Basal cell carcinoma (BCC) is the most common human cancer and represents a growing public health care problem. Although it is known that basal cell carcinoma is minimally associated with the risk of metastasis, this risk is increasingly reported in recent years. As BCC tumors display great variability in morphology, aggressiveness, and response to treatment, there is a need for further understanding of these tumors including diagnosis, molecular alterations, and management. In this report, we present a case of an 88-year-old man with history of BCC of the skin of his right breast, which eventually lead to death due to wide metastatic disease. We describe the features associated with the risk of metastasis and provide a brief review of the current literature.

Extraskeletalmyxoidchondrosarcoma is an uncommon soft tissue sarcoma that can resemble a much more common sarcoma, myxoidliposarcoma, leading to misdiagnosis. This has important clinical implications as these pathologies differ in treatment, recurrence rates, and metastasis. Here, we present a case of a 29-year-old man, who presented with a large soft tissue mass at the front of the left ankle. This case presented a diagnostic challenge based on histomorphology and IHC studies alone. Molecular testing was essential for definitive diagnosis due to lack of agreement among soft tissue pathology experts. Reporting cases of EMC is imperative in order to bridge the gap between the known pathological features of this tumor and the consideration of this neoplasm in differential diagnoses.

We report a case of a 26-year-old who woman presented with a 2.6 cm solitary slowly growing subcutaneous nodule covered by normally appearing skin on her left groin. The Original pathological examination of the mass was described as storiform-appearing cellular with slight subcutaneous fat infiltration positive CD34 immunostain. On second opinion the mass was described as well-circumscribed surrounded by a thin, membranous layer. Histomorphologic examination of the lesion described a storiform architectural pattern composed of spindle cells with plump nuclei, characteristic of Schwann cells. Further evidence of a schwannoma was supported by a positive S-100 stain along with the positive CD34 stain. However, an additional stain of epithelial membrane antigen (EMA) was positive, more consistent with a perineurioma. The clinicopathologic and immunohistochemical features of the lesion supported the diagnosis of a hybrid perineurioma/schwannoma, a unique form of peripheral nerve sheath tumors.

Introduction: Angiomatoid fibrous histiocytoma (AFH) is a rare soft-tissue neoplasm often arising in children and young adults. They commonly occur in somatic soft tissue, mainly the upper and lower extremities. AFH is a translocation associated neoplasm, with the majority of cases positive for EWSR1-CREB1 translocation. The tumor was initially described as “malignant” AFH. However, it has a relatively rare chance of metastasis. AFH shows a broad spectrum of morphological patterns, and metastatic lesions may or may not show malignant features.

Report: We report a case of a 12-year-old female who presented with a left supraclavicular mass that was initially diagnosed as a benign fibrous histiocytoma. The mass was excised with clear surgical margins. Six years later, the patient presented with multiple retroperitoneal masses and later succumbed to metastatic disease. Molecular studies confirmed an EWSR1-CREB1 fusion gene in the primary and metastatic lesions. The culmination of these features led to the diagnosis of a metastatic angiomatoid fibrous histiocytoma.

Conclusion: AFH is a rare neoplasm with a spectrum of morphological characteristics and a vast array of immunophenotypical profiles. This can make the diagnosis of AFH challenging. Few cases of metastatic AFH have been reported in literature. However, when these lesions do metastasize, they are often fatal. It is our hope that this report raises awareness of what remains an unmet need in the diagnosis and management of “angiomatoid fibrous histiocytoma with malignant features.”

Introduction: The most common cause of primary spontaneous pneumothorax (PSP) is sub pleural bleb apical rupture. Little is known about the relationship between PSP and exercise and return to exercise time. In this study, we tend to investigate the relationship between exercise and PSP and time of return to exercise and previous activities.

Method: This study was designed as a case series and the sample size included all patients diagnosed with PSP in Razi and Poursina and Aria hospitals of Rasht during 2015-2019 based on inclusion criteria. Variables were analyzed using Fisher’s exact test, Chi square, Mann Whitney U and t-test (p<0.05).

Results: The most common type of treatment in patients was transaxillary thoracotomy with pleurodesis with iodine (TTP) in 58.2% and tube thoracostomy and pleurodesis in 41.7%, which was not statistically significant between athletes and non-athletes (p=0.806). Athletes who underwent TTP after 4 weeks and those treated with tube thoracostomy and pleurodesis after 8-12 weeks were advised to return to their previous activity. Of athletes, 9.5% had recurrence; of non-athletes, 9.8% had recurrence. Of athletes, 4.8% did not tolerate a return to their previous activity; of non-athletes, 7.3% did not tolerate returning to their previous activity regardless of treatment, and this difference was not significant.

Conclusion: Our study showed no significant difference between clinical manifestations and image findings as well as frequency of treatment and complications in both athlete and non-athlete patients. There is no increase in recurrence and intolerance at the time recommended for return to previous activity.