Based on our histological findings, an osteoblastic metaplasia seems to be a possible pathogenic theory. This metaplasia seems to be secondary to a chronic inflammation. Concerning therapeutic procedures, they are non consensual and debated and are based on surgical or medical treatment. More reports are needed in order to assess the therapeutic management of this disease and its inducing factors.
Seborrheic keratosis is a benign epidermal neoplasm, representing one of the most common skin tumors. Clonal seborrheic keratosis is one of the histological subtypes of this entity. It is an uncommon lesion which may resemble other benign or malignant lesion. We report a case of a 60-year-old woman presented with a 7 year history of a gradually growing, cutaneous lesion on her left arm. On physical examination, the lesion was elevated, well-circumscribed, measuring 5 cm in maximum diameter. The tumor was biopsied. Histopathological examination revealed the presence of well-defined nests of clear-looking or basaloid keratinocytes within an acanthotic epidermis, corresponding to the Borst-Jadassohn phenomenon. The tumor cells were small and monomorphic. We diagnosed this tumor as clonal seborrheic keratosis. Although surgical excision was recommended, our patient refused an operation. This case of clonal seborrheic keratosis is presented for its rarity and for differential diagnosis.
Mucinous cystic neoplasm of the liver is a rare slow-growing lesion accounting for less than 5% of all hepatic cystic neoplasms. Differential diagnosis from other cystic lesions remains challenging despite progress achieved in the radiological modalities. Only histopathological examination of the surgical specimen establishes with certainty the diagnosis.
CLINICAL IMAGEA 40-year-old female patient with a past medical history of hypothyroidism, presented with a four-month history of right upper quadrant pain and weight loss. Abdominal computed tomography scan revealed a 73.75 x 48.38 mm unilocular cystic mass in the right hepatic lobe suggestive of hydatid cyst (Fig. 1A). Laboratory tests were within normal limits. Tumor markers (including CA19-9) and serum IgE level were not performed. Given her history of proximity to livestock in an endemic area, the diagnosis of a hydatid cyst was strongly favored. However, echinococcosis serology was negative. The patient underwent a right hepatectomy through a right subcostal incision. Grossly, the cystic mass was surrounded by a thick whitish capsule and contained a clear mucinous fluid (Fig 1B). Histological examination demonstrated a cystic lesion lined by a columnar biliary type epithelium overlying dense spindled ovarian type stroma (Figures 1C and 1D). There were signs of cytological atypia or mitoses. The final pathological diagnosis was mucinous biliary cystadenoma of the liver. The postoperative course was uneventful. At present, the patient is still being followed up.
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