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Antonio Ieni,1 Valeria Barresi,1 Rosario Caltabiano,2 Anna Maria Cascone,3 Rachele Del Sordo,4 Daniela Cabibi,5 Pio Zeppa,3 Salvatore Lanzafame,2 Angelo Sidoni,4 Vito Franco,5 Giovanni Tuccari1 1Department of Human Pathology Gaetano Barresi, Section of Anatomic Pathology, University of Messina, Messina, 2Department GF Ingrassia, Section of Anatomic Pathology, University of Catania, Catania, 3Department of Medicine and Surgery, University of Salerno, Salerno, 4Institute of Pathologic Anatomy and Histology, Division of Cancer Research, University of Perugia, Perugia, 5Department of Human Pathology, Section of Anatomic Pathology, University of Palermo, Palermo, Italy Background: Human epidermal growth factor receptor 2 (HER2) is considered to be a therapeutic and prognostic marker in the management of breast carcinoma (BC), although discordance rates between primary and metastatic or locally recurrent lesions have been reported. Methods: One hundred and forty-eight paraffin-embedded BC tissues from patients of mean age 59.27 (33–96) years and corresponding synchronous lymph node metastases were collected and retrospectively studied using immunohistochemistry and fluorescence in situ hybridization to evaluate HER2 status. Fleiss-Cohen weighted k statistics were used to assess the concordance rate between HER2 status of the primary BC and the synchronous metastatic lesions. Results: The overall concordance rate for HER2 was 95.28%. Eighty-nine cases were concordantly HER2-negative in primary BC and nodal metastases, and 52 cases were HER2-positive in both primary and metastatic tumors. Changes in HER2 status between primary BC and corresponding synchronous metastases were observed in seven (4.72%) cases. Three of the discordant cases were HER2-negative in the primary tumor and HER2-positive in the metastases, while four cases were HER2-positive in the primary BC and HER2-negative in the metastases. No significant correlations were identified between HER2 status

We describe a case of isolated primary laryngeal leishmaniasis in an immunocompetent Italian patient with a previous medical history negative for visceral or cutaneous leishmaniasis, presenting with hoarseness. We also summarize the epidemiological, clinical, and diagnostic features and the therapeutic management of other cases of laryngeal leishmaniasis in immunocompetent subjects, described in the literature. Considering the insidious and nonspecific clinical presentation, the increasing number of different forms of mild or underestimated immunosuppressive conditions, and the number of people travelling in endemic zones, along with the ability of Leishmania amastigotes to survive for a long period in the body, we believe it is important for pathologists and clinicians to be aware of this unusual form of leishmaniasis in order to avoid delayed recognition and treatment. The rarity of the presentation and the lack of guidelines on mucosal leishmaniasis may contribute to the potential undiagnosed cases or delayed diagnosis, the possible relapses, as well as the correct pharmacological and/or surgical therapeutic approach.