Recurrence in Uterine Tumors with Ovarian Sex-Cord Tumor Resemblance: A Case Report and Systematic Review.

OBJECTIVE: The aim of this study was to evaluate the prognostic factors of recurrence in uterine tumors resembling ovarian sex-cord tumors (UTROSCT) and to determine clinical-pathological characteristics, treatment options and outcome. MATERIAL AND METHOD: An electronic literature search was conducted from 1976 to 2018. After the comprehensive evaluation and conjunction with our case, the study included 79 cases. RESULTS: The median age at initial diagnosis was 49 years (range; 16-86 years). The age was under 40 years in 21 (26.6%) patients. Whereas 68 patients underwent at least hysterectomy, 9 patients had organ sparing surgery. There was necrosis in 4 (5.1%) patients, atypia in 16 (20.3%) patients, and infiltrative tumor border in 34 (43%) patients. At least one mitosis per 10 high power fields was determined in 36 (45.5%) patients. The tumor involved at least part of the myometrium in 54 (68.3%) patients. Median follow-up time was 30 months (range; 3-296 months). Recurrence was determined in 5 (6.3%) patients. The disease free survival (DFS) was significantly related only to surgery type. None of the pathologic features were associated with DFS. The 5-year DFS was 86% and 96% in patients who underwent organ sparing surgery or not, respectively (p=0.038). CONCLUSION: The accurate pathologic diagnosis of UTROSCT has great value in shaping surgical management and management during the follow-up period. Organ sparing surgery was related to poor DFS. Although recurrence is rare, it should be kept in mind for patients with UTROSCT.

Uterine adenosarcomas: A dual-institution experience.

There has been limited literature about treatment and follow-up strategies of uterine adenosarcomas because of their rare nature. For this study we retrospectively investigated the medical database of the two major womens' health hospitals in Turkey. A total of 15 patients were identified from the hospital's database. Median follow-up was 86.43 months for all patients. Seven out of 15 patients had recurrences during their follow-up. Among these 7 patients, 4 of them had stage IA disease. Median Disease Free Survival (DFS) and Overall Survival (OS) were calculated as 41.47 and 57.21 months, respectively. According to our study, polypoid tumours confined to the uterus with superficial myometrial invasion can be treated without comprehensive surgical staging. We believe that, publishing all the data in an organised manner even though they are small in size, gives us an opportunity to design meta-analysis for the development of more appropriate treatment strategies.

Leiomyomatosis peritonealis disseminata presenting with intravascular extension and coexisting with endometriosis: a case report.

BACKGROUND: Leiomyomatosis peritonealis disseminata is a benign disease of women of reproductive age. Female gonadal steroids play the major role in pathogenesis, but reported cases in postmenopausal women suggests other factors. A few cases in the literature with coexisting endometriosis confirm the hypothesis that both originate in submesothelial multipotential mesenchymal cells. The clinical behavior can be life threatening due to extension through the pelvic veins. CASE: A 46-year-old woman with endometriosis diagnosed at laparotomy 3 years earlier presented with a huge pelvic mass. Postoperative histologic examination of the peritoneal nodules confirmed the diagnosis. Magnetic resonance angiography performed postoperatively revealed intravenous leiomyomatosis. Surgical castration was satisfactory after 2 years of follow-up. CONCLUSION: Although malignant transformation of the disease is known, intravascular extension of the tumor increases the risk of mortality. Close follow-up by clinical examination and radiologic evaluations is required.

Laparoscopic resection of urinary bladder paraganglioma: a case report.

The case report of a 55-year-old woman with an incidentally diagnosed urinary paraganglioma of the bladder is presented. The patient had no irritative voiding symptoms, hematuria or hypertension. She was diagnosed to have an immobile solid mass on the left side neighboring the lower segment of the uterus. Transvaginal ultrasonography revealed a well-limited ovoid mass with solid and cystic areas adjacent to the urinary bladder and the uterus. Tumor markers were within normal range. Laparoscopy was performed for the treatment of the mass and complete excision of the cyst was accomplished. Frozen section was performed revealing a benign cystic structure but the identification of the origin was left to definitive histopathological examination which showed paraganglioma of the bladder. Immunohistochemically, the tumor cells were strongly positive for chromogranin A and synaptophysin and there was focal positiveness for neuron specific enolase although vimentin and cytokeratin were negative.

Splenosis mimicking pelvic mass.

BACKGROUND: Splenosis is a rare complication after splenectomy and generally does not cause clinical symptoms. CASE: A 34-year-old woman who had splenectomy in childhood after trauma presented with a pelvic mass. Ultrasound examination demonstrated a right adnexal mass and a myomatous uterus. Exploratory laparotomy revealed multiple splenic implants along the small and large bowel and in the ileocecal region, including the appendix. Total hysterectomy, right salphengectomy, and appendectomy were performed. CONCLUSION: After splenectomy, splenic implants may mimic benign or malignant tumors of the pelvis and may require surgical exploration.