Kaushik Saha

Primary Intraparenchymal Squamous Cell Carcinoma of the Kidney: A Rare and Unique Entity

Primary squamous cell carcinoma (SCC) of the renal parenchyma is a very unusual entity which needs to be differentiated from primary SCC of renal pelvis, SCC from another primary site, and urothelial carcinoma with extensive squamous differentiation. We are most probably describing the second case of primary SCC of the renal parenchyma in a 51-year-old male who presented with heaviness of right upper abdomen with intermittent pain in right flank. Contrast-enhanced computed tomography (CECT) revealed a mass in the right lower pole of the kidney and histopathology following nephrectomy displayed the features of well-differentiated squamous cell carcinoma without urothelial involvement.

Amoeboma of colon mimicking colonic carcinoma

Entamoeba histolytica is a major cause of diarrhea in the developing countries and it can present with a wide range of gastrointestinal symptoms depending on the phase of the infection. We describe a case of 65-year-old male patient presented with abdominal pain and vomiting. On the clinical and radiological examination provisional diagnosis of colonic carcinoma was suspected. After resection of perforated caecal growth, histopathological sections showed numerous trophozoites of E. histolytica in a background of abundant necrosis. This case revealed differentiation between amoeboma and carcinoma is critical.

Clinico-pathological study of breast carcinoma: A prospective two-year study in a tertiary care hospital

Background: Breast cancer is the most frequent cancer in female, both in developed and developing regions, and ranks second overall next only to lung cancers. International variation in both incidence and mortality is one of the most striking features of breast cancer. Aims: To assess the clinical profile of the patients of breast carcinoma as well as relevant macroscopic and microscopic features of the mastectomy specimens. Materials and Methods: The present prospective study was carried out on clinically suspected and pre-operative FNAC-confirmed 120 cases of breast carcinoma who were admitted in the department of surgery for mastectomy during the study period of two years. In addition to relevant clinical features, macroscopic and microscopic features of mastectomy specimens were noted. Results: Mean age of the study population was 46.53 years. Most of the patients presented with breast lump with or without other features. Mean tumor size in the study population was 5.91 cm with standard deviation ± 2.59. Most of the cases (90.8%; 109 cases out of 120 cases) were diagnosed as IDC, NOS (Infiltrating ductal carcinoma, not otherwise specified). Mostly (62 cases; 51.7%), we got the histological grade 3 tumors. Lympho-vascular invasion was identified in 25.8% cases (31 cases out of 120 cases). Skin and nipple areola was involved in 15.0% cases (18 cases). Conclusion: IDC, NOS is the most common histologic type of breast cancer in our study population. Most commonly affected age group by breast cancer is 35-50 years. In most of the cases, size of the mass was more than 5 cm involving multiple quadrants of breast and with positive lymph nodes. Histologically, grade 3 tumor is most prevalent in this population.

Metastatic breast lump: A rare presentation of squamous cell lung cancer

Breast metastases from extramammary neoplasm are uncommon with an incidence of 0.5% to 3% of patients with extramammary malignancy. We reported an extremely rare case of breast metastasis from squamous cell lung carcinoma. A 60-year-old woman suffered from dry cough with shortness breath for one month with simultaneous development of breast lump. The histological diagnosis, achieved by bronchoscopic lung biopsy with the aid of immunohistochemistry was squamous cell lung carcinoma. Breast lump was a metastasis from lung, confirmed by histopathology and immunohistochemistry after core needle biopsy. Secondary malignancy metastatic to the breast is uncommon, yet this entity does exist. In view of the therapeutic implication, a metastatic breast lesion should not be mistaken for a primary breast carcinoma. Only with the awareness of such a possibility can prompt diagnosis and optimal treatment be achieved.

Sarcoma-like mural nodule in a borderline mucinous tumor of the ovary: A rare entity.

Sarcoma-like mural nodule (SLMN) is a very uncommon and misleading benign entity which may be associated with benign, borderline or malignant mucinous neoplasm of the ovary. It should be distinguished from other malignant mural nodules with sarcoma, carcinosarcoma or anaplastic carcinoma for proper management. We report a rare case of SLMN in a borderline mucinous tumor of the ovary in a 30-year-old lady. In spite of having confusing histopathological features the final diagnosis was made depending on the younger age of the patient, well circumscription of the nodule, absence of vascular invasion and immunohistochemical profile.

A rare co-occurrence of tubulocystic and clear cell type renal cell carcinoma

Tubulocystic renal cell carcinoma (TC-RCC) is a recently described rare subtype of RCC. Less than 70 cases have been reported until date. The concurrent papillary RCC (P-RCC) and TC-RCC has been documented many times in the literature, but the co-occurrence of clear cell RCC (CC-RCC) and TC-RCC is very rare. We are probably describing the third case of TC-RCC occurring with CC-RCC in a 62-year-old male who presented with heaviness of left upper abdomen and dull intermittent pain in the left flank. Grossly, there was two distinct parts in the total nephrectomy specimen. The larger solid part displayed the histopathological features of CC-RCC and the smaller spongy part revealed the features of TC-RCC.

Poorly differentiated Sertoli-Leydig cell tumor of ovary: A diagnostic challenge

Sertoli-Leydig cell tumors (SLCTs) account for less than 0.5% of all ovarian tumors. The patients can present with androgenic as well as estrogenic manifestations. Poorly differentiated tumors are very difficult to diagnose under microscope. Here, we report a rare case of poorly differentiated SLCT (Meyers type III) presenting with androgenic manifestations. Histopathologically, we got a variety of features from which the final diagnosis was quite impossible. Preoperative clinical features, hormonal level, and immunohistochemistry played a great role in finalizing the diagnosis.

Hypertrophic pulmonary osteoarthropathy: In coexistent lung cancer with pulmonary tuberculosis

Association of lung cancer with pulmonary tuberculosis is approximately 1-2% and pulmonary tuberculosis is associated with lung cancer in approximately 1-5% of cases. A 46-year-old male presented to us with low-grade fever for 3 months, increased severity of cough for 2 months, and painful swelling of fingers with both wrist joints for 1 month. Chest X-ray PA view revealed a homogenous opacity in the right upper and mid zone. Contrast-enhanced CT scan of the thorax showed soft tissue density, enhancing lesion (11.5 × 8.6 cm) with areas of necrosis in the right upper lobe. The patient suffered from squamous cell lung cancer as well as active pulmonary tuberculosis. As a complication of these two coexisting conditions, the patient developed hypertrophic pulmonary osteoarthropathy.