Biomedical subjects
Publications and source records attributed to J L Rodríguez-Peralto.
Follicular keratosis may be a rare paraneoplastic disease having unknown etiopathogeny that is sometimes associated to myeloma whose diagnosis and evolution follow a parallel course. We describe the case of a 57-year-old female patient diagnosed of multiple myeloma 8 years ago. She developed generalized follicular hyperkeratotic spicules coinciding with leukemization of the myeloma.
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The combination of cisplatin and capecitabine was evaluated in patients with recurrent or unresectable squamous cell carcinoma of the head and neck (HNSCC), and outcome parameters were correlated with the expression of thymidine phosphorylase (TP), thymidilate syntetase (TS), vascular endothelial growth factor receptor (VEGFR) 1-3, and microvessel density (MVD). Patients with recurrent or unresectable HNSCC were eligible if they had received prior neoadjuvant chemotherapy, concurrent chemo-radiotherapy, or no prior systemic therapy. Patients received cisplatin (75 mg m(-2) day 1), and capecitabine (2000 mg m(-2) day 1-14) every 3 weeks. A total of 41 patients received 194 cycles. In all, 16 complete responses (39%) and 12 partial responses (29%) were documented, for an overall response rate of 68% (95% CI, 53-80%). Grade 3-4 uncomplicated neutropenia was documented in five subjects. Asthenia, anorexia, hand-foot syndrome, and constipation were the most frequent nonhaematologic events. Median progression-free and overall survival were 6.4 and 12.6 months. Cytoplasmic TP expression was more prevalent in patients with a laryngeal location vs other, and in patients with a recurrence vs primary disease. Microvessel density count was higher in patients with recurrent vs primary disease. The combination of cisplatin and capecitabine is effective in recurrent or unresectable HNSCC, and shows a manageable toxicity.
BACKGROUND: Extramammary Paget's disease of the glans penis secondary to transitional cell carcinoma (TCC) of the bladder is rare, with only a few cases reported in the literature. We report two new cases, one detected before diagnosing bladder TCC. METHODS: We describe the clinicopathologic features of two patients with intraepithelial spread of glans TCC and the histochemical and immunohistochemical features of the neoplasm. RESULTS: Light microscopy detected intraepithelial proliferation of neoplastic, large, pale cells located predominantly in the basal and parabasal layers of the epithelium. The pagetoid cells showed positive cytoplasmic staining for mucosubstances and immunoreactivity for CK20. The previously reported cases are reviewed and the differential diagnosis is discussed. CONCLUSIONS: As many benign and malignant glans lesions may be clinically similar, histologic study is necessary to correctly diagnose primary lesions and promptly detect underlying asymptomatic visceral malignancies initially presenting as Paget's disease.
Although spindle cell carcinoma (SC) is a common neoplasm in the oral cavity, upper respiratory tract, and other head and neck areas, its occurrence in the vulva is rare. We report a case of this rare condition with immunohistochemical, ultrastructural, and human papillomavirus (HPV) testing. The neoplastic cells were positive for vimentin, keratins (AE1-AE3, keratin 902, and keratin 903), and epithelial membrane antigen. Ultrastructurally, they showed primitive junctions and tonofilaments. HPV testing by polymerase chain reaction was negative. In addition, we review the clinicopathologic findings of the four well-documented cases of vulvar SC that have been reported previously in the English language literature.
BACKGROUND: Adenosquamous carcinoma (ASC) of skin is a rare but distinctive neoplasm that usually exhibits an aggressive course. To date, 13 well-documented and undisputed cases of primary cutaneous ASC have been reported. This term has been used for tumors with better prognosis, such as mucoepidermoid carcinomas and acantolytic squamous cell carcinomas, originating confusion. We report a primary cutaneous ASC and review the literature. METHODS: In this report a woman with primary ASC of the skin was studied. Histopathological examination and immunohistochemical stains were performed. RESULTS: The tumor had two components: conventional squamous cell carcinoma merging with adenocarcinoma. After a local recurrence and lymph node metastases, the patient has no evidence of disease 8 months later. CONCLUSIONS: Pathologists should reserve the term ASC for tumors exhibiting the above mentioned appearance. In such circumstances, a metastatic origin must always be excluded.
In this report we describe a primary giant cell tumor (GCT) of soft tissues located in the left dorsal wrist of a 52-year-old man. Plain radiographs did not reveal any lesion in his carpal or hand bones. Although the tumor was clinically considered a ganglion initially, the microscopic features were identical to those found in classic GCT of bone. Light microscopy showed a lesion composed of a homogeneously mixed proliferation of spindle and polygonal mononucleated stromal cells and evenly distributed multinucleated, osteoclast-like giant cells. Whereas most bone tumors have an extraosseous counterpart, only 13 cases of GCT in soft tissues had been published until 1998. Moreover, 64 new cases have been reported in three series. Nevertheless, most major reviews and textbooks do not consider this tumor as a specific entity and regard it as a low grade variant of malignant GCT of soft tissue. We describe the clinical, histologic, and immunohistochemical features of this rare benign neoplasm emphasizing the differential diagnosis with its malignant soft tissue counterpart, an ominous tumor.
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Primary cutaneous signet-ring cell carcinoma (CSRCC) is a very unusual but distinctive clinicopathologic entity. It is defined as a diffuse malignant epithelial neoplasia localized in dermis and subcutis without epidermal involvement, showing variable amounts of signet ring cells, without evidence of a visceral adenocarcinoma. We report a case of CSRCC in a 70-year-old man along with its histologic and ultrastructural characteristics, and review of previous cases. We describe their main diagnostic features and discuss its wide differential diagnosis.
The histogenesis, morphology, immunophenotype, and clinical behavior of cutaneous large B-cell lymphomas (CLBCL) are largely a matter of controversy. We performed an investigation to determine whether CLBCL have features that differentiate them from other large B-cell lymphomas and whether CLBCL is itself a heterogeneous group. To this end, we reviewed the main characteristics of a series of 32 cases of LBCL found in the skin. We reviewed the clinical findings and paraffin sections of the tumors from these 32 patients. The immunohistochemical study performed included p53, MIB1, Bcl2, Bcl6, and CD10 markers. We carried out statistical analysis of these data (univariate and multivariate), seeking an association between the features of the tumors and clinical outcome, as defined by failure-free survival time. Only one patient died as a consequence of the lymphoma. Nevertheless, the accumulated probability of survival without failure at 48 months was 0.46. The number, type, and localization of the lesions were not associated with variations in either survival or failure-free survival. The expression of p53 was negative in this group of CLBCL, whereas Bcl-2 expression or localization in the lower leg did not relate to any other significant feature. Histologic examination of the cases disclosed three different groups: Grade III follicular lymphomas (FLs), monomorphous large B-cell lymphomas (LBCL type I), and LBCL with an admixed component of small B-lymphocytes (LBCL type II). Grade III FL (11 cases) tended to be found in the head and neck and showed CD10 expression in a majority of cases. A higher probability of lymph node relapses was associated with cases located in the head and neck and with CD10+ tumors. Cutaneous large B-cell lymphomas are indolent tumors, but follow an insidious course. Our data support the interpretation that CLBCL is a heterogeneous condition; comprises some LBCL derived from CD10+ germinal center cells which manifests more frequently as tumors in the head and neck region, with an increased probability of relapse in lymph nodes [1] and has some distinctive morphologic features. The existence of a component of small B-cells within the other CLBCL could lend support to the theory that some of these tumors, more than arise de novo, may have originated in preexistent small B-cell lymphomas, but no firm evidence of this is provided in this study.
Patients with pericardial teratomas usually present shortly after birth with cardiorespiratory distress or in utero with hydrops fetalis. We report a case in which the tumor was diagnosed in utero using sonography during a routine obstetric examination. Sonograms showed a 3-cm echogenic mass compressing the right atrium. The lesion was inhomogeneous with solid and cystic areas. The fetus was followed to term, and additional radiologic studies were performed before the infant underwent surgery. Prenatal identification of a pericardial teratoma is essential for planning fetal management and delivery and potential prenatal surgery.
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Proliferating trichilemmal cyst (PTC) is a rare but morphologically distinctive tumor that usually occurs in the scalp of elderly women. Furthermore, only 30 well-documented examples of so-called malignant PTC have been reported. Alternatively, some authors have recently proposed that PTC is squamous cell carcinoma. We describe a case of PTC with focal invasion that was indistinguishable from squamous cell carcinoma in areas, and we review the literature. This debate should be considered in PTCs to provide adequate treatment (wide local excision) and follow-up (long term), particularly in large and long-standing lesions.
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Although cutaneous epidermal (infundibular) cysts are extremely common lesions, neoplastic transformation of their epithelium is quite rare. We describe a patient with a squamous cell carcinoma arising in the wall of an otherwise conventional epidermal cyst. In addition, we review the literature concluding that most of the previously reported cases may not correspond to this rare occurrence.