Since then, 17 additional cases of this rare neoplasm have been reported.4 The patient age ranged from 9 to 69 years, with a male-to-female ratio of 5:1. Lesion duration ranged from 3 months to 7 years. Although

this neoplasm occurred in different locations (scalp, thigh, wrist, knee, forearm, etc), 9 were localized to subcutaneous tissues, 1 occurred in the spermatic cord, 1 in a subungual location, 1 in the buccal mucosa, 2 intra-articular, 1 in the oral cavity, 1 in the colon, and 1 in the posterior learn more mediastinum.3 Our patient is the first to present with renal angiomyxolipoma (Table 1). The combination of adipose tissue, spindle cells, vascular channels, and myxoid stroma may overlap with several other neoplasms that share similar morphologic features. Distinguishing clinical, morphologic, and immunohistochemical features of each entity, which may enter the differential diagnosis, are summarized in Table 2.4 and 5 To date, only 1 case of angiomyxolipoma has been studied cytogenetically. In 1 case report by Sciot et al,2 analysis revealed translocations t(7;13)(p15;q14) and t(8;12)(q12;p13), genetic aberrations similar to ordinary lipoma, spindle cell and/or pleomorphic CDK inhibitor lipoma, and myxoma. In instances where the clinical, morphologic, and immunohistochemical findings overlap with other neoplasms, cytogenetic analysis may be of utility

in resolving difficult cases (Table 2).4 and 5 Since his last operation, the patient has been clinically asymptomatic. Follow-up consisted of imaging by CT scan every 6 months for the first year and then yearly for the last 2 years. The last CT scan done 3 months ago showed no tumor recurrence. Laboratory studies have been consistent with normal renal function and reserve. Angiomyxolipomas have thus far been regarded as benign neoplasms. This may be attributed to their circumscribed nature, bland morphologic features, absence of necrosis and mitotic activity, a low proliferation index (Ki-67), and nonrecurring

nature on follow-up. Angiomyxolipoma Casein kinase 1 is a rare benign neoplasm with characteristic histopathologic and immunohistochemical features, usually located in the subcutaneous tissue, with a characteristic morphology and a consistent immunoprofile, whose line of differentiation is not completely clarified.2 and 4 Its location, as demonstrated in this case report, can be variable. The pathologic behavior, prognosis, and follow-up have only been extrapolated from existing reported cases. Strong evidence will not be possible, except after a significant number of reported cases and analysis of their natural course of disease. “
“High-grade neuroendocrine carcinomas, which are also known as poorly differentiated neuroendocrine carcinomas, arise more frequently in the lung, and approximately 2.5% occur in extrapulmonary sites, including the genitourinary tract.