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In this paper we summarize the results of a retrospective investigation of tumor budding in endoscopic preoperative biopsies in patients with colorectal adenocarcinoma (CRC). The aim of this study was to assess the peritumoral budding evaluation interpretability, based on endoscopic colorectal biopsies in left and right sided colorectal carcinoma and some of the factors that influence it. A group of 100 patients, with preoperative endoscopic biopsies was selected and the tumor buds were counted on H&E stained slides, according to contemporary clinical recommendations. In the studied patient group, budding was identified in a total of 13 patients (13% of the studied cases). The primary localization of the tumor in the left or right colon was not associated with the reporting of budding in endoscopic biopsies of colorectal carcinoma. No budding was observed in highly differentiated tumors, and the presence of budding was reported less frequently in poorly differentiated tumors compared to moderately differentiated ones. Budding was accessible for evaluation in nearly 1/10 of the small biopsies from CRC. Artifacts from the sample management as well as factors related to the tumor characteristics predetermined the possibility for evaluation of tumor budding on small biopsies.

Background and Objectives: Neoplasms of the vagina are rare and account for 1–2% of all tumors of the female reproductive system. Primary neoplasms of the vagina are most often carcinomas originating from squamous or glandular epithelium. Of the primary glandular tumors, clear cell, endometrioid, and serous adenocarcinomas are the most common types, while mucinous and mesonephric types are very rare. Mucinous adenocarcinoma is histologically subclassified into endocervical and intestinal types. We add to the existing literature another case of an extremely rare gynecological neoplasm—primary vaginal mucinous adenocarcinoma (PVMAC) intestinal type associated with vaginal villous adenoma with high-grade dysplasia. We discuss the clinical, radiological and morphological features of this rare entity. Materials and Methods: We report a case of a 59-year-old woman with PVMAC intestinal type associated with vaginal villous adenoma with high-grade dysplasia. The patient was evaluated with a gynecological exam, and biopsy, curettage and tumor excision were performed. The positron emission tomography-computed tomography (PET/CT) scan, at the level of the pelvis, supported the primary location of the disease. Histological and immunohistochemical methods were applied. Results: The gynecological examination of the vagina revealed an exophytic polypoid mass with a diameter of 3 cm, located on the posterior wall, in the area of introitus vaginae. The PET/CT scan revealed a hypermetabolic malignant formation involving the vagina and anal canal, without evidence of pelvic and inguinal lymphadenopathy, and also, it excluded disease at sites other than the vagina. The histological and immunohistochemical investigations, as well as the clinical and radiological data, lent support to the diagnosis “primary vaginal mucinous adenocarcinoma intestinal type”. Conclusions: PVMAC intestinal type is a rare gynecological pathology, which presents a serious challenge for oncogynecologists, radiologists and pathologists.

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