Giant serous adenofibroma of the fallopian tube.

Serous adenofibroma of the fallopian tube is a rare, benign tumour of the female genital tract. They are usually small, asymptomatic and incidentally diagnosed during a surgery for another gynaecological condition. This report presents an atypical case of a 17-year-old girl with a tubal serous adenofibroma that presented with a palpable mass occupying the entire abdomen accompanied by urinary symptoms. She underwent a laparoscopic surgery with drainage of 1800 mL of yellow, citrine liquid from the cyst and left salpingectomy with no complications.

Tumor mixto epitelial y estromal del riñón con diferenciación endometrioide asociado a un tumor sólido seudopapilar de páncreas / Mixed epithelial and stromal tumor of the kidney with endometrioid differentiation associated with pancreatic solid pseudopapillary tumor

El tumor mixto epitelial y estromal del riñón (MESTK) es una neoplasia quística benigna. El tumor sólido seudopapilar pancreático (SPT) es un carcinoma quístico de bajo potencial maligno. Este artículo describe un MESTK sincrónico con un SPT en una mujer con un cuerpo lúteo quístico ovárico. Las glándulas mostraban diferenciación endometrioide y el estroma fusocelular creaba complejas estructuras foliáceas similares a un adenofibroma mulleriano. El SPT estaba formado por células poligonales con patrón seudopapilar y un área quística. La expresión de receptores de estrógenos y progesterona en las células estromales del MESTK y de receptores de progesterona en el SPT es clave para su diagnóstico, confirmando una dependencia hormonal en la patogénesis. Dado que nuestro MESTK es polipoide y tiene diferenciación endometrioide, discutimos el diagnóstico diferencial con la endometriosis polipoide(AU)

Mixed epithelial and stromal tumor of the kidney (MESTK) is a benign cystic neoplasm. Pancreatic solid-pseudopapillary tumor (SPT) is a typically cystic carcinoma of low malignant potential. We describe a MESTK synchronous with a SPT in a female with an ovarian cystic corpus luteum. Glands showed endometrioid differentiation and the spindle cell stroma created complex leaflet-like structures similar to Müllerian adenofibroma. The SPT consisted of polygonal cells with a pseudopapillary pattern and a cystic area. Expression of estrogen and progesterone receptors in MESTK stromal cells and progesterone receptors in SPT provided a diagnostic clue, confirming the hormonal dependence in pathogenesis. Given that our MESTK is a polypoid tumor with endometrioid differentiation, the differential diagnosis with polypoid endometriosis is considered(AU)

Pancreaticoduodenal tuberculosis simulating metastatic ovarian carcinoma.

A patient from Thailand presented with symptoms suggestive of peptic ulceration. Radiology showed an ulcerated duodenal stricture, a pancreaticoduodenal mass and extensive retroperitoneal lymphadenopathy suggestive of metastatic carcinoma. Tuberculosis was diagnosed only at laparotomy. The incidence of tuberculosis is increasing, and alimentary tuberculosis should be considered in patients from populations at risk presenting with obscure abdominal complaints or unexplained radiologic findings.

[In vivo measurements of electrical bio-impedance of breast tumors].

The electrical bio-impedance of 17 breast tumors including 12 breast cancers and 5 fibroadenomas, were measured in vivo with three-electrode method in the frequency range of 0 to 200 KHZ. The three-electrode consists of a coaxial needle electrode inserted into the tumor and a large reference electrode on upper abdominal wall. The tissue can be regarded electrically as a equivalent consisted of extracellular resistance (R1), intracellular resistance (R2), and electric capacitance of the cell membrane (C). These three parameters were calculated from the measured values of electrical bioimpedance. It was found that R1, and R2 of breast cancers were significantly higher than those of fibroadenomas (p less than 0.001), and that C of breast cancers was significantly lower than that of fibroadenomas (p less than 0.001). The measurement of the electrical impedance of breast tumor in vivo may be useful for the differential diagnosis of breast lesions.

Aberrations of normal development and involution (ANDI): a new perspective on pathogenesis and nomenclature of benign breast disorders.

A framework for understanding and management of benign breast disorders is presented, based on the notion that most breast complaints can be explained as minor aberrations of the normal processes of development, cyclical change, and involution. The generic term ANDI (aberrations of normal development and involution) is introduced to allow breast problems to be placed within an overall framework of pathogenesis; this concept also permits more detailed individual assessment with respect to normality and disease. Fibrocystic disease and its synonyms are discarded in favour of terms that are strictly descriptive of the clinical and/or histological picture.

Altered monocyte function in patients with benign breast disease.

Monocyte migration, lysozyme production and phagocytosis was studied in 34 patients with fibroadenosis, 28 patients with fibroadenoma and 48 healthy female controls. In patients with fibroadenosis and fibroadenoma, monocyte migration and phagocytic activity were significantly reduced when compared to controls (P less than 0.001). Conversely, lysozyme production by monocytes from patients with benign breast disease was significantly higher than in controls (P less than 0.001). In 20 patients with benign breast disease, there was no significant difference in monocyte function before and 3 months after operation. The observed impairment of monocyte function in fibroadenosis and fibroadenoma would not appear to be the result of abnormal blood biochemistry or due to a direct serum inhibitor, but is probably related to an intrinsic cellular defect. Further studies are required to evaluate the significance of impaired monocyte function in the pathophysiology of benign breast disease.

The significance of multiple, recurrent, and "complex" cardiac myxomas.

We reviewed the Mayo Clinic records of 56 patients who underwent operation for cardiac myxoma and 29 cases in which cardiac myxoma was found at autopsy. Five patients had a "complex" of unusual findings including multiple pigmented skin lesions (lentiginosis), myxoid fibroadenomas of the breast, skin myxomas, and primary pigmented nodular adrenocortical disease (a cause of Cushing's syndrome). Four of these five patients had multiple cardiac myxomas. Three of the four patients who underwent surgical excision of the cardiac myxomas had recurrent myxomas (the only recurrences in our series), and one of these patients had a second recurrence. The occurrence of multiple and recurrent myxomas in patients with the complex was significantly (p less than 0.001) higher than in our 80 patients with sporadic myxomas. The world literature was searched for cases of cardiac myxomas with the unusual associations of the complex, and also for familial, multiple, and recurrent myxomas. A group of patients were identified who had unusual biologic behavior including early development of myxomas, atypical myxoma locations, and a high risk for the development of recurrent myxomas. For these patients, we recommend a thorough search for multiple tumors at operation, close postoperative follow-up, and careful screening of family members.

Feline mammary hypertrophy/fibroadenoma complex: clinical and hormonal aspects.

Abnormal mammary enlargement, characterized microscopically by hyperplasia of both epithelial and mesenchymal tissues, was studied in 26 cats which were mostly young, sexually intact females. Clinicopathologic data indicated that mammary hypertrophy was likely progesterone-dependent. Administration of progestins preceded this condition in 5 cats, 4 of which were neutered. Serum progesterone concentrations (6.7 ng/ml) were increased in 1 of the 3 cats tested. Estrogen receptors were not found in the cytosols or nuclei of mammary tissues in the 2 cats studied. However, there were convincing 4S [3H]progesterone or 5S [3H]R5020 binding peaks which were suppressible by nonlabeled progestins. Progesterone receptors were measured at 14.9 and 8.6 fm/mg of protein, respectively. The apparent influence of progesterone, whether present as exogenous therapy in the male or female or as endogenous steroid of ovarian origin, has thus been demonstrated directly and indirectly in cats with mammary hypertrophy.

Benign breast disease I: hormonal investigation.

One hundred eighty-four patients with benign breast disease (BBD) were studied and compared with 50 normal women. All of the women had ovulatory cycles according to a biphasic basal body temperature and a plasma prolactin in the normal range. Their corpus luteum function was evaluated by way of plasma progesterone (P) and estradiol (E2) determinations at days 5, 7, and 9 of the hyperthermic phase. In the 184 patients, plasma P over plasma E2 ratio during the luteal phase was found significantly lower than in normal women. When the patients were grouped according to type of breast lesions, it appeared that plasma P was constantly lower in all groups than in the normal women, while plasma E2 was either normal or elevated in the groups of patients with adenosis tumors and increased nodularity of both breasts. From these results it may be postulated that an imbalance in the secretion of E2 and P by the corpus luteum is a constant finding in women with benign breast disease.

[Protein bound iodine indices in patients with mastopathy]. / Pokazateli sviazannogo s belkami krovi ioda u bol'nykh mastopatiei.

Under study was the content of blood protein bound iodine (SBI) in 102 patients with mastopathy, aged from 18 to 44 years. The law of distribution of these indices was formulated, and the mean values were determined for 6 ethiopathogenetic groups of patients. The mean value for the whole selected group prior to the treatment (3.95 +/- 0.14 mKg%) was significantly less than in the control group of healthy females (5.81 +/- 0.21 mKg%). The asthenic-depressive syndrome and other factors were shown to influence the changes in the thyroid activity in some patients with mastopathy.

[Hormonal function of the ovarian corpus luteum during benign mammary diseases]. / La fonction hormonale du corps jaune ovarien au cours des affections mammaires bénignes

Plasma progesterone and oestradiol levels were estimated in 54 women who were suffering from breast pathology. (There were 18 cases of benign breast dysplasia, 28 cases of cystic disease of the breast and 8 cases of adenofibromata.) All these women had menstrual cycles that were apparently ovulatory, and the blood sampling was carried out on the 4th day after the rise in the temperature plateau. By way of controls, the same estimations were carried out on 20 normal women of the equivalent age at the same stage of the raised plateau. The levels of plasma oestradiol in patients who had breast pathology (136 +/- 75 pg/ml) were not significantly different from those of normal women (120 +/- 50 pg/ml). On the other hand patients with mastopathies had a far lower level of progesterone in the phase of the cycle that was considered to be luteal (5-7 +/- 3-1 ng/ml) in comparison with normal women (13-2 +/- 3-5 ng/ml). From these results the conclusion can be drawn that women who have benign breast disease while they are active from the ovulation point of view show a defect in secretion of progesterone by the corpus luteum. This defect is an isolated one. The physiopathological implications derived from this observation are discussed.