Synchronous tumors of the female genital tract: A 20-year experience in a single center

Objective: To evaluate the clinicopathological characteristics and the clinical outcome of synchronous malignant neoplasms of the female reproductive tract. Material and Methods: Patients who were operated and diagnosed with synchronous malignant tumor of the genital system (n=25) at the Dokuz Eylul University Department of Obstetrics and Gynecology, Gynecologic Oncology Unit between 1992 and 2012 were included into this study. Recurrent, metastatic and metachronously detected tumors were not included. Age at diagnosis, parity, menopausal status, hormone use, presenting sign or symptoms and the clinical outcomes were evaluated. Results: 20 of 25 patients had endometrial-ovarian cancer. The mean age at diagnosis was 53,6 years. The most common presenting symptom was abnormal uterine bleeding. The median follow-up duration for all patients was 69 months. Overall survival for all patients was 87 months and 81 months for patients with endometrial-ovarian cancer. 5-year survival rate was 73% for all patients and 68% for patients with endometrial-ovarian cancer. Conclusions: Endometrial-ovarian cancer togetherness is the most common in synchronous gynecologic malignancies. They occur at a younger age and have more favorable prognosis than metastatic primary gynecologic tumors

Effect of mucinous differentiation in endometrioid type endometrial cancers on prognosis

Objectives: To evaluate the influence of mucinous differentiation in endometrioid endometrial cancer regarding spread and prognosis. Material and methods: Endometrioid endometrial cancer cases between 2015 and 2020 were collected retrospectively and divided into two groups according to the cytoplasmic mucin including. Prognostic factors and cancer spread related parameters were evaluated. Results: A total of 219 patients were enrolled in this study. One hundred twenty-two (55.7%) were endometrioid and 97 (44.3%) were in the mucinous differentiated endometrioid catagory. Age was similar between the groups (59.3 vs 58.7, p = 0.62), however, grade 3 lesions were more frequent in endometrioid type endometrial cancer (8.7% vs 1.4%, p < 0.01). Poor prognostic factors including myometrial invasion, lymphovascular space invasion (LVSI), lymph node metastases, peritoneal cytology, endocervical involvement, and stage were not significantly different between groups (p = 0.23, p = 0.49, p = 0.40, p = 0.15, p = 0.17, p = 0.55). The median overall survival time of endometrioid and mucinous differentiated endometrioid type endometrial cancer patients was determined 88.5 and 96.8 months, respectively (p = 0.46). Conclusions: Mucinous differentiation in the endometrioid type of endometrial cancer does not seem to affect the prognosis in endometrioid endometrial cancer patients

Expression of matrix metalloproteinase-2 and survivin in endometrioid and nonendometrioid endometrial cancers and clinicopathologic significance

Objective: To determine matrix metalloproteinase-2 and survivin expressions in endometrial cancers, their relation to clinical and histologic parameters and to investigate any difference in the expression of these markers between endometrioid and non-endometrioid cancers

Reproducibility of endometrial intraepithelial neoplasia diagnosis is good, but influenced by the diagnostic style of pathologists

Endometrial intraepithelial neoplasia (EIN) applies specific diagnostic criteria to designate a monoclonal endometrial preinvasive glandular proliferation known from previous studies to confer a 45-fold increased risk for endometrial cancer. In this international study we estimate accuracy and precision of EIN diagnosis among 20 reviewing pathologists in different practice environments, and with differing levels of experience and training. Sixty-two endometrial biopsies diagnosed as benign, EIN, or adenocarcinoma by consensus of two expert subspecialty pathologists were used as a reference comparison to assess diagnostic accuracy of 20 reviewing pathologists. Interobserver reproducibility among the 20 reviewers provided a measure of diagnostic precision. Before evaluating cases, observers were self-trained by reviewing published textbook and/or online EIN diagnostic guidelines. Demographics of the reviewing pathologists, and their impressions regarding implementation of EIN terminology were recorded. Seventy-nine percent of the 20 reviewing pathologists' diagnoses were exactly concordant with the expert consensus (accuracy). The interobserver weighted kappa values of 3-class EIN scheme (benign, EIN, carcinoma) diagnoses between expert consensus and each of reviewing pathologists averaged 0.72 (reproducibility, or precision). Reviewing pathologists demonstrated one of three diagnostic styles, which varied in the repertoire of diagnoses commonly used, and their nonrandom response to potentially confounding diagnostic features such as endometrial polyp, altered differentiation, background hormonal effects, and technically poor preparations. EIN diagnostic strategies can be learned and implemented from standard teaching materials with a high degree of reproducibility, but is impacted by the personal diagnostic style of each pathologist in responding to potential diagnostic confounders

Spinal Enterogenous Cysts In Infants

Intraspinal enterogenous cysts are very rare congenital cysts of endodermal origin, and tend to occur in anterior spinal intradural space. The diagnosis is usually established during the first or second decade of life. Those cysts are frequently associated with vertebral or spinal cord anomalies and dual malformation with mediastinal or abdominal cysts. We report two infants of posterior spinal enterogenous cyst in this study, one thoracolumbar (T12-L1) and one lumbar (L2-L4) presenting with features of subcutaneous lesion of posterior spinal. In one magnetic resonance imaging (MRI) showed a cystic mass extending to posterior intramedullary from subcutaneous localization at T12-L1, and in the other MRI demonstrated a syrinx extending from T11 to L1, tethered cord syndrome associated with a meningocele sac between L2 and L4. The cystic lesions in the patients were removed. The postoperative courses were uneventful. The patients appeared well after six years and four years of follow-up, respectively. Successful treatment requires early recognition of those cysts and their associated abnormalities

Spinal enterogenous cysts in infants

Intraspinal enterogenous cysts are very rare congenital cysts of endodermal origin, and tend to occur in anterior spinal intradural space. The diagnosis is usually established during the first or second decade of life. Those cysts are frequently associated with vertebral or spinal cord anomalies and dual malformation with mediastinal or abdominal cysts. We report two infants of posterior spinal enterogenous cyst in this study, one thoracolumbar (T12-L1) and one lumbar (L2-L4) presenting with features of subcutaneous lesion of posterior spinal. In one magnetic resonance imaging (MRI) showed a cystic mass extending to posterior intramedullary from subcutaneous localization at T12-L1, and in the other MRI demonstrated a syrinx extending from T11 to L1, tethered cord syndrome associated with a meningocele sac between L2 and L4. The cystic lesions in the patients were removed. The postoperative courses were uneventful. The patients appeared well after six years and four years of follow-up, respectively. Successful treatment requires early recognition of those cysts and their associated abnormalities

Ovarian metastasis of Mullerian adenosarcoma of the cervix with sarcomatous overgrowth

WOS: 000413787700013PubMed ID: 29085712The aim of this study is to present a rare case of Mullerian adenosarcoma of the cervix with ovarian metastasis and sarcomatous overgrowth. A gravida 2, para 2 woman aged 32 years with vaginal bleeding was admitted to the gynecology department. A 3-4 cm polypoid mass protruding from the cervix was detected in a pelvic examination. Total abdominal hysterectomy and bilateral salpingoopherectomy was performed because of metastatic implants on the right ovary. The pathologic evaluation revealed Mullerian adenosarcoma of the cervix with sarcomatous overgrowth and ovarian metastasis. After surgery, the patient was planned to undergo chemo- and radiotherapy. This is the first cervical Mullerian adenosarcoma case mentioned in the literature with metastasis to the ovary in a young woman. There is no optimal management option for cervical adenosarcomas due to the rarity of this phenomenon. Nevertheless, even if the patient is young and imaging techniques do not elucidate metastatic disease, surgeons should evaluate the ovaries for the spread of tumor, especially if histology reveals sarcomatous overgrowth

Three synchronous primary tumors with different histology detected by 18F-FDG PET/CT

The aim of this study is to present a patient with 3 primaries diagnosed with the 18F-FDG PET/CT study performed for the staging of endometrial cancer. Pathologic accumulations of the tracer were detected in both lobes of the thyroid gland, in the left lung and in the known primary of the uterus. A bilateral multifocal differentiated thyroid carcinoma and a peripheral carcinoid tumor in left lung were the final diagnosis as shown by histology. In conclusion, in this patient the PET/CT study performed for staging endometrial cancer demonstrated two new synchronous primary tumors. This is the second similar case but the first where all three primaries had entirely different histology