Placental site trophoblastic tumour mimicking an intramural pregnancy: a case report and review of the literature.

Gestational trophoblastic disease (GTD) covers a range of proliferative disorders from non-neoplastic hydatid moles to malignant neoplastic conditions such as choriocarcinoma. The incidence of these diseases is low and often challenging to diagnose. Placental site trophoblastic tumour (PSTT) is the rarest form of GTD, accounting for up to 3% of all cases. We present a case of a 35-year-old patient diagnosed with PSTT mimicking an intramural pregnancy. Placental site trophoblastic tumour occurred after pregnancy, which ended as a blighted ovum. ß-hCG was not very high, and the patient had no complaints. The diagnosis was made after resection of formation which was accepted for intramural pregnancy. To our knowledge, this is the first such case described in the literature. A hysterectomy performed later confirmed the absence of a residual tumour after conservative intervention. The lack of distant metastases, confirmed by positron emission tomography-computed tomography scan, allowed for only hysterectomy with bilateral salpingo-oophorectomy to be performed. The patient was classified as low risk according to the World Health Organization (WHO) scoring system. Placental site trophoblastic tumour is a rare malignant tumour (despite its WHO coding) from the group of GTDs. It is not presented with a classic clinical picture, and its clinical diagnosis is challenging. However, clinicians should consider it in the case of unclear events after any type of pregnancy.

Patterns of Myometrial Invasion in Endometrial Adenocarcinoma with Emphasizing on Microcystic, Elongated and Fragmented (MELF) Glands Pattern: A Narrative Review of the Literature.

Endometrioid endometrial adenocarcinoma (EEC) is the most common malignancy of the female genital tract. According to the 2009 FIGO staging system, the depth of myometrial invasion (MI), and tumor spread to adjacent organs or tissues are the staging criteria for endometrial carcinoma (EC). Therefore, assessment of the depth of MI is of great importance. There is a spectrum of morphological patterns of MI. Still, their number and features vary according to the scientific literature, with a certain overlap that creates difficulties and controversies in the precise assessment of MI depth. The purpose of this review is to present and discuss the most important and recent information about patterns of MI, focusing on the more aggressive and the elongated and fragmented glands (MELF) pattern in particular. Assessment of MI depth and correct staging of EC is possible only after the precise recognition of each MI pattern.

An Overview of the Role of Long Non-Coding RNAs in Human Choriocarcinoma.

Choriocarcinoma (CC), a subtype of trophoblastic disease, is a rare and highly aggressive neoplasm. There are two main CC subtypes: gestational and non-gestational, (so called when it develops as a component of a germ cell tumor or is related to a somatic mutation of a poorly differentiated carcinoma), each with very diverse biological activity. A therapeutic approach is highly effective in patients with early-stage CC. The advanced stage of the disease also has a good prognosis with around 95% of patients cured following chemotherapy. However, advancements in diagnosis and treatment are always needed to improve outcomes for patients with CC. Long non-coding (lnc) RNAs are non-coding transcripts that are longer than 200 nucleotides. LncRNAs can act as oncogenes or tumor suppressor genes. Deregulation of their expression has a key role in tumor development, angiogenesis, differentiation, migration, apoptosis, and proliferation. Furthermore, detection of cancer-associated lncRNAs in body fluids, such as blood, saliva, and urine of cancer patients, is emerging as a novel method for cancer diagnosis. Although there is evidence for the potential role of lncRNAs in a number of cancers of the female genital tract, their role in CC is poorly understood. This review summarizes the current knowledge of lncRNAs in gestational CC and how this may be applied to future therapeutic strategies in the treatment of this rare cancer.

Leiomyosarcoma of the vulva: a case report.

INTRODUCTION: Leiomyosarcoma of the vulva is a rare disease accounting for about 1% of all primary vulvar neoplasia but it is the most common type of vulvar sarcomas. Usually it arises from the smooth muscles, blood vessels, rough ligaments, and erector-pili muscles. No treatment algorithms have been established yet. Tumour excision with clean resection lines is considered sufficient, with radiation therapy applied in certain cases. CASE REPORT: We report a case of a 73-year old patient in whom the disease was manifested by pain syndrome and rapidly growing mass with irregular margins in the symphysis area and satellite nodules. She underwent extensive local excision followed by radiation therapy. DISCUSSION: Isolated cases and limited series of LMS cases have been described in literature. Leiomyosarcoma is most commonly localized to the labia majora, the Bartholin gland area, clitoris and labia minora. It most often affected perimenopausal women but in younger and pregnant patients was described. The diagnosis is not always easy and different histological markers has to be used. There are no definitive therapeutic algorithms due to the rarity of the disease. The management is surgical treatment and the entire tumour must be removed with histologically verified clean resection margins, followed by radiation therapy in some cases. CONCLUSIONS: Vulvar tumours are difficult to distinguish macroscopically. Accurate histological diagnosis allows adequate treatment.