FNA of parathyroid adenomas can cause a severe fibrotic process that typically involves adjacent tissues. This reaction dramatically increases the difficulty of surgical resection, often requiring microdissection techniques to preserve nerves and assure complete removal. The fibrosis can cause confusing histology mimicking malignancy. FNA of parathyroid adenomas should be avoided unless absolutely necessary.

Primary fallopian canal glomus tumor has been reported only once previously, although the occurrence of glomus body tissue in the fallopian canal was documented many years ago. Facial paresis as a presenting symptom of glomus tumors is well known, as is facial nerve invasion by glomus tumors. However, a primary fallopian canal glomus tumor that extends extratemporally to the pes anserinus is unusual. Although facial nerve grafting may be necessary for removal of some glomus jugulare tumors, the need for facial nerve grafting appears to be uniform in the patients with primary fallopian canal glomus tumors. The primary fallopian canal glomus tumors that we report did not involve the jugular fossa or the Jacobson's branch of the glossopharyngeal nerve. Both tumors did extend to the middle ear and mastoid and followed the facial nerve extratemporally. The latter features appear to typify primary fallopian canal glomus tumors.

Context. Leiomyosarcomas are rare malignant smooth muscle tumors that may arise in any organ or tissue that contains smooth muscle, commonly within the gastrointestinal tract. They are most often found in the stomach, large and small intestines, and retroperitoneum. Primary pancreatic leiomyosarcoma is extremely rare, and to the best of our knowledge only 30 cases have been reported in the world literature since 1951. Our case represents the first to have a clear origin from the main pancreatic duct. Case Report. This case was diagnosed in a large, tertiary care center in Tampa, Florida. Pertinent information was obtained from chart review and interdepartmental collaboration. A mass in the tail of the pancreas was identified with large pleomorphic and spindle-shaped cells. Immunohistochemistry for vimentin, smooth muscle actin, and desmin was positive. All remaining immunohistochemical markers performed were negative. The tumor clearly originated from the pancreatic duct wall, filled and expanded the duct lumen, and was covered with a layer of benign biliary epithelium. Conclusion. Leiomyosarcoma of the pancreas is an extremely rare malignancy with few reported cases in the literature. The prognosis is poor, and treatment consists of alleviating symptoms and pain management. To our knowledge, this represents the first reported case demonstrating clear origin of a leiomyosarcoma from the pancreatic duct.

Pregnancy complicated by sarcoma is a rare event, and metastasis to the placenta is exceptionally rare. Of reported malignancies involving the products of conception, only 8% are sarcomas. We report the first case of placental metastasis of an epithelioid sarcoma, an uncommon malignancy which most frequently affects young adults. In addition to the typical histological features and immunophenotypic profile expected of epithelioid sarcoma, this tumor also expressed human chorionic gonadotrophin (HCG). Although uncharacteristic, the production of HCG has been previously reported in other nontrophoblastic tumors. It may have contributed to the pathogenesis of the tumor metastatic to the placenta in this case.