Adrenocortical neoplasm of uncertain malignant potential with a myelolipomatous component

2020 ◽  
Vol 13 (6) ◽  
pp. e234591
Author(s):  
Adithya Balasubramanian ◽  
Jason Scovell ◽  
Adam E Dowell ◽  
Wesley Mayer
Keyword(s):  
Adrenal Mass ◽  
Benign Neoplasm ◽  
Malignant Potential ◽  
Uncertain Malignant Potential ◽  
The Third ◽  
Potentially Malignant ◽  
Indeterminate Lesion ◽  
Fatty Component ◽  
Oncocytic Neoplasm

Macroscopic fat inside an adrenal lesion on CT is pathognomonic for myelolipoma, a benign neoplasm. Without macroscopic fat, it can be difficult to discern the nature of an indeterminate adrenal mass on imaging. One possible diagnosis for an indeterminate lesion without macroscopic fat is an adrenal oncocytic neoplasm (AON). Despite its typical benign presentation cases of malignant AON have been reported. Patients with malignant AON are often not surgical candidates and survival for unresected disease is 20%–35%. We present the third report of an AON of uncertain malignant potential (AONUMP) associated with a macroscopic fatty component with the largest reported size and longest duration of follow-up in the literature. This report details diagnostic and therapeutic challenges posed by AONUMP. This case highlights how pathognomonic radiographical findings associated with benign myelolipoma might mask rare, potentially malignant, lipomatous tumours.

scholarly journals Application of the Milan System for Reporting Salivary Gland Cytopathology: A Retrospective 12-Year Bi-institutional Study

2019 ◽  
Vol 151 (6) ◽  
pp. 613-621 ◽  
Author(s):  
Howard H Wu ◽  
Fatimah Alruwaii ◽  
Bao-Rung Zeng ◽  
Harvey M Cramer ◽  
Chiung-Ru Lai ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Benign Neoplasm ◽  
Malignant Potential ◽  
Salivary Gland Neoplasm ◽  
Uncertain Malignant Potential ◽  
Risk Of Malignancy ◽  
Predictive Rate ◽  
Sensitivity Specificity ◽  
Undetermined Significance

Abstract Objectives Multi-institutional studies are required for the validation of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). Methods A total of 1,560 fine-needle aspirations of the salivary glands were retrieved from two institutions for a 12-year period. The diagnoses were reclassified based on the MSRSGC. Risk of malignancy (ROM) for each category was calculated based on 694 histologic follow-up cases. Results The ROM for each category was: 18.3% for nondiagnostic, 8.9% for nonneoplastic, 37.5% for atypia of undetermined significance (AUS), 2.9% for benign neoplasm, 40.7% for salivary gland neoplasm of uncertain malignant potential (SUMP), 100% for suspicious for malignancy, and 98.3% for malignant. The sensitivity, specificity, positive predictive rate, and negative predictive rates were 89%, 99%, 98%, and 96%, respectively. Conclusions The results of the current study are in keeping with the MSRSGC. The indeterminate categories of AUS and SUMP showed intermediate ROMs at 37.5% and 40.7%, respectively.

scholarly journals The risk for malignancy using the Milan salivary gland classification categories: A 5-year retrospective review

CytoJournal ◽  
2019 ◽  
Vol 16 ◽  
pp. 14 ◽  
Author(s):  
Christine A. Liang ◽  
Jing Liu ◽  
Jaiyeola Thomas Ogunniyi ◽  
Hui Zhu ◽  
Songlin Zhang
Keyword(s):  
Salivary Gland ◽  
Positive Predictive Value ◽  
Risk Stratification ◽  
Predictive Value ◽  
Benign Neoplasm ◽  
Malignant Potential ◽  
Uncertain Malignant Potential ◽  
Sensitivity Specificity ◽  
Undetermined Significance

Aims: Since the six-tier Milan salivary gland classification has been introduced, there are very limited studies in literature reporting the risk stratification of the Milan classification. Methods: We retrospectively classified a total of 285 salivary gland cytology cases into Milan reporting categories; there were 23 (8.1%) nondiagnostic, 48 (16.8%) nonneoplastic, 19 (6.7%) atypia of undetermined significance (AUS), 138 (48.4%) benign neoplasm, 13 (4.6%) neoplasm of uncertain malignant potential (NUMP), 8 (2.8%) suspicious for malignancy, and 36 (12.6%) malignant. Almost 110 cases (38.6%) had surgical follow-up resections. Results: The overall risk for malignancy (ROM) was 12.5% for AUS, 3.2% for benign neoplasm, 72.7% for NUMP, and 100% for the suspicious for malignancy and malignant. The ROM for nondiagnostic and nonneoplastic categories was not representative due to limited follow-up resections. The salivary cytology had sensitivity, specificity, positive predictive value, and negative predictive value of 93.0%, 100%, 100%, and 46.2% for neoplasm and 82.3%, 95.8%, 90.3%, and 92.0% for malignant. Conclusion: Our study supports the adaptation of the six-tier Milan classification for reporting salivary gland cytology, as well as emphasizing the utility of the NUMP category.

scholarly journals Minimally invasive treatment options to borderline ovarian tumors

2016 ◽  
Author(s):  
Punita Bhardwaj ◽  
T. K. Das ◽  
S. Batra ◽  
Keyword(s):  
Early Stage ◽  
Treatment Options ◽  
Malignant Potential ◽  
Ovarian Tumors ◽  
Conservative Approach ◽  
Uncertain Malignant Potential ◽  
Invasive Treatment ◽  
Younger Women ◽  
Borderline Ovarian Tumors

Borderline Ovarian tumors are tumors of uncertain malignant potential. They have favour able prognosis. They occur in younger women and present at an early stage. They are difficult to diagnose preoperatively as macroscopic picture is a combination of benign and invasive ovarian tumors. Over the years surgical treatment has changed from radical to conservative approach without overlooking oncologic safety. Follows up is essential. Prolonged follow up (>10 yrs) is required because of later recurrences. Special attention is to be paid to the conserved ovary in follow up.

Incidental Prostatic Stromal Tumor of Uncertain Malignant Potential (STUMP): Histopathological and Immunohistochemical Findings

2012 ◽  
Vol 79 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Ettore De Berardinis ◽  
Gian Maria Busetto ◽  
Gabriele Antonini ◽  
Riccardo Giovannone ◽  
Mariarosaria Di Placido ◽  
...  
Keyword(s):  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Radical Retropubic Prostatectomy ◽  
Malignant Potential ◽  
Stromal Tumor ◽  
Uncertain Malignant Potential ◽  
Transperineal Prostate Biopsy ◽  
Stromal Sarcoma ◽  
Long Term Follow Up

Stromal prostate tumors are rare neoplastic proliferative lesions that have been classified into prostatic stromal tumor of uncertain malignant potential (STUMP) and prostatic stromal sarcoma (SS) based on these criteria: stromal cellularity, presence of mitotic figures, necrosis, and stromal overgrowth. A prostatic stromal tumor of uncertain malignant potential (STUMP) is a non-epithelial, mesenchymal spindle-cell tumor that can be classified as a specialized stromal tumor of the prostate. STUMPs have the capability to diffusely infiltrate the prostate gland and extend into adjacent tissues. Furthermore, they often recur and this is why they are considered as neoplastic entities. STUMPs usually tend to be not aggressive, but occasional cases have been reported with an extension into adjacent tissues. A few cases develop a sarcomatous dedifferentiation. A 67-year-old male referred to the Department of Urology, Sapienza Rome University, with acute urinary retention (AUR) and bladder overdistention. Digital rectal examination (DRE) showed the presence of a severe prostatic hyperplasia and a transvesical prostatic adenomectomy (TVPA) was performed. The pathological evaluation performed at the Department of Pathology, Sapienza Rome University, revealed an incidental diagnosis of prostatic STUMP. The patient's follow-up is made every year with transrectal ultrasonography and nuclear magnetic resonance with spectroscopy, and every two years with a transperineal prostate biopsy to exclude a progression to a stromal sarcoma. After 5 years of follow-up the STUMP is still detectable but there is no sign of sarcoma. As a result of its relative rarity and lack of long-term follow-up, the prognosis of STUMP is unclear. Therapy varies from a wait-and-see approach to a radical retropubic prostatectomy.

scholarly journals Adrenal Oncocytic Neoplasm with Uncertain Malignant Potential : ورم أونكوسايتوما للغدة الكظرية ذات السلوك الخبيث غير المؤكد

2013 ◽  
Vol 13 (2) ◽  
pp. 334-338 ◽  
Author(s):  
Mooyad A. Ahmed ◽  
SureshKannan K. S. ◽  
Zaid R. Raouf ◽  
Sreedharan V. Koliyadan ◽  
Christopher S. Grant ◽  
...  
Keyword(s):  
Malignant Potential ◽  
Uncertain Malignant Potential ◽  
Oncocytic Neoplasm

Clinical outcome of atypical uterine smooth muscle tumors

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15028-15028 ◽  
Author(s):  
B. Pothuri ◽  
S. M. Kehoe ◽  
T. Wright ◽  
T. Herzog
Keyword(s):  
Smooth Muscle ◽  
Clinical Outcome ◽  
Retrospective Chart Review ◽  
Malignant Potential ◽  
Low Grade ◽  
Uncertain Malignant Potential ◽  
Histologic Diagnosis ◽  
Cellular Atypia ◽  
Smooth Muscle Tumors

15028 Background: Smooth muscle tumors of uncertain malignant potential (STUMP) and atypical leiomyomas have increased mitotic activity, cellular atypia and necrosis but the degree is less than that used to define uterine leiomyosarcomas. Our objective is to evaluate the clinical outcome of patients with uterine masses histologically defined as smooth muscle tumors of uncertain malignant potential or atypical leiomyomas. Methods: A thorough search of our institution’s pathology database from 1990 to 2005 was performed. A retrospective chart review was performed to obtain initial and subsequent treatments, documented recurrences and clinical outcomes. Pathology reports and slides were reviewed and the presence of atypia, necrosis and number of mitosis was recorded. Statistical analysis was performed by Student’s T-test. Results: Eighteen patients with a histologic diagnosis of atypical leiomyoma were identified with 14 STUMP, 2 bizarre leiomyomas, 1 myxoid and 1 mitotically active leiomyoma. The mean age of these patients was 41.8 years (range: 25–77) and was significantly younger than those with leiomyosarcoma (mean age was 54 years, p < 0.001). The histologic characteristics of the tumors included the presence of atypia at 50%, necrosis at 82% and mitoses at 94%. The rate of necrosis and number of mitosis was significantly less in the atypical group as compared to the leiomyosarcoma group (p values < 0.05). However the rate of cellular atypia was not statistically different between the two groups. The median follow-up period was 25 months, range 1–138 months. One of the eighteen patients developed a pelvic and pulmonary recurrence at which time a low grade leiomyosarcoma was diagnosed. The recurrence occurred 32 months after the initial diagnosis of a mitotically active leiomyoma. Sixteen patients demonstrated no recurrence or metastatic disease at the time of follow-up. Conclusions: Atypical leiomyomas appear to be diagnosed in younger women which leads to challenging treatment issues involving fertility preservation. While these tumors generally behave in a benign fashion, they have histologic characteristics that may allow for progression or recurrence. Close follow-up is warranted for patients who are diagnosed with atypical leiomyomas and smooth muscle tumors of uncertain malignant potential. No significant financial relationships to disclose.

Nested (Ossifying) Stromal Epithelial Tumor of the Liver: Case Report

2009 ◽  
Vol 12 (3) ◽  
pp. 233-236 ◽  
Author(s):  
Karen Meir ◽  
Alexander Maly ◽  
Victoria Doviner ◽  
Eitan Gross ◽  
Michael Weintraub ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
English Language ◽  
Malignant Potential ◽  
Liver Mass ◽  
Uncertain Malignant Potential ◽  
Cytokeratin 18 ◽  
Epithelial Tumor ◽  
Antenatal Ultrasound ◽  
Language Literature

Nested stromal-epithelial tumor (NSET) of the liver is an extremely rare primary hepatic tumor with uncertain malignant potential. To date, only 11 cases have been described. We describe the case of a 2 1/2-year-old girl with an incidental liver mass. The mass was discovered on follow-up abdominal imaging for asymptomatic hydronephrosis diagnosed on antenatal ultrasound. Needle biopsy showed a mixed stromal and epithelial process in a nested pattern, with foci of ossification and no significant pleomorphism or necrosis. The nest cells stained with WT-1, cytokeratin 18, and CD56. Ossifying stromal epithelial tumor of the liver was strongly suspected. The findings were confirmed in the subsequent partial hepatectomy specimen. To our knowledge, this is the 12th case of NSET in the English-language literature and the 3rd case of NSET associated with genitourinary system abnormalities. Possible associations with dysregulated WT-1 expression are discussed.

Clinical and Pathological Features of Prostatic Stromal Tumor of Uncertain Malignant Potential: A Retrospective Study of 23 Chinese Cases

2020 ◽  
pp. 1-9
Author(s):  
Qi Shen ◽  
Zhaohui Zhou ◽  
Zhenhua Liu ◽  
Shuai Hu ◽  
Zhiyong Lin ◽  
...  
Keyword(s):  
Disease Progression ◽  
Rare Disease ◽  
Subgroup Analysis ◽  
Specific Antigen ◽  
Malignant Potential ◽  
Stromal Tumor ◽  
Uncertain Malignant Potential ◽  
Stromal Sarcoma ◽  
The Mean

<b><i>Introduction:</i></b> Prostatic stromal tumor of uncertain malignant potential (STUMP) is a rare disease that may coexist with prostate stromal sarcoma (PSS). We aimed to analyze the histological and clinical features of STUMP. <b><i>Methods:</i></b> Twenty-three patients diagnosed with STUMP from 2008 to 2019 were included. Clinicopathological and follow-up information was collected. In the subgroup analysis, we divided the patients into a pure STUMP group (<i>N</i> = 18) and a mixed STUMP (STUMP coexisting with PSS) group (<i>N</i> = 5). Student’s <i>t</i> test was used to compare the 2 groups. <b><i>Results:</i></b> Patients had a mean age of 55.5 ± 19.4 years and an average follow-up time of 42.3 months. The mean prostate volume was 109.2 ± 73.5 cm<sup>3</sup>, and the mean prostate-specific antigen was 8.03 ± 10.5 ng/mL. In the subgroup analysis, 16.7% (2/12) of pure STUMP patients had disease progression, while 100% (3/3) of mixed STUMP patients suffered from recurrence. Compared with the pure STUMP group, the mixed STUMP group was younger (37.2 vs. 60.6 years, <i>p</i> = 0.013) and had lower expression of estrogen receptor and progesterone receptor (<i>p</i> = 0.004 and <i>p</i> &#x3c; 0.001, respectively). <b><i>Conclusion:</i></b> STUMP is a rare disease with a relatively good prognosis. However, there is still a possibility of disease progression or coexistence with stromal sarcoma. Timely diagnosis and regular monitoring may be helpful in improving treatment outcomes.

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