scholarly journals Hepatoid Carcinoma of the Ovary: Clinical, Histopathologic, and Immunophenotypic Features

2019 ◽  
Vol 143 (7) ◽  
pp. 883-889 ◽  
Author(s):  
Andres M. Acosta ◽  
Michael R. Pins

Hepatoid carcinoma of the ovary (HCO) is a rare malignant tumor of uncertain histogenesis that was first described by Ishikura and Scully in the late 1980s. Unlike hepatoid yolk sac tumor (HYST), one of its main differential diagnoses, HCO usually presents in perimenopausal and postmenopausal women without gonadal dysgenesis. Most cases show advanced local disease at initial presentation, with diffuse intraperitoneal dissemination. Despite aggressive treatment, including surgery and adjuvant chemotherapy, 61.5% of patients either die of the disease (11 of 26; 42.3%) or are alive with recurrent or residual disease (5 of 26; 19.2%) after a median follow-up of 11.5 months (range, 1–60 months). Most HCOs are solid, with high-grade histology, significant nuclear pleomorphism, scattered giant cells, and a high mitotic index. Their immunophenotype is defined by the expression of broad-spectrum cytokeratins, α-fetoprotein, and hepatocellular antigens with absence of sex cord and germ cell markers. Although immunohistochemistry can be very helpful to distinguish between sex cord–stromal tumors and HCO, differentiation of the latter from HYST, metastatic hepatocellular carcinoma, and metastatic gastrointestinal tumors with hepatoid phenotype requires integration of clinical, radiologic, and pathologic information.

2009 ◽  
Vol 64 (7) ◽  
pp. 455-457
Author(s):  
Gabriele Hölscher ◽  
Christoph Anthuber ◽  
Gunther Bastert ◽  
Alexander Burges ◽  
Doris Mayr ◽  
...  

2021 ◽  
Vol 8 (4) ◽  
pp. 1325
Author(s):  
Samir Paruthy ◽  
Shivani B. Paruthy

Gastrointestinal stromal tumors (GIST) are soft tissue mesenchymal tumor originating from intestinal cells of Cajal which are pace makers of the intestine. GIST commonly arises from stomach and intestine although they seem to appear occasionally in mesentery, omentum and esophagus, but origin from retro-peritoneum is very infrequent.  We herein report case of a huge retroperitoneal GIST measuring 16x13x9 cm size, in a 52-year-old lady occupying whole abdomen arising as pelvic mass. GIST was initially mistaken with associated large intramural fibroid uterus and a large pedunculated sub-serosa broad ligament fibroid. Patient was taken for abdominal open hysterectomy with complete tumor excision after all adhesions from adjoining intestine was separated. Histopathological examination of the mass confirmed it was retroperitoneal GIST with positive immune-histochemistry. Patient responded well to Imatinib therapy, and for last 4 years there has been no residual disease or recurrence as evidenced with regular follow up. 


2003 ◽  
Vol 21 (12) ◽  
pp. 2357-2363 ◽  
Author(s):  
D.T. Schneider ◽  
G. Calaminus ◽  
R. Wessalowksi ◽  
R. Pathmanathan ◽  
B. Selle ◽  
...  

Purpose: To develop diagnostic standards and a risk-adapted therapeutic strategy for ovarian sex cord–stromal tumors (OSCST). Patients and Methods: Fifty-four patients were prospectively enrolled as follow-up patients onto the German Maligne Keimzelltumoren protocols. Surgical protocols and histopathology were reviewed centrally (53 patients with complete data). Surgery included ovariectomy in 18 patients, salpingo-ovariectomy in 34 patients, and hysterectomy in one patient. Patients with stage IA tumors were followed-up at regular intervals, whereas nine patients with stage IC and six patients with stage II to III tumors were treated with cisplatin-based chemotherapy. Results: International Federation of Gynecology and Obstetrics stage was IA in 27 patients, IC in 21 patients, II in three patients, and III in three patients. After a median follow-up of 59 months (range, 6 to 193 months), event-free survival ± SD was 0.86 ± 0.05 (47 of 54 patients) and overall survival was 0.89 ± 0.05 (49 of 54 patients). Prognosis correlated with stage (event-free survival ± SD: IA, 1.0 [27 of 27 patients]; IC, 0.76 ± 0.09 [16 of 21 patients]; and II/III, 0.67 ± 0.19 [four of six patients]; P = .02). Ten of 15 patients treated with chemotherapy, including four of six stage II to III patients, are alive after a median follow-up of 33 months. Conclusion: On the basis of a standardized clinical and histopathologic assessment, risk-adapted therapeutic strategies for OSCST can be evaluated. Considering our experience, we would recommend that stage IA tumors be followed up at regular intervals, whereas we would recommend cisplatin-based chemotherapy in stage IC tumors with preoperative rupture or malignant ascites, especially those with high mitotic activity. Finally, cisplatin-based chemotherapy also seems to be effective in advanced-stage tumors.


2004 ◽  
Vol 128 (4) ◽  
pp. 440-443 ◽  
Author(s):  
Luigi Insabato ◽  
Dolores Di Vizio ◽  
Giuseppe Ciancia ◽  
Guido Pettinato ◽  
Luigi Tornillo ◽  
...  

Abstract Context.—One case of leiomyosarcoma and one case of gastrointestinal stromal tumor with prominent osteoclast-like giant cells have so far been reported in the digestive tract. Objective.—To ascertain the clinicopathologic features and biologic behavior of these tumors, we report 3 additional cases of leiomyosarcoma of the gastrointestinal tract and one malignant gastrointestinal stromal tumor. Design.—Histologic and immunohistochemical examinations were performed. Clinical and follow-up data were recorded, and the literature was reviewed. Results.—The age of the patients ranged from 50 to 68 years (mean, 62 years). One of the lesions arose in the stomach, one in the ileum, and 2 in the colon. Three tumors showed a strong positivity for muscle actin and desmin and were diagnosed as leiomyosarcomas, 2 of them showing spindle cells and 1 of them showing epithelioid cells. The fourth tumor reacted strongly positive for c-Kit (CD117) and vimentin, and it was diagnosed as an epithelioid malignant gastrointestinal stromal tumor. All tumors were characterized by numerous osteoclast-like giant cells that were unevenly distributed and that, using immunohistochemistry, reacted strongly with CD68. Conclusions.—Malignant stromal tumors with osteoclast-like giant cells of the gastrointestinal tract are rare entities, are more commonly of a myogenic origin such as leiomyosarcoma, and seem to have an aggressive behavior.


2004 ◽  
Vol 22 (17) ◽  
pp. 3517-3523 ◽  
Author(s):  
Jubilee Brown ◽  
Hyun S. Shvartsman ◽  
Michael T. Deavers ◽  
Thomas W. Burke ◽  
Mark F. Munsell ◽  
...  

Purpose To determine the efficacy and side effects of taxanes, with or without platinum, for the treatment of sex cord-stromal tumors of the ovary. Patients and Methods We conducted a retrospective review of all patients seen from 1985 to 2002 at The University of Texas M.D. Anderson Cancer Center with ovarian sex cord-stromal tumors. Eligible patients underwent pathology confirmation and clinical evaluation at M.D. Anderson and received a taxane for initial or recurrent disease. Results Of 222 patients identified, 44 were eligible for analysis. For nine patients treated in the first-line adjuvant setting, median progression-free survival (PFS) was not reached at 51 months. Of two patients treated for measurable disease in the first-line setting, one had a complete response. Median PFS was 34.3 months; median overall survival (OS) was not reached. Median follow-up was 90.3 months (range, 39.4 to 140.5 months). Response rate for 30 patients treated with a taxane ± platinum for recurrent, measurable disease was 42%. Median PFS was 19.6 months; median OS was not reached. Median follow-up was 100.7 months (range, 8.1 to 361.3 months). The presence of platinum correlated with response in the recurrent, measurable disease setting. The number of patients was insufficient to detect relative efficacy of paclitaxel and docetaxel. Adverse effects of paclitaxel included neutropenia (n = 6), anemia (n = 1), thrombocytopenia (n = 1), myelodysplasia (n = 1), and hypersensitivity (n = 1). Conclusion Taxanes seem to be active agents in the treatment of patients with sex cord-stromal tumors of the ovary. The combination of taxanes with platinum in the treatment of this disease deserves additional investigation.


1970 ◽  
Vol 39 (136) ◽  
pp. 351-353
Author(s):  
Kaveeta Dawaka ◽  
A Gupta ◽  
S Joshi ◽  
S Bajpai ◽  
H S Basi

A twenty eight year old lady, married for two years with no issue, presented at WesternRegional Hospital Pokhara on 8th July, 1999 with a history of amenorrhea for 1½years, lump abdomen 1 year, hoarseness of voice for 1 year and signs of hirsutism forthe same duration. She was taken up for laparotomy wherein a left ovariectomy withsalpingectomy was done and a large cystic ovarian tumor was removed. Post operativeperiod was uneventful and she was advised follow up. The histopathological diagnosiswas Adult Granulosa Cell Tumor. What made this case interesting is that mostGranulosa Cell Tumors (about 3/4th) are estrogenic or feminizing, but rare examples,including a disproportionate number of large thin walled cystic tumors are androgenic.This was one of those rare virilizing tumors with classical features of infertility,amenorrhea, hoarseness of voice, clitiromegaly, and breast atrophy, but we could notestimate testosterone levels due to lack of facilities available.Key Words: Granulosa Cell Tumor, Virilizing Ovarian Tumors, Sex Cord stromal tumors.


2009 ◽  
Vol 88 (4) ◽  
pp. 440-448 ◽  
Author(s):  
Gabriele Hölscher ◽  
Christoph Anthuber ◽  
Gunther Bastert ◽  
Alexander Burges ◽  
Doris Mayr ◽  
...  

2018 ◽  
pp. 3-14

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract (1%). These tumors express the CD 117 in 95% of cases. The stomach is the preferential localization (70%). Diagnosis is difficult and sometimes late. Progress of imaging has greatly improved the management and the prognosis. Computed tomography (CT) is the gold standard for diagnosis, staging, and treatment follow-up. The increasing recognition of GIST’s histopathology and the prolonged survival revealed some suggestive imaging aspects. Key words: gastro-intestinal stromal tumors; computed tomography; diagnosis


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