1/9. Concurrent primaries of vaginal clear cell adenocarcinoma and endometrial adenocarcinoma in a 39-year old woman with in utero diethylstilbestrol exposure.diethylstilbestrol (DES) was used widely in the late 1940s in an attempt to prevent adverse pregnancy outcomes. In 1971 the US food and Drug Administration proscribed its use for pregnancy support secondary to its association with clear cell adenocarcinoma of the vagina. Several studies in animal models demonstrated an association with endometrial cancer among offspring following in utero DES exposure. To date, there is only one case report of endometrial cancer in women exposed to DES in utero. We present the first case, to our knowledge, of a woman exposed to DES in utero who presented with double primaries of clear cell cancer of the vagina concomitant with endometrial cancer.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/9. Renal cell carcinoma in pregnancy.Renal cell carcinoma is a rarely reported neoplasm in pregnancy. The pregnancy demands special consideration in terms of the diagnostic evaluation and management. Two patients with renal cell carcinoma who presented during the second trimester of pregnancy and underwent radical nephrectomy are reported with a review of published studies. It seems that because the mother's welfare is the primary concern, surgical management need not be delayed.- - - - - - - - - - ranking = 3.5keywords = pregnancy (Clic here for more details about this article) |
3/9. Clear cell ovarian carcinoma in a pregnant woman with a history of infertility, endometriosis and unsuccessful IVF treatment.Ovarian cancer in pregnancy is a very rare event. We present here the case of a 37-year-old woman in whom a clear cell ovarian carcinoma was diagnosed in the first trimester of pregnancy. This patient had a history of infertility, endometriosis and two previous unsuccessful attempts of in vitro fertilization. Transvaginal sonography at six gestational weeks revealed a 6 x 4 cm ovarian cyst with an internal papillary excrescence. The cyst persisted throughout the first trimester, whereas the initial CA 125 value of 226 U/ml dropped to 61 U/ml at 12 gestational weeks. Exploratory laparotomy and cystectomy was performed at 14 weeks and the disease was classified as Stage Ic, arising in endometriosis. The couple decided to continue with pregnancy and the woman was followed by serial sonographic, MRI and CA 125 examinations. A cesarean section, hysterectomy, bilateral salpingo-oophorectomy and omentectomy was performed at 34 weeks. histology and cytology were negative for recurrence. Four months later the woman and baby are doing well. We review cases of ovarian clear cell carcinoma diagnosed during pregnancy and discuss the association of endometriosis, infertility, infertility drugs and ovarian cancer.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
4/9. Arias-Stella reaction of the endocervix: a report of 18 cases with emphasis on its varied histology and differential diagnosis.We report 18 cases of Arias-Stella reaction involving the endocervix with an emphasis on histologic features that can be encountered and result in the misdiagnosis of carcinoma. The patients ranged in age from 19 to 44 years. Two patients had a history of oral contraceptive use and 15 were pregnant; clinical information was not available in one case. Ten lesions presented as cervical polyps, and six were incidental findings in specimens obtained because of cervical dysplasia, dysfunctional uterine bleeding, fibroids, and a missed abortion. One patient was found to have a cervical "lesion" on a routine gynecologic examination. In the remaining patient, a cervical biopsy was obtained, for unknown reasons, at the time of termination of pregnancy. Microscopic examination showed a varied histologic appearance including vacuolated clear cytoplasm (18 cases), intraglandular tufts (16 cases), hobnail cells (14 cases), oxyphilic cytoplasm (13 cases), delicate filiform papillae (12 cases), intranuclear pseudoinclusions (10 cases), cribriform intraglandular growth (3 cases), and a single mitotic figure in 1 case. The histologic changes involved the superficial glands (6 cases), deep glands (4 cases), or both (8 cases); confluent or extensive gland involvement was seen in 8 cases. Follow-up information, available in four cases (4, 2, 1, 1 years), was unremarkable. The principal consideration in the differential diagnosis was clear cell carcinoma. The features most helpful in this distinction were the usual lack of a mass suspicious for cancer, absence of a desmoplastic response, lack of an infiltrative pattern, spectrum of cytologic atypia, low nuclear-cytoplasmic ratio, and usual lack of mitotic activity.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
5/9. hypercalcemia induced by ovarian clear cell carcinoma producing all transcriptional variants of parathyroid hormone-related peptide gene during pregnancy.BACKGROUND: parathyroid hormone-related peptide (PTHrP) appears as the major causative agent responsible for the humoral hypercalcemia of malignancy (HHM). However, the use of promoters and splicing patterns of PTHrP gene in HHM have not been reported yet. CASE: A 35-year-old woman was diagnosed as an ovarian clear cell carcinoma with HHM caused by elevated serum PTHrP after delivery. An immunohistochemical study showed PTHrP expression in the tumor tissue. The Southern blot analysis following RT-PCR confirmed the presence of all types of PTHrP mRNA transcripts produced by a combination of three promoters, one 5' alternative splicing and three alternative 3' splicing events. CONCLUSION: An ovarian clear cell carcinoma induced PTHrP-related HHM, which resulted from the high expression of all isoforms for PTHrP gene.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
6/9. Hemihypertrophy, bilateral Wilms' tumor, and clear-cell adenocarcinoma of the uterine cervix in a young girl.We report the case of a young girl who had hemihypertrophy and developed Wilms' tumor in both kidneys and clear-cell adenocarcinoma of the uterine cervix with no maternal history of stilbestrol ingestion during pregnancy. karyotype on the second Wilms' tumor showed monosomy 22. The link between hemihypertrophy and Wilms' tumor is well known, but their association with clear-cell carcinoma of the cervix has not been previously described.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
7/9. Rapid growth of an ovarian clear cell carcinoma expressing LH/hCG receptor arising from endometriosis during early pregnancy.The complete clinical course of a case of ovarian clear cell carcinoma expressing luteinizing hormone (LH)/human chorionic gonadotropin (hCG) receptor arising from endometriosis in a pregnant woman is presented. A 31-year-old woman visited a private clinic in May 1993 for screening tests for infertility. Transvaginal ultrasonography revealed no abnormal findings in the uterus or ovaries. Her menstrual cycle was regular; however, a slight luteal insufficiency was noted. She had been treated with clomiphene, and soon became pregnant. She was diagnosed to be at 5 weeks gestation in June, and at the same time, an ovarian tumor with the diameter of 5 cm was identified. Since the tumor had grown rapidly and was 9 cm in diameter 1 week later, she was referred to our hospital. When she was admitted to our hospital at 9 weeks gestation, the tumor diameter was 14 cm and we found the solid portion within the ovarian tumor. The levels of the tumor markers CA125 and CA19-9 were 106 and 51 U/ml, respectively. The crown-rump length of the fetus (24 mm) was compatible with the gestational age, and fetal heartbeat was confirmed. Under the diagnosis of ovarian carcinoma, right salpingo-oophorectomy was performed at 10 weeks of gestation. Postoperative histological examination revealed a clear cell carcinoma and endometriosis of the right ovary. Immunohistochemically, the clear cell carcinoma stained positively for LH/hCG receptors and estrogen receptors, but not progesterone receptor. No malignant cells were detected by ascitic cytology. Exploratory specimens obtained at the time of operation from the left ovary and pelvic lymph nodes exhibited no malignant cells. Based on these findings, the pregnancy was allowed to proceed, and she delivered a 3010-g male baby at 39 weeks of gestation. She had no signs of recurrence for 2 years after the operation.- - - - - - - - - - ranking = 2.5keywords = pregnancy (Clic here for more details about this article) |
8/9. A pregnant woman with clear cell adenocarcinoma of the ovary arising from endometriosis and with benign and borderline adenofibroma of the clear cell and endometrioid types.We encountered a case of ovarian cancer in a 33-year-old, 8-week pregnant woman. Histological examination revealed both a transitive form of ovarian endometriosis with marked decidual changes due to pregnancy and clear cell carcinoma. Benign and borderline clear cell adenofibroma and benign and borderline endometrioid adenofibroma were also found. Parts of these adenofibromas showed transformation to clear cell carcinoma. This case suggests that clear cell carcinoma can arise from clear cell adenofibromas and/or ovarian endometriosis, even in young patients.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
9/9. Clear cell carcinoma arising in extragonadal endometriosis in a caesarean section scar during pregnancy.Malignancy arising in ectopic endometriosis is a rare event. This paper documents a case of clear cell carcinoma arising in a focus of ectopic endometrium in a low abdominal transverse scar.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |