1/56. Malignant mixed Mullerian tumor with rhabdoid features: a report of two cases and a review of the literature.Rhabdoid tumors were originally described as a type of pediatric renal neoplasm that contains cells resembling rhabdomyoblasts but lacking muscle differentiation. Extrarenal rhabdoid tumors have since been reported in multiple anatomic sites in the pediatric and adult population. These tumors are characterized by an aggressive clinical course, resistance to treatment, and a rapidly fatal outcome. Eight cases of uterine neoplasms with rhabdoid differentiation have been previously reported. In the three cases where clinical follow-up was available, the patients died of disease within 3 to 17 months after the diagnosis was established. We report two cases of uterine malignant mixed Mullerian tumor (carcinosarcoma) with rhabdoid differentiation. The findings and clinical outcome confirm the aggressive nature of uterine tumors with rhabdoid differentiation. One of the patients died of disease 3 months after initial operative treatment while the other patient's tumor recurred in 1 month and she died within 10 weeks. The poor prognosis of these neoplasms makes their histopathologic recognition important.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/56. Partial hydatidiform mole with diploid karyotype in a live fetus.Even though most instances of partial mole are triploid, only a few cases of diploid partial moles have been reported. prognosis of partial mole is usually better than the complete mole as few cases of partial moles progress to persistent trophoblastic disease. However, the nature and the risks of diploid partial moles are not well established and they seem to be a distinct clinical entity. Here we report a case of partial mole presenting with a 22 weeks live fetus and preeclampsia. fetal blood sampling was performed for cytogenetic analysis which revealed a diploid (46XY) karyotype. No progression to malignant gestational trophoblastic disease occurred.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/56. 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) |
4/56. diagnosis of recurrent uterine carcinosarcoma by fine-needle aspiration cytology: report of a case.Uterine carcinosarcomas are uncommon, aggressive neoplasms usually afflicting postmenopausal women. Histologically, they are characterized by the presence of both malignant epithelial and stromal cells. The latter may be either homologous or heterologous in nature. The cytologic diagnosis of carcinosarcoma via fine-needle aspiration (FNA) was previously described for primary tumors arising in the parotid gland, breast, lung, and ovary. Although the diagnosis of uterine carcinosarcoma via cervicovaginal, endometrial, and peritoneal fluid cytology has been described, the FNA cytology diagnosis of recurrent uterine carcinosarcoma has only been rarely described. We present a case of recurrent uterine carcinosarcoma in a 59-yr-old woman, diagnosed by ultrasound-guided FNA cytology. Cytologic smears showed a biphasic neoplasm consisting of both malignant columnar epithelial and spindle cells, in a background of tumor diathesis. This case illustrates the diagnostic utility of aspiration cytology in the investigation of recurrent carcinosarcoma in clinically suspicious lesions arising postsurgery.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/56. Partial mole, triploidy and proteinuric hypertension: two case reports.We present two cases of proteinuric hypertension in the early second trimester of pregnancy, associated with partial mole and triploidy karyotyping. This demonstrates the complementary nature of ultrasound in the diagnosis and management of this rare association.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/56. Malignant fibrous histiocytoma of the uterus.A 56-year-old menopausal woman was admitted to hospital because of vaginal spotting of several months duration. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy. On divalving, the uterus showed an ulcerated nodule 8 cm in diameter, protruding into the uterine cavity from the posterior wall. Histologically the tumor had a typical morphology of malignant fibrous histiocytoma (MFH). Multinucleated giant cells were strongly positive for CD 68 alpha antichymotripsin and alpha antitrypsin. Mononuclear cells also showed the same immunohistochemical pattern though less intensive than the giant cells. The cells were uniformly negative for S-100 protein, myoD1, myogenin desmin and actin. Electron microscopical investigation disclosed ultrastructural features compatible with the histiocytic nature of the tumor. Thirty-three months later the patient was free of disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/56. Conservative treatment of recurrent ovarian fibromas in a young patient affected by Gorlin syndrome.The case of recurrent bilateral ovarian fibromas occurring in a 22 year old Italian girl affected by Gorlin syndrome is reported. Ovarian fibromas occur in 75% of female patients with Gorlin syndrome and their recurrence has rarely been reported in the literature. Management is guided by the benign nature of the lesion and consists of surgical removal of the fibroma. Preservation of the normal ovarian tissue is recommended even though there is risk of recurrence of the fibroma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/56. 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 = 1keywords = nature (Clic here for more details about this article) |
9/56. The palliative management of fungating malignant wounds--generalising from multiple-case study data using a system of reasoning.The project focused on individual experiences, from 45 participants, of living with a fungating wound and the performance of wound dressings in reducing the impact of the wounds on daily living. A case study design was adopted. This posed a key methodological challenge in the form of the contentious epistemological issue, characterised in the literature as the "nomothetic-idiographic dilemma". This issue concerns the nature of knowledge generated from an individual case and its generalisability. A system of reasoning was adopted as the analytic strategy, within a theory-driven evaluation, to abstract general issues from the case study data to construct explanations of symptom control and dressing performance. The latter were generalised beyond the individual cases with the use of theory. This paper focuses on the methodological issues that are inherent in the use of a case study design and the nature of the evidence generated. The system of reasoning is described and illustrated using data from a single participant with advanced uterine cancer and a fungating nodule in the groin.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
10/56. Anesthetic implications of a partial molar pregnancy and associated complications.In the united states, molar pregnancy occurs between 1 in 1,200 and 1 in 2,500 pregnancies. The critical nature of complications associated with a molar pregnancy requires advanced perioperative anesthetic management. This case report details the perioperative events of a 34-year-old gravida 5, para 3, with a partial molar pregnancy who underwent general anesthesia for a dilatation and curettage procedure, following therapeutic termination of a coexisting fetus at 18 weeks' gestation. Her initial presentation, anesthetic and operative management, and postoperative course are described clearly. The medical and anesthetic interventions required for treatment of molar pregnancy are reviewed. Of molar pregnancies, 80% are uncomplicated and follow an unremarkable course. However, for the remaining 20%, complications can be severe and may lead to substantial morbidity and mortality in otherwise healthy women.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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