Primary ovarian rhabdomyosarcoma associated with clear cell carcinoma of the ovary: a case report and review of the literature.

The clinicopathologic and immunohistochemical findings of a case of coexistent primary ovarian rhabdomyosarcoma and clear cell carcinoma of the ovary are reported. The tumor was detected in a 41-year-old premenopausal woman who had a 1-year history of pelvic pain. On physical examination, a 14.0-cm left adnexal mass was found for which a hysterectomy with bilateral salpingo-oophorectomy and staging biopsies were performed. The tumor was composed of solid and cystic areas, and two distinct microscopic components were identified: clear cell carcinoma and rhabdomyosarcoma. Immunoperoxidase studies demonstrated that the neoplastic cells in the latter component were positive for desmin, muscle-specific actin, and myoglobin. A biopsy taken from the pelvic peritoneum revealed rhabdomyosarcoma (FIGO stage IIB). Despite two cycles of chemotherapy, the disease persisted in the pelvis 4 months after diagnosis.

Minocycline pigmentation of heart valves.

Minocycline, a derivative of tetracycline, is a broad spectrum antibiotic used in the treatment of gram-positive and gram-negative infections. Benitz et al. (1) were the first to report black discoloration of the thyroid gland in rats, dogs, and monkeys given minocycline. Since that time, there have been numerous reports in the literature describing minocycline related black pigmentation of the skin, thyroid gland, and other sites. We report an unusual case of minocycline induced pigmentation of the cardiac valves and coronary vessels. The pigment stained with Fontana-Masson and was reduced with bleaching. The exact nature of the pigment is unclear; however, various theories have been advocated. Ochronosis is another cause of black pigmentation of the heart valves; the clinical history should allow distinction between the two.