IntroductionAdult rhabdomyoma (ARM) is an exceedingly rare benign neoplasm accounting for less than 2% of all striated muscle tumors. Originating from striated muscle cells, it primarily occurs in the head and neck region but is particularly rare in the parapharyngeal space.Case PresentationWe report a case of a 64-year-old male patient who presented with a 6-month history of progressive dysphagia and globus pharyngeus. CT and MRI scans revealed a well-defined multilobular mass in the right parapharyngeal space. Surgical excision was performed, and histopathological evaluation confirmed ARM. ARM diagnosis presents a challenge due to nonspecific clinical and radiological manifestations. Histopathological examination remains the gold standard for definitive diagnosis. Surgical excision is the treatment of choice, and close postoperative monitoring is crucial due to high recurrence rates.ConclusionThis case highlights the diagnostic challenges and treatment modalities for ARM in a rare anatomical location. A multidisciplinary approach incorporating radiological, cytological, and histopathological evaluations is essential for accurate diagnosis and effective management.

Introduction: Metastasis is a critical factor in colorectal cancer (CRC) outcomes, with 22% of patients presenting with metastasis at diagnosis and an eventual 70% experiencing it. This report highlights a rare case of ascending colon adenocarcinoma with metastasis to the kidney, underscoring the diverse and complex nature of CRC progression.Case Presentation: A 60-year-old man presented with abdominal discomfort, constipation, and rectal bleeding after colonoscopy revealed a colon mass, leading to a diagnosis of adenocarcinoma after colonoscopic biopsy. Initially without distant metastasis, he underwent four cycles of chemotherapy, but follow-up imaging 6 months later showed liver and renal metastases, prompting a colectomy and nephrectomy. Pathological examination confirmed moderately differentiated adenocarcinoma in both the colon and kidney, with staging indicating advanced disease, and the patient succumbed to his illness shortly after surgery.Clinical Discussion: Metastatic carcinomas to the kidney are uncommon, with CRC metastasis being particularly rare, as evidenced by a limited number of cases in the literature. Typically originating from primary tumors in the lung, liver, and gastrointestinal tract, renal metastases often present as well-defined lesions, complicating the differentiation from primary renal cancers. Our case highlights a solitary, well-circumscribed renal metastasis from CRC, emphasizing the diagnostic challenges and the need for careful evaluation in patients with known malignancies.Conclusion: Metastatic carcinoma of the colorectal tract is very rarely reported to the kidney, it does so at a higher stage of the disease with systemic disease and has a poor outcome for the patient.

Ectopic splenic tissue may arise as either a congenital anomaly or acquired seeding of fragments from a mechanically disrupted spleen. Regardless of the etiology, splenic tissue presenting at unexpected sites may lead to symptomatic or incidentally discovered lesions that may raise clinical suspicion for neoplasia. We present three cases of ectopic splenic tissue that were clinically ominous and necessitated pathologic tissue examination for definitive diagnosis.

While very commonly encountered in the uterus, in particular in the wall of the uterine corpus, leiomyomas are far less frequently found in extragenital sites in females. Atypical leiomyomas (synonyms: pleomorphic leiomyomas, leiomyomas with bizarre nuclei, bizarre leiomyomas, or symplastic leiomyomas) are a rare subtype of leiomyomas, characterized by cells with bizarre, pleomorphic-appearing nuclei without (or with extremely low) associated mitotic activity. Despite the cytologic appearance, such tumors have a benign clinical course. Although there are cases of leiomyomas appearing outside the uterus in a background of endometriosis, cases specifically of atypical leiomyomas in this setting are exceptionally rare. We present a case of an atypical leiomyoma arising from pararectal endometriosis in a patient presenting with endometriosis-associated primary ovarian clear cell carcinoma, metastasis to the bladder peritoneum, and a peri-intestinal lymph node, in addition to a concurrent ovarian fibroma.

Collision tumors are rare tumors comprising two morphologically distinct tumors within the same organ without histological admixture. Thyroid collision tumors are extremely rare. We present a case of a 64-year-old male patient with a radiologically suspicious, TI-RADS-TR4 lesion in the right lobe of the thyroid. Fine needle aspiration cytology (FNAC) from the lesion was diagnosed as medullary thyroid carcinoma. Total thyroidectomy with central and right lateral neck dissection was performed. On histopathological evaluation, a collision tumor was identified. Components of the collision tumor were multifocal medullary thyroid carcinoma (MTC) and multifocal infiltrative follicular variant of papillary thyroid carcinoma (PTC). Several hypotheses have been suggested regarding the pathogenesis of the collision tumor. Further management and prognosis of the tumor depend on the component with the higher stage and more aggressive behavior. The case report emphasizes the need for thorough sampling of uninvolved areas in the specimen for microscopic evaluation and staging of each component.

Introduction: Placental site nodules (PSNs) are uncommon lesions typically found in uterine specimens and extremely rarely in extrauterine locations such as the fallopian tubes. PSNs are usually discovered incidentally and result from prior implantation sites. This case report describes an unexpected PSN found in a fallopian tube during a cesarean section with concurrent tubal sterilization.Case Presentation: A 38-year-old multiparous woman (gravida 4, para 2) with a previous vaginal delivery underwent tubal sterilization during a cesarean section. The surgical procedure was uneventful, with no macroscopic abnormalities noted. The patient's medical history included treatment for an ectopic pregnancy with methotrexate. Pathological examination revealed the right fallopian tube to be unremarkable. However, the left fallopian tube contained a 0.3 cm nodule within its wall, characterized by central hyalinization, dystrophic calcifications, and peripheral intermediate trophoblast cells. Immunohistochemical analysis demonstrated GATA3 positivity and a low proliferative index (MIB-1). The absence of mitotic activity, necrosis, and typical morphology confirmed the diagnosis of a PSN.Discussion: PSNs are benign lesions derived from intermediate extravillous trophoblasts. Their identification relies on both morphological characteristics and immunohistochemical staining. The differential diagnosis includes various trophoblastic diseases, which can be distinguished from PSNs by their specific features. This case contributes to the limited literature on extrauterine PSNs, highlighting the importance of recognizing these lesions in atypical locations and differentiating them from pathologies that are more aggressive.Conclusion: This case highlights the rarity of PSNs in the fallopian tubes and underscores the importance of comprehensive pathological analysis for an accurate diagnosis.

Synovial sarcomas are rare malignant soft tissue tumors with significant metastatic potential. Although they can occur in various parts of the body, they are most commonly found on the extremities. These tumors typically develop in children and young adults, making occurrences in individuals over 50 years of age unusual. Due to their slow-growing and nonpainful nature, synovial sarcomas can often be mistaken for benign pathologies. The standard treatment involves complete surgical excision with negative margins, which offers a favorable 5-year prognosis. This case highlights the importance of early recognition and intervention in managing soft tissue sarcomas. In this case report, we present a 57-year-old African male with a 2-year history of gradual, nonpainful swelling on his left hand, diagnosed as synovial sarcoma. The patient was successfully treated with complete surgical excision.

Encapsulated papillary carcinoma (EPC) is an invasive carcinoma which shows papillary architecture within a thickened fibrous capsule. Multiple studies have shown that this tumor follows an indolent course with excellent prognosis, and as such, it is recommended that it be staged as in situ lesions. It is an uncommonly encountered tumor most often diagnosed in postmenopausal females. As breast cancer in males is overall rare, available data on diagnosis, management, and outcomes of EPC in males is limited. Typically, cases of EPC that present with advanced stage and/or lymph node metastases show an associated invasive process. We present a case of pure EPC in a male patient with associated skin ulceration and positive lymph nodes, leading to a final stage of ypT4bN1a. The present report underscores the indolent nature of EPC, even when diagnosed at an advanced stage.

Salivary gland carcinosarcoma is a combination of malignant epithelial and sarcomatous tumors and can develop from a preexisting pleomorphic adenoma or de novo. These tumors are rapidly growing infiltrative tumors and have an extremely poor prognosis, with a high frequency of lymphatic and hematogenous spread at the time of diagnosis. Approximately half of the cases of carcinosarcoma arise from preexisting pleomorphic adenoma with a long-standing clinical history of parotid mass. The carcinomatous component is most commonly squamous cell carcinoma or adenocarcinoma, while chondrosarcoma is the most frequent sarcomatous component. Our case is particularly unusual due to the presence of osteosarcomatous differentiation as the sarcomatous component. In addition to its histological rarity, our patient has never been reported a prior parotid mass or history of pleomorphic adenoma in this location. However, thorough examination of the radical parotidectomy specimen revealed sclerosed foci of pleomorphic adenoma in addition to carcinosarcoma with osteoid formation. In conclusion, we report an unusual case of carcinosarcoma ex-pleomorphic adenoma with osteoid formation and osteoclast giant cells in a patient without a history of pleomorphic adenoma or parotid mass.

Lymphoepithelioma-like urothelial carcinoma (LELUC) and plasmacytoid urothelial carcinoma (PUC) are rare subtypes. We report a case of simultaneous urothelial carcinoma composed of LELUC and PUC subtypes, along with prostatic adenocarcinoma, with successful clinical management by immunotherapy. The patient, a 54-year-old man with a 40 pack-year smoking history, presented with gross hematuria and dysuria. Imaging revealed focal bladder wall thickening. The patient underwent transurethral resection of bladder tumor (TURBT), followed by cystoprostatectomy. The TURBT revealed LELUC, with muscle invasion. The subsequent cystoprostatectomy specimen displayed a 6.0 cm ulcerative mass, which had focal penetration through the urinary bladder wall. Microscopically, the tumor consisted of sheets of enlarged and pleomorphic tumor cells, mixed with a lymphoplasmacytic infiltrate. Focal plasmacytoid and occasional signet ring cell-like morphologies were observed. Rare tumor cells showed positivity for GATA-3 and p63 immunostains, while the plasmacytoid tumor cells exhibited loss of E-cadherin expression. Additionally, adenocarcinoma of the prostate was present, with a Gleason score of 3 + 3, involving 2% of the prostate tissue. The diagnoses of LELUC, comprising 95% of the tumor, PUC, comprising 5%, and prostatic adenocarcinoma were made. Molecular studies revealed a high tumor mutational burden, and the tumor exhibited PD-L1 expression. The patient received adjuvant immunotherapy with Pembrolizumab and showed no evidence of disease for 3 years up to the time of this report. Morphologic recognition of the various subtypes of urothelial carcinoma, supported by immunohistochemistry, is essential for the proper clinical management of patients. A search of the literature on PubMed revealed no similar cases.