RESUMEN
Biliary adenofibroma is a rare tumor with a bile duct origin characterized by a complex tubulocystic non-mucin secreting biliary epithelium with abundant fibrous stroma. The MRI features of biliary adenofibroma are not well established. The authors encountered two patients with biliary adenofibroma and reviewed the literature focusing on the MRI findings. A well-circumscribed multicystic tumor with septal enhancement and no intrahepatic bile duct communication may be the characteristic MRI findings of biliary adenofibroma.
Asunto(s)
Humanos , Adenofibroma , Conductos Biliares , Conductos Biliares Intrahepáticos , Epitelio , Imagen por Resonancia MagnéticaRESUMEN
Ovarian clear cell adenocarcinomas (CCACs) are frequently associated with endometriosis and, less often with clear cell adenofibromas (CCAFs). We encountered a case of ovarian CCAC arising from benign and borderline adenofibromas of the clear cell and endometrioid types with endometriosis in a 53-year-old woman. Regions of the adenofibromas showed transformation to CCAC and regions of the endometriosis showed atypical endometriotic cysts. This case demonstrates that CCAC can arise from CCAF or endometriosis.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Adenocarcinoma de Células Claras , Adenofibroma , Cistoadenofibroma , Endometriosis , OvarioRESUMEN
Introduction : Le cancer du sein fait la gravité des tumeurs mammaires. C'est le cancer le plus fréquent chez la femme dans le monde et qui représente 16 % de l'ensemble des cancers féminins. En Côte d'Ivoire, il occupe le 1er rang chez la femme, suivi du cancer du col de l'utérus. Il représente aujourd'hui un problème majeur de santé publique aussi bien dans nos pays en développement que dans les pays développés. Son diagnostic requiert plusieurs examens dont l'analyse cytologique d'orientation. L'objectif de ce travail était d'évaluer l'apport de la cytoponction mammaire dans la prise en charge de ces tumeurs. Matériel et Méthodes : il s'agit d'une étude transversale rétrospective à visée descriptive et analytique sur une période de 15 ans à la Polyclinique Internationale Sainte Anne Marie(PISAM). Les données ont été recueillies à l'aide d'une fiche d'enquête renfermant les paramètres sociodémographiques et les résultats des différentes analyses. Ces données ont été analysées à l'aide du logiciel Epi-data et le test Khi 2. Résultats : 76 dossiers ont été colligés. L'âge moyen des patients était de 35,96 ans avec des extrêmes de 13 et 71 ans. Le sexe féminin prédominait, 97,4 %. Les nulligestes représentaient 43,4 % des patientes et les nullipares 54 %. Les motifs d'analyse étaient dominés par le nodule mammaire dans 63,2 %. 10,3 % des masses étaient fixées et douloureuses dans 58,5 %. Au plan cytologique, 82,9 % des tumeurs étaient bénignes dominées par l'adénofibrome, 48,4 % et 17,1 % malignes avec 78,6 % d'adénocarcinome. La concordance entre l'examen cytologique et anatomopathologique a été de 95 %. Conclusion : la cytoponction à l'aiguille fine permet une bonne orientation diagnostique des tumeurs mammaires. Cependant, pour une meilleure prise en charge thérapeutique faisant recours au traitement hormonal, elle est de plus en plus remplacée par la microbiopsie qui permet la détection de récepteurs hormonaux spécifiques par la technique de l'immunohistochimie
Asunto(s)
Adenocarcinoma , Adenofibroma , Biopsia con Aguja Fina , Côte d'IvoireRESUMEN
<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of recurrent Müllerian adenofibroma (MAF) of the uterus.</p><p><b>METHODS</b>Clinicopathologic information of 7 cases of recurrent MAF of uterus was retrieved from January 1992 to April 2006 and compared with 12 cases of MAF without recurrence and 14 cases of low-grade Müllerian adenosarcoma (MAS). EnVision immunohistochemistry of estrogen receptor (ER), progesterone receptor (PR), smooth muscle actin (SMA), CD10, Ki-67 and p53 were performed in all cases.</p><p><b>RESULTS</b>All cases of recurrent MAF of the uterus were polypoid, lobulated, and broad based mass arising from the corpus or cervix. Microscopically, the tumor consisted of benign epithelial and mesenchymal components with low mitotic activity ( ≤ 1/10 HPF). The clinical and pathologic features of 3 recurrent tumors were similar to their primary tumors, while 4 cases of recurrent tumor presented with focally higher cellularity and mitotic activity, meeting the diagnostic criteria of adenosarcoma. The stromal expression patterns of ER, PR, SMA and p53 in recurrent MAF were similar to those of clinically benign MAF and low-grade MAS. Negative or focally positive stromal cell expression of CD10 was seen infrequently in recurrent MAF (1/7) and clinically benign MAF (1/12). In contrast, a moderate to strong CD10 staining was frequently seen in MAS (9/14, P < 0.05). The difference of Ki-67-labeling index between MAF and MAS did not reach a statistical significance (P > 0.05). Ki-67-labeling index increased in areas of periglandular stromal cuffing as compared with interglandular areas in all MAS cases, but it was not observed in either recurrent MAF or clinically benign MAF cases.</p><p><b>CONCLUSIONS</b>Recurrent MAF may be associated with aggressive behavior. It is difficult to distinguish MAF from low-grade MAS. CD10 and Ki-67 staining pattern in stromal cells may be helpful for the differential diagnosis.</p>
Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Adenofibroma , Metabolismo , Patología , Cirugía General , Adenosarcoma , Metabolismo , Patología , Biomarcadores de Tumor , Metabolismo , Diagnóstico Diferencial , Histerectomía , Métodos , Antígeno Ki-67 , Metabolismo , Clasificación del Tumor , Recurrencia Local de Neoplasia , Neprilisina , Metabolismo , Tasa de Supervivencia , Neoplasias Uterinas , Metabolismo , Patología , Cirugía GeneralRESUMEN
Adenofibroma is an extremely rare benign mullerian mixed tumor composed of epithelium and mesenchymal cells. Most uterine adenofibromas occur in the endometrium, but they rarely protrude into the vagina. To date, only a few such cases with the imaging findings have been reported. Therefore, we report here on the sonographic and magnetic resonance (MR) imaging findings of a case of endometrial adenofibroma protruding into the vaginal cavity in a 28-year-old woman. The uterine adenofibroma appeared as a large intracavitary echogenic mass containing multiple small internal cysts, and it was distending the vaginal cavity on transrectal sonography. T2- weighted MR images showed a large intracavitary mass with heterogeneous high signal intensity protruding into the vaginal cavity. On gadolinium-enhanced T1-weighted MR images, heterogeneous septa-like enhancement was noted in the mass. Although uterine adenofibroma is extremely rare, adenofibroma can be suggested as a possible diagnosis when an intracavitary uterine mass, with multiple internal small cystic components and enhancing septa-like structures, is protruding into the vaginal cavity on imaging.
Asunto(s)
Adulto , Femenino , Humanos , Adenofibroma , Endometrio , Epitelio , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Tumor Mulleriano Mixto , Útero , VaginaRESUMEN
Las hamartomas de la mama son denominadas adenofibrolipomas o fibroadenolipomas, y consisten en lesiones benignas sin potencial cancerígeno, que presentan consistencia blanda y son móviles. Se describe su diagnóstico diferencial a través de la ecografía mamaria
Asunto(s)
Humanos , Femenino , Adenofibroma/diagnóstico , Adenofibroma , Mama/lesiones , Ultrasonografía MamariaRESUMEN
Toremifene is an anti-estrogen which has been shown to be effective in the treatment of breast cancer, and is thought to be a less uterotrophic agent than tamoxifen. The risk assessment concerning endometrial cancer has been inconclusive because of its rare use up to the mid-1990s. We report a case of an adenosarcoma, which is a very rare type of uterine malignancy, after toremifene treatment for 5 years in a breast cancer patient. After 1 year of toremifene use, the patient had a benign Mullerian adenofibroma. After an additional 4 years of toremifene treatment, the endometrial polypoid lesion was transformed into a Mullerian adenosarcoma. Although toremifene is a promising anti-estrogenic agent in the treatment of breast cancer patients, clinicians should not neglect the possibility of a uterine malignancy.
Asunto(s)
Femenino , Humanos , Adenofibroma , Adenosarcoma , Mama , Neoplasias de la Mama , Neoplasias Endometriales , Medición de Riesgo , Tamoxifeno , ToremifenoRESUMEN
Borderline clear cell adenofibroma of the ovary is rather rare since most of clear cell tumors are carcinomas. We report a case of ovarian borderline clear cell adenofibroma in a 52-year-old postmenopausal woman. The tumor had the characteristic histologic features of borderline clear cell adenofibroma except for central extensive hemorrhagic necrosis. The prognosis of borderline clear cell adenofibroma is excellent. Because the invasiveness cannot be assessed in the necrotic areas, our patient needed long-term follow-up
Asunto(s)
Humanos , Femenino , Adenofibroma , Adenocarcinoma de Células Claras , Necrosis , Hemorragia , PosmenopausiaRESUMEN
El fibroadenoma (FA) es un tumor frecuente de la mama que se presenta usualmente en la segunda y tercera década de la vida. Los carcinomas de la mama raramente se desarrollan dentro de un FA, existiendo alrededor de 200 casos descritos en la literatura. Nosotros reportamos la presencia de carcinoma ductal in s/fu(CDIS) al interior de un FA en tres pacientes mujeres de 31, 45 y 47 años. La presencia de microcalcificaciones en dos pacientes y la sospecha de un papiloma intraductal en la tercera, determinaron la necesidad de mastectomía parcial y el consiguiente hallazgo de CDIS al interior de un FA. En dos casos hubo presencia de CDIS extenso en el parénquima mamario adyacente y fueron sometidas finalmente a una mastectomía total. Recomendamos un seguimiento estricto en mujeres con FA a partir de la cuarta década de la vida. En pacientes con lesiones mamarias pro I iterativas o con CDIS que presentan además un FA, se recomienda vigilancia del FA o resección de éste al momento de extirpar el CDIS.
The fibroadenoma (FA) is a common tumor of the breast that usually occurs in the second or third decade of Ufe. The carcinomas of the breast rarely arising within a FA, with around 200 cases reported in the literature. We report the presence of DCIS within a FA on three female patients of 31, 45 and 47 years old. Due to the presence of microcalcifications in two patients and the suspicion of an intraductal papilloma in the third, they underwent a partial mastectomy with the consequent finding of DCIS inside a FA. In two cases there were extensive DCIS in the adjacent breast parenchyma and finally they underwent a total mastectomy. We recommend a strict follow up in women with FA from the fourth decade of life. In patients with proliferatives breast lesions or DCIS that simultaneously presenting a FA, we recommend surveillance of FA or remove it at the same time of the resection of DCIS.
Asunto(s)
Humanos , Adulto , Femenino , Persona de Mediana Edad , Adenofibroma/patología , Carcinoma Intraductal no Infiltrante/patología , Carcinoma in Situ/patología , Neoplasias de la Mama/patología , Mastectomía Radical , Neoplasias de la Mama/cirugíaRESUMEN
El adenofibroma metanéfrico es un tumor renal bifásico estromal-epitelial infrecuente, que ocasionalmente se asocia a carcinoma papilar de células renales. Se describe el caso de una niña con un cuadro clínico de cuatro años de evolución de hematuria intermitente, a quien se le diagnosticó, en una biopsia renal izquierda por trucut, un tumor de Wilms con componente estromal y epitelial, sin evidencia de anaplasia. Posteriormente, en el producto de la nefrectomía izquierda, realizada en el Instituto Nacional de Cancerología, se le diagnosticóadenofibroma metanéfrico asociado a un carcinoma papilar de células renales.
Asunto(s)
Adenofibroma , Carcinoma , Carcinoma Papilar , Neoplasias RenalesRESUMEN
OBJECTIVE: To evaluate the feasibility and effectiveness of laparoscopic adnexal surgery in posthysterectomy patients and review clinical characteristics including comparison of the adhesion score of left with that of right adnexal mass. METHODS: From February 2004 to January 2007, we reviewed the medical records of 23 post-hysterectomy patients who received laparoscopic adnexal surgery including age, parity, type of hysterectomy, operative indications, histopathological diagnosis, operating time, size of the adnexal mass, adhesion score, change in the hemoglobin level, hospital stay, and any complications. RESULTS: The median age of patients was 48 years (range 35-69 years), and median parity was 2 (0-3). The median operating time was 100 minutes (range 35-180 minutes), and the median size of the adnexal mass was 7.1 cm (range 4-12 cm). The median change in hemoglobin level was 1.8 g/dL (range 0.6-4.1 g/dL). The median hospital stay was 4 days (range 3-19 days). The adhesion score was significantly higher in the left adnexal mass than in the right adnexal mass. Histopathological diagnosis included 6 cases of mucinous cystadenoma, 6 cases of functional cyst, 4 cases of hydrosalpinx, 3 cases of serous cystadenoma, 1 case of fibrothecoma, 1 case of mucinous adenofibroma, 1 case of endometrioma, and 1 case of tubo-ovarian abscess. There were no intraoperative complications or conversion to laparotomy. One case of postoperative ileus was noted. CONCLUSION: The skilled laparoscopic surgeon is capable of achieving successful result by performing laparoscopic surgery primarily to patients with adnexal mass for posthysterectomy patients who are expected to suffer severe adhesion. In posthysterectomy patients, left adnexal mass has more extensive adhesion than right adnexal mass, and these finding was represented as a high adhesion score of left adnexal mass.
Asunto(s)
Femenino , Humanos , Absceso , Adenofibroma , Cistoadenoma Mucinoso , Cistadenoma Seroso , Diagnóstico , Endometriosis , Histerectomía , Ileus , Complicaciones Intraoperatorias , Laparoscopía , Laparotomía , Tiempo de Internación , Registros Médicos , Mucinas , ParidadRESUMEN
Adenofibromas endometrióides são neoplasias raras, caracterizadas por proliferação de glândulas do tipo endometrial, dentro de denso estroma fibroso. Nós relatamos o caso de uma paciente, que apresentou massa anexial direita, cujo diagnóstico foi de adenofibroma endometrióide.
Endometrioid adenofibromas are rares neoplasm characterized by proliferation of endometrial glands within a dense and thick stroma. We report a case of a patient, that has presented a right adnexial mass, whose diagnosis was endometrioid adenofibroma.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Adenofibroma , EndometriosisRESUMEN
Adenofibromas of the uterine cervix, which are classified as benign tumors of mixed epithelium and mesenchymal cells, are extremely rare. Most common symptom is usually abnormal genital bleeding. It is very difficult to diagnose preoperatively. Recommended method of treatment is total hysterectomy, because it usually recurs. We experienced a case of adenofibroma of the uterine cervix with increased CA125, so report it with a review of the literature.
Asunto(s)
Femenino , Adenofibroma , Cuello del Útero , Epitelio , Hemorragia , HisterectomíaRESUMEN
Paciente de 27 años, nuligesta, consultó por sangrado genital irregular de aproximadamente 4 meses de evolución. El examen ginecológico reveló una masa blanda que salió a través del orificio cervical externo. En la ecografía pélvica se evidenció útero aumentado de tamaño, con cavidad uterinaocupada por masas amorfas con pequeñas áreas anecoicas-ecolúcidas en su interior. El informe de anatomía patológica indicó tumor mülleriano mixto, polipoide, benigno tipo adenofibroma de origenendometrial. A los 3 meses, la paciente presentó reaparición de la sintomatología por lo cual se decide prepararla para realizarle histerectomía. Durante este período ingresa con diagnóstico de abdomen agudo quirúrgico, obstrucción intestinal y deshidratación moderada, realizándose histerectomía total ampliada y ooforosalpingectomía bilateral más omentectomía. El informe de anatomía patológica reportó adenosarcoma mülleriano de origen endometrial
Asunto(s)
Femenino , Adulto , Humanos , Adenofibroma , Adenosarcoma , Neoplasias Endometriales , Tumor Mulleriano Mixto , Útero , Venezuela , GinecologíaRESUMEN
OBJECTIVE: We wanted to assess the MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma, and we wanted to find clues for making the differential diagnosis between them. MATERIALS AND METHODS: The MR images of 12 pathologically proven cystadenofibromas and two cystadenocarcinofibromas were reviewed, with a focus on the internal architecture, signal intensity and enhancement. RESULTS: All the tumors appeared as multilocular cysts, except for a single unilocular cystic mass and a single solid mass. The previously reported characteristic MR findings of cystadenofibroma (a multilocular cystic mass with a T2-dark-signal-intensity solid component containing small cystic locules) were found in only 43% of the tumors (6/14). Diffuse or partial thickening of the cyst wall with T2-dark signal intensity without a definite solid component was as common as the previous reported findings (6/14). Two cystadenocarcinofibromas showed more prominent solid portions with higher T2-signal intensities and stronger enhancement than did the cystadenofibromas. CONCLUSION: Diffuse or partial thickening of the cyst wall with dark-signal-intensity in multilocular cystic masses may suggest ovarian cystadenofibroma, and this type of appearance may be as common as the previously reported characteristic appearance. A prominent solid component with a higher T2-signal intensity and strong enhancement are the typical findings of cystadenocarcinofibroma.
Asunto(s)
Persona de Mediana Edad , Humanos , Femenino , Adulto , Sensibilidad y Especificidad , Reproducibilidad de los Resultados , Neoplasias Ováricas/diagnóstico , Imagen por Resonancia Magnética/métodos , Leiomioma/diagnóstico , Aumento de la Imagen/métodos , Diagnóstico Diferencial , Cistoadenoma/diagnóstico , Adenofibroma/diagnósticoRESUMEN
Uterine adenofibroma is an extremely rare benign biphasic neoplasm that is classified into mixed m?llerian tumor. This mass lesion appears to be clinical and histologically benign but it should be differentiated from other malignant neoplasms of uterus. We have experienced a case of uterine adenofibroma in a 53-year-old woman and report this case with a brief review of literature.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Adenofibroma , ÚteroRESUMEN
No Abstract Available.
Asunto(s)
Humanos , Femenino , Neoplasias Ováricas/diagnóstico , Imagen por Resonancia Magnética/métodos , Leiomioma/diagnóstico , Aumento de la Imagen/métodos , Diagnóstico Diferencial , Cistoadenoma/diagnóstico , Adenofibroma/diagnósticoRESUMEN
The main objective was to determine the clinical and radiological features of metanephric neoplasms. The tumors were diagnosed on histopathological examination. The clinical data and imaging features were retrospectively analyzed. Between 1998 and 2003, 3 patients underwent radical nephrectomy for renal masses turning out as metanephric neoplasms on histopathology. Two of these tumors were metanephric adenoma (MA) and one was metanephric adenofibroma (MAF). Clinical and radiological features were reviewed. All patients were adult females who presented with flank pain. Tumor was detected on screening ultrasound as a hyperechoic lesion. In all cases CT showed a hyper-attenuating exophytic lesion with cystic areas that enhanced with IV contrast. Based on combination of clinical and imaging features it may be possible to prospectively identify metanephric neoplasms and thus avoid unnecessary radical nephrectomy in favor of conservative surgery.
Asunto(s)
Adenofibroma/diagnóstico , Adenoma/diagnóstico , Adulto , Medios de Contraste , Diagnóstico por Imagen , Femenino , Dolor en el Flanco/diagnóstico , Estudios de Seguimiento , Humanos , Neoplasias Renales/diagnóstico , Laparoscopía , Nefrectomía , Intensificación de Imagen Radiográfica , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
Ovarian leiomyoma is a rare mesenchymal tumor, accounting for only 1% of all benign ovarian neoplasm. Most patients are asymptomatic and the tumors are usually found incidentally during operation or at autopsies. Ovarian adenofibroma is a rare benign tumor which originates from the germinal lining and the stroma of the ovary. This tumor may be solid, semisolid or cystic, depending on the relative amount of the epithelial and stromal component. We have experienced a case of ovarian leiomyoma accompanied with ovarian serous adenofibroma in a 42-year-old woman and report this case with a brief review of literature.
Asunto(s)
Adulto , Femenino , Humanos , Adenofibroma , Autopsia , Leiomioma , Neoplasias Ováricas , OvarioRESUMEN
"Un module ou une"" boule "" de sein suscite des inquietudes chez la femme; a savoir:-quelle est la nature de ce nodule-quelle attitude adopter vis-a-vis de ce nodule?Pour tenter de repondre a ces inquietudes et cerner les problemes qui decoulent; nous avons entrepris une etude prospective de 104 dossiers d'Adenofibrome de sein collige dans le service de gynecologie et d'obstetrique du CHU de Treichville.Nos investigations nous ont permis de rassembler les faits suivants :-Les donnees epidemiologique; clinique et paraclinique de l'affection retrouvee corroborent avec la revue de la litterature. La plus jeune patiente de notre serie a 13 ans.-L'apparition de l'adenofibrome a eu lieu avant Ia demarche dans trois cas.-Les difficultes de diagnostic avec les autres etats d'hypertrophie mammaire notamment les kystes et les tumeurs phyllodes sont soulignes.-L'anatomie-pathologie a permis de preciser le diagnostic dans 101 cas.-101 patientes ont beneficie de traitement chirurgical qui a consiste en une enucleation et exerese complete de la tumeur. Nous n'avons pas note de recidive."