Unexpected Leiomyosarcoma 4 Years after Laparoscopic Removal of the Uterus Using Morcellation.

Background. Laparoscopic hysterectomies are increasingly popular; a morcellation device is often used. Although there are some clear benefits, morcellation of tissue does have potential risks. Case Presentation. In this case report we present a 55-year-old woman with an abdominal tumour 4 years after a laparoscopic hysterectomy using a morcellation device. Postoperative histological analysis, compromised by morcellated tissue, showed benign myoma. Because of the benign tumour no follow-up was performed. The patient presented now with an abdominal tumour, and she was scheduled for surgical removal of the tumour. During abdominal surgery the tumour appeared malignant and biopsies were taken. Histological analysis showed leiomyosarcoma, and the patient was referred to a third care centre for further treatment. The patient recovered quickly after abdominal removal of the tumour; however, after 7 months the patient had complaints and a CT scan showed a large intra-abdominal tumour with possible lung metastasis. The patient received palliative chemotherapy and died after 10 months. Conclusion. This case shows that although unexpected after a hysterectomy, a leiomyosarcoma has to be considered in case of a suspect tumour in the lower abdomen.

[Struma ovarii during pregnancy]. / Struma ovarii tijdens de zwangerschap.

A 41-year-old pregnant woman, gravida 10, para 7, with gestational diabetes, was diagnosed with subclinical hyperthyroidism. At 16-weeks gestation a left-sided unilateral ovarian cyst was discovered. At 37 weeks of pregnancy an elective caesarean section was carried out, due to the transverse presentation caused by the cyst, followed by an adnexectomy. Histological examination showed a struma ovarii, a rare mature ovarian teratoma mainly consisting of thyroid tissue. There was no evidence of malignancy.

Comparison of cytogenetic abnormalities and deoxyribonucleic acid ploidy of benign, borderline malignant, and different grades of malignant soft tissue tumors.

BACKGROUND: Both DNA flow cytometry and cytogenetic analysis have been used to study soft tissue tumors. With flow cytometry, the DNA content of a relatively large number of cells can be examined, but cytogenetic analysis gives more detailed information about genomic changes. EXPERIMENTAL DESIGN: In order to compare the advantages and drawbacks of DNA flow cytometry versus chromosomal analysis, 92 primary or recurrent malignant, 16 borderline malignant, and 13 benign soft tissue tumors were karyotyped after short-term culture. DNA ploidy was determined by flow cytometry of suspensions prepared from frozen or paraffin-embedded samples. From 97 patients, 121 samples were analyzed. RESULTS: On the basis of the results, four groups were distinguished: DNA-euploid tumors with normal diploid karyotypes (group a) or with abnormal (group b) karyotypes, and DNA-aneuploid tumors with normal (group c) or abnormal (group d) karyotypes. The findings in group b show that structural chromosomal abnormalities or minor numerical aberrations of chromosomes are not detected by DNA flow cytometry. In group c, the finding of tumors with an aneuploid DNA-profile and cells with normal karyotypes is most likely due to overgrowth of fibroblasts during culture and subsequent karyotyping of normal cells. CONCLUSIONS: The findings show that a) DNA flow cytometry has a higher success rate than karyotyping, b) both techniques are complementary, such that DNA flow cytometry gives an "overview", whereas karyotyping gives more detailed information; comparison of both techniques in individual cases leads to a better understanding of the chromosomal events that occurred during oncogenesis, c) histologically low grade tumors are generally DNA-diploid, but may have an abnormal karyotype, and d) histologically high-grade sarcomas tend to have an aneuploid DNA-profile; they are generally more difficult to karyotype.

Significance of aneuploidy in melanoma of the extremity.

Tumor nuclear DNA content was determined by flow cytometry in routinely prepared paraffin blocks from 25 primary malignant melanomas of the extremities. Twelve of the tumors were aneuploid, and 13 were euploid. In this series the presence of aneuploidy appeared to have no prognostic value.

The use of DNA flow cytometry in the diagnosis of triploidy in human abortions.

The ploidy of placental tissue from 59 abortions was determined using DNA flow cytometry. The specimens were also screened histologically for features considered to be characteristic of a partial mole. Triploidy was found in six cases; three of these cases presented histologically as partial moles. From the four specimens histologically classified as partial moles, three appeared to be triploid. The most specific histologic features of triploidy were cystic change of the placental villi and trophoblastic hyperplasia with vacuolation of the syncytiotrophoblast; however, these changes were also found in some of the nontriploid abortions. Irregularity of villous contours was less specific.

Dedifferentiated parosteal osteosarcoma of the femur with aneuploidy and lung metastases.

In this report, the pathologic findings and the results of cellular DNA measurements of a tumor that on first presentation seemed to be a classical parosteal osteosarcoma are described. After resection 8 months later, part of the tumor appeared to display highly malignant features. DNA flow cytometry of this part of the tumor showed an aneuploid cell population. The aggressive nature of the tumor was confirmed by the development of lung metastases approximately 1 year after resection of the primary tumor.