Intracavitary cardiac metastasis of squamous cell carcinoma as first presentation of occult malignancy - a case report

Intracavitary cardiac metastasis of squamous cell carcinoma as first presentation of occult malignancy - a case report

ABSTRACTS was absent but mitoses ranging from zero to 3/10 HPF were noted. Tumour was present at inked resection margins. Follow up PET scan showed n...

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was absent but mitoses ranging from zero to 3/10 HPF were noted. Tumour was present at inked resection margins. Follow up PET scan showed no residual tumour or abnormal lymphadenopathy. Ongoing tumour surveillance has been planned. Discussion: Myoepithelial carcinoma ex pleomorphic adenoma is rare. Clinical follow-up is critical in these low-grade but locally aggressive tumours that often recur and/or metastasise late in the course of the disease. Recognition of this entity is crucial for the patient to receive appropriate follow-up and clinical care. We highlight important clinical and histological findings that are helpful in the diagnosis of these rare tumours.

TRICHOFOLLICULOMA-LIKE LESION OF THE VULVA ASSOCIATED WITH VULVAR INTRAEPITHELIAL NEOPLASIA – A CASE REPORT Namita Mittal1, Sanjiv Jain1,2, Neil Lambie3, Robyn Sayer4 and Millie Lui1 1Department of Anatomical Pathology, ACT Pathology, The Canberra Hospital, ACT, 2ANU Medical School, ACT, 3Prince of Wales Hospital, Sydney, NSW, and 4Gynaecology Cancer Centre, Royal Hospital for Women, Sydney, NSW, Australia Aim: Only three cases of vulval trichofolliculoma-like lesion associated with vulvar intraepithelial neoplasia (VIN) have been previously described in the English literature. This is the fourth reported case of trichofolliculoma-like lesion associated with VIN. Case presentation: A 39-year-old female presented with a white plaque in the vulva. She had a history of radical hysterectomy for invasive squamous cell carcinoma (SCC) of the cervix 8 years ago and posterior vulvectomy for invasive SCC 2 years ago. The anterior vulval biopsy showed VIN 3 and a dermal trichofolliculoma-like lesion colonised by dysplastic squamous cells. The lesion showed positive immunoperoxidase staining with p16, as seen in overlying VIN 3. This colonised lesion easily mimics an invasive SCC. Discussion: Trichofolliculoma is a rare benign pilar neoplasm of the skin usually found on the scalp, face, or neck. It is an exceedingly rare finding in the genital area. Its histogenesis is unknown. It is not associated with a family history or with other abnormalities. Juxtaposition of trichofolliculoma with VIN 3 in our and previously reported cases is likely to be coincidental. Recognition of benign appendageal tumours in an unusual site allows one to reach the correct diagnosis, and not to misdiagnose them as malignant process.

THE EFFECT OF IMMERSION FORMALDEHYDE FIXATION ON PLACENTAL WEIGHT Ali Moghimi, Saurabh Prakash, Chris Dow and Philip Kostos Dorevitch Pathology, Western Hospital, Footscray, Vic, Australia The normal reference ranges for placental weight are based on fresh placental status; however, in routine practice, placentas are frequently received in formaldehyde solution prior to the examination. The aim of this study was to assess the effect of formalin fixation on placental weight and the underlying factors affecting this process. We prospectively studied 71 placentas and measured their fresh weight and volume as well as their weight in five consecutive days following fixation in 10% formaldehyde solution.


The volume of formalin added primarily and also findings of subsequent macroscopic and histological examination were recorded. The results showed a significant 8.47% (SD 6.33%, p ¼ 0.000) increase in placental weight after formalin fixation for 24 h. This weight change was reversely correlated with fresh placental weight (r ¼ –0.59, p ¼ 0.000) and also had a poor positive correlation with formalin to placenta volume ratio (r ¼ 0.31, p ¼ 0.04). Mean placental weight remained approximately constant in the following days of follow-up. Association between the placental pathologies and changes in weight was also assessed. Our study showed a wide range of changes in placental weight following formalin fixation which is affected by different factors. Knowing them provides a more accurate estimation of the fresh placental weight.

INTRACAVITARY CARDIAC METASTASIS OF SQUAMOUS CELL CARCINOMA AS FIRST PRESENTATION OF OCCULT MALIGNANCY – A CASE REPORT Renn T. Montgomery and Leonardo D. Santos Department of Anatomical Pathology, Liverpool Hospital, Liverpool, NSW, Australia Cardiac metastases usually appear in patients with disseminated disease. Solitary metastases to the heart as the initial presentation is very uncommon. This case study reports a patient presenting with ischaemic heart disease and a mobile lesion in the left ventricle. He was scheduled for a coronary artery bypass graft, with intraoperative assessment of the mobile lesion to be performed at the same time. Tissue was sampled for frozen section, which showed a malignant lesion, favouring metastatic carcinoma. The intraoperative cytology showed similar findings. Paraffin sections and immunohistochemical studies later confirmed the diagnosis of metastatic squamous cell carcinoma. CT scan showed a left upper lobe pleural-based nodule, a right lower lobe apical segment irregular nodule, and a right subcarinal mass, suggesting a possible lung or oesophageal primary. The patient rapidly deteriorated before any further investigation could be undertaken, and was admitted for palliative care.

A BRIEF LITERATURE REVIEW ON AN UNUSUAL PROSTATE CANCER – A CASE PRESENTATION Than H. Oo1, Marianne Kube2 and Harry Lukse2 1Department of Tissue Pathology and Diagnostic Oncology, Institute for Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, Sydney, and 2Department of Anatomical Pathology, Pathology West, ICPMR, Orange Hospital, Orange, NSW, Australia Background: Small-cell neuroendocrine (NE) carcinoma accounts for only 1% of all prostate cancers. However, it represents a distinct clinicopathological category and can pose certain difficulties to reporting pathologists in terms of determining primary or secondary status, and appropriate interpretation of immunohistochemical stains particularly in metastatic lesions. Case presentation: Morphological and immunohistochemical (synaptophysin and thyroid-transcrition-factor-1 or TTF-1 positive; prostatic specific antigen negative) profiles of a metastatic

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