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Small cell carcinoma of ovary-hypercalcemic type is an undifferentiated carcinoma. We describe two cases in women aged 32 and 29. Both presented with large masses and complete surgical extirpation was impossible. Histologically, the images were similar, with diffuse cell proliferation, accompanied by the presence of follicle-like spaces. In both cases it was necessary to make a differential diagnosis with entities such as adult or juvenile granulosa cell tumour, small cell carcinoma of pulmonary type, dysgerminoma and even peripheral neuroectodermal tumour. The absence of SMARCA4/BRG1 immunostaining proved very useful in the diagnosis of hypercalcemic small cell ovarian carcinoma.

Resumen Objetivo Presentar un metodo de analisis grafico de costes ocasionados por los falsos positivos (FP) y falsos negativos (FN) de una prueba diagnostica. Material y metodos Construimos una funcion de costes ligada a la sensibilidad (S) y a la especificidad (E) de la prueba diagnostica. A partir de esta funcion obtenemos lineas de isocoste, cuya pendiente es la relacion coste FP/coste FN. Representamos cada prueba diagnostica en el espacio ROC como el punto (1-E, S). Resultados Las lineas de isocoste permiten visualizar si el gasto asociado a FP y FN de una nueva prueba diagnostica es menor o igual que el de la antigua. Conclusiones El analisis grafico de la funcion de costes de una prueba diagnostica ayuda a decidir su introduccion o su rechazo.

Malignant nodular hidradenoma or hidradenocarcinoma is a rare, malignant tumour of sweat glands that usually arises de novo, although a few cases originating in a nodular hidradenoma have been reported. They are very aggressive neoplasms that recur locally and frequently metastasize to the lymph nodes. The treatment of choice is surgical excision with wide margins, followed by chemotherapy and/or radiotherapy when metastases have occurred. Recently, sentinel lymph node sampling and treatment with Trastuzumab have been proposed for cases with overexpression of Her-2/neu. A case of hidradenocarcinoma arising in a nodular hidradenoma of the breast skin of a 55 year old woman is presented. The tumour was surgically removed with a wide excision and the patient treated with postoperative radiotherapy. She is alive and well without evidence of metastatic disease one year later.

Resumen Los Diagnosticos Criticos en Anatomia Patologica han sido recientemente introducidos y son equiparables a los establecidos a nivel clinico, de forma que, situaciones clinicas concretas pueden precisar de un diagnostico rapido (ya sea por parte del patologo o del citopatologo) y del contacto urgente con el clinico con el fin de facilitar una intervencion clinica urgente o instaurar un tratamiento determinado, de los que el paciente se beneficiaria. Basandonos en la experiencia diaria, presentamos diferentes situaciones clinico- patologicas en las que el diagnostico es critico.