Estudo da correlação das proteínas INGs com a P53 em lesões odontogênicas epiteliais benignas / Study of the correlation of INGs proteins with P53 in benign epithelial odontogenic lesions

As proteínas INGs (inhibitor of growth gene) desempenham papel de supressoras tumorais e podem agir por vias dependentes, ou independentes, da p53 na sinalização do ciclo celular e da apoptose. Este trabalho investigou, por meio de imuno-histoquímica, a correlação entre a expressão das proteínas INGs e a expressão da proteína p53 em ceratocistos odontogênicos (20), TOAs (20) e ameloblastomas sólidos (20). Os espécimes foram submetidos à marcação utilizando os anticorpos anti-Ing3, anti-Ing4, anti-Ing5 e anti-p53. Foi realizada análise quantitativa levando-se em consideração a localização citoplasmática e/ou nuclear para as proteínas INGs e a localização nuclear para a proteína p53. A análise da imunoexpressão das proteínas ING1 e ING2 foi realizada em um estudo prévio e os resultados foram considerados apenas para a análise de correlação com as proteínas estudadas neste estudo. Os dados foram analisados pelo Statistical Package for Social Sciences para Windows (SPSS versão 22.0; IBM, USA). Para a comparação da imunoexpressão entre os grupos de lesões foi utilizado o teste de Kruskal Wallis, e para a investigação das correlações foi utilizado o teste de Spearman. Foram considerados significativos os valores de p ≤ 0.05. O presente estudo evidenciou redução da expressão nuclear e citoplasmática das proteínas ING3, ING4 e ING5 em ceratocistos odontogênicos (COs) e ameloblastomas (AMBs). Além disso, em alguns casos, a perda da expressão nuclear das INGs esteve negativamente correlacionada à expressão da proteína p53. As análises de correlação entre as proteínas INGs indicam a existência de mecanismos compensatórios entre as proteínas INGs em folículos dentários (FDs) e tumores odontogênicos adenomatoides (TOAs), estes mecanismos parecem ser menos evidentes em COs e AMBs. Observou-se redução na expressão da proteína ING3 em AMBs (p=0,003); redução na expressão da proteína ING4, tanto em AMBs (p=0,02) quanto em COs (p=0,001); e uma redução da expressão nuclear da proteína ING5 nos COs (p=0,09) e nos AMBs (p=0,012). Foram evidenciadas correlações positivas entre a expressão nuclear da p53 com a expressão citoplasma/núcleo da proteína ING1 (r=0,603; p=0,05) em COs, e com a expressão citoplasma/ núcleo das proteínas ING3 (r=0,475; p=0,034) e ING4 (r=0,448; p=0,047) em AMBs. Por fim, os resultados deste estudo sugerem que a redução na expressão nuclear das proteínas INGs pode ser um evento envolvido na etiopatogênese de lesões odontogênicas mais agressivas, e que a redução da expressão nuclear/citoplasmática das proteínas INGs não está relacionada ao aumento expressão da p53 em COs e AMBs, o que sugere que a expressão destas proteínas deve resultar em alterações funcionais de maneira independente da p53 em lesões odontogênicas (AU).

INGs (inhibitor of growth gene) proteins play a role of tumor suppressors and can act via p53-dependent or independent pathways in signaling cell cycle and apoptosis. The aim of this study is to evaluate correlation between expression of proteins of ING proteins and expression of protein p53 in dental follicles (DF), odontogenic keratocysts (OK), adenomatoid odontogenic tumors (AOT) and solid ameloblastomas (AMBs). The sample was intentional and non-probabilistic, consisting of 20 cases of solid AMBs, 20 cases of AOT, 20 cases of OKs and 10 samples of DFs. The specimens were subjected to immunohistochemical method, using antibodies anti-Ing3, anti-Ing4, anti-Ing5 and antip53. Quantitative analysis was performed taking into account cytoplasmic and / or nuclear location for ING proteins and nuclear location for the p53 protein. The analysis of ING1 and ING2 immunoexpressions was performed in a previous study and the results were considered only for the correlation analysis. Data were analyzed by Statistical Package for Social Sciences for Windows (SPSS version 22.0; IBM, USA). Kruskal Wallis test was used to compare the immunoexpression between the groups of lesions, and Spearman test was used to investigate correlations. Values of p ≤ 0.05 were considered significant. This study showed a reduction in nuclear and cytoplasmic expression of ING3, ING4 and ING5 in odontogenic keratocysts (OKs) and ameloblastomas (AMBs). In addition, in some cases, loss of INGs nuclear expression was negatively correlated with p53 expression. Correlation analyzes may indicate existence of compensatory mechanisms between all the ING proteins in dental follicles (FDs) and adenomatoid odontogenic tumors (TOAs). These mechanisms seem to be less evident in COs and AMBs. The results of this study showed a reduction in ING3 expression in AMBs (p = 0.003); a reduction in ING4 expression, in OKs (p = 0.02) and in AMBs (p = 0.001); and a reduction in ING5 nuclear expression, also in OK (p = 0.09) and in AMBs (p = 0.012). Positive correlations were found between p53 nuclear expression with ING1 cytoplasm / nucleus expression (r = 0.603; p = 0.05) in OKs, and with ING3 cytoplasm / nucleus expression (r = 0.475; p = 0.034) and also ING4 cytoplasm / nucleus expression (r = 0.448; p = 0.047) in AMBs. Finally, this study suggests that reduction in the expression of INGs proteins seems to be an event that occurred in etiopathogenesis of more aggressive odontogenic lesions. Futhermore, nuclear / cytoplasmic expression of INGs proteins is not related to increase in p53 expression in OKs and AMBs, which indicates that loss of expression of these proteins may results in functional changes independently of p53 (AU).

Tumor adenomatoide de tubas uterinas, reporte de un caso y revisión de la literatura / Adenomatoid uterine tube tumor, case report and literature review

Resumen Los tumores adenomatoides del tracto genital son neoplasias poco frecuentes, de comportamiento benigno; debido a sus características histológicas se confunden fácilmente con tumores de estirpe vascular. Estudios recientes demuestran que los tumores adenomatoides del tracto genital femenino están genéticamente definidos por la mutación TRAF7 que activa la expresión aberrante de la vía NFkB. Presentamos el caso de una mujer de 27 años, asintomática, a quien se le realiza salpingectomía bilateral como método de anticoncepción definitivo; en el examen macroscópico de la tuba derecha se encuentra formación quística que por sus características microscópicas es diagnosticada como tumor adenomatoide de la tuba uterina. Finalmente se realiza una revisión de la literatura.

Abstract The adenomatoid tumors of the genital tract are rare neoplasms, with benign behavior; due to their histological characteristics, they are easily confused with tumors of vascular origin. Recent studies show that adenomatoid tumors of the female genital tract are genetically defined by the TRAF7 mutation that activates the aberrant expression of the NFkB pathway. We present the case of a 27-year-old woman, asymptomatic, who underwent bilateral salpingectomy as a method of definitive contraception; In the macroscopic examination of the right tuba, cystic formation is found which, due to its microscopic characteristics, is diagnosed as an adenomatoid tumor of the uterine tube. Finally, a review of the literature is made

Organ-sparing partial orchietectomy for testicular adenomatoid tumor / 北京大学学报(医学版)

OBJECTIVE@#The incidence of testicular tumors is relatively low which are mainly malignant, so the main way to treat testicular tumors is radical testicular resection. Testicular adenomatoid tumor is a rare testicular benign tumor, but is easily misdiagnosed as malignant tumors with removal of organs. This article aims to explore the clinical features of testicular adenomatoid tumor and its treatment.@*METHODS@#There were 133 cases of testicular tumor in the Peking University Third Hospital from May 1994 to November 2016. We conducted a retrospective analysis of three patients who underwent the treatment of partial orchiectomy with preservation of the organ and were pathologically diagnosed with testicular adenomatoid tumor after surgery. The follow-up was done by outpatient clinics and telephone inquiry after surgery. The related literature was also reviewed for further discussion.@*RESULTS@#Of all the 133 patients, 116 had radical resection of the testis and 17 had partial testicular resection due to specific reasons (5 cases of epidermoid cyst, 4 cases of teratoma, 3 cases of seminoma, 3 cases of adenomatoid tumor, and 2 cases of Sertoli cell tumor). The mean age of the 3 patients was (42.67±10.97) years (30-49 years), the mean hospital stay was (9.00±5.20) d (6-15 d), the mean body mass index was (26.20±1.42) kg/m2 (25.00-27.76 kg/m2), the mean serum human choionic gonadotophin (HCG) was (1.15±0.11) IU/L (1.07-1.23 IU/L) (all normal) and the mean serum alpha-fetoprotein (AFP) was (2.12±0.66) μg/L (1.65-2.58 μg/L) (both were normal). Ultrasound features revealed a clear or unclear border, solid, moderate echo nodule tumor in the testis. The mean maximal diameter of the tumor was (1.00±0.44) cm (0.50-1.30 cm), and the mean duration of intraoperative warm ischemia time was (19.67±17.10) min (0-31 min) (only the last two cases). No recurrence or malignant transformation was observed during the follow-up.@*CONCLUSION@#Testicular adenomatoid tumor is mainly based on the characteristics of ultrasound to determine preoperatively, but easy to be misdiagnosed with testicular radical resection. The recommended surgery for adenomatoid tumor is partial resection of the testis via the inguinal approach according to the frozen section pathology to determine whether to retain the organ.

Comparison of the Classical Method and SEE-FIM Protocol in Detecting Microscopic Lesions in Fallopian Tubes with Gynecological Lesions

BACKGROUND: The objective of this study was to compare the classical method and Sectioning and Extensively Examining the Fimbriated End Protocol (SEE-FIM) in detecting microscopic lesions in fallopian tubes with gynecological lesions. METHODS: From a total of 1,118 cases, 582 with various parts of both fallopian tubes sampled in three-ring-shape sections and 536 sampled with the SEE-FIM protocol were included in this study. Pathological findings of cases with endometrial carcinoma, non-uterine pelvic malignant tumor, ovarian borderline tumors, premalignancy, and benign lesions were compared. RESULTS: We detected two tubal infiltrative carcinomas among 40 uterine endometrioid adenocarcinomas, 15 serous tubal intraepithelial carcinomas in 39 non-uterine pelvic serous high-grade carcinoma cases, seven papillary tubal hyperplasias in 13 serous borderline tumor cases, and 11 endometriotic foci and four adenomatoid tumors among all cases sampled with the SEE-FIM protocol. Using the classical method, we detected only one serous tubal intraepithelial carcinoma in 113 non-uterine pelvic serous high-grade carcinoma cases and two papillary tubal hyperplasia cases in 31 serous borderline tumors. We did not identify additional findings in 185 uterine endometrioid carcinoma cases, and neither endometriotic focus nor adenomatoid tumor was shown in other lesions by the classical method. CONCLUSIONS: Benign, premalignant, and malignant lesions can possibly be missed using the classical method. The SEE-FIM protocol should be considered especially in cases of endometrial carcinoma, nonuterine pelvic serous cancers, or serous borderline ovarian tumors. For other lesions, at least a detailed examination of the fimbrial end should be undertaken.

Tumor odontogénico adenomatoideo: reporte de un caso / Adenomatoid odontogenic tumor: report of a case

El tumor odontogénico adenomatoide (TOA) es una lesión benigna,infrecuente, clasificada por la OMS dentro de los tumores odontogénicoscon participación del ectomesénquima que muestra una morfología histológica muy peculiar. Esta entidad patológica es de baja prevalencia, representa 0.1% de los tumores y quistes de losmaxilares con raras recidivas. Su frecuencia de aparición es más comúnen pacientes jóvenes, generalmente mujeres, de mayor aparición en maxilar superior, asintomático, asociado a dientes sin erupcionar(principalmente caninos) que plantea diagnósticos diferenciales entre otras lesiones de mayor agresividad como el quiste dentígero y el ameloblastoma. Se presenta el caso de una paciente de nueve años de edad con lesión tumoral en el sector del maxilar superior izquierdo de 40 días de evolución. Clínicamente hay ausencia del órgano dentario número 23. Se indica la realización de una radiografía panorámica, en la cual se observa la presencia del órgano dental 23 en el piso de órbita del maxilar superior izquierdo. Se procede a la remoción quirúrgica con diagnóstico presuntivo de quiste dentígero, se biopsia el total de la lesión, con diagnóstico definitivo por histopatología de TOA, con buena evolución clínica odontológica.

The adenomatoid odontogenic tumor (TOA) is a rare, uncommon,WHO-classified lesion in odontogenic tumors with ectomesenchyma,which shows a very peculiar histological morphology. This pathologicalentity is of low prevalence representing 0.1% of the tumors and cystsof the jaws with rare recurrences. Its frequency of appearance is morecommon in young patients, generally females, of greater presentationin the upper jaw, asymptomatic, associated with unruptured teeth(mainly canines) that presents diff erential diagnoses among other moreaggressive lesions such as dentigerous cyst and ameloblastoma. Wepresent the case of a nine-year-old patient with tumor lesion in the leftupper jaw of 40 days of evolution. Clinically there is absence of the tooth23. A panoramic radiograph is indicated, in which the presence of thetooth 23 is observed in the orbital fl oor of the upper left jaw. Surgicalremoval is performed with a presumptive diagnosis of dentigerouscyst; the total of the lesion was biopsied, with defi nitive diagnosis byhistopathology of TOA with good odontological clinical evolution.

Tumor odontogénico adenomatoide en la mandíbula de una niña de 11 años de edad / Adenomatoid odontogenic tumor in the jaw of an 11-year-old girl

Presentar un caso de tumor odontogénico adenomatoide y realizar consideraciones relativas a su diagnóstico y prevención. Caso clínico: una paciente de 11 años de edad presentaba intenso dolor y deformación facial a nivel mandibular. El diagnóstico anatomopatológico de certeza fue tumor odontogénico adenomatoide. Conclusiones: el tumor odontogénico adenomatoide es un tumor benigno de los maxilares, frecuentemente asociado a una pieza dentaria retenida. Sus dimensiones pueden ser importantes, lo cual compromete las estructuras vecinas y su funcionalidad. Se enfatiza la importancia del diagnóstico oportuno de parte del médico pediatra, del odontólogo pediatra y del cirujano bucomaxilofacial...

Tumor odontogénico adenomatoide: presentación característica de un tumor infrecuente; revisión bibliográfica y presentación de un caso clínico / Adenomatoid odontogenic tumor: characteristic presentation of an unusual tumor; review of the literature and report of a case

El tumor odontogénico adenomatoide (TOA) es una neoplasia benigna epitelial de origen odontogénico que se manifiesta con mayor predisposición en el sextante anterior del maxilar superior, aunque puede presentarse en otras localizaciones. Su nombre refleja el rasgo histológico característico de estructuras parecidas a conductos entremezclados con todo el componente epitelial, dando a la lesión un aspecto glandular o adenomatoso. Sigue patrones clínicos y radiográficos característicos. Dado que la lesión no es agresiva biológicamente y requiere de tratamiento conservador, es de extrema importancia su identificación y diferenciación de otras lesiones, especialmente del ameloblastoma...

Tumor adenomatoide pleural / Adenomatoid pleural tumor

Introduction: Adenomatoid tumors are rare benign neoplasms, pleural is a very rare location, reporting only 4 cases worldwide and none in our country. Case report: A 30 year-old female patient, that in the context of a preventive health examination, presents a mediastinal solid mass in the right hemithorax, in the thorax radiography. The lesion of 8 cm x 7 cm x 2.4 cm was surgically removed. Histology shows a lesion compatible with pleural adenomatoid tumor and inmunohistochemistry is positive for markers such as calretinin and cytokeratin 5/6. Discussion: The pleural adenomatoid tumor is an uncommon neoplasm with benign behavior and several differential diagnoses.

Introducción: Los tumores adenomatoides son neoplasias benignas poco frecuentes, cuya ubicación pleural es de muy baja frecuencia, reportándose sólo 4 casos a nivel mundial y ninguno nacional a la fecha. Las muestras parciales en biopsia intraoperaratoria, en ausencia de antecedentes clínico-radiológicos puede representar un desafío diagnóstico. Caso clínico: Paciente de sexo femenino, 30 años que en contexto de un examen preventivo de salud se pesquisa en la radiografía de tórax una masa sólida mediastínica en hemitórax derecho. Se extirpa lesión redondeada de 8 cm. La histología muestra lesión compatible con tumor adenomatoide pleural y la inmunohistoquímica positividad para marcadores Calretinina y Citoqueratina 5/6. Discusión: El tumor adenomatoide pleural en una entidad poco frecuente, de comportamiento benigno, con diversos diagnósticos diferenciales.

Tumor odontogênico adenomatoide mimetizando um cisto radicular / Adenomatoid odontogenic tumour mimetizing a radicular cyst

O tumor odontogênico adenomatoide (TOA) foi considerado como uma entidade clínica distinta, em 1969, por Philipsen e Birn. Trata-se de um tumor odontogênico, de caráter totalmente benigno, assintomático, de crescimento lento e raramente atingindo tamanho maior que 3 cm. Acomete, preferencialmente, a região anterior dos ossos gnáticos, principalmente a maxila, ocorrendo duas vezes mais no gênero feminino, sendo incomum em pacientes maiores que 20 anos. O objetivo deste trabalho é relatar um caso clínico atípico de tumor odontogênico adenomatoide em região anterior de mandíbula, mimetizando cisto radicular, acometendo um paciente de 45 anos, do gênero masculino, tratado com enucleação cirúrgica. O paciente encontra-se atualmente em proservação, não apresentando sinais clínicos e imaginológicos de recidiva. No presente artigo, os aspectos clínicos, radiográficos e histológicos do tumor odontogênico adenomatoide serão discutidos assim como o tratamento recomendado... (AU)

Adenomatoid Odontogenic Tumor (AOT) was so classified as a new tumor in 1969 by Philipsen and Birn. This odontogenic tumor is benign, asymptomatic, has a slow growing and rarely reach a size greater than 3 cm. AOT usually occurs in anterior jaw bones, affects females twice more than males and is unusual in patients older than 20 years-old. The aim of this study is to report an atipic case of AOT in the anterior mandible mimetizing a radicular cyst, affecting a 45 years-old male patient, who was treated by surgical enucleation. The patient has been followed-up and has no clinical and imaging signs of recurrence. In this paper, adenomatoid odontogenic tumor's clinical, radiographic and histological aspects will be discussed, as well the recommended treatment... (AU)

Tumor odontogénico adenomatoide: reporte de un caso y revisión de la literatura / Adenomatoid odontogenic tumor: report of a case and review of the literature

El Tumor Odontogénico Adenomatoide (TOA) es una lesión tumoral benigna de origen odontogénico de la que se conocen 3 variantes clínicas: folicular (70.8 por ciento), extrafolicular (26.9 por ciento) y periférica (2.3 por ciento), todas ellas con un mismo patrón histopatológico. La literatura mundial acepta que la mayoría de estas lesiones se diagnostican en la segunda década de la vida, se presentan con el doble defrecuencia en el género femenino, se ubican generalmente en maxilar superior y asociadas, en su variante folicular, con un canino no erupcionado.En los estudios radiográficos el TOA puede presentar características similares a lesiones como el Quiste Dentígero, el Tumor OdontogénicoQuístico Calcificante (Quiste de Gorlin) y el Tumor Odontogénico Epitelial Calcificante (Tumor de Pindborg), entre otros, de los que debe hacerse el diagnóstico diferencial. En este trabajo se presenta un caso clínico de TOA folicular con una localización poco habitual y se realiza una extensa revisión de la literatura mundial...

Tumor adenomatoide urológico: presentación clínico-patológica de 14 casos / Urologic adenomatoid tumor: clinico pathological presentation of 14 cases

El Tumor Adenomatoide es la neoplasia paratesticular más frecuente y localizada principalmente en el epidídimo. Material y método: Se presenta una serie clínico-patológica de 14 tumores adenomatoides urológicos diagnosticados entre 1975-2011. Resultados: La edad media de presentación fue de 46 años (rango 32-67 años). La mayoría de los casos se presentó como un nódulo firme indoloro en el epidídimo. No hubo casos de localización intratesticular. Se realizó tumorectomía en 13 casos y además orquiectomía en uno. Los tumores midieron una media de 1.9 cm (rango 0.3-5 cm) y macroscópicamente fueron sólidos, blanquecinos y bien delimitados. A la histología estaban formados por estructuras adenomatoides irregulares rodeadas por tejido fibroso. La inmunotinción para Queratina y Calretinina fueron positivas, lo que apoya el origen mesotelial del tumor. El curso clínico fue benigno en todos los casos, sin presentar recurrencias. Conclusión: Corresponde a una neoplasia benigna urogenital rara de origen mesotelial y que compromete con frecuencia el epidídimo. Se presentaron en hombres de edad media y que en la mayoría fueron tratados con tumorectomía, mostrando un curso clínico benigno...

Adenomatoid Tumor is the most frequent paratesticular neoplasia and it is located mainly in the epididymis. Material and methods: A series of 14 cases of Urological Adenomatoid Tumor diagnosed between 1975 - 2011 is presented. Results: Average age at presentation was 46 years (range 32-67 years). The majority of the cases were presented as a painless and firm nodule in the epididymis. No cases involving the testicular parenchyma were seen. The tumors measured an average of 1.9 cm (range 0.3 - 5 cm) and grossly all cases were solid, whitish and fair/y well demarcated. The histology revealed adenomatoid structures surrounded by fibrous tissue. The immunostains were positive for keratin and calretinin which support‘ the mesothelialial origin of the tumor. All cases showed a benign clinical course and no relapses were found. Conclusion: Correspond to a rare benign urogenital/neoplasia that frequently involves the epidermis. They were presented in middle age men and in the majority of the cases were treated by lumpectomy, showing a bening clinical course...

Concurrent hepatic adenomatoid tumor and hepatic hemangioma: a case report

A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.

Tumor odontogénico adenomatoide / Adenomatoid odontogenic tumor

El tumor odontogénico adenomatoide (TOA) es una neoplasia benigna epitelial de origen odontogénico que se manifiesta en mayor porcentaje en el sector anterior del maxilar superior, aunque puede presentarse en otras localizaciones. Estadísticamente afecta más a mujeres que a hombres y se da con mayor frecuencia en la segunda década de vida. Generalmente está asociado a una pieza dentaria retenida y es por eso que, sumado a sus características clínicas y radiográficas, muchas veces el tumor se confunde con otras lesiones odontogénicas. A continuación se presenta un caso clínico con sus características, diagnóstico, tratamiento y descripción de la técnica quirúrgica, y se hace una revisión de la literatura acerca de este tumor benigno.

Tumor adenomatoide epididimário: relato de dois casos e revisão da literatura / Adenomatoid tumor of the epididimys: report a two cases and review the literature

Tumores adenomatóides são tumores mesoteliais benignos geralmente encontrados nas estruturas paratesticulares. Relatamos dois casos de tumor adenomatoide no epididímo. Revisamos a literatura sobre tumores epididimários, suas apresentações, métodos e diagn´soticos e tratamento.

Tumor odontógeno adenomatoide en región mandibular / Adenomatoid odontogenic tumor in mandibular region

El tumor odontogénico adenomatoide es un tumor poco frecuente derivado del epitelio odontontogénico, que contiene estructuras canaliculares con modificaciones inductivas de intensidad variable en el tejido conjuntivo. Es una lesión de crecimiento lento y poco invasiva pero que se puede asemejar a otras lesiones odontógenas de mayor agresividad como el quiste dentígero y el ameloblastoma entre otros. Su localización clásica (área de caninos superiores) nos orienta al diagnóstico y su patrón histológico ductiforme es muy propio de este tumor. Otros tumores que se encuentran dentro de este grupo son el fibroma ameloblástico, el odontoameloblastoma, el quiste odontógeno calcificante y los odontomas compuesto y complejo. Este grupo de lesiones puede o no tener formaciones de tejido duro dental dentro de ellos. Por esta razón, se presenta un paciente con este tipo de tumor, al que se le realizó estudio histopatológico, se revisó la literatura acerca de este tumor odontogénico benigno y sus características clínicas, radiográficas, tratamiento, así como los diagnósticos diferenciales que se deben tener en cuenta(AU)

The adenomatoid odontogenic tumor is an uncommon neoplasm derivative of the odontogenic epithelium containing canalicular structures with inductor modifications of variable intensity in the conjunctival tissue. It is a slow growth lesion and no much invasive but that may to be similar to other odontogenic lesions more aggressive including the dentigerous cyst and the ameloblastoma among others. Its classical location (upper canine area) guides us to diagnosis and its duct histological pattern is very typical of this tumor. Other tumors included in this group are the ameloblastic fibroma, the ameloblastic odontoma, the calcified odontogenic cyst and composed and complex odontomas. This group of lesions may or not to have formations of hard tissue inside. Thus, authors present the case of a patient presenting with this type of tumor making a histopathology study, a literature review on this benign odontogenic tumor and its clinical radiographic features, treatment, as well as the differential diagnoses to be into account(AU)

Correlación entre los hallazgos del ultrasonido doppler pélvico-trasvaginal: con la anatomía patológica: en tumores de ovario / Correlation between transvaginal color doppler and histologic diagnosis: in ovarian tumors

Correlacionar los hallazgos del ultrasonido doppler pélvico-transvaginal con el congelado y la biopsia definitiva en pacientes con tumores de ovario que acuden al Hospital General del Este "Dr. Domingo Luciani" octubre 2007-2008. Se incluyeron 33 pacientes entre 18-70 años con tumores de ovario. Se les realizó ultrasonido Doppler pélvico-transveginal previa intervención quirúrgica indicada para cada patología. Se les realizó corte congelado y biopsia definitiva y éstos se compararon posteriormente con los resultados del ultrasonido. Un 66% fueron tumores benignos, el cistoadenoma seroso fue el más frecuente (36.3%), 33.3% fueron malignos, con 27.2% para adenocarcinoma. La sensibilidad del sistema de puntuación para masas ováricas fue del 100% y 95% de especificidad. El índice de Resistencia (IR), Indice de Pulsatilidad (IP) y la Velocidad Pico Sistólica (VPS), presentaron sensibilidad de 89%, 100% y 90% con especificidad de 95%, 85% y 91% respectivamente. El corte congelado presentó concordancia en el 100% de los casos con la biopsia definitiva. El ultrasonido pélvico transvaginal con efecto Doppler resultó tener alta sensibilidad y especificidad para la diferenciación de tumores benignos y malignos de ovario.

To corelationate finding of transvaginal color Doppler with frozen section and definitive biopsy in patients with ovarian neoplasms attended at Hospital General del Este "Dr. Domingo Luciani" Octubre 2007-2008. There were included 33 patients with ages between 18-70 years old. It was performed a pelvic-transvaginal Doppler before the surgical exploration. There were performed frozen sectin and definitive biopsy and these results were compared with the ultrasound findings. A 66% were beningn neoplasms: serous cystic adenoma (36.3%) malign, with a 27.2% of adenocarcinoma. Sensitivity was 100% and specifity 95%. Resistence Index, Pulsatility Index and Systolic Velocity, had a sensitivity of 89%, 100% and 90% with a specificity of 95%, 85% and 91% repectively. Frozen section and definitive biopsy were 100% concordant. Pelvic-transvaginal Doppler in our study have high sensitivity and specifity in ovarian's tumors.

Adenomatoid tumors of female genital tracts: An analysis of 195 cases / 대한산부인과학회지

OBJECTIVE: Adenomatoid tumors of female genital tracts are benign lesions derived from mesothelium, occurring most commonly during the reproductive years. The aim of this study was to evaluate the overall incidence of adenomatoid tumors in Korean women and to analyze the clinical characteristics. METHODS: One hundred and ninety five patients with adenomatoid tumors were found in a retrospective medical records review of pathologic reports for 44,984 benign uterine diseases at Cheil General Hospital, from January 1995 to April 2009. RESULTS: The overall incidence rate was 0.42% of all benign uterine disease. Among them, 149 patients received hysterectomy, and 46 patients received uterine conservative surgery. Main symptoms of the patients were pain (25.1%), bleeding (30.2%), and palpable mass (18.5%). Most common associated pathologies were leiomyoma (46.6%), adenomyosis (25.1%) and endometriosis (13.1%). Most of the diagnosis was made postoperatively. Among 46 patients with conservative treatment, 13 patients showed successful pregnancy outcome. No recurrence occurred during the follow up period. CONCLUSION: Adenomatoid tumors are associated with fibroids and tend to mimic them clinically, making pre-operative diagnosis difficult. The recurrence is rare even after conservative operation. Our data about this benign neoplasm may be helpful for counseling patients after operations.

Tumor adenomatoide del tracto genital femenino: Informe de dos casos de cuerpo uterino y ovario, y revisión de la literatura / Adenomatoid tumour of the female genital tract: A report of two cases located in the uterine body and ovary and review of the pertinent literature

Objetivo: informar dos casos de tumor adenomatoide (TA) del tracto genital femenino y efectuar una revisión de la literatura, con énfasis en sus aspectos histopatológicos y diagnóstico diferencial. Presentación de los casos: se informan dos casos de TA del tracto genital femenino, diagnosticados mediante estudios histológicos y de inmunohistoquímica de piezas quirúrgicas. El primero corresponde a una paciente de 39 años que consultó por hemorragia uterina, a quien se le realizó diagnóstico clínico y ecográfico de miomatosis uterina, para el cual se le practicó histerectomía y cuyo estudio patológico demostró un tumor adenomatoide del cuerpo uterino. El segundo caso se presentó en una paciente de 26 años con masa de ovario izquierdo, cuyo material histológico fue remitido para consulta con diagnóstico inicial de tumor de seno endodérmico. Discusión: el TA es un tumor benigno de origen mesotelial, infrecuente en el tracto genital femenino, cuyo tratamiento sólo requiere cirugía conservadora. Su diagnóstico diferencial incluye tumores malignos primarios y metastáticos, tanto del cuerpo uterino como del ovario, que de acuerdo con su estado clínico, requieren para su manejo cirugía oncológica y quimioterapia y/o radioterapia complementarias.

Objective: reporting two cases of adenomatoid tumour (AT) of the female genital tract and to reviewing the pertinent literature, emphasising histopathological features and differential diagnosis. Cases report: two cases of AT of the female genital tract are reported; they were diagnosed by histological and immunohistochemistry studies of surgical specimens. The first case concerned a 39-year-old woman who consulted for uterine bleeding; uterine myomatosis was suggested by clinical and ultrasonographic diagnosis, but the pathological study revealed an AT. The second case concernid a 26-year-old woman with a left ovarian mass. Ooforectomy initially diagnosed the histological material as endodermal sinus tumour and it was then sent for consultation. Discussion: AT is an infrequently occurring mesothelial benign tumour of the female genital tract; its treatment only requires conservative surgery. Its differential diagnosis includes malignant primary and metastatic tumours of both the uterine body and the ovaries, requiring oncologic resection and complementary chemo-and/or radiotherapy, according to their clinical state.

Tumores adenomatoides uterinos: estudio anátomo-patológico e inmunohistocitoquímico / Adenomatoid tumor of the uterus: histological and immunohistochemical study

Antecedentes: Los tumores adenomatoides (TA) son poco frecuentes. Se encuentran principalmente en el aparato reproductor femenino y especialmente en el útero. No existen reportes a nivel nacional sobre estos. Objetivos: Describir las características histológicas e inmunohistoquímicas de los TA uterinos. Método: Estudio descriptivo de 32 muestras ingresadas al Servicio de Anatomía Patológica de Clínica Las Condes. Las muestras estudiadas fueron recopiladas entre noviembre de 1999 y noviembre de 2008. Resultados: El diagnóstico de TA fue realizado en 21 histerectomías y 11 miomectomías. En 14 casos se diagnosticaron como lesiones nodulares únicas (43,8 por ciento) y en 18 junto a leiomiomas (56,2 por ciento). El tamaño promedio de las lesiones únicas fue 2,6 cm, significativamente mayor que aquellas asociadas a leiomiomas. El patrón histológico predominante más frecuente correspondió al tipo angiomatoide (81,3 por ciento), seguido por los patrones adenoide (9,4 por ciento), sólido (6,3 por ciento) y mixto (3 por ciento), no se encontraron TA quísticos. El estudio inmunohistoquími-co fue positivo en el 100 por ciento de los casos para citoqueratina AE1/AE3, calrretinina, vimentina y D2-40. Fue negativo para CD31 y CEA. Sólo un 6,3 por ciento (2 casos) fue positivo para citoqueratina 5/6. Conclusiones: Los TA corresponden a tumores benignos de origen mesotelial. Generalmente su diagnóstico es un hallazgo. Al presentarse en el útero, se confunden generalmente con leiomiomas o se presentan en conjunto con estos. En base a lo anterior el tratamiento de estas lesiones debe ser conservador, bastando con la resección del tumor.

Background: The adenomatoid tumors (AT) are rare. They are found mainly in the female reproductive system and especially in the uterus. There is not national reporting on these. Objective: To describe the his-tological and immunohistochemical features of uterine AT. Method: Descriptive study of 32 patients admitted to the Pathology Department of Clinica Las Condes. The cases studied were collected between November 1999 and November 2008. Results: The diagnosis of AT was performed in 21 hysterectomies and 11 myomectomies. In 14 patients were diagnosed as nodular single lesions (43.8 percent) and in 18 cases associated with leiomyomas (56.2 percent), the average size of single lesions was 2.6 cm, significantly greaterthan those associated with leiomyomas. The predominant histologic type most often correspond to angiomatoid (81.3 percent), followed by adenoid patterns (9.4 percent), solid (6.3 percent) and mixed (3 percent), the cystic pattern was not observed. The immunohistochemical study of ST was positive in 100 percent for cytokeratin AE1/AE3, calrretinin, vimentin and D2-40. It was negative for CD31 and CEA. Only 6.3 percent (2 cases) were positive for cytokeratin 5/6. Conclusions: The AT is a benign tumor of mesothelial origin. Usually the diagnosis is a finding. In the uterus they are generally mistaken with leiomyomas or it is in associated with them. Based on the foregoing the treatment of AT should be conservative, only with resection.

One case of adenomatoid tumor of uterus / 대한산부인과학회지

Adenomatoid tumor of uterus is described by Golden and Ash as a tumor that similar to adenoma but found obscured histogenesis. Adenomatoid tumor is a rare benign disease that originated from mesothelium and mostly occurred in male and rarely in female, and can be treated by simple excision of tumor because there is no recurrence or malignant change. We describe the clinical and histologic findings with references to other reported cases. We herein report a case of adenomatoid tumor of the uterus that gets an operation under clinical impression of myoma uteri.