RESUMO
Clear cell tumours of the ovary are relatively uncommon. Most of them are clear cell carcinomas. Benign and borderline clear cell tumours are extremely rare and almost always fibromatous. We report a case of a 34-year-old woman. Ultrasound and computed tomography showed a right ovarian mass 8 cm in diameter. The patient underwent right salpingo-oophorectomy. Microscopic examination revealed glands and cysts different in size and shape within an abundant stromal component without evidence of stromal invasion. Many cysts and glands were lined by a single layer of flattened, cuboidal or hobnail cells with mild to moderate cytologic atypia and prominent nucleoli. Psammomatous calcifications were occasionally indentified. Features of endometriosis were also present adjacent to the tumour. Lesional cells were positive for Ker 7 and CA125. Staining for p53 was focally positive. Based on the above characteristic morphologic and immunohistochemical findings a diagnosis of borderline clear cell adenofibroma was made. The patient was free of recurrence four years after surgery.
Assuntos
Adenofibroma/complicações , Adenofibroma/diagnóstico , Endometriose/complicações , Doenças Ovarianas/complicações , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/diagnóstico , Adenofibroma/cirurgia , Adulto , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Humanos , Doenças Ovarianas/diagnóstico , Doenças Ovarianas/cirurgia , Neoplasias Ovarianas/cirurgiaRESUMO
Malignant mixed müllerian tumour of the fallopian tube is an extremely rare lesion and to date only approximately 50 cases have been reported. The tumour is seldom distinguished preoperatively from other more common lesions or ovarian cancer. We report a case of a 60-year-old woman who presented to our hospital with pelvic pain. There was no clinical evidence of ascites or adenopathy. Ultrasound and abdominal and pelvic computed tomography showed a left adnexal mass. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were carried out. Grossly the left side of the fallopian tube was dilated and the cut surface revealed a solid mass filling the entire lumen. Histological examinations showed a malignant mixed müllerian tumour. The tumor was an admixture of both carcinomatous and sarcomatous elements. The carcinomatous element was composed of well to moderately differentiated squamous cell carcinoma and the sarcomatous component was made up of anaplastic spindle shaped cells with hyperchromatic nuclei. An immunohistochemical study was performed. The patient was admitted to the anticancer hospital for further treatment. The prognosis of a primary malignancy of the fallopian tube is poor and depends more on staging than on histologic type and grade.
Assuntos
Neoplasias das Tubas Uterinas/patologia , Tumor Mulleriano Misto/patologia , Carcinoma/patologia , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Calcifying fibrous tumor is a very rare benign mesenchymal tumor which shows a predilection for soft tissue, mesentery and peritoneum. Up to date only 7 cases have been reported in the literature confined to the gastric wall. We report a rare case of a calcifying fibrous tumor of the stomach in a 60-year-old man who presented with dyspepsia, flatulence and feeling weight. A clinical and laboratory investigation was performed with normal results. Gastroscopy revealed a bulge in the gastric body measuring 1 cm with normal overlying mucosa, and mucosal biopsies showed chronic gastritis. Endoscopic ultrasound of the gastric bulge showed a 1 × 0.8 cm hypoechoic lesion involving the gastric wall. After the above finding a wedge resection of the stomach was performed. Microscopically the lesion consisted of well-circumscribed hypocellular hyalinized fibrosclerotic tissue with lympoplasmatic infiltrates, lymphoid aggregates and psammomatous calcifications. Lesional cells were positive for vimentin and factor XIII and negative for actin, desmin, S100p, CD117, CD34, CD31 and ALK-1. The lesion involved the muscularis propria with variable submucosal extension. Calcifying fibrous tumor has shown an excellent prognosis with recurrences being rare and showing the same morphology as the primary lesion.