Synchronous endometrioid carcinoma of the uterine corpus and ovary. A case report and review of the literature.

Synchronous endometrioid carcinoma of the uterine corpus and ovary is an uncommon but well recognized event. Diagnosis as either a separate independent primary or as a metastatic tumor requires careful consideration of a number of gross and histological features. These features illustrate the criteria helpful in distinguishing independent primaries from metastatic carcinomas which have a different therapeutic implication. The possible link between fertility drugs and carcinogenesis still remains controversial. We report a case of a 52-year-old woman who came to our hospital with a cystic left ovarian mass (8 cm). Hysterectomy and bilateral salpingo-oophorecromy were carried out. Histological examinations showed well differentiated endometrioid ovarian cancer and well differentiated endometrioid endometrial cancer. The endometrial tumor was intramucosal without myometrial or vascular invasion and was associated with atypical complex hyperplasia. The woman had not been previously treated with ovulation induction drugs. She was free of recurrence two years after surgery. Patients with synchronous endometrioid tumors of the endometrium and ovary are generally younger than reported for either endometrial adenocarcinomas or ovarian adenocarcinomas. They tend to be low grade and early stage and are frequently associated with endometriosis. The prognosis of endometrioid type carcinomas is better than other histological types of carcinoma.

Malignant adenomyoepithelioma of the breast--case report.

Malignant adenomyoepithelioma (MAME) of the breast is a rare tumor characterized on the basis of histologic, immunohistochemical and ultrastructural features by malignant proliferation of the epithelial and myoepithelial cells. We report a case of an 80-year-old woman with malignant adenomyoepithelioma of the breast, one of the oldest patients described up to today. A primary tumor in the left breast grew within a short period of time. A modified mastectomy with sampling of the axillary lymph nodes was performed. The lymph nodes did not include any metastatic lesions. In this case the malignancy was evidenced by the presence of a high mitotic rate, several nuclear atypia, necrosis, and local invasion. The tumor was associated with adenosis and in adjacent positions to the infiltrating portions a circumscribed nodule with histological features of benign adenomyoepithelioma was present. Reviewing the literature MAME has been reported in women aged between 26-76 years. The metastatic potential of this entity is not well studied. It appears to have hematogenous rather than lymphatic spread and usually occurs in primary tumors more than 2 cm in size.

Combined carcinoid and mixed (composite) glandular - endocrine cell carcinoma of the stomach in atrophic gastritis.

We describe a case of gastric carcinoid and inflammatory fibroid polyp concomitant with a composite tumor of the gastric antrum composed of poorly differentiated adenocarcinoma - endocrine carcinoma with immunohistochemical documentation of endocrine and non endocrine differentiation in a 67-year-old man with atrophic gastritis and intestinal metaplasia. When gastrectomy was carried out, two lymph nodes along the greater curvature harbored metastasis from carcinoid. The same occurrence is reported in several cases in the literature, which suggests that the association of gastric carcinoid to adenocarcinoma could point to the malignant nature of carcinoid. Furthermore, the findings in this patient reinforce the concept that the epithelial and neuroendocrine cells of the gastrointestinal tract both result from multidirectional differentiation of a primitive cell.

Glomus tumor of the stomach: a case report.

Glomus tumors are relatively uncommon benign neoplasms, most common in the skin and subcutaneous tissue, but can also occur in the viscera, most often in the stomach. Preoperative diagnosis, when the tumor occurs in the stomach, seems difficult but is important, since glomus tumors of the stomach are essentially benign and amenable to conservative excision, contrary to aggressive gastric neoplasms. We describe the case of a 75-year-old man presented to the emergency department with gastrointestinal bleeding and epigastric pain. Gastroscopy revealed a submucosal mass in the antrum of the stomach in correspondence to the lesser curvature. Biopsies taken from the lesion showed morphological and immunohistochemical [positivity for alphasmooth muscle actin (alpha-SMA) and vimentin, negativity for CD34, CD117, chromogranin, synaptophysin, desmin and S-100 protein] characteristics attributable to glomus tumor. The patient underwent a laparotomic antrotomy incision. Histological examination of the tumor confirmed the diagnosis of gastric glomus tumor.

Bilateral primary breast lymphoma--case report.

Primary lymphoma of the breast is an uncommon malignant breast tumor which is seldom distinguished preoperatively from other more common forms of breast cancer. Bilateral breast lymphoma affects younger women especially during pregnancy or postpartum. We report a case of a 55-year-old woman who was admitted to our hospital with painless bilateral breast enlargement. A bilateral radical mastectomy with bilateral axillary lymph node dissection was performed. The histology of the surgical specimen was non-Hodgkin's malignant lymphoma of the diffused large B cell type. Most of the neoplastic cells resembled large centrocytes and sometimes blast cells showing some degree of plasmacytoid differentiation. Foci with a sufficient number of immunoblasts were also noted. The patient was also found to have a bilateral axillary lymph node metastasis. After additional clinical and laboratory screening, there was no other evidence of lymphatic disease at other sites. The patient was submitted to the anticancer hospital for further treatment. She was free of recurrence two years after surgery. The rarity of the disease, lack of uniform classification and variable treatment modalities make prognostic predictions of breast lymphoma difficult.