RESUMO
Appendiceal neoplasms with ovarian metastasis are rare. A 35-year-old woman with a left ovarian tumor underwent left salpingo-oophorectomy, partial resection of the right ovary, and a total hysterectomy. Pathological diagnosis of both ovaries was typical, Krukenberg tumor with signet-ring cells, and the second laparotomy revealed an occult appendiceal tumor to be the primary lesion. The appendix showed no evidence of malignant change of the mucosa, but the tumor cells were observed infiltrating from the basiglandular region into the underlying stroma, associated with mucocele. Although, argentaffin and argyrophil staining were negative, a few tumor cells showed immunohistochemical positivity for Chromogranin A. Accordingly, the tumor was diagnosed as adenocarcinoid rather than adenocarcinoma of the appendix. A review of the literature showed less than 40 cases of metastatic ovarian tumor from appendiceal primary, one-third of which were occult and could be detected at the second laparotomy. Cisplatin-based chemotherapy may have partial effect in the treatment of patient with adenocarcinoid tumor.
Assuntos
Neoplasias do Apêndice/patologia , Tumor Carcinoide/patologia , Tumor de Krukenberg/secundário , Neoplasias Ovarianas/secundário , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cromogranina A , Cromograninas/análise , Cisplatino/uso terapêutico , Tubas Uterinas/cirurgia , Evolução Fatal , Feminino , Humanos , Histerectomia , Imuno-Histoquímica , Obstrução Intestinal/etiologia , Tumor de Krukenberg/patologia , Tumor de Krukenberg/terapia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Ovariectomia , Peritonite/etiologiaRESUMO
The MR and pathologic findings of a case of sclerosing stromal tumor (SST) are presented. MR findings reflecting pathological features of SST include pseudolobulation, which consists of low-intensity nodules set against high-intensity stroma on T2-weighted images, and striking enhancement on postcontrast images.
