Cases reported "Ovarian Neoplasms"

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1/548. carcinoid heart disease from ovarian primary presenting with acute pericarditis and biventricular failure.

    A case is described of a 54 year old woman who had acute pericarditis with large exudative effusion accompanied by severe right and left ventricular failure. The patient was finally diagnosed with carcinoid heart disease from an ovarian carcinoid teratoma. She was treated with octreotide--a somatostatin analogue--followed by radical surgical resection of the neoplasm. At one year follow up only mild carcinoid tricuspid regurgitation remained. Only 16 cases of carcinoid heart disease from an ovarian primary have been described in literature. Moreover clinically manifest acute, nonmetastatic pericarditis and left heart failure are not considered as possible presentations of carcinoid heart disease, whatever the origin. In a recent series a small pericardial effusion was considered an infrequent and unexpected echocardiographic finding in carcinoid heart patients. One case of "carcinoid pericarditis" has previously been described as a consequence of pericardial metastasis. Left sided heart involvement is usually caused by bronchial carcinoids or patency of foramen ovale; both were excluded in the case presented.
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2/548. Cytologic diagnosis of metastatic ovarian adenocarcinoma in the urinary bladder: a case report and review of the literature.

    A 53-yr-old woman with a 13-mo history of recurrent ovarian papillary serous adenocarcinoma presented with persistent microscopic hematuria. The patient was undergoing chemotherapy for her recurrent ovarian tumor when she was referred to the urology service for microscopic hematuria. An intravenous pyelogram was normal. cystoscopy was performed, as well as a urinary bladder washing and mucosal biopsies for examination. adenocarcinoma similar to the patient's primary ovarian tumor was detected in both cytology and histopathology specimens. Ovarian carcinoma comprises 1.3-4.0% of all metastatic neoplasms to the urinary bladder and is an important consideration in the differential diagnosis of a cytologic finding of adenocarcinoma in urine specimens of female patients, where it accounts for an even higher percentage of cases (1 of 3 adenocarcinoma diagnoses in a series of 4,677 urine specimens from female patients).
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3/548. The ultrastructure of a poorly differentiated adenocarcinoma of the human tuba uterina.

    A poorly differentiated adenocarcinoma of the human oviduct was studied by light and transmission electron microscopy. Cells contained abundant mitochondria, bound and free ribosomes, prominent Golgi's bodies and aggregates of membrane-bound dense bodies. The small glandular lumina with numerous microvilli were generally devoid of cilia and contained secretory material. The neoplasm was ultrastructurally similar to poorly differentiated ovarian serous carcinomas.
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4/548. Malignant fibrothecomatous tumour of the ovary: diagnostic value of anti-inhibin immunostaining.

    Malignant ovarian tumours of the fibrothecoma group are rare. The clinicopathological features of a case of ovarian malignant fibrothecoma in which there was metastatic disease in the small intestine and peritoneum at presentation are described. A number of differential diagnoses were considered but positive immunohistochemical staining of the resected ovarian and small intestinal neoplasms with anti-inhibin was of value in confirming a sex cord-stromal tumour and in excluding other lesions. The two tumours were also ultrastructurally identical. Classical malignant fibrothecomas are said to show four or more mitotic figures per 10 high power fields (HPF). Although the intestinal secondary was mitotically active, the primary ovarian tumour contained only one to two mitoses per 10 HPF, showing that formal mitotic counts are not an absolute indicator of malignant behaviour in this group of tumours.
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5/548. Ovarian hepatoid yolk sac tumours: morphological, immunohistochemical and ultrastructural features.

    AIM: The clinicopathological, immunohistochemical and ultrastructural features of two ovarian hepatoid yolk sac tumours (H-YST) from our files are reviewed. methods AND RESULTS: Using avidin-biotin-peroxidase complex technique, the immunoprofile of these tumours was compared to that of a classic yolk sac tumour and to that previously reported for hepatocellular carcinomas. The clinicopathological and morphological features of our cases are similar to the seven previously reported ovarian cases. This rare germ cell tumour occurs in young females (mean age = 17.6 years) and presents most commonly with abdominal pain and a large ovarian mass (average size = 140 mm). Histologically, the tumours display a striking resemblance to hepatocellular carcinoma. The absence of an associated typical pattern of yolk sac tumour or other germ cell neoplasm may make it difficult to recognize the germ cell origin of this lesion. Our cases demonstrated positive staining for alpha-fetoprotein and alpha-1-antitrypsin. In addition, there was immunoreactivity with polyclonal carcinoembryonic antigen (CEA) antiserum in a canalicular pattern, focal staining for inhibin, oestrogen and progesterone receptors and absence of immunoreactivity for CK7 that contrasts with the immunophenotype of a usual yolk sac tumour. CONCLUSIONS: Ovarian H-YST and hepatocellular carcinoma share a similar immunoprofile. Ovarian H-YST is a highly aggressive tumour, most patients exhibit recurrence or die of disease within 2 years of diagnosis.
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6/548. Bilateral ovarian carcinoma metastatic from the ampulla of vater: a rare krukenberg tumor.

    Carcinoma of the ampulla of vater is a relatively rare neoplasm and its longterm survival rate is considerably high. However, because of differences in tumor pathologic features and local invasiveness, a 5-year survival rate differ widely. We present a case of metastatic carcinoma of the ampulla of vater presenting as a krukenberg tumor in a 59-year-old woman. Eight months earlier, she had been diagnosed as well-differentiated adenocarcinoma of the ampulla of vater. Abdominal examination revealed a hard mass with mild tenderness in the RLQ area. The laboratory findings were unremarkable except for mild anemia. CT scan of the abdomen revealed enlargement of both ovaries. An exploratory laparotomy disclosed bilateral ovarian masses, 18 x 12 x 8 cm and 8 x 5.5 x 4 cm in size, respectively. Histologic findings of the both ovarian masses were consistent with metastatic adenocarcinoma from the ampulla of vater.
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7/548. An autopsy case of hepatoid carcinoma of the ovary with PIVKA-II production: immunohistochemical study and literature review.

    A case of hepatoid carcinoma of the ovary in a 61-year-old Japanese woman, who showed high serum levels of alpha-fetoprotein and CA125, is reported. Grossly, the left ovarian tumor, which measured 12 x 9 cm, was solid and multinodular. Histologically, the tumor resembled hepatocellular carcinoma by its architectural and cytological features. liver cell differentiation was indicated functionally by the immunohistochemical detection of alpha-fetoprotein and protein induced by vitamin k absence or antagonist II (PIVKA-II) and by positive bile production, and the hepatocellular differentiation was structurally in accord with keratin 7, 8 and 18 expression. CA125 expression, commonly present in ovarian surface epithelial carcinomas, suggested that this neoplasm originated from ovarian common epithelial cells. There are only nine such cases in the literature. A review of these cases reveals that hepatoid carcinoma of the ovary occurs exclusively in postmenopausal women (mean age, 62.7 years) and that the prognosis is poor.
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8/548. Granulosa-theca cell tumour of the ovaries. A late metastasizing tumour.

    Granulosa-theca cell tumours are ovarian neoplasms of low malignancy with hormone secreting potential, accounting for 2-3% of all ovarian cancers. They have an uncertain clinical course and a potential for late recurrence after surgical removal. Clinical features of a patient presenting with pulmonary metastases 21 years after removal of the primary tumour are described, along with a review of the management options.
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9/548. Well-differentiated mucinous carcinoma of the ovary and a coexisting brenner tumor both exhibit amplification of 12q14-21 by comparative genomic hybridization.

    Although the coexistence of mucinous ovarian neoplasms and Brenner tumors is well established, the histogenesis and developmental relationship between the two remain unknown. We used comparative genomic hybridization to analyze two such tumors occurring simultaneously, one in each ovary, in a patient. Amplification of 12q14-21 sequences was found in both tumors; in addition, both tumors also had other, different changes, four identified in the brenner tumor and six in the mucinous carcinoma. The occurrence of the same genetic alteration in both tumors in this woman suggests that the mucinous carcinoma and brenner tumor may be clonally related, i.e., one arose from the other by means of metastatic spreading of transformed cells from one ovary to the other. An alternative explanation is that some unknown, putative tumorigenic agent induced similar and synchronous pathogenetic changes in the epithelium of both ovaries. The phenotypic differences between the tumors are presumably attributable to the other unique genetic abnormalities identified in both tumor types.
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10/548. 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.
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