SUMMARY Introduction: Penile carcinoma is a rare tumour, repre- senting about 1% of all male tumours. The verrucous subty- pe is quite infrequent, displays specific prognostic implica- tions and needs very strict criteria for its diagnosis. Patients, methods and results: Two cases of this entity in patients of 85 and 77 years-old are reported. Partial penec- tomy was performed in both cases. Conclusions: Pathologi- cal features and differential diagnosis of this entity are reviewed. The strict application of histological criteria is very important to perform an adequate diagnosis and prog- nosis.

We describe a case of temporal granulocytic sarcoma in a 26-year-old patient after apparent molecular remission of an acute myeloid leukaemia. He complained of otodynia with hearing loss and facial paralysis on the right side. He was treated with chemotherapy and self-transplant haematopoietic stem cells. He was cured clinically, molecular remission of the haematological processes was achieved, and he remained asymptomatic for three years. Facial paralysis and hearing loss associated with temporal GS should be treated with chemotherapy. Aggressive surgery may complicate the clinical course of the disease and it should be avoided.

CONCLUSION:Sentinel lymph node biopsy (SLNB) is a technique that facilitates the study of metastasis in oral and oropharyngeal cancer and reduces morbidity in patients affected by this pathology.OBJECTIVES:Oral and oropharyngeal cancers are common and are frequently associated with spread to cervical lymph nodes. We attempted to confirm the usefulness of SLNB in patients suffering from squamous cell carcinoma of the oral cavity as a prognostic technique for lymph node prediction of micrometastatic invasion. Using surgical parameters, we compared its relevance against a retrospective group without SLNB.PATIENTS AND METHODS:We studied a prospective group of 22 patients, 21 men and 1 woman, aged 40-83 years (mean=57.77, SD=13) in which SLNB was performed and a retrospective group of 22 patients, 19 men and 3 women, aged 34-76 years (mean=52.68, SD=11) in which SLNB was not performed. Both groups presented oral cavity tumors at clinical stages T1-T3 and radiological stage N0. SLNB consisted of preoperative lymphoscintigraphy (LG), intraoperative detection of the sentinel lymph node (SLN), and a histopathological examination following the recommendations of the Association of Directors of Anatomic and Surgical Pathology (ADASP) and the Canniesburn protocol.RESULTS:We observed SLNs in 21 of 22 patients, with a total of 32 SLNs detected at cervical level II (65.63%), I (21.87%), and III (12.5%). SLNB displayed a sensitivity of 73% (confidence interval (CI)=0.51-0.99) and 100% specificity (CI=1). Negative and positive predictive values were 80% and 100%, respectively. SLNB significantly reduced the incidence of radical neck dissection (p=0.003), the need for recovery/resuscitation beds after surgery (p=0.002), surgical complications (p=0.034), and length of hospital stay (p=0.01).

Trigeminal plexiform neurofibromas involving the orbit and the infratemporal fossa are rare tumours. An uncommon case of a plexiform neurofibroma of the trigeminal nerve occurring in a 53-year-old female patient with severe cosmetic deformity is reported. The clinical findings, neuroradiographic features, surgical management, postoperative results and follow-up of trigeminal plexiform neurofibromas are reviewed.

Background: Metastatic tumors account for less than 1% of all malignant tumors occurring in the oral cavity. Case Report: The clinical case of a 94-year-old patient with a mandibular tumor is reported here. The patient had undergone bilateral mastectomy more than 25 years before. An immunohistochemical study found hormone receptors in signet ring cells, suggesting a diagnosis of breast cancer metastasis. Conclusion: Immunohistochemical diagnosis and antineoplastic hormone therapy is the cornerstone in the management of this clinical case.

Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of cancer that mainly arises in the upper aerodigestive tract. This study reviews the clinico-pathological features and follow-up of a series of cases occurring in the head and neck. During a 32-year period (1974-2005), a total of 40 BSCCs have been diagnosed in the head and neck in our Institution. Males predominated in the series (35M/5F). The average age was 60.2 years (range, 40-85). Tobacco and alcohol consumption was found in more than 80% of the cases. Topographic distribution was as follows: larynx and hypopharynx, 22 cases (55%); oropharynx, 12 cases (30%); and oral cavity 6 cases (15%). The basaloid component predominated in 29 cases (72.5%). Vasculo-lymphatic invasion was detected in 5 cases (12.5%). Lymph node metastases were seen in 25 cases (62.5%, levels II and III in the neck dissection). Local recurrences appeared in 11 cases (27.5%) and distant metastases in 6 (15%). In 7 cases (17.5%) a second primary tumour was detected. The 2002 TNM staging was as follows: Stage I, 5 cases (12.5%); Stage II, 7 cases (17.5%); Stage III, 8 cases (20%), and Stage IV, 20 cases (50%). On follow-up, 21 cases (52.5%) are alive and 19 (47.5%) died of disease. Three- and 5-year overall survival was 50% and 38.5%, respectively. A significant shorter survival was detected in node positive patients (P<0.05).

SUMMARY Introduction: Lipomatous hypertrophy of the atrial septum is diagnosed more frequently after the use of non- invasive imaging techniques. Case presentation: A case of lipomatous hypertrophy of the atrial septum in a 72 year-old woman who consulted because of effort-related angina is reported. The study of the excised tissue fragments showed the typical histology, with mature adipocytes and lipoblasts intermingled with cardiac muscle fibres. Conclusions: This lesion is relatively frequent but surgical treatment is rarely needed. So, pathologists take contact with it mainly in the autopsy. The recent literature related to atrial lipomatous lesions is reviewed.

La hipertrofia adiposa del septo interauricular es cada vez más frecuentemente reconocida gracias al desarrollo creciente de las técnicas de imagen no invasivas. Se presenta el caso de una paciente de 72 años de edad aquejada de angina de esfuerzo a la que en el estudio clínico se detectó una hiperplasia adiposa del septo interauricular. El estudio de la pieza de resección quirúrgica mostró la histología típica de esta entidad, con adipocitos maduros y lipoblastos entremezclados con fibras musculares cardiacas. Aunque esta patología es relativamente frecuente, rara vez necesita ser corregida quirúrgicamente, motivo por el cual los patólogos la suelen diagnosticar en el estudio autópsico. Se revisa la literatura reciente en relación con las lesiones adiposas auriculares. Lipomatous hypertrophy of the atrial septum is diagnosed more frequently after the use of noninvasive imaging techniques. A case of lipomatous hypertrophy of the atrial septum in a 72 year-old woman who consulted because of effort-related angina is reported. The study of the excised tissue fragments showed the typical histology, with mature adipocytes and lipoblasts intermingled with cardiac muscle fibres. This lesion is relatively frequent but surgical treatment is rarely needed. So, pathologists take contact with it mainly in the autopsy. The recent literature related to atrial lipomatous lesions is reviewed.