Potential for Mitochondrial DNA Sequencing in the Differential Diagnosis of Gynaecological Malignancies

In the event of multiple synchronous gynecological lesions, a fundamental piece of information to determine patient management, prognosis, and therapeutic regimen choice is whether the simultaneous malignancies arise independently or as a result of metastatic dissemination. An example of synchronous primary tumors of the female genital tract most frequently described are ovarian and endometrial cancers. Surgical findings and histopathological examination aimed at resolving this conundrum may be aided by molecular analyses, although they are too often inconclusive. High mitochondrial DNA (mtDNA) variability and its propensity to accumulate mutations has been proposed by our group as a tool to define clonality. We showed mtDNA sequencing to be informative in synchronous primary ovarian and endometrial cancer, detecting tumor-specific mutations in both lesions, ruling out independence of the two neoplasms, and indicating clonality. Furthermore, we tested this method in another frequent simultaneously detected gynecological lesion type, borderline ovarian cancer and their peritoneal implants, which may be monoclonal extra-ovarian metastases or polyclonal independent masses. The purpose of this review is to provide an update on the potential use of mtDNA sequencing in distinguishing independent and metastatic lesions in gynecological cancers, and to compare the efficiency of molecular analyses currently in use with this novel method.

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Synchronous primary endometrial and ovarian cancer with three different histologic patterns: A case report

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200309000-00017 ◽

2003 ◽

Vol 13 (5) ◽

pp. 678-682 ◽

Cited By ~ 3

Author(s):

Y.-S. Ree ◽

S.-H. Cho ◽

S.-R. Kim ◽

S.-H. Cho ◽

K.-T. Kim ◽

...

Keyword(s):

Clear Cell ◽

Clear Cell Carcinoma ◽

Female Genital Tract ◽

Figo Stage ◽

Primary Cancer ◽

Metastatic Lesions ◽

Synchronous Cancers ◽

Stage Ia ◽

The Right ◽

Female Genital

Synchronous cancers involving both endometrium and ovary in the female genital tract is a well-recognized phenomenon. However, most of them are metastatic lesions arising from one organ and simultaneous primary cancer occurring in both organs is relatively rare. We report a case with dual primary cancer occurring in both ovaries and endometrium with three different histologies. Recently, a 46-year-old women presented with vaginal bleeding was found to have FIGO stage IC clear cell carcinoma of the left ovary, stage IA borderline mucinous cystadoma of the right ovary, and stage IB endometrial carcinoma of endometrioid type. We present this case with a brief review of references.

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Spectrum of histopathological lesions in the fallopian tubes

Journal of Pathology of Nepal ◽

10.3126/jpn.v3i5.7858 ◽

2013 ◽

Vol 3 (5) ◽

pp. 356-360 ◽

Cited By ~ 1

Author(s):

S Gon ◽

A Basu ◽

B Majumdar ◽

TK Das ◽

M Sengupta ◽

...

Keyword(s):

Genital Tract ◽

Histopathological Examination ◽

Female Genital Tract ◽

Secondary Malignancies ◽

Fallopian Tubes ◽

Serial Sections ◽

Pathology Laboratory ◽

Surgical Specimen ◽

Neoplastic Lesions ◽

Female Genital

Background: Fallopian tubes are common surgical specimen in the pathology laboratory; still there is a lack of data to describe the frequency of various histological fi ndings. The aim and objectives of this study was to describe the various histopathological fi ndings of fallopian tubes. Materials and Methods: Two thousand fi ve hundred and seventy fi ve cases where fallopian tubes were removed either separately or along with other female genital tract organs were studied retrospectively and their histopathological fi ndings documented. Results: Ectopic pregnancy comprised maximum number of cases closely followed by salpingitis. Primary neoplastic lesions were rare as compared to secondary malignancies. Serial sections of fallopian tube and sections from representative areas are essential for a pathologist so that the diagnosis of these pathological entities is not missed. Conclusion: Though the fallopian tubes remain unremarkable in majority of the surgical pathological specimens, it must be subjected for histopathological examination to demonstrate the pathological lesions. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 356-360 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7858

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Synchronous primary tumors of the endometrium and ovary

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i3.6019 ◽

1970 ◽

Vol 2 (3) ◽

pp. 189-192 ◽

Cited By ~ 1

Author(s):

S Karki ◽

U Chapagain

Keyword(s):

Genital Tract ◽

Endometrial Hyperplasia ◽

Female Genital Tract ◽

Premenopausal Women ◽

Ovarian Tumors ◽

University Teaching ◽

Primary Tumors ◽

Atypical Endometrial Hyperplasia ◽

Ovarian Cancers ◽

Female Genital

Background: Primary synchronous cancer of the female genital tract is a relatively uncommon. Simultaneously detected endometrial and ovarian malignancies constitute the commonest occurrence. A set of pathological criteria has been described to differentiate synchronous primaries from metastatic tumors. The purpose of this study was to characterize patients with synchronous primary endometrial and ovarian tumors. Materials and Methods: This was a retrospective study done in Department of Pathology, Tribhuwan University Teaching Hospital from September 2006 to August 2011. The datas were retrieved from computer database. Results: There were totally of 10 cases of simultaneously detected endometrial and ovarian cancers. Out of 10 cases, 7 cases were synchronous primary endometrial and ovarian cancers while three were metastatic. Median age at presentation was 47.4 years. Six (85.8%) of these patients presenting with dual primary tumors were premenopausal. Grade 1 histology was seen in 57% of endometrial and 42% of ovarian tumors. Atypical endometrial hyperplasia was found in 42.8% of cases while none of the cases showed endometriosis. Conclusion: Though limited by relatively small number of cases, younger and premenopausal women were predisposed to developing synchronous primary tumors of the endometrium and ovary. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6019 JPN 2012; 2(3): 189-192

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Xanthogranulomatous Endometritis: A Challenging Imitator of Endometrial Carcinoma

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2007/34763 ◽

2007 ◽

Vol 2007 ◽

pp. 1-3 ◽

Cited By ~ 5

Author(s):

A. Işın Doğan-Ekici ◽

Alp Usubütün ◽

Türkan Küçükali ◽

Ali Ayhan

Keyword(s):

Endometrial Carcinoma ◽

Genital Tract ◽

Plasma Cells ◽

Histopathological Examination ◽

Female Genital Tract ◽

Giant Cells ◽

Polymorphonuclear Leucocytes ◽

Xanthogranulomatous Inflammation ◽

Post Menopausal ◽

Female Genital

Xanthogranulomatous inflammation is a distinguished histopathological entity affecting several organs, predominantly the kidney and gallbladder. So far, only a small number of cases of xanthogranulomatous inflammation occurring in female genital tract have been described, most frequently affecting the endometrium and histologically characterized by replacement of endometrium by xanthogranulomatous inflammation composed of abundant foamy histiocytes, siderophages, giant cells, fibrosis, calcification and accompanying polymorphonuclear leucocytes, plasma cells and lymphocytes of polyclonal origin. We present a case of a 69-year-old female complained of post menopausal bleeding and weight loss. Clinical preliminary diagnoses were endometrial carcinoma or hyperplasia and ultrasound was supposed to be endometrial malignancy, hyperplasia or pyometra by radiologist. Histopathological examination of uterus revealed xanthogranulomatous endometritis. Since xanthogranulomatous endometritis may mimic endometrial malignancy clinically and pathologically as a result of the replacement of the endometrium and occasionally invasion of the myometrium by friable yellowish tissue composed of histiocytes, knowledge of this unusual inflammatory disease is needed for both clinicians and pathologists.

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Synchronous primary ovarian sex cord tumor and endometrial cancer

10.1055/s-0039-1685384 ◽

2016 ◽

Author(s):

S. A. Iqbal ◽

H. Shukla ◽

V. Jain ◽

S. Giri ◽

R. Sekhon ◽

...

Keyword(s):

Genital Tract ◽

Ovarian Tumor ◽

Early Stage ◽

Female Genital Tract ◽

Low Grade ◽

Primary Tumors ◽

Stromal Tumors ◽

Gynaecological Tumours ◽

Sex Cord Stromal Tumors ◽

Female Genital

Synchronous primary tumors of female genital tract are rare with a rate of about 0.7-1.8% of all gynaecological tumours. Most common primary tumours presenting as synchronous lesions are ovary and endometrium. However, sex cord stromal tumors are rare variety of primary ovarian tumor and synchronous with endometrium is even much rarer. These tumors are detected usually in younger, overweight, nulliparous and perimenopausal female. Synchronous primary tumors of endometrium and ovary have a better prognosis than the either of above alone because these are usually low grade and diagnosed at early stage. We present a report of four cases of synchronous endometrial and sex cord stromal tumors of ovary.

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Hydatid cyst of broad ligament: a rare case report

International Surgery Journal ◽

10.18203/2349-2902.isj20201414 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1298

Author(s):

Ajay Gujar ◽

Jayant Pednekar ◽

Nida Khan ◽

Anurag Tiwary ◽

Rohith Pillai ◽

...

Keyword(s):

Hydatid Cyst ◽

Genital Tract ◽

Histopathological Examination ◽

Broad Ligament ◽

Female Genital Tract ◽

Surgical Excision ◽

Cystic Mass ◽

Rare Case Report ◽

Peculiar Case ◽

Female Genital

Hydatid cyst is a parasitic disease caused by tapeworm Echinococcus. It affects the liver and lung most commonly, but may rarely affect fallopian tube, broad ligament and other structures. One such peculiar case is where a 17 years old female presented with a rapidly growing cystic mass in lower abdomen, clinically suspicious of ovarian mass or mesentric cyst. Investigations failed to identify the nature. On laparotomy, excision of the mass was done. Suprisingly histopathological examination identified the lesion as hydatid cyst arising from the broad ligament. Patient responded well to surgical excision followed by albendazole administration. Female genital tract hydatidosis is a rare entity and in most cases the involvement is secondary. Primary hydatid disease of female genital tract is even very rarer and generates considerable diagnostic difficulty.

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EVALUATION OF THE ENDOMETRIAL CHANGES IN FEMALES DIAGNOSED WITH THE UTERINE LEIOMYOMAS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1149 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

Aakarsh Sinha ◽

Kumar Amit

Keyword(s):

Uterine Leiomyoma ◽

Histopathological Examination ◽

Treatment Options ◽

Female Genital Tract ◽

Uterine Leiomyomas ◽

Muscle Fibres ◽

Medical College ◽

Glandular Atrophy ◽

Gross Examination ◽

Female Genital

The female genital tract includes the uterine corpus and cervix. The uterus consists of the endometrium and myometrium which are continuously stimulated by hormones, denuded monthly of its endometrial mucosa and inhabited periodically by foetuses. Together with the lesions that affect the cervix, the lesions of the corpus of the uterus and the endometrium account for most patient visits to gynaecologists. Many treatment options are available nowadays including medical and conservative surgical procedures. Hence based on above findings the present study was planned for Evaluation of the Endometrial Changes in Females Diagnosed with the Uterine Leiomyomas. The present study was planned in Department of Obstetrics and Gynaecology, Madhubani Medical College and Hospital, Madhubani, Bihar. In the present study 50 cases of the females diagnosed with the uterine leiomyomas were enrolled. Gross examination was performed with respect to size and weight of uterus, location of fibroids and endometrial polyp if any was noted. Tissue bits from the fundic endometrium, tissue from both sides of endometrial canal & endometrium subjacent to sub mucosal leiomyoma were taken for histopathological examination, processed and sections of 5 micron thickness stained with haematoxylin and eosin.The data generated from the present study concludes that Different patterns are seen in the endometrium of leiomyomatous uteri as a result of mechanical or hormonal factors such as dilated/ distorted glands, glands parallel to long axis of myometrium, glands separated by muscle fibres, focal total or subtotal glandular atrophy and polyposis which are statistically significant in identifying uterine leiomyoma. Further, total and subtotal endometrial glandular atrophy showed significant association with submucosal leiomyoma. Keywords: Leiomyoma, Endometrium, Menorrhagia, etc.

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Osteosarcoma of the Myometrium Synchronous with Bilateral Papillary Cystadenocarcinoma of the Ovary and Papillary Adenocarcinoma of the Cervix

Tumori Journal ◽

10.1177/030089168807400219 ◽

1988 ◽

Vol 74 (2) ◽

pp. 227-231 ◽

Cited By ~ 3

Author(s):

Fulvio Basolo ◽

Raffaele Pingitore ◽

Angelo Gadducci

Keyword(s):

Genital Tract ◽

Rare Case ◽

Female Genital Tract ◽

Papillary Adenocarcinoma ◽

Pathological Features ◽

Primary Tumors ◽

The World ◽

Clinical And Pathological Features ◽

Female Genital

We report an extremely rare case of a 60-year-old woman with myometrial osteosarcoma associated with bilateral papillary cystadenocarcinoma of the ovary and papillary adenocarcinoma of the cervix. The uterine osteosarcoma is the seventh case reported in the world, while it is the second case of syncronous triple primary tumors of the upper female genital tract. Clinical and pathological features of previously reported cases of uterine osteosarcoma and triple primary neoplasias of the upper female genital tract are critically reviewed.

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The Wide Morphological Spectrum of Deep (Aggressive) Angiomyxoma of the Vulvo-Vaginal Region: A Clinicopathologic Study of 36 Cases, Including Recurrent Tumors

Diagnostics ◽

10.3390/diagnostics11081360 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1360

Author(s):

Gaetano Magro ◽

Giuseppe Angelico ◽

Michal Michal ◽

Giuseppe Broggi ◽

Gian Franco Zannoni ◽

...

Keyword(s):

Female Genital Tract ◽

High Rate ◽

Aggressive Angiomyxoma ◽

Neoplastic Cells ◽

Primary Tumors ◽

Clinicopathologic Study ◽

Recurrent Tumors ◽

Typical Morphology ◽

Locally Recurrent ◽

Female Genital

Background: Deep angiomyxoma (DAM) is currently included in the category of “specific stromal tumors of the lower female genital tract”, along with angiomyofibroblastoma, cellular angiofibroma and myofibroblastoma. Given the high rate of local recurrences, it is crucial to recognize DAM from other tumors that possess indolent behaviour. In the present paper, we analyzed the morphological and immunohistochemical features of 42 surgically-resected vulvo-vaginal DAMs (36 primary and 6 recurrent lesions) in order to widen the morphological spectrum of this uncommon tumor. Methods: A series of 36 cases of surgically-resected primary vulvo-vaginal DAMs were retrospectively collected. Locally recurrent tumors were also available for six of these cases. Results: Out of the primary tumors, 25 out of 36 exhibited the classic-type morphology of DAM. In the remaining cases (11/36 cases), the following uncommon features, which sometimes coexist with one another, were observed: (i) alternating myxoid and collagenized/fibrous areas; (ii) hypercellular areas; (iii) neurofibroma-like appearance; (iv) perivascular hyalinization; (v) microcystic/reticular stromal changes; (vi) “microvascular growth pattern”; (vii) perivascular cuffing; (viii) nodular leiomyomatous differentiation; (ix) hypocellular and fibro-sclerotic stroma. Among the six locally recurrent tumors the following features were observed: (i) classic-type morphology; (ii) hypocellular fibro-sclerotic stroma; (iii) extensive perivascular hyalinization, lumen obliteration and formation of confluent nodular sclerotic masses; (iv) hypercellularity. Immunohistochemically, the neoplastic cells of classic-type DAM in both primary and recurrent tumors were diffusely stained with desmin, suggesting a myofibroblastic nature; in contrast, the neoplastic cells showing elongated fibroblastic-like morphology and set in collagenized/fibrosclerotic stroma in both primary and recurrent tumors were negative or only focally stained with desmin, which is consistent with a fibroblastic profile. Conclusion: Although diagnosis of DAM is usually straightforward if typical morphology is encountered, diagnostic problems may arise when a pathologist is dealing with unusual morphological features, especially hypercellularity, extensive collagenous/fibrosclerotic stroma or neurofibroma-like appearance.

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