1/103. Sonographic presentation of uterine sex cord-stromal tumor.A 24-year-old woman presented with continuous vaginal bleeding and anemia. Pelvic sonography demonstrated an enlarged uterus measuring 8.9 x 4.9 x 4.7 cm and a mass within the endometrial cavity measuring 3.0 x 1.8 cm. The mass appeared to be polypoid and echogenic, contained a small cyst, and was suggestive of a polyp. The patient underwent total vaginal hysterectomy. Pathologic examination revealed a uterine sex cord-stromal tumor. To our knowledge, the sonographic features of uterine sex cord-stromal tumor have not been previously reported. The sonographic appearance mimicked that of a polyp.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/103. Is uterine serous papillary carcinoma a BRCA1-related disease? Case report and review of the literature.OBJECTIVES: Type II endometrial carcinomas are estrogen-independent and have adverse histologic features and a substantially poorer prognosis. No risk factors have been identified. Interestingly, there is a striking clinical and histopathological similarity between serous papillary carcinomas of the ovary (OSPC), endometrium, and peritoneal cavity, suggesting a common oncogenic mechanism. Several common molecular alterations were found using molecular comparative analysis of OSPC and uterine serous papillary carcinoma (USPC). Germline mutations in the BRCA1 tumor suppressor gene predispose to breast and ovarian cancer but no association with sporadic endometrial cancer has been found. A family of Ashkenazi Jewish origin, in which one sister was first diagnosed with USPC and the second diagnosed with OSPC, led to the hypothesis that a BRCA mutation may contribute to USPC. methods: Genomic dna from both patients as well as two unaffected siblings was analyzed for the three mutations common in Ashkenazi jews. loss of heterozygosity (LOH) analysis was performed on dna extracted from USPC tumor tissue. RESULTS: Both affected sisters tested positive for BRCA1 5382insC germline mutation. LOH analysis confirmed the results. CONCLUSIONS: We present a breast-ovarian cancer family including two sisters with advanced serous papillary carcinomas of endometrial and ovarian origins, carrying the same BRCA1 mutation (5382insC). LOH analysis on USPC tumor dna showed loss of the wild-type allele, suggesting a causal relationship between the germline BRCA1 mutation and USPC. We believe a study examining BRCA1 mutations in a large cohort of women with this high-risk endometrial carcinoma is warranted. A positive finding may have implications for surveillance and prophylactic surgery in carriers of BRCA1 mutations.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
3/103. Collision of uterine rhabdoid tumor and endometrioid adenocarcinoma: a case report and review of the literature.Extrarenal malignant rhabdoid tumors have been reported in a variety of anatomic sites but infrequently in the female genital tract. In the uterus, they have been described as a pure tumor, in association with endometrial stromal sarcomas, and as a component of a malignant mullerian mixed tumor. This study reports an unusual uterine neoplasm in a 49-year-old woman, in which a malignant rhabdoid tumor occurred as a collision tumor with a well-differentiated endometrioid adenocarcinoma. The tumor was a 14-cm polypoid mass that filled the endometrial cavity. The two neoplastic components were distinct on microscopic and immunohistochemical examination. Ultrastructural examination confirmed the rhabdoid phenotype of the sarcomatous component. The patient died of disease 4 months after diagnosis with progression of the malignant rhabdoid tumor. The highly aggressive behavior of the rhabdoid (i.e., nonepithelial) component in this collision tumor lends support for a distinction of this neoplasm from a malignant mullerian mixed tumor, with which it may be confused.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/103. Torsion of a functional ovarian cyst in a premenopausal patient receiving tamoxifen.We report a case of torsion of an ovarian follicular cyst that developed during treatment with tamoxifen for breast cancer. A 40-year-old Japanese woman was admitted complaining of acute lower abdominal pain. Eight months earlier, she had undergone a partial mastectomy and local irradiation for ductal carcinoma of her left breast, estrogen receptor-positive stage I (T(1a) N(1b) M(0)). The administration of tamoxifen, 20 mg/day, and doxifluridine, 600 mg/day, were started immediately postoperatively. Pelvic examination after admission revealed the left ovarian cyst and enlarged uterus. Transvaginal ultrasonography and computed tomography revealed a multilocular cystic mass in the pelvic cavity. The pathological diagnosis of the tumor after total hysterectomy and bilateral salpingo-oophorectomy was a typical follicular cyst with torsion and uterine leiomyoma. This ovarian cyst was believed to have developed during tamoxifen administration.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
5/103. hemoperitoneum from spontaneous bleeding of a uterine leiomyoma: a case report.Bleeding from uterine leiomyoma is a rare cause of hemoperitoneum. In most cases bleeding is a result of trauma or torsion. Spontaneous rupture of a superficial vein is extremely rare. Fewer than 100 cases have been reported. Our patient is a 44-year-old black woman who presented in the emergency room with acute onset of epigastric pain. Past medical and surgical history was not contributory except for a uterine "fibroid." In the emergency room, the patient's abdomen became diffusely tender. Her pregnancy test was negative, and the abdominal ultrasound showed fluid in the peritoneal cavity. The patient became hemodynamically unstable, and there was a significant drop of the hemoglobin/hematocrit. A surgical consultation was requested, and the patient underwent exploratory laparotomy. A subserosal uterine leiomyoma was found, with an actively bleeding vein on its dome. The leiomyoma was excised and 3 liters of blood and blood clots were evacuated from the peritoneal cavity. The patient was premenopausal and had a known leiomyoma. The clinical course was similar to that of previously reported cases. Although extremely rare, when there is no history of trauma, pregnancy, or other findings, spontaneous bleeding from uterine leiomyoma should be in the differential diagnosis. Emergent surgical intervention is recommended to establish the diagnosis and stop the hemorrhage.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
6/103. Prolonged remission of recurrent, metastatic placental site trophoblastic tumor after chemotherapy.BACKGROUND: Placental site trophoblastic tumor (PSTT) is a form of gestational trophoblastic neoplasm that is frequently resistant to chemotherapy. In most cases disease is confined to the uterus and can be cured by curettage or simple hysterectomy. patients with metastases, however, frequently have progression of disease and die despite aggressive multiagent chemotherapy. CASE: A 31-year-old woman was found on review of uterine curettings to have a PSTT. Imaging studies revealed multiple lung lesions, a liver lesion, and an enlarged irregular uterus. hysterectomy and staging surgery revealed a large tumor in the endometrial cavity and multiple metastases. She was treated with etoposide-methotrexate-dactinomycin and cyclophosphamide-vincristine and had a complete clinical remission. Six months later, however, she had a recurrence. She was then treated with six cycles of etoposide-methotrexate-dactinomycin and etoposide-cisplatin. Three years after completion of the second regimen she is without evidence of disease. CONCLUSION: Treatment with multiagent chemotherapy can produce long-term remission, even in patients with recurrent, metastatic PSTT. Addition of platinum may be helpful in patients who have recurred or progressed after treatment with non-platinum-containing regimens.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
7/103. Uterine myxoid leiomyosarcoma.BACKGROUND: Uterine myxoid leiomyosarcoma is rare, has a poor prognosis, and must be distinguished from a uterine myoma with myxomatous change. CASE: A 56-year-old woman with a history of epigastric pain and generalized abdominal swelling had a peritoneal cavity filled with tumor that originated from the posterior uterine wall. Chemotherapy and two operations for recurrence could not prevent fatal metastases to the vascular system. Histopathology showed a typical myxoid leiomyosarcoma. CONCLUSION: Although the patient's prognosis was poor, no mitoses were observed, and the nuclear abnormalities were not sufficient to diagnose the tumor as malignant at the initial surgery. Whenever a uterine myoma with myxomatous change is found, the patient should be monitored carefully.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
8/103. A large yolk sac may be important in the early diagnosis of gestational trophoblastic disease: a case report.A large yolk sac in a deformed shape gestational sac was detected by ultrasonography in an 8 week pregnant woman. The disappearance of the yolk sac and the gestational sac, enlargement of the uterine cavity and a heterogeneous appearance similar to early gestational trophoblastic disease were recognized when ultrasonographic examination was performed 2 weeks later. After uterine evacuation, partial hydatidiform mole was diagnosed by histopathological evaluation of the curettage material. In our study, the role of the large yolk sac in predicting trophoblastic disease is discussed.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
9/103. Endometrial stromal sarcoma of the uterus: MR and US findings.We describe the MRI and US features of two patients with endometrial stromal sarcoma of the uterus. Both lesions appeared as voluminous polypoid masses within an expanded endometrial cavity on both US and MRI. They had mixed echo-texture and heterogenous signal intensity on both T1- and T2-weighted sequences. T2-weighted images were most helpful in detecting the endometrial nature of the disease and its relationships with surrounding myometrium.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
10/103. Adenomyomatous polyp mimicking hydatidiform mole on ultrasonography.The authors present a case report of a 62-year-old woman who experienced irregular genital bleeding. Although the serum hCG level was extremely low, transvaginal ultrasonography revealed vesicle pattern in the uterine cavity, suggesting trophoblastic disease. hysterectomy was performed and histological diagnosis was adenomyomatous polyp. To our knowledge, this is the first report that the adnomyomatous polyp can demonstrate the vesicle pattern on ultrasonography.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
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