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Introduction: The breast's angiosarcoma is a rare entity, representing 1% of the breast's malignant neoplasms and is classified as primary and secondary; the latter is associated with radiotherapy and chronic lymphedema. Clinically both present as a voluminous and rapidly growing lesion. Surgery is the cornerstone of a treatment since it provides the most outstanding local control, whereas radiotherapy and chemotherapy have little impact on the disease. Similarly, the oncological prognosis is poor because this type of tumor has a high recurrence rate and overall, 5-year survival of only 20%. Objective: Two cases of angiosarcoma of the breast (primary and secondary) are reported, both treated in the Breast Tumor Service and a bibliographic review of the disease is presented. Materials and Methods: All breast cancer cases were reviewed in the Breast Tumor Service for two years. Results: In the first clinical case, a 61-year-old patient was presented with a 5-month-old primary angiosarcoma in the right breast, treated with modified radical mastectomy. While in the second case, the clinical history of a 76-year-old woman with secondary breast angiosarcoma is related; the patient had a history of right breast cancer, treated ten years previously with conservative surgery, sentinel node and adjuvant radiotherapy. However, the woman presented local recurrence six years later, and she was operated on with a total mastectomy. Three years later, she developed an angiosarcoma in the surgical bed that warranted a wide resection of the chest wall. Conclusion: The breast's angiosarcoma is an aggressive and rare tumor of unknown aetiology, since it has a high recurrence rate and poor survival. Its main prognostic factors are tumor volume and resection margins. Therefore, early diagnosis is essential because it allows complete resection of the lesion.

Micropapillary adenocarcinoma has been reported as an aggressive variant of adenocarcinoma in several organs, where it is associated with poor clinical outcome. This study reports the clinicopathologic features and outcomes of cervical adenocarcinomas with a micropapillary component (micropapillary cervical adenocarcinomas); this represents the largest reported study of these neoplasms. The study comprised 44 cervical adenocarcinomas of usual (human papillomavirus-related)-type (84%), mucinous, not otherwise specified (4.5%), gastric-type (4.5%), endometrioid (4.5%), and adenosquamous carcinoma (2%). The micropapillary component comprised50% of the neoplasm in 34 cases (77%) (group 1), and 10% to 50% in 10 cases (23%) (group 2). Lymph node metastasis was present in 41 of 44 (93%) cases and typically the nodal tumor retained a prominent micropapillary morphology. Follow-up ranged from 7 to 123 months (mean, 65.9 mo). Seventeen of 44 (38.6%) patients had no evidence of disease on follow-up, 6/44 (13.6%) were alive with disease, and 21/44 (47.7%) died of disease. There were no survival differences between group 1 and group 2. On univariate analysis, lymph node metastasis (P=0.0015), lymphovascular space invasion (P=0.002), parametrial involvement (P=0.03), and depth of stromal invasion (P=0.045) were related to tumor recurrence. On multivariate analysis, lymph node metastasis (P=0.001), and extent of lymphovascular space invasion (P=0.027) were significant independent predictors of tumor recurrence. Our study shows that a micropapillary component in cervical adenocarcinoma may be associated with aggressive behavior and that a micropapillary architecture may occur within a variety of types of cervical adenocarcinoma.

The current model of human breast cancer progression proposes a linear multi-step process which initiates as flat epithelial atypia (FEA), progresses to atypical ductal hyperplasia (ADH), evolves into ductal carcinoma in situ (DCIS) and culminates in the potentially lethal stage of invasive ductal carcinoma. FEA commonly coexists with well-developed examples of ADH, low-grade DCIS, lobular neoplasia and tubular carcinoma. These findings and those of recent genetic studies suggest that FEA is a neoplastic lesion that may represent a precursor to or the earliest morphologic manifestation of ductal carcinoma in situ. At the same time, many of the genomic changes of ADH are also shared by common sporadic breast cancer, consistent with a high risk for future development of metachronous breast cancer.

Background Carcinoma of the fallopian tube is a rare gynecological malignancy. A previous review of Primary Fallopian Tube Carcinoma (PFTC) from a multi-institutional study identified several poor prognosis indicators, including the depth of invasion, advanced stage disease, tumor grade and the presence of lymph node metastases. The detection of the malignant lesion at an early stage and the identification of biomarkers with prognostic significance are the major concerns of recent studies. Aims In this study, we have investigated the immunohistochemical expression of 4 proteins in cases of low-grade ( n :5) and high-grade ( n :65) serous PFTC to determine their role in PFTC prognosis. Material and methods HER2/neu, p53, PAX8 and MIB-1 were evaluated using immunohistochemistry on a tissue microarray of 70 serous PFTC and the expression was correlated to the following clinico-pathologic variants: age, grade, lymph node metastases, stage and survival. Results HER2/neu oncoprotein overexpression was demonstrated in 20 of 65 (31%) high-grade serous fallopian tube carcinomas. p53 was demonstrated in more than 50% (3+) of the tumor in 59 (90.7%) high-grade serous FTCs, while eight cases (12%) were moderate or weakly positive (2+). The expression of PAX8 was positive in 55 (78.5%) cases, the remaining 15 (21%) cases being negative. The outcome of the disease for patients with tumors showing HER2/neu overexpression was worse ( p :0.0001). p53, MIB-1 or PAX8 failed to have a predictive value in disease outcome. Conclusion The potential prognostic relevance of HER2/neu in tubal cancer and its potential role in the selection of patients for targeted therapy should be investigated further.

Breast biopsies are common surgical specimens to search for possible cancer via evaluation of palpable masses, radiologic lesions, or nipple discharge. It is crucial for the pathologist to have the knowledge of all the breast specimens that could be received, and the best manner to process them, in order to provide accurate information about the diagnosis, prognostic factors (e.g., tumor staging, histologic type, precursor lesions, etc.) and assessment of treatment response. Appropriate grossing of breast specimens is indeed a cornerstone for achieving a quality diagnosis. We also must consider that grossing of breast specimens has been evolving over the past few decades. As image-guided core-needle biopsy has gradually replaced surgical biopsy in the initial assessment of breast lesions, most patients have a definitive diagnosis at the time of excision.

A 35-year-old woman presented with abdominal pain and weight loss. Pelvic computed tomography showed a 15 cm mass in the left ovary. Grossly, the removed ovary was completely replaced by a solid tumor mass. On histological analysis (100 sections), the lesion showed the typical morphological features of dysgerminoma (20%) admixed with a major (80%) fibrosarcoma component. Tumors did not have well-demarcated boundaries with a close intermingling of both cell types. Despite surgery and combination chemotherapy, the disease progressed rapidly and the patient died of disease 18 months after diagnosis. Review of the literature showed that soft tissue sarcomas of several types may occasionally be associated with gonadal and extragonadal mixed germ-cell tumors or with spermatocytic seminoma of the testis. However, no previously published report of an ovarian fibrosarcoma associated with a pure dysgerminoma was found in the literature.

Background and Aims In its most florid form, classic lobular intraepithelial neoplasia (LIN) proliferates to form a solid mass of tumor cells that fill and expand the duct within the terminal duct lobular unit lumen. Foci such as these can develop central necrosis and calcifications, detectable on mammograms. The immunohistochemical expression of E-cadherin has been found to be absent in all reported examples of LIN with necrosis. The occurrence of LIN composed entirely of signet ring cells with central necrosis is extraordinarily rare. Methods We described 10 of these cases to illustrate this uncommon morphologic pattern of LIN. The cases were encountered during routine clinical practice of the authors over a 5-year period at the Oncology Hospital of the Mexican Social Security Institute in Mexico City. Cases were comprised of several (>6) foci of LIN with signet ring cells as well as with comedo-type necrosis. Results Age of patients ranged from 45–75 years (mean age: 51.2 years). The indications for biopsy were calcifications ( n = 7) and mass ( n = 3) on mammograms. Luminal necrosis was seen in all ten cases and calcifications in seven cases. Eight cases had associated invasive carcinoma, including six lobular carcinomas and one composite carcinoma (lobular and ductal). All cases showed a lack of E-cadherin membrane staining and a diffuse cytoplasmic immunoreactivity for high molecular weight keratin, positivity for estrogen receptors and progesterone receptors was present in 9/10 and 8/10 of cases, respectively. Conclusions LIN composed entirely of signet ring cells can develop macro-acini, central necrosis and calcifications. These cases are frequently associated with invasive lobular carcinoma at the time of initial presentation.

We describe an outbreak of nosocomial endophthalmitis due to a common source, which was determined to be trypan blue solution prepared in the hospital's pharmacy service. We assume that viable bacteria probably gained access to the trypan blue stock solution during cooling after autoclaving. The temporal cluster of Pseudomonas aeruginosa endophthalmitis was readily perceived on the basis of clinical and microbiological findings, and an exogenous source of contamination was unequivocally identified by means of DNA fingerprinting.

Objective: Historically, cervical adenocarcinomas have been viewed as more aggressive than squamous cell carcinoma (SCC) in multiple small cohorts. We analyzed the largest Latino cohort of early stage cancer to determine the impact of histologic type. Methods: Retrospective analysis of patients with SCC and adenocarcinoma stages IA1-IB2 at the Mexican Oncology Hospital from 2000-2010 was performed for: age, stage, tumor size, lymphovascular invasion (LVI), invasion depth, lymph node status, recurrence and survival. Pathologic review proceeded inclusion. 64 patients with SCC were recruited between 2000-2003. 101 patients with adenocarcinoma were recruited between 2000-2010. Categorical variables were analyzed by chi square and continuous variables using one-way ANOVA analysis. Results: Results are summarized in Table 1. Adenocarcinomas tended to be higher grade (p= 0.01), while SCC's were larger with deeper invasion (p Conclusion: Patients with early stage adenocarcinomas have smaller, higher grade tumors than patients with SCC with no difference in LVI, lymph node involvement, recurrence rate or survival. . A potential confounding factor was higher rate of adjuvant RT in adenocarcinoma vs. SCC patients. Overall, these findings suggest the need for more aggressive therapy in the treatment of early stage cervical adenocarcinoma should be investigated further, potentially reducing morbidity in this cohort of patients. Adenocarcinoma (n = 101) Squamous (n = 64) p-value Age (Median) 51 (35–80) 51 (22–86) NS Stage NS IA1 3 (3%) 1 (1.6%) IA2 1 (1%) 0 (0%) IB1 96 (95%) 54 (84.4%) IB2 1 (1%) 9 (14%) Lymph Node NS Positive 16 (15.8%) 13 (20.3%) Negative 85 (84.2%) 51 (79.7%) Grade p = 0.01 1 19 (18.8%) 14 (21.9%) 2 50 (49.5%) 45 (70.3%) 3 32 (31.7%) 5 (7.8%) LVI NS Positive 26 (25.7%) 21 (32.8%) Negative 75 (74.3%) 43 (67.2%) Missing 0 (0%) 0 (0%) Tumor Diameter(Mean cm) 1.99 (1.8–2.4) 2.77 (2.5–3.03) p < 0.0001 Invasion Depth (Mean cm) 0.78 (0.7–0.86) 1.6 (1.3–1.6) p < 0.0001 Treatment p = 0.001 Surgery 29 (28.7%) 34 (53%) Surgery+RT 72 (71.3%) 30 (47%) Recurrence NS Yes 5 (5.0%) 5 (7.9%) No 76 (75.2%) 56 (87.5%) Missing 20 (19.8%) 3 (4.6%) Survival NS Alive 78 (77.3%) 56 (88.9%) Alive with Disease 3 (3.0%) 4 (6.3%) Dead 1 (0.9%) 3 (4.8%) Missing 19 (18.8%) 0 (%) Follow-up (Median yrs) 4 (1–8) 4 (1–8) NS Citation Format: Ira Winer, Isabel Alvarado-Cabrero, Shelly Seward, Raquel Valencia-Cedillo, Adnan Munkarah, Rouba Ali-Fehmi. The significance of squamous vs. adenocarcinoma subtypes in early-stage cervical carcinoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 168. doi:10.1158/1538-7445.AM2013-168