Synchronous adenocarcinoma and echinococcosis in the same ovary: a rare clinical entity.

BACKGROUND: Serous adenocarcinoma is the most common subtype of ovarian carcinoma, while ovarian echinococcosis is a rare disease of the female genital system. The simultaneous presence of adenocarcinoma and echinococcosis in the same ovary is extremely rare and little data exist regarding diagnosis and treatment approach. MATERIALS AND METHODS: In the present paper, we report a rare case of a 66-year-old Greek Caucasian woman of rural origin, with an adnexal mass, ascitic and pleural fluid. The patient underwent exploratory laparotomy following neoadjuvant chemotherapy, based on positive for malignancy pleural and ascitic fluid cytology results. RESULTS: Histological examination of the surgical specimen indicated the synchronous presence of echinococcosis and adenocarcinoma in the same ovary. CONCLUSIONS: Ovarian hydatid cyst is extremely rare, but should be suspected in patients with echinococcosis in other organs and those coming from endemic areas. Moreover, the disease could mimic ovarian cancer, as there are no specific symptoms and clinical signs. The coexistence of these two diseases in the same ovary, although rare, is possible. It seems that the presence of the hydatid cyst does not change the treatment approach of the malignancy so that surgery with neoadjuvant or adjuvant chemotherapy, according to the present guidelines, should be administered. Hippokratia 2015, 19 (1): 89-91.

Coexistence of three benign and a borderline tumor in the ovaries of a 52-year-old woman.

PURPOSE OF INVESTIGATION: In this paper, the authors describe a rare case of four simultaneous ovarian tumors. MATERIALS AND METHODS: A 52-year-old postmenopausal woman underwent total hysterectomy and bilateral salpingo-ophorectomy. Multiple slides from the ovaries were examined. RESULTS: Histological examination revealed the presence of three ovarian tumors on the right ovary, of the following types: cystadenoma, mucinous borderline ovarian tumor and mature teratoma, and also a benign Brenner tumor on the left ovary. CONCLUSION: Pathologists must examine multiple sections of both ovaries, regardless of the macroscopic or clinical specimen's appearance, in order to exclude the presence of malignancy, which could alter the surgical approach. Particular attention should also be paid to the frozen section of the contralateral ovary, as depending on the result, it could change the surgical approach. From the surgeon's perspective, bilateral salpingo-ophorectomy with total hysterectomy should be the treatment of choice in postmenopausal women with multiple ovarian tumors. The diagnosis of a malignant or borderline tumor on a normal-appearing ovary changes the radicality of the surgical approach. In such a case, staging surgery, including omentectomy, multiple peritoneal biopsies, and washes are required.

Extramedullary (EMP) relapse in unusual locations in multiple myeloma: Is there an association with precedent thalidomide administration and a correlation of special biological features with treatment and outcome?

Extramedullary relapse constitutes an uncommon manifestation of multiple myeloma (MM), characterized by highly malignant histology, special biological features, resistance to treatment and poor outcome. Its incidence has been increased during the last years, probably due to the introduction of novel strategies in the management of MM, including intensified treatment and immunomodulatory drugs. Here we report nine cases of extramedullary relapse of MM, presented in unusual locations, seven of which had previously been treated with thalidomide-containing regimens (TCR). Our aim was to explore the morphological, immunophenotypical, molecular and laboratory characteristics accompanying EMP-relapse and seek possible correlations with treatment and clinical outcome.

Lymphoepithelial carcinoma of the parotid gland: is an association with Epstein-Barr virus possible in non-endemic areas?

Lymphoepithelial carcinoma (LEC) is a rare histological type of cancer of the salivary glands. Here is reported a case of LEC of the parotid gland that developed in a Caucasian female, whose serology was positive for Epstein-Barr virus antibody. The patient underwent surgical treatment and postoperative radiotherapy. Because of the relatively limited clinical data concerning LEC of the salivary glands compared to other more common histological types, the clinical course, optimal treatment and prognosis have not been extensively studied. The aim of this report was to summarize all the key points, following a comprehensive literature review.