Primary mesonephric adenocarcinoma of the fallopian tube: A case report.

BACKGROUND: Mesonephric adenocarcinoma (MNAC) is an extremely rare malignancy in the female genital tract. Only a few cases have been reported in the literature, and most of them occurred in the cervix, with extremely rare cases in the uterine body and ovary. MNAC has never been reported to arise in the fallopian tube. CASE SUMMARY: A 45-year-old woman was referred to our institution with a history of abdominal pain. Ultrasound revealed a cystic and solid mass in left adnexal region. The patient underwent complete staging surgery when intraoperative pathological examination demonstrated that the mass was malignant. The final histological and immunohistochemical results confirmed the diagnosis of MNAC originating from the fallopian tube. Then she received four cycles of combination chemotherapy with carboplatin plus paclitaxel. The tumor recurred with hepatic metastases 4 mo after initial surgery, and second resection of the tumors in the liver plus partial hepatectomy was performed. She was supplemented with five courses of a new combination chemotherapy with gemcitabine plus carboplatin, and there was no evidence of recurrence within the 22-mo follow-up period after the second surgery. CONCLUSION: MNAC originating from the fallopian tube is an extremely rare and high malignancy with a poor prognosis. It can be very aggressive, even at early stage. Little is known about the clinical characteristics, pathological diagnosis, prognosis, and optimal management strategy of MNAC originating from the fallopian tube. Herein we report the first case of primary MNAC deriving from the fallopian tube.

Sclerosing stromal tumor of the ovary with masculinization, Meig's syndrome and CA125 elevation in an adolescent girl: A case report.

BACKGROUND: Sclerosing stromal tumor (SST) is an extremely rare sex cord stromal tumor of the ovary. It was first reported and named in 1973. These tumors typically present with pelvic/abdominal pain and tenderness, a mass, and/or abnormal menses, but rarely present with masculinity in children and adolescents. Only 2 cases of these tumors have been reported in premenarchal girls, who demonstrated hormonal activity, with a history of the development of a virilizing female due to hyperandrogenism. Here, we report a case of a giant SST with obvious masculinity combined with Meig's syndrome and CA125 elevation. CASE SUMMARY: A 17-year-old female presented with a 7-year history of the development of masculinity and a 2-year history of amenorrhea. She had hirsutism, acne, obvious laryngeal prominence, and voice deepening. Physical examination showed a male suprapubic hair pattern and a 4.0 cm × 1.5 cm enlarged clitoris. Laboratory tests showed that the testosterone level was > 15.00 ng/mL (normal range: 0.14-0.76 ng/mL), and androstenedione level was > 10.00 ng/mL (normal range: 0.3-3.3 ng/mL). A computed tomography scan of the abdomen and pelvis was carried out and showed a large, solid and cystic, partly calcified pelvic mass in the right ovary measuring 27.1 cm × 20.0 cm × 11.0 cm, 15 cm above the umbilicus (to the level of the upper part of L1). Intraoperative findings at laparotomy revealed a large tumor arising from the right ovary. Approximately, 500 mL of pale-yellow clear liquid was found in the pelvic cavity. A right salpingo-oophorectomy was performed. Microscopic examination and immunohistochemical staining of the surgical specimen showed an SST of the ovary. CONCLUSION: This report is remarkable as our patient was not only diagnosed with an SST of the ovary, which is extremely rare in this age group, but was the largest and most obvious reported patient with this tumor who presented with virilization. Therefore, gynecologists should be aware of this potential complication in adolescent girls with a mass in the ovary.

Ovarian involvement of a desmoplastic small round cell tumor of unknown primary origin with lymph node and lung metastases: A case report.

Desmoplastic small round cell tumors (DSRCTs) were initially characterized as exhibiting divergent differentiation and were extremely aggressive, belonging to the family of 'small round blue cell tumors'. Due to a male predominance, to date, only 15 cases in women have been reported in the English literature. The present study describes a case of DSRCT in a young woman who initially presented with ovarian masses accompanied with lymph node and lung metastases. A correct diagnosis was reached by combining the hematoxylin and eosin, and immunohistochemical staining results. Following surgery, the patient underwent the chemotherapy and, 3 months later, is in a good condition. The study also provides an overview of this uncommon disease.

Expression of AEG-1 mRNA and protein in colorectal cancer patients and colon cancer cell lines.

BACKGROUND: Astrocyte elevated gene 1 (AEG-1), an important oncogene, has been shown to be overexpressed in several types of cancers. In colorectal cancer (CRC), the protein level of AEG-1 is up-regulated in tumour tissue compared to normal mucosa, showing prognostic significance. Since little is known about the transcriptional level of AEG-1 expression and its biological pathway in CRC the aim of the present study was to examine the relationship of AEG-1 mRNA expression, the protein level and clinicopathological variables as well as its biology pathway in CRC. MATERIAL AND METHODS: The mRNA expression of AEG-1 was analysed by qPCR in fresh frozen patient samples including 156 primary tumours, along with the corresponding normal mucosa, and in five colon cancer cell lines, SW480, SW620, KM12C, KM12SM and KM12L4a. AEG-1 protein expression was investigated by immunohistochemistry in paraffin-embedded materials from 74 distant normal mucosa, 107 adjacent mucosa, 158 primary tumour, 35 lymph node metastasis and 9 liver metastasis samples. In addition, the AEG-1 protein expression was elucidated in the cell lines by Western blot. RESULTS: The lymph node metastatic cell line SW620 had a significantly higher AEG-1 mRNA (0.27 ± 0.02) expression compared to the primary tumour cell line SW480 (0.17 ± 0.04, p = 0.026). AEG-1 expression at the mRNA level and/or the protein level was significantly up-regulated gradually from normal mucosa to primary CRC, and then to lymph node metastasis and finally to liver metastasis (p < 0.05). There were significant associations of AEG-1 mRNA expression with tumour location (p = 0.047), as well as mRNA and protein expression with the tumour stage (p < 0.03). Furthermore AEG-1 protein expression was positively related to biological variables including NF-κB, p73, Rad50 and apoptosis (p < 0.05). CONCLUSION: AEG-1 is up-regulated, at the mRNA and the protein level, during CRC development and aggressiveness, and is related to tumour location and stage. It may play its role in CRC through the NF-κB signaling pathway.

Novel gene hBiot2 is an independent prognostic factor in colorectal cancer patients.

The present study investigated the expression of the novel gene hBiot2 in colorectal cancer (CRC) and its relationships with clinicopathological variables in CRC patients. The expression of hBiot2 in 163 primary CRCs together with the corresponding normal mucosa, 36 liver metastases and 5 colon cancer cell lines was examined using real-time PCR. In situ hybridization (ISH) was performed to evaluate the localization of hBiot2 expression in CRC and normal mucosa. hBiot2 expression at the RNA level was localized in the nucleus of tumor cells and normal epithelial cells. The mean expression of hBiot2 in the CRCs (243.571±564.569) was higher compared to the normal mucosa (107.252±413.635, P<0.0001) and liver metastasis samples (42.002±40.809, P=0.0002). hBiot2 expression was increased from stages I+II to III (P=0.047), and no difference in the expression was found in stages III and IV (P=0.452). A high value of hBiot2 was associated with a poorer prognosis compared with a low value independently of gender, age, tumor site, stage and differentiation (P=0.007, RR 7.519, 95% CI 1.729-32.704). Liver metastasis, smaller tumors, non-local recurrence and primary liver surgery alone were associated with a higher value of hBiot2 compared to larger tumors, local recurrence and repeated liver surgery (P=0.003, 0.044 and 0.026, respectively). An inverse relationship was found between hBiot2 expression and the metastatic potential of the colon cancer cell lines. Thus, increased expression of hBiot2 may be an early and interim event in the development of CRC. A higher expression of hBiot2 in primary CRC patients independently indicates a poorer prognosis.

Overexpression of GLUT1 in colorectal cancer is independently associated with poor prognosis.

BACKGROUND: To investigate the expression of glucose transporter 1 (GLUT1) in colorectal cancer (CRC) and its relationship to clinicopathological variables. METHODS: The expression of GLUT1 in 163 primary tumors together with the corresponding normal mucosa, and 36 liver metastases was examined using real-time PCR. RESULTS: The mean value of GLUT1 was higher in primary tumors (50.390 ± 68.648) than in the corresponding normal mucosa (20.437 ± 28.703, p<0.0001), while there was no significant difference in GLUT1 expression between CRC and liver metastasis (50.390 ± 68.648 vs 52.277 ± 52.482, p=0.190). In CRCs, GLUT1 expression was higher in poorly differentiated than in well and moderately differentiated tumors (p=0.022), and higher in stage III + IV than in stage I + II tumors (p=0.035). The patients with high-expressed GLUT1 had a worse prognosis than those with low-expressed GLUT1 independently of gender, age, tumor site, stage and differentiation (p=0.026, RR 2.737, 95% CI 1.126-6.651) in stage I-III CRCs. In liver metastasis, GLUT1 expression was higher in larger tumors than in smaller ones (p=0.025). CONCLUSIONS: Overexpression of GLUT1 in stage I-III CRCs was independently associated with poor prognosis.

Overexpression of the hBiot2 gene is associated with development of human cervical cancer.

The novel gene human Biot2 (hBiot2) was first reported by our laboratory. Previously, we indicated its function of proliferation and carcinogenesis in human endometrial cancer. In the present study, we aimed to investigate whether hBiot2 played a similar role in human cervical cancer. We tested hBiot2 expression profile in cervical cancer, the corresponding adjacent normal tissues, normal cervix and the cervical cancer cell lines by RT-PCR and compared the mean value of hBiot2 expression between cervical cancer and normal cervix, and cervical cancer with or without lymphatic metastasis by real-time PCR. The location of hBiot2 in normal cervix and cancer tissues together with the corresponding adjacent normal tissues was determined by RNA-RNA in situ hybridization (ISH). hBiot2 expression in the cervical cancer (20/25), the corresponding adjacent normal tissues (3/12), normal cervix (17/18) and the cervical cell lines (2/3) was shown by RT-PCR. The mean value of hBiot2 expression was higher in the cervical cancer than in the normal cervix (0.478±1.612 vs. 0.091±0.107, P=0.0004), higher in the lymphatic metastasis than in the non-lymphatic metastasis in the cervical cancer (1.117±2.483 vs. 0.052±0.071, P=0.014). hBiot2 expression location was mainly in the parenchymal cells of the cervical cancer and normal cervix rather than in the stromal cells. Overexpression of hBiot2 is associated with early and interim development of human cervical cancer.

Malignant mixed müllerian tumor of the fallopian tube: report of two cases and review of literature.

PURPOSE: Malignant mixed müllerian tumors (MMMT) of the female genital tract is rare and it is extremely rare in the fallopian tube, with fewer than 53 cases reported in the literature. METHODS: We had experienced two cases of MMMT of the fallopian tube. The clinical features, pathologic findings, diagnosis, therapy, and outcome were reviewed. RESULTS: The clinical features and diagnosis were similar to those of primary carcinoma of the fallopian tube. Histologically, the two patients had homologous and heterologous elements mixed müllerian tumors. Treatment has focused on surgery with postoperative chemotherapy. Prognosis is poor, with fewer than half of patients surviving 2 years. CONCLUSIONS: MMMT of fallopian tube is an uncommon carcinoma in the female genital tract. Cervical cytology and endometrial curettage could raise the suspicion of a tubal malignancy, but diagnosis is not usually made until the time of surgery. The patient survival will improve after surgery and postoperative chemotherapy.

[Malignant transformation of ovarian endometriosis: a clinicopathologic analysis of 49 cases].

BACKGROUND & OBJECTIVE: Ovarian endometriosis is a common and benign, but progressive disease. We aimed to investigate the clinicopathologic of ovarian endometriosis with malignant transformation and to evaluate the expression differences of estrogen receptor (ER) and progesterone receptor (PR) between ovarian endometriosis samples with and without malignant transformation. METHODS: Clinicopathologic data of 49 ovarian endometriosis patients with malignant transformation were reviewed. The expression of ER and PR in the 49 specimens of ovarian endometriosis with malignant transformation (transformation group) and 49 specimens of ovarian endometriosis without malignant transformation (control group) were detected by immunohistochemistry and compared statistically. RESULTS: The 49 ovarian endometriosis patients were aged of 29-70 years with a median of 49 years. The major initial manifestation was pelvic masses. B-ultrasound examination showed mixed cystic and solid masses in the pelvic cavity. Macroscopically, the ovarian masses were cystoid and parenchymal with diameters of 4.0-20.0 cm; the cysts possessed thick and fibrous walls (in brown or yellow) and contained chocolate-like fluid or semi-fluid materials; the parenchymal part was tender papillary nodules with diameters of 0.5-15.0 cm. Microscopically, the ectopic endometrium proliferated and transformed to atypical hyperplasia and carcinoma. The positive rates of ER and PR proteins were significantly lower in transformation group than in control group (20.4% vs. 95.9%, 14.3% vs. 95.9%, P < 0.05). CONCLUSIONS: The malignant transformation of ovarian endometriosis is likely to occur in peri-menopausal women. Clinical manifestations, B-ultrasound examination and pathologic examination are valuable for diagnosis. The absence of ER and PR protein expression in endometriosis may help to diagnose malignant transformation of ovarian endometriosis.