Malignant Brenner tumor of the ovary with transformation to trabecular carcinoid: an immunocytochemical and electron microscopic study.

Ovarian Brenner tumors are typically of surface epithelial-stromal origin; however, cases associated with mature cystic teratoma and/or struma ovarii possibly have a teratomatous derivation. Although argyrophil cells have been described in ovarian Brenner tumors and in urinary bladder epithelium, we are not aware of any previous reports of carcinoid arising from a malignant Brenner tumor of the ovary. In this study, we describe an 85-year-old woman who had a low-grade malignant Brenner tumor with progressive proliferation of neuroendocrine cells and transformation to trabecular carcinoid as demonstrated by immunocytochemistry and electron microscopy.

Vascular endothelial growth factor staining and elevated INR in advanced epithelial ovarian carcinoma.

BACKGROUND: The purpose of this study was to determine whether vascular endothelial growth factor (VEGF) expression in tumors correlates with the incidence of an elevated prothrombin time (PT), specifically an international normalized ratio (INR) > or = 1.4, in patients undergoing primary surgical cytoreduction for ovarian cancer. METHODS: INRs were obtained on all patients perioperatively. VEGF expression was determined by immunostaining of tumor specimens using published protocols. RESULTS: One hundred patients underwent surgical cytoreduction. Sixty-seven percent of patients had postoperative INR of 1.4 or greater. INRs of greater than or equal to 1.8 were found in 5% of patients. INR elevation was independent of mean estimated blood loss (EBL) with the EBL in the patients with INRs > or = 1.4 not significantly different than the EBL in the patients with INRs < 1.4 (660 ml vs. 530 ml, P = 0.09). There was a significant correlation between elevated INR and tumor VEGF immunostaining (P < 0.005). All but one patient with an elevated INR had positive VEGF staining. CONCLUSIONS: In conclusion, development of an elevated INR (INR > or = 1.4) is common in patients undergoing primary surgical cytoreduction. Positive tumor VEGF staining is very common in patients having a postoperative coagulopathy.

Lumbar spine intracanalicular discal cysts: two case reports.

The only previously reported series of lumbar intracanalicular discal cysts, which were termed "intervertebral discal cysts", described Asian male involvement with verification of diagnosis via discography ( 1). Two cases are presented in non-Asian males under the age of 21 years, one of which was diagnosed preoperatively by MRI scan. Both patients did well with microsurgical intervention.