Background/Objectives To describe the incidence of primary cutaneous squamous cell carcinoma in coastal NSW Australia. Methods The design is a case‐controlled study of reported cSCC from 2016 to 2019 within a defined region of coastal southern NSW. Participants include all reported pathological diagnoses of cSCC in patients greater than 20 years of age. The main outcome measures the incidence and relative risk of cSCC. Results The age‐adjusted incidence rate of primary cSCC was 856/105/year. Men over 60 years of age had an age‐adjusted incidence rate of 2875/106/year. Histologically diagnosed invasive SCC samples were included using SNOMED clinical term codes. Keratoacanthomas and SCC in situ SNOWMED codes were not included. SCC in situ results was found within the sample analysis and was offset by including one SCC per annum per person. Conclusions The rates of cSCC are far higher than previously reported and demand a reappraisal of our national management of this disease.

Carcinoma of the thyroglossal tract is a rare entity. Three patients with thyroglossal cyst carcinomas are presented and the features of the disease, as reported in the literature, are discussed. Epidemiologically, females are more often affected than males and the average age of the patients described lies in the fourth decade. The aetiology is obscure, although previous irradiation is a possible risk factor, Carcinoma of the thyroglossal tract should also be suspected in patients with irregular masses. Pre‐operative evaluation may include a thyroid scan and fine needle aspiration cytological examination of the cyst fluid. These tests, if positive, may alter the basic approach of the Sistrunk procedure to encompass thyroidectomy or wider margins. Neck dissection is preferred for cervical nodal disease. Adjuvant radiotherapy or radio‐iodine is added if indicated by the histology, and the patient receives suppressive thyroxine therapy thereafter.

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Brain metastasis from gastroesophageal adenocarcinomas (GOCs) is a rare but a devastating diagnosis. Human epidermal growth factor receptor 2 (HER2) is a prognostic and predictive biomarker in GOCs. The association of HER2 with GOC brain metastasis is not known. We performed a retrospective analysis of patients with GOCs with known HER2 status between January 2015 and November 2021. HER2 was assessed on either the primary tumour or metastasis by immunohistochemistry or in situ hybridization. The diagnosis of brain metastasis was made on standard imaging techniques in patients with symptoms or signs. HER2 results were available for 201 patients, with 34 patients (16.9%) HER2 positive. A total of 12 patients developed symptomatic brain metastasis from GOCs, of which 7 (58.3%) were HER2 positive. The development of symptomatic brain metastasis was significantly higher in the HER2-positive GOCs (OR8.26, 95%CI 2.09–35.60; p = 0.0009). There was no significant association of HER2 status and overall survival in patients with brain metastasis. Although the rate of brain metastasis remains low in GOCs, the incidence of symptomatic brain metastasis was significantly higher in patients with HER2-positive tumours.

adenosis (AMGA) then to ductal carcinoma has been documented in case reports and series. [1][2][3][4][5][6] We report here the first case of AMGA and residual invasive ductal carcinoma in the context of post-neoadjuvant chemotherapy. Case/Methods/Results: A 57-year-old female presented with a 70×55 mm left breast lump. Her medical history included hysterectomy and bilateral oophorectomy for dysfunctional uterine bleeding and fibroid uterus. A breast needle core biopsy showed invasive carcinoma of no special type with areas of high grade ductal carcinoma in situ. Focal areas of MGA were noted. The tumour was ER-, HER2-and PR+(30%). A left axillary lymph node fine needle aspirate showed cohesive fragments of malignant epithelial cells consistent with metastatic carcinoma. The patient was initially treated with neoadjuvant chemotherapy (adriamycin, cyclophosphamide and docetaxel). The breast lump reduced in size to 10 mm in maximum dimension. Following review with a breast surgeon she underwent a left total mastectomy and axillary clearance. Macroscopic examination of the breast specimen revealed an ill-defined nodular area measuring 80 mm in maximum dimension. Microscopically there was an atypical glandular proliferation with glands arranged haphazardly in fibrous stroma and fat. The glands showed a range of proliferative changes with areas of solid and cribriform architecture. These changes were consistent with a spectrum ranging from MGA to AMGA and ductal carcinoma in situ. The glands were devoid of a myoepithelial layer on immunoperoxidase stains. A 12 mm foci of invasive carcinoma in the form of nests and cords without tubule formation was also present which was similar to the initial core biopsy. All seventeen lymph nodes were negative for malignancy. Discussion: Microglandular glandular adenosis is an uncommon benign proliferative glandular lesion. Case studies have shown that carcinoma arises in cases of MGA 1,3-6 and there is molecular evidence of its progression to malignancy. 7 What is unclear are the effects of chemotherapy on MGA. We report here the first case of atypical MGA in the context of post-neoadjuvant chemotherapy.