Mucocele of the appendix. Two case reports.

The authors present two cases of mucocele of the appendix and discuss them in relation to the literature and the clinical features of this disease. They clarify the definition of mucocele as an intraluminal accumulation of mucus in the appendix, and concentrate on the observable pathological processes, agreeing on the higher frequency of mucinous cystadenoma and the possibility that mucocele can develop into peritoneal pseudomyxoma or degenerate into cystadenocarcinoma. They also note that most diagnoses are made intra-operatively during appendectomy, and that, in cases suspected preoperatively, thorough investigation with imaging techniques is very important in order to plan the best treatment.

Cystadenocarcinoma of the abdominal wall following caesarean section: case report and review of the literature.

OBJECTIVES: Endometriosis affecting surgical scars is a well-described entity that can complicate surgery involving hysterotomies. Malignant transformation is a rare event that has been reported complicating ovarian endometriosis mainly. CASE: A 60-year-old woman having in the past two uneventful caesarean deliveries presented with a solid lower abdominal mass. A surgical biopsy and then a radical resection of the lower half of the abdominal wall were performed, with a diagnosis of adenocarcinoma of endometrial origin. A diagnostic curettage excluded primary endometrial carcinoma. At 1 year she is NED. CONCLUSIONS: This case report illustrates the carcinomatous transformation of an endometrial implant. Despite the rarity of such a diagnosis, it should be borne in mind when endometriosis in abdominal wall is suspected because an oncological resection is required.

p53 gene mutations are common in uterine serous carcinoma and occur early in their pathogenesis.

Uterine serous carcinoma (USC) is an uncommon but aggressive type of endometrial cancer associated with rapid progression of disease and a poor prognosis. Both USC and its recently described putative precursor, endometrial intraepithelial carcinoma (EIC), demonstrate strong p53 overexpression by immunohistochemistry, suggesting alteration of the p53 gene in their pathogenesis. In the present study, we evaluated 21 USCs and 9 EICs for mutations in the p53 gene using direct sequence analysis and found that 90% of USCs and 78% of EICs contain mutations. Significantly, mutations were found in 3 cases of EIC without associated invasive carcinoma and identical mutations were detected in cases with synchronous USC and EIC. Strong p53 immunoreactivity was seen in the majority of USCs and EICs and correlated with p53 gene mutation, although lack of reactivity did not always indicate the absence of a gene mutation. Loss of heterozygosity of chromosome 17p was observed in 100% of USCs and in 43% of EICs, demonstrating that loss of the wild-type p53 allele occurs early in the development of serous carcinoma. Overall, our results reveal that p53 mutations are very common in USC and EIC. The presence of p53 gene mutations in EIC further suggests that p53 alteration plays an important role early in the pathogenesis of serous carcinoma, possibly accounting for its aggressive biological behavior.

Cystic neoplasms of the liver: a report of two cases with special reference to cystadenocarcinoma.

We herein present two cases with cystic neoplasms of the liver, both successfully treated by a surgical resection. One patient underwent a tumor enucleation, while the other had a left hepatic lobectomy and left caudate lobectomy. Although the follow-up period is still relatively short, both patients are doing well without any sign of recurrence. The specimens were histopathologically examined including immunohistochemical staining. Both tumors were unilocular-cystic and contained mucus. One tumor was considered to have originated from a cystadenoma with a mesenchymal stroma, which has been espoused by Wheeler and Edmondson, while the other tumor was considered to have originated from the bile duct. Therefore, the diagnosis of one patient was cystadenocarcinoma, while the other was considered to be a mucin-producing papillary adenocarcinoma of the intrahepatic bile duct. No invasive growth to the liver parenchyma or the surrounding tissues was observed in either case. Thus, a surgical resection should be the first choice of treatment for cystic neoplasms of the liver. Furthermore, a malignant transformation of cystadenoma with a mesenchymal stroma should be given a special entity in cystadenocarcinoma.

Biliary cystadenocarcinoma arising in a liver with fibropolycystic disease.

Intrahepatic cholangiocarcinoma associated with fibropolycystic disease of the liver and biliary cystadenocarcinoma are rare tumors that are considered distinct entities. We present a case of a malignant tumor with features of hepatic cystadenocarcinoma arising in a background of fibropolycystic disease.

Ovarian carcinoma of low malignant potential, infertility, and induction of ovulation--is there a link?

Three cases of ovarian carcinoma of low malignant potential associated with infertility and ovulation induction are reported. The natural history of ovarian epithelial tumors is possibly being interrupted with earlier intervention and diagnosis in patients who may have presented 10 to 15 years later with disseminated ovarian carcinoma.

Fine-needle aspiration biopsy of hepatic papillary cystadenocarcinoma in Caroli's disease.

A case of papillary adenocarcinoma arising in Caroli's disease (CD) in a 25-yr-old woman is reported. The diagnosis of malignancy was made by ultrasound-guided, fine-needle aspiration biopsy (FNAB). As there were no metastasis, a liver transplant was performed and the diagnosis was histologically confirmed. Only 22 cases of malignant transformation of CD have been reported to date, all among middle-aged subjects (mean age: 52 yr) of both sexes. Most of these reported cases (83%) were found to be bile duct adenocarcinomas with occasional reports of hepatocellular and undifferentiated carcinomas. Our case is the youngest reported to date and the first to be diagnosed cytologically.

[Ovarian remnant syndrome. A case report of a malignancy]. / Le syndrome de l'ovaire rémanent. A propos d'une observation maligne.

We operated on a patient who had already had total abdominal hysterectomy with bilateral salpingo-oophorectomy who developed a pelvic mass. The Pouch of Douglas was filled with a friable cystic mass of which the anatomo-pathological diagnosis was of a borderline serous cyst adenoma that probably was ovarian in origin. The case is interesting because of the radiopathological hypotheses that are brought up and by the various ways of treatment that have been suggested.

Bilateral ovarian carcinoma: cytogenetic evidence of unicentric origin.

Cytogenetic analyses were performed on the tumors from both ovaries in 15 patients with bilateral ovarian carcinoma. In 4 of them, omental implants were also examined. Abnormal karyotypes were detected in 11 cases. The baseline karyotypes in the 2 tumorous ovaries were identical in each patient, indicating that bilateral ovarian cancer develops by metastatic spreading. There was no clear-cut evidence of differences in the clonal evolution between the tumors of the 2 ovaries, and hence the side harboring the primary tumor could never be determined. The metastatic nature of the omental implants was proved by the fact that their karyotypes were indistinguishable from those of the ovarian tumor tissue.

[Ovarian cancer in a female patient with von Recklinghausen's disease]. / Cáncer de ovario en una paciente con enfermedad de von Recklinghausen.

A 29-year-old female with von Recklinghausen's disease developed ovarian epithelial cancer. Neurofibromatosis is a dominant autosomal disease predisposing to a wide range of tumors. The association between neurofibromatosis and malignancy was reviewed, analyzing the relevant features for the present case.

Cystadenocarcinoma of the appendix testis.

We report an example of what we believe to be an adenocarcinoma of the appendix testis. This very rare neoplasm arose in a patient on long term treatment with oestrogens which may be implicated as an aetiological factor.

Pancreatic cystadenocarcinoma and pregnancy: a case report.

We report a case of cystadenocarcinoma occurring in a pregnant woman. After child birth, a subtotal pancreatectomy was performed, without rupture of the cyst. The patient is asymptomatic, 24 months after surgery. The presentation of cystadenocarcinoma in pregnancy has been reported in another single case. The possibility of hormonal dependence is discussed.

[A mucin-producing cystadenoma, borderline malignancy, of the renal pelvis and ureter: a case report].

A cystadenoma or a cystadenocarcinoma arising from the renal pelvis is a rare neoplasma and, so far as is known, only two cases have been reported in the literature (Arcadi, 1956, and Ross, 1985). Discussed herein is a case of a 63-year-old woman who developed a mucinous nephrosis, due to a marked retention of mucin produced by a tumor. The ureter as well was found to be involved. The histogenesis of an adenocarcinoma, which includes a cystadenoma and a cystadenocarcinoma, most likely is due to a glandular metaplasia, associated with urolithiasis and pyelonephritis. In this specific case, the patient revealed a history, fifteen years earlier, of renal calculi and pyelonephritis.