Villoglandular papillary adenocarcinoma of the cervix. Beware of a wolf in sheep's clothing.

Villoglandular papillary adenocarcinoma of the cervix is a well differentiated form of cervical adenocarcinoma with a favourable prognosis and a conservative procedure is suggested. We present three cases of villoglandular papillary adenocarcinoma of the cervix. Histological examination of a biopsy of each cervix showed well differentiated villoglandular papillary adenocarcinoma, stage Ib according to FIGO classification. In all cases the disease was limited to the cervix. Nevertheless, histopathological examination of the surgical specimen revealed an infiltrating component with squamous differentiation in one case, while in a second case histopathological examination revealed a moderately differentiated papillary adenocarcinoma with a superficially infiltrating growth-pattern besides the villoglandular papillary adenocarcinoma. Before conservative therapy is considered, careful evaluation of the presence of poor prognostic features must be made. One should consider whether conservative therapy is sufficient because of the predominance of concomitance of other carcinoma besides the villoglandular papillary adenocarcinoma.

Intracranial teratoma with multiple fetuses: pre- and post-natal appearance.

An intracranial teratoma in which six distinct dysmorphic fetuses were included was studied at autopsy. Karyotopic studies showed a normal chromosomal number in the child and the same karyotype in the three tumoral parts were examined. This is the second tumor of this type reported.

Unusual haemostasis for an unusual tumour. Catastrophic bleeding from a tactile neurofibroma affecting the thoracic vertebrae. Case report.

The symptomatology of a typical acute descending thoracic aorta dissection was imitated by profuse haemorrhage caused by a benign tumour composed almost exclusively of Wagner-Meissner like tactile corpuscles and fatty tissue. The tumour caused extensive destruction of the bodies of the fifth and sixth thoracic vertebrae at the level of the vertebro-costal articulation. Emergency cross clamping of the descending aorta and haemostasis of the bleeding from osteal defects by tamponade with bone polymethyl methacrylate appeared the only way to control the life threatening haemorrhage. It seems that an intrathoracic tactile neurofibroma with a similar case history has not been reported till now.

Immunohistochemical and ultrastructural studies of a primary aortic intimal sarcoma.

An intimal sarcoma of the abdominal aorta in a 63-year-old woman is reported. The clinical symptoms consisted of chronic arterial hypertension, vomiting and epigastric pain. Treatment was operative, but the patient died 20 hours after surgery. The studies were performed on a surgical specimen and on autopsy material. The aortic tumour consisted of pleomorphic spindle-shaped and giant cells. In the vertebral metastases a storiform pattern of the tumour cells was found. No specific features characteristic for leiomyogenic, lipogenic or an endothelial nature of the tumour giant cells was disclosed in electron microscopy and the picture rather indicated their histiocytic character. Of the 18 cellular markers studied, the immunostainings for vimentin and alpha-1-antichymotrypsin were evidently positive. The tumour was classified as a pleomorphic intimal aortic sarcoma probably a malignant fibrous histiocytoma (MFH). The literature on 26 previously published aortal tumours is reviewed with emphasis on their topographical distribution and histological classification. In only 4 previous cases was the final diagnosis supported by electron microscopical or immunopathological findings. The role of marker studies in the classification of aortal tumours is discussed.