1/89. Ovarian carcinoma, endometrial carcinoma, and pregnancy.A 31-year-old G1 P0 patient with a history of infertility presented with light spotting and cramping at the end of her first trimester. An ultrasonogram at 19 weeks gestation revealed an intrauterine gestation of 21 weeks, a large leiomyoma, and a 8.9 x 6.8 cm complex left ovarian mass. At 35 weeks gestation she had an emergency cesarean section and left salpingo-oophorectomy due to a presumed ruptured ovarian mass. The ovarian mass was diagnosed as a serous cystadenocarcinoma. An exploratory laparotomy with a total abdominal hysterectomy, a right salpingo-oophorectomy, omental biopsy, and periaortic node sampling at 9 weeks postpartum revealed a diagnosis of stage IC ovarian serous cystadenocarcinoma and a stage IA secretory endometrial adenocarcinoma. Adjunctive 32P therapy was successfully administered and at this time the patient has had no recurrence.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/89. tamoxifen-associated polyps (basalomas) arising in multiple endometriotic foci: A case report and review of the literature.We present a case of a 62-year-old G0P0 Caucasian woman who developed endometrial adenocarcinoma, FIGO grade 2, endometrioid type, after receiving tamoxifen for 2 years following a diagnosis of invasive carcinoma and ductal carcinoma in situ of the breast. An incidental finding in the hysterectomy specimen was numerous endometriotic foci involving the submucosa, subserosa, and serosa of the cervix; lower uterine segment serosa; and bilateral ovaries. Polypoid structures, similar to the endometrial polyps occurring in tamoxifen-treated patients, were observed to arise from endometriotic foci in the serosa of the cervix and bilateral ovaries. We have found only one similar report in the literature. Since these structures do not fit the definition of "polyp," we suggest "basaloma" as an alternative. We also review all cases of tamoxifen-associated endometriosis reported in the world literature and cases of polypoid endometriosis occurring in non-tamoxifen-treated patients. Of 12 reported cases of tamoxifen-associated endometriosis, 4 occurred in premenopausal women, 1 in a perimenopausal women, and 7 in postmenopausal women, of whom none had a known history of endometriosis. The endometriotic foci gave rise to a spectrum of lesions which included epithelial metaplasias, simple and complex hyperplasias, polypoid lesions, and 2 cases of endometrioid carcinomas.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
3/89. Endometrial stromal sarcomas: immunohistochemical, electron microscopical and cytogenetic findings in two cases.Uterine sarcomas are approximately 3% of all malignant uterine corpus tumours. Of these, the tumours that originate solely in the stromal elements of the uterine wall are infrequent and have not been well characterized cytogenetically. We report two cases of endometrial stromal sarcomas (ESS), one low grade and one high grade, diagnosed by conventional histology, immunocytochemistry, electron microscopy and cytogenetics. Morphologically clear-cut differential structures were seen at optical, immunohistochemical, and electron microscopic levels, permitting a clear differential diagnosis. The low-grade ESS expressed hormonal receptors and vimentin, whereas the high-grade ESS showed no hormone receptors, high Ki-67 activity, and occasional cytokeratin-positive cells. Ultrastructurally, no malignant epithelial differentiation was seen in the tumour cells, but cilia were found in both cases. Cytogenetic study of the low-grade ESS showed pseudodiploid karyotype with chromosomes 6 and 20 rearranged. The high-grade ESS showed a complex karyotype with clonal numerical and structural anomalies. The chromosomes involved in the structural rearrangements were 1, 3, 6, 7, 13, 14, 15, 17, 19, and 21.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
4/89. Synchronous genital tract neoplasms.Synchronous genital tract neoplasms constitute a more common clinical problem than would be generally expected. This case focuses on mixed mullerian tumours and postulates a mechanism for an increased incidence found associated with synchronous genital tract neoplasms.- - - - - - - - - - ranking = 1390.2504811065keywords = neoplasm (Clic here for more details about this article) |
5/89. Endometrial stromal sarcoma with clonal complex chromosome abnormalities. Report of a case and review of the literature.Only eleven endometrial stromal sarcomas (ESS) with clonal chromosomal abnormalities have been reported in the literature. Of these, four have been reported to harbor the t(7;17) translocation. We report here an additional ESS that exhibited clonal complex chromosome abnormalities not described earlier: 38,XX,-1,del(1)(q11),-2,add(2)(p13),-3,der(4)add(4)(p12)psu dic(4;14)(q35;q11.2), add(6)(p21.3),add(7)(q22),del(7)(p11.2p13),-8,-9,add(9)(q34),- 10,add(10)(q24),-11,-11,ins(12;?) (q13;?),-14,-14,-15,ins(15;?)(q22;?),add(16)(q22),add(17)(q11.2),- 18,der(18)t(7;18)(q11.2;p11.2),-19, add(20)(p13),add(21)(p11.2),-22,add(22)(p11.2), 6mar in metaphase cells from primary short-term culture.- - - - - - - - - - ranking = 5keywords = complex (Clic here for more details about this article) |
6/89. The use of microsatellite instability in the distinction between synchronous endometrial and colonic adenocarcinomas.The association of endometrial carcinoma with other gynecologic neoplasms, especially ovarian and fallopian tube carcinoma, has been well documented and is usually interpreted as a result of a field defect. Sporadic synchronous primary carcinomas occurring in the endometrium and colon are extremely rare, especially in the absence of the familial genetic abnormalities seen in hereditary nonpolyposis colorectal carcinoma (HNPCC) syndrome, and may present a diagnostic dilemma. Two cases of synchronous adenocarcinomas of the endometrium and colon were studied for genetic abnormalities and differences to test for the presence of two primary tumors. Primary tumors, metastases, and normal tissues were microdissected from formalin-fixed, paraffin-embedded tissues. PCR amplification was performed for microsatellite DNA markers on chromosome 17q and 11q13. The colonic tumors were moderately and poorly differentiated, invasive, nonmucinous adenocarcinomas, whereas one uterine tumor was endometrioid adenocarcinoma and the other was papillary serous carcinoma. Although microsatellite instability, as evidenced by changes in the lengths of the amplified PCR products, was detected at 17q and 11q13 loci in the uterine and colonic neoplasms, the patterns of instability differed between the two primary tumor sites. Moreover, the lymph node metastasis in one colonic tumor had genetic alterations that differed from that of the primary tumor. In both patients, the molecular studies suggested the presence of two synchronous primary tumors. Molecular techniques may assist in distinguishing two separate primaries by determining the contraction and expansion of microsatellite regions in DNA obtained by microdissection from the primary tumors and associated metastases.- - - - - - - - - - ranking = 463.4168270355keywords = neoplasm (Clic here for more details about this article) |
7/89. Endometrial carcinoma in tamoxifen-treated breast cancer patient: clinicopathological, immunohistochemical, and genetic analysis.Endometrial polyps and endometrial neoplasms are a recognized complication of chronic tamoxifen treatment. This study describes an endometrial carcinoma that developed in a woman receiving low-dose tamoxifen treatment for breast cancer. Little is known about steroid receptor status, somatic alterations in oncogenes and tumor suppressor genes, and inherited susceptibility in endometrial carcinomas associated with tamoxifen use. In the present case, the endometrial carcinoma was negative for estrogen receptors and weakly positive for progesterone receptors. In addition, analysis of K-ras, c-erbB2/neu, cyclin d1, and p53 status revealed a codon 12 point mutation in the K-ras oncogene. The patient was determined not to be a carrier of germ-line mutations in cytochrome P-450 1A1 (CYP1A1), an estrogen-metabolizing gene previously associated with enhanced endometrial cancer risk, but she was a carrier of a methylenetetrahydrofolate reductase gene variant related with putative alterations in dna methylation.- - - - - - - - - - ranking = 231.70841351775keywords = neoplasm (Clic here for more details about this article) |
8/89. Symptomatic intracavitary (noninvasive) cardiac metastasis from low grade endometrial stromal sarcoma of the uterus.We report a 49-year-old woman who was operated upon 33 years ago for uterine endometrial stromal sarcoma of low-grade malignancy. The patient showed obstruction of the right ventricular outflow tract. An echocardiogram and MRI showed that a mass emanating from the inferior vena cava filled the right atrium, the right ventricle, and part of the pulmonary artery. The entire intracavitary neoplasm was successfully removed and diagnosed as low-grade endometrial stromal sarcoma. To our knowledge, this is the second report of a low-grade endometrial stromal sarcoma reaching the heart via the inferior vena cava. In this case an intracavitary metastasis may be a feature indicating the progression of the endometrial stromal sarcoma. Therefore, this neoplasm should be included in the differential diagnosis of cardiac intracavitary neoplasms. patients affected by this tumor may benefit from early identification and resection of the obstructing neoplasm.- - - - - - - - - - ranking = 926.83365407099keywords = neoplasm (Clic here for more details about this article) |
9/89. Palliative radiation therapy for brain metastases from endometrial carcinoma: report of two cases.Although endometrial carcinoma is a common invasive neoplasm of the female genital tract, brain metastases are extremely rare and few reports exist of their treatment with radiation therapy. We report two patients with manifest clinical signs of brain metastases from endometrial carcinoma on computed tomography (CT) or magnetic resonance imaging (MRI). These two patients had multiple brain metastases, with widespread dissemination late in the course of the disease and received palliative whole-brain radiation therapy to a total dose of 50 Gy in 25 fractions (case 1) and 30 Gy in 10 fractions (case 2). After radiation therapy, improvement of neurological function (NF) was observed in both patients. The duration of improvement of NF was 9 weeks in case 1 and 12 weeks in case 2. The patients died 5 months and 3 months after the diagnosis of brain metastases, respectively. In these two cases, palliative radiation therapy was effective in improving the quality of the remaining lifetime and appears to be the best treatment for brain metastases from endometrial carcinoma as well as those frequently seen from other primaries.- - - - - - - - - - ranking = 231.70841351775keywords = neoplasm (Clic here for more details about this article) |
10/89. Detection of pulmonary metastasis of low-grade endometrial stromal sarcoma 25 years after hysterectomy.Endometrial stromal sarcoma (ESS) is a rare uterine sarcoma. Low-grade ESS occasionally recurs or metastasizes after long disease-free periods, a fact that may complicate the diagnosis. Here we report a case of multiple lung metastases in a 68-year-old woman who had been disease-free for 25 years after hysterectomy for a uterine tumor. biopsy revealed that the tumor was composed of oval cells with slight nuclear atypism but without mitotic figures, suggesting a low-grade neoplasm. Immunostaining for intermediate filaments revealed strong positivity for vimentin and weak positivity for alpha-smooth muscle actin. In addition, immunostaining for estrogen and progesterone receptors, performed under suspicion of low-grade ESS, was positive. The uterine tumor resected many years before had shown a similar morphology. Thus, it was demonstrated that the lung neoplasm was a metastatic low-grade ESS that had appeared after many disease-free years. A review of the literature revealed that this case had the longest recorded interval between the occurrence of the initial ESS and the development of distant metastases. When low-grade sarcoma appears in the lungs of female patients, it is important to consider the possibility of low-grade ESS. Detailed information on the past clinical history, together with immunostaining for estrogen and progesterone receptors, are important diagnostic keys.- - - - - - - - - - ranking = 463.4168270355keywords = neoplasm (Clic here for more details about this article) |
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