Type II endometrial cancers: A case series

Introduction: Endometrial carcinoma ranks 3rd in India among gynecological malignancies. Endometrial cancer (EC) can be classified into two distinct groups – type I and type II, based on histology, which differs in molecular, clinical and histopathological profiles. Type II is nonestrogen dependent, nonendometrioid, more aggressive and carries poor prognosis. Although type II cancers contribute only about 10% of EC incidence, they present at advanced age and cause approximately 50% recurrence and deaths with a low 5-year, overall survival rate. Type II EC are also characterized by genetic alterations in p53, human epidermal growth factor-2/neu, p16 and E-cadherin. Materials and Methods: Endometrial carcinomas diagnosed from endometrial biopsies and hysterectomy specimens received in the Department of Pathology, Kasturba Medical College, Mangalore, from January 2007 to June 2012 were included in the study. Clinicopathological analysis of the 84 cases of EC was done with emphasis on morphology. p53 immunostaining was performed in two cases of serous carcinoma. Results: Out of a total of 84 cases of EC, ten cases were of type II (11.9%). Out of which, eight were serous carcinoma (9.5%) and two clear cell (2.4%). p53 immunostain was strongly positive in the serous papillary carcinomas. The age of the patients ranged from 45 to 75 years. Myometrial invasion was more than half. Treatment was hysterectomy followed by aggressive chemotherapy. Conclusion: Of the type II EC, serous carcinoma is the most common type. Clinical presentation and prognosis differs in comparison to type I EC, thus the recognition of this type of EC is pivotal

Acquired Horner′s syndrome in an infant: A case report

Horner′s syndrome has varied etiology. We report a case of acquired Horner′s syndrome in an infant. A 3-month-old female child was referred for drooping of right eye upper lid on the second postoperative day following neck surgery. On examination, she had mild ptosis of right eye; with enophthalmos and miosis. A clinical diagnosis of Horner′s syndrome was made. One percent phenylephrine test was done which dilated right pupil, suggestive of a postganglionic lesion. The sample was biopsied and revealed an infected lymphatic cyst. Horner′s syndrome is a collection of signs due to interruption of sympathetic innervation to eye and face, characterized by miosis, mild ptosis, enophthalmos, and anhydrosis. The sympathetic pathway is a three neuron pathway. The present lesion is in the third order fibers which form plexus around the internal carotid artery. Dissection along the carotid can be an important cause for interruption of the sympathetic pathway

Therapy-induced histopathological changes in breast cancers: The changing role of pathology in breast cancer diagnosis and treatment

Aim: Breast cancer therapy causes morphological alterations in the cancerous as well as the surrounding healthy tissue. The histopathological interpretation in such cases, thus, requires a thorough knowledge of the cytological and stromal changes rendered by the therapy during and posttherapy. The aim of the present study was to evaluate such cytological and stromal changes rendered by the therapy in breast cancer cases. Methods: The present study was a combined retrospective and prospective study, wherein clinical and histopathological details were collected from a total of 39 cases of breast carcinoma before and posttherapy, and the changes induced by the therapy were correlated. Results: Stage II breast carcinoma was found to be the most predominant stage, while invasive ductal carcinoma-not otherwise specified (IDC-NOS) of tumor was the most common histologic type both before (94.87%) and after (76.92%) therapy. Pathologic complete response (pCR) was observed in 18% of the cases while 15% showed pathologic partial response (pPR) and 66.7% cases had a stable disease. Intracellular changes commonly noted after chemotherapy included nuclear enlargement, hyperchromasia, and increased nuclear: cytoplasmic ratio while predominant stromal changes included necrosis (74.4%), fibrosis (64.1%), and desmoplasia (59%). Conclusion: Breast cancer therapy causes morphological alterations in the cancerous as well as the surrounding healthy tissue. The histopathological interpretation in such cases, thus, requires a thorough knowledge of the cytological and stromal changes rendered by the therapy

Remoções maternas da Casa do Parto de Sapopemba para hospital de referência

Estudo descritivo com objetivo de caracterizar as remoções maternas da Casa do Parto de Sapopemba, em São Paulo, para hospitais de referência, entre setembro de 1998 e julho de 2008. A população do estudo compôs-se de 229 casos. Os dados foram obtidos dos prontuários e dos livros de registro de remoções. Foi realizada análise descritiva. A taxa de remoção materna foi de 5,8% (5,5% intraparto e 0,3% pós-parto). A maioria das mulheres removidas para o hospital era nulípara (78,6%). O motivo mais frequente para remoção intraparto foi anormalidade da pélvis materna ou do feto (22,6%) e para a remoção pós-parto, anormalidade da dequitação (50%). Destacaram-se a nuliparidade, dilatação cervical na admissão, membranas ovulares rotas e idade gestacional superior a 40 semanas como variáveis importantes para o estudo de fatores de risco para remoção materna