Priti Trivedi

Spermatocytic seminoma associated with undifferentiated sarcoma: A rare case report

The presence of sarcomatous element transforms the usually innocuous spermatocytic seminoma into a highly aggressive neoplasm. We report a case of spermatocytic seminoma with undifferentiated sarcomatous component in a 43-year-old male, presented with testicular mass since two and a half years. Orchidectomy was performed and after 9 months, the patient presented with recurrent scrotal mass with bilateral pulmonary metastases.

Isolated Skull Base Metastasis as the First Manifestation of Hepatocellular Carcinoma—A Rare Case Report with Review of Literature

IntroductionHepatocellular carcinoma rarely metastasizes to skull base.Case ReportWe report an extremely rare case of solitary skull base metastasis without metastasis to any other site, with right third, fourth, and sixth cranial nerve palsy as the initial manifestation of the disease.DiscussionThe biopsy specimen of skull base lytic lesion suggested metastatic hepatocellular carcinoma. Subsequent examination revealed a large mass involving superior segment of right lobe of liver, which was confirmed as hepatocellular carcinoma on histopathological examination.ConclusionUntil now, there have been only 24 cases of hepatocellular carcinoma metastasizing to skull base cited in literature. We report here an unusual case of solitary skull base metastasis from hepatocellular carcinoma prior to the diagnosis of primary tumor.

Recurrent low-grade astroblastoma with signet ring-like cells and high proliferative index.

Astroblastoma is a rare primary glial tumor of children and young adults. Radiologically astroblastoma presents as a large well-circumscribed supratentorial, solid-cystic heterogeneous mass. Histology shows perivascular pseudorosettes with hyalinization. Only a single case has been reported with signet-ring-like cell morphology. Signet-ring morphology in primary central nervous system tumors is exceedingly rare. Complete surgical resection is the recommended treatment. Prognosis of astroblastoma depends on the extent of resection and histology. The proliferative index may be a useful tool to define prognosis. We present a case of 10-year-old girl having recurrent low-grade astroblastoma with signet ring-like cells and high proliferative index.

Intradural spinal granular cell tumor

Granular cell tumor is a rare, usually benign tumor with classical histomorphology. Location of tumor varies widely within body, but spine is distinctly a rare location for this tumor. We report a rare case of granular cell tumor involving intradural extramedullary portion of lumbar region of spinal cord. Knowledge of which is important as subsequent prognosis differs from other tumor at same location.

Primary intratesticular rhabdomyosarcoma in pediatrics

Testicular sarcomas constitute only 1–2% of all testicular tumors and are mostly associated with germ cell tumor. Primary intratesticular rhabdomyosarcoma is rare and only 14 cases have been reported in the literature till date. It should be differentiated from germ cell tumor with sarcomatous component, other intratesticular spindle-cell sarcomas and paratesticular rhabdomyosarcoma. Accurate diagnosis and early treatment is essential as it is an aggressive tumor with high metastatic potential and poor prognosis. Orchidectomy is the treatment of choice. Chemo-radiotherapy is recommended in case of recurrence and metastasis.

Granulosa cell tumor arising in an ovary with mature teratoma

Granulosa cell tumor (GCT) with synchronous mature teratoma is extremely rare and only eight cases are documented in the literature. GCT is low-grade malignancy and need a close follow up for recurrences which may be late. We report a case of GCT and mature teratoma occurring synchronously in the same ovary in a perimenopausal woman.

Evaluation of central nervous system metastases with immunohistochemistry correlation

CONTEXT Brain metastases are the most common intracranial neoplasms. They are often the first symptom of systemic malignancy. Hence, immunohistochemistry (IHC) is of importance in evaluating the origin of brain metastases. AIMS The aim was to detect the primary site of brain metastases and evaluate the role of IHC in diagnosing the same. MATERIALS AND METHODS Data of 74 patients of brain metastases with unknown primary was analyzed. IHC was performed in these cases. The histopathological findings were correlated with clinical and radiological data. RESULTS Of 74 cases in which IHC was done; the most common primary site was lung (51 cases). Even after applying IHC, the primary could not be diagnosed in 10 cases. CONCLUSION Brain metastases are often the first indicator of systemic malignancy. Lung is the most common primary site in cases with unknown primary, as deduced by IHC findings.

Renal Cell Carcinoma with Osseous Metaplasia

Focal calcifications are not an uncommon occurrence in renal masses. Osseous metaplasia however, is a rare finding. We report a case of large renal mass with radiological evidence of calcification. Histopathological examination showed clear cell renal cell carcinoma with osseous metaplasia.

Osteoid differentiation in mesodermal (mullerian) adenosarcoma of ovary.

A 55-year-old female presented with abdominal pain and 10 cm mass per abdominal examination. Computerized tomography scan of abdomen and pelvis revealed a heterogeneously enhancing solid cystic mass right ovarian mass and mild ascites. Surgery was performed. Specimens were sent for examination. Microscopic examination revealed an admixture of benign but occasionally atypical appearing mullerian type glands with sarcomatous stroma. Solid area showed undifferentiated tumour cells. Atypical mitoses and necrosis were also seen. Areas with extensive benign osteoid surrounded by fibroblastic stroma were also present. Glandular component showed positivity for CK-7, AE-1 and EMA while sarcomatous areas showed positivity for vimentin only. Mullerian adenosarcoma of ovary with sarcomatous overgrowth (SO) having heterologous component was confirmed. Postoperative 3 cycles of chemotherapy was given and the patient was well till date (three months after surgery).

Small Cell Variant of Renal Oncocytoma With Liver Metastases A Case Report

Renal oncocytoma is a renal neoplasm considered to be benign. A small cell variant comprising predominantly of oncoblasts is rare. Metastases from a renal oncocytoma are extremely rare. A case of small cell variant of renal oncocytoma with liver metastases is described.