Collision of Three Histologically Distinct Endometrial Cancers of the Uterus

A collision tumor is defined by the presence of two separate masses in one organ, which are pathologically distinct. We described a 70-yr-old patient who complained of abnormal vaginal bleeding with a collision tumor of the uterine corpus. The patient received total hysterectomy, bilateral salphingo-oophorectomy, bilateral pelvic-paraaortic lymphadenectomy, omentectomy, and intraperitoneal chemotherapy. The uterine corpus revealed three separate masses, which were located at the fundus, anterior and posterior wall. Each tumor revealed three pathologically different components, which were malignant mixed mullerian tumor, papillary serous carcinoma, and endometrioid adenocarcinoma. Among these components, only the papillary serous carcinoma component invaded the underlying myometrium and metastasized to the regional lymph node. Adjuvant chemotherapy and radiation therapy were performed. The patient is still alive and has been healthy for the last 8 yr. We have reviewed previously reported cases of collision tumors which have occurred in the uterine corpus.

Endometrioid adenocarcinoma 13 years after total abdominal hysterectomy and bilateral salpingo-oophorectomy

Malignant transformation is an infrequent complication of endometriosis. As endometriosis is an ectopic endometrium, hyperestrogenism may cause hyperplasia or transformation into cancer. We describe a case of a 68-year-old woman who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She was subsequently placed on estrogen-only replacement therapy. She presented with left-sided pelvic mass and shortness of breath. Computed tomography of chest, pelvis, and abdomen, demonstrated right-sided pleural effusion and soft tissue mass in the pelvis. Pleural effusion was tapped and biopsy from the peritoneal mass showed metastatic adenocarcinoma; immunohistochemistry findings favored endometrioid adenocarcinoma. She was treated by 6 cycles of Carboplatin/Paclitaxel and responded well. Unopposed estrogen stimulation may lead to premalignant or malignant transformation in the residual foci of endometriosis. Therefore, the addition of progestins to estrogen replacement therapy should be considered in women who have undergone hysterectomy with oophorectomy due to endometriosis

A comparative study on hematological effects of carboplatin plus cyclophosphamide and carboplatin plus paclitaxel chemotherapy for the first line treatment of epithelial ovarian cancer.

OBJECTIVE: To compare the hematological effects of carboplatin plus cyclophosphamide, and carboplatin plus paclitaxel chemotherapy for first line treatment of epithelial ovarian cancer (EOC). MATERIAL AND METHOD: A retrospective study was conducted between January 2003 and May 2006 on 29 patients who received 145 cycles of carboplatin, area under the curve (AUC) 6 plus cyclophosphamide 600 mg/mm2 (CC) intravenous and on 11 patients who received 65 cycles of carboplatin AUC 5 plus paclitaxel 175 mg/mm2 (CP) intravenous chemotherapy for the first line treatment of epithelial ovarian cancer. They had no history of hematologic disease and complete blood count (CBC), renal function and liver function tests were normal. RESULTS: Both groups were similar regarding age, body mass index, performance status and stage of cancer. Hematological effects were found in 61 of 145 cycles (42.1%) in CC group and 33 of 65 cycles (50.8%) in CP group (p = 0.05). Twenty patients received all 6 cycles of chemotherapy in the CC group and 10 patients in the CP group. Fifteen of 20 patients (75%) and 8 of 10 patients (80%) had hematologic effect of at least one cycle found in the CC and the CP groups, respectively (p = 0.05). There were no treatment-related deaths in both arms. CONCLUSION: Hematological effects did not differ in carboplatin AUC 6 plus cyclophosphamide 600 mg/mm2 regimen and carboplatin AUC 5 plus paclitaxel 175 mg/mm2 regimen and both regimens were accepted adverse effect in the first line treatment of EOC.