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BackgroundSignet-ring cell carcinoma (SRCC) originates from undifferentiated stem cells in the neck of glands within the lamina propria of the mucosa. Primarily affecting the stomach, SRCC can also involve the breast, pancreas, gallbladder, colon, and bladder, although these cases are rare. SRCC of the prostate is extremely rare, and diagnosing it via pelvic puncture is particularly challenging. Prostate SRCC is a distinct type of malignant tumor characterized by unique biological behavior, high malignancy, rapid disease progression, and poor prognosis. Due to its rarity, early diagnosis and treatment are critical. Currently, the diagnosis and treatment of this disease present significant challenges.Case demonstrationA 74-year-old male patient was admitted to our hospital with “left lower abdominal pain, changes in bowel habits, and bloody stools for 2 months.” A contrast-enhanced pelvic CT scan revealed a soft tissue density mass on the left side of the pelvis. Contrast-enhanced Pelvic MRI suggested a tumor with a rich blood supply on the left side of the pelvis, indistinguishable from the left seminal vesicle and prostate gland, indicating the presence of a suspected malignant tumor. Pathologic biopsy of the pelvic mass confirmed the diagnosis of prostate SRCC. The patient subsequently underwent chemoradiotherapy and has been followed up for three months. He is currently in good condition.ConclusionSRCC predominantly occurs in the digestive tract and rarely originates in the prostate. Diagnosing prostate SRCC through abdominal paracentesis is challenging. To the best of our knowledge, this is the first reported case of SRCC of the prostate initially presenting with gastrointestinal symptoms. Additionally, it presents a case of prostate SRCC involving the pelvis, confirmed through pelvic puncture. highlighting its significance for clinical diagnosis.

BackgroundPrimary pulmonary hyalinizing clear cell carcinoma (HCCC) is a rare type of primary salivary gland-type tumor of the lung. HCCC is characterized by unique pathological features, including nests, cords, or trabeculae of clear or eosinophilic tumor cells infiltrating a mucinous or hyalinized stroma. Additional analyses of this carcinoma have revealed positive epithelial markers via immunophenotyping and EWSR1 gene translocation through genetic testing. However, the morphology of HCCC has been found to change during bronchoscopic biopsy, suggesting certain challenges for its clinical diagnosis and treatment.Case presentationA 47-year-old female patient presented with a 2-month history of cough, sputum production, and dyspnea. A chest CT scan found a nodular soft tissue density shadow in the lower segment of the trachea. Subsequently, the patient underwent tumor resection via combined flexible and rigid bronchoscopy. Postoperative pathological examination, including immunohistochemistry and molecular testing, confirmed an EWSR1 gene translocation. The final pathological diagnosis was primary pulmonary HCCC. A follow-up at 6 months post-surgery showed mediastinal lymph node metastasis.ConclusionsPrimary pulmonary HCCC is an extremely rare, low-grade malignant epithelial tumor of the lung, which has a notably difficult clinical diagnosis and treatment due to the absence of a standard treatment protocol. This case report presents a patient with primary pulmonary HCCC confirmed by molecular testing, aiming to raise awareness about this tumor among physicians and provide valuable clinical references.

BackgroundThe coexistence of two or more distinct neoplasms within the same anatomical site characterizes collision tumors. While the presence of dual tumors is frequently observed in esophageal cases, the simultaneous occurrence of three distinct tumor types is extremely rare, posing significant challenges for pathological evaluation and diagnosis. Surgical resection remains the primary treatment, with generally favorable outcomes.Case presentationA 58-year-old male with a two-month history of progressively worsening dysphagia over the past 10 days underwent a gastrointestinal barium meal examination, which revealed an irregular filling defect measuring approximately 89×50 mm in the mid-thoracic esophagus. Subsequent gastroscopic biopsy confirmed undifferentiated pleomorphic sarcoma in the mid-esophageal tissue. As the dysphagia advanced, a partial esophagectomy with lymph node dissection was performed. Postoperative pathology revealed a composite tumor consisting of adenoid cystic carcinoma, undifferentiated pleomorphic sarcoma, and focal squamous cell carcinoma. Squamous cell carcinoma metastasis was identified in one lymph node. No adjuvant therapies, such as chemotherapy, radiotherapy, targeted therapy, or immunotherapy, were administered following surgery. The patient had been under monitoring for 101 months, with no signs of recurrence or metastasis.ConclusionThis case represents the first documented instance of a tripartite collision tumor in the esophagus, composed of undifferentiated pleomorphic sarcoma, squamous cell carcinoma, and adenoid cystic carcinoma, with clear histological distinction. A thorough review of the literature was performed to summarize clinicopathological features. Surgical resection leads to a favorable prognosis. Tumors containing both carcinomatous and sarcomatous elements tend to have a more favorable prognosis compared to those composed entirely of carcinomatous tissue, providing valuable insights for future diagnostic and therapeutic strategies.

BackgroundMyoepithelial carcinoma (MECA) is a malignant tumor primarily affecting the salivary gland, most frequently in the parotid gland. It can manifest as primary or secondary to pleomorphic adenoma or benign myoepithelioma. MECA exhibits aggressive behaviors. In particular, primary MECA is more aggressive, frequently recurring or metastasizing distantly. Its morphological and immunohistochemical characteristics overlap with various tumors, posing challenges in its recognization as a distinct entity. Consequently, MECA may be frequently misdiagnosed, mainly when occurred in the mammary gland. This chance for misdiagnosis poses significant challenges in clinical diagnosis and treatment.Case demonstrationA 77-year-old woman with a history of pleomorphic adenoma presented with a palpable lump in the right breast for 3 months. Subsequent core needle biopsy (CNB) and modified radical mastectomy were performed, with samples subjected to histopathological examination. Based on the patient’s history, histomorphologic features, immunohistochemistry (IHC) results and results of FISH, the pathological diagnosis confirmed MECA in the mammary gland. Postoperative chemotherapy was administered, and the patient exhibited a favorable prognosis during a 40-month follow-up period.ConclusionsPrimary MECA in the mammary gland is exceedingly rare, metastasis from the salivary gland MECA to the mammary gland is even rarer and has not been previously reported. This study presents the first documented case of MECA originating from the parotid gland metastasizing to the mammary gland (also known as breast). Highlighting this case aims to raise awareness among clinical pathologists to prevent underdiagnosis and misdiagnosis of this tumor entity.

BackgroundEndometrial stromal sarcoma (ESS) is a rare type of uterine malignancy typically classified into low-grade ESS (LG-ESS) and high-grade ESS. LG-ESS is characterized by low malignancy and limited metastasis, primarily to the lungs. Metastasis of the breast is extremely rare, posing significant challenges in clinical diagnosis and treatment.Case demonstrationA 33-year-old female with a history of two cesarean sections was diagnosed with uterine LG-ESS five months prior. She was admitted for the excision of a left breast mass discovered during a routine examination. A histopathological biopsy confirmed the mass as a breast metastasis of LG-ESS. Postoperatively, she underwent radiotherapy and chemotherapy at a cancer hospital. She has been followed up on for two years with no recurrence.ConclusionsESS with breast metastasis is extremely rare. The morphological features of ESS with breast metastasis can resemble mesenchymal and sex cord-stromal tumors, complicating imaging and pathological diagnosis, especially if there is no known history of uterine ESS. This study highlights the clinicopathological features of LG-ESS with breast metastasis, including clinical manifestations, imaging features, histopathology, immunohistochemistry, molecular genetic features, and treatment prognosis. It aims to provide new insights for the clinical diagnosis and treatment of ESS with breast metastasis.