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Journal of Cutaneous Pathology Mar 2024Apocrine cystadenoma is a rare, benign adenomatous cystic neoplasm, the pathogenesis of which is not fully understood. We sought to characterize the clinical,...
BACKGROUND
Apocrine cystadenoma is a rare, benign adenomatous cystic neoplasm, the pathogenesis of which is not fully understood. We sought to characterize the clinical, dermatoscopic, and histopathologic features of apocrine cystadenoma and its relationship to hidrocystoma.
METHODS
We retrospectively analyzed cases of apocrine cystadenoma and hidrocystoma retrieved from the dermatopathology laboratory information system.
RESULTS
Of the 350 cases apocrine cystic lesions, 13 cases of apocrine cystadenomas met the inclusion criteria. The age ranged from 20 to 84 years with an average of 64 years. They were long-standing (duration 3-15 years), slow-growing, large tumors usually found on the scalp. Dermatoscopy accentuated translucent light to dark blue color and prominent vessels that were present more at the periphery. All lesions were multilocular with columnar to cuboidal lining and decapitation secretion. A large portion of the lesion consisted of a simple nonproliferative epithelial lining, identical to that observed in apocrine hidrocystomas, while the proliferative adenomatous component made up a smaller portion with two patterns: (1) tubular proliferation, which either protruded into the cystic cavity or expanded outward peripherally, or (2) papillary projections, which were multiple layers thick with fibrovascular core, sometimes accompanied by tubular proliferation. Immunohistochemical stains showed strong staining for p40 and a sparse number of cells stained for Ki-67 and p53.
CONCLUSIONS
The long duration of the lesion and the large areas of simple apocrine epithelial lining suggest that apocrine cystadenomas arise from long-standing apocrine hidrocystomas. However, the retrospective nature of the study from a single institution is a limitation.
Topics: Humans; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Hidrocystoma; Retrospective Studies; Sweat Gland Neoplasms; Apocrine Glands; Cystadenoma; Cell Proliferation
PubMed: 38084825
DOI: 10.1111/cup.14573 -
European Journal of Ophthalmology May 2024We report the clinical features and the management of two cases of orbital hidrocystoma in the setting of an enlarging orbital mass.
INTRODUCTION
We report the clinical features and the management of two cases of orbital hidrocystoma in the setting of an enlarging orbital mass.
CASES DESCRIPTION
A 48-year-old man presented with a mass in the right upper medial orbital quadrant, firmly attached to the supraorbital incisure. A 70-year-old man had a well demarcated lesion in the upper lateral orbital quadrant adherent to the lacrimal gland. There was no history of previous orbital trauma. In both cases histopathology confirmed a diagnosis of apocrine hidrocystoma. Following surgery, the first patient complained of mild hypoesthesia in the territory of the supraorbital nerve that resolved spontaneously within 3 weeks. Surgery was uneventful in the other patient. No recurrence was seen during the follow up.
CONCLUSIONS
Apocrine hidrocystomas have been rarely described in the orbit, but should be considered in the differential diagnosis of orbital cystic masses. Recurrence is rare following complete surgical excision.
Topics: Humans; Male; Hidrocystoma; Middle Aged; Aged; Orbital Neoplasms; Sweat Gland Neoplasms; Tomography, X-Ray Computed; Ophthalmologic Surgical Procedures; Apocrine Glands; Magnetic Resonance Imaging; Diagnosis, Differential
PubMed: 38073082
DOI: 10.1177/11206721231219720 -
Polski Merkuriusz Lekarski : Organ... 2023Aim: The purpose of the study was to identify the influence of the patient's sex and age, the volumes of the salivary gland and pleomorphic adenoma on the histological...
OBJECTIVE
Aim: The purpose of the study was to identify the influence of the patient's sex and age, the volumes of the salivary gland and pleomorphic adenoma on the histological variants of the tumor.
PATIENTS AND METHODS
Materials and Methods: The study included 21 women and 9 men with pleomorphic adenomas of the salivary gland. In 15 cases, a mesenchymal variant of pleomorphic adenoma was identified, in 5 cases - an epithelial variant, in 10 cases - a mixed variant. The average age of the patients was 39.7±2.9 years. Patients with pleomorphic adenomas underwent magnetic resonance imaging using a Siemens MAGNETOM Aera 1.5T device (Germany), during which three projections of the tumor and salivary gland were measured (antero-posterior, lateral, vertical) with subsequent calculation of their volumes, and then the ratios of these volumes. Classification trees were used to determine whether patients belonged to one of three variants of pleomorphic adenoma. The CART (Classification And Regression Tree) algorithm was used as a branching option. Stopping branching was carried out using the FACT (Fact-style direct stopping) method until each terminal (final) node of the tree does not contain incorrectly classified observations or when their number becomes less than a given proportion of the total group size (less than 5%). Determination of the structure and relationships between the tumor variants and such indicators as gender, age and radiological indicators (volume of the tumor, volume of the salivary gland, ratio of tumor volume to salivary gland volume) was carried out using correspondence analysis.
RESULTS
Results: Epithelial variant of pleomorphic adenoma is more typical for women, and the mixed and mesenchymal variant is more common for patients of both sexes. The epithelial variant can develop in patients of any age, while the mixed variant occurs mainly in patients older than 41 years, and the mesenchymal variant - mainly in patients younger than 41 years. The ratio of the volume of the tumor to the volume of the salivary gland will be predominantly >0.17 in the epithelial variant of pleomorphic adenoma, predominantly ≤0.17 in the mesenchymal variant, and can take any value in the mixed variant.
CONCLUSION
Conclusions: The authors conducted a study in order to identify the influence of sex, age of the patient, and the ratio of the volume of pleomorphic adenoma to the volume of the salivary gland on the histological variant of the tumor. The revealed data will be useful in the treatment and diagnostic process in patients with pleomorphic adenoma of the salivary gland.
Topics: Male; Humans; Female; Adult; Adenoma, Pleomorphic; Salivary Gland Neoplasms; Salivary Glands; Magnetic Resonance Imaging
PubMed: 38069847
DOI: 10.36740/Merkur202305105 -
Pathology, Research and Practice Jan 2024The immunoexpression of BubR1 and cyclin B1 in pleomorphic adenoma (PA) and polymorphic adenocarcinoma (PAC) in minor salivary glands is poorly studied. Thus, a... (Observational Study)
Observational Study
The immunoexpression of BubR1 and cyclin B1 in pleomorphic adenoma (PA) and polymorphic adenocarcinoma (PAC) in minor salivary glands is poorly studied. Thus, a retrospective and observational study was performed to provide a better understanding of the role and immunopositivity patterns of these proteins in these lesions. Sixteen cases of PA and 16 cases of PAC were selected. Parenchyma cells were submitted to quantitative immunohistochemical analysis through the labeling index. Cytoplasmic immunoexpression of BubR1 was observed in neoplastic cells from all analyzed PA and PAC cases. All PA cases and 93.7% of PAC exhibited nuclear immunoexpression of BubR1. Higher cytoplasmic and nuclear immunoexpression of BubR1 was observed in PAC (p = 0.001 and p = 0.122, respectively). Cytoplasmic immunoexpression of cyclin B1 was observed in all cases of PA and PAC, with a higher labeling index in the latter (p < 0.001). There was a significant positive correlation between nuclear and cytoplasmic BubR1 immunoexpressions (p < 0.001) in PA and a significant negative correlation between BubR1 and cyclin B1 cytoplasmic immunoexpressions (p = 0.014) in PAC. The higher cytoplasmic and nuclear immunoexpression of BubR1 in PACs suggests the continuous maintenance of neoplastic cells in the cell cycle and migration. Higher immunoexpression of cyclin B1 supports this lesion's enhanced proliferative and migration ability.
Topics: Humans; Adenocarcinoma; Adenoma, Pleomorphic; Cyclin B1; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands, Minor
PubMed: 38043194
DOI: 10.1016/j.prp.2023.154961 -
Oral Radiology Apr 2024We report an unusual case of carcinoma ex pleomorphic adenoma (CXPA) in the submandibular gland. The mass had a unique calcification. Panoramic tomography revealed...
We report an unusual case of carcinoma ex pleomorphic adenoma (CXPA) in the submandibular gland. The mass had a unique calcification. Panoramic tomography revealed sponge-like calcification. The central portion displayed heterogeneous high signal intensity on T1-weighted image (T1WI) and T2-weighted image (T2WI), and heterogeneously moderate signal intensity on a short-TI inversion recovery (STIR) image. The ADC was low (0.78 × 10mm/sec). After surgical excision, a pathological examination revealed that the mass contained CXPA as a minor component. Tumor cells with large hyperchromatic nuclei and eosinophilic or clear cytoplasm proliferated in irregular small tubule formations or cribriform or Roman-bridge structures in hyalinized or focally ossified stroma. The entire mass was calcified, particularly in the central region. Taken together, the reduced T1 relaxation times were related to the surface effects of diamagnetic particles, which were observed at calcium particle concentrations of up to 30%. We report a CXPA with unusual sponge-like calcification, which appeared unusually hyperintense on T1WI due to a surface effect.
Topics: Humans; Adenoma, Pleomorphic; Submandibular Gland; Salivary Gland Neoplasms; Carcinoma
PubMed: 38032399
DOI: 10.1007/s11282-023-00724-4 -
The American Journal of Case Reports Nov 2023BACKGROUND Benign pleomorphic adenoma is the most common primary tumor of the salivary glands and mainly arises in the parotid gland. Warthin's tumor, or papillary...
BACKGROUND Benign pleomorphic adenoma is the most common primary tumor of the salivary glands and mainly arises in the parotid gland. Warthin's tumor, or papillary cystadenoma lymphomatosum, represents <30% of benign parotid tumors. The simultaneous occurrence of multiple parotid tumors is rarely described - depending on the corresponding histology (different/identical), the time of their occurrence (synchronous/metachronous), as well as their location (unilateral/bilateral), multiple parotid tumors can be further sub-classified. CASE REPORT We describe the case of a 54-year-old female patient with progressive and painful swelling of the left parotid gland for the last 6 months. During extra-oral examination, a bulging, displaceable mass of approximately 3 cm was determined. A subsequent MRI (magnetic resonance imaging) examination revealed a multifocal lesion but failed to provide a decisive clue as to the tumor entity of the lesion, and a lateral (superficial) parotidectomy was performed. Postoperative histomorphological interpretation allowed the final pathological diagnosis of synchronous, unilateral occurrence of a pleomorphic adenoma as well as a Warthin's tumor. CONCLUSIONS This report presents a rare case of synchronous unilateral parotid tumors and supports that benign pleomorphic adenoma and Warthin's tumor are the most common associations. Since clinical examination, MRI imaging, and even cytological assessment could be misleading in the detection of synchronous ipsilateral multiple parotid gland tumors, our report also highlights the importance of timely and accurate diagnosis with histopathology to plan surgery and to exclude malignant transformation, which is a rare but important association with both types of primary salivary gland tumor.
Topics: Female; Humans; Middle Aged; Parotid Gland; Adenolymphoma; Adenoma, Pleomorphic; Parotid Neoplasms; Neoplasms, Multiple Primary
PubMed: 38031394
DOI: 10.12659/AJCR.940985 -
Journal of Comparative Pathology Nov 2023This retrospective study documents the occurrence of single and multiple cutaneous apocrine gland tumours (CATs) on the dorsal midline of 16 captive African wild dogs...
This retrospective study documents the occurrence of single and multiple cutaneous apocrine gland tumours (CATs) on the dorsal midline of 16 captive African wild dogs (AWDs, Lycaon pictus) derived from 161 submissions to diagnostic laboratories in South Africa, France and Germany between 1997 and 2022. Animals included in the study came from zoological institutions in South Africa (n = 2), France (n = 5) and Germany (n = 1) and ranged from 5 to 14 years of age. Fifteen affected animals were female (94%) and one was male. CATs presented as raised, hairless, multilobular, grey firm masses, consistently located along the dorsal midline. Apart from a single cutaneous apocrine adenoma and a cystadenoma occurring concurrently with two non-cystic adenocarcinomas, neoplasms were consistent with malignant cutaneous apocrine adenocarcinomas with lymphatic spread and visceral metastases. Advanced age and female sex were identified as risk factors. A genetic component or association with the increasing use of GnRH agonist contraceptives was suspected but could not be established. This study highlights the need for close clinical monitoring of AWDs over the age of 5 years for the development of CATs along the dorsal midline and supports early surgical intervention. More research is needed to determine the role of inbreeding, endocrine changes and husbandry factors that may play a role in the development of CATs on the dorsal midline of AWDs.
Topics: Animals; Male; Female; Apocrine Glands; Retrospective Studies; Canidae; South Africa; Adenocarcinoma
PubMed: 37967496
DOI: 10.1016/j.jcpa.2023.10.005 -
Clinical Nuclear Medicine Dec 2023A 70-year-old man, diagnosed with prostate cancer, was referred to the Department of Nuclear Medicine for tumor staging with prostate-specific membrane antigen (PSMA)...
A 70-year-old man, diagnosed with prostate cancer, was referred to the Department of Nuclear Medicine for tumor staging with prostate-specific membrane antigen (PSMA) PET/CT. High PSMA uptake was observed in the prostate without PSMA-avid lymph nodes or distant metastases. Coincidentally, a PSMA-avid nodule was observed dorsal to the right thyroid lobe. A complementary 4-dimensional CT showed a round nodule of 18 mm with quick contrast enhancement well demarcated from its surroundings. Blood tests revealed elevated serum calcium and parathyroid hormone consistent with primary hyperparathyroidism. Subsequently, parathyroidectomy was performed, and histopathological examination of the nodule confirmed a parathyroid adenoma.
Topics: Male; Humans; Aged; Positron Emission Tomography Computed Tomography; Gallium Radioisotopes; Parathyroid Neoplasms; Prostatic Neoplasms; Prostate; Neoplasm Staging
PubMed: 37934707
DOI: 10.1097/RLU.0000000000004896 -
Nigerian Journal of Clinical Practice Oct 2023TURP remains the gold standard for simple prostatectomy presently. Different fluids have been used for irrigation while performing monopolar TURP. The choice of...
BACKGROUND
TURP remains the gold standard for simple prostatectomy presently. Different fluids have been used for irrigation while performing monopolar TURP. The choice of irrigation fluid depends on a lot of factors.
AIM
We sought to find out if the outcome of monopolar TURP using 5% dextrose water in our setting compares with findings in other studies using different fluids as irrigation fluid in monopolar TURP.
MATERIALS AND METHODS
This was a prospective study of 220 patients who had monopolar TURP using 5% dextrose water as irrigation fluid from 2015 to 2020.
RESULTS
The study was completed by 220 patients. The mean age was 66.25 yrs. The mean weight of prostate was 53.2 g, and mean resected weight was 30.10 g using a mean irrigation volume of 45.35 liters, 5% dextrose water over a mean resection time of 66.08 mins. The mean changes in International Prostate Symptom Score/quality of life score (IPSS/QOLS) were statistically significant. Early complications recorded were postoperative hematuria with clot retention (1.4%), urinary tract infection (UTI) (13.2%), and secondary hemorrhage (10%). TURP syndrome was not recorded. Late complications seen within 2 years follow-up were transient urinary incontinence (6.4%), urethral stricture (4.1%), and bladder neck contracture (2.3%). There was no repeat TURP for residual adenoma within this period.
CONCLUSION
TURP using 5% dextrose water has comparable outcomes to other irrigation fluids for monopolar TURP. It is a good alternative to any other irrigation fluid.
Topics: Male; Humans; Aged; Prostate; Transurethral Resection of Prostate; Quality of Life; Prospective Studies; Prostatic Hyperplasia; Treatment Outcome; Glucose
PubMed: 37929537
DOI: 10.4103/njcp.njcp_278_23 -
Journal of Endourology Jan 2024Holmium laser enucleation of the prostate (HoLEP) has emerged as a new gold standard for treatment of benign prostatic hyperplasia; however, its steep learning curve...
Holmium laser enucleation of the prostate (HoLEP) has emerged as a new gold standard for treatment of benign prostatic hyperplasia; however, its steep learning curve hinders generalization of this technique. Therefore, there is a need for a benchtop HoLEP simulator to reduce this learning curve and provide training. We have developed a nonbiohazardous HoLEP simulator using modern education theory and validated it in a multicenter study. Six experts established key components for a HoLEP simulator through a Delphi consensus over three rounds including 250 questions. After consensus, a digital design was created and approved by experts, then used to fabricate a physical prototype using three-dimensional printing and hydrogel molding. After a process of iterative prototype testing, experts completed a survey assessing the simulator with a 5-point Likert scale for final approval. The approved model was validated with 56 expert and novice participants at seven institutions using subjective and objective performance metrics. Consensus was reached on 85 of 250 questions, and experts found the physical model to adequately replicate 82.5% of required features. Objective metrics were statistically significant ( < 0.0001) when comparing experts and novices for enucleation time (37.4 ± 8.2 16.7 ± 6.8 minutes), adenoma weight (79.6 ± 20.4 36.2 ± 9.9 g), and complications (6 22), respectively. We have effectively completed a multicenter study to develop and validate a nonbiohazardous benchtop simulator for HoLEP through modern education theory. A training curriculum including this simulator is currently under development.
Topics: Male; Humans; Prostate; Lasers, Solid-State; Hydrogels; Consensus; Prostatic Hyperplasia; Transurethral Resection of Prostate; Laser Therapy; Holmium; Treatment Outcome; Retrospective Studies
PubMed: 37917099
DOI: 10.1089/end.2023.0430