Synchronous uterine serous carcinoma and ovarian sex cord stromal tumor (thecoma)–A rare first case report

Synchronous endometrial and ovarian carcinoma is a rare instance and it accounts for 50 to 70% of all synchronous female genital tract tumors. However, it is very rare to find synchronous endometrial carcinoma and ovarian sex cord–stromal tumor (thecoma). The present case is a 75-year-old woman with a complaint of post-menopausal vaginal bleeding. Radiologically, the magnetic resonance imaging (MRI) pelvis revealed altered signal intensity mass in the uterus. Frozen section and routine histopathological examination were done on radical hysterectomy. Microscopically, serous carcinoma involving uterine corpus and left Fallopian tube was identified along with the unusual finding of contralateral ovarian sex cord–stromal tumor (thecoma), which was confirmed on immunohistochemical examination. It is a very rare association and is first reported in the present study after a thorough search of the published literature. Their relationship based on a high level of estrogen produced by the hyperactive ovary is controversial as serous carcinomas are less hormone-dependent.

Synchronous endometrial and ovarian cancer: a rare presentation

Synchronous primary cancers are relatively uncommon in the general population. About 0.5 -1.7% of gynecological malignancies have synchronous primary cancer of female genital tract. Amongst the synchronous gynecological malignancies synchronous endometrioid carcinoma is most common and has good prognosis. Patients with synchronous endometrioid tumors of endometrium and ovary are usually younger, have low grade number, and their prognosis is better than other histologic types. The authors are presenting a case of 38 years old nulliparous obese woman with pain in abdomen and heavy menstrual bleeding for a duration of four months. The MRI pelvis was suggestive of well defined, lobulated, complex, solid cystic multiseptated lesion measuring 8.8×7.7×8.8 cm in right adnexa, with anteverted uterus, and a bulky indistinct emdomyometrial junction. Histopathology revealed synchronous endometrial carcinoma of both uterus and ovary.

Carcinoma endometrioide sincrónico de ovario y endometrio / Ovarian and endometrial synchronous endometrioid carcinoma

ANTECEDENTES: existe una asociación demostrada entre endometriosis y algunas histologías del carcinoma epitelial de ovario. Por otra parte, se ha observado que hasta un 30% de las neoplasias de ovario se presentan de forma concomitante a neoplasias del endometrio. Para considerar la sincronicidad entre estos tumores, estos deben cumplir criterios anatomopatológicos estrictos como los descritos por scully. OBJETIVO: presentar un caso clínico de carcinoma endometrioide sincrónico de ovario y endometrio sobre focos de endometriosis, así como su diagnóstico y manejo. CASO CLÍNICO: paciente de 27 años que consulta por spotting intermenstrual. En la ecografía endocavitaria se observa un pólipo endometrial. Además, se describe un tumor anexial izquierdo de 42mm, trilobulado, con un polo sólido de 17×15mm. Se somete a una polipectomía histeroscópica y quistectomía ovárica laparoscópica. Asimismo, se reseca implante sospechoso en el fondo de saco posterior. El resultado anatomopatológico de las piezas quirúrgicas fue: pólipo endometrial con hiperplasia compleja con atipias y focos de adenocarcinoma endometrioide grado I; el tumor quístico ovárico izquierdo consistente con quiste endometriósico con focos de adenocarcinoma endometrioide. La lesión peritoneal corresponde a un implante de adenocarcinoma endometrioide grado I. El estudio de las características anatomopatológicas y la presencia del implante peritoneal sugieren el diagnóstico de un carcinoma endometrioide ovárico con origen en una lesión endometriósica sincrónico con un carcinoma endometrioide endometrial. CONCLUSIÓN: el diagnóstico diferencial entre la sincronicidad o diseminación de los tumores de ovario y endometrio de estirpe endometrioide supone un reto para el clínico y es fundamental para el correcto manejo de estas neoplasias.

BACKGROUND: there is a demonstrated association between endometriosis and some epithelial ovarian carcinoma histologies. On the other hand, it has been observed that up to 30% of ovarian neoplasms present concomitantly with endometrial neoplasms. To consider synchronicity between these neoplasms, they must meet strict pathological criteria such as those described by scully. OBJECTIVE: to introduce a case of an ovarian and endometrial synchronous endometrioid carcinoma implanted on endometriosis sites, as well as its diagnosis and management. CLINICAL CASE: a 27-year-old patient who consulted because of an intermenstrual spotting. The ultrasound image showed an endometrial polyp. Furthermore, a 42 mm left adnexal trilobal tumor with a 17×15mm solid pole was described. She underwent a hysteroscopic polypectomy and laparoscopic ovarian cystectomy. Likewise, resection of a suspicious implant in the posterior vaginal fornix was done. The pathological result of the surgical pieces was: endometrial polyp with complex hyperplasia with atypia and focal points of grade I endometrioid adenocarcinoma; the left ovarian cystectomy: endometriotic cyst with focal points of endometrioid adenocarcinoma. The peritoneal lesion corresponded to a grade I endometrioid adenocarcinoma implant. The study of the pathological characteristics and the presence of the peritoneal implant suggest the diagnosis of endometrioid ovarian carcinoma originated in a synchronous endometriotic lesion with endometrial endometrioid carcinoma. CONCLUSION: differential diagnosis between the synchronicity or spread of ovarian and endometrial endometrioid cell line carcinomas, is a great challenge and it is essential for the correct management of these neoplasms

Synchronous high-grade bladder carcinoma associated with chronic lymphocytic leukemia: A rare entity in Indian literature

B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) is one of the common lymphoproliferative disorders with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin. The decreased immunity and B-cell dysfunction in CLL probably accounts for this emergence of secondary malignancy. Breast, brain, skin and prostate tumors have been reported as usual coincident malignancies of CLL, while in occasional cases CLL may occur with malignancies of other solid organs, such as skin, lung, heart, and prostate. Synchronous CLL with urothelial carcinoma (UC) is an infrequent occurrence. We report this case because of its rarity in Indian literature and interesting hematological, immunophenotypic, histopathological, and cytopathological features of metastatic high-grade UC in a 61-year-old male with CLL

Triple synchronous tumors presenting as right nasolabial basal cell carcinoma, papillary thyroid carcinoma and prolactinoma: A rare case report / Journal of the ASEAN Federation of Endocrine Societies

@#Multiple primary tumors are rare, with a published meta-analysis that shows the frequency of second primary tumor at 3-5%, and a third tumor at 0.5%. A 57-year-old female sought consultation due to a persistently bleeding right nasolabial mass. On further history and examination, she also presented with a right anterior neck mass, repeated abortions, secondary amenorrhea, and loss of libido years prior. Serum prolactin was significantly elevated and an incidental finding of a pituitary mass on head and neck CT scan was appreciated. Metastasis and syndromic familial disorder were ruled out. Bromocriptine was given and she underwent total thyroidectomy and wide excision of the right nasolabial mass which turned out to be papillary thyroid carcinoma (PTC) and basal cell carcinoma (BCC) respectively on histopathologic report. On follow up, repeat serum prolactin decreased to normal levels. After extensive literature review, this is the first documented case of triple synchronous tumors with a combination of BCC of the right nasolabial area, PTC and prolactinoma in local, national and international studies. With comprehensive work up and literature search, the diagnosis was established and ultimately the patient benefited from a multidisciplinary management.

Adenocarcinoma gástrico y tumor estromal del estómago sincrónico incidental / Gastric adenocarcinoma and incidental synchronous incidental gastrointestinal stromal tumor

Se presenta el caso de un paciente masculino de 73 años de edad operado por adenocarcinoma del antro gástrico. Se practicó gastrectomía subtotal distal más linfadenectomía D2. Durante el examen anatomopatológico de la pieza quirúrgica se encontró otro tumor pequeño en el espesor de la pared del antro cubierto por mucosa normal, separado del adenocarcinoma. El análisis histológico confirmó otra neoplasia incidental sincrónica, un tumor del estroma gastrointestinal de tipo fusiforme, positivo para el marcador tumoral CD117. El objetivo del trabajo es presentar esta asociación tumoral sincrónica, revisar sus características y las teorías etiopatogénicas actuales de esta condición sincrónica según la literatura especializada(AU)

A case is presented of a 73-year-old male patient who was operated for a gastric adenocarcinoma of the antrum. A distal subtotal gastrectomy plus D2 lymphadenectomy were practiced. During the anatomic and pathologic examination of the surgical piece, a second tiny tumor was found in the wall of the antrum and that was covered with a normal mucosa separated from the adenocarcinoma. The histologic examination confirmed another synchronous incidental neoplasm, a spindle-cell gastrointestinal stromal tumor, positive for the tumor marker CD117. This paper is aimed at presenting synchronous tumor entity, to review its characteristics and the current etiologic and pathogenic theories of this synchronic condition according to the specialized literature(AU)

Tumores malignos sincrónicos de ovario y endometrio / Ovary malignant synchronous tumors and endometrium

Los tumores malignos sincrónicos primarios de ovario y endometrio son raros y se reportan en alrededor de un 5 por ciento y pueden tener muy buen pronóstico cuando son detectados tempranamente. El objetivo del presente trabajo es dar a conocer a la comunidad científica el caso de un paciente con tumores malignos concurrentes de ovario y endometrio poco frecuentes. Se presenta una paciente femenina de 67 años de edad, multípara, de color de piel blanca, a la cual se le diagnosticó un adenocarcinoma de endometrio y en el curso de la cirugía se encontró un tumor sólido de ovario y el diagnóstico histopatológico arrojó un tumor de las células de la granulosa. Los tumores sincrónicos de ovario y endometrio parecen tener mejor pronóstico y sobrevida cuando son de bajo grado y diagnosticados en etapas tempranas(AU)

The primary synchronous malignant ovarian and endometrial tumors are rare and they are reported in around 5 percent. They can have very good prognosis when they are early detected. The aim of this paper is to inform the scientific community the case of a patient with concurrent malignant tumors of ovarian and endometrial infrequent. We present a 67 year old female patient, multiparous, white skin color, who was diagnosed with an endometrial adenocarcinoma. In the course of surgery, a solid ovarian tumor was found. Her histopathologic diagnosis yielded a granulose-cell tumor. Synchronous ovarian and endometrial tumors appear to have a better prognosis and survival when they are low grade and diagnosed at early stages(AU)

Neoplasia primaria sincrónica de endometrio y ovario: a propósito de un caso / Synchronous primary neoplasms of the endometrium and ovary: a case report

El desarrollo sincrónico de múltiples tumores en el tracto genital femenino es muy infrecuente, presentándose tan solo en el 1 al 2 por ciento de los cánceres ginecológicos. De estos, el 50 al 70 por ciento lo constituyen el grupo de neoplasias primarias sincrónicas de endometrio y ovario. El objetivo del artículo es exponer un caso diagnosticado histopatológicamente en el Departamento de Patología de la Universidad Industrial de Santander en material procedente de histerectomía abdominal ampliada, salpingooforectomía bilateral, linfadenectomía pélvica y apendicectomía, y hacer una revisión de la literatura de esta entidad, dada la infrecuencia de su diagnóstico y a la escasa información local al respecto.

Synchronous development of multiple tumors in the female genital tract is rare, occurring only in the 1 to 2 percent of gynecologic cancers. Of these, 50 to 70 percent consists of the group of synchronous primary neoplasms of the endometrium and ovary. The aim of this paper is to present a case diagnosed histopathologically at the Department of Pathology of the Universidad Industrial de Santander in a sample for histological study consists of material from enlarged abdominal hysterectomy, bilateral salpingoophorectomy, pelvic lymphadenectomy and appendectomy sent by the Hospital Universitario de Santander in 2010, and a review of the literature of this entity, given the rarity of its diagnosis and the lack of local information about it.

Multiple Primary Malignant Neoplasm Combined with Musculoskeletal Malignancy / 대한정형외과학회잡지

From Jan. of 1990 to Dec. of 1992, we have experienced three cases of multiple primary malignant neoplasms originated from different histogenesis, in the Department of Orthopedic Surgery of Korea Cancer Center Hospital. Liposarcomas, malignant fibrous histiocytoma were combined with renal cell carcinoma, mucinous cystadenocarcinoma of ovary or prostatic cancer. With Moertel's classification, synchronous tumors were found in 2 cases and metachronous in 1 case. Synchronous tumors were 2 liposarcomas-renal cell carcinoma or mucinous cystadenocarcinoma of ovary. Metachronous tumors were malignant fibrous histiocytoma-prostate cancer. We couldn t find any family history among them. The causes of these multiple malignancies were considered as the individual predilrection to tumors.