Primary mucinous carcinoma of the vulva with signet ring cells deriving from the cloaca.

Vulvar neoplasias are rarely encountered lesions at female genital tract, regardless if they are primary or metastatic. Presence of signet ring cells in a tumour at female genito-urinary tract is highly suggestive of a metastatic lesion particularly from a gastrointestinal tumour. Here the authors present a case of vulvar carcinoma with signet ring cells with an undetermined primary site possibly originating from embryonic cloaca.

Idiopathic scrotal calcinosis: the incorrect terminology of scrotal calcinosis.

AIM: Scrotal calcinosis is a rare and benign condition characterized by multiple calcific deposits occurring in scrotum and formed as nodules and lumps within scrotal skin with any systemic metabolic disorder. The so-called idiopathic scrotal calcinosis does not appear to be idiopathic, but rather a process of dystrophic calcification of epidermal cysts. Histological examination shows calcium deposites with in the dermis that may be surrounded with histiocytes and an inflammatory giant cell reaction. The aim of this paper was to detect dystrophic calcification of epidermal cysts and to take attention to the incorrect terminology of "idiopathic calsification". METHODS: This is a two-centered study of scrotal calcinosis with 17 cases, on which clinical and histopathological examinations were conducted. RESULTS: The patients we examined all had scrotal epidermoid cysts in varying stages of inflammation coexisted with scrotal calcinosis. Some cyts (52.9%) had intact epithelial walls, others (35.2%) showed rupture of their epithelial walls associated with the presence of keratin fibers and calcium granules in the surrounding dermis and all had naked calcium deposits lying in the dermis. CONCLUSION: The spectrum of the changes that we experienced in the histology, coupled with the normal values in the biochemical profile, shore up the theory of dystrophic calcification of epithelial cysts. During the time first these cysts become inflamed than rupture in the and calcium depocytes replase with the cysts.

Single coronary artery incidence in 215,140 patients undergoing coronary angiography.

BACKGROUND: The aim of our study is to determine the incidence of single coronary artery (SCA). SCA is a rarely seen coronary anomaly in which the right coronary artery and the left main coronary artery arise from single aortic sinus. Although SCA has a benign course in most cases and its clinical significance is unknown, in some autopsy studies it was shown to be related to sudden cardiac death. MATERIALS AND METHODS: SCA patients detected among 215,140 coronary angiographies (CAG) performed between 1998 and 2013 in SANKO Hospital were included in our study. The classification of CAG was made according to the two different classifications defined by Smith and Lipton and colleagues. RESULTS: A total number of 215,140 patients who underwent routine CAG were included in the study, and SCA was detected in 67 (0.031%) patients. There were 6 (9%) type R-I, 23 (34%) type R-II, 10 (15%) type R-III, 16 (24%) type L-I and 12 (18%) type L-II patients according to the angiographic classification. CONCLUSIONS: SCA is rarely seen during routine cardiac catheterisation and its incidence is 0.014-0.066% in angiographic series. In our study, the incidence was shown to be similar to the previous studies.

The development of papillary serous carcinoma of the peritoneum subsequent to endometrial carcinoma: a case report and review of the literature.

Metachronous papillary serous carcinoma of the peritoneum (PSCP) after endometrial carcinoma (EC) is an extremely rare condition. Only three patients have been reported in the English literature. We present the fourth patient who had a more aggressive and fatal clinical course. A 79-year-old multiparous woman complained of progressive abdominal pain and distension after 5 years, subsequent to total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometrioid type EC. Serum CA-125 level being followed routinely rose above 500 IU/mL. Abdominal and pelvic computed tomography demonstrated ascites, omental thickening, and nodularity. Paracentesis showed malignant cells resembling papillary adenocarcinoma. Omentectomy and bilateral pelvic lymphadenectomy were performed as cytoreductive surgery. The histologic slides of the totally sampled ovaries obtained from the first operation were reexamined and the corresponding paraffin blocks were re-sectioned but no tumor was detected. The microscopic appearance of the tumor in the omentum differed from that of the previous EC. Immunohistochemically, while the tumor showed reactivity for low and high molecular weight cytokeratin (CK) cocktail, epithelial membrane antigen, CK7, CA-125, and Ber-EP4, the immunostains for calretinin, monoclonal carcinoembryonic antigen, and CK20 were negative. On the basis of these results and the criteria proposed by the Gynecologic Oncology Group, the tumor was diagnosed as metachronous PSCP developed after EC, which corresponded to stage IIIC according to FIGO criteria for ovarian carcinoma. The patient received two cycles of carboplatin and paclitaxel and died 2 months after the cytoreductive surgery.

The role of p53, Bcl-2 and Ki-67 in premalignant cervical lesions and cervical cancer.

PURPOSE: The aim of this study was to determine the role of p53, Bcl-2 and Ki-67 expression in the carcinogenesis of cervical carcinoma and aggressiveness of cervical intraepithelial neoplasia (CIN). METHODS: The pathology specimens of 63 patients with a diagnosis of normal squamous epithelium (22 cases), CIN I (14), CIN II (5), CIN III (8) and squamous cell carcinoma (14) were evaluated immunohistochemically for the expression of p53, Bcl-2 and Ki-67 in paraffin sections. RESULTS: The expression of p53 and Ki-67 increased proportionally to the grade of CIN and cervical cancer, but only the increase of p53 expression was statistically significant (p = 0.002). There was no significant correlation between Bcl-2 expression and premalignant and malignant cervical lesions. CONCLUSION: p53 expression may have a role in the carcinogenesis of squamous cell cervical carcinoma whereas Bcl-2 expression has no role. Ki-67 expression can not be used in determining the aggressiveness of CIN lesions.

Epirrubicina en el tratamiento en forma de instigación intravesical tras RTU de tumores superficiales de vejiga / Intravesical epirubicin treatment following TUR in superficial bladder tumours

OBJETIVOS: Evaluar la efectividad y la tolerancia del tratamiento intravesical con Epirrubicina para evitar las recurrencias y la progresión de los tumores superficiales de vejiga después de resección transuretral.MÉTODOS: Se evaluaron 44 pacientes con tumores superficiales de vejiga, 28 de los cuales eran primarios y 16 recidivas. Los pacientes fueron tratados con 50 mg de Epirrubicina intravesical una vez por semana durante 8 semanas después de la resección transuretral.Los pacientes que habían recidivado no fueron tratados con ningún otro agente intravesical antes de Epirrubicina. El seguimiento se realizó mediante cistoscopia, citología urinaria y biopsias randomizadas.RESULTADOS: La recidiva local después del tratamiento fue del 14,28 por ciento y del 18,75 por ciento en la misma zona del tumor y la recidiva en otra área fue del 21,42 por ciento y del 31,25 por ciento respectivamente para los tumores primarios y recidivantes. La recurrencia total en los dos grupos fue del 40,91 por ciento. No encontramos toxicidad sistémica y los efectos secundarios fueron tratados de acuerdo con la sintomatología.CONCLUSIONES: El tratamiento con Epirrubicina intravesical después de resección transuretral para evitar recidivas después de la resección transuretral es un método útil y efectivo con efectos colaterales mínimos (AU)

The prognostic importance of the nucleolar organizer region (AgNOR), Ki-67 and proliferating cell nuclear antigen (PCNA) in primary nonurachal bladder adenocarcinoma.

The aim of this study was to investigate the role of tumor proliferation in patients with nonurachal bladder adenocarcinoma. Samples were obtained from 16 patients (12 men and 4 women, mean age 62 years) with primary nonrurachal bladder adenocarcinoma. The 16 formalin-fixed specimens were stained immunohistochemically for Ki-67 antigen and PCNA using MIB-1 and PC-10 antibodies. In addition, the AgNOR quantity was assessed using the colloid silver nitrate staining technique in all cases. The Ki-67, PCNA and AgNOR proliferation indices were found to be significantly higher in high-grade and invasive tumors. The higher the grade (p<0.01) and stage (p<0.01), the higher were the proliferation indices. Patients whose tumor samples had a high Ki-67, PCNA and AgNOR proliferation index showed a higher incidence of local recurrence (p<0.01) and distant metastasis (p<0.01). In conclusion, our results suggest that Ki-67, PCNA and AgNOR proliferation scores may be important prognostic indices in nonurachal bladder adenocarcinomas.

Intravesical epirubicin treatment following TUR in superficial bladder tumours.

OBJECTIVE: To evaluate the effectiveness and tolerability of intravesical epirubicin treatment to prevent recurrence and progression of superficial bladder tumor after TUR. METHODS: 44 patients with superficial bladder tumor, 28 primary and 16 recurrent cases were given 50 mg intravesical epirubicin once a week for 8 weeks after TUR. Recurrent cases had not been treated by any intravesical agent before. Follow-up was done by cystoscopy, urine cytology and random biopsies. RESULTS: Local recurrence after treatment was found in 14.28% and 18.75%, and recurrence in another area was found in 21.42% and 31.25% of the primary and recurrent tumor groups respectively. Total recurrence in both groups was 40.91%. No systemic toxicity was observed and local side effects were treated symptomatically. CONCLUSION: Intravesical epirubicin after TUR for superficial bladder tumors especially for the primary ones, is a reliable method that provides effective prophylaxis with tolerable side effects.

The nested variant of the transitional cell bladder carcinoma: a case report and review of the literature.

The nested variant of transitional cell carcinoma is extremely rare in the bladder. Here we reported a new case and review the literature.

Papillary adenocarcinoma of the ciliary body simulating retinoblastoma.

PURPOSE: To report a 2 1/2-year-old boy who had papillary adenocarcinoma of the ciliary body that simulated retinoblastoma. METHOD: Initially treated for congenital glaucoma, the patient was referred with a white mass involving the iris, chamber angle, and ciliary body. RESULTS: Enucleation of the right eye, which was initially diagnosed as retinoblastoma, showed a papillary adenocarcinoma of the ciliary body epithelium involving the posterior chamber, iris, anterior chamber, and trabeculum. CONCLUSION: Adenocarcinoma of the ciliary body must be included in the differential diagnosis of tumors originating from the ciliary body in young children.

Choroid plexus carcinoma of the lateral ventricle. Report of a case in an adult.

Choroid plexus carcinoma is a rare neoplasm and occurs more frequently in children than in adults. Most of these neoplasms in adults arise in the fourth ventricle. A 22-year-old male with choroid plexus carcinoma presenting in the lateral ventricle is reported. The patient was treated by radiotherapy after surgical removal of the tumour. Modern management possibilities and its limitations are discussed.