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2.
J Med Case Rep ; 13(1): 319, 2019 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-31655625

RESUMO

BACKGROUND: Papillary squamotransitional cell carcinoma of the uterine cervix is a rare neoplasm, a subtype of transitional cervical carcinoma that appears to be a variation of squamous cervical carcinoma. It has a disposition toward metastasis at an advanced stage and local recurrence. Owing to the difficulty of illustrating the invasion histologically, misdiagnosis is likely to affect the patient's prognosis. CASE PRESENTATION: We present a case report of an 81-year-old Caucasian patient with squamotransitional cell carcinoma with unusual clinical behavior that was primarily thought to be ovarian cancer. According to the clinical examination and radiologic imaging, the patient had no vaginal bleeding and a normal cervix. Nevertheless, the tumor was already metastasized at the retroperitoneal tissue and at the right ovary. Computed tomography-guided biopsy of the right adnexa gave no further clarification. Although the tumor resembled urothelial cancer, this diagnosis was dismissed because of the results of immunohistochemistry analysis with CK7+, CK5+, and CK20-. Because of the differential diagnosis of ovarian cancer, we decided in favor of an exploratory surgical approach. Hysterectomy with bilateral adnexectomy, extensive retroperitoneal tumor debulking, and infragastric omentectomy was performed by laparotomy. Histopathology revealed a squamotransitional cervical cancer as the primary tumor with a tumor stage of pT3b, pN1 (1/2), V0, RX, G2, corresponding to International Federation of Gynecology and Obstetrics stage IIIB. CONCLUSIONS: As far as we are aware, this is the first report of papillary squamotransitional cell carcinoma of the uterine cervix metastatic to the ovary without vaginal bleeding and with a clinically and radiologically unsuspicious cervix. Physicians should always contemplate papillary squamotransitional cell carcinoma of the uterine cervix in unclear cases with ovarian metastasis, especially if the histology indicates a transitional cancer (CK7+ and CK20-), before proceeding with treatment. More cases are needed to illuminate the clinical characteristics and categorization of papillary squamotransitional cell carcinoma of the uterine cervix.


Assuntos
Carcinoma de Células Escamosas/patologia , Carcinoma de Células de Transição/patologia , Neoplasias do Colo do Útero/patologia , Idoso de 80 Anos ou mais , Antígeno Ca-125/sangue , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células de Transição/cirurgia , Evolução Fatal , Feminino , Humanos , Recidiva Local de Neoplasia , Neoplasias Ovarianas/secundário , Neoplasias Ovarianas/cirurgia , Neoplasias Retroperitoneais/secundário , Neoplasias do Colo do Útero/cirurgia
3.
Am J Case Rep ; 20: 1515-1520, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31611546

RESUMO

BACKGROUND Metachronous ovarian metastasis from primary colorectal cancer (CRC) is a rare condition that is diagnosed after the treatment of CRC. In most cases, ovarian metastases present without specific symptoms or signs and are usually diagnosed during follow-up imaging. A rare case is presented of metachronous ovarian metastasis from primary CRC, diagnosed on follow-up by computed tomography (CT) and magnetic resonance imaging (MRI), and includes a review of the literature. CASE REPORT A 66-year-old woman recently underwent a left hemicolectomy for a stage T3, N0, M0 primary adenocarcinoma of the sigmoid colon, which was completely excised. Three years later, follow-up CT and MRI imaging showed a right ovarian cyst. She underwent exploratory laparotomy and bilateral salpingo-oophorectomy, which identified tumor in the right ovary. Histopathology and immunohistochemistry confirmed metachronous ovarian metastasis from CRC. The patient was referred for further treatment. CONCLUSIONS Newly-diagnosed ovarian metastasis from primary colorectal cancer (CRC) is challenging to diagnose and manage, and may initially be incorrectly diagnosed as malignancy of primary ovarian origin. This case demonstrated that it is important to confirm the diagnosis with imaging, histology, and the appropriate use of tumor markers. Because ovarian metastases do not respond favorably to chemotherapy, the treatment of choice is surgery. However, for women who are treated for CRC, the use of prophylactic oophorectomy remains controversial.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Colorretais/cirurgia , Segunda Neoplasia Primária/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/secundário , Adenocarcinoma/patologia , Idoso , Biomarcadores Tumorais , Colectomia , Neoplasias Colorretais/patologia , Feminino , Humanos , Imuno-Histoquímica , Imagem por Ressonância Magnética , Salpingo-Ooforectomia , Tomografia Computadorizada por Raios X
4.
Pediatr Surg Int ; 35(12): 1403-1411, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31555858

RESUMO

PURPOSE: We investigated how local tumor resection affects metastatic lesions in neuroblastoma. METHODS: MYCN Tg tumor-derived cells were injected subcutaneously into 129+Ter/SvJcl wild-type mice. First, the frequency of metastasis-bearing mice was investigated immunohistochemically (metastatic ratio) at endpoint or post-injection day (PID) 90. Second, the threshold volume of local tumor in mice bearing microscopic lymph node metastasis (mLNM) was investigated at PID 30. Finally, local tumors were resected after exceeding the threshold. Mice were divided into local tumor resection (Resection) and observation (Observation) groups, and the metastatic ratio and volume of LNM were compared between the groups at endpoint or PID 74. RESULTS: The metastatic ratio without local resection was 88% at PID 78-90. The threshold local tumor volume in the mice with mLNM was 745 mm3 at PID 30, so local tumors were resected after exceeding 700 mm3. The metastatic ratio and LNM volume were significantly greater in the Resection group (n = 16) than in the Observation group (n = 16) (94% vs. 38%, p < 0.001; 2092 ± 2310 vs. 275 ± 218 mm3, p < 0.01; respectively) at PID 50-74. CONCLUSION: Local tumor resection might augment the growth of synchronous microscopic metastases. Our results provide insights into the appropriate timing of local resection for high-risk neuroblastoma.


Assuntos
Neoplasias da Medula Óssea/secundário , Neoplasias Pulmonares/secundário , Metástase Linfática , Segunda Neoplasia Primária/patologia , Neuroblastoma/patologia , Neuroblastoma/cirurgia , Neoplasias Ovarianas/secundário , Aloenxertos , Animais , Modelos Animais de Doenças , Feminino , Masculino , Camundongos
5.
BMC Cancer ; 19(1): 878, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488087

RESUMO

BACKGROUND: We aimed to develop inhibitory short peptides that can prevent protein interactions of SOS1/EPS8/ABI1 tri-complex, a key component essential for ovarian cancer metastasis. METHODS: Plasmids containing various regions of HA-tagged ABI1 were co-transfected into ovarian cancer cells with Flag-tagged SOS1 or Myc-tagged EPS8. Co-immunoprecipitation and GST-pulldown assay were used to identify the regions of ABI1 responsible for SOS1 and EPS8 binding. Inhibitory short peptides of these binding regions were synthesized and modified with HIV-TAT sequence. The blocking effects of the peptides on ABI1-SOS1 or ABI1-EPS8 interactions in vitro and in vivo were determined by GST-pulldown assay. The capability of these short peptides in inhibiting invasion and metastasis of ovarian cancer cell was tested by Matrigel invasion assay and peritoneal metastatic colonization assay. RESULTS: The formation of endogenous SOS1/EPS8/ABI1 tri-complex was detected in the event of LPA-induced ovarian cancer cell invasion. In the tri-complex, ABI1 acted as a scaffold protein holding together SOS1 and EPS8. The SH3 and poly-proline+PxxDY regions of ABI1 were responsible for SOS1 and EPS8 binding, respectively. Inhibitory short peptides p + p-8 (ppppppppvdyedee) and SH3-3 (ekvvaiydytkdkddelsfmegaii) could block ABI1-SOS1 and ABI1-EPS8 interaction in vitro. TAT-p + p-8 peptide could disrupt ABI1-EPS8 interaction and suppress the invasion and metastasis of ovarian cancer cells in vivo. CONCLUSIONS: TAT-p + p-8 peptide could efficiently disrupt the ABI1-EPS8 interaction, tri-complex formation, and block the invasion and metastasis of ovarian cancer cells.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Proteínas do Citoesqueleto/metabolismo , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/secundário , Peptídeos/farmacologia , Proteína SOS1/metabolismo , Transdução de Sinais/efeitos dos fármacos , Proteínas Adaptadoras de Transdução de Sinal/genética , Linhagem Celular Tumoral , Proteínas do Citoesqueleto/genética , Desenho de Drogas , Feminino , Humanos , Invasividade Neoplásica , Neoplasias Ovarianas/metabolismo , Ligação Proteica , Proteína SOS1/genética , Transfecção
6.
Diagn Pathol ; 14(1): 96, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31455365

RESUMO

BACKGROUND: Ovarian metastatic tumors from lung adenocarcinoma are rare, and a serial study of these tumors is lacking to date. Additionally, a better understanding of the clinicopathological and molecular characteristics of metastatic tumors is needed. METHODS: Seven cases of ovarian metastasis from lung adenocarcinoma from 2013 to 2017 at our institute were investigated. The results were combined with those found in literature review. A total of 16 cases were analyzed in the present study. We examined clinicopathological and immunohistochemical characteristics, further detected ALK rearrangement by FISH (fluorescence in situ hybridization), and assessed EGFR and KRAS mutations using Sanger sequencing or the amplification refractory mutation system (ARMS). RESULTS: The mean age of the patients was 44.6 years (range, 33-56 years). Eleven of sixteen patients developed ovarian tumors within a mean time of 18.5 months (range, 5-48 months) from the initial diagnosis of lung adenocarcinoma; 5 patients had lung tumors and ovarian masses simultaneously. Five tumors (5/16, 31%) occurred in the bilateral ovaries, and the others were unilateral ovarian tumors (11/16, 69%). All seven cases from our institute were positive for TTF-1 and Napsin A but negative for PAX8. In four cases, ALK (D5F3) was diffusely and strongly expressed, with ALK rearrangements (4/7, 57%). Overall, ALK rearrangement was found by FISH or immunohistochemistry in 11/16 (69%) cases. In two cases, EGFR mutations in exons 19 and 21, respectively, were found. One patient did not detected EGFR or ALK mutation in the metastatic tumor, but the primary lung adenocarcinoma did harbor an EGFR mutation. Two cases had no alterations in three genes above. Although the mean survival time of the patients with ALK rearrangement was longer than those without (mean survival time 25 m vs. 20 m), no statistical significance of the difference was found. CONCLUSIONS: As the largest case series of ovarian metastasis from lung adenocarcinoma, our findings indicate that ALK rearrangement is the most common molecular alteration. Although patients with ALK rearrangement appear to have a better prognosis than do those without ALK rearrangement, more cases with longer follow-up and multivariant analysis are needed to clarify this point.


Assuntos
Adenocarcinoma/genética , Adenocarcinoma/secundário , Quinase do Linfoma Anaplásico/genética , Neoplasias Pulmonares/patologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/secundário , Adulto , Feminino , Rearranjo Gênico , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica/genética
7.
Clin Nucl Med ; 44(9): e532-e534, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31274557

RESUMO

Metastasis to the breast is a rare occurrence and constitutes less than 2% of all breast tumors. Similarly, ovarian metastases from neuroendocrine tumors are also uncommon, and if the adnexal masses are bilateral, then the chances of it being metastatic rather than being primary range from 88% to 94%. We present a case of 61-year-old woman who in the course of workup for abdominal pain and diarrhea was eventually diagnosed as ileal neuroendocrine tumor with breast, ovarian, and lymph nodal metastases on Ga-DOTANOC PET/CT scan.


Assuntos
Neoplasias da Mama/secundário , Neoplasias do Íleo/patologia , Tumores Neuroendócrinos/patologia , Compostos Organometálicos , Neoplasias Ovarianas/secundário , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico por imagem , Probabilidade
8.
J Cancer Res Clin Oncol ; 145(8): 2061-2069, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31309301

RESUMO

PURPOSE: Cervical cancer metastases to the ovary may occur with advanced tumor stage, deep cervical stromal involvement and corpus involvement. Endocervical adenocarcinoma in situ (AIS) with ovarian involvement is exceptionally rare with about twelve reported cases. METHODS: Here we present a case of endocervical AIS with ovarian and pulmonary involvement 39 months after the initial diagnosis. The characteristics of that case were compared and summarized with the eleven previously published cases. RESULTS: The patients' age ranged between 30 and 40 years (median 37.4 years). The time interval between the diagnosis of AIS and ovarian involvement was 26.7 months (range 2-84 months). Majority of the patients are alive without evidence of disease after a median time of 63.4 months (range 9-156 months). All reported cases were positive for high-risk HPV which was associated with strong p16 expression on immunohistochemistry. CONCLUSIONS: The ovarian involvement by endocervical AIS suggests the concept of a transtubal spread of the neoplastic cervical cells with or without previous colonization within the endometrium without evidence of invasive growth, suggesting a seed and soil spread of the disease. In cases with ovarian involvement by the AIS and without additional extragenital spread, the prognosis may be favorable.


Assuntos
Adenocarcinoma in Situ/patologia , Suscetibilidade a Doenças , Neoplasias Pulmonares/secundário , Neoplasias Ovarianas/secundário , Neoplasias do Colo do Útero/patologia , Adenocarcinoma in Situ/virologia , Adulto , Suscetibilidade a Doenças/etiologia , Suscetibilidade a Doenças/patologia , Suscetibilidade a Doenças/virologia , Feminino , Humanos , Neoplasias Pulmonares/virologia , Pessoa de Meia-Idade , Neoplasias Ovarianas/virologia , Papillomaviridae/fisiologia , Infecções por Papillomavirus/complicações , Neoplasias do Colo do Útero/virologia
9.
Clin Nucl Med ; 44(10): e577-e578, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31246684

RESUMO

Ovarian thecoma is a benign and rare neoplasm that accounts for 0.5% to 1% of all ovarian tumors. A 55-year-old woman with known breast cancer underwent a metastatic workup before surgery. The Tc-MDP whole-body bone scan revealed intense uptake in the left pelvic region. Hybrid SPECT/CT imaging showed that the elevated Tc-MDP activity was in a tumor with calcification in the left adnexa. Dynamic enhanced MRI revealed marked enhancement of the tumor. Resection of the tumor was subsequently performed, and pathologic analysis confirmed the diagnosis of an ovarian thecoma.


Assuntos
Achados Incidentais , Neoplasias Ovarianas/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Medronato de Tecnécio Tc 99m , Tecoma (Neoplasia)/diagnóstico por imagem , Imagem Corporal Total , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/secundário , Tecoma (Neoplasia)/secundário
10.
Surg Pathol Clin ; 12(2): 565-585, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097115

RESUMO

Ovarian mucinous tumors range from benign cystadenomas to borderline tumors to frankly malignant adenocarcinomas, and may display either intestinal-type morphology or, less frequently, endocervical-type differentiation. The latter category has been the subject of recent controversy owing to its morphologic overlap with so-called "seromucinous" ovarian tumors, a group that shares more molecular features with endometrioid tumors than it does with either serous or mucinous ovarian neoplasias. Endocervical-type differentiation in ovarian mucinous tumors may also represent an endocervical metastasis. Distinction of primary ovarian mucinous tumors from gastrointestinal metastases can be difficult, as the morphology of intestinal-type ovarian mucinous primaries sometimes differs only subtly if at all from gastrointestinal metastases.


Assuntos
Adenocarcinoma Mucinoso/patologia , Cistadenoma Mucinoso/patologia , Neoplasias Ovarianas/patologia , Adenocarcinoma Mucinoso/diagnóstico , Biomarcadores Tumorais/metabolismo , Cistadenoma Mucinoso/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/secundário
11.
Clin Transl Oncol ; 21(10): 1432-1439, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31025168

RESUMO

INTRODUCTION: Goblet cell carcinoma (GCC) is an appendicular neoplasia representing less than 5% of all appendicular tumors, found in 0.3-0.9% of the appendectomies, 35-58% of all appendicular neoplasms, and less than 14% of malign appendix tumors. The most frequent clinical presentation is abdominal pain associated with a picture of acute appendicitis. MATERIALS AND METHODS: We present 3 clinical cases of appendix GCC, 2 subjected to cytoreductory surgery plus intraperitoneal hyperthermic chemotherapy and a third, who is currently receiving neoadjuvant treatment with a good response to chemotherapy and who will be offered the same treatment as the first two patients. Given the unpredictable behavior of these tumors, the use of molecular markers could help us to predict their behavior and prognosis. In this context, the TP73 gene would make an interesting putative marker. ∆Np73 has been described as overexpressed in a great variety of tumor types including colon cancer and this up-regulation is associated with a poor prognosis. To evidence its role in this malignancy, we evaluate here the status of ∆Np73 in the primary tumor and normal counterpart tissues, in the metastatic implants and in healthy areas of the peritoneum from the appendicular GCC patients. In addition, we checked the expression levels of this p73 variant in the tumor and normal tissue of 26 patients with colon cancer. RESULTS: Remarkably, 2 patients showed significant ∆Np73 down-regulation in both the primary tumor and the implants. Case 1 presented a fourfold decrease of levels in the primary tumor and 20-fold decrease in the implants. Case 2 showed a seven- and fourfold down-regulation in the primary tumor and implants, respectively. However, Case 3 showed an up-regulation of 53- and threefold in the primary tumor and implants, respectively. CONCLUSION: Goblet cell carcinoma of the appendix is very rate. It tends to seed throughout the peritoneum, making aggressive surgical cytoreduction and chemotherapy viable treatment options. Investigation into the molecular basis of these tumors may improve the diagnosis, prognosis and therapeutic decisions regarding these patients. ∆Np73 seems a good candidate for further analysis in longer series.


Assuntos
Adenocarcinoma/química , Neoplasias do Apêndice/química , Biomarcadores Tumorais/análise , Células Caliciformes/química , Neoplasias Ovarianas/química , Neoplasias Peritoneais/química , Proteína Tumoral p73/análise , Adenocarcinoma/secundário , Adenocarcinoma/terapia , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/terapia , Colo/química , Neoplasias do Colo/química , Procedimentos Cirúrgicos de Citorredução , Regulação para Baixo , Feminino , Humanos , Hipertermia Induzida , Masculino , Pessoa de Meia-Idade , Neoplasias Ovarianas/secundário , Neoplasias Peritoneais/secundário , Peritônio/química
12.
Medicine (Baltimore) ; 98(17): e15395, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027137

RESUMO

RATIONALE: The biological behavior and clinical features of ovarian metastasis from breast cancer remain unclear; diagnosis and treatment of this condition are challenging. PATIENT CONCERNS: We reported three cases of ovarian metastasis from breast cancer in Chinese women aged 44, 46, and 30 years. The prognosis was different in all three patients; however, no symptoms of ovarian metastasis were observed. DIAGNOSIS: All three premenopausal patients were diagnosed with hormone receptor-positive breast cancer and two of them had axillary lymph node metastasis. All three women had multiple extra-ovarian metastases when ovarian metastasis was detected. INTERVENTIONS: All patients received systemic antitumor therapy and underwent bilateral ovariectomy. OUTCOMES: Patient 1 had stable bone metastasis; patient 2 had stable lung metastasis and died of heart disease, and patient 3 had multiple brain metastases, which suggested poor outcomes. LESSONS: It is important to screen for ovarian metastasis from breast cancer when evaluating suspicious ovarian masses detected via transvaginal ultrasound in patients with a breast cancer history. Therefore, we recommend simple laparoscopic bilateral oophorectomy not only for pathological diagnosis but also for metastatic tumor removal and therapeutic castration. In such cases, systemic therapy is essential because ovarian metastasis is often a component of systemic metastatic disease.


Assuntos
Neoplasias da Mama/patologia , Neoplasias Ovarianas/secundário , Adulto , Neoplasias da Mama/terapia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/terapia , Ovariectomia , Pré-Menopausa
14.
BMC Cancer ; 19(1): 375, 2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31014281

RESUMO

BACKGROUND: Most endocervical adenocarcinomas are human papillomavirus (HPV)-related cancers associated with p16 immunostaining. Ovarian metastasis from cervical cancer is a rare phenomenon, the mechanism of dissemination remains unclear. The diagnosis of metastasis may be difficult to establish when the ovarian neoplasm presents features consistent with primary tumor. Immunohistochemical expression of p16 in ovarian tumors can guide the diagnosis of metastasis from HPV-related cervical cancer, but p16 positivity is nonspecific. Identical HPV genotype in the paired endocervical and ovarian tumors is a better marker for cervical origin, which may also be confirmed by identical HPV integration site. CASE PRESENTATION: Two women presented with HPV18 cervical adenocarcinoma. No signs of disease were visible on MRI after treatment. After several years of follow-up, mucinous ovarian tumors were discovered in both patients. Molecular analyses showed that the ovarian lesions were HPV18-positive; indicating a primary cervical origin. A third woman was diagnosed with grade 1 ovarian endometrioid carcinoma with no peritoneal carcinomatosis. Final histological examination and HPV genotyping revealed HPV18-related in situ endometrioid adenocarcinoma in the endocervix and HPV18-related invasive endometrioid adenocarcinoma in the endometrium and both ovaries. Additional molecular analyses performed in two patients identified the same HPV integration sites in both the ovarian and cervical tumors, confirming that the ovarian mass was a metastasis from the cervical adenocarcinoma. CONCLUSION: We report three new cases of ovarian neoplasia in which the diagnosis of metastasis from cervical cancer was supported by the same HPV genotype and the same integration site in the paired cervical and ovarian tumors. To our knowledge, this is the first report of molecular evidence of the cervical origin of an ovarian metastasis. HPV screening should be performed in ovarian tumors for all patients with history of cervical neoplasia.


Assuntos
Adenocarcinoma/patologia , Carcinoma Endometrioide/patologia , Neoplasias Ovarianas/secundário , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Neoplasias do Colo do Útero/patologia , Integração Viral/genética , Adenocarcinoma/cirurgia , Adenocarcinoma/virologia , Adulto , Carcinoma Endometrioide/cirurgia , Carcinoma Endometrioide/virologia , DNA Viral/genética , Feminino , Humanos , Hibridização In Situ , Pessoa de Meia-Idade , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/virologia , Infecções por Papillomavirus/genética , Prognóstico , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/virologia
15.
Zhonghua Zhong Liu Za Zhi ; 41(3): 178-182, 2019 Mar 23.
Artigo em Chinês | MEDLINE | ID: mdl-30917451

RESUMO

Ovary is one of the common metastatic sites of gastric cancer. In the female patients, ovarian relapse is one of the most important causes of treatment failure for gastric cancer. The most likely mechanism of Krukenberg tumor development is via retrograde lymphatic spreading from gastric cancer. However, neither optimal treatment strategy nor standard treatment guideline for Krukenberg tumor from gastric cancer has been clearly established.The diagnostic key points consist of the previous or concomitant history of gastric cancer and the detection of ovarian solid tumors.The therapeutic regimens mainly include the metastasectomy, chemotherapy, radiotherapy and comprehensive treatment. Surgical resection of metastatic tumor combined with adjuvant chemotherapy can improve the prognosis and survival.


Assuntos
Tumor de Krukenberg/etiologia , Neoplasias Ovarianas/secundário , Neoplasias Gástricas/patologia , Feminino , Humanos , Tumor de Krukenberg/diagnóstico , Tumor de Krukenberg/terapia , Recidiva Local de Neoplasia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/terapia , Prognóstico , Neoplasias Gástricas/terapia
17.
Int J Surg Pathol ; 27(5): 574-579, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30913944

RESUMO

Background. Ovarian carcinosarcomas are rare aggressive biphasic tumors. Evidence suggests that these tumors are monoclonal and that the sarcoma component is derived from a stem cell undergoing divergent differentiation. Currently, there remains a paucity of data regarding its origin, with few reports suggesting an association with serous tubal intraepithelial carcinoma (STIC) by immunohistochemistry and genetics. Objective. We sought to determine the relationship of carcinosarcoma to high-grade serous carcinoma and STIC by investigating for similar mutation signatures through next-generation sequencing. Methodology. A case of carcinosarcoma with associated high-grade serous carcinoma and STIC was macrodissected, and next-generation sequencing was performed on each component separately. Results. The STIC, high-grade serous carcinoma component, and chondrosarcoma component were all diffusely positive for p53 and p16 by immunohistochemistry. Next-generation sequencing demonstrated an identical TP53 gene c.376-1G>A 5' splice site pathogenic mutation in all 3 components. Conclusions. Our findings suggest that carcinosarcomas may also originate from the fallopian tube.


Assuntos
Carcinossarcoma/genética , Cistadenocarcinoma Seroso/genética , Neoplasias das Tubas Uterinas/patologia , Tumor Mulleriano Misto/genética , Neoplasias Ovarianas/genética , Idoso , Carcinossarcoma/diagnóstico , Carcinossarcoma/secundário , Inibidor p16 de Quinase Dependente de Ciclina/genética , Cistadenocarcinoma Seroso/diagnóstico , Cistadenocarcinoma Seroso/secundário , Análise Mutacional de DNA , Neoplasias das Tubas Uterinas/diagnóstico , Neoplasias das Tubas Uterinas/genética , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Tumor Mulleriano Misto/diagnóstico , Tumor Mulleriano Misto/secundário , Mutação , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/secundário , Proteína Supressora de Tumor p53/genética
18.
J Ovarian Res ; 12(1): 10, 2019 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-30700327

RESUMO

OBJECTIVE: The aim of our study was to evaluate and compare the differences in the clinicopathological variables and overall survival (OS) of synchronous primary cancers of the endometrium and ovary (SCEO) and endometrial cancer with ovarian metastasis (ECOM). In addition, we aimed to determine the characteristics of and effective treatments for patients with SCEO to avoid misdiagnosis and overtreatment. MATERIALS AND METHODS: A review of medical records from January 2009 to January 2017 revealed 111 patients with coexisting ovarian and endometrial carcinoma diagnosed at the Obstetrics and Gynecology Hospital of Fudan University. Clinicopathological variables were analysed using the Chi square test and Student's t test. The survival rate was estimated using the Kaplan-Meier method, and statistical significance was analysed using the logarithmic rank test (univariate analysis). RESULTS: There were 51 cases of SCEO and 60 cases of ECOM. The mean age at diagnosis was 53.96 years and 55.41 years, respectively. There were no differences in age, menopausal status, BMI, CA125 level or complaints between the two groups. The 5-year survival rates were 58.8 and 36.7%, respectively (P < 0.001). Significant differences were found in the endometrial tumour classification, ovarian cancer stage, and lymph node and omentum metastasis between SCEO and ECOM. CONCLUSIONS: The differences found between SCEO and ECOM are of great clinical significance. Our results reveal useful prognostic and clinicopathological features. More aggressive therapies should be administered to both SCEO and ECOM patients, especially elderly patients and those with menopause, endometrial tumours, advanced omentum metastasis, and lymph node dissection.


Assuntos
Neoplasias do Endométrio/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Ovarianas/diagnóstico , Neoplasias do Endométrio/tratamento farmacológico , Neoplasias do Endométrio/patologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas/tratamento farmacológico , Neoplasias Primárias Múltiplas/patologia , Omento/patologia , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/secundário , Neoplasias Peritoneais/secundário , Prognóstico
19.
Clin Nucl Med ; 44(5): 397-398, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30789397

RESUMO

Patient was a 52-year-old woman with medical history of lung adenocarcinoma operated in 2009 (stage I, T2 N0 M0), showing increasing levels of tumor markers and a doubtful retrocrural adenopathy by means of CT scan with intravenous contrast. An F-FDG PET/CT was performed, which showed 2 hypermetabolic foci in both annexes. The anatomopathological study detected bilateral ovarian adenocarcinoma compatible with metastases of pulmonary origin.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adenocarcinoma de Pulmão/patologia , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Neoplasias Ovarianas/secundário , Compostos Radiofarmacêuticos
20.
BMJ Case Rep ; 12(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30772831

RESUMO

Neuroblastoma metastasizing to the ovary is rare. We report the 10th case and review the scarce literature. A 5-year-old girl with stage M neuroblastoma presented with an upper abdominal and a pelvic mass. Evaluation after induction showed very good tumour response with three remaining localisations: two abdominal and one pelvic. At gross total resection, the pelvic mass appeared to be the enlarged and abnormal right ovary and was removed completely. Pathology showed an ovarian metastasis. On completion of her postoperative treatment, she achieved complete remission. Literature review showed that underdiagnosing of ovarian metastasis in neuroblastoma is very likely.


Assuntos
Neoplasias Renais/secundário , Nefrectomia , Neuroblastoma/patologia , Neoplasias Ovarianas/secundário , Ovariectomia , Ovário/patologia , Protocolos de Quimioterapia Combinada Antineoplásica , Pré-Escolar , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Neuroblastoma/terapia , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/cirurgia , Radioterapia Adjuvante , Resultado do Tratamento
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