Alveolar soft part sarcoma of the vagina.

We describe a case of primary alveolar soft part sarcoma presenting as a vaginal mass in a 27 year old woman and also review the literature on this type of tumor arising in the lower female genital tract. Histologically, most of the tumor exhibited poorly developed alveolar architecture, but anaplasia was absent. Although the mass was well circumscribed, a few tumor cells were seen focally within the peritumoral tissue. Treatment consisted of wide local excision followed by external radiation therapy. The patient is alive without evidence of disease 17 years after operation.

Epithelial neoplasia of the endometrium in pregnancy. A case report.

A case of focal severe atypical hyperplasia-carcinoma in situ discovered during voluntary abortion is described. The patient did not undergo hysterectomy; after abortion, menses were regular and the endometrium was histologically normal at a control. Ten cases of endometrial epithelial neoplasia in pregnancy (9 cases) or in puerperium (1 case) found in the literature were reviewed. Although in some of them stromal invasion, which actually is the main prognostic indicator of endometrial neoplasia, was absent or not documented, all lesions were designated as adenocarcinoma. There is evidence that young women with a noninvasive neoplasm and desiring children or preservation of the uterus may be treated conservatively even if the lesion is detected in pregnancy or puerperium.

The value of endometrial cytology in a high risk population.

Between January 1982 and November 1983, 335 women at risk for endometrial carcinoma, with or without symptoms, were screened on an out-patient basis at the 3rd Department of Obstetrics and Gynecology of the University of Milan for endometrial carcinoma and its precursors. Cytologic diagnosis of material obtained with the Milan-Markley helix (Mi-Mark) was compared, in terms of acceptability and diagnostic accuracy, with histologic diagnosis of material obtained by Vabra curettage. The Mi-Mark was better accepted by the patients and there were almost no complications. Sensitivity was 93% for adenocarcinoma, 62% for atypical hyperplasia and 76% for hyperplasia without atypia. According to epidemiologic data and to our results, we suggest this screening procedure for asymptomatic obese women.

Primary polypeptide hormones and mucin-producing malignant carcinoid of the larynx.

A case of primary malignant laryngeal carcinoid with dual endocrine and mucous differentiation is reported. Histologically the tumor showed a characteristic organoid pattern and exhibited Alcian-blue, periodic acid-Schiff, and Grimelius silver positivity. By the immunoperoxidase technique calcitonin, ACTH, and alpha-hCG subunit were demonstrated in the tumor cells. Electron microscopy revealed two different types of endocrinelike cells: mucous cells and occasional cells containing both endocrinelike granules and mucin droplets. Diagnostic morphologic criteria of this rare tumor entity are discussed and reference to biologic behavior and possible histogenesis is made.

Natural history of dysgerminoma.

Data on 56 patients with pure dysgerminoma are discussed. Forty-nine patients were classified as having new disease or were to have reassessment of disease, and seven cases were to be restaged (one with and six without clinical evidence of disease). Of new and reassessment cases, 44 patients underwent lymphography, 16 underwent peritoneoscopy with diaphragmatic inspection and 30 had peritoneal cytologic testing performed. Positive lymphography resulted in restaging in 31.6% of patients. Diaphragmatic inspection was always negative. Peritoneal cytologic testing was positive for malignant cells in three patients and worsened the stage in one. Pathologic staging of disease was as follows: Stage IA, 24; Stage IB, one Stage IC, one; Stage III peritoneal disease, two. Stage III retroperitoneal disease, 12; Stage III peritoneal and retroperitoneal disease; four. The 5-year relapse-free survival rates were 91% in patients with pathologic Stages IA, IB, and IC; 74% in those with Stage III retroperitoneal disease, and 24% in patients with Stage III peritoneal disease or peritoneal plus retroperitoneal disease. The results indicate that the prognosis is excellent for patients with Stage I and Stage III retroperitoneal disease whereas peritoneal involvement is associated with a poor prognosis.

Immature teratoma of the ovary stage IA(i) treated with conservative surgery alone.

A review of a series of 245 ovarian teratomas disclosed 6 cases (2.4%) of immature teratoma. The tumors were FIGO stage IA(i) and histologic grade 1 (3 cases). With the exception of 2 specimens, all tumors were larger than 9 cm in the greatest diameter. All patients underwent conservative surgery alone and are alive without evidence of disease form 2.2 to 10.6 years (average 7.9 years). Our data support the view that conservative surgery is the treatment of choice for patients with stage IA(i), grade 1, immature teratoma, as well as for those with stage IA(i), grade 2 tumors, 9 cm or less in the greatest diameter.

Struma ovarii and Brenner tumor.

One struma ovarii with agregates of epithelial nests indistinguishable from Brenner tumor was studied. The presence of a communication between the nests and the follicles and the association of Brenner, mucinous and respiratory epithelium in the lining of 1 cyst in the same tumor strongly support the germ theory of Brenner tumors associated with teratomatous elements.

Endometrial adenocarcinoma with psammoma bodies.

Psammoma bodies were found in less than 9% of 235 cases of endometrial carcinoma, considering both biopsies and surgical specimens. They may originate in papillary adenocarcinoma and do not indicate a slightly infiltrating or a well-differentiated tumor. The clinical profile of patients closely resembles that of women with endometrial carcinoma, but survival appears worse.

[Pathological and embryological studies on abortion cases related to the Seveso accident]. / Pathologisch-embryologische Untersuchungen an Abortusfällen im Zusammenhang mit dem Seveso-Unglück.

After the explosion accident on July 10, 1976 in Seveso (Italy), material from 30 interrupted pregnancies and from 4 spontaneous abortions was investigated by embryological and histomorphological studies. No indications of mutagenic, teratogenic or fetotoxic effects of TCDD could be found. The cases of spontaneous abortion, albeit more suspect for dioxin damage, showed different morphological alterations obviously due to a variety of causative factors independent of TCDD. On the other hand it is not possible to exclude entirely an embryotoxic effect of TCDD because in the majority of cases the fetal tissues were incomplete.

Significance of ascitic fluid and peritoneal washing cytology in ovarian tumor diagnosis.

The results of the cytological test on 179 ascitic fluids and 88 peritoneal washes of patients suspected to have ovarian tumors are critically reviewed to illustrate the difficulties, limitations and future possibilities of this technique. Tissue correlation was available in all cases. The data was evaluated in order to obtain information as to the accuracy, sensitivity and specificity of cytological examination, both in ascitic fluids and in peritoneal washings. A correct diagnosis as to the ovarian tumor histotype was obtained in more than 80 per cent of the cases.