Mucormycosis of the parotid with facial nerve palsy is an uncommon manifestation of this fungal infection. Mucor is an angioinvasive and angiodestructive organism which can cause fatal infection in patients with altered immunity like Diabetes Mellitus and Hematological malignancies. It is essential to include it in the differential diagnosis to avoid delays in the treatment.
Primary rhabdoid tumors are highly malignant, rare tumors occurring in the renal, extrarenal soft tissue or central nervous system. They have non-specific radiological features and present with several histological components that create a problem in differential diagnosis with other embryonal tumors. We report a rare case of malignant rhabdoid tumor of the retina that presented with clinical features like those of retinoblastoma.
A 63 year old homemaker with a history of diagnosed type II diabetes mellitus treated with oral hypoglycemics presented with complaints of breathlessness (mMRC grade II) that had been present for 3 months. Chest radiography showed a well-defined mass in the left upper and mid-zone with no mediastinal shift. Contrast-enhanced chest tomography (CECT) of the thorax showed a large well-defined mass with soft tissue density in the upper left hemithorax extending to the posterior mediastinum. It measured 11.3 mm × 9.1 mm × 12.7 mm and extended from the level of the thoracic inlet to the level of D7 with no evidence of chest wall invasion (Figure 1A). A CT-guided core needle biopsy of the mass was done and showed sheets of haphazardly arranged benign spindle cells showing positivity to beta catenin. EMA, TTF, SMA, and CD-34 were all negative. The differential diagnosis included chest wall fibromatosis and solitary fibrous tumors of the pleura.She underwent left posterolateral thoracotomy for resection of the mass. Intraoperatively, neural elements were attached to the mass but no chest wall invasion was noted. The resected mass (13 × 12 cm) contained tumor cells which were spindle-shaped with wavy nuclei and scanty eosinophilic cytoplasm with abundant myxoid stroma, a few tiny nests, and singly scattered ganglion cells (Figure 1B). They stained positive for synaptophysin. The histopathology confirmed the findings to be that of a ganglioneuroma. After surgical intervention, the left lung expanded.Ganglioneuromas are a distinct type of well-differentiated benign tumors comprised mainly of mature ganglion cells and schwann cells without the presence of a true capsule forming a mature spectrum of sympathetic neuroectodermal tumors [1]. The most commonly involved locations that ganglioneuromas affect include the adrenal medulla (35%), the extra-adrenal retroperitoneum (30-35%), and the posterior mediastinum (20%) [2]. Under macroscopic examination, an excised mass with an attached nerve trunk may facilitate the
Poorly differentiated thyroid carcinoma (PDTC) are unusual tumours which are rarely diagnosed with accuracy in cytology. Plasmacytoid morphology of the tumour cells can cause diagnostic difficulty as it mimics many other primary thyroid tumours: however it can be accurately diagnosed if certain fine morphological clues are identified while reporting.
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