Schistosomiasis may contribute to goblet cell carcinoid of the appendix.

Abstract : To investigate whether schistosomiasis can contribute to appendiceal goblet cell carcinoid, appendix samples were obtained from 3 patients with combined appendiceal schistosomiasis and goblet cell carcinoid (CSG), 6 patients with goblet cell carcinoid only (GCC), 12 patients with appendiceal schistosomiasis only (ASO), and 12 cases with normal appendix (NA), all of similar gender ratio and age distributions. Hematoxylin and eosin-(H&E) stained sections were studied in 3 CSGs and 12 ASOs to diagnose schistosomiasis by detecting schistosome eggs. H&E and alcian blue/PAS-stained sections and immunohistochemistry of CgA and CEA were employed to establish the diagnosis of GCC in the 3 CSGs and 6 GCCs. Then, to determine whether schistosomiasis can contribute to GCC, immunostaining patterns of CgA and Ki67 in mucosal crypt epithelia were investigated and compared among all 33 cases. Our results revealed typical histological and immunohistochemical phenotypes of GCC in the 3 CSGs and 6 GCCs and schistosome egg deposits in 3 CSGs and 12 ASOs. We found that the expression levels of both CgA and Ki67 in mucosal crypt epithelia were significantly higher in CSG than in GCC (P < 0.05  =  0.013 and P  =  0.004, respectively). Moreover, high expression levels of both CgA and Ki67 in mucosal crypt epithelia favor ASO as compared to NA (P < 0.001  =  3.4 × 10(-6) and 3.1 × 10(-5), respectively). Our findings suggest that appendiceal schistosomiasis was associated with increased proliferation and neuroendocrine differentiation of mucosal pluripotent crypt cells and that it may contribute to GCC, which is documented to originate from mucosal pluripotent crypt cells in mucosal crypt epithelia.

Schistosoma japonicum infection and rectal carcinoid tumour: underreported coincidence or neglected association?

Schistosoma japonicum infection associated with a rectal carcinoid in an asymptomatic 44-year-old female from the Philippines is described. A systematic review of the literature could not identify similar reports, suggesting a rare coincidence. However, epidemiological data on the frequency of both conditions as well as published results of a colorectal screening programme from China indicate that underreporting of this concurrence is likely. Moreover, several studies suggest a causal link between schistosomiasis caused by S. japonicum and more common gastrointestinal malignancies such as colorectal carcinoma. Hence the presented case and the apparent neglect of this observation in the current literature allow speculation on a role of S. japonicum in the pathogenesis of rare gastrointestinal neoplasms such as carcinoid tumours as well. Future reports on similar observations could help to determine the need for systematic investigations and are strongly encouraged.

Struma Ovarii with a focus of follicular variant of papillary thyroid cancer: a case report.

BACKGROUND: Struma Ovarii is a mature ovarian teratoma that consists mainly of thyroid tissue. Mature cystic teratomas may contain small amounts of thyroid tissue. Carcinomatous change in Struma Ovarii is extremely rare. No guidelines exist regarding the staging and treatment of malignant Struma Ovarii. OBJECTIVES: To report a case of Struma Ovarii with a focus follicular variant papillary thyroid cancer. CASE: A 36 year old nulligravid patient presented with a pelvic mass palpated on her routine annual exam. Struma Ovarii with a focus of follicular variant of papillary thyroid cancer was diagnosed during the subsequent laparoscopy and ovarian cystectomy. INTERVENTION: She then underwent a staging laparotomy, total hysterectomy, bilateral salpingoophorectomy, and infracolic omentecomy. FOLLOW-UP: Tumor markers, thyroid studies, thyroid scan, and whole body scans were normal. CONCLUSION: Optimal treatment and surveillance of malignant struma ovarii has yet to be determined.