Dhiraj B Nikumbh

Carcinoma of unknown primary (CUP) is commonly known as ‘occult primary cancer’. It’s defined as metastatic malignant cancer confined by pathology in absence of clinically detectable, anatomically defined primary tumor site after an adequate pretreatment diagnostic evaluation. Herein we present a case of 35 year old female of CUP presented with pain in left axillary region that is vague clinical manifestation. Histopathologically it was proved as metastatic adenocarcinoma on axillary mass probably of breast origin. Primary nature is not diagnosed even on IHC. The aim of this case report is to highlight role of ancillary pathology techniques in challenging cases like CUP. Keywords: Occult, Immunohistochemistry, Carcinoma, Unknown origin.

Massons’s hemangioma is an uncommon, benign and rare vascular tumor. It’s often misdiagnosed as soft tissue sarcoma such as angiosarcoma or Kaposi sarcoma. It is also known as intravascular papillary endothelial hyperplasia (IPEH) accounting for 2% of skin and soft tissue vascular tumors. IPEH characterized by exuberant endothelial proliferation within the lumen of medium sized veins. The most common sites affected are head, neck, fingers and trunk. But the occurrence of IPEH in breast is rarely reported in literature. We diagnosed this case in a 2 month old child presented with right breast bud swelling. On histopathology diagnosed as IPEH/ Masson’s hemangioma. The aim of this case report to highlight the important role of clinical suspicious of such rare entities and histopathological diagnosis to avoid unnecessary aggressive line of treatment for better management of patient care. Keywords: Breast bud, IPEH, Masson’s hemangioma.

Myositis Ossificans is a benign heterotopic ossification mainly occurs in muscles and soft tissue. Hoffa’s disease (Lipoma Arborescens) is a rare benign lesion characterized by villous lipomatous proliferation of synovial membrane. Due to its unusual property of abnormal ossification in muscles and soft tissue, myositis ossificans presents a diagnostic and therapeutic problem to pathologist and clinician respectively, as it mimics soft tissue sarcoma. We present a case of 14 year male presented with left thigh swelling near knee joint with restricted movements. Clinically it was suspected as synovial sarcoma. Wide local excision of mass and synovial membrane excision was done. Final diagnosis on histopathology was given as Myositis Ossificans with Hoffa’s disease. The aim of this case is to highlight the unusual combination as myositis ossificans with lipoma arborescens together due to its rarity and sarcoma mimics. Such type of combination was reported for the first time in present literature in Indian context. Keywords: Myositis ossificans, Hoffa’s disease, Lipoma arborescens, Synovial sarcoma, Tumor, Mimics.