1/8. Low-grade endometrial stromal sarcoma with cardiovascular involvement--a report of three cases.BACKGROUND: In low-grade endometrial stromal sarcoma, it has been reported that vascular space involvement in surgical specimens is found in over 50% of patients. However, in contrast to intravenous leiomyomatosis, it has been thought that further tumor extension to large vessels is rarely observed. CASES: We present three cases of low-grade endometrial stromal sarcoma with cardiovascular involvement by recurrent tumors observed on imaging studies. Two cases demonstrated tumor infiltration inside the inferior vena cava while the other case showed tumor growth in the left ventricle. CONCLUSION: This report suggests that attention should be paid to the possibility of cardiovascular invasion during the entire course of this disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/8. Small cell carcinoma of the endometrium: report of a case with analysis of Wnt/beta-catenin pathway.Small cell carcinoma of the endometrium (SCCE) is extremely rare. Previous reports indicate that SCCE frequently shows systemic spread and has a poor prognosis. Beta-catenin has been shown to be a key downstream effector of the wnt signaling pathway, which regulates cell growth and survival. Decreased membranous expression of beta-catenin in cancers correlates with poor prognosis and is associated with dissemination of tumor cells and the formation of metastases. Recently, some different investigators demonstrated aberrant beta-catenin accumulation in neuroendocrine tumors arising in different organs, suggesting a role for the Wnt/beta-catenin signaling pathway during neuroendocrine tumorigenesis. Here, we report a new case of SCCE associated with peritoneal spreading and aggressive course; the patient died one month after surgery. This study also aimed at assessing the involvement of the wnt signaling pathway in this rare neuroendocrine tumor. Interestingly, both intense nuclear beta-catenin accumulation and cyclin d1 immunoreactivity were restricted to carcinoma cells invading lymphatic vessels. However, mutation analysis failed to demonstrate any mutation in exon 3 of the beta-catenin gene or exon 15 of the APC gene in the present case. Although the mechanism of nuclear accumulation of beta-catenin is still unknown, the heterotopic nuclear localization of beta-catenin may play a role in the tumor invasion process and, subsequently, may be associated with the aggressive behavior of SCCE.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/8. Cerebrovascular complications in patients with malignancy: report of three cases and review of the literature.A cerebrovascular thromboembolic event may precede the identification of cancer, and be the first clinical evidence of an underlying malignancy. The malignancy can cause either nonbacterial thrombotic endocarditis or hypercoagulable state, both of which may have clinical manifestions such as thrombotic or embolic occlusion of multiple major cerebral vessels. We present three cases with unusual cerebrovascular events. The first case is a 62-year-old woman who was admitted due to acute left limbs weakness and consciousness disturbance. brain computed tomographic (CT) scan showed right middle cerebral artery (MCA) and posterior cerebral artery (PCA) infarctions with uncal herniation. The second case is a 44-year-old woman who was hospitalized due to acute bilateral limb weakness and consciousness disturbance. Bilateral MCA, left PCA, anterior cerebral artery (ACA) infarctions and deep vein thrombosis in the left leg were diagnosed. The third case is a 63-year-old man who developed sudden onset of right hemiplegia and consciousness disturbance. brain CT scan showed bilateral MCA and left ACA infarction. The results of a series of examinations including biochemistry, lipid profile, carotid duplex, and transthoracic and transesophageal echocardiography were unremarkable. All patients had positive disseminated intravascular coagulation (DIC) tests with elevated D-dimers and fibrinogen degradation products (FDP). Further systemic evaluation for malignancy revealed ovarian cancer in the first patient, endometrial carcinoma in the second patient, and adenocarcinoma of lung in the third patient. They all died of the underlying malignancy. Because the hemostatic system can be altered by malignancy, intravascular coagulation abnormalities of these malignancy-related strokes may be disclosed by laboratory assays of hemostasis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/8. Laparoscopic uterine artery dissection in an undiagnosed endometrial stromal sarcoma. Case report.We present a case of a 24-year-old woman, gravida 0, with menometrorrhagia and pelvic pain. A uterine hemorrhagic fibroid was diagnosed after ultrasound and magnetic resonance imaging (MRI). The endometrial biopsy was negative for malignancy. Laparoscopic sentinel lymph node sampling, lavage, and myometrial biopsy with negative results were performed before dissection of the uterine vessels. The final diagnosis of endometrial stromal sarcoma was made by myomectomy and hysterectomy one year later. This case should demonstrate the difficulty of making the right diagnosis of sarcoma before laparoscopic dissection of uterine vessels in patients with symptomatic fibroids.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
5/8. A case of unsuspected endometrial stromal sarcoma removed by operative hysteroscopy.A 26-year-old woman underwent operative hysteroscopy to remove a polypoid lesion, responsible for recurrent abnormal uterine bleeding. The polypoid mass was 4 cm long, smooth, with dilated vessels. It had a large base and originated from the fundum and posterior wall of the uterus. Pathological examination of the resected specimen showed low-grade stromal sarcoma. The patient subsequently underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. No tumor residual was found in the surgical specimen. As diagnosis of stromal sarcoma is too difficult to be made preoperatively, the complete resection of all intracavitary lesions and the pathology of all tissue specimens are suggested.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/8. Solitary metastasis in the tarsus preceding the diagnosis of primary endometrial cancer. A case report.A solitary metastasis in the left tarsus led to the diagnosis of primary endometrial cancer in a 61 year-old patient with no history of postmenopausal bleeding. Lower leg amputation, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and paraaortic lymphadenectomy were performed. Histopathology showed a well-differentiated endometrioid adenocarcinoma of the uterus with a low mitotic rate, but infiltration of the outer third of the myometrium and lymph vessel invasion (FIGO Stage IVb). Immunostaining was positive for progesterone receptors, but negative for estrogen receptors and p53. The lymph nodes were free of metastases. ascites was positive for malignant cells. Postoperatively the patient received carboplatin, cyclophosphamide and medroxyprogesterone acetate and is alive with no evidence of disease 10 months after diagnosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/8. Alpha-fetoprotein production by a hepatoid adenocarcinoma of the uterus.A case of a 62 year old Japanese woman with an endometrial adenocarcinoma producing alpha-fetoprotein (AFP) is described. Microscopically, the tumour was composed of a major medullary portion and a minor tubular adenocarcinoma which had invaded the myometrium, the myometrial lymphatics and blood vessels. Neoplastic cells in the medullary portion were polygonal with glycogen-rich cytoplasm. Vascular permeation by neoplastic cells was prominent. Extensive hepatoma-like features were observed. The tumour cells lacked features suggestive of a diagnosis of embryonal carcinoma or endodermal sinus tumour. The production of AFP by the tumour cells was demonstrated immunohistochemically using the PAP technique. Only two cases of AFP producing endometrial adenocarcinomas have been reported previously.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/8. Extrauterine low-grade endometrial stromal sarcoma: report of three cases.Three cases of rare low-grade endometrial stromal sarcoma of the extrauterine tissue are presented. Each one occurred in the ovary, pelvic and abdominal cavities. Two were associated with endometriosis. Histologically, the tumors were characterized by an infiltrative and diffuse proliferation of uniform round or oval cells, abundant small vessels, low mitotic activity, the presence of foam cells and vascular invasion. Immunohistochemically, all tumors expressed vimentin, muscle markers (desmin, muscle-specific actin and alpha-smooth muscle actin) and progesterone receptors. Two tumors were diploid and one was aneuploid by flow cytometry. All patients were well with no evidence of disease 16-39 months after surgery. It is suggested that this neoplasm may arise with or without endometriosis under hormonal influence. This rare variant of Mullerian tumors should not be confused with adenosarcoma and soft tissue tumors, such as smooth muscle tumors and solitary fibrous tumor.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |