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MOH Journal of Medical Case Reports

MOH Journal of Medical Case Reports

The MOH Journal of Medical Case Reports is an open-access peer-reviewed journal focusing on the need to have individualized cases examined separately. Our journals currently accept Editorials, Case Reports, Experiences, and Letters to the Editor. All submitted research will be subject to the rigorous standards of our editorial team, as well as other external clinical professionals within their respective fields.

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Latest Articles

Borderline Brenner Tumor of the Ovary: Case Report and Review of the Literature

Abstract: Ovarian neoplasms are a heterogeneous group of tumors with varying presentation and outcomes. The most common are surface epithelial tumors, including transitional cell tumors and Brenner tumors. Brenner tumors are rare neoplasms of the ovary composed of transitional / urothelial-like epithelium, typically embedded in the fibromatous stroma. Benign, borderline, and malignant variants are recognized based on the presence or absence of stromal invasion and histocytological features of the epithelial cells. The vast majority of Brenner tumors are benign, often incidental findings; however, malignant Brenner tumors do occasionally occur. We present a case of a 75-year-old female diagnosed with a symptomatic borderline Brenner tumor of the right ovary. We discuss diagnostic techniques, differential diagnoses, and treatments of Brenner tumors. We encourage further studies to thoroughly understand the clinical features, diagnostic techniques, and treatment of various Brenner tumors. Download PDF 

| Hannah Pulido*1, Makenzie Ammons1, Rona Bakri1, Brandon Kimbrough1, Zachary Elder1, Janelle Cruz1, Nicole Forte1, and Mohamed Aziz2

Primary Retroperitoneal Angiosarcoma with Extensive Metastasis to Abdominal Organs: Case Report and Review of the Literature

Abstract: Angiosarcomas (AS) are subtypes of soft-tissue sarcoma and are aggressive, malignant endothelial-cell tumors of vascular or lymphatic origin and comprise less than 1% of all soft tissue sarcomas. Most AS are cutaneous lesions; however, they can also present in bone, breast, soft tissue, and visceral organs. A substantial variability can be seen in the clinical presentation and survival of AS patients based on AS subset and case-by-case presentation. Retroperitoneal angiosarcoma is a highly uncommon entity and often presents late with unspecific symptoms and high infiltration to nearby anatomical structures contributing to the poor outcomes compared to other AS subtypes. As such, it is paramount to keep AS in the differential when vascular lesions are identified in the abdomen, as early complete surgical resection often yields the best results for AS patients. A consensus treatment algorithm for AS is lacking, and more evidence is needed to understand better the factors that impact prognosis and the efficacy of various therapies. We present a case of rare primary angiosarcoma of the retroperitoneum with extensive metastasis to abdominal organs with a discussion of diagnostic methods and treatment options. Download PDF 

| Abdulrahman Baghdadi*1, Omar Baghdadi1, Khadija Baghdadi1, Rona Bakri1, Brandon Kimbrough1, Haley Gerrits1, and Mohamed Aziz2

Mammary Myofibroblastoma of the Breast: Case Report and Review of the Literature

Abstract: Myofibroblastoma (MFB) is a relatively rare breast tumor that belongs to the family of the “benign stromal tumor of the breast”. The differential diagnosis of MFB includes several reactive, benign, or even malignant entities. A definitive diagnosis of myofibroblastoma can be histomorphologically challenging, requiring ancillary studies. There have been <100 published case reports of mammary MFB reported to date after being first described as a distinct entity in 1987. The clinical significance of this entity lies primarily in its recognition as a distinctive benign neoplasm. We present a case of MFB, and we review the literature. Download PDF  

| Tyler Price*1, Brant Grisel1, Sofia Nunnelee1, Courtney Johnson1, Noreen Masciello2, Diana Rochez1, Stephanie Bernik3, Mohamed Aziz4

Invasive Cribriform Carcinoma of the Breast: Case Report and Review of the Literature

Abstract: Invasive cribriform carcinoma (ICC) is one of several known breast cancer variants. It is a rare type of invasive breast cancer with an incidence of approximately 0.3%-6% in primary breast carcinomas. ICC has a cribriform pattern resembling the histological structures of cribriform ductal carcinoma in situ (cribriform DCIS). Immunohistochemistry studies show a low-grade infiltrating carcinoma with an irregular cribriform growth pattern and absent myoepithelial cells. Distinguishing ICC from other types of breast cancer, particularly those with a cribriform pattern, can be challenging. This report presents a case of ICC in a 51-year-old woman with a brief review of current literature. Download PDF 

| Madeleine Yeakle*1, Kyle Coombes1, Kayvon Moin1, Bishoy Mark Joseph1, Joseph Varney1, Sherif Nasr2, Stephanie Bernik3, Mohamed Aziz2

Metastatic Mucinous Adenocarcinoma of the Colon Presenting as a Solitary Lung Mass: Case Report and Review of the Literature

Abstract: Lung carcinoma is the second most common cancer in both men and women and is the leading cause of cancer-related mortality in the United States and the world. Invasive mucinous adenocarcinoma (IMA) is an uncommon subtype of colorectal adenocarcinoma. Colonic adenocarcinomas can be further classified as invasive or non-invasive and mucinous or non-mucinous. Studies indicated that of all colorectal adenocarcinoma patients, 10-20% were diagnosed with the IMA subtype. IMA malignancies can arise from three main contributors of microsatellite instability, including deficient mismatch repair, hypermethylation of promoter CpG islands, and mutations in the RAS/MAPK pathways. When the diagnosis of IMA is rendered in a lung tumor, it is essential to rule out primary versus metastatic IMS. Commonly identified immunohistochemistry (IHC) studies contributing to differentiation include CK7, CK10, CDX2, and TTF-1. We present a case of metastatic mucinous adenocarcinoma of the colon presenting as a solitary lung mass, and we briefly review the literature. Download PDF 

| Priya Raju*1, Omar Alzein1, Sandhya Roy1, Katie King1, Corey Steinman1, Jessica Jahoda1, Sherif Nasr2, Mohamed Aziz2

Adenoid Cystic Carcinoma of the Breast: Case Report and Review of the Literature

Abstract: Adenoid cystic carcinoma (ACC) is a relatively uncommon malignancy that most commonly develops in the salivary glands or other regions of the head and neck but can also develop in the nasopharynx, trachea, uterine cervix, skin, lungs, kidneys, and rarely the breast. Although few cases of ACC are hormonal positive, it is generally classified as triple-negative breast cancer (TNBC). Still, unlike other TNBCs, it has an indolent clinical behavior with an excellent prognosis. Breast-conserving surgery followed by radiation therapy is the usual treatment strategy. Axillary lymph node dissection or sentinel node biopsy is debatable and may not be necessary in some cases. Definitive diagnosis of ACC can be challenging due to close histomorphological features with other benign and malignant conditions, and immunohistochemistry studies are essential. We present a case of adenoid cystic carcinoma of the breast to add to the limited literature and provide a brief review of the literature. Download PDF 

| Brant Grisel1, Tyler Price1Graeme Benzie1Kiran Singh1Mirelle Alktaish1, Blake Martin2Sherif Nasr3, Mohamed Aziz3

Aneurysmal Bone Cyst: Case Report and Review of the Literature

Abstract: An aneurysmal bone cyst (ABC) is a benign, aggressive lesion that can affect any bone but primarily appears in the metaphysis of long bones. It predominately affects children and young adults and may present anywhere from asymptomatic to a painful, swollen deformity. The pathogenesis of this lesion continues to remain unclear. Nevertheless, the recent discovery of USP6 gene translocations in up to 70% of ABCs solidifies ABC as a true neoplasm. The other 30% are likely due to ABC-like changes (also referred to as secondary ABC) associated with other bone lesions. Although diagnosis is possible through radiographic imaging studies, histologic evaluation is needed to differentiate ABC from other similar entities. Several therapeutic options have been implemented in the treatment of ABC, including selective arterial embolization, surgery, sclerotherapy, and even monoclonal antibodies. We present a case of this uncommon tumor and provide a brief review of the literature. Download PDF 

| Brant Grisel1, Tyler Price1Graeme Benzie1Kiran Singh1Mirelle Alktaish1, Blake Martin2Sherif Nasr3, Mohamed Aziz3

Epithelioid Malignant Peripheral Nerve Sheath Tumor: Case Report and Review of the Literature

Abstract: Malignant peripheral nerve sheath tumor (MPNST) is an uncommon soft tissue tumor originating from peripheral nerve cells, including Schwann cells, perineural cells, and fibroblasts. Epithelioid MPNST (EMPNST) is a rarer variant showing epithelioid morphological features and a distinctive immunohistochemical profile. EMPNST can arise in association with a pre-existing neurofibroma or any peripheral nerve and typically have a relatively long period of slow growth followed by a sudden growth acceleration. This tumor can be confused with other tumors such as malignant melanoma or epithelioid tumors due to similar histology; however, its unique immunohistochemistry and genetic profile allow for precise differentiation. Treatment for both MPNSTs and EMPNSTs is equal, involving a combination of complete resection with negative margins and cytotoxic chemotherapy. To add to the limited literature on EMPNST, we present a case of this rare flank tumor with metastasis to the lungs and review the literature. Download PDF 

| Graeme Benzie*1, Brant Grisel1, Tyler Price1, Amanda Lima1, Maty Boury1, Eric Wallace1, Jessica Jahoda1, Mohamed Aziz2

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