Jessica Falleti

Endocrine carcinoma of the major papilla: Report of two cases and review of the literature

To date, about 100 cases of ampullary NET are reported in International literature. These tumors can cause symptoms mainly secondary to their periampullary location. Up to 25% of patients have von Recklinghausens disease. Carcinoid syndrome is uncommon, unless hepatic metastasis is present. Determination of histopathology is of utmost importance and involves specific immunohistochemical staining. The published data indicate that these tumors, metastasize in approximately half of cases irrespective of primary tumor size. Therefore, radical excision in the form of pancreaticoduodenectomy is recommended regardless of tumor size. Local excision should be confined to patients unable to tolerate more extensive surgery. We here report two case of ampullary neuroendocrine tumors presenting as melena and painless jaundice respectively in a 51-year old man and in a 54-year old man and review the relevant literature, giving special attention to the morphologic features, clinical characteristics, and treatment modalities associated with this disease process.

Congenital Intracranial Mesenchymal Chondrosarcoma: Case Report and Review of the Literature in Pediatric Patients

In this paper we report the 1st case of a congenital intracranial mesenchymal chondrosarcoma in a 2-month-old infant, apparently present at birth. A magnetic resonance image showed a large left parietal solid mass, while microscopy revealed a mixture of undifferentiated small cells and mature hyaline cartilage islands, positive for vimentin, S-100, and CD99. A surgical excision was performed but the patient died after a few weeks as a result of a rapid relapse of the tumor. We also review the pediatric cases (in patients less than 20 years old) of extraskeletal (intracranial) mesenchymal chondrosarcomas of the literature, with a focus on the most recent cytogenetic and immunohistochemical studies.

Synchronous bilateral multifocal canalicular adenoma: a case report of an unusual finding

Canalicular adenoma is a benign neoplasm of the minor salivary glands. The most common site is the upper lip, and the adenoma usually appears as a single lesion. Few cases of multiple foci of canalicular adenoma (CA) have been reported in literature. We report a case of a 78‐year‐old woman with CA of the nasolabial wrinkle on both sides of the nose, which occurred at the same time. The lesions recurred after about 1 year. This report adds to the literature another case of multiple, bilateral CA with synchronous occurrence.

Acinic Cell Carcinoma of the Breast Arising in Microglandular Adenosis

Acinic cell carcinoma is a rare breast tumour belonging to salivary gland-like tumours of the breast. They are “triple-negative” breast cancers even if their biological behaviour seems to be more favourable. Herein we present an acinic cell carcinoma arising on a background of typical and atypical microglandular adenosis in a 58-year-old woman, along with a review of the literature.

Cholesterol granuloma of the breast with unusual ossification features (osseous metaplasia).

Cholesterol granuloma of the breast is a rare benign condition that can be mistaken for breast cancer. We present a case of a 42-year-old woman who presented with a 1-year history of asymptomatic palpable nodule in the upper external quadrant of the right breast. Mammography and ultrasonography suggested carcinoma, but excisional biopsy revealed cholesterol granuloma with unusual osseous metaplasia. Although reported to occur more frequently in the middle ear and mastoid process, we believe that better awareness of this rare benign condition is most important to avoid misdiagnosis and unnecessary surgery.

Symplastic glomus tumor: Report of a challenging lesion with literature review

Glomus tumors are uncommon mesenchymal tumors whose cells closely resemble those of a normal glomus body, and are found most commonly in the hand. Recently, a symplastic form exhibiting marked nuclear atypia, in the absence of any other malignant features, has been described. To date, only 14 cases of symplastic glomus tumor have been reported in the literature; hence, very little information is available about its diagnosis, treatment, and biological behavior. The case reported here concerns a symplastic glomus tumor occurring in the right index finger of a 62-year-old woman. We reviewed the literature concerning previously reported cases, placing emphasis on the documented biological behavior, treatment, and demographic trend. Physicians must be aware of this morphological variation of glomus tumor to avoid the mistake of malignancy, which results in over-treatment of the patient.

Unexpected autoptic finding in a sudden death: Gossypiboma

Gossypiboma, i.e. a retained surgical sponge, is a serious and rare complication in surgical practice, most commonly occurring in abdominal procedures. Migration of retained surgical sponge is an unusual sequelae, particularly if occurring in tracheo-bronchial tree. Herein, we report a 35-year-old man who had had a retained surgical sponge forgotten during a radical thyroidectomy, and subsequently a trans-luminal migration of the gossypiboma which went through the trachea causing a sudden death of the patient. All the operators of the surgical team should keep in mind this terrible complication to avoid unpleasant consequences to patient and themselves.

Capecitabine-induced stomatitis: a likely pathogenetic mechanism of oral lichenoid mucositis

Sirs:Capecitabine is an oral prodrug that is converted to onlyone active metabolite, fluorouracil (5-FU), which is used totreat numerous types of neoplasms, such as those of thebreast, esophagus, and larynx cancer, as well as metastaticbreast cancer as either a single agent or in combination withdocetaxel after the failure of prior anthracycline-basedchemotherapy [ 1]. The Federal Drug Administration hasrecently approved the combination of capecitabine andlapatinib for the treatment of advanced or metastatic breastcancer overexpressing human epidermal growth factorreceptor-2 [ 2].We treated a 61-year-old female patient with breastcancer who, following a right mastectomy, homolateralaxillary lymphoadenectomy, and radiotherapy, entered intoremission. After 7 years of remission, metastatic progres-sion of the disease was determined, and the patient receivedradiotherapy and anthracycline-based chemotherapy, whichwere only partially successful. A drug regimen of lapatinib[1250 mg daily oral dose (PO qd)] continuously pluscapecitabine (2000 mg/m

Mast cell sarcoma of the scalp: the first sign of undisclosed systemic mastocytosis?

Mastocytosis is a neoplastic disease of mast cells and their CD34+ precursors, including a heterogeneous group of disorders. It is characterized by abnormal growth and accumulation of mast cells in one or more organ systems. Mast cell sarcoma is an extremely rare and aggressive disease characterized by local proliferation of atypical mast cells, destructive growth and poor prognosis, without systemic involvement. Very few clinical cases describing this entity have been reported in the literature. In this paper, we report a case of a mast cell sarcoma, localized in the scalp of a 63-year-old woman; it appears to be the first manifestation of undisclosed systemic mastocytosis.

Dysgeusia: An Atypical and Neglected Psychiatric Symptom Induced by Fibrillary Astrocytoma

CASE REPORT A 31-year-old woman with a 4-month history of dysgeusia (which had appeared suddenly) reported “having a salty taste in the mouth after eating any kind of food.” She had had Hodgkin’s lymphoma 10 years previously, which had been treated with chemotherapy and radiotherapy. She also had had Hashimoto thyroiditis, for which she was still taking levothyroxine (50 g daily). The patient had not been taking any medication immediately before the onset of dysgeusia. Neurologic examination revealed nothing else of note. She had no history of depression, anxiety, or psychiatric disorder or therapy. The patient underwent a battery of tests for psychodiagnostic evaluation. Hamilton depression rating revealed mild depression (15 at baseline; normal range 0-8), and StateTrait Anxiety Inventory Form Y 1-2 revealed mild anxiety (50 at baseline; normal range 0-41). The patient scored 8 on the visual analogue scale. We hypothesized that the abrupt appearance of dysgeusia might be related to a neurologic disorder; thus, magnetic resonance imaging of the brain was performed with and without intravenous paramagnetic contrast. Results revealed a large midline chiasmatic mass (14 16 mm) extending to the suprasellar region and exhibiting low signal intensity on T1 and high signal intensity on T2. The mass had caused displacement of the anterior cerebral artery, compressing the carotid siphon laterally and the