is a subset of lung adenocarcinoma that has a distinct clinical presentation, tumor biology, response to therapy, and prognosis compared with other subtypes of non-small-cell lung carcinoma. BAC disproportionately affects women, never-smokers, and is characterized by growth along alveolar septae without evidence of stromal, vascular, or pleural invasion. Microscopically, BACs have been divided into mucinous, nonmucinous, and mixed types. We describe a case of young female who received radiation therapy to the mediastinum and chemotherapy for Hodgkin lymphoma and now develops mucinous bronchioalveolar adenocarcinoma of the left lung which to the best of our knowledge has not been previously described after radiotherapy and chemotherapy for Hodgkin lymphoma. The tumor cells express Galectin-3, CD138, p16INK4a, thyroid transcription factor-1, cytokeratin 7, epithelial membrane antigen, carcinoembryonic antigen, E-cadherin, neuron-specific enolase, and S100 whereas no expression of cytokeratin 20, calretinin, and CDX2 is seen.
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