ABSTRACT
Vaginal villous or tubulovillous adenomas (TVA) are uncommon tumors histologically similar to their intestinal counterparts. After reviewing the literature, we report the eighth case of TVA, which presented as a polypoid tumor in the vagina, at suburethral level, in a 19-yr-old woman with Arnold-Chiari type II malformation and a myelomeningocele at birth. The tumor consisted of long villi lined by columnar cells with brush borders, pseudostratified nuclei, and foci of high-grade atypia. Immunohistochemistry was positive for cytokeratin 7, estrogen and progesterone receptors, CA19.9, p16, p53, and Ki-67 (53%), with a normal membranous pattern for ß-catenin, but negative for cytokeratin 20, CDX2, carcinoembryonic antigen, chromogranin A, and synaptophysin. Neither human papillomavirus nor mutations in the K-RAS, BRAF, or LKB1/STK11 genes were detected. Although a rare neoplasm, awareness of this tumor is important as it must be distinguished from colonic adenocarcinoma or other malignant or benign conditions. The existence of 2 previously reported malignant cases merging with TVAs, and the presence of foci of high-grade dysplasia (p53-positive) in the present case, support TVA as a premalignant lesion.
Subject(s)
Adenoma, Villous/pathology , Vaginal Neoplasms/pathology , Adenoma, Villous/complications , Adenoma, Villous/metabolism , Arnold-Chiari Malformation/complications , Biomarkers, Tumor/analysis , Female , Humans , Immunohistochemistry , Meningomyelocele/complications , Vaginal Neoplasms/complications , Vaginal Neoplasms/metabolism , Young AdultABSTRACT
BACKGROUND: Breast cancer is a heterogenous disease that impacts racial/ethnic groups differently. Differences in genetic composition, lifestyles, reproductive factors, or environmental exposures may contribute to the differential presentation of breast cancer among Hispanic women. MATERIALS AND METHODS: A population-based study was conducted in the city of Santiago de Compostela, Spain. A total of 645 women diagnosed with operable invasive breast cancer between 1992 and 2005 participated in the study. Data on demographics, breast cancer risk factors, and clinico-pathological characteristics of the tumors were collected. Hormone receptor negative tumors were compared with hormone receptor postive tumors on their clinico-pathological characteristics as well as risk factor profiles. RESULTS: Among the 645 breast cancer patients, 78% were estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+), and 22% were ER-&PR-. Women with a family history of breast cancer were more likely to have ER-&PR- tumors than women without a family history (Odds ratio, 1.43; 95% confidence interval, 0.91-2.26). This association was limited to cancers diagnosed before age 50 (Odds ratio, 2.79; 95% confidence interval, 1.34-5.81). CONCLUSIONS: An increased proportion of ER-&PR- breast cancer was observed among younger Spanish women with a family history of the disease.
Subject(s)
Breast Neoplasms/metabolism , Carcinoma/metabolism , Family Health , Receptors, Cytoplasmic and Nuclear/metabolism , Adult , Aged , Aged, 80 and over , Breast Neoplasms/ethnology , Breast Neoplasms/etiology , Breast Neoplasms/pathology , Carcinoma/ethnology , Carcinoma/etiology , Carcinoma/pathology , Cohort Studies , Disease Susceptibility , Family Health/statistics & numerical data , Female , Humans , Middle Aged , Neoplasm Staging , Risk Factors , SpainABSTRACT
Signet-ring cell carcinoma presenting in the uterine cervix is an uncommon neoplasm. It is usually a metastasis from a primary gastric tumor; only rarely, cervical involvement is the first manifestation of the disease. Primary signet-ring carcinoma of the cervix is extremely unusual, and it is always necessary to rule out a metastatic neoplasm. We report 3 cases of signet-ring cell carcinoma diagnosed in cervical biopsies. All cases were initially considered as metastatic, but a primary site other than the cervix could be confirmed in only 2 cases. Although autopsy was not authorized, a very comprehensive clinical workup and the evolution of the disease support the interpretation of the third case as a primary neoplasm. Primary signet-ring cell carcinoma of the cervix is an extraordinary event-the diagnosis of which requires excluding a metastasis from the gastrointestinal tract (usually the stomach), the ovary, or the breast.
Subject(s)
Carcinoma, Signet Ring Cell/pathology , Carcinoma, Signet Ring Cell/secondary , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/secondary , Adult , Aged , Aged, 80 and over , Carcinoma, Signet Ring Cell/diagnosis , Carcinoma, Signet Ring Cell/drug therapy , Fatal Outcome , Female , Humans , Stomach Neoplasms/pathology , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/drug therapyABSTRACT
BACKGROUND: Involvement of the female genital tract by Darier's disease, an unusual genodermatosis, is uncommon, and the manifestation of the disease in a cervicovaginal smear is exceptionally rare. CASE: A 39-year-old woman had an abnormal Pap smear caused by involvement of the female genital tract by Darier's disease. Cytologic examination showed features consistent with a low grade squamous intraepithelial lesion, but during a biopsy it was found to be vaginal involvement by Darier's disease. CONCLUSION: The correct interpretation of cytologic findings is not possible when the diagnosis of Darier's disease is not known since a low grade squamous intraepithelial lesion cannot be ruled out. This case underlines the importance of knowing the patient's medical histoiy in any moment of medical attention.