Masson’s Tumour: A Rare Cause of Cervical Mass

Masson's tumour, also known as intravascular papillary endothelial hyperplasia, is a rare non-neoplastic lesion of vascular origin, caused by an excessive reactive proliferation of endothelial cells in normal blood vessels or vascular malformations. It can affect any part of the body, presenting most frequently in the vessels of the head, neck and upper extremities. The authors describe the case of a 76-year-old female patient presenting an anterior cervical mass, measuring 2×2 cm, which was mobile, tender and slightly painful with no alteration of the overlying skin. Complementary study with ultrasound and computed tomography was inconclusive. Total excision of the lesion was performed with histology compatible with intravascular papillary endothelial hyperplasia.

Immunophenotyping of an Unusual Mixed-Type Extraskeletal Osteosarcoma in a Dog

A 6-year-old female Maltese dog presented with a cervical mass without pain. The tumor was surrounded by a thick fibrous tissue and consisted of an osteoid matrix with osteoblasts and two distinct areas: a mesenchymal cell-rich lesion with numerous multinucleated giant cells and a chondroid matrix-rich lesion. The tumor cells exhibited heterogeneous protein expression, including a positive expression of vimentin, cytokeratin, RANKL, CRLR, SOX9, and collagen 2, and was diagnosed as extraskeletal osteosarcoma. Despite its malignancy, the dog showed no sign of recurrence or metastasis three months after the resection. Further analysis of the tumor cells revealed a high expression of proliferation- and metastasis-related biomarkers in the absence of angiogenesis-related biomarkers, suggesting that the lack of angiogenesis and the elevated tumor-associated fibrosis resulted in a hypoxic tumor microenvironment and prevented metastasis.

Neuroendocrine carcinoma admixed adenocarcinoma of cervix: A case report of young female

Neuroendocrine carcinoma coexisted with adenocarcinoma in cervix is very rare. This disease has a very poor prognosis and so far no standard treatment has been obtained. A 35-years-old woman seeks medical attention with chief complaint of bleeding per vagina outside of menstruation. Ultrasound shows cervical mass of 4.2 cm × 2.9 cm. Microscopic biopsy suggestive of a mixture of neuroendocrine cervical carcinoma and adenocarcinoma, moderate-poor differentiation. Several immunohistochemical staining of the biopsy tissue was done to detect neuroendocrine and adenocarcinoma. In biopsy tissue, P63 immunohistochemical staining was performed to detect squamous cell carcinoma with negative results. Furthermore chromogranin, synaptophycin, CD 56, NSE, and P40 immunohistochemical staining were performed to detect neuroendocrine with positive results and so did CK 19, CEA, and CK 7 staining to detect positive adenocarcinomas. This rare case had a positive immunohistochemical staining of both neuroendocrine carcinoma and adenocarcinoma cervix. Patient received definitive concurrent chemo-radiotherpay.

Intradural Extramedullary Lesions in Cervical Spine in Neurofibromatosis

Introduction: Neurofibromatosis (NF) is isolated into three diseases: NF type 1, type 2, and schwannoma. NF type 2 could be a disorder that's found roughly in 1/25,000–33,000 births with a mutation in gene 22q11.2, and it is passed through eras in an autosomal dominant fashion. Diagnosis is made with both clinical and radiological features. A few clinical features have been characterized in conclusion counting Manchester criteria. There is a scarce number of NF type 2 patients diagnosed with cervical lesions which are 25 in number. We report a case of an intradural extramedullary cervical lesion in a patient later diagnosed with NF type 2. Case Report: A 30-year-old male presenting with gradual onset and progressive course of spastic quadriparesis of six months’ duration was admitted through the emergency unit. MRI spine showed intradural extramedullary masses in the right side of C4 and left side of C6. The patient underwent cervical intradural excision of two masses under general anesthesia with neuromonitoring. The tumor was sent for histopathology and reported as NF type 2. Conclusion: NF is a common entity, but the diagnosis of cervical mass is judicious to avoid any complication in neurological function. It further needs a multidisciplinary approach and screening modalities.

Case of papillary thyroid cancer presenting with an inoperable cervical mass successfully treated with high-dose radiation therapy

External-beam radiation therapy (EBRT) for differentiated thyroid cancer has been controversial. Palliative irradiation is usually recommended for patients with treatment-resistant relapse and/or distant metastases, but high-dose EBRT is not often indicated in this situation. A 50-year-old man had treatment-resistant recurrence of an inoperable cervical mass and multiple lung metastases after total thyroidectomy and neck dissection. Because the patient had good performance status and no other life-threatening metastases, he received high-dose intensity-modulated radiation therapy (IMRT). Remarkably, the tumour shrank during treatment. After 3 months, he had bleeding from the internal carotid artery. The bleeding was outside the high-dose irradiation site and was likely due to infection; emergency interventional radiology was performed. The post-EBRT clinical course was favourable and the cervical mass almost disappeared. The patient remained alive for 3 years post treatment. It is possible to extend the indication of high-dose intensity-IMRT in selected patients with differentiated thyroid cancer.

A case of TFE-3-positive non-neoplastic pseudodecidualized endometrium presenting as a cervical mass

Introduction/Objective TFE-3 gene encodes a transcription factor that promotes the expression of genes involved in cell growth and proliferation. Its overactivation can result in oncogenic activity. Although TFE-3 seems to be almost universally expressed in normal tissues, this expression should be at very low levels and strong nuclear expression of TFE-3 is seen almost exclusively in tumors containing or lacking the TFE-3 gene fusion. These include renal cell carcinoma, alveolar soft part sarcomas, epithelioid hemangioendotheliomas, PEComas, granular cell tumour, solid pseudopapillary neoplasm of the pancreas, and ovarian sclerosing stromal tumors. It must be emphasized that only nuclear expression of TFE-3 is of diagnostic value, as non-specific cytoplasmic staining is common. Methods/Case Report A 30-year-old woman with pelvic pain, heavy vaginal bleeding and ureteral stricture on oral contraceptive pill was found to have a cervical mass on exam. Cervical biopsy showed fragments of benign squamous epithelium and polypoid endometrial tissue with atrophic glandular component, stromal pseudodecidualization and abundant mixed inflammation. The stroma was positive for CD10, and negative for P16, desmin, cytokeratin ae1/ae3, CD34, calretinin. There was patchy moderate to strong nuclear staining for TFE-3 (Anti-TFE-3 rabbit monoclonal primary antibody, Cell MarqueTM). No evidence of a neoplastic process was seen, and the overall findings fit with either prolapsed endometrial tissue or endometriosis. TFE-3 by FISH showed no rearrangement of the TFE-3 gene region, ruling out alveolar soft part sarcoma. Results (if a Case Study enter NA) NA Conclusion The Human Protein Atlas, a program mapping all the human proteins in cells and tissues, shows that endometrial stromal and glandular cells can have moderate TFE-3 nuclear expression, using Anti-TFE-3 rabbit polyclonal antibody (Prestige Antibodies ®). In our case, focal strong expression was seen using a monoclonal antibody. In the pathology literature this finding has not been previously reported. Pathologists should be aware of the possibility of strong nuclear expression of TFE-3 in non-neoplastic endometrium to avoid potential misdiagnosis.