1/14. Malignant fibrothecomatous tumour of the ovary: diagnostic value of anti-inhibin immunostaining.Malignant ovarian tumours of the fibrothecoma group are rare. The clinicopathological features of a case of ovarian malignant fibrothecoma in which there was metastatic disease in the small intestine and peritoneum at presentation are described. A number of differential diagnoses were considered but positive immunohistochemical staining of the resected ovarian and small intestinal neoplasms with anti-inhibin was of value in confirming a sex cord-stromal tumour and in excluding other lesions. The two tumours were also ultrastructurally identical. Classical malignant fibrothecomas are said to show four or more mitotic figures per 10 high power fields (HPF). Although the intestinal secondary was mitotically active, the primary ovarian tumour contained only one to two mitoses per 10 HPF, showing that formal mitotic counts are not an absolute indicator of malignant behaviour in this group of tumours.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/14. Gliomatosis peritonei: a report of two cases and review of the literature.Gliomatosis peritonei is the implantation of miliary glial tissue within the peritoneal cavity of patients with ovarian teratomas. Up to now 86 cases of this rare entity have been reported. In addition to the small number of reported gliomatosis peritonei cases, a condition easily mistaken for peritoneal carcinomatosis, we report two further cases, one combined with endometriosis (fifth case published until now) and one without endometriosis. Both cases were followed up for more than 5.5 years. Thus, further data concerning biological behaviour and prognosis of this rare entity are made available. In addition, a review of all cases published until today is provided, thus summarising the data presently known.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/14. Bcl-2 expression in a primary leiomyosarcoma of the ovary: a case report.BACKGROUND: Primary ovarian leiomyosarcoma is an extremely rare malignant smooth-muscle neoplasm with fewer than 30 documented cases worldwide. Immunohistochemically, ovarian leiomyosarcomas are characterized by the expression of alpha-smooth muscle actin (alpha-SMA). Until recently, no report investigated the role of bcl-2 expression in primary ovarian leiomyosarcoma. We report the management and an immunohistochemical analysis of bcl-2 in a patient with primary leiomyosarcoma of the ovary. CASE REPORT: The patient, a 71-year-old woman, presented with a history of lower abdominal pain and a palpable mass in the lower abdomen. Surgical exploration revealed a large left adnexal mass that had developed from the left ovary and infiltrated one part of the omentum adherent to the left adnexa. Microscopically the left adnexal tumor consisted of spindle cells arranged in smooth-muscle bundles and fascicles. The tumor was characterized by high cellularity and nuclear polymorphism, as well as patchy necrosis and large areas of hemorrhage. Mitotic activity exceeded 5 mitoses per 10 high-power fields with many atypical mitoses. The tumor appeared encapsulated, and the capsule was partially disrupted by tumor cells. Immunohistochemically, the tumor showed a strong staining reaction for muscle actin, alpha-SMA and neuron-specific enolase, and also a weak reaction for vimentin. Strong staining of bcl-2 was detected, with more than 80% of sarcoma cells positive. According to the FIGO staging system for ovarian cancer, the tumor was classified as a primary ovarian leiomyosarcoma stage III C, and the patient was treated with an adjuvant chemotherapy regimen consisting of cisplatin and ifosfamide. Two days after the third cycle of cisplatin/ifosfamid she developed an apoplexy spontaneously and chemotherapy was therefore discontinued. The patient remained without evidence of disease until she died as a result of intercurrent pneumonia 14 months after initial surgery. CONCLUSIONS: Beside the routine histological and immunohistochemical characteristics of primary ovarian leiomyosarcoma, strong staining for bcl-2 was detected. In order to understand more about the nature and the behaviour of this highly malignant neoplasm and to be able to improve the treatment, the prognostic value of bcl-2 has to be investigated in additional studies.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/14. Primary ovarian trabecular carcinoid tumour: a case report with an immunohistochemical study and a review of the literature.INTRODUCTION: Primary ovarian carcinoid tumours are uncommon neoplasias. There are distinct histological types with different behaviours: insular, trabecular, mucinous and mixed. The trabecular subtype is very rare and unlike other carcinoid subtypes, it is characterised by the absence of a clinical carcinoid syndrome and has been related with a better prognosis than the others. No distant metastases have yet been reported. CASE REPORT: We present a case of a 76-year-old woman diagnosed with a left ovarian tumour. She underwent a radical hysterectomy with bilateral salpingo-oophorectomy and regional lymph node clearance. histology revealed an ovarian trabecular carcinoid tumour and no adjuvant treatments were performed. The patient is alive and free of disease 70 months following diagnosis. DISCUSSION: Immunohistochemical staining for p53 protein, and a comparative study with other subtypes of ovarian carcinoid tumours (insular and mucinous) is discussed in this report.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/14. Paraneoplastic limbic encephalitis masquerading as chronic behavioural disturbance in an adolescent girl.AIM: To describe an unusual but treatable cause of behavioural disturbance in adolescence. methods: The case is reported of a 15-y-old girl presenting with acute confusion, memory problems and psychotic symptoms following an 18-mo history of change in personality, school failure and running away from home. A review of the literature is also presented. RESULTS: microbiology, toxicology, computed tomography and magnetic resonance imaging did not show any pathology of the central nervous system. Bilateral ovarian immature teratomas were eventually diagnosed and removed. The rapid improvement in the patient's mental and cognitive functions after corticosteroid treatment and the abnormality shown on the single photon emission computed tomography suggested a diagnosis of paraneoplastic limbic encephalitis. CONCLUSION: Paediatricians and neurologists should be aware of this rare disease entity among the more common conditions of behavioural problems and substance abuse in adolescents.- - - - - - - - - - ranking = 6keywords = behaviour (Clic here for more details about this article) |
6/14. Proliferating Brenner tumour of ovary--a case report.Transitional cell tumours or Brenner tumours of ovary are uncommon neoplasms. Out of all the Brenner tumours less than 2% are either proliferating or malignant type. Borderline or malignant tumours occur in women who are on an average 10 years older than those with benign tumours. It is essential to categorise these tumours as benign, borderline or malignant type as the biologic behaviour and choice of surgery differs in all of the three categories. The gross and microscopic findings of a proliferating brenner tumour are reported here.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
7/14. Sequential recurrences of ovarian granulosa cell tumour 10 and 11 years after initial diagnosis as haemoperitoneum and subhepatic mass: a case report and review of the literature.adult granulosa cell tumours (GCTs) are rare ovarian neoplasms characterised by an indolent course and a propensity for late recurrence. Due to frequent endocrine manifestations most GCTs are diagnosed at an early stage. However, clinical behaviour can not be safely predicted on the basis of conventional clinicopathologic parameters. Surgery remains the cornerstone of therapeutic management. We report on a rare case of a Stage IA GCT twice recurring ten and 11 years after initial surgical treatment. The first recurrence presented as an acute abdomen due to haemoperitoneum after tumour rupture. The second recurrence presented as a subhepatic mass. This case emphasises the need for extended, lifelong follow-up even for patients with early stage, apparently completely removed GCTs. Prognostic parameters and therapeutic options especially for patients with recurrent disease are discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
8/14. Malignant Brenner tumour--a case report.Malignant Brenner tumour is a rare pathological entity. Apart from identification of typical benign, metaplastic and/or proliferating components, stromal invasion must be observed for diagnosis of Brenner tumour. A case of malignant Brenner tumour is described along with a brief review of strict criteria of diagnosis and its biological behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
9/14. Clinical experience of ovarian neoplasm in childhood and adolescence.Clinical behaviour of 12 cases of ovarian neoplasm in childhood and adolescence was reviewed. Diagnostic work-up required a great deal of time, gentleness and patience. Of all ovarian tumours, 58.4% were epithelial, 33.3% were germ cell group and 8.3% were sex cord stromal tumours. Pleuripotent nature of gonads is reflected by the complex variety of ovarian tumours in children. Seventy-five per cent among the tumours were malignant. Amongst the epithelial tumours 85.7% were malignant. Because of certain reasons, comparison of results was felt difficult.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
10/14. Gynandroblastoma of the ovary.Gynandroblastoma is an extremely rare primary tumour of the ovary showing morphological evidence of both male and female differentiation. We describe the light and ultrastructural features of this tumour and review the present knowledge about its nature, function and behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
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