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1.
Int J Gynecol Pathol ; 40(4): 349-354, 2021 Jul 01.
Article in English | MEDLINE | ID: mdl-32925442

ABSTRACT

A 37-yr-old woman presented to the gynecology clinic with abnormal uterine bleeding in the setting of known, large uterine fibroids. Preoperative endometrial biopsy identified atypical melanocytic cells concerning for uterine melanoma. Care was transferred to the gynecologic oncology service for hysterectomy. Intraoperative findings included macular, blue-black pigmentation of the peritoneum of the bladder and cervix, which was resected and sent for frozen section, confirming melanocytic neoplasia. The hysterectomy revealed multiple tan leiomyomas up to 12 cm, and a distinct 3 cm black, incompletely circumscribed mass in the endomyometrium composed of bland spindled cells with delicate melanin granules. The tumor cells were positive for Sox-10, BAP1, and Mart-1 (Melan-A) and negative for PRAME, PD-L1, and BRAFV600E by immunostains. Microscopic elements of similar melanocytes and melanophages were found in the cervix and bladder peritoneum. Molecular analysis of the uterine tumor identified a GNA11 mutation but no TERT or BAP1 mutation. The uterine melanocytic tumor has characteristic findings of a cellular blue nevus arising in association with dendritic melanocytosis of Mullerian and pelvic tissues, a rarely seen benign phenomenon that should be distinguished from malignant melanoma of the upper genital tract.


Subject(s)
GTP-Binding Protein alpha Subunits/genetics , Leiomyoma/diagnostic imaging , Melanoma/diagnostic imaging , Nevus, Blue/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Uterine Neoplasms/diagnostic imaging , Adult , Cervix Uteri/pathology , Diagnosis, Differential , Endometrium/diagnostic imaging , Endometrium/pathology , Female , Humans , Hysterectomy , Leiomyoma/pathology , Leiomyoma/surgery , Melanocytes/pathology , Melanoma/pathology , Mutation , Nevus, Blue/pathology , Nevus, Blue/surgery , Pelvis/diagnostic imaging , Pelvis/pathology , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Treatment Outcome , Urinary Bladder/pathology , Uterine Neoplasms/pathology
3.
Med Sci Educ ; 29(3): 691-696, 2019 Sep.
Article in English | MEDLINE | ID: mdl-34457533

ABSTRACT

OBJECTIVE: Determine and describe the impact of student/student mentoring (SSM) on the senior medical student mentor involved in a formal SSM program. METHOD: An anonymous online survey was administered to fourth-year medical students at the University of North Carolina with questions regarding participation in SSM programs (formal and informal) as well as the impact of these experiences. Responses from fourth-year mentors were compared to non-mentors' answers. Data was analyzed to assess the value of, understand motivations for not participating in, and to describe perceptions regarding SSM. RESULTS: One hundred seven of 178 students in the fourth-year class completed the survey, a 60% response rate. Forty-two students participated in the formal SSM program, 48 did not have mentors (non-mentors), and 17 were excluded as they participated in informal mentoring programs. There were no differences in gender, age, or matched specialty between mentors and non-mentors. Ninety-five percent of all students agreed that SSM was valuable in a way that was different from student/resident or student/faculty mentoring. Mentors were nearly twice as non-mentors likely to believe that being the mentee in an SSM relationship would be beneficial. In addition, mentors were 4 times more likely to believe that being a mentor in an SSM program was valuable and 83% stated they would mentor again. Lastly, nearly three quarters of mentors felt that this was a worthwhile experience. CONCLUSIONS: Students who served as mentors as part of an SSM program had positive experiences and found it a valuable addition to traditional faculty/student mentoring.

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