Anaplastic Carcinoma Arising From Ovarian Mucinous Adenocarcinoma With Massive Cardiopulmonary Metastasis: An Autopsy Case Report.

BACKGROUND: The presence of anaplastic and sarcomatoid components in ovarian mucinous carcinoma is extremely rare. CASE: A 64-year-old woman underwent radical surgery for right ovarian cancer. Pathological examination showed mucinous adenocarcinoma with a focal mural nodule of anaplastic and sarcomatoid carcinoma (FIGO stage IIB). She underwent adjuvant chemotherapy but developed severe respiratory failure and died after 9 months. Autopsy showed that the bilateral pulmonary parenchyma was filled with a multinodular hemorrhagic mass, and the cardiac wall had a massive invasive lesion. Histopathological examination of the lung and myocardium revealed diffuse invasion of the anaplastic carcinoma component with infiltrating osteoclastic giant cells. CONCLUSION: This case is very rare, and the clinical management of anaplastic carcinoma arising in mucinous neoplasms remains challenging.

Well-formed cerebellum and brainstem-like structures in a mature ovarian teratoma: Neuropathological observations.

In the surgical case of a mature cystic teratoma of the ovary that arose in a 16-year-old girl, a large amount of well-differentiated and highly organized cerebellar tissue was found. Three layers of the cerebellar cortex were well formed, and synaptophysin-positive "glomeruli" were found in the granule cell layer. Some Purkinje cells exhibited focal expansion and a dysmorphic appearance of the dendrites. Adjacent to the cerebellar tissue, a large space lined by the ependymal layer and a club-shaped CNS tissue mass resembling the brainstem were found, and structures reminiscent of the midbrain tectum and pontine nuclei were distinguished within this mass. The CNS tissue was surrounded by the leptomeninges and a skull-like, bony shell. Structures consistent with the supra-tentorial CNS tissue were not found. This case represents an example of infra-tentorial CNS tissue that was well-differentiated and organized to an exceptionally high degree in an ovarian mature teratoma. Various degenerative changes have been documented in CNS tissue in ovarian teratomas, but the dendritic abnormalities of Purkinje cells seen in the present case are novel findings.

An extremely rare case of tubo-ovarian abscesses involving corynebacterium striatum as causative agent.

BACKGROUND: We present an extremely rare case of tubo-ovarian abscesses involving Corynebacterium striatum (C. striatum) as causative agent in a 53-year-old woman. CASE PRESENTATION: The patient presented with stomach pain, chills, and nausea. Her medical history included poorly controlled psoriasis vulgaris and diabetes. Laboratory and imaging findings led to diagnosis of septic shock due to tubo-ovarian abscesses. She was treated with antibiotic therapy and surgery to remove the left adnexa. Various cultures detected Prevotella spp. and C. striatum. We concluded that C. striatum from skin contaminated by psoriasis vulgaris had caused the tubo-ovarian abscesses by way of ascending infection. CONCLUSIONS: This may be the first known case of tubo-ovarian abscesses due to C. striatum. In patients whose skin has been weakened by psoriasis vulgaris or other infections, Corynebacterium should be considered as causative microorganisms, and antibiotic therapy including vancomycin should be administered.

Changes in Gestational Weight Gain and Birth Weight in Women who Delivered at Hyogo Prefectural Kaibara Hospital in Tamba, Japan during 27 Years.

Two independent guidelines on appropriate weight gain for Japanese pregnant women have been established in 1997 and 2006. This study aimed to evaluate changes in the amount of gestational weight gain in pregnant women, the birth weight of their neonates, and the incidence of complications of pregnancy and neonatal outcome in women who delivered at Hyogo Prefectural Kaibara Hospital. Between 1988 and 2014, 6367 women delivered live singleton neonates at full term. The study period was divided into period I (1988-1996), period II (1997-2005), and period III (2006-2014). Changes in weight gain and birth weight were assessed. Complications of pregnancy and neonatal outcome were compared among the periods. Weight gain had been decreased in periods I and II, and weight gain was increased in period III. There was no difference in birth weights between the periods. The incidences of pregnancy-induced hypertension in periods II and III were higher than that in period I (p<0.01). The incidences of vacuum extraction in periods II and III were less than that in period I (p<0.01). The incidence of macrosomia in periods II was less than that in period I (p<0.01). There were no significant differences in the incidence of cesarean section, light-for-date, heavy-for-date, or low birth weight among the three periods. The establishment of guidelines for weight gain and maternity education based on the two guidelines significantly affected complications of pregnancy and neonatal outcome. Prevention of pregnancy-induced hypertension might be difficult when only reducing weight gain in pregnant women.