1/14. Collagenous spherulosis mimicking keratinizing squamous metaplasia in a borderline endometrioid tumour of the ovary.AIMS: Collagenous spherulosis (CS) is a rare lesion which is an incidental finding in breast and salivary glands. It is characterized by fibrillar spherules exhibiting an intrinsic radiating or concentric pattern which are surrounded by myoepithelial cells. This entity can be misdiagnosed as adenoid cystic carcinoma and in-situ ductal carcinoma. methods AND RESULTS: We report here the first case of CS arising in a borderline endometrioid tumour of the ovary where it merged with squamous metaplasia. CONCLUSION: This observation illustrates another pitfall of CS which can be misidentified as keratin pearls. The pathogenesis remains unclear but it has been claimed that the accumulation of basement membrane material may be due to the proliferation of pre-existing myoepithelial cells that secrete matrix components. Since ovarian tumours do not contain myoepithelial cells, one should assume that the epithelial cells differentiate towards myoepithelial cells as it has been shown in vitro and ex vivo.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/14. Paraovarian cystic endosalpingiosis in association with tamoxifen therapy.This report describes a case of macroscopically visible cystic endosalpingiosis involving the paraovarian region in a woman who had been taking tamoxifen for breast cancer. A 2.5 cm multicystic lesion was seen on the external surface of the right ovary and histological examination showed a mass of dilated glands lined by ciliated tubal-type epithelium and set in a fibrovascular stroma. Cystic endosalpingiosis resulting in a tumour-like mass is a rarely described entity which is probably not well recognised by histopathologists. Although unlikely to be mistaken for malignancy, the lesion may result in diagnostic confusion. The role of tamoxifen in the development of the lesion in the present case is not clear but the oestrogenic effects of this drug may have contributed to its formation.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/14. Regression of both pituitary and ovarian cysts after administration of thyroid hormone in a case of primary hypothyroidism.We report a 19-year-old woman who was diagnosed as polycystic ovary. hypothyroidism with a markedly elevated TSH level and an enlarged pituitary gland on MRI were noted. The 123I uptake was decreased to 6.5%. After treatment with thyroid hormone, regression of the enlarged pituitary and the ovarian cysts was observed. In the present case, hypothyroidism was considered to have caused a reversible enlargement of the pituitary gland and concomitant polycystic ovary. We concluded that the polycystic ovary might have resulted from the effects of an excessive amount of TSH on immature ovaries.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
4/14. Genital tract tumors in proteus syndrome: report of a case of bilateral paraovarian endometrioid cystic tumors of borderline malignancy and review of the literature.proteus syndrome is a rare, sporadic disorder that causes postnatal overgrowth of multiple tissues in a mosaic pattern. Characteristic manifestations include: overgrowth and hypertrophy of limbs and digits, connective tissue nevus, epidermal nevus and hyperostoses. Various benign and malignant tumors and hamartomas may complicate the clinical course of patients with the syndrome. Commonly encountered tumors include hemangiomas, lymphangiomas and lipomas. Tumors of the genital tract occur less often. Bilateral ovarian cystadenomas are regarded as having diagnostic value in proteus syndrome when occurring within the first two decades of life. We describe a 3-year-old girl with proteus syndrome who developed bilateral paraovarian villoglandular endometrioid cystadenomatous tumors of borderline malignancy (low malignant potential) of the broad ligament. Desmoplastic tumor implants, presumably noninvasive, were present in biopsies from the pelvic floor, cul-de-sac and omentum. This is the first recognized example of a cystic borderline epithelial tumor of the female genital tract and the first paraovarian tumor reported in a patient with proteus syndrome. Previously reported tumors and cystic lesions involving the female genital tract and the male genital tract in patients with proteus syndrome are reviewed. We suspect that specific testicular and paratesticular tumors may prove to have the same diagnostic value in proteus syndrome as do bilateral cystic ovarian and paraovarian tumors.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/14. Mature ovarian cystic teratoma with a highly differentiated homunculus: a case report.BACKGROUND: Mature ovarian cystic teratomas, which are commonly observed benign ovarian tumors, consist of ectodermal, mesodermal, and endodermal components that are generally disorganized. In this report, we document a case in which the solid portion of an ovarian teratoma demonstrated considerable differentiation, forming a doll-like structure. CASE: A 25-year-old virginal Japanese woman underwent surgery for an ovarian tumor that was diagnosed as a mature teratoma. A solid mass within the tumor was found to have a head, trunk, and extremities. Consequently, this mass was diagnosed as a mature fetiform teratoma (homunculus). brain, eye, spinal nerve, ear, teeth, thyroid gland, bone, bone marrow, gut, trachea, blood vessels, and phallic cavernous tissue were confirmed microscopically. Distinctive features were the clear anterior-posterior, ventral-dorsal, and left-right axes, with a spatially well-organized arrangement of the organs. An eye was located on the front of the head, a spinal nerve lay dorsal to the spinal bones, the thyroid gland was anterior to the trachea, and the gut was deep inside the trunk. CONCLUSIONS: These findings indicate that the information necessary for organization of the body plan may be conserved and transmitted, even with parthenogenesis. Mature cystic teratomas of the ovary are mostly benign and do not always attract detailed attention. However, precise analyses of such tumors may significantly enhance our understanding of both parthenogenetic and normal human development.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
6/14. Adrenal myelolipoma in a child.A case of adrenal myelolipoma is reported in a 14-year-old girl. Abdominal ultrasound examination revealed a left-sided ovarian cyst 13 cm in diameter and an 8 x 8-cm hyperechoic heterogenous solid mass localized in the right adrenal gland. The ovarian cyst and adrenal mass were removed surgically. Histological examination of the adrenal mass revealed a proliferation of mature adipose tissue with bone marrow-like hematopoietic elements. The ovarian cyst was a simple serous cyst.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/14. Primary hypothyroidism presenting as ovarian tumor and precocious puberty in a prepubertal girl.We report a case of a prepubertal girl with juvenile primary hypothyroidism presenting as ovarian cysts and precocious puberty. The 7-year-old female was referred to our clinic because of a pelvic/abdominal mass and vaginal bleeding. Besides these findings, on physical examination we noticed the thyroid gland globally increased and the presence of secondary sexual characteristics. Based upon the clinical profile and investigations, the patient was diagnosed with juvenile primary hypothyroidism due to autoimmune thyroiditis. The cysts and precocious puberty resolved spontaneously after the simple replacement of thyroid hormone. It is important to bear in mind hypothyroidism in cases of girls presenting ovarian cysts and precocious puberty in order to avoid unnecessary surgery on the ovaries.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/14. Fine-needle aspiration cytology of ovarian follicle cysts with cellular atypia from reproductive-age patients.The cytologic features of four luteinized ovarian follicle cysts with cellular atypia, obtained by fine-needle aspiration, are presented and discussed. The three patients, ages 31, 32, and 34, underwent laparoscopy for workup of unilateral or bilateral ovarian cysts. In each case, the aspirates were cellular and composed of atypical cells arranged in glandular clusters and papillary configurations. The cells showed an increased nuclear/cytoplasmic ratio and contained nuclei with prominent chromocenters, granular chromatin, and prominent nucleoli, some irregular in shape. Cell borders were indistinct, and the cytoplasm was finely vacuolated. In each case, the smears were interpreted by the cytotechnologist as showing cellular features compatible with malignancy. In addition to the atypical cells, the cytopathologist noted a few sheets of well-preserved small granulosa cells. A thorough review of the clinical histories revealed the patients to be 8, 6, and 6 mo postpartum, respectively, at the time of needle aspiration. In conjunction with the clinical histories, the cytologic findings supported a diagnosis of follicle cysts containing atypical luteinized granulosa cells. It is postulated that hormonal stimulation may have played a role in the development of the cellular atypia present within the luteinized cells. When analyzing ovarian cyst fluid from reproductive-age patients, this entity should be considered so as not to make an erroneous diagnosis of malignancy.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
9/14. endometriosis of the abdominal wall.endometriosis of the abdominal wall typically occurs as a painful mass in a lower abdominal incision from previous cesarean section or hysterectomy. Most patients are young and in their active reproductive years. The histologic diagnosis requires a combination of either endometrial-like glands, endometrial stroma, or hemosiderin pigment. The diagnosis must be considered in any woman with an abdominal wall mass and a history of transabdominal gynecologic surgery. Wide excision offers the best chance to prevent recurrence.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
10/14. Adrenal steroid secretion in girls with pseudoprecocious puberty due to autonomous ovarian cysts.To evaluate the role of adrenal steroids in pseudoprecocious puberty due to large ovarian follicular cysts, we studied the serum 17-hydroxyprogesterone response to a combination of dexamethasone suppression followed by iv ACTH administration in two girls and compared the results to those in girls with premature thelarche, normal prepubertal girls, and a girl with true precocious puberty. Although basal serum 17-hydroxyprogesterone levels were normal in all subjects, there was incomplete suppression of 17-hydroxyprogesterone with dexamethasone in the two girls with pseudoprecocious puberty and large ovarian cysts. The 17-hydroxyprogesterone response to ACTH was much greater in these girls (360 and 540 ng/dl) than in the girls with other types of precocious puberty (mean /- SD, 71 /- 15 ng/dl) or in normal prepubertal girls (80 /- 20 ng/dl). The girls with large ovarian cysts had decreased gonadotropin responses to GnRH, which were reversed subsequent to removal of the cyst. Removal of the ovarian cysts also restored the dexamethasone suppressibility of serum 17-hydroxyprogesterone and abolished the progression of pubertal development. However, 17-hydroxyprogesterone responses to ACTH were still elevated (160 and 350 ng/dl). Preoperatively, both girls had increased levels of dehydroepiandrosterone sulfate, 16-hydroxydehydroepiandrosterone sulfate, and another unidentified steroid sulfate. These steroid sulfates were also found in the cyst fluid from the one patient from whom the fluid was obtained. These results suggest that steroid production by the adrenal gland may stimulate the development of small ovarian cysts (which may be present in normal prepubertal girls) into large ovarian cysts capable of causing gonadotropin-independent precocious puberty.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
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