RESUMO
Only five cases of recurrence of malignant mixed Mullerian tumor (carcinosarcoma) from the ovarian carcinoma have been published in the literature to our knowledge. A 64-year-old woman first underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy because of pelvic mass. Histological diagnosis was serous papillary carcinoma of the left ovary. After six courses of chemotherapy, CA125 level returned to normal range. However, she had persistent multiple mediastinal and para-aortic lymphadenopathies in spite of additional six courses of chemotherapy. Then she underwent the second operation about 2 years after primary surgery. Multiple excisional biopsies were taken from subcutaneous tissue, over the bowels and the left external iliac artery. The histopathological diagnosis which was confirmed by immunohistochemical study was malignant mixed Mullerian tumor for all metastatic foci. A rare case of ovarian serous papillary carcinoma recurring as malignant mixed Mullerian tumor is reported.
RESUMO
BACKGROUND: Breast cancer is the commonest cancer among women in industrialized countries. Most sporadic breast carcinomas are likely to be caused by low-penetrance genes. Genes encoding enzymes involved in estrogen and carcinogen metabolism are among these low-penetrance genes. In this study, for the first time the T/C (A1/A2) polymorphism at the 5' untranslated region (UTR) of CYP17 and the Arg/Trp (T/C) polymorphism at codon 39 of CYP19 among genes regulating endogenous estrogen levels was studied. PATIENTS AND METHODS: Fifty-five female breast cancer patients and ninety-one controls took part in the study. DNA was extracted from paraffin-embedded tissues for the patients and from blood cells for the controls. The distribution of genotypes was determined using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) techniques. RESULTS: The frequency of the TC genotype of CYP19 was significantly higher in the patient group (p<0.001, kappa(2): 12.31, OR: 7.30, 95% CI: 2.29-25.64). CYP17 frequencies were similar to those in Caucasian populations. In combined analysis, when the high risk alleles were evaluated together, the results reached significance (p=0.006, kappa(2)=7.01, OR: 2.53, %95 CI: 1.26-5.07) for the A2 allele of CYP17 and the C allele of CYP19, being more frequent in the patient group compared to the control. The risk possesed by the TC varient of CYP19 was reduced when evaluated with A1, the protective allele of CYP17 (p=0.082). The cumulative protective effects of both A1 allele and the TT genotype were ascertained to occur significantly less frequently in the patient group (p=0.001, kappa(2): 10.53, OR: 8.47, %95 CI: 1.9-37.04). CONCLUSION: The results were consistent with the individual studies of CYP17 and CYP19 in the literature, however, in combined analysis of the alleles of the two genes, the frequency of high risk alleles was higher and the frequencies of low risk alleles were lower in the patient group. The CYP17 A1 + CYP19 TT haplotype may be protective for breast cancer.
