Pooja Chauhan

Massive ovarian edema masquerading as fibroma: A rare case report

Massive edema of the ovary is a rare benign entity affecting young women. Most cases are thought to result from venous and lymphatic obstruction. The ultrasonographic appearance is nonspecific and can mimic neoplasia, and the definitive diagnosis requires histological examination. Massive ovarian edema should be suspected in women in reproductive age group presenting with solid enlargement of the ovary. Awareness of this rare entity among surgeons and pathologists is essential in the diagnosis and to avoid unnecessary oophorectomy. We describe one such rare case of massive ovarian edema in a 22-year-old female.

A rare case of bilateral sertoli cell adenoma in gonads associated with unilateral serous cyst in a patient with complete androgen insensitivity syndrome

Complete androgen insensitivity syndrome (CAIS) is an extremely infrequent disease. The patients exhibit female phenotype because of insensitivity to the androgen receptor and may develop tumors, especially in their undescended gonads. We present here a case of CAIS with bilateral Sertoli cell adenoma along with unilateral serous cyst in a 16-year-old patient.

Cytological, histopathological and immunohistochemical features of merkel cell carcinoma- A case report

Merkel cell carcinoma (MCC) is a rare, potentially aggressive primary cutaneous neuroendocrine carcinoma. MCC commonly occurs on sun-exposed skin in fair-skinned elderly individuals. It usually presents as a banal-appearing lesion, and the diagnosis is rarely suspected at the time of biopsy. We describe the cytomorphologic, histopathological, and immunohistochemical characteristics of MCC in a 76-year-old male patient presenting with rapidly evolving large red raised lesion over cheek for 1 month. Cytohistopathological evaluation suggested MCC. Immunohistochemistry revealed that the tumor cells were negative for leukocyte common antigen, S-100 protein, HMB45, and cytokeratin 20 and positive for neuron specific enolase. Because of the documented aggressiveness and rising incidence, early diagnosis of this rare tumor is necessary for the management of MCC.

Leiomyosarcoma with rhabdoid differentiation arising from leiomyoma: A rare entity

Leiomyosarcoma (LMS) arising in a leiomyoma (LM) is a rare event. Still rare is rhabdomyoblastic differentiation in leiomyosacoma. We present such a case of LMS uterus with rhabdomyoblastic differentiation arising in an LM in a 60-year-old menopausal woman who presented with lower abdominal pain. An ultrasound scan was suggestive of uterine fibroid. Total abdominal hysterectomy was performed for presumed LM. Grossly, fibroid had variegated appearance along with focal areas having whorling pattern and histopathology showed leiomyosarcomatous change in a benign LM with rhabdomyoblastic differentiation. This is a rare complication of LM and precise diagnosis of LMS is essential since it has an aggressive behavior.

Primary synovial sarcoma of pleura: A case report and review of the literature

Primary pleural synovial sarcomas (SSs) are rare tumors comprising <1% of all primary lung tumors. They are frequently misdiagnosed as relatively more common entities such as malignant mesothelioma. We present one such rare case of biphasic SS in the pleura of a 40-year-old female who presented with massive right hemothorax, and computed tomography revealed a pleural-based tumor in the right lung. Histopathological examination of the excised tumor was suggestive of biphasic SS. Immunohistochemical staining showed positivity with antibodies against cytokeratin 7, epithelial membrane antigen, vimentin, and bcl-2.

Cytology and histopathology of an unusual neck mass: Extraskeletal myxoid chondrosarcoma

Extraskeletal myxoid chondrosarcomas (EMCs) are rare soft tissue tumors with estimated incidence of 2.3% among all soft tissue sarcomas. Most of these tumors occur in the extremities with only a few cases reported in the head and neck region. Histologically, these tumors exhibit a broad spectrum of morphologic features, which make distinction from other neoplasms difficult, particularly when the tumor occurs at an unusual anatomic location. We present a case report of a 55-year-old male with colloid goiter who presented with a recent increase in his long-standing anterior neck swelling. A computed tomography scan demonstrated a cartilaginous lesion in the soft tissue of the neck. Subsequent cytological and histological examination revealed EMC.

Oleogranuloma of rectum co-existing with primary malignant melanoma: Report of a rare occurrence

Oleogranulomas are rare in rectum and usually present as pseudotumor as a result of foreign body reaction secondary to injection into wall of any oily substance, most commonly mineral oil for treatment of hemorrhoids or oil enemas for constipation. Their occurrence along with malignant melanomas which are also uncommon tumors in the rectum have not been reported in the literature so far. We report one such rare occurrence in a 55-year-old female who presented with alteration of bowel habits and passage of blood in the stool. Clinical and radiological examination suggested a tumor in the rectum. The biopsy report was suggestive of malignant melanoma. The patient underwent abdominoperineal resection. Gross examination of resected specimen revealed blackish ulceroproliferative growth in the lower part of the rectum. Histopathological examination revealed characteristic features of malignant melanoma along with oleogranulomas comprising of multinucleated foreign body giant cells and epithelioid cell granulomas surrounding large clear spaces giving “swiss cheese appearance.”