RESUMO
BACKGROUND: Uterine tumors resembling ovarian sex cord tumor (UTROSCT) is a rare neoplasm of unknown etiology and has undetermined malignant potential. The emergence of recurrent UTROSCT case reports has led to its initial identification as a tumor of low malignancy potential. Owing to its low incidence, we currently lack any in-depth studies regarding the subset of UTROSCTs that may be aggressive in nature. Here, we sought to identify unique characteristics in aggressive UTROSCT. METHODS: 19 cases of UTROSCT were collected. Their histologic and tumor immune microenvironment were evaluated by three gynecologic pathologists. The gene alteration was also detected by RNA sequencing. For later analyses regarding differences between benign and malignant tumors, we supplemented our 19 included cases with additional reports from the literature. RESULTS: Interestingly, we found PD-L1 expression in stromal tumor-infiltrating immune cells (stromal PD-L1) was markedly higher in aggressive UTROSCT. Patients with high stromal PD-L1 (≥ 22.5 cells/mm2) had worse prognosis. When our cases were added with previous cases identified in the literature, we discovered that aggressive UTROSCT was more likely to have significant mitotic activity and NCOA2 gene alterations than benign UTROSCT. Consistence with those results, patients with significant mitotic activity and gene alteration of NCOA2 had worse prognoses. CONCLUSIONS: Collectively, high expression of stromal PD-L1, significant mitotic activity, and gene alteration of NCOA2 may be useful markers to predict aggressive UTROSCT.
Assuntos
Tumores do Estroma Gonadal e dos Cordões Sexuais , Neoplasias Uterinas , Humanos , Feminino , Antígeno B7-H1 , Recidiva Local de Neoplasia , Útero , Microambiente TumoralRESUMO
Uterine tumors resembling ovarian sex cord tumors are rarely reported with limited imaging findings.The current study reported two case of uterine tumors resembling ovarian sex cord tumors and described the detailed MRI findings,which would provide valuable imaging evidence for the diagnosis of such tumors.
Assuntos
Neoplasias Ovarianas , Tumores do Estroma Gonadal e dos Cordões Sexuais , Neoplasias Uterinas , Feminino , Humanos , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Tumores do Estroma Gonadal e dos Cordões Sexuais/diagnóstico por imagem , Tumores do Estroma Gonadal e dos Cordões Sexuais/patologia , Imageamento por Ressonância MagnéticaRESUMO
Uterine tumors resembling ovarian sex cord tumors are rarely reported with limited imaging findings.The current study reported two case of uterine tumors resembling ovarian sex cord tumors and described the detailed MRI findings,which would provide valuable imaging evidence for the diagnosis of such tumors.
Assuntos
Feminino , Humanos , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Tumores do Estroma Gonadal e dos Cordões Sexuais/patologia , Imageamento por Ressonância MagnéticaRESUMO
Uterine tumors resembling ovarian sex cord tumors are rare neoplasms with varied histological and immunophenotypic profile, uncertain histiogenesis and biological behavior. A critical evaluation of histological features is essential for diagnosis and management of these cases.
Assuntos
Neoplasias Ovarianas/patologia , Tumores do Estroma Gonadal e dos Cordões Sexuais/diagnóstico , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/patologia , Adulto , Feminino , Humanos , Imuno-Histoquímica/métodos , Neoplasias Ovarianas/diagnóstico por imagem , Ovário/patologia , Ultrassonografia , Neoplasias Uterinas/diagnóstico por imagemRESUMO
â¢Uterine tumors with sex-cord elements are very rare.â¢UTROSCT can present with infiltration similar to endometrial stromal sarcomas.â¢Case report of a locally advanced UTROSCT.
