卵巢透明细胞癌的临床特点

目的 探讨卵巢透明细胞癌的临床特点。方法 将北京协和医科妇产科自1984年至2000年收治的43例卵巢透明细胞癌患者进行回顾性分析,并将卵巢透明细胞癌对化学药物治疗（化疗）的敏感性和生存率,与51例卵巢浆液性乳头状囊腺癌患者进行比较。结果 卵巢透明细胞癌早期患者所占比例为14．4％,浆液性乳头状囊腺癌为3．8％,两者比较,差异有极显著性（P＜0．005）。行满意肿瘤细胞减灭术的晚期透明细胞癌化疗耐药型患者为88．9％,明显多于浆液性乳头状囊腺癌患者的57．1％;1年生存率（79．0％）明显低于浆液性乳头状囊腺癌患者（96．2％,P＜0．01）;行不满意肿瘤细胞减灭术的晚期透明细胞癌患者化疗耐药型的比例（83．3％）和生存率（71．4％）与浆液性乳头状囊腺癌患者（94．1％和85．1％）比较,差异均无显著性（P＞0．05）。结论 卵巢透明细胞癌早期患者较多,易复发,预后差,应于术后进行以顺铂为主的化疗,并严密随诊。     

AnnexinⅡ蛋白和p53蛋白在卵巢腺癌中的表达及意义

目的:探讨钙磷脂结合蛋白Ⅱ(AnnexinⅡ)和p53蛋白在卵巢腺癌中的表达及临床意义。方法:采用免疫组化SP法检测77例卵巢腺癌和30例卵巢腺瘤组织中AnnexinⅡ蛋白和p53蛋白的表达。结果:AnnexinⅡ蛋白阳性率在卵巢腺瘤组织中为46.67%(14/30),在卵巢腺癌组织中为80.52%(62/77),两组相比有显著性差异(P<0.05);p53蛋白阳性率在卵巢腺瘤组织中为0.0%(0/30),在卵巢腺癌组织中为70.13%(54/77),两组相比有显著性差异(P<0.05);AnnexinⅡ蛋白、p53蛋白阳性表达与卵巢腺癌的组织学分级、临床分期和淋巴结转移均有关(P<0.05)。卵巢腺癌中AnnexinⅡ蛋白、p53蛋白阳性表达呈正相关。结论:AnnexinⅡ蛋白、p53蛋白阳性表达与卵巢腺癌的发生、发展和淋巴结转移均有关,p53蛋白可促进AnnexinⅡ蛋白的表达。     

Bilateral primary ovarian carcinomas: Case report

A case is presented of a patient with a primary high-grade medullary carcinoma of the left ovary with metastasis to the right ovary and a primary low-grade adenocarcinoma of the right ovary.     

Adenocarcinoma arising from respiratory ciliated epithelium in mature ovarian cystic teratoma

Malignant transformation of a mature cystic teratoma of the ovary is rare, that of an adenocarcinoma is extremely rare. A 32-year-old woman was suspected as having a malignant transformation of her mature cystic teratoma of the ovary because the preoperative level of carcinoembryonic antigen (CEA) was extremely high. Resections of her ovarian cysts were performed, and this particular tumor was histopathologically diagnosed as an adenocarcinoma arising from a mature cystic teratoma of the left ovary. Because adenocarcinomas arising from mature cystic teratomas of the ovary are extremely rare, we report this case with a review of some of the literature.     

Increasing expression of extracellular matrix metalloprotease inducer in ovary tumors: tissue microarray analysis of immunostaining score with clinicopathological parameters.

Ovary cancer invasion is responsible for both local tissue destruction and distant metastasis. Invasion is largely mediated by matrix metalloproteases that are thought to be induced by tumor cell-derived extracellular matrix metalloprotease inducer (EMMPRIN) in surrounding fibroblasts. We hypothesized that EMMPRIN isoverexpressed in ovary tumors. Immunohistochemical analysis of EMMPRIN was performed in tissue microarrays of ovary neoplasms including 84 cases of serous adenocarcinoma, 23 cases of mucinous adenocarcinoma, 10 cases of endometrioid adenocarcinoma, 12 cases of yolk sac tumor, 12 cases of clear cell carcinoma, 8 cases of dysgerminoma, 8 cases of granulosa cell tumor, 6 cases of transitional cell carcinoma, and 6 cases of Brenner tumor. All malignant ovary tumors showed significant immunohistochemical expression of EMMPRIN. The EMMPRIN scores in malignant ovary tumors were significantly higher than their nontumor counterparts (313+/-28 for serous adenocarcinoma; 308+/-25 for mucinous adenocarcinoma; 187+/-19 for endometrioid adenocarcinoma; 265+/-23 for yolk sac tumors; 87+/-13 for clear cellcarcinoma; 126+/-15 for dysgerminoma; 243+/-26 for granulosa cell tumor; 87+/-16 for transitional cell carcinoma). The EMMPRIN score was significantly higher in serous adenocarcinomas than in serous adenomas and serous borderline tumors and was correlated with nodal stage. Our findings show for the first time that EMMPRIN is overexpressed in all malignant ovary tumors.     

Gastric cancer diagnosed by biopsy of the uterine cervix

Biopsy of the uterine cervix from a 46-year-old woman who suffered from epigastric pain and weight loss showed metastatic adenocarcinoma. The primary site of the tumor was the stomach. At laparotomy, disseminated adenocarcinoma on the peritoneum and Krukenberg's tumor in the right ovary were found. A palliative partial gastrectomy, resection of the right ovary, and postoperative chemotherapy were performed. The possible mechanism of metastasis of extragenital cancer to the uterus is discussed.     

A heavily pretreated patient with recurrent clear cell adenocarcinoma of the ovary in whom carcinomatous peritonitis was controlled successfully by salvage therapy with gemcitabine

Introduction  Advanced clear cell adenocarcinoma of the ovary is a histologic type with an extremely poor prognosis. No reports have been published concerning useful drugs for salvage chemotherapy for this type of cancer. We performed salvage therapy with gemcitabine in a patient with multiple-drug- resistant, unresectable recurrent clear cell adenocarcinoma of the ovary and succeeded in stabilizing recurrent lesions and controlling carcinomatous peritonitis. Case report  A 55-year-old woman was in Stage IIIc of clear cell adenocarcinoma of the ovary. She had recurrent tumors after primary cytoreductive surgery, which were unresectable and also resistant to paclitaxel, carboplatin, irinotecan, and oral etoposide. After three courses of fourth-line chemotherapy with gemcitabine for the treatment of carcinomatous peritonitis and hepatic and splenic metastatic lesions, serum CA-125 and the severity of ascites showed marked decreases, and its efficacy for the hepatic and splenic metastatic lesions was classified as 5-month stable disease. The toxicity of this drug was in the acceptable range. Conclusion  Gemcitabine is also useful for heavily pretreated clear cell adenocarcinoma of the ovary. It is necessary to consider the use of drugs without cross resistance to platinum and taxanes in the selection of drugs for this cancer. An erratum to this article can be found at     

Hypercalcemia in association with mucinous adenocarcinoma of the ovary: a case report

Hypercalcemia in association with mucinous adenocarcinoma of the ovary has not previously been reported. Such a case is presented.     

Synchronous carcinomas of the uterine corpus and ovary

The coexistence of carcinoma in the endometrium and ovary is a relatively uncommon but not rare occurrence. In general it has not been possible to determine which, if any, of these tumors represent metastases from endometrium or ovary or separate primary neoplasms, and gynecologists are unable to agree upon appropriate therapy. Twenty-four women with synchronous carcinomas of the ovary and endometrium in whom disease was confined to the pelvis, diagnosed at the Milton S. Hershey Medical Center between 1970 and 1982, were identified. Thirteen women had typical endometrial adenocarcinoma and endometrioid carcinoma of the ovary (Group A), two had unusual variants of endometrial carcinoma and a similar appearing tumor in the ovary (Group B), and nine had typical endometrial adenocarcinoma with carcinomas in the ovary of differing histologic appearance (Group C). There was no significant difference in survival between women in Groups A and C (77 and 56%, respectively, mean follow-up approximately 40 months). However, deep myometrial invasion (outer third) provided a statistically significant indicator of poor prognosis (77% with deep invasion vs 17% with superficial invasion recurred or died of disease P less than 0.05, chi 2 test).     

Alpha-fetoprotein producing endometrial adenocarcinoma: report of a case

A case of endometrial adenocarcinoma which is producing alpha-fetoprotein (AFP) is described. AFP has been reported to be a tumor marker of gynecologic tumors, such as endodermal sinus tumor and embryonal carcinoma of the ovary. However, to our knowledge, there has been no report of AFP producing endometrial adenocarcinoma. The histologic study showed poorly differentiated adenocarcinoma of the endometrium and AFP was detected in the tumor cells by an immunoperoxidase-peroxidase-antiperoxidase technique.     

Primary ovarian small cell carcinoma of the pulmonary type: a case report and review of the literature

Small cell carcinoma of the ovary is a rare type of ovarian carcinoma with a poor prognosis. Two types should be distinguished: the hypercalcemic type and the pulmonary type. We report the case history of a 54-year-old woman with both a Stage IIIC small cell carcinoma, pulmonary type and a well-differentiated endometrioid adenocarcinoma of the left ovary in combination with a Brenner tumor in the right ovary. A review of the literature on small cell carcinoma of the ovary is given and the findings of our patient are brought into perspective in terms of both histopathogenesis and treatment outcome.     

Peutz-Jeghers syndrome with ovarian sex cord tumor with annular tubules and cervical adenoma malignum

A patient with Peutz-Jeghers syndrome, a sex cord tumor with annular tubules, and an initially unrecognized adenoma malignum of the cervix is described. The patient presented with a mucinous adenocarcinoma in the vaginal apex. Review of the hysterectomy slides demonstrated an adenoma malignum of the cervix. In addition to a microscopic sex cord tumor with annular tubules of the right ovary, the left ovary contained mucinous cystadenomas. Adenoma malignum remains a difficult diagnosis and is frequently made only after hysterectomy for a presumed benign indication; pathology frequently demonstrates a deeply invasive, unusually well-differentiated adenocarcinoma of the cervix. Patients with Peutz-Jeghers syndrome need careful clinical and cytologic follow-up to exclude such lesions.     

Complete remission of ovarian endometrioid adenocarcinoma associated with hyperamylasemia and liver metastasis treated by paclitaxel and carboplatin chemotherapy: a case report

Complete remission in the case of a 45-year-old woman with ovarian endometrioid adenocarcinoma associated with hyperamylasemia and liver metastasis is described. Ultrasound examination and CT scan revealed several large solid and cystic intra-abdominal tumors and a metastatic liver tumor. The serum amylase was 600 micro/l (normal value: 60-200 micro/l), and electrophoresis identified isoamylases of the salivary type. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed for invasive carcinoma of the left ovary. The histology of the left ovary showed endometrioid adenocarcinoma. Immunohistochemically, the adenocarcinoma cells were diffusely and strongly positive for amylase. The patient received six courses of paclitaxel and carboplatin combination chemotherapy. Two years later, the patient is alive and well, without evidence of disease. The prognosis of patients with ovarian cancer metastatic to the liver is uniformly poor. This represents the first report of complete remission of such a patient in the literature.     

Primary transitional cell carcinoma of the fallopian tube associated with primary carcinomas of the ovary and endometrium

A patient with primary transitional cell carcinoma of the fallopian tube, primary endometrial adenocarcinoma, and primary endometrioid carcinoma of the ovary is reported. The clinical picture was similar to that of adenocarcinoma of the fallopian tube, but the mode of spread was somewhat different and more aggressive. The patient was treated with surgery and a combination of internal and external radiotherapy.     

A case of coexistence of polycystic ovary syndrome and ovarian carcinoma]

There was a case of carcinoma of the ovary that coexisted with PCO syndrome in young, 25 years old woman. After clinical examination and USG doctors suspected PCO syndrome and hydrosalpings that is why the patient underwent an operation. In intraoperative histopathological examination bilateral adenocarcinoma were found. In prophylactic examination of patient's mother ovarian tumour was found that is also turned out to be an adenocarcinoma.     

Papillary serous carcinoma of the ovary following prolonged tamoxifen treatment.

We present a patient with breast cancer who developed papillary serous adenocarcinoma of the ovary after 13 years of tamoxifen use. The possible association is explored and the literature is reviewed.     

Primary carcinoma of stomach with uterine metastasis.

Curettings from a 42-year-old woman who suffered from heartburn, weight loss and irregular vaginal bleeding showed apparently metastatic mucoid adenocarcinoma in the endocervix. The primary site of tumour was not evident. At laparotomy a gastric adenocarcinoma was found and total hysterectomy with bilateral salpingo-oophorectomy and partial gastrectomy were performed. Histological examination showed a diffuse mucoid adenocarcinoma of stomach with metastases to lymph nodes, uterine body, cervix and one ovary. The literature about metastasis of extragenital cancer to the uterus is reviewed and possible mechanisms are discussed.     

Preoperative diagnostic imaging of normal-sized ovary carcinoma syndrome.

We treated a patient with a massive amount of ascites, the cytology of which contained adenocarcinoma (class V). The left ovary was slightly enlarged and the preoperative diagnostic imaging (PDI) suggested the presence of a malignancy. The right ovary was of normal size and the PDI presented no evidence of malignancy. the intra- and postoperative histological diagnosis was serous cystadenocarcinoma of the right ovary and fibroma of the left ovary. Therefore, this case can be classified as one of a normal-sized ovary carcinoma syndrome. Difficulties involved in the preoperative diagnosis of this syndrome and drawbacks of PDI are discussed.     

Serous ovarian carcinoma recurring as a heterologous carcinosarcoma

Only two cases of recurrence of heterologous carcinosarcoma from adenocarcinoma of the ovary have been documented in the published literature. We report a case of serous ovarian carcinoma recurring as a heterologous carcinosarcoma. The immunohistochemical analysis of several biological parameters in primary ovarian adenocarcinoma and recurrent carcinosarcoma has been also performed.     

Endometrioid adenocarcinoma with a functioning stroma

A case of a 70-year-old woman with endometrioid adenocarcinoma of the ovary with functioning stroma is presented. The symptom was postmenopausal bleeding. The preoperative level of serum estradiol was as high as 162.4 pg/mL, and serum gonadotropin levels were suppressed. The endometrial tissue showed hyperplastic changes. The surgical specimens consisted of a multilocular cystic ovarian tumor of 95 mm in diameter and an enlarged uterus. Histologically, the tumor was composed of proliferating, atypical, columnar cancer cells resembling early secretory endometrial cells, and condensation of plumed stromal cells resembling theca lutein cells. The diagnosis of endometrial adenocarcinoma of the ovary with functioning stroma was made. After surgery, the serum levels of estradiol decreased and of follicle-stimulating hormone increased. Almost all types of ovarian tumor have been reported to be associated with endocrine abnormalities. Mucinous epithelial ovarian tumors most commonly present with estrogenic stroma, although the frequency of endometrioid adenocarcinoma with functioning stroma is very low. Here, a rare case with the patient's clinical course and histopathologic findings is reported.