Hijalinizirajući tumor vretenastih stanica s gigantskim rozetama naen u uterusu – prikaz slučaja

Hyalinizing spindle cell tumor with giant rosettes (HSCTGR) is unusual, recently recognized entity, histologically characterized by the presence of large rosette-like structures. Apart from these formations, histological features of HSCTGR are indistinguishable from low-grade fibromyxoid sarcoma (LGFMS), and available data suggest that these two tumors present different variants of the same entity. Herein we report the case of HSTCGR found in the uterus. To our knowledge, the present case is the first description of HSTGR occurring at this location as well as the first HSCTGR described in the Croatian medical literature. A 38-year-old woman presented to her gynecologist with symptoms of acute pain in the lower abdomen. Gynecological ultrasound examination showed an enlarged uterus with a tumor mass. Total hysterectomy and bilateral adnexectomy with selective pelvic and para-aortal lymphadenectomy were performed. Serial slicing of the enlarged uterus revealed a grayish white tumor mass with 15 cm in maximum length. The margins of the tumor merged with the uterine wall and the tumor infiltrated more than one half of the myometrium. Histologically, the tumor showed typical features of HSTGR. Postoperatively, no complications occurred. Twenty-two months after surgery, our patient is alive with no signs of recurrence. She needs to be followed up for a long period because HSTCGR belongs to a low-grade malignancy group with the potential to recur and produce late metastasis.Hijalinizirajući tumor vretenastih stanica s gigantskim rozetama (HSCTGR) rijedak je, relativno nedavno opisan entitet, čija je histološka značajka stvaranje krupnih struktura koje nalikuju rozetama. Osim po prisutnosti ovih tvorbi, histološki ga se ne može razlikovati od fibromiksoidnog sarkoma niskoga gradusa i danas se vjeruje da su oni različite varijante istog entiteta. Opisujemo hijalinizirajući tumor vretenastih stanica s gigantskim rozetama nađen u uterusu. Prema našim spoznajama radi se o prvom slučaju opisanom na toj lokalizaciji te također prvom slučaju HSCTGR u hrvatskoj medicinskoj literaturi. Dotada zdrava 38-godišnja žena javila se ginekologu zbog akutne boli u donjem dijelu abdomena. Ginekološkim i ultrazvučnim pregledom nađena je veća tumorska tvorba u području uterusa. Učinjena je histerektomija s adneksektomijom i selektivnom limfadenektomijom. Serijskim rezovima kroz stijenku povećanog uterusa prikazao se sivkastobjelkasti tumor najvećeg promjera 15 cm, koji je infiltrirao više od ½ debljine miometrija. Patohistološkom analizom postavljena je dijagnoza HSCTGR. Postoperativni je tijek prošao bez komplikacija, a 22 mjeseca nakon operacije naša je pacijentica bez znakova recidiva bolesti. HSCTGR pripada skupini tumora s niskim malignim potencijalom te mogućnošću recidiviranja i metastaziranja nakon više godina, stoga se preporučuje dugoročno kliničko praćenj

A Case Report of Breast Angiosarcoma

Angiosarcoma is a rare disease of the breast with the reported incidence of only 0.04% of all breast malignancies. The etiology of angiosarcoma remains unknown. It occurs post-mastectomy, in association with chronic lymphedema (Stewart-Treves syndrome), or after radiotherapy. We present a patient with angiosarcoma which developed 12 years of the diagnosis of breast carcinoma and 8 years of the operative procedure and radiotherapy for disease recurrence. A small angiomatous lesion of a few mm in size, cytologically suspect of vascular tumor (hemangioma or hemangiopericytoma) and histopathologically verified to be an atypical vascular lesion, was detected two years before breast enlargement and cytologic and histologic diagnosis of angiosarcoma. The patient died 15 months of the diagnosis of angiosarcoma, after two tumor recurrences and intrathoracic cavity invasion

A Case Report of Breast Angiosarcoma

Angiosarcoma is a rare disease of the breast with the reported incidence of only 0.04% of all breast malignancies. The etiology of angiosarcoma remains unknown. It occurs post-mastectomy, in association with chronic lymphedema (Stewart-Treves syndrome), or after radiotherapy. We present a patient with angiosarcoma which developed 12 years of the diagnosis of breast carcinoma and 8 years of the operative procedure and radiotherapy for disease recurrence. A small angiomatous lesion of a few mm in size, cytologically suspect of vascular tumor (hemangioma or hemangiopericytoma) and histopathologically verified to be an atypical vascular lesion, was detected two years before breast enlargement and cytologic and histologic diagnosis of angiosarcoma. The patient died 15 months of the diagnosis of angiosarcoma, after two tumor recurrences and intrathoracic cavity invasion

Expression of MAGE-A and NY-ESO-1 cancer/testis antigens in medullary breast cancer: retrospective immunohistochemical study

AIM: To immunohistochemically evaluate the expression of MAGE-A1, MAGE-A, and NY-ESO-1 cancer/testis (C/T) tumor antigens in medullary breast cancer (MBC) tumor samples and to analyze it in relation to the clinicopathological features. ----- METHODS: This retrospective study included samples from 49 patients: 40 with typical MBC and 9 with atypical MBC. Tumor specimens were obtained from patients operated on in the University Hospital for Tumors and the Sisters of Mercy University Hospital, Zagreb, Croatia, from 1999 to 2005. Standard immunohistochemistry was used on archival paraffin-embedded MBC tissues. ----- RESULTS: MAGE-A1, MAGE-A, and NY-ESO-1 antigens were expressed in 33% (16/49), 33% (16/49), and 22% (11/49) of patients, respectively. No difference between the groups with and without C/T tumor antigen expression in age at diagnosis, tumor size, axillary lymph node metastasis, adjuvant therapy, and HER-2 expression was identified. Significantly more patients died in the MAGE-A-positive group than in the MAGE-A-negative group (P=0.010), whereas a borderline significance was found between MAGE-A1-positive and the MAGE-A1-negative group (P=0.079) and between NY-ESO-1-positive and NY-ESO-1-negative group (P=0.117). Overall survival, as evaluated by the Kaplan-Meier curves, was lower in MAGE-A1- (P=0.031), MAGE-A- (P=0.004), NY-ESO-1-positive groups (P=0.077). ----- CONCLUSION: Expression of C/T antigens may represent a marker of potential prognostic relevance in MBC