Protein Expression of PTTG1 as a Diagnostic Biomarker in Adrenocortical Carcinoma.

Background: Adrenocortical carcinoma (ACC) has a poor prognosis and there is an unmet clinical need for biomarkers to improve both diagnostic and prognostic assessment. Pituitary-tumor transforming gene (PTTG1) has been shown to modulate cancer invasiveness and response to therapy. The potential role of PTTG1 protein levels in ACC has not been previously addressed.

Detection of mitotic figures and G2+ tumor nuclei with histone markers correlates with worse overall survival in patients with Merkel cell carcinoma.

Background: High mitotic figure count (MFC) correlates with low survival rate in Merkel cell carcinoma (MCC). However, the prognostic impact of histone biomarkers as surrogates of MFC in MCC is unknown. We evaluated the prognostic significance of the immunodetection of mitotic figures and of G2+ tumor nuclei with histone-associated mitotic markers H3K79me3T80ph (H3KT) and phosphohistone H3 (PHH3) in MCC.

p40 is more specific than p63 for the distinction of atypical fibroxanthoma from other cutaneous spindle cell malignancies.

Poorly differentiated, cytologically malignant, spindle cell neoplasms of the skin may present a diagnostic challenge with important clinical consequences. In particular, the distinction between poorly differentiated cutaneous spindle cell squamous cell carcinoma (SpSCC) and atypical fibroxanthoma (AFX) remains controversial, but with important clinical implications: SpSCC exhibits an increased tendency for both local recurrence and metastasis compared with AFX. AFX is generally accepted as a diagnosis of exclusion based on negativity for a broad panel of immunohistochemical markers, including multiple cytokeratins, melanocytic markers, muscle markers, and vascular markers.

Melanoma of unknown primary origin presenting as a rapidly enlarging adrenal mass.

Metastasis to the adrenal can be seen in the context of metastatic melanoma, but primary adrenal melanoma is very uncommon. We present a case of a rapidly enlarging adrenal mass that mimicked non-functioning primary adrenal malignancies but later proved to be part of a widely metastatic melanoma of unknown primary origin. Careful physical examination of the patient led to the discovery of a subcutaneous metastatic focus that was not seen on [(18)F]-fluorodeoxyglucose positron emission tomography/CT imaging.