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1/16. Uterine tumor resembling ovarian sex-cord tumor: report of a case mimicking cervical adenocarcinoma.

    Uterine tumors resembling ovarian sex-cord tumors (UTROSCTs) are unusual neoplasms with histologic features that resemble those within ovarian Sertoli and granulosa cell tumors. We report the case of a 24-year-old woman with a UTROSCT presenting as a cervical mass, which on initial evaluation was thought to represent cervical adenocarcinoma. The patient's cervical biopsy specimen contained epithelioid cells arranged in tubules and anastomosing cords, without significant cellular atypia or mitotic activity. Because this morphology elicited a broad differential diagnosis, immunohistochemical studies were performed. The tumor was found to be diffusely positive for cytokeratin cocktail, calretinin, and desmin, focally positive for CK7 and SMA, and negative for EMA, CEA, inhibin, CD10, CK20, chromogranin, and synaptophysin. Ultrastructural examination revealed occasional gland-like lumens with cells joined by desmosomes and a continuous basal lamina. UTROSCTs have features that may cause them to be confused with more common tumors, especially in limited biopsy samples, and should be included in the differential diagnosis when a gland-forming neoplasm with an unusual appearance is identified in a cervical or endometrial biopsy specimen.
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2/16. Treatment of recurrent cervical adenocarcinoma with BMS-247550, an epothilone B analog.

    OBJECTIVE: The incidence of recurrent cervical adenocarcinoma is rising relative to the squamous subtype. There are limited therapeutic options for women with advanced cervical adenocarcinoma. Only a few chemotherapy agents have demonstrated activity in this disease. This report describes results with BMS-247550, an epothilone B analog that stabilizes microtubules, with activity in previously treated adenocarcinoma of the cervix. METHOD: We present two women with recurrent cervical adenocarcinoma with metastases to the lung. Both women were treated previously with paclitaxel and were enrolled in a phase I study with BMS-247550.Both women had partial responses to BMS-247550 with a decrease in tumor size and CA-125 levels. CONCLUSIONS: The demonstration of a response to BMS-247550, especially after additional chemotherapy had been administered, is encouraging, albeit preliminary. The ultimate role of BMS-247550 and multiagent chemotherapy in the treatment of adenocarcinoma of the cervix should be further investigated.
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3/16. Squamous cell carcinoma in situ involving mesonephric remnants of the uterine cervix.

    Squamous cell carcinoma in situ (CIS) involving mesonephric remnants of the uterine cervix is a very rare lesion, the existence of which is still controversial. A second case of this lesion is reported. It was found in a cone biopsy specimen from an 40-year-old patient. Besides, in surface epithelium and within cervical glands, a structure of CIS was seen in conjunction with mesonephric tubules in deeper cervical stroma. The mesonephric nature of these tubules and of tubule-appearing epithelium within islands of CIS was supported by immunohistochemical positivity for CD10 and vimentin. The lesion strongly simulated invasive carcinomas, such as adenosquamous carcinoma and adenoid basal carcinoma (epithelioma) of the cervix.
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keywords = tubule
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4/16. peutz-jeghers syndrome with multiple genital tract tumors and breast cancer: a case report with a review of literatures.

    We report here on the multiple genital tract neoplasms in a 41-yr-old Korean woman with peutz-jeghers syndrome (PJS). The patient presented with lower abdominal pain. Her previous medical history was PJS and breast cancer. Pelvic ultrasound showed a multilocular cyst at the right adnexal region, diagnosed as bilateral ovarian mucinous borderline tumors. An ovarian sex cord tumor with annular tubules was incidentally diagnosed together with a minimal deviation adenocarcinoma of the uterine cervix and mucinous metaplasia of both the Fallopian tubal mucosa and the endometrium. Although the cases of multiple genital tract tumors with PJS has rarely been reported, the present case appears to be the first in korea in which the PJS syndrome was complicated by multiple genital tract tumors and infiltrating carcinoma of the breast. The clinical significance of the multiple genital tract tumors and breast cancer associated with PJS is reviewed.
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5/16. Mucinous neoplasm in the cervix associated with a mucinous neoplasm in the ovary and concurrent bilateral sex cord tumors with annular tubules: immunohistochemical study.

    The patient described synchronous mucinous tumors of the cervix and ovary and concurrent annular tubules, but without the classical stigmata of peutz-jeghers syndrome. The cervical tumor was an invasive mucinous adenocarcinoma with mixed components of minimal deviation and less-well-differentiated endometrioid morphology. The ovarian tumor had the benign appearance of a mucinous adenoma but histologically revealed areas of invasive carcinoma. Immunohistochemical studies of the mucinous neoplasms of the cervix and ovary are discussed. Neither the staining properties of mucin, the pattern of immunostaining for carcinoembryonic antigen, nor any other common markers were helpful in distinguishing the mucinous neoplasms. Positive immunostaining for low-molecular-weight cytokeratin in the filament profile of sex cord tumors with annular tubules was of particular interest since it has not to our knowledge been previously described.
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keywords = tubule
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6/16. peutz-jeghers syndrome with ovarian sex cord tumor with annular tubules and cervical adenoma malignum.

    A patient with peutz-jeghers syndrome, a sex cord tumor with annular tubules, and an initially unrecognized adenoma malignum of the cervix is described. The patient presented with a mucinous adenocarcinoma in the vaginal apex. review of the hysterectomy slides demonstrated an adenoma malignum of the cervix. In addition to a microscopic sex cord tumor with annular tubules of the right ovary, the left ovary contained mucinous cystadenomas. adenoma malignum remains a difficult diagnosis and is frequently made only after hysterectomy for a presumed benign indication; pathology frequently demonstrates a deeply invasive, unusually well-differentiated adenocarcinoma of the cervix. patients with peutz-jeghers syndrome need careful clinical and cytologic follow-up to exclude such lesions.
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7/16. Florid mesonephric hyperplasia of the cervix: a report of a case with review of the literature.

    A rare case of florid mesonephric hyperplasia (FMH) of the cervix found incidentally in the hysterectomy specimen of a 49-year-old woman was studied with light and electron microscopy as well as histochemistry and immunohistochemistry. A lack of architectural and cytologic atypia of the glands and tubules and a benign clinical course are consistent with a hyperplastic rather than neoplastic process. Direct histologic continuity between mesonephric duct remnants and hyperplastic glands with numerous cytotelolysosomes and lack of intracellular mucin and carcinoembryonic antigen are the features that distinguish FMH from minimal deviation adenocarcinoma of the endocervix.
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8/16. Pelvic neoplasia in peutz-jeghers syndrome.

    A cervical adenocarcinoma, a left ovarian granulosa cell tumor, and a right ovarian sex cord tumor with annular tubules developed in a woman with peutz-jeghers syndrome. This apparent first report of three different pelvic tumors occurring in a patient with Peutz-Jeghers polyposis suggests a possible link between pelvic tumors and the peutz-jeghers syndrome.
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9/16. Does ovarian sex cord tumour with annular tubules produce progesterone?

    Probable progesterone production was identified by an immunoperoxidase assay in a case of an ovarian sex cord tumour with annular tubules. The tumour was associated with a serous cystadenofibroma in the opposite ovary and with adenoma malignum (adenocarcinoma) of the cervix.
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keywords = tubule
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10/16. female genital tract tumors in peutz-jeghers syndrome.

    Multiple genital tract tumors, including bilateral ovarian sex cord tumors with annular tubules, adenoma malignum of the cervix, and bilateral ovarian mucinous tumors, developed in a female patient with peutz-jeghers syndrome. Although each of these tumor types has been reported to occur in this syndrome, the present case appears to be the first in which the syndrome was complicated by tumors of all three types.
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ranking = 1
keywords = tubule
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