ABSTRACT
Choriocarcinoma of the gastrointestinal tract is rare. Among them, that of the stomach is the most common. Six cases of choriocarcinoma of the colon were found in the review of the literature. All of these previously reported cases had multiple metastatic foci in the liver, lung, lymph nodes and the prognosis seemed to be very poor. Therefore we think that choriocarcinoma of the colon should be distinguished from conventional adenocarcinoma. A 66-year old female patient, described in this case, was operated on under the impression she was suffering from acute appendicitis. The resected ascending colon revealed extensive hemorrhagic necrosis and perforation with fibrous adhesion in the cecum. On the cut section, the mural tumorous thickening was not definite. Histologically, the tumor showed a focus of typical adenocarcinoma arising from glandular epithelial cells, which were transformed into highly anaplastic tumor cells. There were frequent vascular invasions of tumor cells, similar to syncytiotrophoblasts. In the immunohistochemical stains, both glandular and highly anaplastic tumor cells reacted with cytokeratin. The glandular cells were also reactive for carcinoembryonic antigen (CEA) and anaplastic tumor cells for human chorionic gonadotrophin (hCG). This is the first report of choriocarcinoma of the colon in Korea. We describe this case with a review of the literature.
Subject(s)
Aged , Female , Humans , Pregnancy , Adenocarcinoma , Appendicitis , Carcinoembryonic Antigen , Cecum , Choriocarcinoma , Chorion , Colon , Colon, Ascending , Coloring Agents , Epithelial Cells , Gastrointestinal Tract , Keratins , Korea , Liver , Lung , Lymph Nodes , Necrosis , Prognosis , Stomach , TrophoblastsABSTRACT
A 35-year-old woman presented with amenorrhea, polydipsia, polyuria, general weakness and intolerance of cold; the duration of these symptoms had been five years. On brain MRI with Gadolinium enhancement, an intrasellar mass protruding above the sella turcica was demonstrated, and the patient was thought to be a pituitary adenoma. The transsphenoid approach(TSA) was employed, and during at surgery, pus was drained. In a culture of this, no microorganism was identified, and on histologic examination, which suggested lymphocytic infiltration with fibrosis and occasional neutrophils were seen, findings which suggested the possibility of capsule of chronic abscess. Transient postoperative polyuria was noted, but this disappreared soon after broad spectrum antibiotics were administered; hormonal therapy was required for anterior and posterior pituitary hypofunction. Clinical features of this condition and its treatment are also discussed, and the literature pertaining to reported cases is reviewed. An enlarged or erosive sella coexisting with bacterial meningitis, sphenoid sinusitis, cavernous sinus thrombophlebitis or bacterial meningitis coincident with a known or suspected pituitary tumor suggests the presence of a pituitary abscess.
Subject(s)
Adult , Female , Humans , Abscess , Amenorrhea , Anti-Bacterial Agents , Brain , Cavernous Sinus Thrombosis , Fibrosis , Gadolinium , Magnetic Resonance Imaging , Meningitis, Bacterial , Neutrophils , Pituitary Neoplasms , Polydipsia , Polyuria , Sella Turcica , Sphenoid Sinus , Sphenoid Sinusitis , SuppurationABSTRACT
Adenomatoid tumors are well-recognized neoplasms generally to be of mesothelial derivation. We experienced a case of an adenomatoid tumor of the tail of the epididymis in a 56-year-old male. Grossly the tumor was firm and whitish gray, and microscopically it consisted of glandular, cord-like, microcystic structures which were lined by flattened endothelial like to plump cuboidal cells. Immunohistochemical stains whowed positivity for keratin and negativity for facter VIII related antigen and carcinoembryonic antigen. Ultrastructually, there was many long microvilli projecting into the glandular lumina and intracytoplasmic luminal spaces, desmosomes, and prominent cytoplasmic tonofilaments. Those findings strongly support the mesothelial origin of the adenomatoid tumor especially in the glandular type. It also lead us to suggest that the term adenomatoid tumor should be remain in use for light microscopic diagnosis, and that the term adenomatoid mesothelioma should be applied when the mesothelial nature of an adenomatoid tumor is proven by electron microscopy and immunohistochemical stains.