93 research outputs found
The Rarity in the Rarity: Presentation of Three Cases of Cutaneous Carcinosarcoma with Clinical and Histopathological Insights
No full textfirst_page settings Order Article Reprints Open AccessCase Report The Rarity in the Rarity: Presentation of Three Cases of Cutaneous Carcinosarcoma with Clinical and Histopathological Insights by Gerardo Cazzato 1,* [ORCID] , Anna Colagrande 1 [ORCID] , Valentina Caputo 2 [ORCID] , Giuseppe Ingravallo 1 [ORCID] , Eliano Cascardi 1 [ORCID] , Francesco Fortarezza 3 [ORCID] , Emanuela Bonoldi 2 and Franco Rongioletti 4 [ORCID] 1 Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy 2 U.O. Anatomia Patologica, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy 3 Surgical Pathology and Cytopathology Unit, University Hospital of Padova, 35100 Padova, Italy 4 Dermatology Clinic, Vita-Salute San Raffaele University, 20132 Milan, Italy * Author to whom correspondence should be addressed. Dermatopathology 2024, 11(3), 209-217; https://doi.org/10.3390/dermatopathology11030022 Submission received: 31 May 2024 / Revised: 10 July 2024 / Accepted: 12 July 2024 / Published: 15 July 2024 Download keyboard_arrow_down Browse Figures Review Reports Versions Notes Abstract A cutaneous carcinosarcoma (cCS) is a rare and aggressive skin cancer characterized by both carcinomatous (epithelial) and sarcomatous (mesenchymal) components, making it a biphasic tumor. Despite its occurrence in various organs, a cCS is exceptionally rare in the skin, predominantly affecting older males. The etiology of a cCS is unclear, but it may originate from a single progenitor cell capable of dual differentiation or from a collision of carcinoma and sarcoma cells. Clinically, a cCS presents as a rapidly growing, painful, ulcerated nodule or plaque on sun-exposed skin, with a high risk of local invasion and metastasis. Histopathologically, a cCS includes various epithelial components, such as squamous cell carcinoma and basal cell carcinoma, along with undifferentiated sarcomatous components resembling atypical fibroxanthoma. The tumor may also exhibit heterologous differentiation like angiosarcomatous or rhabdomyosarcomatous features. We present three cases of a cCS, highlighting their clinical and histological characteristics and comparing them with previously reported cases. Understanding a cCS is complicated by its rarity and diverse presentation, emphasizing the need for further research to elucidate its pathogenesis and optimal management
“Black Ovaries”: An Uncommon Case of First Systemic Recurrence of Melanoma
No full textHere we describe a rare case of a 48-year-old woman with a previous history of malignant melanoma (pT2a pathological stage, IB clinical stage) occurring about five years previously. She complained of abdominal pain and pelvic discomfort, diagnosed as a consequence of a bilateral ovarian solid masses completely occupying the recto-uterine space. She underwent laparotomy surgery with total hysterectomy and bilateral salpingo-oophorectomy. Gross examination of the excised material revealed an unusual grey-black bilateral ovarian tumor; a histopathological diagnosis of ovarian bilateral metastatic melanoma was made. Imaging study (CT/MRI) did not reveal metastasis in other zones of the body. Melanoma metastasis usually affects the skin, liver, brain and lungs, and rarely gynecological localizations. On the other hand, most bilateral ovarian tumors are comprised of serous carcinoma, mature teratoma and gastrointestinal carcinoma metastasis. Exceptionally, primary ovarian melanoma may arise in mature ovarian cystic teratomas
A Unique Case of the Transformation of a Hepatic Leiomyoma into Leiomyosarcoma with Pancreatic Metastases: Review of the Literature with Case Presentation
No full textPrimary hepatic leiomyoma (PHL) is a rare entity, with very few cases reported in the literature. Even more rarely, until now practically undescribed, is the transformation of a hepatic leiomyoma into leiomyosarcoma with pancreatic metastases. Here, we report a single case of the progression of PHL in primary hepatic leiomyosarcoma, with clinical–surgical and histopathological features, and we conducted a review of the literature of related cases that can be found
Edema-like marrow signal intensity: a narrative review with a pictorial essay
No full textThe termedema-likemarrowsignal intensity (ELMSI) represents a general termdescribing an area of abnormal signal intensity atMRI. Its appearance includes absence of clear margins and the possibility of exceeding well-defined anatomical borders (forexample, physeal scars). We can define “ELMSI with unknown cause” an entity where the characteristic MR appearance isassociated with the absence of specific signs of an underlying condition.However, it ismore often an important finding indicatingthe presence of an underlying disease, and we describe this case as “ELMSI with known cause.” It presents a dynamic behaviorand its evolution can largely vary. It initially corresponds to an acute inflammatory response with edema, before being variablyreplaced by more permanent marrow remodeling changes such as fibrosis or myxomatous connective tissue that can occur overtime. It is important to study ELMSI variations over time in order to evaluate the activity state and therapeutic response of aninflammatory chronic joint disease, the resolution of a trauma, and the severity of an osteoarthritis. We propose a narrative reviewof the literature dealing with various subjects about this challenging topic that is imaging, temporal evolution, etiology, differentialdiagnoses, and possible organization, together with a pictorial essay
“Animal-Type Melanoma/Pigmented Epithelioid Melanocytoma”: History and Features of a Controversial Entity
No full textAnimal-type melanoma (ATM) was first described in the literature by Levene in 1979 in relation to a patient with a characteristic clinical presentation, and only later, rare and anecdotal case series have tried to shed light on an entity that has undergone several nosographic classification changes, and which, since 2018, is classified under the term “pigmented epithelioid melanocytoma”. Here, we conduct a brief review of the current literature on ATM and present a new clinical case with histopathological, immunophenotypic, and molecular investigations
Pilomatrixcarcinoma of the Foot: A New Localization of an Extremely Rare Adnexal Tumour
No full textPilomatrixcarcinoma is a very rare follicular neoplasm that shows matrical differentiation. The majority of these lesions originate de novo, while only a few cases of transformation of pilomatricoma (calcifying epithelioma of Malherbe) have been described in the literature. The neoplasm affects mostly middle-aged males with a male-to-female ratio of 3–4:1. The most common localizations are the face, head, trunk and extremites, though there are a few reports of pilomatrixcarcinoma of the eyelid, eyebrow, axilla and clitorid. Here, we describe the first case of a pilomatrixcarcinoma on the anterolateral surface of the first toe of the left foot of an 83-year-old patient, which developed in less than six months and led to amputation of the distal phalanx. We report a brief review of the current literature with particular emphasis on histopathological features useful for diagnosis
Hidradenocarcinoma of the Chest With Axillary Lymph Node Metastasis: Report of 2 Cases and Systematic Literature Review of a Breast Cancer Mimicker
No full textHidradenocarcinoma (HAC) is a rare malignant neoplasm originating from eccrine sweat glands, often presenting diagnostic challenges because of its resemblance to other malignancies, particularly breast cancer when occurring in the chest region. This report describes 2 cases of HAC with axillary lymph node metastasis, both initially misinterpreted clinically. The first case involved a 63-year-old woman with a sternal mass, near the right breast, initially suspected to be a sebaceous cyst. Histologic examination revealed a solid-cystic epithelial tumor with features suggestive of HAC, confirmed by immunohistochemical analysis. The second case concerned an 81-year-old woman with a subcutaneous growth in the sternal area, also diagnosed as HAC after histopathologic and immunohistochemical assessment. Both cases demonstrated strong estrogen receptor positivity, leading to the recommendation of hormonal therapy. A systematic review of the literature identified 21 similar cases of HAC in the chest wall, highlighting the diagnostic complexities and the potential for these tumors to mimic breast carcinoma. This review underscores the need for careful histologic and immunohistochemical evaluation to differentiate HAC from other malignancies, particularly in the breast region. Given the rare and the potential aggressive nature of HAC, early and accurate diagnosis is crucial for guiding appropriate therapeutic strategies and improving patient outcomes
Atypical Fibroxanthoma-Like Amelanotic Melanoma: A Diagnostic Challenge
No full textAtypical fibroxanthoma-like amelanotic melanoma is a very rare variant of melanoma that can, if not correctly recognized and framed, lead to diagnostic errors that can potentially cause problems of extreme relevance to patients. Correct knowledge of this entity and the execution of adequate immunohistochemical investigations are the basic conditions for the correct management of this lesion. We report on a case of atypical fibroxanthoma-like amelanotic melanoma, which clinically simulated a fibrohistiocytic lesion, and which created differential diagnostic problems, and finally, we conduct a short review of the literature
Spitz Nevus with Features of Clark Nevus, So-Called SPARK Nevus: Case Series Presentation with Emphasis on Cytological and Histological Features
No full textBackground: SPARK nevus represents a little-known and characterized entity, with few case series available in the literature. Methods and results: we present a case series of 12 patients (6 F and 6 M) between January 2005 and December 2020 and conduct a review of the current literature. Ten articles were selected on the basis of the adopted inclusion criteria and the PRISMA guidelines. Conclusions: The definition of histopathological and dermoscopic criteria are important to allow for an agreement to be reached among dermopathologists, and for the development of a consensus on higher case studies. To our knowledge, there are not many case series in the literature, and ours is part of the attempt to increase the knowledge of an entity that remains little-known and characterized
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