1/6. Metastatic foci of signet ring cell carcinoma in a tubular adenoma of the colon.We describe a case of adenomatous polyp of the colon that harbored small foci of signet ring cell carcinoma. The patient was a 64-year-old woman with end-stage renal disease and sepsis who underwent colonoscopy to evaluate the possibility of pseudomembranous colitis. A polyp was found incidentally in the right colon and a biopsy was performed. Histologic examination of the polyp revealed typical features of tubular adenoma without evidence of high-grade dysplasia. However, 2 small foci of signet ring cell carcinoma were identified that infiltrated the lamina propria. In contrast to adenomatous epithelium, the signet ring cells were immunohistochemically positive for cytokeratin 7 and negative for cytokeratin 20, suggesting a metastasis rather than a primary tumor. Multiple random biopsies from the right and left colon, as well as the ileum, exhibited no histologic evidence of malignancy. Subsequently, signet ring cell carcinoma with similar morphology and identical immunophenotype was detected in biopsies from the endometrium, an unusual location for primary signet ring cell carcinoma. Preliminary workup excluded the breast as a possible primary site, but further investigation was not possible because of the patient's death with no autopsy granted. To the best of our knowledge, this is the first reported case of metastatic signet ring cell carcinoma to an adenomatous polyp of the colon. This case illustrates the necessity of submitting all polyps entirely and the importance of examining them carefully.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |
2/6. Solitary spleen metastasis and amyloidosis in a patient with endometrial cancer.BACKGROUND: In contrast to autopsy findings, solitary splenic metastases from solid tumors are extremely rare. It may occasionally be the first manifestation of recurrent solid cancers, and in particular of gynecologic malignancies. Secondary amyloidosis is also found in malignancy. CASE: A 52-year-woman originally diagnosed with a Stage IB, grade 2 endometrial carcinoma presented two and a half years later with a paroxysmal non-productive cough, weakness, loss of appetite and daily afternoon fever. On clinical examination wheezing on forced exhalation and painful splenomegaly was found. After an extensive work-up the patient underwent an explorative laparotomy and a splenectomy was performed. Histologic examination showed solitary spleen metastasis with amyloidosis. All symptoms resolved. As the patient had received a full course of postoperative irradiation after a total abdominal hysterectomy, six cycles of combination chemotherapy were administered. The patient remains free of recurrence, 46 months later. CONCLUSION: A case of solitary spleen metastasis with amyloidosis in a patient with endometrial cancer is presented.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |
3/6. Metastatic papillary endometrial carcinoma of the tongue. Case report and review of the literature.tongue metastases are exceptional, with a frequency of 0.1% to 0.2% in autopsy series of patients with disseminated cancer. A case of secondary papillary endometrial carcinoma of the tongue is reported as the first sign of metastasis in a 78-year-old white woman treated 7 years before by complete hysterectomy and radiotherapy. The lesion presented as a 3 x 3-cm submucosal mass of the dorsum of the tongue. Fine-needle aspiration and excisional biopsy established the diagnosis. Metastases to the lungs, liver, and bone developed 3 months later, and she died 6.5 months after initial diagnosis. A review of reports of 77 lingual metastases showed that the mean age was 57 years, with a male predominance. The lung, kidney, and skin were the most common primary sites. The tongue was the first site of metastases in 61% and the first sign of the primary malignant neoplasm in 15% of the cases. Average survival was 10 months.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |
4/6. Primary extranodal NK/T cell lymphoma ("nasal type") of the endometrium: report of an unusual case diagnosed at autopsy.Primary natural killer (NK)/T cell lymphoma of the female genital tract is extremely rare. We here report the case of a "nasal type" NK/T cell lymphoma arising in the uterus. The diagnosis was established only at autopsy.- - - - - - - - - - ranking = 5keywords = autopsy (Clic here for more details about this article) |
5/6. Synchronous primary endometrial and ovarian carcinoma in a patient with marantic endocarditis.BACKGROUND: Nonbacterial thrombotic endocarditis (NBTE), or marantic endocarditis, is a rare form of endocarditis found in patients with advanced malignancy and collagen-vascular disorders. There is limited information about the clinical course of patients with NBTE because the majority of cases are found at the time of autopsy. CASE: A 38-year-old woman presented to the emergency department with recent onset of chest pain and fatigue. Initial evaluation revealed cardiac valvular disease, and the patient underwent aortic valve replacement. Final pathology revealed nonbacterial thrombotic endocarditis. A metastatic work-up revealed a complex pelvic mass and elevated CA 125. The patient underwent an exploratory laparotomy and was subsequently found to have synchronous primary endometrial and ovarian carcinoma. CONCLUSION: Nonbacterial thrombotic endocarditis is rare and carries a high mortality. This case is unusual in that the diagnosis of nonbacterial thrombotic endocarditis led to the diagnosis of a gynecologic malignancy.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |
6/6. Endometrial metastases from gastric adenocarcinoma: a case report.Embolic metastases to the endometrium are unusual, especially from extragenital cancers. Metastases in the uterine corpus are generally detected at autopsy. We describe a patient with abnormal vaginal bleeding in whom endometrial metastases from an inoperable gastric tumor were discovered in hysteroscopic biopsy specimens.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |