Differential Diagnosis Of Tumors Research Articles

Hairy Cell Leukemia Presenting as Presternal Soft Tissue Mass: A Case Report With Review of Literature

Abstract Hairy cell leukemia (HCL) is an uncommon chronic lymphoproliferative disorder. Initial presentation frequently includes symptoms related to peripheral blood cytopenias. It can sometimes have atypical manifestations and can present at unusual sites. We report an unusual presentation of HCL as a presternal soft tissue mass in a 45-year-old man. His peripheral blood counts showed pancytopenia. There were no palpable lymph nodes or hepatosplenomegaly. CT-scan revealed a middle mediastinal mass with extension into the presternal soft tissue. Tissue core biopsy was taken and histopathologic findings confirmed the diagnosis of HCL. To our knowledge, this is the second reported case of HCL presenting as a presternal soft tissue mass. Although rare, HCL should be considered in the differential diagnosis of tumors involving extramedullary/extranodal sites including the soft tissue and bone, so the patient can get the utmost benefit for early diagnosis of a treatment responsive disease.

Differential diagnosis and analysis of pancreatic cancer resectability using CT and MRI

The purpose of this publication is to comprehend the modern achievements of radiological diagnosis in surgical oncopancreatology via a critical analysis of recent English-language publications. CT and MRI are essential diagnostic methods in surgical and oncological pancreatology. The possibilities of tomography examination regarding analysis of tumor dimension, CT criteria for pancreatic cancer diagnosis, assessment of vascular invasion, differential diagnosis of tumors, as well as estimation of possible early postoperative complications and radiological features of the region of interest after neoadjuvant and adjuvant therapy for pancreatic tumors are critically analyzed. The role of modern diagnostic methods in improvement of treatment directly related to the early staging of pancreatic tumors is negligible, since the factors affecting the phases of slow and rapid tumor growth are unclear. Most likely, cyclic clinical and radiological evaluation of the pancreas will not give the expected results and is associated with advanced financial and physical costs. Perhaps, one of the approaches for effective treatment of pancreatic cancer will be the recognition of the need for laboratory and instrumental examinations by each patient. Acceptable frequency of examinations and own funds are determined by a patients himself in this case.

Clear Cell Odontogenic Carcinoma of the Maxilla: A Case Report With Emphasis on Differential Diagnoses

Abstract Objectives Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic epithelial neoplasm composed mainly of clear cells. It was first described in early 1980s with great uncertainty of its behavior. Nearly 100 well-characterized cases have been reported to date with mean age at presentation of 54 years and female-to-male ratio of 1.6:1. It shows greater predilection for mandible compared to maxilla. Herein, we present a case of CCOC arising in maxilla and discuss the clinicopathologic presentation with emphasis on the potential differential diagnoses of other head and neck clear cell tumors (HNCCTs). Case Presentation A 68-year-old male presented with facial swelling and hard palate bleeding. CT scan revealed large destructive mass at the floor of right maxillary antrum with involvement of hard palate. Biopsy showed invasive carcinoma with squamous differentiation and focal keratinization. No evidence of lymph node metastasis was noted radiographically. The patient subsequently underwent total maxillectomy with complete resection of the tumor. Results Histologic sections revealed tumor arranged in lobular islands showing biphasic morphology including peripheral palisaded hyperchromatic basaloid cells and central clear to faintly eosinophilic cells with well-demarcated cell membranes. The intervening stroma was fibrous and showed hyalinization. The diagnosis of CCOC was made on the basis of tumor morphology in conjunction with EWSR1 gene rearrangement, which was detected by fluorescence in situ hybridization (FISH). Conclusion CCOC, although rare, should be considered in the differential diagnosis of tumors with a clear cell component. It can mimic a variety of HNCCTs, particularly clear cell variant of squamous cell carcinoma, clear cell tumors from minor salivary glands, or metastases from other sites. These tumors can be locally aggressive with a relatively high recurrence rate. Pathologists should be cognizant of this entity with other HNCCTs and the use of proper ancillary testing to avoid potential pitfalls.

Benign bone tumours of tibial tuberosity clinically mimicking Osgood-Schlatter disease: a case series.

Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tubercle and a common cause of anterior knee pain in growing adolescents. A variety of benign neoplasms can also cause bony prominence over the tibial tubercle in adolescents that might clinically imitate OSD. Therefore, the differential diagnosis of tumours mimicking OSD is critical and considered the primary goal of this study. Eleven patients who were referred to our orthopaedic oncology department with clinical suspicions of OSD and obscure radiographic presentation were identified. The final diagnosis was OSD in three cases. The demographic, clinical, and radiologic characteristics of the remaining eight patients in whom a tumour mimicked OSD were evaluated. The diagnosis was confirmed by pathologic examination. The final diagnosis was periosteal chondroma in four cases, osteochondroma in three cases, and dysplasia epiphysealis hemimelica (DEH) in one case. The average age of the patients was 10.5 ± 3.1years. In the majority of patients (62.5%), the lesion was painless. The mean size of the bump was 6.5 ± 1.2cm2. In patients with a painful knee, the pain was constant and activity-independent. At history taking, the pain and bump size were progressive. Lack of pain, progressive pain and bump, activity-independent pain, a bump size larger than 5cm2 at presentation, and age fewer than ten years could be considered in favour of tumours and against OSD.

Relevance of endosonography in diagnosis of tumor and pretumor pathology of the larynx, oropharynx and laryngopharynx

Aim. The study objective is studying the possibility of endosonography in the diagnosis of tumor and pretumor pathology of the larynx, oropharynx and laryngopharynx. Materials and methods. Endosonographic study was conducted in 20 patients with tumors and suspected tumors of the larynx, laryngopharynx and oropharynx. Results. The use of endoscopic ultrasound (EUS) method was useful and important in determining the thickness and structure of the tumor, with hyperplasia of the lingual and palatine tonsils. Endosonographic picture of fibrous changes after surgery and post-radiation changes, lack of blood flow in the fibrous tissue and blurred contours gave additional information in the differential diagnosis of tumor and non-tumor changes. The results of the ultrasound examination performed in the standard B-mode for the presence of tumors, cysts and formations, suspicious of the tumor of the submucosal layer of the oropharynx and larynx, which were not determined by endoscopic examination, were confirmed. Conclusion. Obtaining a sonographic image simultaneously with endoscopic examination of the formations in the submucosal layer of the oropharynx and larynx will shorten the diagnostic algorithm of the study in patients with pathological changes in this area. The use of endosonography made it possible to confirm the data obtained by ultrasound examination in B-mode and which were not confirmed by endoscopic examination.

Brain Tumor in Differential Diagnosis of Seizures in Puerperium: Case Report

Convulsive crisis is a transient disturbance of cerebral function, and the etiology of which may be manifold. Its clarification is essential for establishing adequate therapy and seizure control. In the pregnancy-puerperal cycle, eclampsia is the most common cause of it, but brain tumor, epilepsy and other disorders are part of the differential diagnosis. We report a case of seizure triggered by tumor in a primigest, 22 years old, at 38 weeks’ gestation with premature rupture of membranes. Cesarean section was performed due to non-reassuring fetal condition. On the second day of puerperium, she presented recurrent episodes of generalized tonic-clonic seizures and elevated blood pressure. She received magnesium sulfate for 24 hours and persisted with severe headache. Magnetic resonance imaging of the brain showed an expansive lesion in the left frontoparietal region. The patient underwent intracranial microsurgery on the eighth day after cesarean section, with complete resection of the lesion and anatomopathological diagnosis of schwannoma. She went through good postoperative evolution, without neurological deficits, and stayed on phenobarbital, with no seizures until 6 months of follow-up. From the case we conclude that although the first diagnosis in pregnant or puerperal women with seizures should be eclampsia, there are other causes, such as brain tumor and Posterior Reversible Encephalopathy Syndrome (PRES). Careful evaluation is required, especially in refractory cases and not responding to usual treatment.

ESTIMATION OF METASTATIC NEOGENESIS IN ASCITIC EXUDATE BY AN AUTOMATED ANALYSIS OF BIOLOGICAL LIQUIDS

The aimis to carry out an automated analysis of biological liquids for the estimation of metastatic neogenesis in ascitic exudates.Materials and methods.A retrospective analysis of 40 case histories of patients with the ascitic syndrome of non-tumour (cirrhotic) and tumour genesis was performed. Traditional cytology was accompanied by an automated analysis of exudative fluids. The final diagnosis was verified using instrumental and pathomorphological methods. The processing of statistical data included an assessment of the intergroup difference significance.Results.Compared with cirrhotic ascites, the following parameters of the automated analysis of biological fluids are found to be statistically significant (p30% in the atypical cell screening system has been established. In the absence of an acute inflammatory reaction, the presence of eosinophils in the exudate should be interpreted as an indirect marker of a tumour process. According to the data obtained, the content of neutrophils, lymphocytes and monocytes in ascitic fluids does not depend on the nature of the process (p>0.05).Conclusion.The diagnostic capabilities of automated analysis of ascitic fluids are analysed. In the system of differential diagnosis of tumour and non-tumour processes, the following parameters are established to possess the greatest informative value: TCN, HF, and the presence of eosinophils (EO).Conflict of interest: the authors declare no conflict of interest.

Phenotypic plasticity of metastatic melanoma

Introduction. Metastatic melanoma is characterized by clinical and morphological heterogeneity and plasticity. Rare cases of metastatic melanoma are known, that have no visual expression of melanocytic markers. Contradictory histology of such melanomas requires a differential diagnosis from morphologically similar non- melanocytic tumors, sarcoma or lymphoma. objective is to describe the extraordinary cases of metastatic melanomas with low expression of differentiation markers. material and methods. 15 melanoma cases with unusual clinical and morphological characteristics were included in the study. These tumors were examined by pathologist and cytologist, by immunohistochemical and FISH analyses, mutations in BRAF, NRAS and KIT genes were detected by PCR. results. Some primary tumors were amelanotic, therefore, they were difficult for differential tumor diagnosis. Most frequently, primary tumors were located on the back, shin or head. In 4 patients the primary focuses were not detected. Metastatic lesions were as large nodular tumors in soft tissues of the back or lower limb. Most tumors belong to mixed or spindle-cell histological types. Spindle-shaped cells were also revealed by cytological analysis. BRAF gene mutations were identified by genetic analysis in 27 % of tumors, NRAS and KIT gene mutations were not detected. In 4 cases FISH analysis was performed to detect EWSR1 gene rearrangements, but it did not confirm the diagnosis of sarcoma. conclusion. The results indicate the presence of a heterogeneous group of melanoma cases, which have a number of morphological and molecular features that bring them closer to sarcomas.

Verification of image quality and quantification in whole-body positron emission tomography with continuous bed motion.

Whole-body dynamic imaging using positron emission tomography (PET) facilitates the quantification of tracer kinetics. It is potentially valuable for the differential diagnosis of tumors and for the evaluation of therapeutic efficacy. In whole-body dynamic PET with continuous bed motion (CBM) (WBDCBM-PET), the pass number and bed velocity are key considerations. In the present study, we aimed to investigate the effect of a combination of pass number and bed velocity on the quantitative accuracy and quality of WBDCBM-PET images. In this study, WBDCBM-PET imaging was performed at a body phantom using seven bed velocity settings in combination with pass numbers. The resulting image quality was evaluated. For comparing different acquisition settings, the dynamic index (DI) was obtained using the following formula: [P/S], where P represents the pass number, and S represents the bed velocity (mm/s). The following physical parameters were evaluated: noise equivalent count at phantom (NECphantom), percent background variability (N10mm), percent contrast of the 10mm hot sphere (QH, 10mm), the QH, 10mm/N10mm ratio, and the maximum standardized uptake value (SUVmax). Furthermore, visual evaluation was performed. The NECphantom was equivalent for the same DI settings regardless of the bed velocity. The N10mm exhibited an inverse correlation (r < - 0.89) with the DI. QH,10mm was not affected by DI, and a correlation between QH,10mm/N10mm ratio and DI was found at all the velocities (r > 0.93). The SUVmax of the spheres was not influenced by the DI. The coefficient of variations caused by bed velocity decreased in larger spheres. There was no significant difference between the bed velocities on visual evaluation. The quantitative accuracy and image quality achieved with WBDCBM-PET was comparable to that achieved with non-dynamic CBM, regardless of the pass number and bed velocity used during imaging for a given acquisition time.

Multilobular Tumor of Bone in a Dog

Background: Multilobular tumor of bone (MTB) is a primary bone neoplasm, uncommon in dogs. This tumor was called of many names for a long time, as: chondroma rodens, multilobular osteochondrosarcoma, multilobular osteoma, multilobular chondroma, calcificating aponeurotic fibroma, although MTB was preferred chosen, because these other name could be correlated with humans’ tumors. This tumor is observed specially in skull bone, although it was reported in zygomatic arc, hard palate, axilla, spine and penis. Mostly happen in big breeds dogs, and middle to old age patients. Clinical signs depending of region and how aggressive the tumor is, usually are related to compression of any structure. The growth of MTB is frequently slow and progressive, locally invasive, occurring relapse after surgical revomal, although the tumor has low to moderate metastatic potential. The aim of this study is to report a case of MTB in a female dog and describe anatomopathological changes.Case: A female dog, mixed breed, 13 year-old, of middleweight was admitted in Pathology Department of College of Agricultural Sciences and Veterinary Medicine (FCAV-Unesp), Campus of Jaboticabal - SP, to be undergone to necropsy. The patient have never shown any epileptic crisis or neurologic signs. In macroscopic examination was found a mass in skull, which invaded the orbit and frontal sinus, but it was not invading brain cavity. The neoplasm had and irregular surface, firm consistent, color was white mixed to red areas, after cut it was granular and rough, and had some point mineralized areas. The lobs of lung had much firm masses, colored gray to white. In cytology it was observed fusiform to polyhedric isolated mesenchymal cells, moderated pleomorphic, basophilic cytoplasm, thin granulated nuclear chromatin, and visible nucleoli that was involved by eosinophilic extracellular matrix. The proposed diagnostic was bone sarcoma. Histopathological assessment showed mesenchymal neoplastic proliferation, and multilobular characteristic, the lobules had different sizes and was well organized, and they were separated by thin conjunctive septs. In the center of lobules, there was an “island” with mineralized or chondroitin bone matrix, in some of these islands there were osteoclast. The cells had moderated pleomorphism and low mitotic activity (three mitotic cells in ten high-power field). At least, it showed big necrosis areas and invasion of near tissue. In lung was observed metastatic areas, which had same histopathologic way of primary neoplasm in skull. That way, the histopathologic exam was similar to Multilobular tumor of bone grade II.Discussion: The MTB is an uncommon neoplasm, which assaults mostly skull bone in large breeds dogs and middle age of eight years old. This case accord to literature about breed size, age and local of tumor. The clinical signs in this dog was related to region what it was growing and near structure compression. Besides that, the patient had lung metastasis, that is the principal metastatic sites according to literature. The Histopathologic exam showed the same characters of MTB, which was considered grade II according to literature. Despite MTB is an uncommon neoplasm in clinic of dogs and cats, the epidemiological knowns as age, breed and localization, anatomopathological changes, and histopathological exam allows to have a diagnosis, showing the importance of including this neoplasm in differential diagnosis of bone tumor in dogs.

Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report

BackgroundGastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia.Case presentationAn 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall. Esophagogastroscopy confirmed the presence of a huge submucosal tumor that extended from the lower esophagus to the gastric fundus. According to computed tomography, the mediastinal mass measured 12.7 cm and had heterogeneous low-density areas. A submucosal gastric tumor, which we suspected to be a GIST, was diagnosed in association with an esophageal hiatal hernia. Using thoracolaparotomy, we performed a total gastrectomy, a lower esophagectomy, and a Roux-en-Y reconstruction with the jejunum. The presumptive diagnosis was confirmed through immunohistochemical examination; immunostaining yielded results positive for CD34 and c-kit. The patient was discharged from the hospital 13 days after surgery with no complications and remained disease-free at follow-up 24 months after surgery.ConclusionsGIST should be considered in the differential diagnosis of tumors growing in the mediastinum.

Thymomas With a Prominent Alveolar Growth Pattern: A Clinicopathologic and Immunohistochemical Study of 12 Cases.

Twelve cases of thymomas with prominent alveolar-like growth pattern are presented. The 12 cases were identified during a review of more than 350 cases of thymomas. The patients were five women and seven men between the ages of 48 and 69 years (mean, 58.5 years). Clinically, all patients presented with nonspecific symptoms. Grossly the tumors varied in size from 3.5 to 5 cm in greatest diameter. Histologically, all tumors showed a predominant alveolar-like growth pattern without a significant lymphocytic component. Immunohistochemistry showed positive staining for pan-keratin, keratin 5/6, and p63. Clinical follow-up showed that nine patients have remained alive and well with no recurrence, while no follow-up was obtained in three patients. The cases herein described highlight the spectrum of growth patterns that thymomas may show and also highlight the importance to keep thymomas in the differential diagnosis of tumor with prominent alveolar-like growth pattern.

Intramuscular Follicular Lymphoma

We present an interesting image of a painless growing mass of the right arm in a 76-year-old man. A musculoskeletal MRI of the right arm showed a 7.5 × 3-cm homogeneous, well-defined mass, elongated along the course of muscle fascias and independent of the adjacent bone. A core-needle biopsy was performed, and the diagnosis of low-grade follicular lymphoma was established. Intramuscular lymphoma should be integrated into the differential diagnosis of tumors surrounding neurovascular structures, alongside peripheral nerve tumors and soft tissue sarcoma. MRI and whole-body F-FDG PET/CT features provided useful information to refine differential diagnosis in this case.

Desmoplastic infantile ganglioglioma: A case report and review of literature

Background and objective: Desmoplastic infantile gangliogliomas are rare low grade supratentorial masses that are seen in the pediatric age group. Typically, they involve the superficial cerebral cortex and leptomeninges. Despite the large size of these lesions and some worrisome histological and radiological features, prognosis is generally favorable after gross total resection. To our knowledge, out of about one hundred cases reported worldwide, this is the first Desmoplastic infantile ganglioglioma reported in Kurdistan region-Iraq. Case presentation: We report a case of Desmoplastic infantile ganglioglioma in a 2-month-old male infant, Computed tomography and magnetic resonance imaging revealed a supratentorial mixed cystic and solid temporal tumor. Near total surgical removal was done. Histopathology revealed features of desmoplastic infantile ganglioglioma, with marked desmoplastic component, glial and neuronal elements. Immunohistochemistry showed positive staining for glial fibrillary acidic protein with areas of synaptophysin positivity. Conclusion: The diagnosis of Desmoplastic infantile ganglioglioma should be considered in differential diagnosis of tumors with a cystic component and an aggressive appearance.

Fibroma tipo nucal laterocervical. Descripción de un caso

Introduction: Nuchal-type fibroma is a rare proliferation of soft tissues of a benign nature. It appears more frequently in middle-aged men, usually as a solitary mass and less than 6 cm, poorly circumscribed, not encapsulated, dense and whitish in color. Its etiopathogenesis is unknown and is usually asymptomatic. Its diagnosis is histological, and its treatment the complete resection. Case description: We present the case of a 72-year-old patient who came to our hospital due to the chance finding of a right laterocervical tumor 5 days ago. She does not treat dysphonia, odynophagia, otalgia, dyspnea, fever or constitutional syndrome. After the exploration and the necessary imaging tests, it is surgically intervened with good results, the result is a type of fibroma of laterocervical localization. Conclusions: The clinical evaluation of a solitary neck mass can be difficult, so the nuchal fibroid should include the possible differential diagnoses of tumors in the posterior cervical region.

Analysis of proliferative lesions of haematopoietic and lymphoid tissue in the female productive tract

Objective: To study the clinicopathologic features, diagnosis and differential diagnosis of tumors of haematopoietic and lymphoid tissue in the female productive tract. Methods: Eleven cases of myeloid sarcoma and leukemia, 9 of non Hodgkin lymphoma (NHL) , 13 of cervical lymphoma-like lesions were selected from Peking University People's Hospital from January 2006 to August 2017. According to WHO classification of tumors of haematopoietic and lymphoid tissues (2008) and updated classification(2016), the cases were studied by microscopy, immunohistochemistry and in situ hybridization. Results: In 20 cases of tumors of haematopoietic and lymphoid tissue, the mean and median age was 48.5 and 56 years old (range: 16-77 years old) . In cases of lymphoma-like lesion of uterine cervix, the mean and median age was 45.9 and 48 years old (range: 23-62 years old) . The patients with neoplasm present as fever, fatigue, hypogastralgia, colporrhagia and mass etc. Eight cases had history of acute myeloid leukemia, and 3 had myeloid leukemia while pregnancy. One case of chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) had history of ovary small cell carcinoma and high grade serous carcinoma resected with chemotherapy. One case of diffuse large B cell lymphoma (DLBCL) had history of renal transplantation. Lactic dehydrogenase (LDH) was elevated in 9 cases (9/18) . The cases of lymphoma-like lesion present as contact bleeding in most cases and all located in cervix. Four cases of neoplasm located in vulva, 1 in vagina, 4 in cervix, 4 in uterine corpus, 8 in ovary and 2 in placenta. Clinical staging of NHL: 4 case was stageⅠ, 1 case of stageⅢ, and 4 cases of stage Ⅳ. Pathological morphology: 9 cases were myeloid sarcoma, 2 cases were placenta invaded by myeloid leukemia. Six cases were DLBCL, and 1 case was CLL/SLL, 1 case was mucosa associated lymphoid tissuse lymphoma (MALToma) , and 1 case was anaplastic large cell lymphoma. Resected mass, chemotherapy was performed in tumors of haematopoietic and lymphoid tissue. Five cases of myeloid sarcoma and 2 of NHL died. In 13 cases of lymphoma-like lesion of uterine cervix, the general condition was good as following up. Conclusions: The clinical history, pathological morphology and immunohistochemistry are very important for diagnosing tumors of haematopoietic and lymphoid tissue in the female productive tract. Resection with chemotherapy is recommended in treatment. The prognosis of lymphoma-like lesion of uterine cervix is good, and should be differentiated from lymphoma.

Development of reliable techniques for the differential diagnosis of avian tumour viruses by immunohistochemistry and polymerase chain reaction from formalin-fixed paraffin-embedded tissue sections

ABSTRACTA variety of techniques have been developed as diagnostic tools for the differential diagnosis of tumours produced by Marek’s disease virus from those induced by avian leukosis virus and reticuloendotheliosis virus. However, most current techniques are unreliable when used in formalin-fixed paraffin-embedded (FFPE) tissues, which often is the only sample type available for definitive diagnosis. A collection of tumours was generated by the inoculation of different strains of Marek’s disease virus, reticuloendotheliosis virus or avian leukosis virus singularly or in combination. FFPE tissue sections from tumour and non-tumour tissues were analysed by optimized immunohistochemistry (IHC) techniques and traditional as well as quantitative polymerase chain reaction (PCR) with newly designed primers ideal for DNA fragmented by fixation. IHC and PCR results were highly sensitive and specific in tissues from single-infected birds. Virus quantity was higher in tumours compared to non-tumour spleens from Marek’s disease (MD) virus-infected birds. Thus, using FFPE sections alone may be sufficient for the diagnosis of MD by demonstration of high quantities of viral antigens or genome in tumour cells, along with the absence of other tumour viruses by traditional PCR, and if standard criteria are met based on clinical history and histology. IHC furthermore allowed detection of the specific cells that were infected with different viruses in tumours from birds that had been inoculated simultaneously with multiple viruses. Following validation with field samples, these new protocols can be applied for both diagnostic and research purposes to help accurately identify avian tumour viruses in routine FFPE tissue sections.

Ependymoma mimicking cavernous malformation of the third ventricle

Introduction: Misdiagnosis of third ventricle lesions is not that rare. Case Description: The authors report on a patient who presented with a third ventricle lesion that neuroimaging appearance led to an initial diagnosis of cavernous malformation. A transcallosal transchoroidal approach was performed and complete microsurgical resection of the tumor was done. Histopathological and immunohistochemistry examination features a rare diagnosis of ependymoma in the third ventricle. Conclusion: Ependymomas should not be omitted from the differential diagnosis of tumors of third ventricle despite this place to be an unusual region for these lesions and they are rarely described.

Rare and Difficult Differential Diagnosis for Eyelid Tumor that Mimics Basal Cell Carcinoma-Case Report

Tumor of the follicular infundibulum is a rare, benign lesion of the skin; the very few cases presented in the literature had a clinical diagnosis of BCC with a histological analysis indicating tumor of the follicular infundibulum. Basal cell carcinoma is the most frequent eyelid malignancy, about 90%-95% of all eyelid malignant tumors. Differential diagnosis for tumor of the follicular infundibulum can be made based on clinical appearance with basal cell carcinoma, nevi, actinic keratosis, trichoepithelioma, seborrheic keratosis, warts. Benign tumors like tumor of the follicular infundibulum can be safely excised with a narrow margin making their clinical diagnosis important in order to avoid extensive surgery. Histopathological characteristics of the tumor of the follicular infundibulum are unique and provide an accurate diagnosis.

Prepontine Chordoma Presenting with MRI Features of an Epidermoid Cyst: Case Presentation and a Mini-Review

Background: We report a patient with a prepontine chordoma, presented with MRI features of an Epidermoid Cyst (EC) including hypointensity on T1-weighted image, hyperintensity on T2- weighted image, hyperintensity on DWI, and no contrast enhancement. We also presented a concise review of the relevant clinical data, since such cases were rarely reported in the English medical literature. Results & Conclulsion: To avoid delays in the management of patients with this locally aggressive tumor, clival chordoma should be taken into consideration as a differential diagnosis of tumors residing in close proximity to the clivus even in the absence of a bony erosion. Keywords: Chordoma, clivus, differential diagnosis, epidermoid cyst, MRI, prepontine.