ABSTRACT
We report a patient with ovarian malignant mixed mesodermal tumor (MMMT) that produced immunoreactive human chorionic gonadotropin beta-subunit (IR-hCG beta). Qualitative analysis indicated that IR-hCG beta in the patient's serum represented the free form of the beta-subunit of hCG. Immunohistochemical localization of hCG beta in MMMT was observed in the sarcomatous stroma, but not in the adenocarcinoma component. Reverse transcription-polymerase chain reaction (RT-PCR) for hCG subunits revealed that the mRNA transcripts of two of six hCG beta genes (beta-1 and -2) were predominantly expressed in the tumor tissue. The serum level of free hCG beta correlated with disease status and was helpful for monitoring the response to therapy for MMMT in this patient.
Subject(s)
Adenocarcinoma/physiopathology , Chorionic Gonadotropin, beta Subunit, Human/biosynthesis , Gene Expression Regulation, Neoplastic , Mixed Tumor, Mesodermal/physiopathology , Ovarian Neoplasms/physiopathology , Chorionic Gonadotropin, beta Subunit, Human/analysis , Female , Humans , Immunohistochemistry , Middle Aged , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
El pólipo estromal mesodérmico de vagina es una lesión benigna, asintomática que se diagnóstica en forma incidental y se presenta a cualquier edad (recién nacidas a 71 años). Se localiza en las paredes laterales en el tercio inferior de la vagina, es generalmente único, de aspecto digitiforme o nodular. Aun cuando su origen no es claro, la presentación en mujeres embarazadas o con manejo hormonal hace suponer que la estimulación hormonal juega un papel relevante en su desarrollo. Se informan cuatro casos estudiados en el Instituto, la edad de presentación osciló entre 19 y 54 años, dos pacientes se encontraban embarazadas y dos con manejo hormonal, el diagnóstico se realizó en todas de forma incidental, el tamaño de las lesiones varió de 1.5 a 5 cm de eje mayor. Se efectuó excisión local en todos los casos, sin presentar recurrencias con un seguimiento de 1 a 40 meses. Histológicamente eran bien circunscritos, revestidos por epitelio escamoso, el estroma incluyó un espectro de lesiones constituidas por tejido fibroconectivo laxo, poco celular sin atipias, hasta lesiones constituidas por estroma fibroconectivo denso, con aumento en la celularidad, presencia de atipias y escasa actividad mitótica . Los receptores hormonales fueron positivos en todos lo casos. Estos resultados apoyan el comportamiento indolente y la influencia de los factores hormonales en el desarrollo de estas lesiones.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Mixed Tumor, Mesodermal/surgery , Mixed Tumor, Mesodermal/physiopathology , Vaginal Neoplasms , Histological Techniques , Immunohistochemistry/methodsABSTRACT
During 1971-1996, 17 patients with mixed mesodermal uterine tumors were treated. Average age at diagnosis was 67.3 years, 12/17 were of European and 5/17 of Afro-Asian extraction. The overall 5-year survival was 21%. 10/17 patients had mixed mesodermal tumors with a heterologous mesenchymal element, and 7/17 had a homologous mesenchymal element (carcinosarcoma). 6/17 had another primary malignancy, including breast cancer (3/17), bilateral metachronous breast tumor (2/17), and malignant lymphoma of the neck region (2/17). All 3 with breast cancer had previously been treated with tamoxifen. I had simultaneous mesodermal tumor and ovarian thecoma. Simultaneous autoimmune manifestations occurred in 2/17, including thrombocytopenic purpura in 1, and myasthenia gravis in another. Mesodermal tumor of the uterus is a relatively rare malignancy with aggressive behavior and poor prognosis. It also had unusual associations with other primary tumors, hormonal treatment, and autoimmune manifestations.
