1/42. A case of fallopian tube carcinoma: successful preoperative diagnosis with MR imaging.We report a case of fallopian tube carcinoma, successfully diagnosed preoperatively. The patient was a 64-year-old woman. Transvaginal sonography and computed tomography showed a cystic and solid tumor on the left side of the uterus, suggesting ovarian cancer. The tumor was, however, suspected to be a fallopian tube carcinoma on MR imaging. MR images showed a solid mass surrounded by a tube-shaped cystic part. At surgery, a solid and cystic tumor was found in the left fallopian tube. MR imaging may be useful to assist in the diagnosis of fallopian tube carcinoma.- - - - - - - - - - ranking = 1keywords = fallopian tube, tube (Clic here for more details about this article) |
2/42. 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 = 0.0020632457661043keywords = disease (Clic here for more details about this article) |
3/42. Supradiaphragmatic manifestations of papillary serous adenocarcinoma of the ovary.AIM: To illustrate unusual patterns of isolated supradiaphragmatic presentation and relapse of papillary serous adenocarcinoma of the ovary. methods: Retrospective study of five women (26-57 years) managed by a specialist gynaecological oncology unit. RESULTS: Three women relapsed in the neck, mediastinal or axillary nodes 3 to 5 years after complete abdomino-pelvic remission. Two women presented with pleural or cervical lymph node metastases respectively 2 and 13 years before the primary pelvic tumour was discovered. Clinical presentations in these five women mimicked metastatic thyroid and breast cancer and mesothelioma. In four of the five woman supradiaphragmatic nodal disease was heavily calcified. CONCLUSION: women with papillary serous ovarian cancer may develop supradiaphragmatic disease without evidence of peritoneal metastasis or primary pelvic tumours. Isolated supradiaphragmatic relapse may occur many years after complete remission of abdomino-pelvic disease. Calcification in supradiaphragmatic lymph nodes should not be assumed to be due to old granulomatous disease as this may be the only clue to relapsing disease. review of prior histology and use of immunohistochemical stains were valuable in diagnosis of these cases.- - - - - - - - - - ranking = 0.0025790572076304keywords = disease (Clic here for more details about this article) |
4/42. Old ectopic pregnancy remnants with morphological features of placental site nodule occurring in fallopian tube and broad ligament.Placental site nodule (PSN) is an asymptomatic benign proliferation of intermediate trophoblast from a previous gestation that failed to involute. It is most commonly found in the endometrium or endocervix; however, placental site nodule has recently been reported to occur at sites of ectopic gestation. This is the first case of PSN in the broad ligament in direct contact with the fallopian tube. The patient underwent surgery for an adenocarcinoma of the opposite tube. Microscopically and immunohistochemically, the lesion showed the characteristics of a proliferation of intermediate trophoblast.- - - - - - - - - - ranking = 0.50059828911389keywords = fallopian tube, tube (Clic here for more details about this article) |
5/42. Papillary serous carcinoma of the peritoneum: analysis of clonality of peritoneal tumors.Papillary serous carcinoma of the peritoneum (PSCP) is a primary neoplasm of peritoneal origin, and is histologically difficult to differentiate from papillary serous carcinoma of the ovary (PSCO). PSCP is frequently accompanied by many peritoneal tumors, and has been managed as a disseminated disease. In previous reports, however, the clonality of the tumors has not been fully discussed. Recently, the significant roles of the p53 and BRCA1 genes in PSCP have been reported. In this study, we investigated immunohistochemical staining for p53 proteins, and investigated p53 gene mutations, using dna sequencing analysis, to clarify the clonality of PSCP tumors. Immunohistochemically, all the tumor samples demonstrated nuclear overexpression of p53 proteins, and the dna sequencing analysis of the p53 gene showed diverse point mutations at codons 167 and 192 in two of four anatomically different tumors. In conclusion, the possibility of polyclonality of PSCP tumors is suggested.- - - - - - - - - - ranking = 0.00051581144152608keywords = disease (Clic here for more details about this article) |
6/42. Micropapillary serous carcinoma of the ovary: case report and review of literature.The term "micropapillary serous carcinoma" (MPSC) has recently been introduced to define a subset of ovarian serous borderline tumors morphologically characterized by a micropapillary pattern and clinically associated with a more aggressive behavior than that of the typical ovarian serous borderline tumors. Ovarian MPSC's are associated with extra-ovarian invasive peritoneal implants and invasive recurrences much more frequently than typical ovarian serous borderline tumors. The case of a women, who at age 28 had bilateral ovarian cystectomy and four months later total abdominal hysterectomy and bilateral salpingo-oophorectomy for bilateral ovarian MPSC, is reported. She was free of disease for the next 15 years and then presented with a central pelvic mass. At laparotomy, a recurrence in the form of a solitary invasive peritoneal implant was discovered and completely resected. No postoperative adjuvant therapy was given. To date, 16 years after initial diagnosis of MPSC, and one year after detection of recurrence, the patient is alive, well and without disease. literature data and this case report support the view that MPSC's should be classified separately from both typical serous borderline tumors and invasive carcinomas of the ovary.- - - - - - - - - - ranking = 0.0010316228830522keywords = disease (Clic here for more details about this article) |
7/42. Uterine papillary serous carcinoma presenting as distant lymph node metastasis.BACKGROUND: Uterine papillary serous carcinomas are highly aggressive malignancies that often present with high-stage disease. We report two cases that presented initially as distant metastatic disease. One case was found incidentally at the time of axillary dissection for breast cancer and the second case in the workup of a neck mass. CASES: Clinicopathologic review of the patient material including review of routine H&E pathology and immunohistochemical studies of the patients tumors was performed. Both cases showed high-grade papillary carcinomas with psammoma bodies metastatic to lymph nodes in the axilla or neck. Sampling of the endometrium in these patients confirmed primary uterine papillary serous carcinoma. patients were treated with adjuvant chemotherapy. CONCLUSIONS: Metastatic uterine papillary serous carcinoma presenting initially in distant sites is an unusual manisfestation of this highly aggressive tumor. This tumor should be considered in the differential diagnosis when patients present with metastatic high-grade papillary serous carcinomas and the primary site is unknown.- - - - - - - - - - ranking = 0.0010316228830522keywords = disease (Clic here for more details about this article) |
8/42. Prolonged symptom-free survival in a patient with persistent primary peritoneal carcinoma and a rising CA-125: a note of caution.BACKGROUND: The optimal management of patients with ovarian and primary peritoneal carcinomas who experience an elevation of the serum ca-125 antigen level following the completion of therapy, and who remain without other clinical evidence of recurrent/progressive disease, remains controversial. CASE: A patient with primary peritoneal carcinoma cared for in the Gynecologic Cancer Program of the Cleveland Clinic Foundation has experienced prolonged symptom-free survival (>4 years) after a documented tripling of her persistently elevated postchemotherapy serum CA-125 without the reinstitution of cytotoxic therapy. CONCLUSION: This case emphasizes that caution must be exercised when electing to initiate second-line treatment solely on the basis of an abnormal tumor antigen level.- - - - - - - - - - ranking = 0.00051581144152608keywords = disease (Clic here for more details about this article) |
9/42. Cutaneous metastasis of papillary serous uterine cancer.BACKGROUND: Cutaneous metastases from uterine cancer are uncommon. They usually indicate the aggressive nature of the underlying disease. CASE: A 65-year-old patient presented with stage 3 papillary serous carcinoma of the uterus. Eight months after surgery and pelvic radiation therapy, this patient presented with cutaneous metastases. A single cobalt field was used on three occasions over the next 9 months to provide symptomatic control of the abdominal and vulvar cutaneous metastases. CONCLUSIONS: This is the first case report of cutaneous metastases from papillary serous cancer of the uterus. Cutaneous metastases were the first indication of unsuspected occult disease. Palliative local radiation has a useful role in controlling symptoms like pruritis.- - - - - - - - - - ranking = 0.0010316228830522keywords = disease (Clic here for more details about this article) |
10/42. Metastatic uterine papillary serous carcinoma to the pericardium.BACKGROUND: Uterine papillary serous carcinoma is an aggressive tumor with a high propensity for distant spread. Metastases to the heart or pericardium are rare in gynecologic malignancies and usually fatal. CASE: A 64-year-old African American woman was diagnosed with recurrent uterine papillary serous carcinoma metastatic to the pericardium. Her case at presentation was significant for an elevated serum CA-125, evidence of metastatic disease to the liver, and massive cardiomegaly. Cytologic analysis of fluid obtained by pericardiocentesis confirmed recurrence. Despite treatment with paclitaxel and a pleuropericardial window, the patient succumbed to her disease. CONCLUSION: The prognosis for patients whose recurrent uterine papillary serous carcinoma has metastasized to the heart or pericardium is extremely poor. Effective adjuvant and salvage therapies are essential.- - - - - - - - - - ranking = 0.0010316228830522keywords = disease (Clic here for more details about this article) |
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