1/16. Benign lymphangiomatous papules of the skin following radiotherapy: a report of five new cases and review of the literature.AIMS: The aim of this report is to summarize the clinicopathological findings of five cases of a pseudosarcomatous vascular proliferation of the skin at the site of radiotherapy following surgery for carcinoma of the breast and carcinoma of the endometrium. To our knowledge, only five cases of this presumably rare pseudomalignant proliferation have been reported previously. methods AND RESULTS: All patients were females ranging in age from 44 to 70 years. The lesions appeared as solitary or multiple papules or vesicles localized to the field of radiation. Microscopically, they were composed of vascular spaces that exhibited atypical features without qualifying for a diagnosis of angiosarcoma. CONCLUSIONS: Our cases provide additional evidence supporting the benign nature of this atypical vascular proliferation, not recurring, never developing metastases and being cured readily by local excision. Clinical, histopathological and ultrastructural findings suggest a lymphatic origin. Whether these lesions represent a neoplastic or a reactive condition secondary to radiotherapy is unclear. The name 'benign lymphangiomatous papules of the skin following radiotherapy' is proposed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/16. Endometrial stromal sarcoma of the uterus: MR and US findings.We describe the MRI and US features of two patients with endometrial stromal sarcoma of the uterus. Both lesions appeared as voluminous polypoid masses within an expanded endometrial cavity on both US and MRI. They had mixed echo-texture and heterogenous signal intensity on both T1- and T2-weighted sequences. T2-weighted images were most helpful in detecting the endometrial nature of the disease and its relationships with surrounding myometrium.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/16. Glassy cell carcinoma of the endometrium: a case report and review of the literature.Endometrial glassy cell carcinoma (GCC) is a rare neoplasm, with 11 cases reported in the literature. Although GCC is considered to be a poorly differentiated variant of adenosquamous carcinoma, its real nature is still debatable. We report a case of GCC of the endometrium in a 60-year-old woman and review the literature. The patient presented with vaginal bleeding, and pelvic computed tomographic scan showed a polypoid lesion in the uterine fundus. Histologically, the tumor showed 2 components: a moderately differentiated adenocarcinoma with extensive areas of squamous metaplasia (adenoacanthoma) and a GCC. The clinical stage of the patient's disease was IB as classified by the International Federation of gynecology and obstetrics. She was treated by a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic radiation therapy. The patient was still alive and free of disease at 5 years of follow-up.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/16. The nature of tamoxifen action in the control of female breast cancer.tamoxifen, now in use in the breast cancer clinic worldwide, was a study subject of controversy showing an estrogenic property on one occasion and an anti-estrogenic property on another occasion. The outcomes of 4 case-control studies of tamoxifen use were disclosed through 4 publications in 1998. The contents of these reports were intriguing, not only to surgeons of breast cancer clinics, but also to researchers of oncological science in general. The results of 4 research groups, being compatible with each other, were summarized in succession as follows: a) long-term use of tamoxifen reduced the occurrence of estrogen receptor (ER)-positive tumors by 69%, but no difference in the occurrence of ER(-) tumors was seen; b) the incidence of endometrial cancer was increased in the tamoxifen group; c) in women who did not have breast cancer and who had had a hysterectomy, there was no difference of breast cancer occurrence between the placebo- and tamoxifen-arms. Nevertheless, there was a statistically significant reduction of breast cancer among women receiving tamoxifen who also used hormone-replacement therapy during the trial; d) there was also no case-control difference of breast cancer occurrence between tamoxifen- and placebo-groups, when tested in a healthy population with a strong family history; e) the beneficial effect of long term use of tamoxifen in patients with early breast cancer, as assessed in terms of recurrence reduction, survival improvement and suppression of a contralateral tumor growth, was restricted to ER( ) patients; f) there was a positive correlation between the duration of tamoxifen use and the occurrence of endometrial cancer. All these observations provide strong support to the concept of the steroid criminal theory of human carcinogenesis in general. On the basis of both tamoxifen data and other information surrounding the hormonal aspect of human carcinogenesis of multiple tumors including breast cancer, we propose that the steroid generating system, as linked to the ever changing environment, plays a cardinal role as the transmitter of steroidal signals that can be taken as a "go" sign by the local oncogene-tumor suppressor gene complex of one target tissue and as a "stop" sign by that of another target tissue. The fitness of the tamoxifen data to the steroid carcinogenesis concept was discussed in the light of experimental pathology of chemical carcinogens, including the mammocarcinogen 7,12-dimethyl-benz(a)anthracene.- - - - - - - - - - ranking = 4keywords = nature (Clic here for more details about this article) |
5/16. acanthosis nigricans with endometrial carcinoma: case report and review of the literature.BACKGROUND: acanthosis nigricans is classified into benign and malignant forms on the basis of clinical associations. The main interest in acanthosis nigricans has been based on its association with malignancy because of the dramatic clinical appearance of the skin lesions and the usually rapidly fatal nature of the underlying disease. "Tripe palms" is a descriptive term of acanthosis nigricans of the palms. It more often is associated with internal malignancy. Most importantly, it often precedes the diagnosis of a new or recurrent tumor. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. There are very few reports in the literature of malignant acanthosis nigricans associated with gynecological malignancies. Only five cases of endometrial carcinoma associated with acanthosis nigricans and/or tripe palms have been reported in the literature. CASE: A 69-year-old African-American female presented with skin changes consistent with the diagnosis of acanthosis nigricans and tripe palms. More than 14 months later she was found to have endometrial carcinoma. She subsequently underwent total abdominal hysterectomy and salpingo-oophorectomy followed by chemotherapy with paclitaxel and carboplatin. During treatment of the underlying malignancy the skin condition dramatically improved. CONCLUSION: Tripe palms can be associated with endometrial carcinoma and may be the first sign of malignancy. Malignant acanthosis nigricans may improve with treatment of the underlying malignancy. patients who present with tripe palms may need to undergo workup to search for underlying malignancy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/16. Primary squamous cell carcinoma of the endometrium: case history, pathologic findings, and discussion.Primary squamous cell carcinoma of the endometrium (PSCCE) is an exceedingly rare tumor. Rarely are cytological criteria discussed. We report our experience in the cytological diagnosis of a case. A postmenopausal, 64-yr-old woman suffered from pyometria. An endometrial Pap smear displayed some malignant squamous cells. curettage of the cervix and the uterine cavity only recovered some fragments of atypical squamous epithelium whose origin could not be precisely identified. A hysterectomy with bilateral adnexectomy was decided upon. Pathological study evidenced a primary squamous cell carcinoma in the uterine cavity while the cervix was tumor-free and the lymph nodes were devoid of metastases (pT1, pN0, pM0). The patient died 46 mo PO with multiple pulmonary and renal metastases. The histological feature of PSCCE is identical to that of any tumor of a similar nature, whatever the site, especially the cervix. Confirmation of the primary endometrial nature is only possible on the hysterectomy specimen.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
7/16. Prolonged survival in recurrent endometrial carcinoma to the brain.BACKGROUND: recurrence of endometrial cancer in the brain is a rare event generally accompanied by limited life expectancy. We present an unusual case of long-term survival following surgical resection of an intracranial endometrial cancer metastasis. CASE: The present case is a patient with FIGO stage IIB, grade III endometrial cancer which recurred 2 months following completion of primary therapy with an isolated lesion in the brain. Aggressive trimodal therapy was initiated with curative intent and she has remained without clinical or radiographic evidence of disease for more than 30 months following treatment of her recurrence. CONCLUSIONS: Aggressive multi-modal therapy is warranted in the treatment of isolated intracranial recurrences of endometrial cancer in carefully selected patients. With complete surgical resection of disease, the precise nature and role of adjuvant treatment has yet to be clearly defined.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/16. Metastatic uterine serous carcinoma originating in an endometrial polyp: a report of 2 cases.BACKGROUND: Endometrial carcinoma is the most common cancer of the female genital tract. Two histologic variants have been described: an estrogen-dependent form and a more aggressive, non-estrogen-dependent form, which includes uterine serous carcinoma. CASES: Two cases of uterine serous carcinoma were confined to an endometrial polyp without myometrial invasion and were widely metastatic. One patient presented with abdominal pain and constipation, while the other patient was asymptomatic. Both patients had elevated CA-125 levels. At the time of surgery, these patients were found to have extensive carcinomatosis and underwent surgical staging procedures that required bowel resections. pathology showed metastatic disease originating in a small focus of serous adenocarcinoma at the tip of an endometrial polyp. Combination chemotherapy was planned; but 1 of the patients died prior to its initiation. CONCLUSION: These cases emphasize the aggressive nature of uterine serous carcinoma despite insignificant myometrial invasion.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/16. Atypical endometrial stromal cells related with a polypoid leiomyoma with bizarre nuclei: a case report.We presented a polypoid leiomyoma with bizarre nuclei having atypical endometrial stromal cells adjacent to the leiomyoma. Although atypical stromal cells of the female genital tract have been described, to our knowledge, no lesion identical to ours has been reported thus far. These atypical cells may be mistaken for malignant cells on histologic examination, especially in small endometrial samples. To differentiate these kinds of atypical-featured lesions from sarcoma is important, especially in curettage materials. The etiology and precise nature of multinucleated giant cells and atypical stromal cells in the endometrium are unclear. To prevent radical surgery, pathologists must be familiar with these atypical cells in the female genital tract.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/16. Endometrioid carcinoma of the ovary and endometrium, oxyphilic cell type: a report of nine cases.Six endometrioid carcinomas of the ovary and three of the endometrium composed predominantly or entirely of large eosinophilic (oxyphilic) cells are reported. The ovarian tumors occurred in women 31-75 years of age, with a mean of 58 years, and the endometrial tumors occurred in women 37-50 years, with a mean of 44 years. All the ovarian tumors and one endometrial tumor contained focal areas typical of endometrioid carcinoma, with round to oval tubular glands lined by simple or stratified columnar cells and focal squamous differentiation. Two endometrial tumors were composed almost exclusively of oxyphilic cells lining glands. One endometrial tumor contained prominent luminal and intracytoplasmic mucin. Five of the ovarian tumors were grade 2/3 and one was grade 3/3, whereas two of the endometrial tumors were grade 1/3 and one was grade 2/3. The prominence of the oxyphilic cells posed diagnostic difficulty in most of the cases. Electron microscopic examination performed on all tumors showed abundant mitochondria in only one, an ovarian tumor. Other organelles, especially microfilaments and tonofibrils, are cited as other possible reasons for the eosinophilia. Four of the nine cases were recent; follow-up of the remaining five showed a biological behavior similar to the typical endometrioid carcinoma of the ovary and endometrium. We suggest that the diagnosis of "endometrioid carcinoma, oxyphilic cell type" is appropriate for this variant of carcinoma largely composed of eosinophilic cells that may or may not be "oncocytic" in nature. The importance of recognizing this entity lies in distinguishing it from diverse other primary and metastatic oxyphilic cell tumors of the ovary and eosinophilic cell metaplasia and rare other types of primary carcinoma with eosinophilic cells of the endometrium, which may be especially challenging in a curettage or biopsy specimen.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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