Alfa-fetoprotein secreting ovarian sex cord-stromal tumor.

Ovarian sex cord-stromal tumors are relatively infrequent neoplasms that account for approximately 8% of all primary ovarian tumors. They are a heterogeneous group of neoplasms composed of cells derived from gonadal sex cords (granulosa and Sertoli cells), specialized gonadal stroma (theca and Leydig cells), and fibroblasts. They may show androgenic or estrogenic manifestations. We report such a tumor associated with markedly raised serum alpha-fetoprotein (AFP) levels in a young female presenting with a mass and defeminising symptoms. Serum AFP levels returned to normal on removal of tumor.

The surgical pathologist and laparoscopic gynecologic surgeries.

Background: Laparoscopic surgery is a recent advance in the field of gynecological surgery. There are innumerable reports in literature on its advantages and disadvantages. However, problems faced by the surgical pathologist during grossing and histopathological reporting of these morcellated specimens have never been discussed before. We present our experience and the difficulties faced by a gynecologic pathologist (first author) and try to provide some clues for their solution. Materials and Methods: Sample size was 153 consecutive laparoscopic specimens, which varied from in toto uterus with cervix, fibroid or ovarian cyst to morcellated specimens. 153 non-laparoscopic gynecologic specimens constituted controls; 34.0% were ovarian cystectomies and remaining 66.0% were hysterectomies, myomectomies and salpingectomies, of which 36.6% were morcellated, rest were in toto. Result: Contents were not seen in majority of the ovarian cystectomies. Many more sections were taken in morcellated specimens, as compared to controls, for identification of endometrium, endocervix and ectocervix. Even then, in occasional cases identification was not possible. Congested bits in morcellated specimens interpreted as endometrium on grossing turned out to be parametrial tissue. Ectocervix could be identified as soft tissue bits covered by whitish membrane. Identification of transformation zone of the cervix was not possible in any of the morcellated hysterectomy specimens. Conclusion: The advantage of laparoscopic gynecological surgery to the patient need not prove to be so for surgical pathologist. The present study does not discourage gynecologists from performing laparoscopic surgeries but wishes to highlight the surgical pathologist's problems and limitations.

Metastasis of breast lobular carcinoma in a cervical leiomyoma.

We report here a case of 40-year-old female admitted in view of bilateral ovarian tumors. There was past history of modified radical mastectomy. CT scan revealed a uterine cervicalfibroid in addition to bilateral adnexal masses. Lobular carcinoma metastasis were seen in the leiomyoma as well as in the bilateral ovaries. Metastasis of ductal carcinoma to uterine leiomyoma have been reported in literature. The present case is unique in two ways--(1) metastasis of lobular carcinoma (2) occurring in a cervical leiomyoma.

Role of carotid intima-media thickness in assessment of atherosclerosis: an autopsy study.

BACKGROUND: The non-invasive technique of measuring carotid artery intima-media thickness has generated considerable interest as a marker of atherosclerosis, particularly in predicting clinical coronary events and coronary artery disease. In the present study, a postmortem comparative analysis of intima-media thickness of carotid artery with coronary artery atherosclerosis has been carried out. To date no such morphological tissue studies are available from our country. METHODS AND RESULTS: Right and left common carotid arteries with their branches were removed at postmortem in 40 cases with history of diabetes, hypertension or both. Intima-media thickness was measured and compared with coronary artery atherosclerosis. There were 10 control postmortem cases without history of diabetes or hypertension. Common carotid artery and internal carotid artery intima-media thickness were found to be good predictors of coronary events. There was also significant correlation (by Pearson's correlation formula) between the carotid artery intima-media thickness and the percentage of block in the coronary arteries. CONCLUSIONS: Internal carotid artery along with common carotid artery intima-media thickness measurement is a good predictor of coronary artery disease. However, carotid artery intima-media thickness has no bearing on the status of collateral circulation of the coronary arteries.

Mucosal neuromas and prominent corneal nerves without MEN IIB.

Multiple endocrine neoplasia type II B or the mucosal neuroma syndrome is an autosomal dominant hamartoneoplastic syndrome. This is a report of a 17 year old female who presented with mucosal neuromas at age 7 years and had surgical excision of the lesion. Ten years later (at age 17 years) she had further recurrence of mucosal neuromas which were again surgically excised. She has been thoroughly investigated & followed, however to date she has no evidence of thyroid carcinoma which is a major complication of this syndrome.