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While histological diagnosis of Paget disease of vulva is mostly straightforward, identifying and confirming invasion can be challenging. Often invasion is accompanied by epidermal hyperplasia, marked inflammatory response and desmoplastic reaction. Diagnosis of invasion in Paget disease portends a poor outcome. We report findings from a recurrent primary vulvar Paget disease where overall histomorphology of possible invasive disease is unusual and raises a possibility of displacement of Paget cells in the dermis. We compare histology of the index case with known invasive vulvar Paget disease cases retrieved from our pathology archives. Unique histomorphology in the index case suggests a possibility of previous excision related dermal displacement of Paget cells. [ABSTRACT FROM AUTHOR]

Mesonephric-like adenocarcinoma (MLA) of the endometrium shows a variety of morphologic appearances, including small glands, tubules with eosinophilic materials in the lumen, prominent papillary patterns, spindled cells, solid formations, and corded and hyalinized patterns. Unique morphology, characteristic immunohistochemical staining patterns, molecular alterations, and awareness of the pathologists make it possible to identify this tumor accurately. This report of two additional morphologic patterns, intestinal goblet cells mimicking intestinal-type mucinous carcinoma and squamous differentiation with spindle and epithelioid cells mimicking carcinosarcoma of the endometrium will expand the literature on MLA. [ABSTRACT FROM AUTHOR]

(A) Alternating mucinous and ciliated epithelia, mucinous epithelia with cilia, acidic, blue mucin, and neutral mucin (hematoxylin and eosin [H&E] 40×); (B) Predominantly low columnar mucinous epithelia (H&E 40×); (C) Exceedingly tall columnar mucinous epithelia (H&E 40×); (D) Bird's eye view of the seromucinous cystadenoma (H&E 4×). Microscopic examination revealed a cystadenoma lined by 2 types of epithelia: tubal-type ciliated epithelium alternating with endocervical-type mucinous epithelium. Seromucinous tumors, introduced in the 2014 World Health Organization classification as one of the categories of ovarian epithelial tumors, are defined as neoplasms with 2 or more Müllerian epithelial cell types.[1] Benign tumors of this category are rare and may represent fewer than 1% of benign epithelial neoplasms of the ovary.[1],[2] We report a case of a 55-year-old female who presented with back pain and was found to have a complex cystic lesion of the left adnexa by computed tomography examination. [Extracted from the article]