A Case of Pseudomyxoma Peritonei / 대한산부인과학회잡지

Pseudomyxoma peritonei is a poorly understood condition characterized by gelatinous, mucinous implants, and often massive gelatinous ascites. It is commonly associated with mucinous tumors of the ovary or appendix, and a frequently relapsing and protracted disease. But, there are much confusion about its etiology, clinical manifestation, treatment, and prognosis. We experienced a case of pseudomyxoma peritonei originating from the borderline and microinvasive mucinous tumor of the ovary. So we report this case with a brief review of literatures.

Two Cases of uterine arteriovenous malformation / 대한산부인과학회잡지

Arteriovenous malformation of the pelvic organ is a very rare cause of massive uterine bleeding. But, it is important to consider in the assessment of a patient with abnormal uterine bleeding because accurate diagnosis can allow appropriate treatment to be planned and avoid hysterectomy in women who wish to retain their reproductive capacity. This malformation may be congenital or acquired. In the past, the diagnosis is usually made retrospecively after hysterectomy, however, recently it may be made before management by ultrasound, doppler ultrasound, pelvic angiography, magnetic resonance imaging, etc. We have experienced two cases of arteriovenous malformation of the uterus, which is presented with a brief review of the literatures.

TSP-1 mRNA Expression in Invasive Cervical Cancer: Correlate with Angiogenesis and Clinicopathological Features / 대한산부인과학회잡지

OBJECTIVE: Acquisition of a proangiogenic environment is essential to the cervical cancer growth, invasion and metastasis, and the angiogenic phenotype in cervical cancer is strongly associated with clinical outcome. However, the regulation of the metastatic process in cervical cancer has not been well defined. Thrombospondin-1 (TSP-1) is a representative angiogenesis suppressor whose loss or reduced expression has been frequently observed in many types of human neoplasms. In this study, we examined whether expression of TSP-1 is associated with clinicopathological features, including microvessel density and evaluated its prognostic significance in patients with cervical cancer. METHODS: The expression and mutation status of TSP-1 was examined by quantitative RT- and genomic PCR and RT-PCR-SSCP analysis and microvessel density was performed using immunohistochemical staining in 7 normal cervix and 37 cervical cancers. RESULTS: All normal cervix tissues express easily detetable levels of TSP-1 transcript in range of 1.41-1.62 (mean 1.51 +/- 0.07). In contrast to normal tissue, mRNA expression of TSP-1 in primary cancer was detected in range of 0.51-1.69 (mean 1.03 +/- 0.36), and 35.1% (13 of 37) of carcinomas expressed abnormally low levels of TSP-1 (p<0.05). Moreover, abnormal reduction of TSP-1 expression was more frequently observed in IIa-IIb cancer (60%, 6 of 10) compared to Ib cancer (25.9%, 7 of 27) (p<0.05). None of carcinoma tissues we tested showed abnormal reduction of TSP-1 gene level and no evidences for sequence alterations leading to amino acid substitution were identified, indicating that allelic deletion or mutational alteration of TSP-1 might be a rare event in cervical carcinogenesis. Microvessel density was significantly higher in tumors showing decreased expression of TSP-1 (abnormal low group: 11.3 +/- 5.06, others: 6.64 +/- 7.15) (p<0.05). To detect the possible deletion of the gene and the presence of sequence alteration in TSP-1 transcripts, we performed quantitative genomic PCR and RT-PCR-SSCP analysis. However, none of carcinoma tissues we tested showed abnormal reduction of TSP-1 gene level and no evidence for sequence alterations leading to amino acid substitution were identified. CONCLUSION: Our study demonstrates that abnormal reduction of TSP-1 mRNA expression is frequent in cervical cancer and correlates with the malignant progression of cervical cancers. Our data also show that allelic deletion or mutational alteration of TSP-1 is rare in cervical cancers, suggesting that abnormal reduction of TSP-1 mRNA expression in cervical cancers might be caused by altered transcriptional down regulation of the gene, such as epigenetic gene silencing. The inverse correlation between TSP expression and microvessel density also indicates that decreased TSP-1 expression might be associated with an angiogenic phenotype in cervical cancer.

A Case of Squamous Cell Carcinoma Arising in Mature Cystic Teratoma of the Ovary / 대한산부인과학회잡지

Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and almost benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common (70-80%). The presentation in stage I disease dose not differ from that of benign cystic teratoma. In the early stage, the treatment is possible through surgical intervention alone. We experienced a case of squamous cell carcinoma of the ovary arising in mature cystic teratoma, which is presented with a brief review of literature.

A Case of Malignant Mixed Mullerian Tumor of the Ovary / 대한산부인과학회잡지

The malignant mixed mullerian tumor (MMMT) is an uncommon tumor containing epithelial and mesenchymal components. MMMT of the ovary is rare, constituting less than 1% of all primary ovarian tumors. It is a particularly aggressive and rapidly progressive tumor, especially in advanced stages. This disease is usually advanced when diagnosed, because it is asymptomatic in early stage. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. The optimal treatment for this neoplasm is still controversial because of its rarity. We experienced one case of malignant mixed mullerian tumor of the ovary and report with a brief review of literature.