Synchronous adenocarcinoma and echinococcosis in the same ovary: a rare clinical entity.

BACKGROUND: Serous adenocarcinoma is the most common subtype of ovarian carcinoma, while ovarian echinococcosis is a rare disease of the female genital system. The simultaneous presence of adenocarcinoma and echinococcosis in the same ovary is extremely rare and little data exist regarding diagnosis and treatment approach. MATERIALS AND METHODS: In the present paper, we report a rare case of a 66-year-old Greek Caucasian woman of rural origin, with an adnexal mass, ascitic and pleural fluid. The patient underwent exploratory laparotomy following neoadjuvant chemotherapy, based on positive for malignancy pleural and ascitic fluid cytology results. RESULTS: Histological examination of the surgical specimen indicated the synchronous presence of echinococcosis and adenocarcinoma in the same ovary. CONCLUSIONS: Ovarian hydatid cyst is extremely rare, but should be suspected in patients with echinococcosis in other organs and those coming from endemic areas. Moreover, the disease could mimic ovarian cancer, as there are no specific symptoms and clinical signs. The coexistence of these two diseases in the same ovary, although rare, is possible. It seems that the presence of the hydatid cyst does not change the treatment approach of the malignancy so that surgery with neoadjuvant or adjuvant chemotherapy, according to the present guidelines, should be administered. Hippokratia 2015, 19 (1): 89-91.

Struma ovarii. A case report.

BACKGROUND: Struma ovarii is the presence of thyroid tissue as a major cellular component in an ovarian teratoma. CASE REPORT: A 46-year-old old woman, with a palpable mass at the anatomical position of the right adnexa known for the preceding 3 years underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histology reported struma ovarii. CONCLUSION: Struma ovarii is a rare tumor of the ovaries and its clinical appearance may vary: it may be asymptomatic, mimic malignant ovarian tumor, or present with symptoms of hyperthyroidism and, in rare cases, it can even be a malignant tumor.

Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum in asymptomatic women in Northern Greece.

AIM: This study attends to determine the prevalence and the antimicrobial susceptibility of Ureaplasma urealyticum in asymptomatic women in Northern Greece. MATERIALS-METHODS: A total of 347 cervical smears were divided into 5 groups according to age. Samples were cultured, Ureaplasma urealyticum isolation was confirmed by the detection of the urease gene and the antimicrobial susceptibility of the isolates to 9 commercially available antibiotics was determined. RESULTS: Fifty-six (16.13%) samples were found positive. Women >60 years old were rarely infected. Only 9 (16.07%) isolates were susceptible to all antimicrobials tested. Thirteen isolates were resistant and 34 intermediately resistant to ciprofloxacin, two resistant and 29 intermediately resistant to ofloxacin, three intermediately resistant to macrolides, while all were susceptible to tetracyclines. CONCLUSIONS: In Northern Greece, 16.13% of asymptomatic women seem to be carriers of Ureaplasma urealyticum mostly in reproductive ages. Almost no resistance to macrolides and tetracyclines has been noticed, while most of the isolates present resistance or moderate sensitivity to quinolones.

A unique case of palatinate tonsil metastasis from endometrial cancer.

Metastases from malignancies of the female genital tract to the tonsils have never been reported. A case of a 55-year-old woman presenting with a palatinate tonsil tumour two and half years after primary diagnosis of endometrioid endometrial adenocarcinoma (FIGO Stage IB, G2) and six months after local disease recurrence is presented. The tonsillar malignancy was poorly differentiated and tumour cells were immunohistochemically positive to LMW keratin and EMA, and negative to HMW keratin and LCA, strongly suggesting a possible endometrial origin of the tumour. Metastatic disease was treated with systemic chemotherapy, but the patient soon succumbed due to rapid disease progression. In conclusion, a unique case of a palatinate tonsil tumour as the first metastatic site in an endometrial cancer patient is reported.

Basaloid squamous cell carcinoma of the uterine cervix with an uncommon metastasis to the left iliac region--case report.

We describe a rare and interesting case of a basaloid squamous cell carcinoma (BSC) of the uterine cervix with metastasis in the left iliac region diagnosed by fine needle aspiration (FNA). A 54-year-old woman underwent FNA because of a mass in the left iliac region. The material was processed by conventional liquid based cytology (ThinPrep), and by the cell-block technique and diagnosis was based on the cytomorphologic and immunochemical characteristics as well as the patient's history. The cytologic diagnosis concerned a poorly differentiated squamous cell carcinoma. After a laborious search, we found out that the patient had undergone a total hysterectomy almost 15 years before. The histological diagnosis then was an "infiltrative squamous cell carcinoma of basaloid type" of the uterine cervix. Our case is of particular interest because it is a rare type of neoplasm with an unusual site of metastasis after a long disease-free period.

E-cadherin expression during progression of squamous intraepithelial lesions in the uterine cervix.

Alterations of E-cadherin expression in cervical intraepithelial neoplasias and invasive carcinomas of the uterine cervix have been described by some authors but their clinical significance has not yet been clarified. Archival specimens of 27 normal cervical epithelia, 15 atypical cells of undetermined origin (ASCUS), 53 low-grade squamous intraepithelial lesions (LSIL), 19 high-grade squamous intraepithelial lesions (HSIL) and six invasive squamous carcinomas were evaluated for E-cadherin expression. The cytological material was processed using liquid based cytology (ThinPrep technique) and immunostained for E-cadherin. All HPV infections (koilocytes) showed strong cell membranous E-cadherin expression. In HSIL a strong decrease in E-cadherin expression and heterogeneous distribution was noticed. In the relatively small number of squamous cell carcinomas of the cervix studied, a significant decrease or loss in E-cadherin expression, predominantly cytoplasmic, was noted. We concluded that decreased E-cadherin expression appears to be a useful parameter of malignant potential of cervical lesions. E-cadherin immunoexpression could provide an additional criterion in correlation with cyto- and histomorphology and colposcopy to define high grade CIN lesions.

Mammographic changes during postmenopausal hormonal replacement therapy with tibolone.

PURPOSE OF INVESTIGATION: To evaluate mammographic changes in postmenopausal women receiving hormonal replacement therapy (HRT) with tibolone. METHODS: 83 postmenopausal women aged 45-62 received the same dose of tibolone for a period of six months to five years without interruption. The women were examined mammographically every six to 12 months during the observation period. RESULTS: There was a low incidence of breast tenderness. Also, we did not observe any significantly increased mammographic density or neoplasmatic disease of the breast. As far as dysplastic changes are concerned, no remarkable aggravation in the mammographic picture was noted. CONCLUSION: The new synthetic steroid tibolone, in contrast to conventional HRT, rarely causes breast pain. At least short-period tibolone therapy (less than 5 years) has good effects on climacteric disorders and does not cause breast changes (dysplasia or cancer). Our study is on-going.

Metastatic squamous cell vulvar carcinoma of the lung: a case report and review of the literature.

Recurrent squamous cell carcinoma of the vulva advances locally, spreads via the regional lymphatics and hematogenous spread is late and unusual. This is a rare case of a patient with a solitary pulmonary tumor originating from squamous cell carcinoma of the vulva. According to the literature this form of pulmonary involvement has not previously been described in cases of vulvar carcinoma in the last 20 years.