Amar Bhatnagar

Clear cell odontogenic carcinoma: a diagnostic and therapeutic dilemma

BackgroundClear cell odontogenic carcinoma is a rare odontogenic tumor occurring in the anterior region of the mandible in 5th–7th decades and shows a female preponderance. It is potentially aggressive, capable of frequent recurrences and loco-regional and distant metastases.Case presentationA 45- year- old woman presented with a radiolucent left mandibular swelling associated with loss of teeth. Left cervical lymph nodes were enlarged on palpation. The patient underwent resection of the tumor but consequent to resected margins being positive for tumor cells underwent left hemimandibulectomy with ipsilateral functional neck dissection and was free of recurrence at 8 months follow-up.ConclusionClear cell odontogenic carcinoma should be considered in the differential diagnosis of jaw tumors with conspicuous clear cell component. Curettage or conservative resection inevitably results in recurrences and/or metastasis and more radical resection is warranted in these tumors, especially when they are large and show soft tissue invasion.

Emperipolesis in a common breast malignancy. A case report.

BACKGROUND Emperipolesis is a phenomenon characterized by the presence of leukocytes/lymphocytes within the cytoplasm of other cells. The present report describes this unusual observation within epithelial cancer cells of the breast. CASE A 52-year-old female presented with a hard, adherent lump over the right breast for one year. Fine needle aspiration and histopathologic examination of the tumor showed features of infiltrating duct carcinoma with emperipolesis as a striking feature of the tumor cells. The tumor showed a near-total response to neoadjuvant chemotherapy. CONCLUSION The mechanism and biologic significance of emperipolesis in producing a near-total response to neoadjuvant chemotherapy in the present case suggest its role in inducing a tumoricidal effect, possibly involving a cascade of chemokines.

Metastasizing granular cell ameloblastoma.

Ameloblastoma is a slow growing odontogenic epithelial tumor of jaw. It accounts for 1% of all tumors and cysts arising in maxilla and mandible. Although it is locally invasive and has a marked tendency to recur, metastasis is rare. Of the various histological patterns of ameloblastoma, the granular cell type is extremely rare accounting for 4% of ameloblastomas. We report a case of granular cell ameloblastoma with metastasis to the cervical lymph node presenting in a 40-year-old Indian female.

Cytomorphological study of soft tissue neoplasms: role of fluorescent immunocytochemistry in diagnosis

Objectives:  Exact categorization of soft tissue tumours (STTs) on smears requires application of various ancillary techniques. This study was aimed at evaluating the role of fluorescent immunocytochemistry (FICC) in cyto‐diagnosis of 30 STT cases.

Malignant melanoma and basal cell carcinoma of the face: a rare coexistence.

The simultaneous presence of two disparate neoplasms occurring in the same specimen has been well documented, albeit uncommonly. The juxtaposition of malignant melanoma (MM) and basal cell carcinoma (BCC) as collision tumors has been rarely reported, with most cases describing melanoma in situ and BCC. We report a case of a 20-year-old male presenting with three papillomatous growths on the face, localized over the left frontotemporal region, below the right eye and over the right eyebrow. On histopathology and immunohistochemistry the lesions were diagnosed as pigmented MM and BCC. MM and BCC presenting at different sites on the face in the same patient along with a focus of metastasis in the same anatomical region as the primary tumor is quite rare. To the best of our knowledge this is the first report of such a case.