Review of 32 gastro-intestinal stromal tumours with CD117

The Aim of this study is to review clinical data, histological and immunohistochemical findings and prognosis of stromal gastrointestinal tumors. A retrospective Study of 32 cases of stromal gastrointestinal tumors diagnosed in the Department of Pathology of Mongi Slim Hospital of Tunis from 1991 a 2004. The average age of the patients was of 54, 4 years, equal for sex. Tumors were essentially gastric [50%] and of the small intestine [37, 5%]. All the patients had surgical treatment. Gastro-intestinal Stromales Tumors or GIST represent the most frequent stromale tumor with 56, 2% of cases. After immunohistochimestry study, using CD117, this revision allows better management of GIST. Glivec +/- is the standard treatment of advanced GIST

[Abdominal desmoid tumor pathologic and therapeutic concepts]

Abdominal desmoid tumors arise in young adults between 20 and 40 years. They are character/i2ed by a local recurrence in 20 to 30% of eases. Review the clinical and pathologic features of this entity, look for the expression of immunohistochemical markers [actine, desmine, CD34, vimentin] and also to estimate the expression of two potential targets therapy; the hormonal receptors and the CD117. From 1990 to 2004, three cases of abdominal desmoid tumors were diagnosed in the Pathologic laboratory of the Charles Nicole Hospital of Tunis. The study concerned three women 62, 35 and 30 year-old. All the patients were operated and the site of tumours varied to 5 to 7cm. The CD117 and the hormonal receptors were negative in every case. None of the patients presented local recurrence. Abdominal desmoid tumors are locally aggressive but never give metastasis. The negativity of these lesions to the CD117 and in the hormonal receptors does not imply resistance in the hormonal treatment by anti-estrogens

[Diagnostic value of immunohistochemistry in ovarian sex cord-stromal tumors]

The ovarian tumors' diagnosis is bused on biological and radiologic tests but only the histological examination associated to an immunohistochemical study allow best diagnosis. The purposes of this study is to examine inhibin and other markers immunoreactivity to ovarian sex cord-stromal tumors and their histological mimics and to discuss its value in the differential diagnosis. We report a retrospective study of 31 cases of ovarian sex cord-stromal tumors and review the clinical, pathologic and immunohistochimical features of these tumors. The average age of our patients was 51.3 years with an average size of 8,4 cm. Immunostaining for inhibin was positive in 66% of granulosa cell tumor, in 50% of Sertoli-Leydig cell tumor and in 54% of thecoma-fibroma group. Inhibin immunoreactivity was more important than with cytokeratin and epithelial membrane antigen, but less marked than with CD99, vimentin, smooth muscle actin, desmin and 5-100 protein. The results of this study show that although it is not complete specificity, inhibin, contrarily to the other markers, can be used to help in the distinction between ovarian sex cord-stromal neoplasms and the other primary and metastatic tumors

Isolated adenomatous polyposis of the appendix. Report of two cases

Adenomas are rarely diagnosed in the appendix and may be isolated or may coexist with other neoplasms in the gastrointestinal tract. This emphasizes the need for postoperative colonoscopy when a polyp of the appendix is found. Moreover, the polyps are considered to be premalignant lesions. Report two new cases of adenomas of the appendix. We report the cases of 23-year-old and 22-year-old men, for whom appendicectomy performed for acute appendicitis. In both cases, histologic studies revealed adenomas in moderate dysplasia colonoscopy did not reveal any polyps

[Inflammatory fibroid polyp of the ileum presenting as intussusception: a case report in an adolescent]

Inflammatory fibroid polyp is an uncommon and benign submucosal lesion of the gastrointestinal tract. The maximal incidence is in the fifth and sixth decades. The main histological characteristics are diffuse inflammatory infiltrate with eosinophils and highly vascularized fibrocystic stroma. We report a case of 15-year-old woman who underwent emergency surgery because of acute intestinal obstruction as a results of an intussusception. The macroscopical study after segmental ileal resection showed a nodular lesion 3x2x2 cm, arising from the submucosa with an ulcerated surface. The pathologic diagnosis was ileal inflammatory fibroid polyp. Immunohistochemically, the cells reacted with vimentin and CD34. It has no malignant potential although extensive infiltration may occur. The aetiology is unknown. We prepose to discuss the clinical, the pathological aspects and the possible aetiological factors of the inflammatory fibroid polyp

[Malignant degeneration of mature benign teratoma of the ovary: a case report]

Malignant transformation of ovarian mature benign teratomas is an uncommon complication which often occurs in the postmenopausal period. Clinical presentation is similar to that of benign ovarian cysts. The diagnosis of malignant transformation is often made per-operatively by the break of the capsule and the adhesions of the tumor or during histological examination. The diagnosis is based on the association between a mature teratoma and a non metastatic unitissular, carcinoma or sarcoma. All histological forms can be met, but squamous cell carcinoma accounts for 75% of all cases. We report the case of a 70-year-old woman who had a squamous cell carcinoma which developed on a teratoma of the ovary, for whom the disease was fatal. The survival rate for this kind of ovarian tumour is reduced, with 15 to 30% survival after 5 years, irrespective of stages and histological types. Although it is not easy to define the best requested therapy, surgery associated with polychemotherapy or radiotherapy is apparently the only way of improving the poor prognosis for these tumours