Cases Of Malignant Tumors Research Articles

Giant Malignant Phyllodes Tumor of the Breast

Phyllodes tumor is a rare fibroepithelial tumor of the breast that account for less than 1% of all breast neoplasms [1]. Clinically, it is typically a large, smooth and fast-growing mass that forms from the periductal stroma of the breast [2]. Phyllodes tumor can be considered benign, borderline, or malignant and the percentage of malignant tumors ranges from 23 to 50%. This classification depends on histologic features, as the degree of stromal cellularity and atypia, mitotic count and stromal overgrowth [3]. We report a case of a huge malignant phyllodes tumor in a 62-year old woman who presented with a large breast mass with 10-month disease evolution time. The patient underwent total mastectomy and the pathology analysis revealed a malignant tumor.

Prevalence and diagnostic challenges of thyroid lymphoma: a multi-institutional study in non-Western countries.

Research on the primary thyroid lymphoma (PTL) diagnosis is limited, with only a few large sample size studies, reported from Asian countries. The aim of the present study was to clarify the current prevalence and challenges in PTL diagnosis, and recommended ancillary studies for PTL in non-Western countries. PTL (n = 153) cases were retrieved from 10 institutions in non-Western countries and analyzed. Ultrasound examination (UE) and fine needle aspiration cytology (FNAC) were used as main preoperative diagnostic tools in all participating institutions. Flow cytometry (FCM) was performed in the 5 institutions (50%). Lobectomy was the most common histological procedure to confirm the PTL diagnosis. All institutions routinely performed immuno-histochemical analysis. PTL was 0.54% of malignant thyroid tumor cases, with mucosa-associated lymphoid tissue lymphoma (MALTL) and diffuse large B-cell lymphoma (DLBCL) being 54.9% and 38.6%, respectively. Kuma Hospital, where the frequency of MALTL was highest (83.7%), routinely performed FCM using the materials obtained by FNAC. UE and FNAC sensitivities were 62.5% and 57.8%, respectively. In both UE and FNAC, sensitivity of MALTL was lower than of DLBCL. The study elucidated that the prevalence of PTL in non-Western countries was lower than previously reported. We propose that FCM should be more actively used to improve the preoperative diagnosis of MALTL. Our data predicted that the MALTL proportion will increase with improved diagnostic tools, while observation of PTL-suspected nodules without histological examination remains a viable option.

Komplikacije nakon dezartikulacije kuka i hemipelvektomije

Introduction: Hip disarticulation and hemipelvectomy are surgical procedures with a high rate of local complications: swollen scrotum/labia, superficial necrosis, infection, and wound dehiscence. Aim: We present local complications in our series. Material and methods: 17 patients were included in the study, there were 16 cases of malignant tumors and one case of osteomyelitis. Twelve of the tumors were soft tissue tumors, and four were malignant bone tumors. The descriptive statistical methods and methods for hypothesis testing used were the following: mean value, standard deviation, and absolute numbers as structure indicators, the t-test, and Fisher's exact test. Results: Local complications were observed in ten patients. Scrotum/labia edema was observed in five, superficial necrosis in four, wound infection in six, and wound dehiscence in seven cases. A single complication was observed in three patients; two and three complications were observed in three cases, each; and four complications were observed in one patient. No significant statistical difference was found between male and female patients (p=1.000). Patients with complications were significantly older (p=0.008). The correlation was found only between wound infection and dehiscence (p=0.001). Staphylococcus aureus was found in three cases, Enterococcus faecalis in one, Pseudomonas aeruginosa in three, Proteus mirabilis in two, and Acinetobacter spp. in one. Two patients had a single agent infection, the remaining four had polymicrobial infection. The complication rate was 58.8%, with wound infection being the most common one. Age was found as a possible predictor. This might be in relation to the condition of the blood vessels, but also with the general condition of the patient. Conclusion: Complications in hip disarticulation/hemipelvectomy vary from insignificant to life-threatening, prolonging recovery and rehabilitation.

Detection of Plasma Circulating Tumor DNA in Ovarian Cancer and Its Clinical Significance

To explore the application value of circulating tumor DNA in the diagnosis of benign and malignant ovarian tumors and its clinical significance in ovarian malignant tumors. A total of 70 patients with ovarian tumors who treated surgery in the first people’s hospital of Lianyungang and the affiliated cancer hospital of Nanjing medical university from January 2017 to August 2020 were collected, including 32 cases of benign tumors, 15 cases of cross-sectional tumors, and 23 cases of malignant tumors. Venous blood was collected before the operation, and the expression level of the plasma circulating tumor DNA was detected by Next-Generation Sequencing, and the expression of circulating tumor DNA chromosome copy number variation in benign and malignant ovarian tumors was analyzed. At the same time, the relationship between the preoperative plasma circulating tumor DNA and clinicopathological features such as tumor size, clinical stage, histological grade, pathological type, and related immunohistochemical indexes were analyzed. There was a significant difference in preoperative plasma circulating tumor DNA among patients with benign, cross-sectional, and malignant tumors of the ovary (p<0.05). In terms of the clinical stage, there were 9 cases in the early stage group (I+II), 5 (55.56 %) cases were positive for plasma circulating tumor DNA before the operation. In the advanced stage group (III+IV), there were 14 cases, 12 (85.71 %) cases were positive for plasma circulating tumor DNA before the operation. In the histological grade of malignant ovarian cancer, there were 6 cases of ovarian low-grade cancer, of which 3 (50.0 %) cases were positive for plasma circulating tumor DNA before the operation. There were 17 cases of ovarian high-grade cancer, of which 14 (82.35 %) cases were positive for plasma circulating tumor DNA before the operation. Among the pathological types of tumors, there were 16 cases of plasma carcinoma and 14 (87.5 %) cases were positive for plasma circulating tumor DNA. There were 7 cases of non-plasma carcinoma and 3 (42.85 %) cases were positive for plasma circulating tumor DNA. In terms of tumor size, there were 7 cases with a diameter <10cm, of which 3 (42.85 %) cases were circulating tumor DNA positive. There were 16 cases of tumor diameter ≥10 cm, of which 14 (87.5 %) cases were circulating tumor DNA positive. In terms of pathological immunohistochemistry, among the 17 ovarian cancer patients with positive preoperative plasma circulating tumor DNA, there were 14 (82.35 %) patients with p53 mutation, and 3 (17.65 %) negative patients. There was no significant difference between the detection rate of plasma circulating tumor DNA and the immunohistochemical indexes such as Ki67, P16, estrogen receptor, progesterone receptor, and Wilms tumor protein-1 before the operation. Circulating tumor DNA level has a high predictive value for the disease progression in patients with ovarian cancer, and can be used as a reference index for clinical monitoring of patients’ condition and prognosis.

НОВООБРАЗОВАНИЯ НОСА И ОКОЛОНОСОВЫХ ПАЗУХ У ДЕТЕЙ, КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ

Resume. Neoplasms of the nasal cavity and perinasal sinuses at the beginning of their development are asymptomatic or non-specific symptoms may appear that mask them as inflammatory diseases (acute and chronic rhinosinusitis). The study was carried out on the basis of the Grodno University Clinic. 3 cases of malignant tumors of the nose and perinasal sinuses and 187cases of benign (10 angiofibromas) were detected during 2009-2019. CTexamination, brain RCT, CT-examination of facial skull with intravenous contrast, biopsy of the neoplasm under control of endoscopic technique were actively used for diagnosis. The article describes two clinical cases of neoplasms of this area – rhabdomyosarcoma and angiofibroma, which were almost the same by clinical signs, but they are an example of benign and malignant tumors.

Double primary malignant tumor in a centenarian female: Case report and review of literature

A hundred and three year old female patient was evaluated for ulcer over the nasion area and a mass arising from the right upper eyelid, appearing two months apart. Histopathology revealed nasion ulcer as basal cell carcinoma while right eyelid mass was diagnosed as poorly differentiated squamous cell carcinoma. Based on these findings and the time gap between two lesions a diagnosis of synchronous double primary malignant tumor was made. Although the prevalence of multiple primary malignant tumor is highest in breast, colo-rectum and prostate cancer we report a rare case of double primary malignant tumor of the eyelid and nasion in a centenarian female.

Extraordinarily Large Malignant Extra Gastro Intestinal Stromal Tumor Presenting as an Abdominal Mass

Background: Gastrointestinal stromal tumors (GIST) are rare of all gastrointestinal neoplasms with histology and immunohistochemistry similar to gastrointestinal stromal tumors. They occur outside the gastrointestinal tract rarely and are, hence, called the extra gastrointestinal stromal tumors (EGIST). Herein, we report a rare case of malignant extra intestinal gastrointestinal tumor.&#x0D; Case report: A 39 yr old female presented to the surgical OPD with a lump in the abdomen since 4 months. We received a lobulated tumor which measured 40x25x20 cm3 and showed capsule. Cut surface was predominantly solid, grey white with areas of hemorrhage and necrosis along with cystic areas. Histopathology and immunohisto chemistry revealed it to be a malignant EGIST of mesentery because of no continuity of the tumor with the small intestine microscopically.&#x0D; Conclusion: EGIST is a rare no epithelial tumor of mesentery. Omentum histopathological examination is a standard technique to diagnose the tumor and to differentiate it immunohistochemically from other tumors having similar morphology. Correct diagnosis plays valuable role in the treatment.

Malignant Tumor in Knee Joint Cavity Extra-Articular Resection: Clinical Observation of 4 Cases Series

Background: The knee is one of the most common places to develop a primary sarcoma. Malignant bone tumors are rare conditions that may be encountered by non-oncologic surgeons only a few times in their careers, but a delay in diagnosis or a misinterpretation of data can have limb and life-threatening consequences. Methods: A retrospective analysis was conducted on 4 cases of knee joint problems. Patients admitted to the hospital between June 2016 to March 2019. We identified 2 males and 2 females with knee joint malignancy, aged 38 ~76 years. The diagnosis was confirmed by histopathology. All 4 patients underwent total knee joint tumor resection with prosthesis replacement. Results: The interventions were successfully completed without vascular and nerve injury, but in 1 case, the wound healing was delayed. Knee function was recovered satisfactorily after 24-37 months of follow-up. At the last follow-up, the knee flexion angle range for the 4 patients was 95°, 100°, 100°, and 110°, respectively, and the delay of knee extension was 5°, 10°, 10° and 5°, respectively; tissue tumor association scores were 53%, 77%, 80%, and 83%. Quadriceps muscle strength was grade 4 in two cases and grade 5 in the other two cases. No tumor recurrence or metastasis was detected, and no death occurred. Conclusion: We identified 4 cases of malignant tumor involving the knee in which total and partial excision and reconstruction were performed.

Immunoexpression of Ki-67 Labelling Proliferation Index in Phyllodes Tumour of Breast by Polymer-based Detection Method

Phylloides tumours (PTs) are rare breast neoplasms with a variable clinical course depending on the tumour category. The classification of PTs proposed by the World Health Organization (WHO) into benign, borderline and malignant is based on a combination of several histologic features, including Stromal cellularity, nuclear atypia, mitotic activity, stromal overgrowth and tumour margin appearance. However, there are no defined criteria or clear cut-offs for individual histologic parameters. Thus, the diagnosis of PTs based on the integration of morphology remains challenging. Along with the grade, additional study of proliferative markers such as Ki-67 are essential to identify those with potential for aggressive behaviour. This study was undertaken to assess the histopathological characters and correlate Ki-67 expression in different subtypes of PTs. In this study, 30 cases of PTs were studied. Regarding histologic features, routine H&amp;E stains were taken into consideration for diagnosis and classification of tumours. Immunostaining for Ki-67 was also performed by polymer-based detection method. Ki-67 labelling index (LI) was categorized as 0-10, 11-30, 31-50, 51 and above depending on the percentage of positive tumor cells and was correlated with histologic grade and clinical features in each case. Twenty cases (66.7%) of benign phyllodes tumour (BPT), 3 cases (10%) of borderline PT, and 7 cases (23.3%) cases of malignant phylloides tumour (MPT) were examined in this study. Among 20 cases of BPT, 3 cases (15%) were recurrent tumours. Average Ki-67 LI in BPT was 5% (range 1-10%) and borderline PT was 17.5% (range 15-20%). MPT exhibited Ki-67 LI range of 15-35% with average LI of 25%. A significant association was seen between expression of Ki-67 in different grades of PT(p=0.01). So, Ki-67 LI should be performed in routine histopathology reporting of phylloides for sub-categorisation of phylloides.

Immunoexpression of Epidermal Growth Factor Receptor (EGFR) in Malignant Surface Epithelial Tumours of Ovary

Ovarian cancer is the deadliest gynaecological cancer and approximately 70% are diagnosed in an advanced stage with 5 years survival rate of only 35%. The aim of this study was to find out the distribution of epidermal growth factor receptor (EGFR) immunoexpression in different histological types and grades of malignant surface epithelial tumours of ovary. A total 54 cases of malignant surface epithelial tumours of ovary from North Okkalapa General and Teaching Hospital and Thingangyun Sanpya General Hospital from August 2015 to September 2016 were included. This study included 30 cases (56%) of serous tumour, 18 cases (33%) mucinous tumour, 5 cases (9%) clear cell tumour and one case (2%) of malignant Brenner tumour. Of the 54 cases, 11 cases (20%) were well differentiated, 33 cases (61%) moderately differentiated and 10 cases (19%) poorly differentiated tumours. Different histological types and grades of malignant surface epithelial ovarian tumours were determined for EGFR immunoexpression by peroxidase antiperoxidase method. Out of 54 cases, 31 cases (57.4%) were found to be positive for EGFR immunoexpression and 23 cases (42.6%) showed negative immunoexpression. Among 31 positive cases of EGFR, 54.8% were serous, 32.3% mucinous, 9.7% clear cell and 3.2% were malignant Brenner tumour. The highest EGFR immunoexpression was found in malignant serous, tumour (54.8%). Regarding the histological grades of the 31 positive cases, EGFR immunoexpression was found 9.7% in well differentiated, 64.5% moderately differentiated and 25.8% in poorly differentiated tumours. Increased EGFR immunoexpression was observed predominantly in higher histological grades of ovarian cancers. Since, high EGFR levels have a negative prognostic role in ovarian cancers, further studies with long-term follow-ups are required to determine the prognosis and management of patients with malignant surface epithelial ovarian tumours.

NI-03 USEFULNESS OF IMP-SPECT IN PREOPERATIVE GRADE EVALUATION OF INTRAORBITAL TUMOR

INTRODUCTIONThe frequency of intraorbital tumors is small as 0.9% of all brain tumors, but its pathological type is diverse. Among them, the diagnosis of whether particularly malignant tumor scan clinically, is extremely important. Nuclear medical testing is essential for non-invasive differential diagnosis in brain tumors. SPECT, good malignancy differentiation, evaluation of malignancy, usefulness such as differentiation of non-tumorous lesions have been reported many. However, there are few reports that SPECT was useful in preoperative differential diagnosis of orbital tumors. Since 123IMP-SPECT was useful in preoperative differential diagnosis of intraorbital tumors, we report some literature considerations.METHODAmong the 27 cases of intraorbital tumors that were operated on in our clinic between August 2005 and August 2016, 14 cases of SPECT prior to surgery were examined for the usefulness of preoperative differential diagnosis. Breakdown of cases, as the malignant tumor, two cases of malignant lymphoma, MALT lymphoma 2 cases, adenoid cystic carcinoma 1 case, in one case plasma cytoma, as a benign tumor, false tumors 4 cases, three hemangioma cases, neurocytoma 1 case it was.RESULTSIn IMP early image, accumulation of clear IMP was observed in all six cases of malignant tumors. In benign tumors, there is no accumulation in hemangioma and neurosheath, there is a strong accumulation in one of the four cases in false tumors, it was observed mild accumulation in the remaining two cases. Tumor to normal ratio of IMP early image was an average of 2.39 in six malignant tumors and 1.52 in 8 benign tumors.CONCLUSIONThis time, we examined the usefulness of 123IMP-SPECT in preoperative differential diagnosis of intraorbital tumors. The T/N ratio of intraorbital malignant tumors is higher than benign tumors, and it was thought to help to evaluate preoperative malignancy of intraorbital tumors.

COT-01 SYMPTOMATIC EPILEPSY INDUCED BY MALIGNANT BRAIN TUMOR

CASESWe report about 41 cases of malignant brain tumor which were treated with operation, irradiation, chemotherapy during past 62 months. 34 cases of glioblastoma, 2 cases of malignant glioma(WHO grade III), 2 cases of medulloblastoma, 1 case of germ cell tumor, 1 case of malignant neurocytoma, and 1 case of malignant ependymoma were included in 41 cases. Two cases of glioblastoma survived over than 25 years, but the median survival of dead 11 glioblastoma cases was 22 months. 4 cases were expired among another 7 cases.RESULTS6 cases showed mutation in ATRX and one case had mutation of IDH-1 among 34 cases of glioblastoma. One case showed mutation in ATRX and IDH-1 among 2 cases of malignant glioma. But the mutation in ATRX and IDH-1 had no correlation with convulsion. The initial symptom was epilepsy in 3 cases of glioblastoma and another 3 cases of glioblastoma showed convulsive seizure thereafter. One case of glioblastoma showed rapid aggravation of symptom after convulsion. The initial symptom was epilepsy in 1 case of malignant glioma. One case of malignant ependymoma and one case of medulloblastoma showed rapid aggravation of symptom after convulsion.DISCUSSIONNine cases showed convulsion among our 41 cases. Convulsion happened as initial symptom in 4 cases but it happened during treatment in 5 cases. Three cases among these 5 cases showed rapid aggravation of symptom after convulsion. So pre- and post-operative anti-epileptic treatment seems to be necessary.

Epidemiological data of the malignant neoplasms of bladder in St. Petersburg

The main epidemiological and statistical data on the observations of malignant neoplasia of the bladder in residents of St. Petersburg in 2013–2017 were evaluated. Was established that, despite the increase in the incidence of bladder cancer and large volumes of diagnostic and treatment work, the quality of medical care for patients with this pathology remains at an appropriate level. The latter is due to the permanent improvement of technological and organizational methods of examination, as well as treatment with the possibility of timely verification of neoplasia and oncological sanation of patients. The proportion of patients suffering from localized forms of bladder cancer over the past 5 years has increased by 15%. However, quantitative indicators of the number of patients suffering from invasive variants of the disease are quite high. The annual mortality of patients due to malignant bladder tumors in St. Petersburg is lower than the average in Russia (16 and 16,5%, respectively). At the same time, the «crude» mortality rate for this disease in St. Petersburg remains stable, although exceeding the same parameter in the regions of the Russian Federation. However, the mortality rate does not always unambiguously reflect the inadequate quality of examination and treatment of patients, as it depends on many reasons. The 5-year survival rate for patients with bladder cancer is one of the highest in the country. We believe that the quality of medical care for residents of the city who have bladder cancer is not inferior in its characteristics to that in other regions of Russia, and in a number of indicators it is in the leading position. The purposeful introduction into practice of St. Petersburg doctors of modern information technologies for the collection, processing, storage and analysis of medical and statistical data on cases of malignant neoplasms is one of the priority tasks of improving the organization of anti-cancer control in the perspective of the successful implementation of measures for the development of healthcare in Russia.

Clinicopathological features of malignant urachal tumor: A hospital-based cancer registry data in Japan.

To identify the clinicopathological features of malignant urachal tumor in Japan, and analyze the 5-year overall survival of malignant urachal tumor patients. We used the hospital-based cancer registry data to extract malignant urachal tumor cases that were diagnosed in 2008-2009 and 2012-2015, histologically confirmed, and received the first course of treatment. We analyzed the 5-year overall survival using the 2008-2009 cohort's data. We identified 456 patients, and malignant urachal tumor accounted for 0.4% of all malignant bladder cancers. The median age was 61years (range 2-97), and 66% were men. The most common histology was adenocarcinoma (80%), followed by urothelial carcinoma (11%) and squamous cell carcinoma (3%). The proportions of patients were: 19% Ta/Tis/T1N0M0, 55% T2-3N0M0, 13% T4/N+ and 13% M+. Regarding the initial treatment, the proportions of surgery alone were 79% and 33% in cases of T3 or less N0M0 and T4/N+, respectively. The proportion of combination therapy including surgery and chemotherapy were 13% and 44% in T2-3N0M0 and T4/N+, respectively. Radiation therapy was not common at any stage. In the 2008-2009 cohort, the 5-year overall survival rate in Ta/Tis/T1N0M0, T2-3N0M0, T4/N+ and M+ were 60%, 64%, 63% and 12%, respectively. Malignant urachal tumors are quite rare in Japan, and most of those without metastasis are likely to be treated by surgery alone, even at advanced stages. A standard of care must be established for malignant urachal tumor patients at advanced stages or with metastasis, as the prognosis of these patients can be poor.

Absence of H3F3A mutation in a subset of malignant giant cell tumor of bone

Giant cell tumor of bone typically involves the epiphysis of the long bones of skeletally mature patients. It is genetically characterized by highly recurrent and specific mutations of the H3F3A gene, which encodes histone H3.3. The most common mutation H3F3A G34W can readily be detected by a recently developed mutation-specific antibody. Giant cell tumor of bone rarely transforms to a sarcoma (malignant giant cell tumor of bone), which has not been genetically characterized in detail. We studied seven clinicopathologically defined malignant giant cell tumors, as well as two H3F3A-mutant bone sarcomas without giant cell tumor histology using a combination of clinicopathological, immunohistochemical, and molecular methods (Sanger sequencing + pyrosequencing or next generation sequencing). The cases included five men and four women, with a median age at initial diagnosis of 27 years. The two H3F3A G34W-positive sarcomas without giant cell tumor histology involved the subarticular epiphyseal sites, suggesting relatedness with giant cell tumor of bone. In two of the seven clinicopathologically defined malignant giant cell tumor cases, the sarcoma tissue showed the H3F3A G34W mutation. However, in the remaining five cases, in contrast to their associated H3F3A G34W-mutant giant cell tumor, the sarcoma lacked the H3F3A G34W mutation, either entirely or sub-clonally in the samples tested. This discordant mutation status was confirmed in all instances by immunohistochemistry and sequencing. A FISH analysis suggested that the absence of the H3F3A G34W mutation may be related to deletion of the H3F3A gene. Therefore, we have demonstrated that H3F3A G34W mutation, a critical driver in giant cell tumor, is absent in a subset of malignant giant cell tumor of bone. This novel recurrent phenomenon has potential biological and diagnostic implications, and further study is required to better characterize this progression pathway and understand its mechanism.

Application of Serum Thymidine Kinase-1 in Cancer Risk Detection in Healthy Population

The purpose of this study was to evaluate the application of serum thymidine kinase 1 (STK1) in cancer risk detection in health general investigation. Using the method of dot-blot immunofluorescence enhancement, the data of STK1 of 12600 people were selected, and were carried out simultaneously with routine physical examination items. The results showed that the positive rate of STK1 (STK1&gt; 2 pmol/L) was 2.10% with 2 pmol/L as the threshold, and the positive rates of male and female were 2.01% and 2.19%, respectively. There was no significant difference between male and female (χ2 = 0.46, P &gt; 0.05). Compared with other age groups, both male and female between 40–59 years old had the highest detection rate in the age group of STK1 elevation, and twelve cases of malignant tumors were detected in the group of STK1 elevation, accounting for 4.55%. Compared with the normal group, it has significant significance. In the cases of benign tumors/cell dysplasia, 2194 cases detected were in normal group (17.78%) and 120 cases were in elevated group (45.45%). There was significant difference between normal group and elevated group (χ2 = 74.44, P &lt; 0.01). There was no significant difference between the normal group and the elevated group in inflammatory, viral, fatty liver disease, other diseases and no special clinical conditions (P &gt; 0.05). In the screening of cancer risk of general health investigation, STK1 can be applied to truly evaluate the abnormal proliferation of cells in vivo, and to screen a variety of tumors. It is suitable for early cancer risk screening of physical examination population.

A rare case report of orbital malignant solitary fibrous tumor

A rare case report of orbital malignant solitary fibrous tumor - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2019.135, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

Melanocytic tumors with MAP3K8 fusions: report of 33 cases with morphological-genetic correlations.

We report a series of 33 skin tumors harboring a gene fusion of the MAP3K8 gene, which encodes a serine/threonine kinase. The MAP3K8 fusions were identified by RNA sequencing in 28 cases and by break-apart FISH in five cases. Cases in which fusion genes were fully characterized demonstrated a fusion of the 5' part of MAP3K8 comprising exons 1-8 in frame to one of several partner genes at the 3' end. The fusion genes invariably encoded the intact kinase domain of MAP3K8, but not the inhibitory domain at the C-terminus. In 13 (46%) of the sequenced cases, the 3' fusion partner was SVIL. Other recurrent 3' partners were DIP2C and UBL3, with additional fusion partners that occurred only in a single tumor. Clinically, the lesions appeared mainly in young adults (2-59 years of age; median = 18), most commonly involving the lower limbs (55%). Five cases were diagnosed as Spitz nevus, 13 as atypical Spitz tumor, and 15 as malignant Spitz tumor. Atypical and malignant cases more commonly occurred in younger patients. Atypical Spitz tumors and malignant Spitz tumors cases tended to show epidermal ulceration (32%), a dermal component with giant multinucleated cells (32%), and clusters of pigmented cells in the dermis (32%). Moreover, in atypical and malignant cases, a frequent inactivation of CDKN2A (21/26; 77%) was identified either by p16 immunohistochemistry, FISH, or comparative genomic hybridization. Gene expression analysis revealed that MAP3K8 expression levels were significantly elevated compared to a control group of 57 Spitz lesions harboring other known kinase fusions. Clinical follow-up revealed regional nodal involvement in two of six cases, in which sentinel lymph node biopsy was performed but no distant metastatic disease after a median follow-up time of 6 months.

Clinical features and pathological analysis of lacrimal gland occupying lesions in 91 cases

Objective: To analyze the pathogenesis, histopathological classification and clinical features of lacrimal gland occupying lesions. Methods: This was a retrospective case series study. Clinical data of 91 patients (102 eyes) with lacrimal gland area occupying diseases who received ophthalmic surgery in the Second People's Hospital of Yunnan Province from January 2014 to November 2018 were retrospectively analyzed, including patients' age, reasons for treatment, gender, imageological examination data and pathological diagnosis results. All patients had more than one medical imaging examination results and histopathological diagnosis results. Results: Among 91 cases, 46 patients (50.5%) were male and 45 (49.5%) were female. The age distribution ranged from 1.1 years to 72 years old, with an average age of 43 years. All of benign tumors added up to 58 cases (63.7%). Pleomorphic adenoma (43 cases, 47.3%), dermoid cyst (6 cases, 6.6%), and inflammatory pseudotumor (6 cases, 6.6%) were the most common cases in the benign lacrimal gland occupying tumors. There were 33 cases (36.3%) of malignant tumors. Adenoid cystic carcinoma (15 cases, 16.5%), adenocarcinoma (6 cases, 6.6%) and lymphoma (5 cases, 5.5%) had the highest incidence among the malignant lacrimal gland occupying tumors. The most common reason for seeking medical treatment was exophthalmos (50 cases, 54.9%; 30 cases were pleomorphic adenoma). Brow arch mass (22 cases, 24.2%) and pain in and around the eye (9 cases, 9.9%; 5 cases were adenoid cystic carcinoma) were also major reasons. Conclusions: The most common benign lacrimal gland area occupying lesion in surgery patients of Yunnan is pleomorphic adenoma, which more occurred in patients with exophthalmos as the main symptoms. The most common malignant tumor in the lacrimal gland area is adenoid cystic carcinoma and the most common reason to seek medical advice was pain in and around the eye. (Chin J Ophthalmol, 2019, 55:842-846).

Evaluation of neoplastic bone lesions: A morphological study at a tertiary care centre.

Objectives: To determine the pattern and frequency of various bone tumors at a tertiary care centre in rural area. Study Design: Retrospective study. Setting: Orthopaedic Peoples University of Medical and Health Sciences (PUMHS), Nawabshah. Period: June to December 2018. Material and Methods: The 5 years record from July 2015 to June 2018, of all the patients who were admitted and operated for any bone tumor was retrieved. A total of 68 cases were included in the study having complete file record, regardless of their age and sex, the histopathological report of their bone biopsy was mandatory for inclusion in the study. The patients of incomplete file record, without histopathological report and the cases of other bone non-neoplastic conditions were not included in the study. All the collected data was recorded on a proforma, analysed statistically and results were tabulated. Results: In present study 68 cases of bone tumors were evaluated. The patients were aged between 7.5 to 73 years with a mean of 26.4 + 12.7 years. Among these 68 cases 41 (60.3%) were male. The malignant tumors were diagnosed in 25 (36.8%) cases among these 14 (20.6%) cases in male patients and 11 (16.2%) cases in female. The overall benign tumors were observed in 43 (63.2%) cases, and among these 27 (39.7%) cases were male and 16 (23.5%) cases were female. Osteosarcoma was the most common malignant tumor diagnosed in 14/25 (56%) cases followed by chondrosarcoa in 4/25 (16%) cases. In benign tumors the osteochondroma was the commonest tumor detected in 11/43 (25.6%) cases followed by benign giant cell tumor which was diagnosed in 9/43 (21%) cases. Most of the malignant tumors (24%) were diagnosed in 11 - 20 years age group, and most of benign tumors were detected in 21-30 and 31- 40 age groups each comprising of 23.3% cases. Three cases of metastatic tumors were also diagnosed and all were present in older 61 – 70 years age group. Conclusion: The bone tumors are more common in males, occurred predominantly in the second decade of life. osteochondroma and osteosarcoma was the most common benign and malignant bone tumors. Metastatic lesions were observed in older age group.