A Tale of 5Ms: Massive Uterine Leiomyoma Mimicking Ovarian Malignancy along with Multiple Fibroids Displaying Multiple Degenerations

Background: Leiomyomas are by far the commonest uterine neoplasms in the female reproductive age group. Giant leiomyomas are quite scarce and when longstanding tend to undergo various degenerations owing to decreased blood supply which on imaging may simulate malignancy owing to compromised blood supply and may simulate malignancy on imaging.Case Presentation: We present a case of a 48-year-old post-menopausal multiparous woman complaining of intermittent lower abdominal pain for a month. Suspected as an ovarian tumor clinically and on ultrasound, this was seconded by raised serum CA125 levels. Histopathological examination gave a definitive diagnosis of a giant uterine leiomyoma along with multiple fibroids exhibiting multiple degenerations.Conclusion: Degenerated leiomyomas can masquerade malignancy and hence should be one of the first differentials in women of reproductive age group presenting with complex abdominopelvic masses

Stromal Expression of CD10 in Breast Carcinoma and Its Association with Known Prognostic Factors—A Tissue Microarray-Based Study

Background Breast cancer is an epithelial malignancy; however, stroma plays a key role with its stimulatory and inhibitory factors in modulating tumor invasion and metastasis. CD10, a matrix metalloproteinase, is known to regulate cell adhesion, migration and helps in determining the progression of tumor. This knowledge helps to identify specific signals that promote growth, dedifferentiation, invasion, metastasis and serve as target for better therapeutic management. Objectives The aim of this study was to estimate frequency of expression of stromal CD10 and assess its prognostic significance in breast carcinomas by correlating with known prognostic factors. Materials and Methods Morphological parameters of 62 cases of carcinoma breast were studied on H&E (hematoxylin and eosin) stained sections and expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2/neu), and CD10 on manually constructed tissue microarray sections by immunohistochemistry (IHC). Staining pattern, percentage of stained cells, and intensity of stains were evaluated and IHC scoring of all markers was done. CD10 scores were correlated with the known prognostic factors (ER, PR, and HER2/neu). A p-value less than 0.05 was considered as significant. Results Stromal expression of CD10 was found in 82.3% of cases and it was significantly associated with increasing tumor size (p = 0.012), increasing tumor grade (p = 0.001), lymph node metastasis (p = 0.018), necrosis (p = 0.008), lymphovascular invasion (p = 0.008), ER negativity (p = 0.001), PR negativity(p = 0.007), HER 2 positivity (p = 0.012), triple-negative molecular subtypes (p = 0.001), and poor prognostic groups (p = 0.01). Conclusion CD10 can be used as an independent prognostic stromal marker and this will help to envisage new therapeutic strategies

A Tale of 5Ms: Massive Uterine Leiomyoma Mimicking Ovarian Malignancy along with Multiple Fibroids displaying Multiple Degenerations

Abstract Background: Leiomyomas are by far the commonest uterine neoplasms in the female reproductive age group. Giant leiomyomas are quite scarce and when longstanding tend to undergo various degenerations owing to decreased blood supply which on imaging may simulate malignancy owing to compromised blood supply and may simulate malignancy on imaging. Case Presentation: We present a case of a 48-year-old post-menopausal multiparous woman complaining of intermittent lower abdominal pain for a month. Suspected as an ovarian tumor clinically and on ultrasound, this was seconded by raised serum CA125 levels. Histopathological examination gave a definitive diagnosis of a giant uterine leiomyoma along with multiple fibroids exhibiting multiple degenerations. Conclusion: Degenerated leiomyomas can masquerade malignancy and hence should be one of the first differentials in women of reproductive age group presenting with complex abdominopelvic masses