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INTRODUCTION AND IMPORTANCE: Congenital hypopharynx duplication cysts are a medical rarity; nevertheless, they offer an important differential diagnosis in neonatal dyspnea or feeding problems. CASE REPORT: Herein, we describe a case of delayed diagnosis but successful surgical removal of a large congenital hypopharynx cyst in a 4-month-old infant presenting with stridor. CLINICAL DISCUSSION: Early and proper diagnosis and surgical handling of hypopharynx cyst can help to achieve the best prognosis and outcome. CONCLUSION: We present the successful management of a newborn with a pharyngeal duplication cyst. In our case, the temporary postoperative laryngeal nerve palsy resolved within four weeks. Overstretching of recurrent laryngeal nerve might have caused this complication.

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The anticarcinogenic potential of vitamin D is attributed to antiproliferative and prodifferentiative effects on cells for a wide variety of carcinomas. The biological effects of 1,25(OH)(2)D (calcitriol) are mediated through a soluble receptor protein termed vitamin D receptor (VDR). However, thus far there have been no studies evaluating the association between VDR expression and vulvar cancer. Using immunohistochemical analysis, VDR expression was evaluated separately in the nucleus, cytoplasm and membrane, in vulvar cancer samples and adjacent non-pathological vulvar tissue from 48 squamous cell carcinoma patients with no prior therapy, and the association between VDR and overall survival was investigated. Overall, among the 48 vulvar cancer cases, nuclear and cytoplasmic VDR expression was present in 47 (97.9%) and 23 (47.9%) cases respectively. The median nuclear VDR expression was significantly higher as compared to the cytoplasmic VDR in the vulvar cancer tissue. No significant correlation between VDR values and the age of the patients was detected. Nuclear and cytoplasmatic VDR in the vulvar cancer tissue were also compared according to the tumor size, and no significant association between mean tumor VDR and tumor size was detected. There was no association between cytoplasmatic VDR expression and OS, but better OS was observed in patients with reduced nuclear VDR expression as compared to those with high VDR expression. VDR may be considered as a useful pathological marker.

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PURPOSE: Malignant tumors of the parotid gland are very rare. Until now there have only been a few reported cases of patients with distant metastasis of breast cancer in the parotid gland. This case shows the rarity of the disease. METHODS: This case is about a 74-year-old woman with an invasive lobular carcinoma of the left breast. The initial diagnosis was made four years ago. The operation which was done was a quadrantectomy and axillary lymph node dissection. It was followed by radiotherapy of the breast. The recommended chemotherapy was declined by the patient. RESULTS: Three years after the initial diagnosis of lobular invasive breast cancer a nodular change in the cicatrice of the mastectomy occurred. The patient also had a contralateral peripheral facial paralysis, caused by a distant metastasis in the right parotid gland. CONCLUSIONS: When there is a tumor in the parotid gland and a histological classified adenocarcinoma is found, the differential diagnosis of breast cancer metastasis should be considered.

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BACKGROUND: Sometimes, cytological lung cancer diagnosis is challenging because equivocal diagnoses are common. To enhance diagnostic accuracy, fluorescent in situ hybridization (FISH), DNA-image cytometry, and quantitative promoter hypermethylation analysis have been proposed as adjuncts. METHODS: Bronchial washings and/or brushings or transbronchial fine-needle aspiration biopsies were prospectively collected from patients who were clinically suspected of having lung carcinoma. After routine cytological diagnosis, 70 consecutive specimens, each cytologically diagnosed as negative, equivocal, or positive for cancer cells, were investigated with adjuvant methods. Suspicious areas on the smears were restained with the LAVysion multicolor FISH probe set (Abbott Molecular, Des Plaines, Illinois) or according to the Feulgen Staining Method for DNA-image cytometry analysis. DNA was extracted from residual liquid material, and frequencies of aberrant methylation of APC, p16(INK4A) , and RASSF1A gene promoters were determined with quantitative methylation-specific polymerase chain reaction (QMSP) after bisulfite conversion. Clinical and histological follow-up according to a reference standard, defined in advance, were available for 198 of 210 patients. RESULTS: In the whole cohort, cytology, FISH, DNA-image cytometry, and QMSP achieved sensitivities of 83.7%, 78%, 79%, and 49.6%, respectively (specificities of 69.8%, 98.2%, 98.2%, and 98.4%, respectively). Subsequent to cytologically equivocal diagnoses, FISH, DNA-image cytometry, and QMSP definitely identified malignancy in 79%, 83%, and 49%, respectively. With QMSP, 4 of 22 cancer patients with cytologically negative diagnoses were correctly identified. CONCLUSIONS: Thus, adjuvant FISH or DNA-image cytometry in cytologically equivocal diagnoses improves diagnostic accuracy at comparable rates. Adjuvant QMSP in cytologically negative cases with persistent suspicion of lung cancer would enhance sensitivity.

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