Primary Vaginal Mucinous Adenocarcinoma of Intestinal Type-Clinical, Radiological and Morphological Aspects.

Background and Objectives: Neoplasms of the vagina are rare and account for 1-2% of all tumors of the female reproductive system. Primary neoplasms of the vagina are most often carcinomas originating from squamous or glandular epithelium. Of the primary glandular tumors, clear cell, endometrioid, and serous adenocarcinomas are the most common types, while mucinous and mesonephric types are very rare. Mucinous adenocarcinoma is histologically subclassified into endocervical and intestinal types. We add to the existing literature another case of an extremely rare gynecological neoplasm-primary vaginal mucinous adenocarcinoma (PVMAC) intestinal type associated with vaginal villous adenoma with high-grade dysplasia. We discuss the clinical, radiological and morphological features of this rare entity. Materials and Methods: We report a case of a 59-year-old woman with PVMAC intestinal type associated with vaginal villous adenoma with high-grade dysplasia. The patient was evaluated with a gynecological exam, and biopsy, curettage and tumor excision were performed. The positron emission tomography-computed tomography (PET/CT) scan, at the level of the pelvis, supported the primary location of the disease. Histological and immunohistochemical methods were applied. Results: The gynecological examination of the vagina revealed an exophytic polypoid mass with a diameter of 3 cm, located on the posterior wall, in the area of introitus vaginae. The PET/CT scan revealed a hypermetabolic malignant formation involving the vagina and anal canal, without evidence of pelvic and inguinal lymphadenopathy, and also, it excluded disease at sites other than the vagina. The histological and immunohistochemical investigations, as well as the clinical and radiological data, lent support to the diagnosis "primary vaginal mucinous adenocarcinoma intestinal type". Conclusions: PVMAC intestinal type is a rare gynecological pathology, which presents a serious challenge for oncogynecologists, radiologists and pathologists.

A rare case of angiomyomatous hamartoma in the pelvic and paraaortic lymph nodes.

Angiomyomatous hamartoma (AMH) of the lymph node is an extremely rare, benign vascular disease of unknown etiology. It is characterized by partial or complete replacement of the lymph node parenchyma by irregularly distributed, thick-walled blood vessels, smooth muscle bundles and adipose tissue in a fibrotic stroma. Angiomyomatous hamartoma occurs mainly in inguinal and femoral nodal regions, but there are a few reports of some other locations - submandibular, cervical, popliteal and paraaortic lymph nodes. We present a case of a 37-old female patient with AMH in the pelvic and paraaortic lymph nodes who presented with weight loss - 7 kg in 7 months. The differential diagnosis of AMH includes lymphangiomyomatosis, which, unlike AMH, involves primarily thoracic and intra-abdominal lymph nodes: nodal leiomyomatosis with less pronounced vascular proliferation and angiomyolipoma of the lymph node. The latter is composed of the same tissues as in AMH, but the smooth muscle component shows increased cellularity, polymorphism and increased mitotic activity, as well as a typical immune profile with coexpression of melanocyte markers and estrogen, which were negative in our case. The world literature references show that this is the first reported case in which the disease manifested itself with weight loss and affected paraaortic lymph nodes in a female patient.

Lymphoepithelioma-like Carcinoma of the Breast Synchronous with a High-Grade Invasive Ductal Carcinoma and Ductal Carcinoma in Situ in a Different Quadrant of the Same Breast: A Case Report.

Lymphoepithelioma-like breast carcinoma (LELC) is a rare type of malignant breast tumor that is not included in the current edition of the World Health Organization (WHO) classification of breast tumors. Currently, there are no clearly defined therapeutic strategies, and the general information on breast LELC is based on sporadic clinical cases described in the medical literature. We present a clinical case that describes a 49-year-old woman with a tumor formation in the right breast, histologically verified as LELC, together with a non-palpable, synchronous high-grade invasive ductal carcinoma and ductal carcinoma in situ Grade 2 (DCIS G2) in a different quadrant of the same breast. To our knowledge, this is the first case described in the literature that combines a LELC with a synchronous carcinoma in the same breast.

Changes in the activity of Cu/Zn superoxide dismutase, lipid profile and aorta morphology of spontaneously hypertensive rats on zinc diet.

UNLABELLED: The aim of the present study was to investigate the effect of zinc on the activity of copper-zinc superoxide dismutase (Cu/Zn SOD), the lipid profile, the arterial blood pressure and the morphological changes of the aorta in male spontaneously hypertensive rats (SHR). MATERIALS AND METHODS: The study included 52 male SHR animals. The animals were randomly asigned into three groups to be fed one of three zink diets--in group one animals (G1, control group) the zinc content was 50 mg/kg, in group two (G2)--155 mg/kg and in group three (G3) 250 mg/kg. The laboratory chow zinc content and the zinc and copper serum levels were measured by a direct flame atomic-absorption spectrophotometry. The Cu/Zn SOD activity was measured in the erythrocytes using a reagent from RANSOD (RANDOX Laboratories). Systolic arterial blood pressure was measured on the rat's tail (tail cuff) by an indirect method without anesthesia (Ugo Basile). The lipid profile was determined with ABX reagents (France). Histological investigations of the aortas were performed using histochemical and electron microscopic methods. RESULTS: Statistically significant increase of Cu/Zn SOD activity (p < 0.05) was found in G2 (2276.88 +/- 145.53) and G3 (2337.31 +/- 146.25) in comparison with the control group of animals (2099.46 +/- 111.73). There was significant decrease of serum LDL levels (p < 0.05) in G3 (1.09 +/- 0.32) compared with G2 (1.19 +/- 0.42) and G1 (1.62 +/- 0.28). Increased number of migrated smooth muscle cells was found in G1 animals. Lipid drops were increased in the aortic wall of SHR animals and then decreased after zinc diet was applied. CONCLUSIONS: The results indicate that high zinc content in the diet has a protective effect as it increases Cu/Zn SOD activity, decreases the LDL serum levels and the lipid infiltration of the aorta in male SHR animals.

Effect of Selenium Supplementation on Redox Status of the Aortic Wall in Young Spontaneously Hypertensive Rats.

Selenium (Se) is an exogenous antioxidant that performs its function via the expression of selenoproteins. The aim of this study was to explore the effect of varying Se intake on the redox status of the aortic wall in young spontaneously hypertensive rats (SHR). Sixteen male Wistar Kyoto (WKY) rats and nineteen male SHR, 16-week-old, were tested after being given diets with different Se content for eight weeks. They were divided into 4 groups: control groups of WKY NSe and SHR NSe on an adequate Se diet and groups of WKY HSe and SHR HSe that received Se supplementation. The Se nutritional status was assessed by measuring whole blood glutathione peroxidase-1 (GPx-1) activity. Serum concentration of lipid hydroperoxides and serum level of antibodies against advanced glycation end products (anti-AGEs abs) were determined. Expression of GPx-1 and endothelial nitric oxide synthase (eNOS) were examined in aortic wall. Se supplementation significantly increased GPx-1 activity of whole blood and in the aortas of WKY and SHR. Decreased lipid peroxidation level, eNOS-3 expression in the aortic wall, and serum level of anti-AGEs abs were found in SHR HSe compared with SHR NSe. In conclusion, Se supplementation improved the redox status of the aortic wall in young SHR.

Appendiceal mucocele presenting as a right adnexal mass: a case report.

A 68-year-old female presented to the Gynecologic Oncology Clinic with a right-lower quadrant abdominal mass 3 × 4 cm in diameter palpable on pelvic examination. Her routine laboratory tests were normal. Transvaginal ultrasonography revealed a cystic mass in the right adnexa 3.9 cm in diameter, which was thought to arise in the ovary. At the time of laparoscopy, a 3 × 4 cm tumor arising from the distal end of the appendix was noted. A laparoscopic appendectomy with tumor removal was performed. Histologic examination of the surgical specimen revealed a mucocele of the appendix (AM). Although rare, this tumor should be considered in the differential diagnosis of a right adnexal mass. These tumors can be identified laparoscopically and removed by minimally invasive surgery.