MRI Findings of the Uterine Tumors Resembling Ovarian Sex Cord Tumors:Report of Two Cases / 中国医学科学院学报

Uterine tumors resembling ovarian sex cord tumors are rarely reported with limited imaging findings.The current study reported two case of uterine tumors resembling ovarian sex cord tumors and described the detailed MRI findings,which would provide valuable imaging evidence for the diagnosis of such tumors.

Lipoleiomioma uterino

El lipoleiomioma es una neoplasia uterina benigna poco frecuente cuya incidencia varía entre 0,03% y 0,2%. Este tumor es considerado una variante benigna de los leiomiomas uterinos típicos. Está formado por una proporción variable de adipocitos maduros y células musculares lisas. La etiología puede estar relacionada con la deficiencia de estrógenos que se produce después de la transición menopáusica; generalmente aparece en mujeres obesas perimenopáusicas o menopáusicas. La sintomatología es inespecífica y la mayoría es diagnosticada de forma incidental. Se presenta un caso de lipoleiomioma uterino en paciente de 45 años quien consultó por presentar dolor abdominal. La ecografía mostró tumor en pared anterior de un útero homogéneo y bien definido. Durante la laparotomía se encontró tumor amarillento y de textura blanda. Se realizó histerectomía total más ooforosalpingectomía. El diagnóstico anatomopatológico fue de lipoleiomioma uterino.

Lipoleiomyoma is a rare benign uterine neoplasm whose incidence varies between 0.03%-0.2%. This tumor is considered a benign variant of typical uterine leiomyomas. It consists of a variable proportion of mature adipocytes and smooth muscle cells. The etiology may be related to estrogen deficiency occurring after the menopausal transition; it usually appears in obese perimenopausal or menopausal women. The symptomatology is nonspecific, and most are diagnosed incidentally. We present a case of uterine lipoleiomyoma in a 45-year-old patient who consulted for abdominal pain. Ultrasonography showed a tumor in the anterior wall of a homogeneous and well-defined uterus. During laparotomy, a yellowish tumor with a soft texture was found. Total hysterectomy plus oophorosalpingectomy was performed. The anatomopathologic diagnosis was uterine lipoleiomyoma.

Clinical analysis of 19 mullerian adenosarcoma of uterus / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the clinical characteristics and treatment experience of mullerian adenosarcoma ofuterine.METHODS:A retrospective analysis was conducted on the clinical data of 19 women with Mullerianadenosarcoma of uterus between January 2005 and December 2015.RESULTS:The patients were 28 to 70 years old,withan average of 51.9 years old.9 were premenopause and 10 were postmenopause.The main clinical features are abnormalvaginal bleeding and cervical neoplasms.Preoperative b-ultrasound examination showed abnormal findings in 11 patientsand MRI examination in 8 patients.Sixteen patients received preoperative pathological examination(diagnosticcurretage or cervical biopsy),and the diagnosis accuracy reached 87.5%.Seventeen patients received surgical treatmentand 7 patients received postoperative chemotherapy.The patients were followed up until June 2018,for 11 to 148 months,and 7 died,of which one died from complicated renal failure and 6 died in 5 years after surgery.4 were lost to follow-up,and 8 survived.CONCLUSION:Clinical symptoms of Mullerian adenosarcoma of the uterus are not typical,and abnormalvaginal bleeding is often the first symptom.Endometrial curettage or cervical biopsy can improve the clinical diagnosisrate,and surgery and chemotherapy are the main treatment.

Effects of High-Intensity-Focused Ultrasound Treatment on Benign Uterine Tumor

In this study, the effects of high-intensity-focused ultrasound (HIFU) treatment on benign uterine tumor patients were examined. A total of 333 patients diagnosed with fibroids or adenomyosis using diagnostic sonography, treated with HIFU between February 4, 2010 and December 29, 2014 at a hospital in Korea, and followed up for three or six months were selected for this study. Their benign uterine tumor volume was measured, and the effects of HIFU treatment on the volume were analyzed according to age, disease, fertility, and treatment duration. The volume of benign tumors of the uterus changed by age in all age groups after conducting HIFU treatment for 3 and 6 months, respectively. The rate of decrease in individuals' in their twenties was the largest, at 64.9%. When the decreasing volume of benign tumors of the uterus was analyzed by type of disease, the treatment efficacy for adenomyosis was the best, with a decrease of 164.83 cm3 after 6 months. Myoma had the fastest decreasing rate, at 68.5%. When evaluated on the basis of fertility, the volume of benign tumors of the uterus continued to decrease until 6 months after completing all procedures. The volume has continued to decrease for 6 months after all procedures. This study showed that HIFU treatments for uterine fibroid and adenomyosis is an effective non-invasive therapy via reducing the benign uterine tumor volume. Therefore, the HIFU method might replace other conventional treatment methods.

Effects of High-Intensity-Focused Ultrasound Treatment on Benign Uterine Tumor

In this study, the effects of high-intensity-focused ultrasound (HIFU) treatment on benign uterine tumor patients were examined. A total of 333 patients diagnosed with fibroids or adenomyosis using diagnostic sonography, treated with HIFU between February 4, 2010 and December 29, 2014 at a hospital in Korea, and followed up for three or six months were selected for this study. Their benign uterine tumor volume was measured, and the effects of HIFU treatment on the volume were analyzed according to age, disease, fertility, and treatment duration. The volume of benign tumors of the uterus changed by age in all age groups after conducting HIFU treatment for 3 and 6 months, respectively. The rate of decrease in individuals' in their twenties was the largest, at 64.9%. When the decreasing volume of benign tumors of the uterus was analyzed by type of disease, the treatment efficacy for adenomyosis was the best, with a decrease of 164.83 cm3 after 6 months. Myoma had the fastest decreasing rate, at 68.5%. When evaluated on the basis of fertility, the volume of benign tumors of the uterus continued to decrease until 6 months after completing all procedures. The volume has continued to decrease for 6 months after all procedures. This study showed that HIFU treatments for uterine fibroid and adenomyosis is an effective non-invasive therapy via reducing the benign uterine tumor volume. Therefore, the HIFU method might replace other conventional treatment methods.

Comparative study of the efficacy of vasopressin and oxytocin in intramural myomectomy / 中国基层医药

Objective To compare the application effect of vasopressin and oxytocin in intramural myomectomy. Methods 50 in -patients for myomectomy were randomly divided into the observation group and the control group, with 25 cases in each group.By injecting oxytocin around hysteromyoma in the control group,and vasopressin in the observation group,hysteromyoma size,number,operation time,amount of bleeding,postoperative hemoglobin,normal body temperature recovering time,anal exhaust time and hospitalization time were compared in two groups.Results Operation time of the observation group was (86.4 ±1.8)minutes,which of the control group was (112.4 ±1.5)minutes,the difference was statistically significant (t =78.462,P 0.05 ).The comparing of normal body temperature recovering time,hospitalization time,anal exhaust time of the two groups were not statistically significant (P >0.05). Conclusion Hemostasis effect was evident after applying vasopressin in myomectomy,which can significantly reduce blood loss,shorten surgery time and reduce hemoglobin changes,it′s better than oxytocin and is worth in clinical application.

Clinical value of magnetic resonance diffusion weighted imaging and dynamic enhanced imaging in endome-trial carcinoma staging / 中国基层医药

Objective To study the value of magnetic resonance diffusion weighted imaging (DWI)and dynamic enhanced imaging (DCE)in endometrial carcinoma staging.Methods 200 cases with endometrial carcinoma were selected,DWI and DCE were given before operation.The diagnostic value of two kinds of examination methods for the diagnosis of endometrial carcinoma in general and basic level was compared.Results The overall accuracy of muscle invasion of magnetic resonance DWI was 91.5%(183 /200),which was significantly higher than 77.5%(155 /200)of magnetic resonance DCE,the difference was statistically significant (χ2 =11.231,P <0.05 ).The accuracy,sensitivity and positive predictive value of the magnetic resonance DWI superficial and deep muscular layer were significantly higher than those of the magnetic resonance DCE (χ2 =9.283,8.231,9.021,8.927,8.142, 9.405,all P <0.05).Compared with pathological results,Kappa value of magnetic resonance DWI was 0.807,Kappa value of magnetic resonance DCE was 0.587.Conclusion Magnetic resonance DWI compared with magnetic reso-nance DCE,the accuracy and sensitivity of the infiltration of endometrial carcinoma was higher.

Health guidance role in treatment of uterine fibroids in high intensity focused ultrasound ablation / 中国基层医药

Objective To explore the health guidance role on treating uterine fibroids in high intensity fo-cused ultrasound thermal ablation(HIFU).Methods High intensity focused ultrasound ablation treatment was used in 74 cases of uterine fibroids patients before and after treatment to enable patients to better health guidance with treatment.Results After treatment,symptoms of patients with the clinical manifestation including menstrual too much,dysmenorrhea,frequent urination,constipation and anemia,were significantly improved.The volume of myoma of uterus before treatment and after treatment for 3 months,6 months and 1 year were (100.780 ±104.243 )cm3 , (53.446 ±49.546)cm3,(32.704 ±32.246)cm3 and (21.991 ±16.301)cm3,respectively.The volume of myoma of uterus gradually reduced after treatment as compared with that before treatment,the difference had statistical signifi-cance(t=6.758,186,7.567,all P<0.01).Conclusion Effective health guidance is beneficial to HIFU treatment for patient.

Successful delivery after conservative resectoscopic surgery in a patient with a uterine tumor resembling ovarian sex cord tumor with myometrial invasion

Uterine tumor resembling ovarian sex cord tumors (UTROSCT) is an extremely rare type of uterine stromal neoplasm that exhibits prominent sex cord-like differentiation. The clinical characteristics of a UTROSCT are not fully understood. Most reported cases of UTROSCT were treated by hysterectomy with or without bilateral salpingo-oophorectomy; however, a few cases have been treated by only tumor resection in patients who had a strong desire to preserve their fertility. We present a case of UTROSCT with myometrial invasion, which resulted in a successful delivery after the patient was treated by resectoscopic surgery and conservation of the uterus, and a brief review of the literature.

Lipoleiomyoma associated to uterine prolapse: a case report / Lipoleiomioma associado a prolapso uterino: relato de caso

Lipoleiomyoma is a rare benign tumor of the uterus, with an incidence ranging between 0.03 por cento and 0.2 por cento. DESCRIPTION: the authors report a case of lipoleiomyoma diagnosis in an 82-year-old woman with a totally prolapsed uterus. DISCUSSION: lipoleiomyoma is most common among postmenopausal women and is associated with ordinary leiomyomas. Histologically it is composed of smooth muscle, adipocytes and fibrous tissue. In general asymptomatic, the diagnosis usually involves imaging studies such as ultrasound and computed tomography of the pelvis...

Lipoleiomioma é um raro tumor benigno do útero, com uma incidência variando entre 0,03 percent e 0,2 percent. DESCRIÇÃO: os autores relatam um caso de diagnóstico ocasional de lipoleiomioma ocorrido em uma mulher de 82 anos e com prolapso uterino total. DISCUSSÃO: o lipoleiomioma é mais frequente entre mulheres pós-menopáusicas associado a leiomiomas comuns. Histologicamente é composto por músculo liso, adipócitos e tecido fibroso. Em geral assintomático, o diagnóstico envolve normalmente estudos de imagem como ultrassom e tomografia computadorizada da pelve...

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.

A case of uterine tumor resembling ovarian sex-cord tumor / 부인종양

Uterine tumor resembling ovarian sex cord tumors (UTROSCTs) are uncommon neoplasms that histologically resemble ovarian sex cord tumor. Over 50 cases have been reported up to recently. Clement and Scully reported 14 cases of UTROSCT, which they devided into two groups by clinicopathological features. Group I tumors are endometrial stromal sarcomas with partially sex-cord like elements (less than 40% of total tumor volume). On the other hand, group II tumors are mostly or entirely composed of sex-cord like elements. We have experienced a very rare case of type II UTROSCT at the uterine fundus in a 52-year-old woman and report it with a brief review of the literatures.

A case of uterine tumor resembling ovarian sex-cord tumor with clinical review / 대한산부인과학회잡지

Uterine tumor resembling ovarian sex-cord tumor (UTROSCT) were first described by Clemen and Scully in 1976. They are a heterogenous group of uterine neoplasm characterised by pure or predominant histological patterns that resembled sex cord tumors of ovary. Clemen and Scully divide the tumors into two groups according to sex-cord-like structures within tumors (the so-called group I tumors with 50% of sex-cord elements, the so-called group II tumors with almost completely sex-cord-like structures). The histogensis of the sex-cord-like elements is uncertain, the group I tumor appears to be more malignant. We experienced a case of UTROSCT in a 44 years old woman underwent LAVH under tantative diagnosis of uterine myoma and report the case with brief review of literature.

Uterine Tumor Resembling Ovarian Sex-cord Tumor in a 21-year-old Woman: Immunophenotype Consistent with True Sex-cord Differentiation / 대한산부인과학회잡지

A case of Clement and Scully's type II uterine tumor resembling ovarian sex cord tumors (UTROSCT) occurring in a 21-year-old woman is presented. Grossly, a 10 cm-sized fundic myometrial tumor, which was projecting into the endometrial cavity, was excised. Histologically, most parts of tumor showed the morphology of sex cord-like differentiation, including solid anastomosing cords or tubules, solid nests, and trabeculae arranged in a plexiform pattern. The sex cord elements were studied immunohistochemically with markers of sex cord, steroid cell differentiation (inhibin, O13, and A103), or both. The tumor cells were found to be diffusely immunoreactive for O13 (MIC2, CD99) and very focally positive for inhibin. There were also constant immunoreactivity for vimentin and hormone receptors and relatively rare positivity for desmin, actin, and cytokeratin. These findings provide strong evidence for the presence of true sex cord elements, the derivation of which seems to derive from the capacity for divergent differentiation of uterine stroma. This report demonstrates immunohistochemically true sex cord differentiation in UTROSCT.

Uterine Tumor Resembling Ovarian Sex-Cord Tumor: A case report

The authors report a case of uterine tumor resembling ovarian sex-cord tumor in a 31-year-old woman with emphasis on immunohistochemistry. Histologically this case showed identical features to a well-recognized endometial stromal tumor except for focal epithelial-like differentiation that resembled sex-cord tumors of the ovary. The sex-cord like differentiation of tumor cells were manifested by trabeculae, plexiform cords, and gland-like pattern. We diagnosed this case, according to the features described by Clement and Scully(1976), as uterine tumor resembling ovarian sex-cord tumor, group I. Although the histogenesis of this tumor is unclarified, most authors believe that this tumor may be originated from multipotent mesenchymal cells of the uterus. On immunohistochemical stains, Desmin was uniformly reactive in epithelial-like cells and in focal areas of endometrial stromal sarcoma-like component. Vimentin was partly reactive in all tumor components, however EMA was non-reactive.