RESUMO
BACKGROUND: FIGO stage II ovarian cancer comprises 8% of ovarian cancers. It is a common but not universal practice to upstage densely adherent pathologic stage I tumors to stage II. FIGO guidelines are not clear, and data supporting this practice are sparse. METHODS: We retrospectively reviewed patients with stage II ovarian cancer and grouped them based upon histologic evidence of extraovarian extension. Tumors densely adherent to extraovarian structures but without histologic tumor outside the ovary were considered pathologic stage I. All others were considered surgical-pathologic stage II. Three histologic patterns of extraovarian tumor involvement were identified. RESULTS: Eighty-four patients were studied. Twenty-four patients had pathologic stage I disease and 60 had histologic evidence of extraovarian pelvic spread and were surgical-pathologic stage II. The 5-year survival for stage I was 100%, and the median survival was not reached. The 5-year survival for those with surgical-pathologic stage II disease was 56.8% and the median survival was 73 months. There were no differences observed based upon pattern of extraovarian spread. The survival difference between pathologic stage I and surgical-pathologic stage II was significant (p<0.001). There were no differences seen in 5-year survival among surgical-pathologic stage II patients with serous, endometrioid or clear cell histologies (64.5%, 64.8% and 64.3% respectively). CONCLUSION: These retrospective data suggest that the practice of upstaging densely adherent pathologic stage I tumors to stage II may not be warranted. Cell type is not a prognostic factor in stage II.
Assuntos
Adesão Celular/fisiologia , Neoplasias Ovarianas/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/cirurgia , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
The development of Philadelphia chromosome-positive chronic myelogenous leukemia (CML) in the adolescent population is very rare. CML occurring as a secondary malignancy in individuals treated for anaplastic large cell lymphoma (ALCL) is also rare. We present the case of a 16-year-old adolescent boy who developed a right orbital mass that was diagnosed as ALCL with the t(2;5)(p23;q25) chromosomal aberration. Four years after receiving treatment for ALCL, he presented with a swollen leg and a white cell count of 431,000. Peripheral blood and bone marrow evaluation revealed a myeloproliferative disorder. Cytogenetic and molecular studies demonstrated the presence of t(9;22). We present the histopathologic, molecular, and cytogenetic findings of this patient's initial presentation with systemic ALCL as well as his secondary presentation with CML 4 years later. Therapy-related CML and non-therapy-related secondary CML are discussed as potential explanations of this highly unusual clinical presentation.
Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Linfoma Difuso de Grandes Células B/patologia , Segunda Neoplasia Primária/patologia , Proteínas Tirosina Quinases/metabolismo , Adolescente , Quinase do Linfoma Anaplásico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Medula Óssea , Ciclofosfamida/uso terapêutico , Daunorrubicina/uso terapêutico , Citometria de Fluxo , Proteínas de Fusão bcr-abl/genética , Humanos , Hibridização in Situ Fluorescente , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/metabolismo , Masculino , Segunda Neoplasia Primária/genética , Segunda Neoplasia Primária/terapia , Neoplasias Orbitárias/patologia , Receptores Proteína Tirosina Quinases , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Vincristina/uso terapêuticoRESUMO
⺠Cowden Syndrome is a rare hereditary cancer syndrome, which confers an increased risk of breast, thyroid, endometrial and colon cancer. ⺠Atypical polypoid adenomyoma does not generally represent a premalignant lesion, but must be carefully screened for foci of malignancy. ⺠Cancer screening must be intensified for patients who meet the diagnostic criteria for Cowden Syndrome.