Cosme Ereño

Basaloid-squamous cell carcinoma of the larynx and hypopharynx. A clinicopathologic study of 7 cases.

During a 16-year period (1974-1989), a retrospective review of 468 surgical specimens of laryngectomy yielded 7 cases (0.66%) of basaloid-squamous cell carcinoma. They were all males between 42 and 63 years of age. Four cases were supraglottic and one transglottic. The other two arose in the left pyriform sinus and vallecula, respectively. At diagnostic time, 4 cases were Stage III and 2 Stage IV, only one being Stage II. Glanz index of histologic malignancy was high (> 5) in most cases (6/7). Mitotic rate was also high (22-78 mitoses/10 HPF). Lymph node metastases were documented at diagnosis in 5 cases, 3 of them presenting with extracapsular extension. One case developed liver metastases. During the follow-up, lymph nodes of the neck were again metastasized in 4 cases, and stomal recurrence was present in another one. Death of disease was confirmed in 5 cases after 10 to 35 months of follow-up. Overall survival was 28.5% after 3 years.

Inflammatory myofibroblastic tumour of the larynx

A case of inflammatory myofibroblastic tumour of the larynx in a 74-year old man is reported. The lesion presented as a polypoid tumour arising in the left true vocal fold. The patient died of non-tumour-related causes and the autopsy showed persistence of the laryngeal tumour. Multicentricity and distant metastases were not detected. The literature about this entity and its differential diagnosis is reviewed and briefly commented upon.

Papillary squamous cell carcinoma of the larynx

A case of papillary squamous cell carcinoma of the larynx in a 50-year-old man is reported. The lesion was located in the supraglottic region and grossly presented a characteristic finger-like pattern of growth. The tumour pursued an indolent clinical course, and the patient is well and free of disease after 47 months of follow-up. The present paper recapitulates the macro- and microscopic features of this rare neoplasm and stresses its differential diagnosis with other exophytic squamous cell carcinomas of the region.

Atypical carcinoid of larynx: presentation with scalp metastases.

A case of atypical carcinoid tumour of the larynx in a 72-year-old woman is presented. The neoplasm was located in the supraglottic region and was first manifest by metastases to the scalp. The presence of amyloid-like material and calcitonin-positive cells were features that resembled medullary carcinoma of the thyroid. Clinically, it pursued an aggressive course that led to death 58 months after diagnosis. The literature is reviewed, particularly that regarding the differential diagnosis.

Inflammatory myofibroblastic tumor of the temporal bone: a histologically nonmalignant lesion with fatal outcome.

INTRODUCTION Inflammatory myofibroblastic tumor (IMFT) of the temporal bone is an unusual but distinct clinicopathologic entity. CASE REPORT We report the case of a 75-year-old patient with an IMFT located in the temporal bone. Symptoms included VI, X, XI, and XII cranial nerves palsies. Computed tomography and magnetic resonance images are described. The lesion was locally aggressive and outcome was fatal. IMFT was identified by analysis of postmortem specimen with histopathologic and immunohistochemical confirmation. DISCUSSION IMFT can be locally destructive lesions. Involvement of the skull base and cervical spine is indistinguishable from an aggressive infection or a malignant tumor and can be fatal as in our case report. The difficulties in establishing clinicopathologic diagnosis, radiological imaging characteristics, and treatment are discussed.

Primary sinonasal ameloblastoma

A case of primary ameloblastoma of the right sinonasal tract in a 66‐year‐old man is reported. The tumour presented as a radiographically solid mass filling the right nasal cavity and sinuses and without continuity with maxillary alveola. After radical surgery plus postoperative radiotherapy, the patient has pursued a non‐aggressive clinical course after nine months of follow‐up. The paper reviews the clinico‐pathological features of this rare tumour and supports the theory of its sinonasal epithelium origin.

A case of Whipple's disease presenting as supraclavicular lymphadenopathy

A case of Whipples disease occurring in a 63‐year‐old woman is reported. Cervical lymphadenopathy and vague constitutional symptoms were soon followed by diarrhea and weight loss. Supraclavicular lymph node exeresis suggested the initial diagnosis, which was confirmed by intestinal biopsy. The concurrence of cystic spaces, PAS‐positive foamy histiocytes and epithelioid granulomas is considered by the authors to provide a useful histological clue in the diagnosis of lymph node involvement in Whipples disease. Pathologists must be aware of such an un‐conventional presentation of this rare entity and therefore include it within the differential diagnosis of cervical and/or axillary lymphadenopathies.

Extraskeletal Myxoid Chondrosarcoma. A Clinicopathologic and Immunohistochemical Study of two Cases

Two extraskeletal myxoid chondrosarcomas arising on the left lower extremity of two women, aged 48 and 72 years, respectively, are reported. One case mimicked clinically an organized hematoma. By light microscopy, they showed a lobular architecture. Anastomosing cords of cells lying in a myxoid background were the histologic hallmark. Based on conventional criteria, they were classified as neoplasms of low (G1) and intermediate (G2) grade malignancy. Both cases were strongly positive for S-100 protein and vimentin. Follow-up confirmed the low aggressiveness of this entity.

Middle-ear carcinoid tumor with distant metastasis and fatal outcome

Hematol Oncol Stem Cell Ther 1(1) January 2008 hemoncstem.edmgr.com 53 The term carcinoid, karzinoid (carcinomaslike), was first mentioned in the literature in 1907 by Oberndorfer.1 Since its recognition as a distinct entity it has been quite a controversial tumor, especially with respect to its biological behavior. In fact, although traditionally considered a benign neoplasm, distant metastases and tumorsrelated deaths were very soon sporadically recorded.1 Carcinoids are exceedingly rare neoplasms in the middle ear2 and are usually referred to as adenoma/ carcinoid tumors because they are considered benign glandsforming neoplasms with an overt tendency to des velop neuroendocrine and mucinous differentiations.3,4 Most literature reviews and textbooks on pathology highlight the benign clinical course of this entity. Some authors, however, have reported in recent years both los cal recurrences and extracranial lymph node metastases in the neck.5s8 Interestingly, no visceral metastases have been reported so far.9 The case reported here represents a unique example of middle ear carcinoid with regional lymph node and liver metastasis that led to the patient’s death after 11 years of follow up.

Non-sentinel node tumor invasion in oropharyngeal and oral cancer: risk of misdiagnosis of metastasis

Conclusion. The existence of patients with positive non-sentinel node indicates a risk of misdiagnosis of metastasis in oropharyngeal and oral cancer. Objectives. We attempted to confirm the usefulness of sentinel lymph node biopsy (SLNB) in oropharyngeal and oral cavity cancer to detect clinically occult metastases. Patients and methods. Twenty-two patients with a mean age of 57 (SD=13) years were studied prospectively. All presented T1–T3 squamous cell carcinoma (SCC) of the oropharynx or oral cavity, and were cN0 on palpation and CT. A preoperative (24 h) lymphoscintigraphy was performed with 99mTc-labelled sulfur colloid injected around the primary tumor. Subsequently, we proceeded with tumor exeresis and detection of SLN following the procedures described in a previous paper. Results. We detected a total of 32 SLNs in 21 of 22 patients. Ipsilateral neck node location was observed in 18 patients and bilateral in 3. We observed 10 patients with true positive SLNs (3 patients had micrometastases), indicating occult metastases. We harvested a total of 454 nodes in our selective neck dissections, 19 of which presented metastatic invasion. We identified four patients with positive non-sentinel nodes.