Sonia Gon

Post-radiotherapy locoregional recurrence of hyalinizing clear cell carcinoma of palate

Clear cell carcinoma of the salivary glands is a rare tumor that represents less than 1% of all salivary tumors and is a new disease that is only recognized in recent years. It is rare and the standard treatment is still under investigation. This tumor often follows an indolent course and treatment includes wide surgical excision with or without adjuvant radiotherapy. Recurrence of the hyalinizing clear cell carcinoma (HCCC) after complete surgical resection is uncommonly documented. We hereby report a case of post-radiotherapy locoregional recurrence of HCCC of the palate and recommend further clinicopathological study and long-term follow-up to document the biological behavior of this entity along with highlighting the role of special stains and immunohistochemistry in its diagnosis.

Endometriosis of the appendix: A diagnostic dilemma

The incidence of endometriosis of the appendix is reported to be just <1% of the total endometriosis cases. Laparoscopic visualization and diagnostic yield are of profound significance to women in whom gynecologic diseases such as endometriosis, pelvic inflammatory disease, ruptured ovarian follicles or tubal pregnancy may be the source of pain and mimic appendicitis. Therefore, lower abdominal pain in reproductive age group female must invite the attention of the surgeon or gynecologist to entertain the possibility of endometriosis since appendiceal endometriosis, while relatively uncommon in patients with endometriosis, is rare in the general population.

Pure primary small cell carcinoma of urinary bladder: A rare diagnostic entity

Small cell carcinoma of the bladder is a rare, aggressive, poorly differentiated neuroendocrine neoplasm accounting for only 0.3-0.7% of all bladder tumors. Since the tumor is very rare, pathogenesis is uncertain. Small cell carcinomas of the urinary bladder are mixed with classic urothelial carcinomas or adenocarcinomas of the bladder in 68% cases, making pure primary small cell carcinoma even a rarer entity. The unknown etiology and natural history of small cell carcinoma of the urinary bladder represent a challenge both to the pathologist and urologists for its diagnosis and treatment, respectively.

Trichostasis spinulosa: An unusual diagnosis presenting as a double lower eyelid

Trichostasis spinulosa (TS) is a relatively common but underdiagnosed disorder of the pilosebaceous follicles in which there is follicular hyperkeratosis of a dilated hair follicle with retention of telogen hairs. Clinical presentation of this disorder can be confused with comedogenic acne, keratosis pilaris, eruptive vellus hair cysts, and Favre–Racouchot syndrome. A case of a nonpruritic variant of TS in a 16-year-old boy is reported because of its unusual location as well as presentation in the lower eyelid, giving an appearance of a double eyelid. Although TS is common, it is mostly under diagnosed and henceforth underreported hair follicular disorder. The differential diagnosis of this disorder should be always kept in mind even if it presents in unusual location to avoid unnecessary application of various therapeutic modalities.

A Study on Histopathological Patterns of Endometrium in Different Types of Abnormal Uterine Bleeding Among Peri And Postmenopausal Women

Introduction: Abnormal uterine bleeding (AUB) is considered as one of the most common problems both to the patient and the gynecologist. Until the pathology underlying atypical uterine bleeding is accurately diagnosed, proper therapy is hardly possible. The objectives of the study were to determine the types and frequencies of pathologies in endometrial curettings of abnormal uterine bleeding & compare different endometrial pathologies in different types of abnormal uterine bleeding in peri and postmenopausal patients. Methods: This is a retrospective study, conducted in the Department of Pathology, in a tertiary care teaching hospital, Kolkata from November 2014 to October 2015. All cases of AUB in the peri and postmenopausal patients with a probable endometrial cause were included in the study. Results: A total of 156 cases were analyzed. AUB was most prevalent in the perimenopausal age group. The most common presenting complaint was menorrhagia (43%). Histopathological diagnosis was not possible in 5 cases with inadequate sample material. Non-organic causes of the endometrium comprised 80.1% of total while in the rest (19.9%) definite organic pathology was found. Among the nonorganic causes secretory endometrium(42.9%) and in the organic group polyp(43.3%) was found to be commonest. Malignancy comprises 23.3% and hyperplasia constitutes 30% of total organic causes. Conclusion: Histopathological diagnosis of hyperplasia and malignancy is maximum in the patients presented with menometrorrhagia followed by postmenopausal bleeding. Hereby Histopathological evaluation of endometrial samples is especially indicated in peri and postmenopausal women to rule out neoplastic and preneoplastic conditions.

Omentum: An unusual site for distant metastasis for post-surgery radiotherapy treated squamous cell carcinoma larynx

Squamous cell carcinoma of the larynx is the most common histologic type, accounting for up to 90% of cancers with more predilections to spread locoregionally to the cervical lymph nodes. Distant metastasis, usually to lungs, bone, and liver is seen much less frequently, with an overall incidence of 6.5–7.3%. A case of 55-year-old male with the previous history of surgery and radiotherapy treated squamous cell carcinoma of the larynx, presenting with a chief complaint of pain abdomen is hereby reported for its unusual diagnosis of metastatic deposits of squamous cell carcinoma in the omentum. Though there are reference available for peritoneum as the distant metastatic site for hypopharyngeal carcinoma, reference for laryngeal carcinoma metastasizing to omentum were not found even with an extensive search of literature. Awareness of unusual sites of distant metastasis such as omentum must be kept in mind for treated laryngeal carcinoma patients presenting with non-specific symptoms like pain abdomen. And also, chances of involvement of unusual site of the distant metastasis increases with advanced tumor-node-metastasis stage and nodal status.

Synchronous multifocal osteosarcoma with small cell histological variant: A double rarity

Multifocal osteosarcoma (MFOS), osteosarcoma involving multiple sites, is a rare variant of osteosarcoma. When the lesions appear within 6 months of initial presentation of the tumor, it is known as synchronous MFOS. Synchronous MFOS has an incidence of 1%–3% only. Moreover, the histological variant of small cell osteosarcoma is even rarer. A case of 14-year-old male with synchronous MFOS of small cell type involving frontal and mandibular bone simultaneously is being reported here. It poses a dilemma to both the clinician and the pathologist to diagnose whether it represents multiple primary tumor or metastatic disease.

Infarction of a polyp within a mesenteric cyst: An unusual presentation as an acute abdomen.

A case of mesenteric cyst in a five-year-old male child who presented with acute abdomen due to an infarcted polyp present within the cyst is reported. To the best of our knowledge, such an event has never been reported in the literature previously.