However, some other features, including necrosis, mitotic activity of more than five mitoses/ 50 HPF, and combination of high nuclear grade and high mitotic activity showed a trend toward but did not achieve statistical significance.24 As a matter of fact, our patient, as well as case no. 25 of their series and the patient reported by Watanabe et al.,22 showed high nuclear grade and high mitotic activity and, even though superficial in location, metastasized.
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