Pleomorphic rhabdomyosarcoma of the vagina: A case report

BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.

Undifferentiated high-grade pleomorphic sarcoma of the common bile duct:A case report and review of literature

BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis.Here we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such cases.CASE SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk.Her laboratory data suggested significantly elevated hepatorenal function levels.The imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal CBD.After endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were performed.The frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was performed.Finally,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.CONCLUSION This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies.

Pleomorphic adenoma(mixed tumor)of the upper lip:A case report

BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.

Pleomorphic leiomyosarcoma of the maxilla with metastasis to the colon:A case report

BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients.CASE SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver.His most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending colon.The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet.Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma.CONCLUSION Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.

Obstructive Tumor of the Palate in the Old Person: A Case Report

Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the accessory salivary glands, are rarer. We report a case of a pleomorphic adenoma of the posterior palate which posed management problems. Observation: This is an 85-year-old patient who consulted for a tumor of the posterior palate that had been evolving for 3 years. The examination revealed a globular tumor of the posterior palate extending beyond the midline by approximately 7 cm in long axis, shooting towards the oropharynx and hindering breathing, speech and eating, indicating a life-saving tracheotomy. A CT scan of the facial area revealed a well-circumscribed tumor at the expense of the soft palate, with multiple sites of bone lysis. The biopsy performed was in favor of a pleomorphic adenoma. The patient underwent total surgical excision of a huge tumor on the palate. The aftermath of the operation was marked by a loosening of the sutures with an oronasal fistula requiring the creation of an obturator plate due to the patient’s refusal to have another operation. Conclusion: Large pleomorphic adenoma of the posterior palate is a rare entity that can cause respiratory problems and surgical difficulties. His prognosis is generally good.

Pleomorphic Adenoma of the Salivary Glands: Two Atypical Locations

Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “Luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.

Benign Nasosinus Tumors: Epidemiological, Clinical, Morphological, Therapeutic, and Evolutionary Aspects at the Adolphe SICE General Hospital in Pointe-Noire (Congo-Brazzaville)

Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invaginations. These include nasosinusal polyps, pleiomorphic adenoma and inverted papilloma. The aim of our study was to investigate the epidemiological, clinical, morphological, therapeutic, and evolutionary particularities of these three clinical entities, including two tumors with the potential for progressive malignancy (pleiomorphic adenoma and inverted papilloma) and one strictly benign tumor with a favorable evolution (nasosinus polyp or Schneider polyp). Materials and Methods: This was a retrospective, analytical, cross-sectional study conducted from January 1, 2006 to December 31, 2019 (13 years), in the Department of Otolaryngology and Cervicofacial Surgery at Adolphe SICE Hospital, Pointe-Noire, Congo-Brazzaville. Results: During the study period, 74 patients were registered for a nasosinus tumor, of which 23 were benign tumors of epithelial origin (31%) distributed as follows: 15 cases of nasosinus polyp, 5 cases of pleomorphic adenoma and 3 cases of inverted papilloma. The mean age was 42.5 for polyps, with an estimated median of 38, and 42.9 for the other two entities (pleomorphic adenoma and inverted papilloma), with an estimated median of 41. Nasosinus allergy accounted for 17% of cases, followed by chronic sinusitis (12%);however, in 49% of cases, the patient’s history was not specified. There was no sexual predominance, the sex ratio being 1.08. Occupation, socio-economic level, and education had no impact on the development of these tumors. Most of our patients (52%, 12 cases) had a consultation delay of more than one (1) year, whatever the histological nature of the tumor. The complete nasosinus syndrome (NSS) included nasal obstruction, rhinorrhea, epistaxis, and anosmia, and was found in 19 cases (83%), most often reflecting a nasosinus polyp. CT scans were performed in all patients, with hyperdense images predominating in 22 cases. Management of benign nasosinus tumors was mainly surgical. Postoperative management was straightforward in 15 cases (65%). Conclusion: Benign nasosinus tumors are dominated by nasosinus polyps. Management of these tumors is essentially surgical, with the best clinical outcome.

Clear Cell Pleomorphic Dermal Sarcoma: A Case Report and Literature Review

Introduction: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are one spectrum of rare cutaneous neoplasms that typically arise in sun-exposed skin of older population. AFX/PDS is essentially diagnosis of exclusion requiring Immunohistochemical work-up to exclude other types of tumors. Case Report: We present a case involving an ulcerated solitary lesion on the scalp of an elderly man. Histological examination revealed that the dermal tumor was composed of large pleomorphic, epithelioid, and spindle cells with clear cytoplasm. These cells were negative for cytokeratins, melanocytes and smooth muscle markers, but positive for CD10. These findings are consistent with a diagnosis of clear cell (CC) PDS. Conclusion: PDS is a low-grade malignancy that can recur locally and metastasize, which is distinguished from AFX by its larger size and the presence of aggressive histopathologic features including deeper invasion into the subcutaneous tissue, tumor necrosis, and lymphovascular and/or perineural involvement. Among several histopathologic variants, the CC variant is extremely rare with only two cases of PDS reported in the literature to date.

Preliminary proteomic analysis of human tears in lacrimal adenoid cystic carcinoma and pleomorphic adenoma

·AIM: To detect proteomic differences in tears between adenoid cystic carcinoma(ACC) and pleomorphic adenoma(PA).·METHODS: Tear samples were collected from 4 patients with ACC, 5 with PA, and 4 control cases. Label-free analysis and parallel reaction monitoring(PRM) were used to screen and validate the tear proteome. Gene Ontology(GO) annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG) were conducted for bioinformatics analysis.·RESULTS: In total, 1059 proteins in tear samples were identified by label-free analysis. Between ACC and PA, 415 differentially expressed proteins were detected. Based on the GO annotation, enzyme regulator activity and serinetype endopeptidase inhibitor activity in the molecular function category, blood microparticle and extracellular matrix in the cellular component category, and response to nutrient levels in the biological process category were most predominant. By KEGG pathway annotation, the different proteins between ACC and PA mainly par ticipated in complement and coagulation cascades, amoebiasis, African trypanosomiasis and cholesterol metabolism. Eight proteins with mostly significant differences were verified by PRM, and five proteins with more than 10-fold increases in ACC compared with PA, including integrin β, α-2-macroglobulin, epididymal secretory sperm binding protein Li 78p, RAB5C, and complement C5, were identified.·CONCLUSION: The combined tools of label-free analysis and PRM are very effective and efficient, especially for samples such as tears. Some proteomic dif ferences in tears between ACC and PA are identified and these protein candidates may be specific biomarkers for future exploration.

Argon-helium cryoablation treatment of undifferentiated pleomorphic sarcoma of the thyroid:A case report and literature review

Undifferentiated pleomorphic sarcoma is an extremely rare malignant thyroid tumor.Thyroid sarcoma differs from common malignant thyroid tumors,such as thyroid follicular cell carcinoma.It is usually highly malignant,progresses rapidly,and is prone to remote metastasis.Currently,there is no standard protocol for the treatment of thyroid sarcomas,and most treatment effects are unsatisfactory.Argon-helium cryoablation is an important method of local treatment that is widely used in patients with unresectable advanced tumors.However,owing to the low incidence of thyroid sarcomas,there are no relevant literature reports on the treatment of thyroid sarcomas using cryoablation in China.This study reports the case of a patient with undifferentiated pleomorphic sarcoma of the thyroid gland who was treated with argon-helium cryoablation,and the immediate outcome was good.Based on a review of relevant literature,we discussed the effectiveness and safety of argon-helium cryoablation treatment,to provide clinical guidance and references for the treatment of patients with thyroid sarcoma.

Indications and Results of Parotidectomies in the Orl Department of the Idrissa Pouye General Hospital in Dakar. Concerning 31 Cases

Introduction: The parotid tumors are benign or malignant, primary or secondary neoformations developed at the expense of the parotid gland. The aim of the present study was to describe the indications and results of parotidectomies in the ENT department of the Idrissa Pouye General Hospital in Dakar. Patients & Methods: We conducted a retrospective study between January 1, 2004 and December 31, 2012, including all patients who had been consulted for a parotid tumor with or without histological evidence collected in the otolaryngology and anatomy-pathology department of the Idrissa Pouye General Hospital in Dakar. Results: We collected 31 patient files. The mean age was 47.45 years, with extremes of 16 and 74 years. Females predominated, with a sex ratio of 0.82. Swelling of the parotid region was the main reason for consultation in 100% of cases. Parotidectomy was the most frequently performed procedure, accounting for 41.93%. Benign tumors accounted for 72% of cases, the majority being pleomorphic adenomas (50%). The outcome was favorable in 67.74% of cases. Conclusion: Management of parotid tumors at HOGIP would be improved by informing and educating patients to consult early, and by upgrading the technical platform.

Pattern and Trends in the Presentation of Salivary Gland Tumours in a Tertiary Centre in Gombe, Northeast Nigeria

Background: Salivary gland tumours (SGTs) are rare, but recent reports suggest an increasing incidence. Although there are previous Nigerian studies on the patterns of SGTs, patterns and trends of disease may change over time. The aim of this study was to describe the pattern of presentation of SGTs, and to determine the trends in occurrence of SGTs at Federal Teaching Hospital (FTH), Gombe over a period of 15 years. Method: This descriptive study included cases of histologically diagnosed SGTs from January 2008 to December 2022. Relevant information (age, gender, site, year of diagnosis, and histopathologic diagnosis) was extracted from the cancer registers and histopathologic records. The lesions were then categorized into benign and malignant SGTs and grouped into three groups spanning 5 years each based on the year of diagnosis. Data analysis was done using IBM SPSS version 23, and p ≤ 0.05 was considered statistically significant. Results: There were 93 (61.2%) benign and 59 (38.8%) malignant SGTs. Benign SGTs had a mean age of 36.4 ± 13.6 years, and were more common in females (57.0%), and in the parotid (41.9%). Pleomorphic adenoma (94.6%) was the most common benign SGT. Malignant SGTs had a mean age of 44.5 ± 18.4 years, with male predilection (54.2%) and occurrence mostly in the palate (27.6%) and parotid (22.4%). Mucoepidermoid carcinoma (39.0%) and adenoid cystic carcinoma (32.2%) were the most frequent malignant SGTs. The mean age of occurrence of malignant SGTs was significantly higher than that of benign SGTs (p = 0.005). The trend analysis showed that there has been a steady rise in the proportion of males presenting with malignant SGTs. Similarly, there has been a steady increase in the frequency of benign SGTs in the parotid. The palate was the predominant site for the malignant SGTs between 2008 and 2012, but in the last five years (2018 to 2022), the parotid has become the predominant site. Over the duration of the study, the ratio of benign to malignant SGTs has remained relatively constant. Conclusion: While the overall pattern of presentation of SGTs in Gombe is similar to reports in the literature, this study has identified some changes in trends over the years.

咽部多形性腺瘤1例

多形性腺瘤又称混合瘤，多发于腮腺，颌下腺次之，腭部占第3位，咽部少见．我科于2006-03-01收入1例，报道如下。

鼻腔多形性腺瘤1例

1临床资料 患者,女,42岁,因右鼻渐进性阻塞伴头痛6个月于2005-08-05入院。患者于半年前起渐感右侧鼻腔通气不良,同时伴有头痛,流黏液样鼻涕,面部麻木等症状,且逐渐加重。查体：右侧鼻腔外侧壁向内侧膨隆突起,表面光滑,因肿瘤阻塞而看不到中鼻甲及鼻腔的中、后段。鼻窦CT检查示：右侧鼻腔内可见软组织影,CT值31.0Hu,

Tumor invasion front in oral squamous cell carcinoma

Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma.It is an invasive neoplasia with a significant recurrence rate;40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis.The tumor invasion front is a characteristic of tumor growth,which can be infiltrative or noninvasive.The histopathological parameters examined include the number of mitoses,depth of the tumor,invasion pattern,degree of keratinization,and nuclear pleomorphism.For the pathologist,these parameters are routinely evaluated but are not reported to the treating physician in all cases,which we consider to be useful information when determining the therapeutic route.

Chronic Lyme Disease: Persistent Clinical Symptoms Related to Immune Evasion, Antibiotic Resistance and Various Defense Mechanisms of <i>Borrelia burgdorferi</i>

There are several factors involved in the ability of Borrelia burgdorferi to retain a persistent infection within a mammalian host. These factors of immune evasion include regulation of membrane proteins, variable epitopes of surface proteins, protection against the immune system through tick saliva, the ability to migrate to regions where it is not exposed to the immune system or antibiotics, invagination or invasion within various cells, pleomorphic forms, and the potential to produce biofilms. The window of conventional treatment for Lyme disease is short and has the potential to display different symptoms depending on the strain of Borrelia bugdorferi. These symptoms are dependent on the localization of Borrelia burgdorferi which correlates to the significance of diagnosing Lyme disease early to prevent such a spread throughout the body. Such complications of Borrelia burgdorferi may demand new clinical treatment discoveries for patient fighting the chronic form.

Virus Destruction by Resonance

Viruses and other microbes can be inactivated in a selective way by subjecting them to an oscillating electric field of adequate frequency. Royal R. Rife discovered this method already about 100 years ago. He proved its efficiency by means of high resolution microscopes and in 1934, by controlled clinically tests. However, these results seemed to be unbelievable, since the underlying mechanism was not yet understood. Actually, we are faced with three problems: 1) the functioning of Rife’s supermicroscopes, 2) his observation that bacteria can undergo size reduction, and 3) the decisive resonance phenomenon. We explain the high magnification and resolving power of Rife’s microscopes and show that new discoveries confirm that the postulate of invariable forms of bacteria has to be abandoned. Then we prove that forced oscillations of virus spikes lead to a peculiar resonance, because of nonlinear effects. It causes total destruction of the virus by rupture of its coating. The same theory applies to bacteria and nanobacteria, because of their pili. The worldwide coronavirus pandemic, the constant threat of unpredictable mutations and the now available explanations should make it obvious that biophysical methods cannot be neglected anymore.

The Corneal Endothelium in Children after Congenital Cataract Surgery--A Comparison of Pre- and Post-Operative Results

Three months after surgery, the research group showed significantly statistical improvement in visual acuity, a statistically significant decrease in corneal endothelial cell density, a statistically significant increase in the percentage of 5 and 8 sided cells and a statistically significant decrease in the percentage of six sided cells. Central corneal thickness and the percentage of 4 and 7 and more than 8 sided did not change in a statistically significant way. Comparing the test group and control group, no statistically significant differences were detected in the examined parameters. The present study also shows that the cornea in the eyes with congenital cataract does not show statistically significant changes in the density and the morphology of the corneal endothelial cells and the thickness of the cornea and in terms of corneal thickness in comparison to the corneas of healthy eyes. Although in corneas undergoing cataract occurs statistically significant changes, the influence of the cornea does not affect the improvement in visual acuity which was also demonstrated in this study.

鼻咽多形性腺瘤1例

多形性腺瘤亦称混合瘤,是最常见的涎腺肿瘤,发生部位以腮腺最为多见,其次为颌下腺、舌下腺,发生于鼻咽部者临床上较为罕见,国内外文献也少有报道[1,2]。我院近来收治1例鼻咽部多形性腺瘤,现报道如下。1临床资料患者,男,48岁。双鼻塞伴鼻出血10余年,鼻塞呈渐进性发展,阵发性鼻出血,每次量不多,能自止,无头痛,无流脓涕及嗅觉减退,无牙齿松动及面部麻木感,

Different histological subtypes of parotid gland tumors: CT findings and diagnostic strategy

AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.