Brain Metastases from Breast Cancer Histologically Exhibit Solid Growth Pattern with at Least Focal Comedonecrosis: A Histopathologic Study on a Monocentric Series of 30 Cases

Since there are no morphological clues capable of making a pathologist suspect a possible mammary origin of a metastatic lesion without adequate clinical information, the histologic diagnosis of brain metastasis from BC is still based on the immunohistochemical expression of mammary gland markers such as GATA-3, ERs, PgRs and HER-2. The present retrospective study aimed to select purely morphological features capable of suggesting the mammary origin of a metastatic carcinoma in the brain. The following histological features were collected from a series of 30 cases of brain metastases from breast cancer: (i) a solid growth pattern; (ii) the presence of comedonecrosis; and (iii) glandular differentiation. Our results showed that most cases histologically exhibited a solid growth pattern with at least focal comedonecrosis, producing an overall morphology closely reminiscent of mammary high-grade ductal carcinoma in situ. Although the above-mentioned morphological parameters are not strictly specific to a mammary origin, they may have an important diagnostic utility for leading pathologists to suspect a possible breast primary tumor and to include GATA-3, ERs, PgRs and HER-2 in the immunohistochemical panel.

Impact of comedonecrosis on prostate cancer outcome: a systematic review

Cribriform architecture has been recognised as an independent parameter for prostate cancer outcome. Little is yet known on the added value of individual Gleason 5 growth patterns. Comedonecrosis is assigned Gleason pattern 5 and can occur in both invasive and intraductal carcinoma. The aim of this study is to systematically review the literature for the prognostic value of comedonecrosis in prostate cancer. A systematic literature search of Medline, Web of Science, Cochrane library and Google scholar was performed according to the Preferred reporting items for systematic reviews and meta-analysis (PRISMA)guidelines. After identification and screening of all relevant studies published up to July 2022, 12 manuscripts were included. Clinicopathological data were extracted and the presence of comedonecrosis in either invasive, intraductal or ductal carcinoma was associated with at least one clinical outcome measure. No meta-analysis was performed. Eight of 11 studies showed that comedonecrosis was significantly associated with biochemical recurrence and two studies with metastasis or death. The only studies using metastasis-free and disease specific-free survival as an endpoint both found comedonecrosis to be an independent prognostic parameter in multivariate analysis. The studies were all retrospective and demonstrated considerable heterogeneity with regard to clinical specimen, tumour type, grade group, correction for confounding factors and endpoints. This systematic review demonstrates weak evidence for comedonecrosis to be associated with adverse prostate cancer outcome. Study heterogeneity and lack of correction for confounding factors prohibit drawing of definitive conclusions.

Basaloid squamous cell carcinoma in the maxillary gingiva

Basaloid squamous cell carcinoma (BSCC) is a rare, unique, and aggressive variant of squamous cell carcinoma which mostly occurs in the upper aerodigestive tract. Histologically and immunologically different from conventional squamous cell carcinoma, it is mostly seen in men of the sixth and seventh decades and is commonly associated with tobacco and alcohol usage. BSCC usually presents as a high stage disease with distant metastasis, high recurrence rate, and poor prognosis. In the head-and-neck region, BSCC has a strong predilection for sites such as the base of the tongue, soft palate, and epiglottis. Less commonly, it may also occur on the floor of the mouth, gingiva, and tonsils. In the present article, we report a case of BSCC in the right maxillary anterior gingiva of a 57-year-old female for its rarity.

Basaloid squamous cell carcimoma: A rare case report with review of literature

Basaloid squamous cell carcinoma (BSCC) is a distinct variant of conventional squamous cell carcinoma (SCC), predominantly localized in the upper aerodigestive tract. In the head and neck region, the tumor has a strong predilection for extra-laryngeal sites, such as the base of the tongue, tonsil, hypopharynx and supraglottic larynx. BSCC has well-defined histological features, characterized by nesting, lobular and trabecular arrangement of basaloid cells. Central comedonecrosis within the cell nests, cells with nuclear palisading and high-grade dysplasia in overlying mucosa are the main characteristics. The tumor is considered to be highly aggressive and often presents itself as an advanced stage lesion, thus demanding early diagnosis and prompt treatment. We here report a case of 72-year-old male diagnosed with BSCC involving the right tonsillar region.