Primary pure squamous cell carcinoma of the endometrium: a case report.

Because primary pure squamous cell carcinoma (SCC) of the endometrium is very rare and its frequency is unknown, the author reviewed 142 archival hysterectomy specimens of endometrial cancers. As the results, one case of primary pure SCC was found. Thus, the frequency of SCC of the endometrium was 0.7% of all endometrial malignancies in our institution. The patient was a 72-year-old woman presenting with uterine bleeding. Uterine curettage biopsy and uterine discharge cytology revealed SCC. No malignancy was seen in cervical biopsy. Radical hysterectomy, bilateral salpingo-oophorectomy, omentectomy and lymph node dissection were performed. The endometrial carcinoma was an infiltrative polypoid tumor composed of non-keratinizing SCC with stratification and intercellular bridges. No adenocarcinoma element was recognized. The SCC cells were immunohistochemically positive for p53 protein and showed high Ki-67 antigen (labeling, 70%). The SCC was found to invade into the deeper third of the myometrium. No tumor cells were seen in other sites including the cervix, ovaries, omentum, and lymph nodes. The patients was FIGO stage IC (pT1C, N0, M0), and was treated with radiation and adjuvant chemotherapy. The patient is now alive without recurrence and metastasis 15 months after the operation.

Ovarian cystic tumor composed of Brenner tumor and struma ovarii.

Ovarian tumor composed only of Brenner tumor and struma ovarii is very rare; only 6 cases have been reported in the English literature, to the best of the author's knowledge. A 66-year-old woman underwent right oophorectomy because of torsion of right ovarian cyst. Macroscopically, the ovarian cyst was hemorrhagic and red. Cystic content was hemorrhagic fluid. Microscopically, the cyst walls were composed only of Brenner tumor (50% in area) and struma ovarii (50% in area). Hemorrhage and ischemic changes were seen. Other elements were not recognized. No malignant transformation was noted. These two elements were separately present, and no mergers between them were recognized. Immunohistochemically, the Brenner tumor element was positive for cytokeratins (AE1/3 and CAM5.2) and Ki67 (labeling=3%), but negative for thyroglobulin, TTF-1, p53, CA125, and vimentin. The struma ovarii element was positive for cytokeratins (AE1/3 and CAM5.2), thyroglobulin, TTF-1 and Ki67 (labeling=5%), but negative for p53, CA125 and vimentin. The findings suggests that there were cases of ovarian cyst composed only of Brenner tumor and struma ovarii, that such a case may be monodermal mature cystic teratoma or the Brenner tumor element was derived from surface epithelium in the preexisting struma ovarii, and that such a tumor manifest as cystic torsion.

Supraclavicular lymph node metastasis as the initial presentation of primary fallopian tube carcinoma.

Supraclavicular lymph node metastasis is a rare presentation of primary fallopian tube carcinoma. A 76-year-old woman presented with an enlarged supraclavicular lymph node. A biopsy was performed, and its findings confirmed metastatic adenocarcinoma. Subsequent exploratory laparotomy revealed right fallopian tube carcinoma as the primary lesion; consequently, right salpingo-oophorectomy was performed. After adjuvant chemotherapy, she underwent a laparotomy with total abdominal hysterectomy, left salpingo-oophorectomy, pelvic and para-aortic lymph node sampling, and omentectomy. Supraclavicular lymph node metastasis was thought to be, although rarely, the first manifestation of primary fallopian tube carcinoma (PFTC). When supraclavicular lymph node metastasis of an unknown origin is encountered, the possibility of PFTC should be considered.

Primary precursor B-cell lymphoblastic lymphoma of the ovary: case report and review of the literature.

Primary ovarian lymphoma is a rare disease, and its definition is still controversial. Many cases of primary ovarian lymphoma are diagnosed as diffuse large B-cell type, whereas the precursor lymphoblastic type is extremely rare. Herein, we describe a case of precursor B-cell lymphoblastic lymphoma of the ovary that was successfully treated with surgery and chemotherapy. A 19-year-old woman presented ovarian tumors and paraaortic lymphoadenopathy, which were suggestive of advanced ovarian cancer. Exploratory laparotomy and right salpingo-oophorectomy were performed, and the diagnosis of precursor B-cell lymphoblastic lymphoma was established. The patient was treated with a combination of chemotherapy and is currently disease-free 1 year after surgery. To our best knowledge, this is the fourth reported case of precursor lymphoblastic lymphoma of the ovary.