Cases reported "Cystadenoma, Mucinous"

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1/10. Endocrine cell micronests in an ovarian mucinous cystadenofibroma: a mimic of microinvasion.

    An ovarian mucinous cystadenofibroma with peculiar neuroendocrine cell micronests is described in a 59-year-old Japanese woman. Aggregates of epithelial cells resembling microinvasive carcinoma cells were scattered throughout the adenofibromatous area. These micronests were composed of small uniform cells with argentaffin and argyrophil granules. Numerous small cells with neuroendocrine granules were also seen within mucinous glands. This is the first report of neuroendocrine micronests in an ovarian neoplasm, a finding that should be distinguished from microinvasion.
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2/10. Micropapillary carcinoma of the parotid gland arising in mucinous cystadenoma.

    We describe a 45-year-old man who had a 2-year history of a slowly enlarging tumor in the left parotid gland. Histologically, the tumor was a mucinous cystadenoma with focal apocrine differentiation, which revealed a widespread invasive micropapillary adenocarcinoma component. A rim of lymphoid tissue surrounded the margins of the micropapillary carcinoma. The invasive micropapillary adenocarcinoma component was morphologically identical with the invasive micropapillary carcinoma of the mammary gland. The tumor is different from so-far recognized salivary gland tumor entities.
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3/10. Mullerianosis of the mesosalpinx: a case report.

    We report a case of mullerianosis of the mesosalpinx, the appearance of which simulated metastatic adenocarcinoma. The patient was a 37-year-old woman with a mixed epithelial cystadenoma of borderline malignancy associated with endometriosis in both ovaries. The left mesosalpinx contained a firm, 2.2-cm, gray-white mass that on microscopic examination consisted of glands lined mostly by endocervical-type epithelium with admixed tubal-type glands and foci of endometriosis. rupture of glands with extravasation of mucin into the surrounding stroma was observed, but there was no desmoplastic stromal reaction. awareness of this relatively uncommon lesion is critical to avoid misdiagnosis and overly aggressive treatment.
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4/10. struma ovarii coexisting with mucinous cystadenoma detected by radioactive iodine.

    The authors describe a case of struma ovarii coexisting with mucinous cystadenoma. ultrasonography and magnetic resonance imaging showed a multilocular cystic mass with a solid component. The ovarian tumor demonstrated uptake of I-123 sodium iodide, allowing a preoperative diagnosis of struma ovarii. In women with an unexplained increase in thyroid function and low I-123 uptake in the cervical thyroid gland, scintigraphy of the pelvis should be considered.
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5/10. Mucinous cystadenoma of the ovary with functioning stroma and virilization in pregnancy: a case report and review of the literature.

    Virilization caused by ovarian tumors with functioning stroma during pregnancy is extremely rare and has been reported in many ovarian tumors. In mucinous cystadenomas with maternal virilization during pregnancy the stromal cells responsible for the hormone secretion resemble lutein or leydig cells and have been referred to as luteinized stromal cells. We present a case of a 30-year-old, gravida 2, para 1, woman who presented at approximately the 38th week of pregnancy with features of virilization. At the same time, a cesarean section was performed because of fetal distress and a male weighing 3,030 g without any gross abnormalities was delivered. A large tumor of the right ovary was detected and a right salpingo-oophorectomy was performed. Histopathologically, the tumor proved to be a benign mucinous cystadenoma. Masses typically resembling lutein stromal cells or leydig cells of the testes or ovarian hilus were found in the wall of the cyst below the mucinous epithelium. No crystalloids of Reinke were identified. The stromal component of the tumor was characterized as functioning stroma with luteinized stromal cells. The glandular mucinous epithelium showed focal positivity for human chorionic gonadotrophin. The cytoplasm of the luteinized stromal cells reacted strongly and diffusely with antiserum for vimentin. Also, the cytoplasm of the luteinized stromal cells showed focal intense positivity for synaptophysin, and focal mild positivity for human chorionic gonadotrophin. Staining results for oestrogen and progesterone receptors were negative. In conclusion, we present an unusual case of clinical virilization during pregnancy associated with an ovarian mucinous cystadenoma with functioning stroma. The virilizing manifestations disappeared after removal of the ovarian neoplasm, supporting the perception that the functioning ovarian stroma was responsible for the androgen production.
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6/10. telomerase gene expression in intraductal papillary-mucinous tumors (IPMT): preliminary findings.

    BACKGROUND AND AIM: The surgical management of IPMT is based upon a preoperative suspicion of malignancy, that is difficult to obtain from the available diagnostic tools. methods: telomerase gene expression was investigated by means of hTERT/RT-PCR on total rna from peripheral blood, tumour and non-tumour pancreatic samples of 2 patients with IPMT. RESULTS: Histological diagnosis was mild-grade dysplasia in the first case and invasive carcinoma in the second. telomerase expression was undetectable in all the samples derived from the first case. blood and tumour samples from the second patient were positive for telomerase mRNA expression, while the pancreatic non-tumour specimen was not. CONCLUSIONS: The following suggestions are made: 1) the telomerase gene expression seems to be implicated in the malignant evolution of IMPT; 2) the malignant transformation may be limited to a single area of the gland; 3) the presence of invasive carcinoma may be preoperatively suspected by peripheral venous blood sample collection. A possible clinical employment of telomerase gene expression determination in the management of IPMT is thus hypothesized.
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7/10. Intraductal papillary mucinous neoplasm of the pancreas in a patient with attenuated familial adenomatous polyposis.

    A 67 year old man with a clinical diagnosis of attenuated familial adenomatous polyposis (AFAP) and a past history of synchronous colon cancers in the transverse colon was also found to have an intraductal papillary mucinous neoplasm (IPMN) of the pancreas. In addition, several foci of heterotopic gastric oxyntic mucosa were noted in the duodenum, interspersed with flat and polypoid adenomas. The duodenal adenomas showed low grade dysplasia, loss of adenomatous polyposis coli (APC) protein expression, but retention of beta catenin staining, localised to the nucleus and cytoplasm. The IPMN in the pancreas showed an identical immunohistochemical profile to the duodenal adenomas. The heterotopic gastric foci in the duodenum were negative for the APC protein, and beta catenin staining was membranous in location. Although the patient did not show germline truncating APC mutations or mutations in the MYH gene, the past history, clinical features, and immunohistochemical profile of the various lesions suggest strongly that the IPMN is part of the spectrum of lesions encountered in AFAP. Whether the heterotopic oxyntic gastric mucosa in the duodenum is also related is unclear, but it may represent a forme fruste of fundic gland polyps.
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8/10. Borderline and malignant serous tumor arising in pelvic lymph nodes: evidence of origin in benign glandular inclusions.

    This report describes two cases of malignant serous cancers with areas of borderline malignancy, which appear to have arisen within benign glandular inclusions of coelomic origin in pelvic or para-aortic lymph nodes. The patients were 44 and 62 years of age. In both cases the nodes contained benign glandular inclusions lined by a single layer of epithelium which resembled that of tubal epithelium. The location of the glandular epithelium varied from within the fat near the node to intracapsular, subcapsular, or interfollicular positions. The number of glands ranged from few to extensive. In both cases the glandular inclusions disclosed epithelial proliferations, ranging from minor degrees of stratification with formation of small papillae of atypical cells (borderline serous tumor) to almost solid tumor typical of serous cancer. In both cases, the borderline and cancerous tumors exhibited areas of transition which appeared to arise from benign glands. Although benign glandular inclusions of coelomic origin are well documented to occur in pelvic or para-aortic lymph nodes of 5-20% of women and have been considered to be of significance only because of the possibility of the misdiagnosis of cancer, it should now be recognized that the glandular inclusion cysts themselves can become neoplastic.
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9/10. Multiple primary neoplasms. Ovarian carcinoid tumor, mucinous cystadenoma of low malignant potential tumor of left ovary, and adenocarcinoma of the colon.

    We describe a case of primary left ovarian carcinoid tumor with metastases to the right paraovarian tissue, left fallopian tube, the right lung, omentum, cul-de-sac, pericolonic fat, and, most likely, metastasis to the contralateral ovary, as well as a simultaneous left ovarian mucinous cystadenoma of low malignant potential and a well-differentiated colonic adenocarcinoma. Primary ovarian carcinoids are almost always unilateral. Metastases from such tumors to the lung and adrenal gland are very rare. To our knowledge, no such combination of all the above tumors has been reported.
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10/10. Mucinous cystadenoma with malignant transformation arising in the renal pelvis.

    Mucinous cystadenoma with malignant transformation occupying the lower half portion of the right renal pelvis in a 69-year-old Japanese man was recorded. The patient had recent dysuria but no clinical history of pyelonephritis or urolithiasis. Under the clinical diagnosis of unusual renal cyst, the right total nephrectomy was performed. Grossly, the cystic tumor, 5 cm across, formed a monolocular lumen filled with mucins and showed no direct communication with the renal pelvis inside. Microscopically, the epithelial lining was characterized by a single layer of benign mucin producing columnar cells that scattered foci of non-invasive papillary projections with cell stratification and nuclear atypia suggestive of malignancy. Although there was non-specific chronic pyelitis, no pyelitis cystica et glandularis was encountered. Of circa 60 glandular neoplasms arising in the renal pelvis reported previously, adenomas are only five including two mucinous cystadenomas, while the remainder are adenocarcinomas. The histological findings of mucinous cystadenoma in the present case may represent the process of a transition from adenoma to adenocarcinoma. The result suggests the possibility that adenoma-carcinoma sequence may exist among the glandular neoplasma arising in the renal pelvis. The histogenesis was unclarified.
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