RESUMO
Background: Solid pseudopapillary neoplasms (SPNs) are uncommon tumors of low malignancy with a generally favorable prognosis, mostly originating from the pancreas. To date, 12 cases of SPNs with a primary ovarian origin (SPN-Os) have been reported globally, and their detailed characteristics have not been fully elucidated. Case description: We reported the 13th SPN-O case, which occurred in a 52-year-old woman with an 18.5 cm left ovarian mass. Four imaging methods, including ultrasound, computed tomography, magnetic resonance imaging and positron emission tomography, were utilized before surgery. An elevated level of serum cancer antigen 125 was detected and a total hysterectomy plus bilateral salpingo-oophorectomy was performed. Microscopic examination revealed a typical solid pseudopapillary structure. The tumor cells were stained focally for pan-cytokeratin, synaptophysin, CD99 and CD10, while ß-catenin, vimentin and CD56 were diffusely expressed. The Ki-67 proliferation index was 3%, and immunohistochemical (IHC) staining for chromogranin-A, inhibin-a, and E-cadherin was negative. No evidence of recurrence or metastasis was observed by clinical and imaging data during a 5-month postoperative follow-up. Conclusion: This is a report of an unusual case of a primary ovarian SPN with an up-to-date review of SPN-Os. A minimum combination of imaging methods and IHC stains was proposed for SPN-Os, which may prove beneficial in clinical practice.
RESUMO
To gain more insights into the epidemiology of hantaviruses in the coastal region of Zhejiang Province, China, the morbidity and mortality of hemorrhagic fever with renal syndrome (HFRS) were analyzed in two coastal areas: Cixi (hilly terrain) and Wenzhou (mountainous terrain). More HFRS cases have been reported in Cixi than in Wenzhou. Annual incidence rate of HFRS in Cixi had been on the level of approximately 1.5/100,000 from 1968 (when the first HFRS case was reported) to 2007, with the highest incidence rate of 8.54/100,000 in 1999. The annual incidence rate in Wenzhou has been relatively low, less than 0.5/100,000 since the first HFRS case was reported in 1981. A total of 461 rodents and 199 shrews were captured in these two areas. Hantavirus antibodies were detected in 16 of 241 (6.64%) Rattus norvegicus and 13 of 122 (10.66%) R. flavipectus. Interestingly, hantavirus antigens were identified in 6 of 196 (3.06%) Suncus murinus. Genetic analysis showed that partial M and S segment sequences recovered from rats in the two regions belong to Seoul virus (SEOV) and can be assigned into two genetic lineages. SEOV variants that belong to these two lineages of viruses are distributed widely in China and have been found outside China. As most trapped rodents were rats and SEOV was the only hantavirus detected, these results suggested that SEOV plays an important role in human hantavirus infections. They also reinforce the need for vigilance in preventing HFRS caused by hantaviruses in the coastal region.