The prognostic significance of the heterologous component in uterine carcinosarcomas

SUMMARY OBJECTIVE: Uterine carcinosarcomas are aggressive, rare biphasic tumors with malignant epithelial and malignant sarcomatous components. The prognostic significance of the presence of extrauterine sarcoma (heterologous component) is controversial. Therefore, the aim of this study was to investigate the effect of heterologous components in uterine carcinosarcomas on disease-free survival, overall survival, and other prognostic factors. METHODS: Clinical and histopathological data from patients treated for uterine carcinosarcoma in a tertiary cancer center in Turkey between July 2000 and January 2020 were collected. Independent risk factors affecting overall survival and disease-free survival were analyzed by univariate and multivariate Cox regression analyses. RESULTS: A total of 98 patients were identified. The median follow-up was 21.8 (1.2-233.1) months. In the multivariate analysis, the median overall survival and disease-free survival were 23.8 and 20.7 months in those with homologous mesenchymal components and 17.6 and 9.7 months in those with heterologous mesenchymal components, respectively. It was found that the presence of heterologous mesenchymal components significantly reduced both overall survival and disease-free survival (odds ratio [OR], 2.861; 95% confidence interval [CI] 1.196-6.841; p=0.018 and OR, 3.697; 95%CI 1.572-8.695; p=0.003, respectively). In addition, both lymphadenectomy and adjuvant radiotherapy were found to significantly increase overall survival and disease-free survival. Age was found to increase only disease-free survival. CONCLUSION: The results obtained in this study showed that the presence of heterologous components in uterine carcinosarcoma is a prognostic factor that adversely affects both overall survival and disease-free survival. Lymphadenectomy and adjuvant radiotherapy have beneficial effects on both overall survival and disease-free survival.

Prognostic factors for recurrence and survival in uterine leiomyosarcoma: Korean single center experience with 50 cases

OBJECTIVE: The aim of this study was to determine the possible prognostic factors in patients with uterine leiomyosarcoma (LMS). METHODS: This study retrospectively investigated 50 patients with uterine LMS treated at the Samsung Medical Center between 2001 and 2017. To analyze the prognostic significance of factors for recurrence-free survival (RFS), overall survival (OS), and survival after recurrence, the log-rank test and Cox proportional hazards model were used for univariate and multivariate analysis. RESULTS: Of the 50 patients, 30 (60.0%) experienced recurrence and 16 (32.0%) died within a median follow-up period of 21 (range, 3–99) months. Multivariate analysis revealed that older age, absence of residual tumor after surgery, lower mitotic count, and a history of adjuvant radiotherapy at first treatment were significantly associated with better RFS. Presence of residual tumor after surgery and severe nuclear atypia were associated with poor OS. In the analysis of survival after recurrence, hematogenous recurrence, severe nuclear atypia, and presence of residual tumor at primary surgery were significantly associated with worse prognosis. Notably, residual tumor status at primary surgery was associated with RFS, OS, and survival after recurrence. CONCLUSION: We demonstrated the possible prognostic factors for RFS, OS, and survival after recurrence for patients with LMS. These results may provide useful information for patients with LMS.

Current Status of Magnetic Resonance Imaging in Patients with Malignant Uterine Neoplasms: A Review

In this study, we summarize the clinical role of magnetic resonance imaging (MRI) in the diagnosis of patients with malignant uterine neoplasms, including leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma, uterine carcinosarcoma, and endometrial cancer, with emphasis on the challenges and disadvantages. MRI plays an essential role in patients with uterine malignancy, for the purpose of tumor detection, primary staging, and treatment planning. MRI has advanced in scope beyond the visualization of the many aspects of anatomical structures, including diffusion-weighted imaging, dynamic contrast enhancement-MRI, and magnetic resonance spectroscopy. Emerging technologies coupled with the use of artificial intelligence in MRI are expected to lead to progressive improvement in case management of malignant uterine neoplasms.

Analysis of tumor metastasis caused by minimally invasive surgery of uterine neoplasm / 医学研究生学报

Objective Gynecologic minimally invasive surgery has become popular in the treatment of tumor therapy in re-cent years, but improper application can result in tumor metastasis.In this paper, we presented 6 uterine neoplasm cases of tumor me-tastasis after minimally invasive surgery and analyzed the causes and the preventive measures. Methods Retrospective analysis was made on the clinical data and pathology characteristics of the 6 uterine neoplasm cases of tumor metastasis after primary minimally inva-sive surgery in our department from January 1, 2013 to 2015 June 30, and related literature were reviewed. Results The ages of 6 patients were 39-52 years old.The primary operation methods included 2 cases of hysteroscopic myomectomy, 3 cases of laparoscopic myomectomy and 1 case of radiofrequency ablation.The pathological diagnosis after primary operations were 4 cases of uterine sarcoma ( low grade endometrial stromal sarcoma in 2 cases and leiomyosarcoma in 2 cases) who were found metastatic tumor at 3-16 months after primary surgery and finally died of the disease and 2 cases of uterine fibroids who were found metastatic tumor in abdominal cavity and puncture hole at 60 months and 108 months respectively after primary operation followed by a good prognosis after the second surgi-cal resection. Conclusion Owing to uterine neoplasm by hysteroscopy, laparoscopy often needs certain pressure and morcellation which may result in easy plantation of crushing tumor tis-sue or metastasis with circulation and puncture under pressure.Ra-diofrequency ablation lack of histopathologic diagnosis has heating effect which is inclined to speed up the spread and transfer of tumor cells once it is diagnosed as malignant.Therefore, clinicians should know the defects and risk of being lack of histopathologic diagno-sis, diagnostic curettage pathology and fast pathology to avoid tumor metastasis induced by minimally invasive surgery.

Cryopreservation of in vitro matured oocytes after ex vivo oocyte retrieval from gynecologic cancer patients undergoing radical surgery / 대한생식의학회지

OBJECTIVE: The aim of this study was to report a case series of in vitro matured (IVM) oocyte freezing in gynecologic cancer patients undergoing radical surgery under time constraints as an option for fertility preservation (FP). METHODS: Case series report. University-based in vitro fertilization center. Six gynecologic cancer patients who were scheduled to undergo radical surgery the next day were referred for FP. The patients had endometrial (n=2), ovarian (n=3), and double primary endometrial and ovarian (n=1) cancer. Ex vivo retrieval of immature oocytes from macroscopically normal ovarian tissue was followed by mature oocyte freezing after IVM or embryo freezing with intracytoplasmic sperm injection. RESULTS: A total of 53 oocytes were retrieved from five patients, with a mean of 10.6 oocytes per patient. After IVM, a total of 36 mature oocytes were obtained, demonstrating a 67.9% maturation rate. With regard to the ovarian cancer patients, seven IVM oocytes were frozen from patient 3, who had stage IC cancer, whereas one IVM oocyte was frozen from patient 4, who had stage IV cancer despite being of a similar age. With regard to the endometrial cancer patients, 15 IVM oocytes from patient 1 were frozen. Five embryos were frozen after the fertilization of IVM oocytes from patient 6. CONCLUSION: Immature oocytes can be successfully retrieved ex vivo from macroscopically normal ovarian tissue before radical surgery. IVM oocyte freezing provides a possible FP option in patients with advanced-stage endometrial or ovarian cancer without the risk of cancer cell spillage or time delays.

Expression of estrogen receptor and progesterone receptor on PTEN-deficient endometrial carcinoma / 临床与实验病理学杂志

Purpose To investigate estrogen receptor ( ER ) , progesterone receptor ( PR ) expression in PTEN-deficient endometrial carcinoma and to analysis the relationship of PTEN, ER and PR protein expression with histological grade, pathological staging and muscle invasive. Methods Immunohistochemistry EnVision was used to detect the expression of PTEN, ER and PR protein in 100 ca-ses of endometrial carcinoma. Results The rate of PTEN-deficient endometrial carcinoma was 52. 0% (52/100). The expression rate of ER, PR protein on PTEN-deficient endometrial carcinoma was 15. 4% (8/52), 19. 2% (10/52), respectively. And the expression rate of ER, PR protein on PTEN over-expression endometrial carcinoma was 72. 7% (8/11), 63. 6% (7/11), respectively. The rate of PTEN, ER and PR expression types shown PTEN-ER-PR- was 42. 0% (42/100), which was higher than other types (P <0. 05). Different PTEN, ER and PR expression types were well correlated with histological grade and pathological staging (P<0. 05), but not with muscle invasive. Conclusion Combined detection of PTEN, ER and PR may have an important reference value for prog-nosis and treatment of endometrial carcinoma.

Expression and clinical significance of Foxp3 in 84 cases of human endometrial carcinoma / 临床与实验病理学杂志

Purpose To investigate the expression and clinical significance of Foxp3 ( cell surface marker of regulatroy T) mRNA and its protein in endometrial carcinomas and normal endometrial tissues. Methods Real-time fluorescence quantitative PCR and immuno-histochemical SP methods were used to detect the expressions of mRNA and protein in tumor tissue of 84 cases of endometrial carcino-mas and 40 cases of normal endometrial tissue, then to analyze the relationship between Foxp3 gene and clinical pathological character-istics of endometrial carcinoma specimens, such as differentiation, FIGO stage. Results Foxp3 mRNA and it′s protein expression of endometrial carcinomas were significantly higher than that of normal endometrial tissues. There were significantly relationships between Foxp3 mRNA expression and FIGO stage of endometrial cancer, Foxp3 mRNA expressions of III+IV stage was higher than that ofⅠ+Ⅱ stage endometrial carcinoma (P<0. 05). But the relationship between Foxp3 expression and differentiation degree reached differ-ent conclusions in the two detection methods. By immunohistochemistry the expression of Foxp3 protein was correlation with histological differentiation grade (rs =0. 72, P <0. 01). In poorly differentiated endometrial carcinoma Foxp3 + cell number was significantly higher than that in well differentiated endometrial carcinoma. By detection of real-time fluorescence quantitative PCR method, Foxp3 mRNA expression was not correlated with tumor grade (rs =0. 01, P=0. 35). Conclusion Foxp3 in endometrial carcinomas are high expressions. Immunohistochemical method has more clinical value than real-time fluorescence quantitative PCR test results. Foxp3 may be involved in the regulation of the development of endometrial cancers.

A Clinical Analysis of Brain Metastasis in Gynecologic Cancer: A Retrospective Multi-institute Analysis

This study analyzes the clinical characteristics of the brain metastasis (BM) of gynecologic cancer based on the type of cancer. In addition, the study examines the factors influencing the survival. Total 61 BM patients of gynecologic cancer were analyzed retrospectively from January 2000 to December 2012 in terms of clinical and radiological characteristics by using medical and radiological records from three university hospitals. There were 19 (31.1%) uterine cancers, 32 (52.5%) ovarian cancers, and 10 (16.4%) cervical cancers. The mean interval to BM was 25.4 months (21.6 months in ovarian cancer, 27.8 months in uterine cancer, and 33.1 months in cervical cancer). The mean survival from BM was 16.7 months (14.1 months in ovarian cancer, 23.3 months in uterine cancer, and 8.8 months in cervical cancer). According to a multivariate analysis of factors influencing survival, type of primary cancer, Karnofsky performance score, status of primary cancer, recursive partitioning analysis class, and treatment modality, particularly combined therapies, were significantly related to the overall survival. These results suggest that, in addition to traditional prognostic factors in BM, multiple treatment methods such as neurosurgery and combined chemoradiotherapy may play an important role in prolonging the survival for BM patients of gynecologic cancer.

Reviews on association between the inhibitory costimulatory molecules B7 -H4 and female malignant tumor / 实用肿瘤学杂志

The new costimulatory molecule B7-H4,also called V-set domain containing T cell activa-tion inhibitor 1(VTCN-1),is a member of the B7 family.B7-H4 can negatively regulate the immune response of T lymphocytes through inhibiting their proliferation and cytokine production .The expression of B7-H4 plays an important role in initiation ,progression and regression of malignant tumors ,including female malignant tumor , such as breast cancer ,ovarian cancer and uterine neoplasm .The association between the female tumors and B 7-H4 causes great concern in recent years .In this review,the function of B7-H4 in female tumor research and the potential target of B7-H4 in the diagnosis and treatment of female tumor are summarized .

The clinical value of Thinprep cytology test combined with h -TERC and c -myc in the diagnosis of cervical ;cancer / 中国基层医药

Objective To explore the clinical value of Thinprep cytology test (TCT)combined with h -TERC and c -myc in the diagnosis of cervical cancer.Methods hTERC amplification was detected by dual -color interphase fluorescence in situ hybridization (FISH),and the results were compared with TCT and histological examination.Examination the positive which TCT,h -TERC and c -myc by pathological examination.The final diag-nosis was determined by the pathological examination.Results TCT was abnormal in 26.4% of 500 case,18.0%abnormal h -TERC gene,16.0% abnormal c -myc gene.In 270 cases according to the cervical biopsy,the positive rate of chronic inflammation,cervical intraepithelial neoplasia (CIN)Ⅰ,CINⅡ,CINⅢ and cervical cancer:44.4%, 38.2%,36.4%,18.2%,and 7.3% respectively.The positive rates of h -TERC were 18.1%,45.4%,52.5%, 65.9% and 100.0%,respectively.The positive rates of c -myc were 21.4%,48.9%,56.7%,59.9% and 100.0%.With increased pathological grade,the expressions of h -TERC and c -myc were high.Conclusion TCT combined with h -TERC and c -myc can test cervical cancer more effective.

Expression of LC3B in cervical squamous carcinoma and its relationship with Ki-67 expression / 临床与实验病理学杂志

Purpose To investigate the expression of autophagy-related protein LC3B in cervical squamous carcinoma and its relation-ship with Ki-67 expression. Methods To detect the expression of LC3B in 16 cases of normal cervical tissues and 126 cases of squa-mous cell carcinoma by immunohistochemical staining. In addition, Ki-67 protein was also detected in 126 cases of squamous cell car-cinoma in the same assay. The relationship between LC3B expression and Ki-67 in cervical squamous cell cancer was statistical analy-sis. Results Expression level of LC3B were significantly lower in cervical squamous carcinoma than normal squamous epithelial cells (P<0. 05), and the expression of LC3B was negatively correlated with Ki-67(rs = -0. 248, P<0. 05). Conclusion It appears that decreased levels of autophagy which indicated by low expression of LC3B may promote cancer cell proliferation in the early stages of cervical squamous cell carcinoma, which provides a clinical referential evidence for further explore the mechanism of autophagy in cer-vical cancer development.

Expression and significance of p57 kip2, Cyclin D1 in human endometrial carcinoma / 临床与实验病理学杂志

Purpose To study the effects of p57kip2, Cyclin D1 on the carcinogenesis and progression of endometrial carcinoma. Meth-ods 100 cases of endometrial adenocarcinoma ( EA) , 20 cases of endometrial intraepithelial neoplasia ( EIN) , 20 cases of hyperpla-sia lesion, 20 cases of endometrial proliferative phase were selected. Different endometrial cells ( well-differentiated endometrial cancer cells Ishikawa, moderately differentiated endometrial cancer cells JEC, poorly differentiated endometrial cancer cells KLE and normal endometrial cells ESC) were cultured. Protein expression of p57kip2, Cyclin D1 was measured by immunohistochemical EliVision meth-ods. The expression of p57kip2, Cyclin D1 protein in different endometrial cells was detected by Western blot. Results The highest expression of p57kip2 protein was in EIN, the higher expression was in endometrial proliferative phase, the low expression was in EA and the lowest expression was in hyperplasia lesions, but only the expression of p57kip2 protein in EIN was higher than that in hyperplasia le-sions (P<0.05). The highest expression of Cyclin D1 protein was in EA and the lowest expression of Cyclin D1 protein was in endom-etrial proliferative phase, expression of Cyclin D1 protein increased gradually in hyperplasia lesions and EIN, p57kip2, Cyclin D1 pro-tein expression in the tissue of EA increased along with the histological grade, all present decreasing trend, but only p57kip2 protein ex-pression related to histological grade ( P<0.05 ) . The highest expression of p57 kip2 protein was in KLE and the lowest expression of p57kip2 protein was in ESC, but only the expression of p57kip2 protein in KLE was higher than that in ESC (P<0.05). The expression of Cyclin D1 in JEC, Ishikawa higher than that in ESC (P<0.05). Conclusion p57kip2, Cyclin D1 are involved in the occurrence and development of endometrial carcinoma, Cyclin D1 is an early event in endometrial carcinoma, but there may also be have abnormal p57kip2 protein by synthesized, synergistically. Cyclin D1 promoting endometrial malignant transformation. Combined detection of p57kip2, Cyclin D1 expression in endometrial carcinoma, to predict the prognosis of endometrial carcinoma has a certain clinical signifi-cance.

Expression of tumor buds and its relationship with clinicopathological characteristics in endo-metrial carcinoma / 临床与实验病理学杂志

Purpose To investigate the expression of tumor buds and its relationship with clinicopathological characteristics in endome-trial carcinoma. Methods 47 cases of endometrial carcinoma were observed and analyzed by means of clinicopathologic data and im-munohistochemical staining. The connections between tumor buds and clinicopathologic parameters were studied by statistics. Results Of the 47 endometrial carcinoma cases, tumor buds were seen in 18 cases. Tumor buds were correlated with histological grade, lymph node metastases, vascular invasion, Ki-67 index and survival. There were no associations between tumor buds with age, tumor size, pTNM stage or myometrial invasion depth. Immunohistochemistry demonstrated that the level of N-cadherin, vimentin in bud cells was higher than normal carcinoma cells while the level of CK(AE1/AE3),β-catenin and E-cadherin got the opposite results. Conclu-sion Tumor buds may play an important role in the progression of endometrial carcinoma. The immunohistochemical features of bud cells indicated that tumor buds may be a key step in epithelial-mesenchymal transition.

Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012

OBJECTIVE: Much of the early investigative work on the usefulness of preoperative serum CA-125 levels in identifying patients with early-stage endometrial carcinoma who have occult metastases were carried out in Europe and the United States. This article reviews CA-125 as a possible index for determining the need for full surgical staging, from the results of large medical centers in Asia, particularly Taiwan and Korea. METHODS: A Medline search was performed using CA-125 and endometrial cancer as index words from 1981 to 2012. Those publications felt to be the most important especially from institutions from Asia since 2000 were identified in this review. RESULTS: Most articles that analyzed the utility of serum CA-125 levels as predictive marker for disease extent or prognosis in uterine cancer used univariate and multivariable logistic regression analysis, and performed receiver operative curves to find the best cut-off values. The main factor of interest was whether clinicians can stratify patients that need lymphadenectomy in early stage disease. Suggested optimal cut-off value ranged from 20 to 210 U/mL. Not only preoperative CA-125 level, but myometrial invasion status by magnetic resonance imaging was the most significant combined parameter for predicting disease extent. CONCLUSION: Elevated CA-125 in patients with apparent early-stage disease is clearly a risk factor for the presence of extra-uterine disease although the optimal cut-off levels vary. The evolution of clinical investigations over the past decade, particularly in Asia, suggests employment of the test in a more focused manner to identify high risk patients preoperatively.

Retained placenta accreta after a first-trimester abortion manifesting as an uterine mass

Placenta accreta during the first trimester of pregnancy is rare. Only a few cases of placenta accreta manifesting as a uterine mass have been published. Most patients with placenta accreta present with vaginal bleeding during or after pregnancy. This report describes a patient with placenta accreta that caused vaginal bleeding three years after a first trimester abortion. The patient had regular menstruation for three years after the abortion. Initially endometrial cancer or a uterine myoma with degeneration was suspected. This is the first report of a placenta accreta detected as a uterine mass long after a first trimester abortion with delayed vaginal bleeding.

Análise espacial dos indicadores pactuados para o rastreamento do câncer do colo do útero no Brasil / Spatial analysis of the indicators agreed for screening cervix cancer in Brazil / El análisis espacial de los indicadores acordados para detección de cáncer de cuello uterino en Brasil

O câncer do colo do útero, embora seja uma doença curável e altamente prevenível, apresenta elevado índice de mortalidade no país. Teve como objetivo analisar a distribuição espacial dos indicadores pactuados para o câncer do colo do útero no Brasil, no período de 2006 a 2009. Estudo ecológico, utilizou dados do Sistema de Informação do Câncer do Colo do Útero e Sistema de Informação sobre Mortalidade. Apesar de estruturado e com melhoras nos indicadores, o programa ainda se encontra abaixo das metas pactuadas em alguns Estados, configurando um padrão desigual de desempenho dos indicadores no território brasileiro. As diferenças regionais mostraram falhas na captação de mulheres, na cobertura populacional, na qualidade das amostras do exame citológico e estabilidade da taxa de mortalidade. Estados que se encontram abaixo das metas pactuadas precisam otimizar os recursos e promover acesso às mulheres que não estão inseridas no programa de rastreamento.

Although cervix cancer is a highly preventable and curable disease, it shows high mortality rate in the country. The study analyzes the spatial distribution of the indicators agreed for cervix cancer, in Brazil, between 2006 and 2009. Ecological study that used data from the Information System of Cervical Cancer and the Information System on Mortality. Although structured and with indicators improvement, the program is still below the targets agreed in some States, forming an uneven pattern of indicators performance, in the country. Regional differences showed some failures on women screening, population coverage, quality of cytologic samples and mortality rate stability. States that are below the targets agreed need to optimize resources and provide access to the women who are not included in the screening program.

El cáncer de cuello de útero, a pesar de ser una enfermedad altamente prevenible y curable, presenta alta tasa de mortalidad en el país. Este estudio tuvo como objetivo analizar la distribución espacial de los indicadores acordados para el cáncer del cuello de útero en Brasil entre 2006 y 2009. Estudio ecológico que utilizó datos de Sistema de Información del Cáncer de Cuello de Útero y Sistema de Información sobre la Mortalidad. Se considera que, si bien estructurado y con mejoras en los indicadores, el programa está todavía bajo las metas acordadas en algunos estados, que forman un patrón irregular de los indicadores de resultados en Brasil. Las diferencias regionales mostraron fallas en la detección, la cobertura de la población, la calidad de las muestras citológicas y la estabilidad en la tasa de mortalidad. Los Estados que están bajo las metas acordadas necesitan optimizar recursos y facilitar el acceso a las mujeres que no están incluidas en el programa de rastreamiento.

Localized Uterine Recurrence of Hepatocellular Carcinoma 4 Years after Curative Resection / 대한내과학회지

Extrahepatic metastasis of hepatocellular carcinoma (HCC) can be found in various organs, but metastasis to the female genital tract is extremely rare. A 48-year-old woman who had undergone curative left lobectomy for small HCC 4 years earlier was admitted because of sequential alpha-fetoprotein elevation. Upon abdominal MRI and hepatic angiography, no evidence of HCC recurrence was found in the remnant liver. However, a positron emission tomography CT scan showed a hypermetabolic lesion in the uterine fundus, which was revealed as metastatic HCC after total hysterectomy. This is, to our knowledge, the first documented case of metastatic uterine tumor that originated from HCC without intrahepatic recurrence.

Localized Uterine Recurrence of Hepatocellular Carcinoma 4 Years after Curative Resection / 대한내과학회지

Extrahepatic metastasis of hepatocellular carcinoma (HCC) can be found in various organs, but metastasis to the female genital tract is extremely rare. A 48-year-old woman who had undergone curative left lobectomy for small HCC 4 years earlier was admitted because of sequential alpha-fetoprotein elevation. Upon abdominal MRI and hepatic angiography, no evidence of HCC recurrence was found in the remnant liver. However, a positron emission tomography CT scan showed a hypermetabolic lesion in the uterine fundus, which was revealed as metastatic HCC after total hysterectomy. This is, to our knowledge, the first documented case of metastatic uterine tumor that originated from HCC without intrahepatic recurrence.

Uterine artery embolization for treatment of leiomyoma: long term results and effects on outcomes / 中国医师杂志

Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.

Hepatocellular Carcinoma Presenting as Uterine Metastasis / Journal of the Korean Cancer Association, 대한암학회지

Metastatic extragenital cancer that spreads to the uterus is rare. When it occurs, the extragenital primary disease is often in the breast or gastrointestinal tract. We report here on a case of hepatocellular carcinoma (HCC) that metastasis to the uterus. The patient was admitted for evaluation of a pelvic mass. The serum alpha-fetoprotein level was highly elevated. Magnetic resonance imaging of the abdomen and pelvis showed hepatic and uterine masses. The patient underwent surgical treatment. The histopathologic findings and immunohistochemical staining results of the uterine mass were characteristics of metastatic HCC. The endometrium and both ovaries were free of tumor. Up to now, there have been only two cases of uterine metastasis from HCC reported in the English literature. This case is the first documented instance of a metastatic uterine tumor from HCC that spared both ovaries.