Mullerian adenosarcoma of the uterine cervix in an adolescent girl.

BACKGROUND: Cervical adenosarcoma is a rare gynecological tumor which is prone to recur locally. A case of cervical adenosarcoma in a 14-year-old girl treated in order to preserve fertility. CASE: A 14-year-old girl presented with a pedunculated mass protruding from the vagina. Simple excision was performed. Histological evaluation revealed adenosarcoma. Her clinical course has been uneventful for fifteen months. SUMMARY AND CONCLUSION: Adenosarcoma is a low malignant potential tumor of the female genital tract. A simple excision may be an option for young women who need to preserve their fertility. It is mandatory to monitor regularly the cervical base of the lesion for the purpose of the high potential of the local recurrence.

Fallopian tube carcinoma metastatic to the pericardium and breast.

INTRODUCTION: Fallopian tube carcinoma is a rare gynecological tumor and simultaneous pericardial and breast metastasis of this cancer is an extremely exceptional event. CASE: A 46-year-old woman with FIGO Stage IIIc, grade 3 adenocarcinoma of the fallopian tube received cyclophosphamide and carboplatin subsequent to surgery. The disease had been completely silent for 41 months and then it relapsed with pericardial and breast metastasis consecutively. She expired one year after the relapse. CONCLUSION: Although clinical and biological behavior and response to the treatment of fallopian tube carcinoma is quite similar to epithelial ovarian carcinoma, breast and pericardium are unusual sites of metastasis for each malignancy. As survival is prolonged with new chemotherapeutics these atypical cancer metastases will be observed more frequently.

EGFR and PDGFR differentially promote growth in malignant epithelioid mesothelioma of short and long term survivors.

BACKGROUND: Malignant pleural mesothelioma (MPM) is an asbestos related tumour difficult to detect early and treat effectively. Asbestos causes genetic modifications and cell signalling events that favour the resistance of MPM to apoptosis and chemotherapy. Only a small number of patients, approximately 10%, survive more than 3 years. The aim of our study was to assess possible differences within signalling pathways between short term survivors (survival <3 years; STS) and long term survivors (survival >3 years; LTS) of MPM. METHODS: 37 antibodies detecting proteins engaged in cell signalling pathways, enforcing proliferation, antiapoptosis, angiogenesis and other cellular activities were investigated by tissue microarray (TMA) technology. RESULTS: Epidermal growth factor receptor (EGFR) was expressed stronger in LTS whereas platelet derived growth factor receptor (PDGFR) signalling was more abundant in STS. Expression of TIE2/Tek, a receptor for tyrosine kinases involved in angiogenesis, was differentially regulated via PDGFR and thus is more important in STS. Antiapoptosis was upregulated in STS by signal transducer and activator of transcription 1 (STAT1)-survivin and related molecules, but not in LTS. Our study provides novel insights into the regulatory mechanisms of signalling pathways in MPM, which differentially promote tumour growth in LTS and STS. CONCLUSION: We have demonstrated that small scale proteomics can be carried out by powerful linkage of TMA, immunohistochemistry and statistical methods to identify proteins which might be relevant targets for therapeutic intervention.

Metastatic thymoma as a retrovesical mass.

Retrovesical masses can be of various histopathological origin, most often prostatic. Primary tumours as well as metastatic lesions should be considered in the differential diagnosis. Metastatic thymoma, as presented in this case report, can be an extremely rare cause of retrovesical space occupying lesion.

Anticipated administration of GM-CSF in the treatment of non small cell lung cancer.

The purpose of this study was to verify the kinetic response of the human marrow myeloid progenitor cells to the short term use of GM-CSF and its impact on the therapeutic activity of this three-drug cisplatinum containing regimen in non small cell lung cancer (NSCLC). Sixty patients with stage III-B and IV NSCLC were randomised to receive GM-CSF for 3 days, five days prior to the onset of chemotherapy. The chemotherapy regimen consisted of Mitomycin-C: 6 mg/m2 on day one, Ifosfamide: 2000 mg/m2 days 1 to 3, Mesna: 2000 mg/m2 days 1 to 3, Cisplatinum: 30 mg/m2 days 1 to 3, and was repeated every 4 weeks. All the patients received 30-50 Gy of radiotherapy to the primary and/or metastatic sites. There were positive correlations between stage of the disease, chemosensitivity of the tumor, number of chemotherapy cycles and overall survival (p=0.000). Administration of GM-CSF was an independent prognostic parameter in locally advanced and metastatic disease (p=0.041). In the GM-CSF receiving arm more courses could be given (117 versus 99, p=0.0415), and less courses were postponed (6 versus 22). In this arm, the mean of granulocyte nadir was higher (p=0.033) and mean time to granulocyte recovery became shorter (p=0.001) as the number of chemotherapy cycles increased. It was concluded that, dose intensification with GM-CSF prophylaxis is benefical in increasing the treatment tolerability by decreasing the intensity of granulocytopenia as well as providing rapid recovery.

Early ultrastructural findings and superoxide dismutase levels in experimental ischemic optic neuropathy: effect of hypertension and hypotension on ischemic changes.

We induced ischemia, hypertension and hypotension in 15 rabbits in order to evaluate the ischemic changes in the optic nerve and the effect of hypertension and hypotension on ischemia. We cauterized the right internal and external carotid arteries of 15 rabbits and applied dopamine hydrochloride and glycerol trinitrate to 5 each of these rabbits. Two rabbits were used as controls. We enucleated both eyes of all animals at the 24th hour. All of the optic nerves underwent biochemical, histopathological and ultrastructural examination. Histopathological and transmission electron-microscopic changes were found to be more prominent in the hypotensive group. We observed decreased superoxide dismutase levels in all groups, but it was more evident in the third group. In comparison to hypertension, hypotension is found to be a more important factor in the development of early degenerative changes.

Primary pulmonary sarcomas with features of monophasic synovial sarcoma: a clinicopathological, immunohistochemical, and ultrastructural study of 25 cases.

We present 25 cases of a primary pulmonary sarcoma bearing histological, immunohistochemical, and ultrastructural features indistinguishable from those of monophasic synovial sarcoma of soft tissue. The patients were 11 men and 14 women between the ages of 16 and 77 years. Clinically, the most common symptoms were chest pain, cough, shortness of breath, and hemoptysis. The lesions involved all lung segments. Grossly, they varied in size from 0.6 to 20 cm and were described as soft to rubbery tumors with areas of necrosis and hemorrhage, some with cystic changes. Two lesions involved the bronchial wall and in one case the tumor was described as encircling the bronchial tree. Histologically, all of the lesions were characterized by an atypical spindle cell proliferation with a solid growth pattern. Areas of myxoid, neural, hemangiopericytic, and epithelial-like growth pattern were observed. Mitoses, necrosis, and hemorrhage were seen in all lesions in varying proportions. Immunohistochemical studies for epithelial membrane antigen (EMA) and keratin showed strong focal positivity in 25 of 25 and 23 of 25 lesions, respectively. Immunohistochemical study for vimentin showed diffuse strong positivity in all lesions. Other immunostains, including desmin, smooth muscle actin, and S-100 protein, were negative. Electron microscopy in three cases showed spindle cells with elongated nuclei containing abundant cytoplasmic rough endoplasmic reticulum and well developed desmosome type intercellular junctions. Follow-up information ranging from 2 to 20 years was obtained in 18 patients. Six patients died of their tumors, whereas four patients died of unrelated causes without evidence of recurrence or metastases. Eight patients were alive with disease (recurrence and/or metastases) from 1 to 7 years after diagnosis. Four patients were alive and well without evidence of recurrence or metastases from 2 to 20 years (mean follow-up, 12.5 years). The present group of lesions appears to constitute a distinctive and as yet previously undescribed primary sarcoma of the lung, which probably represents the visceral counterpart of monophasic synovial sarcoma of soft tissue in a pulmonary location. Because of their distinctive biology these lesions should be distinguished from a variety of primary and metastatic malignancies of the lung.

Sclerosing hemangioma of the lung. Granulomatous variant.

We present a case of granulomatous sclerosing hemangioma of the lung in a 43-year-old white woman in whom a pulmonary nodule was found on a routine chest roentgenogram. Surgical resection of a well-circumscribed pulmonary nodule was performed. Histologically, the tumor showed the typical features of sclerosing hemangioma with the unusual feature of a florid granulomatous reaction. Immunohistochemical studies using antibodies for epithelial membrane antigen decorated the tumoral cells, while factor VIII was positive in the vascular structure. Histochemical stains for microorganisms yielded negative results.

Thymofibrolipoma. A histologic variant of thymolipoma.

We report two cases of a thymic neoplasm showing abundant fibroconnective tissue with focal areas of fatty tissue. The two patients, a 9-year-old girl and a 32-year-old man, were found to have an anterior mediastinal mass on routine chest roentgenograms. Surgical resection was performed in both cases. Because of the histologic features shown by these neoplasms, we believe that these cases represent a variant of thymolipoma, and we have named it thymofibrolipoma.