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Background: Deep angiomyxoma (DAM) is a slow-growing benign tumor with high risk of local recurrence after surgical resection. Although DAM in a lower extremity is extremely rare, clinicians must be aware of its possible occurrence. Suspicion can be made based on clinical examination and radiological imaging but final diagnosis is confirmed on histopathological examination and immunohistochemistry. We intend to present an extremely rare case of DAM in the knee, managed successfully with marginal excision. Case Presentation: A 4-year-old male child presented with the complains of a painless, progressively increasing, soft, non-tender, and fluctuant swelling in his right knee. The plain radiograph showed a non-calcified soft-tissue swelling and MRI revealed a multi-loculated cystic lesion with multiple septations. A pre-operative diagnosis of a benign cystic lesion was made. It was managed by marginal excision of the tumor and a histological diagnosis of DAM was made. IHC staining showed positivity for SMA, CD34 and vimentin were focally positive, while desmin and calponin were negative. At 12 months of follow-up, the patient had a normal painless gait and full knee ROM, without any local recurrence. Conclusion: DAM is a rare tumor which is often misdiagnosed. In this report, we present a rare case of benign cystic lesion which turned out to be DAM on HPE of resected specimen. Marginal excision of this lesion revealed good outcomes with no recurrence until 12 months of final follow-up. With this, we conclude that surgical excision should be the gold standard in cases of DAM. [ABSTRACT FROM AUTHOR]

An 11-year-old male Miniature Dachshund dog was presented with dyschezia. Computed tomography examination 35 days after the initial visit revealed a prostate mass (4.0 × 3.5 × 2.7 cm) and prostatectomy and orchiectomy were performed 13 days later. Grossly, the prostate was rubbery and the cut surface of the mass was swollen. The mass was whitish and demarcated from the surrounding tissues. Microscopically, the mass had a capsulate consisting of atypical spindloid stromal cells arranged in a phyllode pattern and also in a fasciculated pattern admixed with acinar ductal cells. Atypical stromal cells contained round-to-oval finely hyperchromatic nuclei that had distinct nuclei and abundant eosinophilic cytoplasm. Immunohistochemically, the atypical stromal cells were positive for vimentin, CD34, desmin, α-smooth muscle actin, progesterone receptor and androgen receptor but negative for cytokeratin AE1/AE3, p63, c-Kit, DOG-1 and SOX10. On the basis of these findings, the tumour was diagnosed as a prostatic stromal tumour of uncertain malignant potential. [ABSTRACT FROM AUTHOR]

Aims: Nuclear receptor subfamily 1 group D member 1 (NR1D1)‐rearranged soft tissue tumour is a newly described entity with an epithelioid morphology and a potential for aggressive behaviour. Largely due to under‐recognition, this tumour type has not yet been widely acknowledged. Herein, we report four additional cases to further expand its clinicopathological and molecular spectrum. Methods and results: Four mesenchymal tumours with NR1D1 rearrangement were identified from our consultation files. There were one male and three females with ages ranging from 19 to 47 years (median = 28.5 years). Tumour occurred in the tongue, neck, hip and index finger, respectively. Histologically, two tumours were composed predominantly of epithelioid cells; one tumour had admixed epithelioid‐spindle cells and one tumour consisted of monomorphic small round to ovoid cells. By immunohistochemistry, none of the tumours expressed lineage‐specific markers. Targeted RNA‐sequencing identified NR1D1 fusions in all four tumours, the partner genes being MAML2, MAML3, KMT2A and NCOA2, respectively. The novel MAML3 and NCOA2 rearrangements were confirmed by fluorescence in‐situ hybridisation analysis. On follow‐up (2–23 months), one patient experienced local recurrence due to incomplete resection and one patient developed lung metastasis. The other two patients were alive without disease. Conclusions: This study adds more support for NR1D1‐rearranged soft tissue tumour as an emerging entity. The occurrence of two additional tumours in the head and neck region, description of a small round cell variant and identification of novel MAML3, KMT2A and NCOA2 partners further expand its clinicopathological and molecular spectrum. More studies on larger series are necessary to validate the fully malignant potential of NR1D1‐rearranged soft tissue tumour. [ABSTRACT FROM AUTHOR]

Vulval tumours are rare, representing merely 4% of all gynaecological neoplasms. 98% of vulvar lesions are benign, and only 2% are malignant. Of all vulvar malignancies, while squamous cell carcinoma is the most common malignancy, leiomyosarcomas of the vulva are extremely rare. Usually these tumours have nonspecific clinical manifestations, often leading to misdiagnoses of Bartholin cysts or abscesses. We describe a case of a 47-year-old woman who presented with a nonspecific painless swelling in the left vulva for 2 months which was diagnosed as leiomyosarcoma of the vulva on biopsy as well as resection.

Synovial sarcomas are a rare entity in the head and neck region. We present a rare case of a 50 year old female presenting with a painless mass over right cheek since one year which gradually increased in size since past two months. Imaging was done which revealed a mass lesion in soft tissue of right cheek deep to the masseter muscle with no obvious involvement of the adjacent part of maxilla and mandible. Local wide excision of tumor was done. Histopathological examination revealed a malignant mesenchymal tumour. Further the specimen was subjected to immunohistochemical marker studies and diagnosis of high grade spindle cell sarcoma possibly synovial sarcoma was given. Patient then received Image guided radiation therapy and along with platinum based chemotherapy. Patient tolerated the treatment well. Patient was followed up for one year after completion of treatment and no recurrence was observed. [ABSTRACT FROM AUTHOR]

Scrotal masses are a frequent complaint in general practice. A benign from a malignant scrotal lump had to be distinguished by the treating doctor in order to perform the precise surgery and provide ongoing care. A 61-year-old male presented with a painless scrotal mass for six months duration. On clinical examination, the scrotal mass was firm and fixed to the perineal membrane [Table/Fig-1a]. Magnetic Resonance Imaging (MRI) scan revealed a 13X8X5 cm heterogeneous soft tissue mass [Table/Fig-1b] in the peranal/perineum lesion abutting anterior wall of anal canal, root of penis and scrotum, the possibility of myxoid/spindle cell neoplasm of perineum to be considered was mentioned; in addition, remark of locally aggressive neoplasm, likely of malignancy was made in view of presence of infiltrating margins. Trucut biopsy was reported as a benign soft tissue tumour. Trans-scrotal excision was done. The postoperative resected specimen was sent for histopathological examination [Table/Fig-1c]. Gross appearance of the external surface was grey white to grey brown. Cut surface was homogenous grey white soft in consistency with solid region at one pole measuring 7×5×0.5 cm [Table/Fig-1d]. No areas of necrosis or haemorrhage noted. Tissue bits from representative sites were given. The microscopic examination revealed an unencapsulated infiltrative hypocellular lesion composed of spindle to stellate shaped tumour cells with delicate cytoplasmic processes and bland nuclear chromatin. No atypia or increase in mitosis was noted. The tumour cells were seen to be embedded in a myxoid stroma with scattered delicate collagen fibers [Table/Fig-2a]. Entrapment of mature adipose tissue was noted at foci [Table/Fig-2b]. Numerous small and medium sized thick walled hyalinised blood vessels were also noted and it was reported as Aggressive Angiomyxoma (AAM). The patient did not have recurrence at three and six month postoperative follow-up period. Scrotal masses accounts to 1% of cases in the surgical Out Patient Department (OPD). Although some types of scrotal masses are more prevalent at particular ages, they can appear at any age [1]. AAM is a very rare benign spindle cell mesenchymal tumour usually occurring in the pelviperineal region, more commonly in females than males (M:F is 1:7) in their fourth decade [2]. It was first described in 1983, by Steeper and Rosai. So far only 36 cases of scrotal AAM are reported in the literature. AAM usually present as a painless mass. About 30% of these tumours recur locally, as it shows infiltrative nature hence the term ‘Aggressive’, although distant metastasis is extremely uncommon, MRI aids in determining the tumour’s extent [3]. Its aetiology is not clearly established yet. Few studies hypothesised that AAM might develop from stem cells with the capacity for multiple differentiation near arteries that eventually give rise to fibroblasts and myofibroblasts [4,5]. Most AAM patients noted to have a long history of asymptomatic mass or swelling in the scrotum. The tumour size range from 1.5 cm to as big as 25 cm. The genital location and subtle clinical presentation of the tumour delays the treatment requirement by patients, which leads to a progressively growing tumour size with a high rate of clinical misdiagnosis. It is challenging to get an accurate preoperative diagnosis, and the differential diagnosis includes non neoplastic and neoplastic lesions [5]. On macroscopic examination, AAM is typically a soft, lobulated, grayish-white, fairly delineated tumour with vague infiltrative margins and myxoid appearance. The essential diagnostic criteria of AAM include the histological features of ill marginated lesion with uniformly dispersed tumour cells in abundant myxoid stroma, vascular components and invasive proliferation. The bland tumour cells may be spindled, star or oval-shaped with bland nuclei and sparse mitoses. The vessels may vary from thick hyalinised or thinwalled walls of different diameters. The aberrant HMGA2 expression is considered as desirable for diagnosis however is not essential, as its sensitive but not specific marker for AAM. It is useful especially to define tumour margin, as the non tumourous mesenchyme lacks positivity to HMGA2 [6]. AAM in the scrotum is typically treated with a large local excision with tumour-free surgical margins [7]. When surgical complications are common or fertility retention becomes an issue, some specialists think incomplete or partial resection is permissible. The likelihood of local AAM recurrence is significant and differs by gender, particularly within 2-3 years. Myxoid liposarcoma, angiomyofibroblastoma, myxoid neurofibroma, and myxoma are the tumours in the main differential diagnosis of AAM. Malignant myxoid neoplasms should be recognised from AAM since the management protocol varies for the both. Although it is not usually necessary, immunohistochemistry aids in distinguishing AAM from other mesenchymal tumours. Desmin, Vimentin, Smooth Muscle Actin (SMA), and CD34 are all positive in AAM, while S-100, CK, and CD68 are all negative [6]. Due to its infiltrative boundaries, AAM might radiographically evoke suspicion of malignancy, as in the present case. Owing to the rarity of this lesion and lack of distinct imaging findings, an accurate preoperative diagnosis is frequently challenging. From the experience with above described case and literature reviews, it was observed that the preoperative imaging techniques and intraoperative pathology investigations can partly aid with the diagnosis. However, the gold standard for the diagnosis of AAM relies on the thorough histological evaluation of postoperative specimens. Despite being an uncommon phenomenon in the male genital region, the surgeon should consider it as one of their differential diagnosis to prevent over diagnosing malignancy and subsequent treatment.

Background: Aggressive angiomyxoma is a rare mesenchymal tumour of the genital tract with a high incidence in women of reproductive age. The aim of our work is to understand which is the best management strategy for this condition, starting from the description of a rare case report up to the performance of a narrative review of the literature. Methods: We report a case of a 46-year-old woman who came to our attention because of the growth of a 10-centimetre pedunculated, non-soft, non-tender mass of the left labium majus. She underwent surgical excision, and the histologic diagnosis was aggressive angiomyxoma. Due to a lack of tumour-free margins, radicalization surgery was carried out after three months. A review of the literature of the last ten years was performed following the PRISMA statement on MEDLINE (PubMed). We obtained data from twenty-five studies describing thirty-three cases. Results: Aggressive angiomyxoma is characterized by a high recurrence rate of between 36 and 72% after surgery. There is no universal consensus about hormonal therapy, and most studies (85%) describe surgical excision followed by only clinical and radiological follow-up. Conclusion: Wide surgical excision is the gold-standard treatment for aggressive angiomyxoma, succeeded by either clinical or radiological (ultrasound or MRI) follow-up. [ABSTRACT FROM AUTHOR]

Plexiform angiomyxoid myofibroblast tumour (PAMT) is a rare mesenchymal tumour of the stomach. To date, about 45 cases of PAMT have been reported in the literature. This is an extremely rare mesenchymal gastric tumour with definite histological pattern and is a tumour typified by spindle cells with myofibroblast characteristics. A 70-year-old woman was admitted with vague upper abdominal pain and dyspepsia and on OGD was found to have a polypoidal lesion with ulceration on the posterior wall of the body of the stomach towards the greater curvature. The endoscopy biopsy suggested the above diagnosis. The patient was investigated with CT scan and CT showed a large nodular growth 10 × 8 cm with pancreatic tail involvement and splenic involvement. The patient was treated with multi-visceral resection and favourable outcome was achieved. This entity of PAMT was a histological rarity and a technically challenging case and hence was analysed and presented. PAMT is a rare mesenchymal tumour of the stomach and is characterised by spindle cells with myofibroblast characteristics with a potential to differentiate towards smooth muscle cells. These tumours have a benign course and rarely can have an infiltrative behaviour. PAMT of the stomach is a very rare mesenchymal tumour with a unique histological appearance, and it needs to be distinguished from GIST and other gastrointestinal mesenchymal tumours, although extra gastric extension and vascular invasion are sometimes observed. Here, we are reporting this case as a case of PAMT arising from the body of the stomach which required multi-visceral resection. [ABSTRACT FROM AUTHOR]

Mucinous tubular and spindle cell carcinoma (MTSCC) of kidney is a rare variant of renal cell carcinoma which was first described in the 2004 World Health Organization classification of tumours of the kidney. Morphologically, MTSCC is composed of tubules merging with bland appearing spindle cells in a myxoid/mucinous stroma. Diverse morphological patterns have been reported in MTSCC; however, a spindle cell predominant morphology mimicking a mesenchymal tumour is rare and only two cases have been reported so far. We report a case of MTSCC with spindle cell predominance in kidney which was a diagnostic challenge. Though MTSCC usually shows an indolent course, there have been cases showing aggressive behaviour even with bland morphology. Hence, a thorough histopathological evaluation with ancillary studies are required to differentiate spindle cell predominant MTSCC from its mimics. Our case was a 40-year-old female who was incidentally found to have a well-defined hypodense lesion measuring around 2 cm in the upper pole of the right kidney. Right partial nephrectomy was performed which showed a 2.7 × 2.5 × 2 cm well-defined grey tan tumour without necrosis or haemorrhage, limited to kidney. Histopathological examination showed sheets of bland-appearing spindle cells mimicking a mesenchymal tumour. The tumour was extensively sampled, revealing small foci of tubule formation and mucinous stroma. Tumour cells were positive for CK7, AMACR, and PAX8. A final diagnosis of MTSCC was made. Hereby, we discuss ways of differentiating MTSCC from other spindle cell tumours of the kidney. [ABSTRACT FROM AUTHOR]

Introduction: Neck masses are frequently encountered in clinical practice and differential diagnoses of a patient presenting with a neck mass is wide. Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) is an imaging technique based on molecular diffusion. It is a very helpful complementary technique in distinguishing neoplastic from non neoplastic tissue and has numerous applications in the evaluation of head and neck masses especially in head and neck lymphadenopathy. Aim: To evaluate the accuracy of Apparent Diffusion Coefficient (ADC) in differentiating benign and malignant neck masses. Materials and Methods: A single-centre cross-sectional study comprising of 50 patients of all age groups with clinical suspicion of neck swelling was conducted in Department of Radiodiagnosis at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India from March 2018 to February 2020. All patients included were subjected to general physical and detailed local examination. MRI was carried out on 1.5 Tesla Unit On Philips Intera Achieva using Sense Body Coil with b factor of 0 and 1000 s/mm² and ADC maps were generated and the results were compared with histopathological results and/or follow-up. Statistical assessment was carried out using Statistical Package for the Social Sciences (SPSS) version 24.0. Qualitative data were compared using the Chi-square test. Results: The most common cause of neck mass was lymph nodal masses (18%) with highest numbers of patients in age group 40-60 years (34%). When a cut-off ADC value of 1.1×10-3 s/ mm² was used, sensitivity of 95.23% and specificity of 89.65% were obtained for characterisation of malignant lesions which was statistically significant. There was a strong agreement (k value=0.838) in diagnosing the nature of lesion using ADC value on MRI with histopathological findings. Conclusion: Diffusion Weighted Imaging (DWI) and ADC values are new promising aspect of MRI and can help in differentiating the nature of the neck lesions. DWI can readily differentiate between benign and malignant lesions of neck with good efficacy and reproducibility.

Retroperitoneal liposarcoma is a malignant mesenchymal tumour. The incidence is rare and early diagnosis is difficult as they present with non specific symptoms. A 55-year-old male patient, presented to General Surgery Department with complaints of abdominal swelling since two months and discomfort for three to four months. Abdominal examination revealed a mass, soft to firm in consistency with restricted mobility, was palpated in right quadrants. A clinical diagnosis of soft tissue tumour was made. Abdominopelvic computed tomography (CT) scan was performed showing a well-defined circumscribed, low-attenuated mass of retroperitoneal origin crossing midline and significantly displacing the intestinal loops, right grade 2 hydronephrosis and was compressing on inferior vena cava posteriorly. The patient underwent a resection surgery of the lesion and the histopathological examination showed a well-differentiated liposarcoma and Castleman’s disease. These tumours are generally resistant to radiotherapy and/or chemotherapy. Thus the major prognostic factor related to survival is resection with tumour-free margins that includes the tumour as well as adjacent structures showing infiltration.

Introduction: Primary pulmonary synovial sarcoma (PPSS) is a rare mesenchymal tumour with characteristic translocation SS18-SSX1/2/rarely 4 fusion transcripts, and presents most often in adolescents and young adults. According to the World Health Organization (WHO) classification, synovial sarcoma is a malignant tumour of uncertain differentiation. Aims: To present a case series of PPSS with clinical, pathological and molecular analysis at a rare primary site. Setting and design: Retrospective study conducted in a tertiary care hospital. Materials and Methods: Twenty-two cases of PPSSs were retrieved from electronic database between January 2009 to December 2018. Metastatic tumours from soft tissue primaries were excluded. Immunohistochemistry (IHC) and reverse transcription polymerase chain reaction (RT-PCR) were performed. Statistical analysis was performed using Mann-Whitney non-parametric test. Results: Among 22 patients, the male-female ratio was 3.4:1 and the median age was 31.5 years. The tumours were classified as monophasic (90.9%) and biphasic (9.1%) subtypes and graded as grade 2(77.3%) and grade 3(22.7%). IHC demonstrated expression of TLE1 (17/17 cases), Bcl-2 (7/8 cases), focal EMA (16/17 cases), CD99 (10/11 cases), focal pancytokeratin (8/12 cases) and CD56 (14/14 cases). The fusion transcripts included SYT-SSX1(4/11, 36.4%) and SYT-SSX2 (2/11, 18.2%). The remaining five cases were negative for SS18 rearrangement by RT-PCR. Only 8 patients had localised tumour. Surgical excision was performed in 5 patients. The median follow-up period was 6 months and 21 days. Conclusions: Monophasic SS was the most common subtype. Small core biopsies pose a diagnostic challenge, in such a scenario, a combination of clinical, histomorphological, immunomarkers and genetic studies help confirm the diagnosis of PPSS. [ABSTRACT FROM AUTHOR]

Plexiform Fibrohistiocytic Tumour (PFHT) is an intermediate malignant tumour of soft tissue. It is a rarely metastasising dermal subcutaneous neoplasm. It affects children and young adults. The age range of presentation is from birth to age 77 years. The tumour is most commonly located on the upper extremities, whereas the involvement of the frontal region is rare. The differential diagnosis includes benign fibrous histiocytoma, fibromatosis, giant cell tumour and neurofibroma. Plexiform fibrohistiocytic tumour is a slow-growing mass and which is considered a low grade malignant tumour. Treatment is simple excision. It can exhibit aggressive behaviour and rate of local recurrence is 12-38%. A 45-year-old female was presented with a solid mass on the frontal region of the head which was diagnosed as a plexiform fibrohistiocytic tumour with underlying frontal bone invasion on histopathological examination of an excised mass in the Pathology Department. Plexiform Fibrohistiocytic Tumour (PFHT) is a mesenchymal neoplasm that shows a multinodular growth pattern and which is composed of fibroblasts, histiocyte like cells and multinucleated osteoclast like giant cells. Clinically, it is usually a slow-growing mass with frequent local recurrence and rare regional lymphatic and systemic metastasis.

Vulval tumours are rare, representing merely 4% of all gynaecological neoplasms. 98% of vulvar lesions are benign, and only 2% are malignant. Of all vulvar malignancies, while squamous cell carcinoma is the most common malignancy, leiomyosarcomas of the vulva are extremely rare. Usually these tumours have nonspecific clinical manifestations, often leading to misdiagnoses of Bartholin cysts or abscesses. We describe a case of a 47-year-old woman who presented with a nonspecific painless swelling in the left vulva for 2 months which was diagnosed as leiomyosarcoma of the vulva on biopsy as well as resection. [ABSTRACT FROM AUTHOR]

Case summary: A 7-year-old female neutered domestic shorthair cat was presented with weight loss, abdominal distension, lethargy, pyrexia and hyporexia. Haematology and biochemistry were unremarkable. Abdominal ultrasound revealed a cystic mass within the left cranial abdominal quadrant, adjacent to the pancreas, stomach and spleen. CT revealed a 10.5 cm, rounded, well-encapsulated, hypodense mass arising from the left pancreatic lobe. The remaining organs of the abdominal and thoracic cavity were unremarkable. A partial left lobe pancreatectomy and splenic lymph node removal were performed. Histopathology of the pancreatic mass reported a proliferating population of neoplastic spindle cells most consistent with a preliminary diagnosis of soft tissue sarcoma. Immunohistochemistry characteristics, together with the morphological findings, were consistent with a diagnosis of leiomyosarcoma. The patient recovered without any concerns after receiving routine postoperative care. Clinical examination and abdominal ultrasound 5 months postoperatively revealed no abnormalities. Relevance and novel information: To our knowledge, this is the first report of pancreatic leiomyosarcoma in a cat. Pancreatic leiomyosarcoma should be considered as one of the possible differential diagnoses for cats presenting with a pancreatic mass. [ABSTRACT FROM AUTHOR]

Introduction: Gastrointestinal Stromal Tumours (GISTs) are the most common mesenchymal tumours of the alimentary canal. Interstitial cells of Cajal are believed to be the cell of origin of GIST which regulates gastrointestinal peristalsis. GISTs encompass a clinicopathologically distinctive, but heterogenous group of neoplasms with reference to their origin, cellular differentiation and prognosis. Aim: The aim of this study was to analyse the histopathological and immunohistochemical characteristics of GIST. Materials and Methods: A hospital-based cross-sectional study of 108 cases of GIST were studied over a period of three years from January, 2017 to December, 2019 in Department of Pathology, Vydehi Institute of Medical Sciences and Research Institute (VIMS&RC), Bangalore. Patient’s demographic data like age and gender were collected. Tumour characteristics like site, size and number of lesions were analysed. Histopathological and immunohistochemistry for Desmin, CD117 and DOG-1 were analysed for significant association with risk groups. Risk stratification according to the Fletcher's risk classification, the cases were divided was divided into very low, low, intermediate and high risk groups. The master chart of collected data was prepared in Excel sheet. Chi-square test with Yates correction was used to calculate p-value to ascertain statistical significance. The master chart of collected data was prepared in Excel sheet. Descriptive statistical analysis was presented in the form of tables, figures and diagrams wherever necessary using Epi info 07 statistical software package. Results: The mean age of the patients was 55.6±14.4 years. Males (55.6%/60 cases) were commonly affected than females (44.4%/48 cases). Small intestine was the commonest location (44.4%/48 cases). Tumour size ranged from 1.5 cm to 25 cm with a mean of 9.1 cm. Microscopic findings revealed that spindle cell type was the most common (86.1%/93 cases). Majority of the cases belonged to high risk category. Multifocality, necrosis, tumour size and >5 mitosis/50 High Power Field (HPF) showed significant association with high risk category tumours (p-value 0.033, 0.016, 0.004 and 5/50 HPF. Risk categorisation of GIST remains important. A combination of CD117 and DOG-1 will be more useful in diagnosing GIST rather than using them alone.

Introduction: Gastrointestinal Stromal Tumours (GISTs) are the most common mesenchymal tumours of the alimentary canal. Interstitial cells of Cajal are believed to be the cell of origin of GIST which regulates gastrointestinal peristalsis. GISTs encompass a clinicopathologically distinctive, but heterogenous group of neoplasms with reference to their origin, cellular differentiation and prognosis. Aim: The aim of this study was to analyse the histopathological and immunohistochemical characteristics of GIST. Materials and Methods: A hospital-based cross-sectional study of 108 cases of GIST were studied over a period of three years from January, 2017 to December, 2019 in Department of Pathology, Vydehi Institute of Medical Sciences and Research Institute (VIMS&RC), Bangalore. Patient’s demographic data like age and gender were collected. Tumour characteristics like site, size and number of lesions were analysed. Histopathological and immunohistochemistry for Desmin, CD117 and DOG-1 were analysed for significant association with risk groups. Risk stratification according to the Fletcher's risk classification, the cases were divided was divided into very low, low, intermediate and high risk groups. The master chart of collected data was prepared in Excel sheet. Chi-square test with Yates correction was used to calculate p-value to ascertain statistical significance. The master chart of collected data was prepared in Excel sheet. Descriptive statistical analysis was presented in the form of tables, figures and diagrams wherever necessary using Epi info 07 statistical software package. Results: The mean age of the patients was 55.6±14.4 years. Males (55.6%/60 cases) were commonly affected than females (44.4%/48 cases). Small intestine was the commonest location (44.4%/48 cases). Tumour size ranged from 1.5 cm to 25 cm with a mean of 9.1 cm. Microscopic findings revealed that spindle cell type was the most common (86.1%/93 cases). Majority of the cases belonged to high risk category. Multifocality, necrosis, tumour size and >5 mitosis/50 High Power Field (HPF) showed significant association with high risk category tumours (p-value 0.033, 0.016, 0.004 and <0.001, respectively). Immunohistochemical staining showed positivity for CD 117 (83.3%/90 cases), DOG-1 (88.9%/96 cases) and 108 cases/100% negativity for desmin. Conclusion: This study found significant association of high risk groups with tumour size, multifocality, necrosis and mitosis >5/50 HPF. Risk categorisation of GIST remains important. A combination of CD117 and DOG-1 will be more useful in diagnosing GIST rather than using them alone. [ABSTRACT FROM AUTHOR]

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Background: A fifteen‐year old, female spayed domestic longhaired cat was presented for a routine vaccination during which an incidental abdominal mass was palpated. After further inquiry, occasional vomiting was reported to occur once every few weeks to months, associated with no other gastrointestinal signs. Case report: Ultrasonography revealed a gastric mass. Histopathology and immunohistochemistry confirmed a CD117 positive, smooth muscle actin and desmin negative neoplasm, consistent with a gastrointestinal stromal cell tumour (GIST). Treatment was initiated with toceranib phosphate resulting in stable disease for over eighteen months, and the patient was still alive at the time of writing. Conclusion: GISTs are rare in cats and this is the first report of medical management of feline GIST using toceranib. [ABSTRACT FROM AUTHOR]

Abstract Background To report six cases of CD34+ fibroblastic mesenchymal tumours, which are uncommon neoplasms in the orbit. Case presentation Six patients presenting with proptosis and palpable mass who were later diagnosed with fibrous solitary tumours, fibrous histocytoma or haemangiopericytoma in the orbit were included. All patients received radiologic examinations and surgical excision for histopathology and immunohistochemistry examinations. Five patients had no recurrence after a minimum follow-up of 12 months. One patient (case 6) experienced recurrence twice, and had debulking surgeries each time. At present, the patient still has remnant tumour in the orbit, but no growth has been detected during the past two years. The tumour size will be closely monitored. Conclusions Even though fibroblastic tumours are rarely found in the orbit, they can present as a palpable mass with proptosis. Complete surgical excision is important for long-term prognosis, and immunohistochemical study is helpful for confirming pathologic diagnosis.

Tumour induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting and hypophosphatemic osteomalacia, caused by FGF-23 (Fibroblast growth factor-23) producing mesenchymal tumours. Here, we report the case of a 40 year old lady referred by her family physician for multiple joint pains of 2 years duration. There was no evidence of inflammatory arthritis. Biochemical investigations revealed low phosphorus, with raised alkaline phosphatase and high levels of FGF-23. As a TIO was considered likely, functional imaging with a DOTATATE PET scan was done, which revealed a DOTA avid lesion in the right foot. Following surgical excision of the tumour, there was significant relief in symptoms and gradual recovery of phosphate to normal levels. It is relevant and important for family physicians as in subjects with symptom like polyarthralgia, a simple measurement of analytes like phosphate, calcium and alkaline phosphatase in primary care setting will help to arrive at a cause and referral for further evaluation as this condition is potentially treatable.

Gastric schwannomas are rare types of gastrointestinal mesenchymal tumours that are slow-growing and mostly benign. They are usually asymptomatic. In some cases, nonspecific gastric symptoms, palpable mass, and bleeding can be seen. A definitive diagnosis requires pathological and immunohistochemical examination, and surgical resection offers an excellent prognosis with uncommon recurrence. We present a case of a 62-year-old woman who underwent exploratory laparotomy and wedge resection with preoperative diagnosis as gastrointestinal stromal tumor and postoperatively diagnosed as schwannoma on histopathology., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, K A et al.)

Gastrointestinal stromal tumor (GIST) represents a rare neoplasm affecting the gastrointestinal (GI) tract and is classified as a common nonepithelial tumor within the GI tract. It originates from the interstitial cells of Cajal, and GIST typically manifests with symptoms such as abdominal pain, weight loss, and gastrointestinal bleeding. This case involves a 33-year-old male who presented with GI bleeding symptoms after eight months of treatment for anemia. Oesophagogastroduodenoscopy (OGDS) revealed a singular ulcerated mass measuring 4x4cm while a computed tomography (CT) scan identified a large fundal exophytic component extending from the gastroesophageal junction to the stomach. Subsequently, the patient underwent a laparotomy and proximal gastrectomy with Roux-en-Y reconstruction, which revealed a 12x10 cm tumor located at the fundus of the stomach. This report aims to underscore the potential for misdiagnosis in the initial presentation of GIST, emphasizing the importance of raising clinical awareness in such cases., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Zahidin et al.)

Adrenal myelolipoma is a rare mesenchymal tumour with benign biological behaviour that is mainly composed of mature adipose and myeloid tissue. Both sexes are equally affected, most commonly between the fifth and seventh decades of life. The diagnosis of adrenal myelolipoma is mostly incidental. Although it may occasionally be associated with necrosis, rupture and haemorrhage, causing abdominal pain, this tumour is usually asymptomatic. Consequently, management is conservative, while surgical treatment is reserved for symptomatic cases, or for masses growing quickly or to a size >6 cm. Giant myelolipomas (sized >10 cm) are rare. Open radical adrenalectomy is the standard treatment for giant myelolipomas, while the minimally invasive approach has been used in only few cases. We herein report the case of a patient with a giant adrenal myelolipoma who underwent robotic partial adrenalectomy. To the best of our knowledge, this is the largest giant adrenal myelolipoma treated with robotic surgery reported in the literature to date. A 55-year-old male patient underwent an abdominal computed tomography scan during follow-up after radical prostatectomy for prostate cancer Gleason Score 6 (ISUP 1) due to biochemical recurrence. The examination revealed a right hypodense adrenal mass, sized 16×13 cm. Abdominal magnetic resonance imaging confirmed the presence of characteristics suggestive of a myelolipoma. The patient did not report any symptoms. Due to the benign characteristics of the mass, robotic partial adrenalectomy and enucleation of the mass were performed. The operative time and estimated blood loss were 205 min and 100 ml, respectively. No intra- or postoperative complications occurred. The patient was mobilized on the first postoperative day and the time to flatus was 36 h; the length of hospitalization was 4 days. Histological examination confirmed the diagnosis of adrenal myelolipoma, sized 18×11.5×6 cm. No tumour recurrence occurred over a follow-up period of 12 months. In conclusion, robotic surgery allows performing partial adrenalectomy with a lower risk of bleeding and with preservation of healthy adrenal tissue, which is of paramount importance for the patient as it reduces recovery time and the need for medical substitution therapy. [ABSTRACT FROM AUTHOR]

Synovial sarcoma (SS) is a rare and aggressive mesenchymal tumour accounting for around 5-10% soft tissue neoplasms usually found in joints of upper and lower extremities. A 35years old healthy looking male patient from Afghanistan presented with swelling on palmar side of base of thumb from last one year. Seven months back excisional biopsy was taken report of which showed neurofibroma/dermatofibroma with. No evidence of malignancy seen. From last 5months mass reappeared and gradually increased in size with itching sensation and mild pain. On local examination there was 5x4x5 cm reddish mass on palmar surface of base of thumb with extension into mid thenar eminence with diffuse margins. X-ray showed soft tissue density mass with spikes of calcification. Ultrasound showed 4.2x4x4.5 cm heterogeneous solid lesion on anteromedial surface of root of right thumb without any remarkable intralesional calcification and remarkable intralesional vasculature. MRI reported lobulated well defined soft tissue mass eliciting low to intermediate signal on T1 and WIs and bright signal on T2and STIR Vividly enhancing mass. Case was operated mass was excised and biopsy sent. Post op status was unremarkable. Biopsy reported poorly differentiated biphasic synovial sarcoma. No recurrence seen till 3months. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 61-year-old male with a painless scrotal mass that was identified as Aggressive Angiomyxoma (AAM), highlighting the importan ce of accurate preoperative diagnosis and histological evaluation for proper treatment.

The aim of this retrospective cohort study was to review urological complication rates arising from familial adenomatous polyposis associated desmoid tumours and their management. All patients over a 35-year period were identified from a prospectively maintained polyposis registry database and had an intra-abdominal desmoid tumour. Those without ureteric complications (n = 118, group A) were compared to those that developed ureteric obstruction (n = 40, group B) for demographics, treatment interventions and survival outcomes. 158 (56% female) patients were identified. Median age at diagnosis was 31 years and desmoids typically occurred 3.6 years after colectomy for familial adenomatous polyposis. Ureteric obstruction secondary to tumour growth occurred in 25% of cases. There was no significant difference in gender distribution or overall age at desmoid diagnosis between the two groups. In group B, the median age at desmoid diagnosis was significantly younger in women compared to men (25 and 43 years, respectively) (p = 0.01). Thirty-eight percent of patients already had ureteric obstruction at desmoid diagnosis, the remainder occurred after 48.6 months, but 20 years in two cases. Seventy-three percent (29/40) had ureteric stenting, a long-term requirement for most. Permanent renal injury occurred in six cases but survival between the two groups was not significantly different. Ureteric obstruction occurs frequently in patients with familial adenomatous polyposis and an intra-abdominal desmoid tumour. Those most at risk are the young following colectomy. Clinicians should actively survey the renal tract at regular intervals after a diagnosis of an intra-abdominal desmoid tumour as complications can arise insidiously, at any stage. [ABSTRACT FROM AUTHOR]

Soft tissue sarcomas are rare mesenchymal tumours. Leiomyosarcoma is a rare malignant tumour of smooth muscle origin that generally arises from soft tissues and uterine tissue. On occasions, they may arise from smooth muscle of the vessel walls, more commonly from the veins. Renal leiomyosarcomas frequently originates from the smooth muscles of renal capsule, renal pelvis or renal vessels. Correct diagnosis and appropriate management is very essential in such cases. We highlight the possibility of malignant soft tissue sarcoma like leiomyosarcoma in the kidney. We emphasize on the suspicion of rare possibility and clinicopathological correlation is required to identify such cases, which has pronounced prognostic implications as whether to do surgical resection or biopsy or treat such patient with chemotherapy or radiotherapy vary with diagnosis.

Uterine sarcomas accounts for about 3% of all uterine cancer. Cutaneous and bony metastasis is extremely rare in uterine leiomyosarcomas. Bony metastasis to fibula from endometrial carcinomas is very rare and very few case reports have been documented with axial skeletal and cutaneous metastasis from uterine leiomyosarcoma. We hereby reports a rare case of metastasis to the fibula and soft tissue, which occurred in less than six months after uterine leiomyosarcoma diagnosis and its treatment, demonstrating the ability of this tumour to metastasize to both bone and soft tissue.

Glomus Tumour (GT) is a rare mesenchymal tumour of the stomach with Gastrointestinal Stromal Tumour (GIST), leiomyoma and schwannoma being far more common and comprising more than 90% of all gastric mesenchymal tumours. As glomus bodies are located in the peripheral parts of the human body, these tumours are peripherally located, classically the subungual region, hands, feet and trunk. While being evaluated for renal problems, a middle aged lady was incidentally found to have a gastric tumour. This was submucosal in location and was excised by a wedge resection and reported elsewhere as carcinoid tumour. The patient came to our hospital for further management. The biopsy was reviewed here and the modified diagnosis given was GT, confirmed by panel of immunohistochemistry. Two years after regular clinical follow up the patient is free of disease or any distant metastasis. In this paper the authors discuss the potential pitfalls, differential diagnoses and diagnostic clues that help in diagnosing this gastric tumour.

Mesenchymal tumours of the orbit are uncommon. Beyond childhood primary sarcomas are extremely rare and the literature is limited to case reports and short case series. However there is a diverse assortment of benign and malignant soft tissue tumours that may involve the orbit. Techniques to identify tumour specific cytogenetic or molecular genetic abnormalities often resulting in over- expressed proteins are becoming an increasingly important ancillary technique for these tumours. This review focuses on 3 specific areas: 1. Orbital mesenchymal tumours where cytogenetics are important to reach the correct diagnosis. The majority of these are chromosomal translocations that often result in a fusion gene and protein product; 2. Orbital mesenchymal tumours where cytogenetics are important to identify patients who will do well versus those with a poorer prognosis. This is turn helps with therapeutic options. In some tumours e.g. synovial sarcoma the chromosomal translocations can occur with 2 different regions resulting in different fusion products that carry a different prognosis. Alternatively whilst the majority of alveolar rhadomyosarcomas are fusion positive a minority are fusion negative with a better prognosis; 3. Orbital mesenchymal tumours where the identification of specific cytogenetic abnormalities has resulted in overexpression of specfic proteins which are diagnostically useful biomarkers for immunohistochemistry. [ABSTRACT FROM AUTHOR]

Tumour induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting and hypophosphatemic osteomalacia, caused by FGF-23 (Fibroblast growth factor-23) producing mesenchymal tumours. Here, we report the case of a 40 year old lady referred by her family physician for multiple joint pains of 2 years duration. There was no evidence of inflammatory arthritis. Biochemical investigations revealed low phosphorus, with raised alkaline phosphatase and high levels of FGF-23. As a TIO was considered likely, functional imaging with a DOTATATE PET scan was done, which revealed a DOTA avid lesion in the right foot. Following surgical excision of the tumour, there was significant relief in symptoms and gradual recovery of phosphate to normal levels. It is relevant and important for family physicians as in subjects with symptom like polyarthralgia, a simple measurement of analytes like phosphate, calcium and alkaline phosphatase in primary care setting will help to arrive at a cause and referral for further evaluation as this condition is potentially treatable. [ABSTRACT FROM AUTHOR]

Non-Islet Cell Tumour Induced Hypoglycaemia (NICTH), presenting with recurrent fasting hypoglycaemia is a very rare paraneoplastic syndrome. It usually presents with large metastatic mesenchymal tumours. NICTH secondary to Gastrointestinal Stromal Tumour (GIST) is even rarer. Diagnosis of NICTH is based on the low serum insulin level, low serum concentrations of Insulin Like Growth Factor (IGF-I) and IGF binding protein- III (IGFBP-III) in combination with elevated concentrations of pro-IGF-II. Various Immunohistochemical (IHC) markers are integral to diagnosis of GIST namely 2-deoxyglucose-6-phosphate phosphatase -1(DOG-1), Cluster Differentiation 34 (CD 34), Cluster Differentiation 117 (CD117). The management requires prompt intravenous hydration and glucose infusions followed by surgical resection. We hereby, report a rare case of a 65-year-old female with intractable fasting hypoglycaemia due to overproduction of "big" insulin-like growth factor II diagnosed to have pelvic GIST and managed by Steroids and Imatinib.

Myxomas are gelatinous tumours that commonly appear as circumscribed masses situated within muscles. It can occur at various sites. However, mostly found in cardiac muscles and skeletal muscles of extremities. Published cases of intrascrotal myxoma are rare in literature. A 28-year-old male was admitted to our General Surgery Department with a history of a gradually enlarging mass in the scrotum and scrotal discomfort since two years. After cytological and imaging investigations, a scrotal exploration was performed with plexiform neurofibroma as the preoperative diagnosis. Histopathological examination of the specimen revealed features of intramuscular myxoma. Although a relatively rare diagnosis, intramuscular myxoma should be considered as a differential diagnosis of testicular and paratesticular tumours.

A 6-year-old pet female degu (Octodon degus), in good body condition, was referred to a clinic with the presence of a large tumour in the anogenital area. The mass was bluntly dissected from the surrounding skin and muscles. The medial part of the tumour was associated with the vaginal wall which was also excised with 2 mm margins. No visible changes on the inner vaginal surface were seen. On gross examination the surface of the mass was glossy and pink-coloured; the cut surface was grey to red with greyish-white foci in a part of the mass. Histopathological examination showed a tumour composed of pleomorphic spindle to ovoid cells forming interlacing bundles and variably dense fibrous connective tissue separated by streams of neoplastic cells. Several smaller foci of coagulation necrosis were present within the tumour tissue. The neoplastic cells exhibited a high mitotic index, which ranged from six to seven mitoses per 10 high power fields. By immunohistochemical examination the positivity of neoplastic cells was demonstrated with smooth muscle actin (SMA) and vimentin, while no immunoreactivity was acquired for cytokeratins. Based on morphological features of the tumour and immunohistochemical examination a diagnosis of vaginal leiomyosarcoma was made. To our knowledge, this is the first report of a vaginal leiomyosarcoma in a degu.

Background: Oncogenic osteomalacia is an acquired form of hypophosphatemic osteomalacia where the tumour resection may lead to cure of the disease. Tumours originating from the musculoskeletal region form an important subgroup of oncogenic osteomalacia. Methods: This was a retrospective study conducted at a tertiary care centre in south India where we analyzed the hospital records of all the patients with musculoskeletal oncogenic osteomalacia from January 2010-April 2016. Results: A total number of 73 patients were diagnosed to have adult onset hypophosphatemic osteomalacia out of which 13 patients (M: F = 6:7; mean age: 45.38 ± 18.23 years) with musculoskeletal oncogenic osteomalacia were included in the study. Common presenting symptoms were bony pains, proximal myopathy and fractures. Mean duration of symptoms from the initial hospital visit was 58.46 ± 64.48 months. The initial mean fibroblast growth factor (FGF) 23 levels being 828.86 ± 113.22 RU/ml (Normal range: 22-91). Imaging modalities used for localization of the tumour: DOTATATE PET/CT (8 patients), FDG PET/CT (3 patients), 1 patient (Both DOTATATE PET/CT and FDG PET/CT) and whole body Tc 99 m Red blood cell (RBC) blood pool scintigraphy (2 patients). 9 patients underwent surgery and all achieved remission. 4 patients denied surgical consent. Conclusion: Musculoskeletal oncogenic osteomalacia is a major subgroup of oncogenic osteomalacia which need more extensive whole body imaging for the localization of the tumour. Surgical excision often leads to remission of the disease. [ABSTRACT FROM AUTHOR]

Introduction Soft tissue mesenchymal tumours are a common occurrence in surgical practice with particular predilection for the extremities. Approximately 1 in 100 soft tissue tumours are found to be sarcomas. The main concern is to exclude any evidence of malignancy. Both imaging studies and a detailed histological analysis is required to ensure that a diagnosis of a high-grade tumour is not missed. Presentation of case Here we present a 38-year-old previously fit and well gentleman with a slowly growing lump in the upper aspect of his abdomen over the previous year being completely asymptomatic from it. He underwent ultrasound, computed tomography and magnetic resonance imaging of the lump. He underwent ultrasound guided biopsy with eventual wide local excision of the lump for a complete histological assessment. This was noted to be a soft tissue mesenchymal tumour. Discussion We highlight the importance of review of the literature and the use of markers that enable histopathologist reach an eventual diagnosis. Mesenchymal tissue during development differentiates into fat, skeletal muscle, peripheral nerves, blood vessels and fibrous tissue. Thereby any of these components may give rise to a tumour. In the majority of cases, the patient is asymptomatic unless there is invasion of nerve sheath or the effects of mass effect. Conclusion Our case is unique due to location of the tumour and its immunohistochemistry findings which required frequent and extensive discussion at our national sarcoma soft tissue meeting. The importance of surgeons working with histopathologists was also highlighted in our case. [ABSTRACT FROM AUTHOR]

Plexiform Fibrohistiocytic Tumour (PFHT) is an intermediate malignant tumour of soft tissue. It is a rarely metastasising dermal subcutaneous neoplasm. It affects children and young adults. The age range of presentation is from birth to age 77 years. The tumour is most commonly located on the upper extremities, whereas the involvement of the frontal region is rare. The differential diagnosis includes benign fibrous histiocytoma, fibromatosis, giant cell tumour and neurofibroma. Plexiform fibrohistiocytic tumour is a slow-growing mass and which is considered a low grade malignant tumour. Treatment is simple excision. It can exhibit aggressive behaviour and rate of local recurrence is 12-38%. A 45-year-old female was presented with a solid mass on the frontal region of the head which was diagnosed as a plexiform fibrohistiocytic tumour with underlying frontal bone invasion on histopathological examination of an excised mass in the Pathology Department. Plexiform Fibrohistiocytic Tumour (PFHT) is a mesenchymal neoplasm that shows a multinodular growth pattern and which is composed of fibroblasts, histiocyte-like cells and multinucleated osteoclast like giant cells. Clinically, it is usually a slow-growing mass with frequent local recurrence and rare regional lymphatic and systemic metastasis. [ABSTRACT FROM AUTHOR]

Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors. Anemia is a common finding in GIST, but the relationship between tumor volume and anemia severity is not well established., Methods: This study aimed to investigate the correlation between the severity of anemia and various factors, mainly tumor volume, in GIST patients who underwent surgical resection. The study included 20 patients with GIST who underwent surgical resection at a tertiary care center. Demographic data, clinical presentation, hemoglobin level, radiological findings, surgical procedure, tumor characteristics, pathological findings, and immunohistochemical analysis were recorded. The tumor volume was calculated from the final resected tumor dimensions., Results: The mean age of the patients was 53.8 ± 12 years. Eleven were males, and nine were females. The most common presentation was upper gastrointestinal bleeding (50%), followed by pain in the abdomen (35%). The most common tumor location was the stomach (75%). The mean hemoglobin level was 10.29 ± 1.9 g/dL. The mean tumor volume was 470.8 ± 1269.07 cc. R0 resection was achieved in 18 (90%) patients. There was no significant correlation between tumor volume and hemoglobin level (r=0.227, p=0.358)., Conclusion: This study found no significant correlation between tumor volume and the severity of anemia in patients with GIST. Further studies with larger sample sizes are needed to validate these findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sakaray et al.)

Cellular Angiofibroma (CA) represents a quite recently described mesenchymal tumour that occurs in both genders, in particular in the vulvo-vaginal region in women and in the inguino-scrotal area in men. The first description of this tumour dates from Nucci et al. article in 1997; since then, the literature reports different reviews and case report of this tumour in both genders, but no article specifically addressing CA treatment and follow-up in women. In this review we collected all 79 published female CA cases, analyzing the clinical, pathological and immunohistochemical features of the tumour. CA affects women mostly during the fifth decade of life, it is generally a small and asymptomatic mass that mainly arises in the vulvo-vaginal region, although there are reported pelvic and extra-pelvic cases. The treatment requires a simple local excision due to an extremely low ability to recurrent locally and no chance to metastasize. Throughout the immunohistochemical and pathological findings it is also easily possible a differential diagnosis from the other soft tissue tumours which affect the vulvo-vaginal area, such as spindle cell lipoma, solitary fibrous tumour, angiomyofibroblastoma and aggressive angiomyxoma. [ABSTRACT FROM AUTHOR]

Plexiform angiomyxoid myofibroblastic tumour (PAMT) of the stomach is a rare mesenchymal tumour predominantly involving the gastric antral region. There has been continued dispute about its nomenclature with other terminologies used for this tumour as plexiform angiomyxoid tumour, plexiform fibromyxoma. Pathologically, this tumour exhibit distinct morphological and immunophentypic features which aid in differentiating it from a wide range of differential diagnoses list. Here, in this paper, we present a case of PAMT with detailed discussion about its clinical profile, radiologic, and pathologic features including its histogenesis and differential diagnoses. [ABSTRACT FROM AUTHOR]

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours usually located in the stomach. They rarely occur in the colon and rectum. These tumours originate from the cells of Cajal and may reach a considerable size before symptoms become obvious. Preoperative diagnosis is difficult to establish, and only a detailed histopathological analysis of the excised tumour will reveal the nature of the disease. We present a case of an elderly male patient with the extraluminal location of a large gastrointestinal stromal tumour at the splenic flexure of the colon which was accidentally discovered at a routine CT examination of the abdomen after a fall on the ground. The literature on this rare modality is briefly reviewed. [ABSTRACT FROM AUTHOR]

Abstract: INTRODUCTION: Haemangioma of ovary is a rare tumour. PRESENTATION OF CASE: We report an ovarian haemangioma which presented as an acute abdomen due to an adnexal mass. DISCUSSION: We report an ovarian haemangioma which presented as an acute abdomen due to an adnexal mass. Haemangiomas have been reported in other organs but ovarian haemangioma is a rare tumor, usually asymptomatic and presenting as an incidental finding. Large lesions tend to present clinically with pain. A few cases have been described in the literature. CONCLUSION: Considering their rare occurrence such tumors are a diagnostic challenge. [Copyright &y& Elsevier]