Ronald L. Goldman

Glycogen-rich adenoma of the parotid gland. An uncommon benign clear-cell tumor resembling certain clear-cell carcinomas of salivary origin

An instance of glycogen‐rich adenoma of the parotid gland is presented. This lesion contains conspicuous numbers of clear cells, causing confusion with certain clear‐cell salivary carcinomas. In the glycogen‐rich adenoma, the clear cells form a peripheral mantle within tubular complexes and contain abundant glycogen, whereas similar appearing clear cells within acinic cell and mucoepidermoid carcinomas occur in nests and trabeculae, and lack glycogen. Although the precise nosologic position of this lesion is speculative, the admixture of epithelial and clear‐celled myoepithelial elements may justify placing this lesion in the broad category of mixed tumors, particularly those variants lacking a prominent stromal component elaborated by such myoepithelium. The presence of areas of cytologically atypical, locally invasive growth in the recurrent tumor are interpreted as evidence of malignant degeneration, and may have been related to prior radiotherapy.

The cartilage analogue of fibromatosis (aponeurotic fibroma). Further observations based on 7 new cases.

This paper presents observations derived from 7 new examples of the cartilage analogue of fibromatosis and reviews 27 relevant cases from the literature. The present report further widens the scope of this entity, both in its site of occurrence and in terms of the age of affected individuals, and reaffirms the efficacy of conservative surgical procedures in its control. The hallmark of this particular variety of fibromatosis is regarded as the differentiation of peculiar chondroid conformations within the spindle‐cell stroma. Many of these complexes resemble fibrocartilage and recall the emergence of fibrocartilaginous transformation in tendons and aponeuroses in the vicinity of their attachments to skeletal structures. The predominant occurrence of this lesion in children and young adults and the observation of its development in the vicinity of a fracture in a 64‐year‐old man, coupled with its predilection to originate in paraskeletal tissues, suggests the possibility that the cartilage analogue of fibromastosis represents a proliferation of specialized mesenchymal elements related to the stimulatory effect of normal or reactive skeletal growth.

Necrobiotic granulomas of the uterine cervix. A probable postoperative reaction.

Three cases of necrobiotic granulomas of the uterine cervix occurring in patients with a history of previous cervical surgery are described. This distinctive lesion histologically resembles a rheumatoid nodule but is not associated with infection or connective tissue disease. The clinicopathologic features of these cases are virtually identical to analogous postoperative lesions that have been described in the prostate. Such necrobiotic granulomas seem to be a result of prior surgery and should not be confused with other more portentous granulomatous diseases.

Angiomyolipoma of penis

We report a case of angiomyolipoma of the penis in a fifty-three-year-old patient. This lesion is rare outside of its usual intrarenal location, and, to our knowledge, has never before been reported to occur in the penis.

Focal Arteritis of the Breast

The fourth case of focal (isolated) arteritis of the breast is reported. The lesion, which may be unilateral or bilateral, presents as a painful or tender mass and has been confused clinically with carcinoma. Arteritis, either necrotizing or granulomatous, may occur as an isolated phenomenon re stricted to a solitary organ; it does not necessarily imply concurrent or subsequent systemic vasculitis.

Hepatocellular carcinoma in a woman on long-term oral contraceptives

A 32‐year‐old woman on oral contraceptives for 12 years developed a hepatocellular carcinoma, which resulted in death 15 months after initial diagnosis. The possible association between this malignant hepatic tumor and the long‐term use of oral contraceptives is reviewed. Cancer 40:884–888, 1977.

A brenner tumor of the testis

The third case of a testicular Brenner tumor is presented. Based on histologic as well as embryologic studies, a hypothesis is made which reconciles advocates of origin of the Brenner tumor from germinal epithelium (müllerian) with proponents of origin in the rete complex (wolffian) the rete tubules have been tacitly linked with mesonephric rests, but they are, in fact, probably derived from germinal epithelium, and commingling with the mesonephric system is by no means constant the ovarian Brenner tumor is thus viewed as a derivative of germinal epithelium, whether it be located over the cortical surface or lining tubules of the rete ovarii. Testicular Brenner tumors conceivably arise from known müllerian vestiges in the epididymotesticular groove.

Pure squamous cell carcinoma of the larynx with cervical nodal metastasis showing rhabdomyosarcomatous differentiation. Clinical, pathologic, and immunohistochemical study of a unique example of divergent differentiation.

We describe a unique case of pure squamous carcinoma of the larynx that developed a cervical lymph node metastasis showing rhabdomyosarcoma admixed with squamous carcinoma (that is, carcinosarcoma). The rhabdomyosarcoma showed foci immunoreactive to multiple cytokeratin monoclonal antibodies, as well as to markers for striated muscle, thus indicating true divergent epithelial and rhabdomyosarcomatous differentiation. Although the morphogenesis of carcinosarcomas remains controversial, the sequence of events for the current case favors sarcomatous transformation of the original carcinoma (that is, sarcomatous neometaplasia of the primary carcinoma clone). The possible contributory role of radiation therapy in this case in inducing such a change is noted.

Epithelioid Monophasic Synovial Sarcoma

A 47-year-old man presented with a soft tissue mass of the distal right thigh near the knee. The tumor was highly vascular with epithelioid tumor cells growing in a peritheliomatous pattern, suggesting a soft tissue glomus tumor. Yet many tumor cells contained hemosiderin pigment and formed papillary structures suggestive of pigmented villonodular synovitis. Tumor cells were cytologically bland, and there was minimal mitotic activity. The tumor cells were strongly immunoreactive for cytokeratin, however, and contained true desmosomes, gland lumina, microvilli, tonofilaments, and well-developed basal lamina. These findings plus the absence perinuclear aggregates of intermediate filaments rule out malignant rhabdoid tumor and epithelioid sarcoma. Also, magnetic resonance imaging revealed no other lesions to suggest metastatic carcinoma. Thus this tumor appears to be a predominantly epithelioid form of monophasic synovial sarcoma. Recognition of this variant of synovial sarcoma is important for prognostication and therapeutic decision making because some studies indicate that this variant of synovial sarcoma follows a relatively benign clinical course.

Normal Paraganglia in the Human Prostate

A normal paraganglion was discovered incidentally in prostatic fragments resected for nodular prostatic hyperplasia.