Metastatic melanoma may simulate a broad spectrum of primary malignant tumors. Significant similarity in cytomorphologic features can exist in both melanoma and lobular carcinoma of the breast. This can cause significant diagnostic difficulty, especially when there is inadequate patient history and/or limited biopsy material. The extraordinary phenotypic plasticity of metastatic melanoma adds to the diagnostic challenge of these tumors. Awareness of this pattern variance is essential to avoid diagnostic errors and inappropriate treatment. Here we present a case of metastatic lobular carcinoma, which was initially diagnosed as metastatic melanoma. Awareness of the similar cytomorphologic features of both melanoma and lobular carcinoma as well as the use of immunohistochemistry studies aided in providing the final diagnosis of this case and avoiding a diagnostic error.

Adenoid Cystic Carcinoma (ACC) is a slow growing neoplasm which often recurs within one to two decades after treatment. There are many subtypes of ACC, including cribriform, tubular, and solid forms, which have been found to correlate with overall prognosis as well as recurrence among patients with history of previously resected or treated ACC. Review of the existing literature shows that it is difficult to detect and control recurrence of ACC as most sites of metastasis do not show clinical signs or indications until the neoplasm has become increasingly advanced. Adenoid cystic carcinoma of the head and neck is usually found in the salivary glands, oral cavity, nasopharynx, and palate. There have been only a few reported cases of adenoid cystic carcinoma involving the External Auditory Canal (EAC). We present a case of ACC of the EAC along with a review and discussion of the literature to date.

Decubital ischemic fasciitis is a rare disease process characterized by pseudosarcomatous fibroblastic proliferation. The disease process is most commonly observed in elderly debilitated or immobilized patients. Its pathophysiology is characterized by degeneration and regeneration of mitotically active fibroblasts. Due to its histologic appearance, proximity to bone, and patient population, decubital ischemic fasciitis is occasionally mistaken for a soft tissue sarcoma. We report a case of this rare condition, diagnosed utilizing magnetic resonance imaging and subsequent core needle biopsy with microscopic evaluation. We also discuss the importance of early and accurate diagnosis in patients suspected of having this condition, as it is vital to rule out the potentially malignant soft tissue sarcoma, while also utilizing effective quaternary prevention and avoiding overtreatment in patients with benign decubital ischemic fasciitis.

This report presents the diagnosis of Kaposi sarcoma by the minimally invasive procedure of fine needle aspiration. The patient, a 65-year-old HIV negative Mediterranean man with a history of colon cancer, presented with right inguinal lymphadenopathy. Biopsy of the lymph node showed histological morphology consistent with Kaposi sarcoma confirmed by HHV-8 positive immuno stain. We review the role of HHV-8 in the pathogenesis of Kaposi sarcoma. We also discuss how it presents differently than Multicentric Castleman disease of the lymph node, caused by the same virus. How the latent and lytic pathways of the virus can influence the progression of the Kaposi sarcoma and Multicentric Castleman disease, respectively. Also, we review various treatment modalities for Kaposi sarcoma.

Ovarian granulosa cell tumor (GCT) is the most common malignant sex cord–stromal tumor, representing 2% to 3% of all ovarian cancers. It is generally considered to have a good prognosis with late recurrence typically occurring 5 to 20 years later. The majority of these tumors are locally aggressive and recur in the abdomen, pelvis, or lymph nodes. Distant metastases have been reported, particularly to the  lung and liver, bone metastases are extremely rare and reflect hematogenous spreading. We present a case of a 60-year-old woman who was found to have an isolated lytic lesion in the right medial clavicle. The clavicle lesion proved to be a metastatic GCT with recurrence 20 years later. There are only a few GCTs with bone metastases reported in the literature and to the best of our knowledge this is the first reported metastasis to the clavicle bone.