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Key Clinical Message: Odontogenic carcinosarcoma, a rare and challenging diagnosis, was identified in a 60‐year‐old male through histopathology, revealing a biphasic neoplasm with malignant epithelial and mesenchymal components. Surgical resection is crucial for management, highlighting the importance of vigilant postoperative follow‐up to ensure early detection of any recurrence. One rare mixed malignant odontogenic tumor is odontogenic carcinosarcoma, which comprises malignant epithelial and mesenchymal components. Diagnosing odontogenic carcinosarcoma is challenging due to its rarity and atypical clinical presentation. This study reports a 60‐year‐old male patient who presented with a painless swelling on the right side of his face and experienced facial asymmetry for 6 months, ultimately diagnosed with odontogenic carcinosarcoma. A biphasic neoplasm with malignant alterations in both epithelial and mesenchymal components was identified upon histopathological examination. MRI imaging showed an expansile multilobulated lytic lesion with cortical erosion and extraosseous extension in the posterior region of the right mandibular body and ramus. Following contrast administration, homogeneous lesion enhancement was observed, with a few small non‐enhancing necrotic areas in central parts. The patient subsequently underwent a right hemi‐mandibulectomy with resection of adjacent soft tissues and neck dissection due to lymph node involvement. The resulting defect was reconstructed using a pectoralis major flap. No recurrence or metastasis was reported during the 6‐month follow‐up, reinforcing the positive results. This case highlights the importance of recognizing odontogenic carcinosarcoma and underscores the challenges in diagnosing and managing this rare tumor. Early identification and aggressive treatment can lead to positive outcomes, as evidenced by the absence of recurrence or metastasis in this patient during the follow‐up period. [ABSTRACT FROM AUTHOR]

Chondroid syringoma (CS) is a rare benign skin adnexal neoplasm. Its incidence is very low among all primary skin tumors. Diagnosing it clinically can be difficult as it closely resembles other benign salivary or adnexal neoplasms. Until now, only a few cases have been reported from the periorbital region. Clinically, it can be mistaken for epidermal cysts, but ectopic salivary glands are a close differential diagnosis. To diagnose it, a complete removal is usually required, followed by a histopathological examination. We present a unique case of a 45-year-old female patient with a CS in her right supraorbital ridge and review the pertinent literature. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Subcutaneous tumors of the head and neck resembling cutaneous mixed tumors may be misdiagnosed pleomorphic adenomas of salivary gland origin. Physicians should consider salivary mixed tumors in the differential diagnosis for suspected cutaneous tumors. [ABSTRACT FROM AUTHOR]

Background: Pure uterine serous carcinoma (p-USC) and mixed tumors with serous component (m-USC) are aggressive subtypes of endometrial cancer associated with high mortality rates. This retrospective study aimed to compare clinicopathologic features and outcomes of p-USC and m-USC in a single center. Methods: This study retrospectively reviewed patients diagnosed with USC at Peking University People's Hospital between 2008 and 2022. T-tests and chi-square tests were used to compare clinicopathological characteristics between p-USC and m-USC. Kaplan-Meier survival curve and Cox regression analysis were used to analyze the impact of clinical and pathological variables on OS and PFS. Results: Among the 91 patients who underwent surgery, 65.9% (n = 60) were p-USC, and 34.1% (n = 31) were m-USC. Patients with p-USC had earlier menopause (P = 0.0217), a lower rate of progesterone receptor(PR) expression (P < 0.001), and were more likely to have positive peritoneal cytology (P = 0.0464). After a median follow-up time of 40 months, 28 (46.7%) p-USC and 9 (29%) m-USC patients had progression disease, 18 (30%) and 8 (25.8%) patients died of their disease. 5-year PFSR were 51.2% and 75.3%, respectively, and 5-year OS rates were 66% and 67.4%. Kaplan-Meier survival analysis showed that p-USC was more likely to relapse than m-USC (P = 0.034), but there was no significant difference in OS. Cox regression analysis showed that lymph node metastasis and surgical approach were risk factors for OS, and myoinvasion depth ≥ 1/2 was an independent risk factor for PFS. Conclusions: p-USC was more likely to relapse than m-USC, but there was no significant difference in OS between the two subtypes. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Benign mixed salivary gland tumor is comprised of epithelial and myoepithelial cells and represents up to 80% of tumors of the parotid gland. It is relatively rare in the soft palate and in other minor salivary glands. Surgery is the standard care. Salivary gland tumors are relatively rare and morphologically diverse group of lesions. Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for approximately 80% of all major and minor salivary gland tumors. PA usually affects the parotid gland. Huge PA occurring in soft palate is extremely rare. Patients with these tumors are usually between at the age of 40 and 60 years. The tumors exhibit pleomorphic nature microscopically that may pose diagnostic challenges to pathologists as may confuse PA histopathologically with other salivary gland tumors. Surgery is the standard treatment. The purpose of writing this case study is to describe unusual case of a giant PA of the soft palate found in a 44‐year‐old male successfully managed at our facility. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma (PA) is the most common benign salivary gland tumor of which parotid gland involvement is the most common. PA may arise from minor salivary glands as well, however, PA is very rare in the sinonasal and nasopharyngeal areas. It usually affects middle aged females. They are frequently misdiagnosed due to high cellularity and myxoid stroma, leading to delay in diagnosis & further appropriate management. Here we present a case report of a female who presented with gradually progressive nasal obstruction, on examination found to have a nasal mass in right nasal cavity. Imaging was done and the nasal mass was excised. Histopathological report revealed a PA. Common tumor in an uncommon location: Pleomorphic adenoma of the nasal cavity – a case report. [ABSTRACT FROM AUTHOR]

Malignant mixed mullerian tumors (MMMT) are infrequent and highly malignant tumors. MMMTs, emerging from the uterine cervix, are very rare and to the best of our knowledge, there are no specific symptoms for the diagnosis of MMMTs whose early diagnosis is challenging. Almost all of them are diagnosed with pathological tests and reports. A 52-year-old post-menopause woman was referred to us, who suffered from postmenopausal bleeding from four months earlier. Upon pelvic examination, the position of the biopsy was identified in the anterior lip of the cervix. In former fractional dilatation and curettage, we found a pathology report with MMMT in the anterior lip of cervix. We performed a radical hysterectomy type II. In the permanent pathological report, MMMTs stage IBI was established. The patient was followed by chemoradiation. After 20 months, examination showed no evidence of recurrence. [ABSTRACT FROM AUTHOR]

Chondroid syringomas are rare, benign tumors originating from sweat glands occurring as singular lesions of the head and neck. This case report presents a patient in whom multiple chondroid syringoma lesions were found. Thus illuminating the possibility for such occurrences in the future of which physicians should be aware. [ABSTRACT FROM AUTHOR]

Chondroid syringoma (CS) represents the cutaneous counterpart of mixed tumor (pleomorphic adenoma) of salivary glands. Definitive diagnosis is made on histopathology and is based on the presence of characteristic epithelial and stromal components. We report a case of an atypical CS arising on the extremity of an elderly male patient. Histomorphologic features of necrosis and cellular atypia raised suspicion for malignant degeneration, an exceptionally rare circumstance in this context. To further support the diagnosis of malignancy, array comparative genomic hybridization was performed from both low and higher grade areas of the tumor. Both regions demonstrated multiple copy number gains and losses, with additional loss of q7p (TP53), loss of 19p, and loss of heterozygosity on16q demonstrated in the more atypical foci. To our knowledge, this is the first case description of malignant degeneration of a CS with correlative microarray analysis. The findings in this case may prove useful in confirming the diagnosis in future ambiguous cases. [ABSTRACT FROM AUTHOR]

Background: Mixed adenoneuroendocrine carcinoma of the gallbladder (gMANEC) is an extremely rare cancer. Most of the cases are reported in Asia, North America, and Europe, with no cases reported in Latin America; this is the first report for this region, and the 24th case reported worldwide. Case Report: A 68-year-old woman was referred to our department due to asthenia and moderate abdominal pain in the right upper quadrant for 6 months, with imaging examinations showing a solid heterogeneous expansive lesion in gallbladder topography and segment IV of the liver. The MRI displayed an expansive and heterogeneous lesion with inaccurate limits in the gallbladder affecting segment IVb of the liver, in addition to lymphadenopathy in the hepatic hilum. A cholecystectomy with resection of segments IV-B and V of the liver (radical cholecystectomy) and hepatic hilar lymphadenectomy were performed. Anatomopathological examination and immunohistochemistry confirmed a primary mixed adenoneuroendocrine carcinoma of the gallbladder. The patient received adjuvant chemotherapy and radiotherapy; however, after the patient reported experiencing low back pain, a CT was performed, revealing retroperitoneal metastasis, and the radiotherapy was interrupted. Currently, the patient has a stable disease, following a protocol of 5-Fluorouracil and somatostatin, and she reports having low back pain of low intensity. Conclusions: This is the 24th gMANEC case reported in the literature. The tumor was successfully resected; however, the patient presented retroperitoneal metastasis 6 months after surgery, despite combined adjuvant therapy. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The pleomorphic adenoma is the most common benign mixed tumor of salivary glands, rarely found in the nasal cavity. Its typical clinical presentation is a unilateral nasal obstruction associated with an epistaxis and a presence of a polypoid, smooth, lobulated, and firm mass in the nasal fossa. It is diagnosed by anatomopathological examination, and the treatment of choice is surgical with tumor resection, keeping a safety margin. CASE REPORT: The case reported is a female 49-year-old patient, diagnosed with a nasal pleomorphic adenoma that was surgically treated. CONCLUSION: The importance of the case reported lies in the rarity of the pleomorphic adenoma located in this area. Therefore, this is a differential diagnosis that must be remembered for nasal tumors. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the clinical and pathological characteristics of mixed endometrial carcinoma (MEC). Materials and Methods: The clinical and pathological records of the 29 MEC patients, who were operated on and regularly followed up in the clinic between January 2000 and December 2019, were reviewed. Clinicpathologic features and survival in the MEC group (n=29) were compared to pure serous (n=42) and pure clear cell adenocarcinomas (n=13). Clinical features, operation characteristics, pathological findings, myometrial invasion degree (MI), lymph node involvement (LNI), lymphovascular space invasion (LVSI), adjuvant therapies, and follow-up data of the patients and their effects on survival were investigated. Results: Eighteen of the cases had endometrioid + serous, 7 had endometrioid + clear, 3 had endometrioid + serous, and 1 had clear + serous histopathology. Laparoscopic surgery was performed in 8 of the cases (27.6%) in the mixed group. Stage, the rate of LVSI, LNI, MI ≥50%, and omental metastasis were similar among the groups. There were no significant differences in the rates of receiving adjuvant therapy among the groups. Overall survive (OS) was similar among the groups. Conclusion: MECs are tumors that can be difficult to diagnose and manage. There was no difference between MEC and pure serous carcinoma (SC) and pure clear cell carcinoma (CC) in terms of clinicopathological features and prognosis. In addition to histopathological features, revealing and evaluating their molecular properties will help us to better understand this group of tumors. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Testicular mixed germ cell tumors (GCTs) represent a spectrum of malignancies that differ in terms of histopathology, clinical complications, and overall outcome. A variety of aggressive combinations containing different histological types have been described among such testicular tumors. However, a histopathology characterized by a combination of teratoma and choriocarcinoma, as seen in this case, in which the teratomatous component shows a secondary transformation to chondrosarcoma, is considered very rare. Case Report: The patient presented with progressive hemoptysis and dyspnea secondary to bilateral pulmonary cannon-ball lesions indicative of a metastatic process. His workup was remarkable for primary testicular cancer complicated by liver metastasis and very high levels of B-HCG at more than 175 000 mlU/ml. He deteriorated quickly with no improvement following the first cycle of Etoposide/Cisplatin (EP) chemotherapy regimen and died 15 days after starting cancer treatment. Such non-seminomatous GCTs with extrapulmonary visceral metastasis associated with very high tumor markers are deemed poor risk based on the International Germ Cell Cancer Collaborative Group (IGCCCG) criteria, with a reported 5-year overall survival rate reaching up to 73%. Conclusions: This case is considered unique in terms of rapid clinical deterioration and lack of improvement following the standard EP chemotherapy regimen. This unusual dramatic presentation should draw attention to the possible association between the aggressiveness of the disease and its very rare histopathology. [ABSTRACT FROM AUTHOR]

Background and Aim: Recent study showed that early gastric cancer (EGC) with Lauren mixed‐type (MT) histology is associated with worse prognosis. We aimed to evaluate the clinicopathologic features and prognostic significance of Lauren MT‐EGCs that meets the criteria for endoscopic submucosal dissection (ESD). Methods: We reviewed 2665 patients with EGC who underwent surgery between 2010 and 2015. The clinicopathologic features and invasiveness including lymph node metastasis (LNM) and lymphovascular invasion (LVI) of MT‐EGC were compared with those of intestinal type and diffuse type by Lauren histology. Results: Among 2665 patients, EGCs in 241 (9%) patients were classified as MT. Tumor size was larger and depth of invasion was greater than other histology. Among patients with MT‐EGC, 16.6% (40/241) showed LNM and 22.8% (55/241) showed lymphatic invasion, which were significantly higher than that of patients with other Lauren types (8.2% and 15.3% in intestinal type and 9.1% and 8.7% in diffuse type, P < 0.001). This finding remained significant even after adjusting for depth of invasion. However, when we analyzed the patient groups who met the absolute or expanded criteria of ESD, no significant difference was observed in the rates of LNM or LVI or cancer mortality by Lauren classification. Conclusion: Mixed‐type early gastric cancer (MT‐EGC) exhibited larger tumor size, greater depth of invasion, and higher risk of LNM and LVI. However, among the patients who met the absolute or expanded criteria of ESD, no significant difference was observed in LNM, LVI, and gastric cancer mortality risk. [ABSTRACT FROM AUTHOR]

Mixed adenoneuroendocrine carcinomas are rare and usually occur in the gastrointestinal tract. Although there have been several investigations regarding their developmental mechanism, the molecular origin of these tumors remains unclear. In this article, we present an exceedingly rare case of a mixed tumor of the urinary bladder with an adenocarcinomatous and a neuroendocrine component and a concomitant urothelial carcinoma in situ (CIS). Due to this extraordinary combination of tumor components, our goal was to extensively examine the 3 tumor components with regard to a representable common origin. Therefore, a comprehensive immunohistochemical analysis and review of the literature was performed. Besides expected outcome, our examination also revealed surprising staining results. Urothelial CIS, like the adenocarcinomatous component, showed strong staining for CDX2. In addition, parts of the adenocarcinoma were positive for synaptophysin like the neuroendocrine tumor component. All 3 components showed a significant overexpression of p53 and a moderate to strong membranous and cytoplasmatic staining for β-catenin. To our knowledge, we are the first to describe a case of a mixed tumor of the urinary bladder with an adenocarcinomatous and a neuroendocrine component and a concomitant CIS. The components share striking molecular features that argue for a common clonal origin and a development of the invasive tumor via the urothelial precursor lesion. [ABSTRACT FROM AUTHOR]

Mixed carcinomas in the esophagus are highly uncommon neoplasms that represent a diagnostic challenge on small tissue biopsies. We present a case of a primary mixed sarcomatoid–small cell carcinoma of the esophagus that was diagnosed after repeat sampling of the lesion. The components were morphologically distinct and could be further classified by immunohistochemistry. Next-generation sequencing identified mutations in PIK3CA and CDKN2A. The small cell component morphology was also identified in brain metastasis. [ABSTRACT FROM AUTHOR]

Die primären hepatobiliären Malignome sind das hepatozelluläre Karzinom, das Cholangiokarzinom und das seltene Hepatozellulär-Cholangiokarzinom (Mischtumor). Je nach Entität unterscheiden sich die Indikationen und Erfolgsaussichten einer Lebertransplantation erheblich. Die Behandlung dieser Tumoren wird zudem häufig durch eine zugrunde liegende Lebererkrankung kompliziert. Das Ziel dieser Übersichtsarbeit ist es, Transplantationsindikation, Bridging-Behandlungen und transplantationsspezifische Aspekte sowie die Regeln zur Organvergabe für jede Erkrankung im Einzelnen darzustellen. [ABSTRACT FROM AUTHOR]

Calcifying nested stromal-epithelial tumor (CNSET) of the liver is an extremely rare primary tumor of nonhepatic and non-biliary origins which generally affects children and young adults, mainly women. We report a case of 28-year-old woman with a history of oral contraceptive consumption for 9 years, who underwent surgery for a large right hepatic mass that proved to be a CNSET, according to the pathology report. Postoperatively the patient had a slow recovery and after discharge the patient was sent to the oncology department where she underwent several treatment cycles with Imatinib. The case report documented all the clinical and histopathological features necessary for diagnosis of CNSET. CNSET of liver should always be considered and included in the differential diagnosis of hepatic tumors especially if the patient is a young woman with a long history of oral contraceptive consumption and an abdominal palpable mass. [ABSTRACT FROM AUTHOR]

Mixed tumor of the vagina is a rare benign tumor containing both epithelial and mesenchymal components. The authors report the case of a 35-year-old woman who presented with a painless mass that had descended from the vagina in the last six months. Physical examination showed the presence of a solitary, non-tender nodule that was 3×3×2 cm in size and seemed to originate from the posterior wall of the lower vagina. The tumor was removed and pathologically examined. The findings were indicative of a mixed tumor of the vagina, and were in agreement with previous cases. No recurrence or progression occurred during the ten-month follow-up. As this tumor shares common features with some other tumors, its differential diagnosis is very important. Moreover, due to the rarity of this disease, gynecologists and pathologists need to familiarize themselves with the features in order to avoid a misdiagnosis. [ABSTRACT FROM AUTHOR]

Benign cutaneous mixed tumor (chondroid syringoma) is the cutaneous counterpart of the benign mixed tumor (pleomorphic adenoma) of salivary glands, consisting of both epithelial and mesenchymal elements. The incidence of cutaneous mixed tumor is rare, composing <0.01% of all primary skin tumors. Herein, we report a case of malignant mixed tumor which recurred in the right thumb 20 years after the reported initial diagnosis of a benign mixed tumor at this site. Histologically, the lesion consisted of highly atypical and infiltrative cells in cords and ductal structures, with an adjacent focus of residual benign mixed tumor present. Perineural invasion of multiple dermal and subcutaneous nerves was also seen. Immunohistochemical staining was strongly and diffusely positive for CK5/6 and p63, with patchy positive S100 and CK7 staining. Wide excision was performed, with no evidence of recurrence or metastasis 5 years later. [ABSTRACT FROM AUTHOR]

Background Synchronous tumors of the cerebellopontine angle (CPA) are very rare and inconsistently described. We present 2 cases of contiguous vestibular schwannoma (VS) and meningioma and a systematic literature review of all multiple CPA tumors. Methods Retrospective chart review and systematic literature review were performed. Results A 64-year-old woman and a 42-year-old man presented with symptoms referable to the CPA. Magnetic resonance imaging in both patients revealed 2 separate contiguous tumors. Retrosigmoid craniotomy and tumor removal in each case confirmed VS and meningioma. Systematic literature review identified 42 previous English-language publications describing 46 patients with multiple CPA tumors. Based on Frassanito criteria, there were 4 concomitant tumors (8%), 16 contiguous tumors (33%), 3 collision tumors (6%), 13 mixed tumors (27%), and 11 tumor-to-tumor metastases (23%). Extent of resection was gross total in 16 cases and subtotal in 16 cases (50% each). Unfavorable House-Brackmann grade III–VI function was documented in 27% overall and in 33% of patients with VS and meningioma, a marked increase from the observed range in isolated VS. Conclusions Multiple CPA tumors are rare, heterogeneous lesions with a marked predisposition toward poor facial nerve outcomes, potentially attributable to a paracrine mechanism that simultaneously drives multiple tumor growth and increases invasiveness or adhesiveness at the facial nerve–tumor interface. Preceding nomenclature has been confounding and inconsistent; we recommend classifying all multiple CPA tumors as “synchronous tumors,” with “schwannoma with meningothelial hyperplasia” or “tumor-to-tumor metastases” reserved for rare, specific circumstances. [ABSTRACT FROM AUTHOR]

Myoepithelial tumors of the soft tissues represent a rare group of neoplasms that vary in their clinical behavior, pathologic features and genetics. They are histopathologically typified by a myoepithelial immunohistochemical phenotype, of expression of one or more epithelial markers, S100 protein and smooth muscle actin. Because of their rarity and occurrence over a wide age range and at a variety of anatomic sites, they can be difficult to diagnose due to the lack of familiarity by physicians, which is compounded by their spectrum of histologic features and morphologic overlap with several other neoplasms. Recent genetic insights have aided classification, and it is increasingly understood that soft tissue myoepithelial neoplasms can be stratified into two distinct morphologic and genetic subgroups. We describe a case of a 44-year-old man who was diagnosed with a primary myoepithelial neoplasm of the paracecal mesentery, which showed aggressive local recurrence after four years. The tumor was composed of cords of ovoid cells within chondromyxoid stroma, and displayed a characteristic pancytokeratin, S100 protein and smooth muscle actin-positive myoepithelial immunoprofile. Primary myoepithelioma has not been previously described at this site, and this case highlights this varied family of tumors, emphasizes the need to consider myoepithelial tumor in the differential diagnoses of carcinoma variants occurring in the bowel or mesentery, and also adds to the number of reported myoepithelial neoplasms showing markedly aggressive behavior. [ABSTRACT FROM AUTHOR]

Mixed serous neuroendocrine neoplasms are extremely rare tumors that are usually seen in female patients and are often associated with von Hippel Lindau (VHL) disease. We describe the case of a 38-year-old male who presented with complaints of anorexia, weight loss, and abdominal pain. CT abdomen showed a mass in the head of the pancreas, multiple small nodules in the body of pancreas, and bilateral adrenal masses. Fine needle aspiration cytology (FNAC) from the mass showed features of a neuroendocrine tumor, with many of the cells demonstrating abundant clear cytoplasm. Histopathological examination of the pancreaticoduodenectomy specimen showed a mixed serous neuroendocrine neoplasm with two components viz. serous cystadenoma and neuroendocrine tumor (NET) World Health Organization (WHO) grade 2. In addition, he was diagnosed to have bilateral pheochromocytomas and a paraganglioma. The synchronicity of these tumors suggested the possibility of VHL disease. Thus, identification of a NET with clear cells or of a mixed serous neuroendocrine neoplasm should raise suspicion of VHL disease. In a mixed tumor, FNAC may identify only one of the two components. Thorough processing of all pancreatic serous tumors for pathological examination is recommended, as NET may occur as a small nodule within the serous cystadenoma. [ABSTRACT FROM AUTHOR]

Introduction: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is rare. This study investigated the clinicopathological features of cHCC-CC and compared the postresection survival outcomes of cHCC-CC, hepatocellular carcinoma (HCC), and intrahepatic cholangiocarcinoma (IHC).Methods: Between January 2000 and September 2012, 53 patients with cHCC-CC underwent tumor resection, accounting for 1.1 % of surgeries for primary liver malignancies. Control groups included patients with HCC (n = 1452) and IHC (n = 149) who underwent R0 resection of stage I/II tumors ≤5 cm.Results: Mean tumor diameter of cHCC-CC group was 5.5 ± 2.9 cm, and single tumor was identified in 50. Pathological classification included combined (n = 41), mixed (n = 11), and double (n = 1) tumors. The 1-, 3-, 5-, and 10-year tumor recurrence rates were 60.8, 71.8, 80.7, and 80.7 %, respectively. The 1-, 3-, 5-, and 10-year overall survival rates were 73.3, 35.6, 30.5, and 11.1 %, respectively. Tumor recurrence and patient survival did not differ significantly according to AJCC tumor staging and histological type (all p ≥ 0.2). Tumor recurrence rates did not differ significantly between the cHCC-CC, HCC, and IHC groups (p = 0.43), whereas differences in survival rates were significant (p = 0.000), with a median survival after tumor recurrence of 8, 51, and 6 months, respectively (p = 0.000).Conclusions: Patients with cHCC-CC showed similar recurrence rates to those of control patients with HCC and IHC, whereas their survival outcomes were worse than those of control HCC patients because of poor responses to recurrence treatment. Further evaluation of differences in tumor characteristics and tumor biology is necessary to accurately predict the prognosis of patients with cHCC-CC. [ABSTRACT FROM AUTHOR]

Spindle cell epitheliomas of the vagina are rare benign tumors of uncertain histogenesis. It has been hypothesized that they originate from a pluripotent cell population. Here, we report 2 cases of spindle cell epitheliomas of the vagina. Both patients presented with a painless vaginal nodule. The resected lesions were solid, well circumscribed, and composed of a proliferation of epithelioid or epithelial cells admixed with spindle cells without atypia. The 2 cellular populations expressed epithelial and mesenchymal markers. Based on these morphologic and immunohistochemical findings, a diagnosis of spindle cell epithelioma was rendered in both cases. Furthermore, we describe for the first time the expression of WT-1 (Wilms’ tumor protein 1) and calretinin in addition to the previously defined immunohistochemical profile. [ABSTRACT FROM AUTHOR]

We present a rare case of a gastric mixed adenoneuroendocrine tumor and review the related English literature. A 77-year-old Caucasian woman was admitted to our department with nausea, anorexia, weight loss, and anemia. Esophagogastroduodenoscopy showed a large (>7 cm) ulcerative mass in the greater curvature of the stomach. Biopsy showed the presence of an adenocarcinoma with moderate differentiation. The patient underwent D2 subtotal gastrectomy. Histopathological analysis revealed a diagnosis of mixed gastric adenoneuroendocrine carcinoma. The post-operative course was uneventful, and at the 6-month follow-up, the patient was alive without evidence of recurrence. Our review of the English literature suggested that such cases are most often reported from eastern countries. Multimodal treatment should be the aim for these patients because of the neuroendocrine component of the tumor. [ABSTRACT FROM AUTHOR]

Introduction: Nasal neoplasms are very rare. The most commonly observed tumors in the nasal cavity are epithelial papillomas, angiomas, transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma. The pleomorphic adenoma belongs to the group of tumors, being the most common benign glandular tumor originating in the head and neck, however, they are less frequent in the nasal cavity. The clinical presentation of patients with pleomorphic adenoma of the nasal septum is unilateral nasal obstruction, epistaxis and a painless mass in the nasal cavity. Objectives: Due to the rarity of the clinical presentation of pleomorphic adenoma in this location, the authors describe a case of nasal pleomorphic adenoma in a 62-year-old female patient, where they report clinical findings, diagnostic criteria, treatment, prognosis and review. of literature. Summary Report: female patient, 62 years old. A lesion in the right nasal cavity in the anterior part of the nasal septum has been reported, with intermittent local pain. He denied epistaxis, trauma, nasal obstruction and olfactory alterations. The condition started 1 year after the consultation, with a progressive perception of lesion enlargement, undergoing two surgical procedures, the second at the expense of suspected recurrence of the lesion. Conclusion: The rarity of the pleomorphic adenoma with this location and the success of the surgical treatment motivated us to prepare this case report. It is a benign neoplasm that should be part of the differential diagnoses of nasal tumors associated with epistaxis and nasal obstruction. [ABSTRACT FROM AUTHOR]

Background: Tumors that arise in the temporal lobes of infants and spread to the neural system are limited to several diagnoses. Herein, we present an infantile case of a temporal tumor showing neuronal and glial differentiation. Case presentation: The patient was a 9-month-old boy with low body weight due to intrauterine growth retardation. At 9 months after birth, he presented partial seizures. Computed tomography scanning revealed a mass (35 * 40 mm) in the left temporal lobe. Isointensity was noted on magnetic resonance T1-weighted images and fluid attenuation inversion recovery images. The tumor was heterogeneously enhanced with gadolinium. Positron emission tomography showed high methionine uptake in the tumor. During surgery, the tumor, which was elastic and soft and bled easily, was gross totally resected. A moderately clear boundary was noted between the tumor and normal brain parenchyma. Histologically, the tumor mainly comprised a ganglioglioma-like portion and short spindle cells at different densities. The former was immunohistochemically positive for some kinds of neuronal markers including synaptophysin. The spindle cells were positive for glial fibrillary acidic protein, but desmoplasia was not observed. Discussion: The tumor contained both neuronal and glial elements; the former were the main constituents of the tumor and included several ganglion-like cells. Because neuronal elements gradually transited to glial cells, a mixed neuronal-glial tumor was diagnosed. [ABSTRACT FROM AUTHOR]

Abstract: The so-called mixed tumors occur in a variety of sites throughout the body. While most cases are encountered in the salivary glands, several cases have been described in the female genital tract. A variety of monikers have been applied to this lesion including “spindle cell epithelioma.” As in other locations, the vaginal spindle cell epithelioma (VSE) consists of a proliferation of both epithelial and mesenchymal components. Based on our extensive review of the literature, we present the 53rd reported case of VSE. More significantly, we present the most up-to-date review of this lesion, including its immunohistochemical and electron microscopic features. We also review the theories pertaining to its histogenesis incorporating current embryologic data, which together suggest a Müllerian derivation. [Copyright &y& Elsevier]

Background The facial nerve should be sacrificed only if there is strong indication. Sometimes it is possible to sacrifice only part of the facial nerve and this termed "semiconservative parotidectomy". The commonest operation performed is superficial conservative parotidectomy, which is removal of the parotid superficial to the facial nerve with nerve preservation. A total conservative parotidectomy was performed only if clearly indicated by the pathological condition, since the complete freeing of the facial nerve in this operation increases the incidence of nerve paralysis. Objective To demonstrate under what circumstances is the surgeon likely to be called upon to sacrifice the facial nerve deliberately, and mentioning what be done to reduce the risk of functional facial paralysis following conservative parotidectomy. Methods The material comprises 30 cases of parotidectomy of all types. We analysed the incidence and degree of functional facial paralysis following conservative parotidectomy and also we reported some experimental work attempting to elucidate its etiology. We classify the degree of facial nerve paralysis to grade I, absent or slight, grade II moderate, grade III complete. Results We did superficial parotidectomies for 22 cases, 19 had grade I, two had grade II and only one had grade III facial nerve paralysis. Conservative total parotidectomies done for 2 cases, one had grade I and one had grade III facial nerve paralysis. Semiconservative parotidectomies done for 4 cases all had grade I facial nerve paralysis and lastly radical parotidectomies done for 2 cases, the results had grade III for two cases facial nerve paralysis. Conclusion To reduce the incidence of facial paralysis after conservative parotidectomy: carrying total parotidectomy only when clearly demanded by pathological condition by avoiding washing out the wound, and by measures designed to preserve the blood supply of the trunk of the facial nerve. The present study support that ischemia is the principal factor in post-parotidectomy functional facial paralysis. [ABSTRACT FROM AUTHOR]

Abstract: Mixed tumors are uncommonly observed in the musculoskeletal system, where they form a common spectrum with a myoepithelioma and a parachordoma. Herein, we present a rare case of a mixed tumor/myoepithelioma arising in the iliac bone of a young adult male who presented with swelling in his right hip. Radiological imaging disclosed a large, intraosseous, lytic, heterogenous mass with a soft tissue component. Biopsy and subsequent tumor resection showed an 18cm sized tumor involving the iliac bone and soft tissues and comprising polygonal and spindly cells, arranged in cords and aggregates, embedded in a myxohyaline stroma with osteochondroid differentiation. Tumor cells exhibited mild nuclear variation, rare mitotic figures, focal cytoplasmic clearing, and prominent squamous differentiation. On immunohistochemistry (IHC), tumor cells were diffusely positive for S100-P, EMA, CK5/6, p63, GFAP, calponin, and focally positive for CK/MNF116, but negative for Brachyury/T. Diagnosis of a myoepithelioma/mixed tumor was offered. Further, cytogenetic analysis revealed lack of EWSR1 gene rearrangement and showed clonal trisomies of 11, 15, 17 with del (16q) and del (22q11). The present case is a rare documentation of a myoepithelioma in the appendicular bones and the second such case identified in the iliac bone. IHC and cytogenetic findings supported a myoepithelial cell origin, and reinforced its relationship with a parachordoma and its distinction from mixed salivary gland tumors, a chordoma, and an extraskeletal myxoid chondrosarcoma that form its differential diagnoses. [Copyright &y& Elsevier]

Background: Sweat gland mixed tumors (SGMT) are considered a rare neoplasm in dogs. This tumor present clinically as nodules large, well defined and looks similar to other skin tumors. The diagnosis of cancer is based on aspiration cytology and histopathology. Due to the rarity of the tumor, absence of appropriate criteria for analysis and divergence in the diagnosis, identification and characterization of the SGMT can be considered a challenge for veterinary medicine. Thus, it becomes necessary to adopt standardized criteria for the diagnosis and understanding of the biological behavior of these tumors. This paper aims to describe the characteristics of a histomorphological and immunophenotypic SGMT canine. Case: Microscopic examination showed a measuring 6,8x11,0x6,4cm surface, with subcutaneous mass with firm consistency, solid look and ulcerated. Presented to the court rangência containing well-defined multilobulated mass of soft consistency, solid look, color usually brownish with whitish spots. In some lobes the content presented was friable. On microscopic examination showed proliferation of epithelial cells forming glands or clefts lined by cubical epithelium and mesenchymal component characterized by a proliferation of spindle cells, which sometimes had starring appearance. In addition, there was also formation of cartilage and bone necrosis and mixed inflammatory infiltrate discreet. The immunohistochemical analysis revealed intense and diffuse cytoplasmic staining (++) for CK AE1/AE3 antibody in ductal epithelial cells, reactivity for p63 in myoepithelial cells and periductal myoepithelial cells of weak in myxoid matrix. The cell proliferation rate was low. Histopathology demonstrated a tumor mass composed by an epithelial component with glandular formation lined by cuboidal epithelium and a mesenchymal component characterized by a spindle cell proliferation. Cells with a stellate appearance, cartilage and bone formation, necrosis and mild mixed inflammatory infiltrate were also observed. Discussion: The SGMT is a rare neoplasm in dogs. These tumors usually present myoepithelial proliferation with formation of chondroid metaplasia, and in some cases, osteoid. Usually, a set of molecular changes at different levels of cell regulation is responsible for the formation of tumors. Cancers of the skin appendages comprise a broad spectrum of benign and malignant tumors that exhibit morphological differentiation. Studies using immunohistochemical markers for components of the cytoskeleton are extremely useful in the diagnosis of these neoplasms. In evaluating the expression of cytokeratin AE1/AE3 positivity was observed cytoplasmic components of ductal epithelial apocrine glands. The expression of p63 for myoepithelial cells in the periductal areas was observed in this study demonstrating preservation of the basal layer, thus confirming the benign nature of the neoplasm. Furthermore, immunostaining for the protein helped disclosure of myoepithelial cells forming the myxoid matrix. The evaluation of proliferative activity of SGMT for Ki67 proved to be weak. Low proliferative index are related to well-differentiated cancer cells and better prognosis in these cases. Before we confirmed the histomorphological diagnosis of mixed tumor of sweat gland. Immunohistochemical markers such as CK AE1/AE3, p63 and Ki67 may aid in the diagnosis of cancer, helping in understanding the biological behavior of this tumor. [ABSTRACT FROM AUTHOR]

Abstract: Myoepithelial soft tissue tumors represent less than 1% of soft tissue tumors. Diagnosis is based on histology, but clinical and radiological features can orient the practitioner. Myoepithelial tumors do not involve the bone as they are not malignant. In this article, we report a case of a myoepithelioma occuring on the volar aspect of the right ring finger involving the first phalanx. [Copyright &y& Elsevier]

Leptomeningeal dissemination of an oligodendroglioma is rarely reported in the neurosurgical literature, especially in cases with a classical 1p19q deletion. The authors describe a case wherein a 1p19q deletion in a disseminated tumor with mixed immunohistochemical features of oligodendroglioma and neurocytoma was encountered and treated. Stereotactic right frontal craniotomy was undertaken for obtaining definitive histological diagnosis. The results revealed a neuroectodermal neoplasm with histologic and immunohistochemical features of oligodendroglioma and neurocytoma. FISH analysis confirmed classical 1p19q deletion. The patient was treated postoperatively with chemotherapy and radiation therapy. He showed good clinical response and remains alive 16 months after diagnosis. [ABSTRACT FROM AUTHOR]

A 10-year-old female miniature poodle had a mass in its carpal joint of the left forelimb. The tumor was divided into small multiple lobules by delicate connective tissues, and necroses were found in some of the central lobules. In some connective stromal areas, chondroid and osteoid tissues were formed. The tumor cells were similar to the structure of apocrine gland epithelial cells with apical blebs resembling apocrine secretion and eosinophilic secretary materials within the luminal space, and spindle cells were sometimes found in the basal area of the glandular structure. In some areas, tumor cells invaded in the blood vessels, bone and bone marrow. Immunohistochemically, the tumor cells forming tubulo-acinar to solid structures were intensely positive for cytokeratin and keratin K8/K18, and the spindle cells were positive for vimentin and alpha-smooth muscle actin. This case was diagnosed as a malignant mixed apocrine gland tumor with metastases to the bone and bone marrow. [ABSTRACT FROM AUTHOR]

Abstract: Chondroid syringoma of skin is a rare type of soft tissue tumor originating from the sweat glands. We report a documented case of giant chondroid syringoma occurring in the upper arm, which developed over the course of one year. The radiographic, sonographic, MR imaging, gross pathologic, and histologic findings of the tumor are described. Because the clinical suggestion of such a tumor was low, we present the imaging appearances of chondroid syringoma that could be used to make a presumptive diagnosis, and discuss the many entertained differential diagnostic possibilities. [Copyright &y& Elsevier]

Summary: Pleomorphic adenoma represents a most common benign neoplasm of major salivary glands. Most occurrences of this benign tumor in the submandibular gland have been treated surgically without difficulty via transcervical approach. However, a few clinical problems in the transcervical approach have been mentioned, such as nerve injury or aesthetic scaring. In this study, we introduced the intraoral approach for the removal of the submandibular mixed tumor. In total, 12 cases of pleomorphic adenoma of the submandibular gland were treated via intraoral approach. The surgical technique and morbidity associated with this approach were reviewed. During surgery the tumor and submandibular gland are easily dissected from surrounding tissue and removed through intraoral incision. Early postoperative morbidity developed, such as a temporary paresis of lingual nerve and a temporary limitation of tongue movement, but recovered within a short-term period. No late complaints appeared, such as neurological discomforts. All patients were followed up for the recurrence of the tumor from 20 months to 10 years. One patient showed a tumor recurrence at the early stage of this approach. We propose that the benign mixed tumor of the submandibular gland could be removed easily via intraoral route without an external scar or nerve injury. [Copyright &y& Elsevier]

Abstract: Pleomorphic adenoma (PA) rarely occurs in the external auditory canal (EAC). A case of PA complicated with chronic otitis media is reported. The patient was a 36-year-old male who began to experience a hearing loss in the left ear in 1996. He sought medical attention only after ear pain developed in April 2003. At the initial examination, a tumor covered by smooth skin was seen filling the left EAC. Pure-tone audiometry showed residual hearing at low frequencies and scale-out across middle to high frequency range. The CT and MRI findings led to a diagnosis of a tumor of the left EAC complicated with an inflammatory middle-ear lesion. The tumor was excised en bloc with the overlying skin, and tympanoplasty was performed. The pathological diagnosis was PA of the left EAC and inflammatory granuloma of the middle ear. [Copyright &y& Elsevier]

Malignant myoepithelioma of soft tissue is extremely rare. Presented herein is a case arising in a 17-year-old man. The tumor was initially noticed as a painless deep soft-tissue mass in the right forearm when the patient was aged 3 years. Thereafter, it grew without remarkable symptoms, such as pain or tenderness, until his visit to the hospital because of swelling of his forearm when he was 17 years old. An excisional biopsy specimen disclosed an invasive tumor exhibiting a lobular architecture. The tumor cells were arranged in a reticular and/or trabecular fashion with a myxoid background, and nuclear atypia was evident. Mitoses and tumor necrosis were also observed. Immunohistochemically, S-100 protein and epithelial markers were diffusely positive. Faint intercellular junctions and basal laminae were identified by electronmicroscopy. On the basis of these findings, the tumor was diagnosed as a malignant myoepithelioma of soft tissue. Six months later, multiple lung metastases were observed, and an open biopsy revealed a neoplasm displaying the same histological feature as the previously biopsied specimens. The patient died of his disease 18 months after the lung biopsy. Malignant myoepithelioma shoud be kept in mind in diagnosis of deep soft-tissue tumors with epithelioid features. [ABSTRACT FROM AUTHOR]

A bilateral ovarian tumor composed of mixed Brenner tumor and struma ovarii in the right ovary and mature cystic teratoma in the left ovary, is described. Mixed Brenner tumor and struma ovarii is rare; eight cases are reviewed. In this case, in addition to the typical Brenner tumor and struma ovarii, some nests composed of both Brenner tumor and struma ovarii in one nest were found in the right ovarian tumor. Immunohistochemically, the struma ovarii is stained for thyroglobulin, and Brenner nests showed various degrees of positive stain for thyroglobulin, which is a specific finding. Brenner tumor, in this case, may produce thyroglobulin or have a receptor to thyroglobulin or analog of thyroglobulin. The origin of mixed Brenner tumor and struma ovarii may be germ cell, as described in some literature, or the Brenner tumor may be of a metaplastic nature, although the Brenner tumor is fourfold the size of struma ovarii in the case presented. [ABSTRACT FROM AUTHOR]

The histologic diagnosis of myoepithelioma is often problematic. We here describe a case of myoepithelioma, composed exclusively of neoplastic myoepithelial cells, in the vulva of a 52-year-old female. The vulva is a very rare site for this neoplasm. A subcutaneous tumor measuring 3.0×2.5×2.0 cm displayed a multinodular growth pattern. Histologically, it was characterized by epithelioid, trabecular, cord, solid, or reticular arrangements of tumor cells and markedly hyalinized stroma. The tumor cells were large and polygonal with eccentrically located round to oval nuclei with prominent nucleoli and eosinophilic cytoplasm. Some cells had clear cytoplasm. Moderate cellular atypia was seen and there were 4 mitotic figures per 10 high-power fields. No ductal architecture was found and there were no areas of chondroid or osseous differentiation. There was no destructive invasive growth. Immunohistochemically the tumor was positive for vimentin, epithelial membrane antigen, wide keratin, alpha-smooth muscle actin, S-100 protein, and glial fibrillary acidic protein. The patient was well and free of disease at 6 months. This neoplasm should be distinguished from other epithelial and mesenchymal neoplasms as it shows a different clinical behavior. [ABSTRACT FROM AUTHOR]

Mixed tumors of the salivary gland and skin are relatively common but are quite rare in soft tissue. It is believed that, as in the salivary gland form, most of these lesions are benign, but that a small subset behave in an aggressive fashion. We report here a patient with recurrent mixed tumor of soft tissue with infiltrative growth. The primary tumor arose in deep subfascial soft tissue of the right lower leg and was adjacent to the surface of the fibula. An open biopsy and complete resection were performed. Upon histological examination of the resected specimen, neoplastic cell infiltration at the tumor/soft tissue interface was not obvious; local recurrence, however, was observed 1 year later. The patient was treated with wide resection. Histological examination confirmed that the recurrent tumor with an extensive chondroid area invaded the osseous tissue of the fibula. At present, 1 year after the second resection surgery, there is no evidence of disease. [ABSTRACT FROM AUTHOR]

To elucidate the roles of CD34-positive stromal cells and alpha-smooth muscle actin-positive stromal cells at the tumor border of skin sweat gland neoplasms, we examined expression of stromal cell markers in the tumor capsule of 19 skin sweat gland neoplasms (16 mixed tumors of the skin and three nodular hidradenomas) using monoclonal antibodies to CD34, CD31, cytokeratin 14 (CK14), alpha-smooth muscle actin (ASMA) and high molecular weight caldesmon (HCD). We regarded CD34-positive, CD31-, CK14-, ASMA- and HCD-negative stromal cells to be CD34-positive stromal cells, and ASMA-positive, HCD-, CK14-, CD34- and CD31-negative stromal cells to be ASMA-positive stromal cells. CD34-positive stromal cells were detected in the tumor capsule of all 19 of the tumors examined. In nine of the 16 mixed tumors (56%) and all of the three nodular hidradenomas, ASMA-positive stromal cells were detected at the immediate inner side of the CD34-positive stromal cell layers. These results indicate that cellular components in the tumor capsules of mixed tumors of the skin and nodular hidradenomas are CD34-positive stromal cells and ASMA-positive stromal cells, and suggest that stromal cells of these two cell types are associated with tumor capsule formation of skin sweat gland neoplasms. [ABSTRACT FROM AUTHOR]

Four diagnostically unusual soft tissue tumors are presented. All lesions were of consistent size and long duration. Histologically, one lesion was analogous to mixed tumors of the usual sites (i.e., salivary glands), one lesion was totally spindled, and the two other lesions both had oncocytic appearances ( epithelioid and spindle biphasic pattern in a case, purely epithelioid in the other). Immunohistochemically, the mixed tumor was positive for vimentin, cytokeratins, S-100 protein, and focally for EMA. The purely spindled tumor exhibited immunoreactivity for vimentin, actins, S-100 protein, EMA (focally), and GFAP. The oncocytic biphasic tumor was positive for mitochondrial antigen, vimentin, and actins. The purely epithelioid oncocytic neoplasm was immunoreactive only for mitochondrial antigen and vimentin. Ultrastructurally, in the epithelial-like portion of the first (mixed) tumor, peripheral arrays of contractile filaments were detected along with well-developed desmosomes. In the second (spindled) case, peripheral contractile filaments and attenuated desmosomes were also seen. In the third case, a huge number of mitochondria, some desmosomes, and actin-type microfilaments were found. In the fourth case, desmosomes and punctate subplasmalemmal densities, in addition to numerous mitochondria, were documented. In all cases an external basal lamina were present, which was discontinuous in the first three cases and almost continuous in the fourth. These tumors were respectively designated as mixed tumor, myoepithelioma of the classic type, myoepithelioma of oncocytic type with biphasic cell architecture, and true oncocytoma. So far, all tumors have followed benign clinical courses (median follow up: 12 months). Comparisons with similar tumors of other sites are drawn, and suggestions for considering all of them as members of the same myoepithelial-derived tumor family are given. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma is the most common benign tumor of salivary glands, usually occurs in major salivary glands (mostly in parotid gland). It also affects the minor salivary glands present in the oral cavity. Most of the time it occurs in postero-lateral part of palate, but the involvement of upper lip is rare. The present report describes a case of 55-year-old male with asymptomatic firm nodular swelling of upper lip which was later diagnosed as pleomorphic adenoma. [ABSTRACT FROM AUTHOR]

A 4-year-old, female terrier dog was presented with complaint of a solid mass found incidentally on the left groin area. Touch of mass was painless. The skin overlying the mass was normal in appearance, with no ulceration. Complete physical examination, hematological tests, and radiology were done. No other abnormality was detected in clinical examination, and laboratory findings were within normal ranges. Radiographic surveys showed no local and distal metastasis. With excisional biopsy, the whole abnormal area was removed. It was loosely attached to the adjacent tissues. Grossly, the lesion was a 2.5 × 2.5 × 2, well-circumscribed, septate, and yellowish-white mass. At the time of excision, the surgical margin at the deep subcutis was separated by a thin capsule, but the border between the tumor and dermis was unclear. No areas of hemorrhage or necrosis were noted. Histopathological examination revealed a well-circumscribed tumor composed of both epithelial and mesenchymal components. Epithelial component was composed of well-differentiated apocrine glands containing one or two layers of epithelial cells with characteristic decapitation secretion. Mesenchymal component had myxoid tissues containing fusiform or stellate cells, and chondroid tissue. There was a lipomatous differentiation from small-sized adipocytes to vacuolated spindle cells. No osteoid tissue was observed. There were no cellular atypia and evidences for vascular invasion of neoplastic cells. Based on characteristic morphologic findings, and lack of clinical or radiographic features to support metastasis, the diagnosis of apocrine mixed tumor was made. Complete tumor removal was accepted as a recommended treatment. [ABSTRACT FROM AUTHOR]

Spindle-cell epithelioma or "mixed tumor" of the vagina is an unusual and intriguing vaginal tumor consisting of both epithelial and mesenchymal components. A case of spindle-cell epithelioma of the vagina diagnosed at delivery of a 31-year-old primiparous woman is described. The excision of the mass was performed immediately after the delivery, which was uneventful. The patient was regularly followed up and no evidence of local recurrence or dissemination was found 40 months after surgery. The presentation and the diagnosis of this kind of tumor in pregnancy, and its effect on the pregnancy and delivery are still largely unknown. Since it is unlikely that any institution will have a large number of patients with this rare disease, case reports add further information to this entity. As the number of cases studied is small, close follow-up is recommended although there has been no report in the literature of metastasis so far. [ABSTRACT FROM AUTHOR]

Cutaneous mixed tumors show a wide range of differentiation and metaplastic changes in their components. However, pilomatricomal differentiation is a rare phenomenon and, when present, is usually only focal. We report a case of a 59-year-old male who presented with a large tumor in the scalp. Histopathologic examination revealed an apocrine mixed tumor with prominent pilomatricomal differentiation. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma, also known as mixed tumor, is a benign tumor which typically presents as a painless and persistent mass. The majority of pleomorphic adenomas involve the salivary glands, most commonly the parotid gland. Other sites include breast and skin. It is a rare tumor in the vulva. In this article we are reporting a case of pleomorphic adenoma of labia with characteristic pathologic and clinical findings, as reminder of a common benign neoplasm occurring with rare locality. [ABSTRACT FROM AUTHOR]