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1/19. Salivary duct carcinoma of the larynx: report of a rare case.

    Salivary duct carcinomas are primarily high-grade, aggressive malignancies that affect men in the fifth and sixth decades of life. These tumors are usually found in the major salivary glands; rarely do they originate in the minor salivary glands. The distinctive feature of these neoplasms is their remarkable histologic resemblance to infiltrating ductal carcinomas of the mammary gland; both types of tumor feature epithelial and myoepithelial cells arrayed in solid, papillary, and cribriform patterns. To the best of our knowledge, only one case of a primary salivary duct carcinoma of the larynx has been previously reported. In this article, we describe a new case, and we review the literature on salivary duct carcinomas.
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2/19. Drug-induced sweat gland necrosis in a non-comatose patient: a case presentation.

    BACKGROUND: coma-induced bullae and sweat gland necrosis is a rare clinicopathological entity often associated with drug-induced coma. SUBJECT: We report a case with clinical and histopathologic findings characteristic of blisters and sweat gland necrosis occurring in a non-comatose patient. CONCLUSIONS: skin blisters with underlying sweat gland necrosis is an entity previously reported to occur in comatose patients, our findings open new questions about the role of the drugs in the pathogenesis of those conditions.
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3/19. Mucosa-associated lymphoid tissue lymphoma of the thymus resected using combined thoracoscopic and transcervical approaches.

    Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade variant of B cell lymphoma that arises in extranodal tissue of the gastrointestinal tract, lung, salivary gland, thyroid, or other organ derived from the foregut. However, MALT lymphoma in the thymus is extremely rare. We report a case of thymic MALT lymphoma, extending to the neck, resected using combined thoracoscopic and transcervical approaches. To the best of our knowledge, thoracoscopic management of MALT lymphoma in the thymus has not previous been reported.
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4/19. Suppurative thyroiditis with gas formation.

    Acute suppurative thyroiditis with gas formation is very rare. A 70-year-old woman was admitted with dysphagia and fever. The clinical diagnosis of acute thyroiditis was supported by fine needle aspiration biopsy. X-ray examination showed gas collection within the soft tissue of the anterior neck and ultrasonography of the thyroid gland showed a cavity filled with thick liquid. The patient was treated with antibiotic therapy followed by thyroidectomy.
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5/19. lipomatosis of the parotid gland in children.

    Parotid lipomatosis is extremely rare in children. Only 4 cases have previously been reported in the English language medical literature. Surgical excision is frequently complicated by recurrence. We report, a fifth case, on a 5-month-old girl with rapidly progressive parotid lipomatosis. Emphasis is laid on the importance of preserving the unusually delicate tumor capsule to prevent tissue spillage and recurrence. The creation of an appropriate cleavage between the mass and the expanded skin with sparse subcutaneous fat, safeguarding the tumor capsule on one side and the skin blood supply on the other, represents a rewarding technical challenge.
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6/19. Cytologic findings of a pleomorphic adenoma of the breast: a case report.

    BACKGROUND: Pleomorphic adenoma of the breast is a rare benign tumor. Only a few cases have been reported. The histologic features have been described well. However, the cytologic findings have been described in only a few papers. CASE: A 47-year-old female presented with a left breast mass of several months' duration. The clinical and mammographic findings were highly suspicious for malignancy. Following an aspiration biopsy diagnosis of "positive for malignancy," the mass was excised. The histologic diagnosis was pleomorphic adenoma (mixed tumor of salivary gland type) rather than carcinoma. CONCLUSION: The cytologic presentation of pleomorphic adenoma of the breast can masquerade as that of a malignant tumor, in this case colloid carcinoma. This case delineates the cytomorphologicfeatures of pleomorphic adenoma, which may mimic carcinoma.
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7/19. Signet ring cell carcinoma of the breast as a source of pelvic floor metastatic mass. A case report.

    Primary signet ring cell carcinoma of the breast is a very rare tumour. We present a case with pure signet ring cell carcinoma of the breast, which was recognized as metastasis on the pelvic floor, before developing breast symptoms and signs. A 40-year old woman was admitted with abdominal pain. First diagnostic effort revealed a cystic mass on the pelvic floor, compressing the colon and other neighbouring organs. A biopsy of the pelvic mass was performed. The histopathological examination revealed metastatic signet-ring cell carcinoma. At the time of the first operation, the mammary glands were not suspicious. No other sources of primary tumour were evidenced. An inflammatory sign developed in right breast two months after biopsy of the pelvic metastasis. The histopathology of the breast incisional biopsy revealed primary pure signet ring cell carcinoma of the breast. Because the oestrogen and progesterone receptor were negative in the tumoral tissue, the patient underwent chemotherapy followed by modified radical mastectomy, chemotherapy, and palliative resection of the metastatic mass. The patient was followed up for eight months. To our knowledge, in English literature, we believe that this case is the first report of signet ring cell carcinoma of the breast presenting with pelvic floor metastasis without breast sign.
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8/19. Metastatic adrenal neuroblastoma in an adult.

    BACKGROUND: neuroblastoma (NB) is a common malignancy in children, but rarely occurs in adults. Accepted unfavourable prognostic factors include age > 1 year, low histologic grade and advanced stage, MYCN amplification, chromosomal aberrations, elevations of neuron specific enolase and lactate dehydrogenase, and increased catecholamine metabolites in urine or serum. In adults, abdomen/retroperitoneum are the primary sites and in children the adrenal gland. CASE REPORT: A 51- year-old man was admitted to our hospital with hypertension and a large right retroperitoneal mass. Clinically, phaeochromocytoma was suspected. Tumour resection revealed adrenal NB grade III. Chemotherapy according to the paediatric German neuroblastoma Trial (NB97) was started. Follow-up computed tomography showed regression of the enlarged mediastinal and retroperitoneal lymph nodes. Because of local and systemic progression palliative radiochemotherapy was started. The patient died 9 months after diagnosis. CONCLUSION: To the best of our knowledge this is the oldest NB patient registered so far in germany. Currently there are no standard treatment guidelines for patients with NB in adulthood. Collection and evaluation of data in adult patients with this tumour are warranted in order to optimise treatment strategies.
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9/19. Apparent sialadenopathy of the sublingual glands after general anesthesia with placement of laryngeal mask airway.

    Sialadenopathy, inflammation of the salivary glands, is a rare anesthetic complication. This case conference describes a patient who developed sialadenopathy of the sublingual glands after placement of a laryngeal mask airway during a brief surgical procedure. The patient's history is detailed, the surgical and anesthetic procedures are described, and a discussion follows, which describes the different causes of this inflammatory process. In the comment, the physiology of the salivary gland is described in detail.
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10/19. Oncocytic carcinoma of the maxillary sinus: a rare neoplasm.

    Oncocytic neoplasms are tumors composed of oncocytes (i.e., epithelial cells with a large cytoplasm that is rich in mitochondria). Most cases are benign and originate from the major salivary glands, while the minor salivary glands are rarely involved. Occurrence of oncocytic carcinoma (or malignant oncocytoma) within the sinonasal tract is an unusual event. We report a rare case of maxillary sinus oncocytic carcinoma occurring in a 45-year-old male. biopsy was consistent with an unspecified salivary gland neoplasm. The patient underwent total maxillectomy through a lateral rhinotomic approach; hard palate reconstruction with temporal myofascial flap was performed. Definitive histology was consistent with oncocytic carcinoma. Due to the local extension of the lesion, postoperative radiotherapy (60 Gy) was delivered. Three years after surgery, the patient is free from disease. A brief analysis of the literature was also accomplished in order to discuss treatment options and prognosis of this unusual neoplasm.
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