Sarcomatoid carcinoma of the cervix: case report of a rare entity

Background Sarcomatoid carcinoma of the cervix is a rare entity. To date, less than 20 cases have been reported in the English literature. Case We present a case of a 75-year-old multigravida woman who was treated with radiation therapy. Conclusion It is an aggressive tumour and primary treatment with radiation in early stage disease offers an effective form of therapy.     

Giant mucinous cystadenocarcinoma: a case report

We present a mucinous cystadenocarcinoma weighing 10 kg in a postmenopausal woman and the way how we managed the case. Received: 7 December 2001 / Accepted: 29 December 2001 Correspondence to N. K. Kuşcu     

A rare case of a variant cervical polyp in adolescence

The authors, stress on the importance of the examination of the vagina and the cervix in case of a mucous bleeding at adolescent girls. The following case is being introduced: after examination of a 16-year-old patient who had undergone a two-year treatment for a vaginal discharge, a bleeding polyp, the size of an egg and attached to a leg was found and extirpated. The histological examination read as "a myomatous polyp of the cervical canal with hemorrhagic necrosis". This case has been compared with the already published classes. The authors discuss some possibilities for differential diagnosis of the subjective symptoms and biopsy in adolescence. The conclusion is that gynecologists should use vaginoscopy as additional diagnostic method.     

Post-coital bleeding: a rare and unusual presentation of cervical endometriosis

Introduction: Often due to benign conditions such as cervical ectopy, post-coital bleeding is a distressing symptom for the patient. However, for the clinician, the identification of the etiology is important in order to effect proper treatment. Case report: We present a case referred to the colposcopy clinic because of post-coital bleeding and a smear report of ‘groups of benign glandular cells of endometrial origin’. Colposcopy was normal but histology of an excised haemorrhagic nodule revealed endometriosis with resolution of symptoms. Conclusion: Cervical endometriosis should be considered in the differential diagnosis of post-coital bleeding with no obvious ectopy or malignancy.     

Mesonephric adenocarcinoma of the cervix: a case report and review of the literature

BACKGROUND: Malignant mesonephric tumor arising in the uterine cervix is an exceedingly uncommon variant of cervical adenocarcinoma with only 30 well-documented cases in the literature. CASE: We present a case of a 54-year-old woman with postmenopausal vaginal bleeding who was found to have a stage IB mesonephric adenocarcinoma of the cervix. CONCLUSION: At present there is no consensus on a standardized treatment protocol for malignant mesonephric tumors of the cervix. The present case suggests that a favorable outcome may be achieved for patients with stage IB tumors with aggressive initial therapy.     

Lymphoma of the cervix: a case report with review of literature

Although secondary involvement of the genital tract by non-Hodgkin’s lymphoma is not uncommon, primary malignancies are very rare. We describe a case of primary non-Hodgkin’s lymphoma of the cervix in a 44-year-old woman. The clinical history and management along with a review of literature regarding this condition is described.     

Ovarian ligament adenomyoma: report of a rare entity with review of the literature

Adenomyoma is a benign tumor composed of endometrial glands, specialized endometrioid stroma, and smooth muscle. These tumors typically originate within the uterus. An extrauterine adenomyoma is an extremely rare entity. We present the case of a 56-year-old perimenopausal woman with a right adnexal mass, diagnosed histopathologically as an ovarian ligament adenomyoma. This report documents a fourth case of an extrauterine adenomyoma and only the second case in ovarian ligament. The differential diagnosis includes endometrioma, leiomyomatosis peritonealis disseminata, uterus-like mass lesion and extrauterine leiomyoma with entrapped endometrioid glands and stroma. Two theories for the etiology of adenomyoma have been proposed: (i) Müllerian duct fusion defect and (ii) metaplasia.     

Mullerian adenosarcoma with sarcomatous overgrowth of the cervix presenting as cervical polyp: a case report and review of the literature

An aggressive variant of adenosarcoma, mullerian adenosarcoma with sarcomatous overgrowth (MASO) in the cervix is extremely rare. This variant contains obvious, high-grade sarcoma in addition to a low-grade form. In this report, we describe a case of MASO of the uterine cervix and review the clinical and pathological features of these tumors. The patient was a 37-year-old woman with a cervical polypoid mass, which was morphologically considered as a benign endocervical polyp. Microscopically, polypoid cervical mass showed diffuse and dense malignant spindle cell proliferation around the benign endocervical glands and also an area of markedly anaplastic and pleomorphic spindle cell proliferation, so called, sarcomatous overgrowth. Total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection were performed. The patient has been followed-up and neither chemotherapy nor other adjuvant therapies have been administered. At present, she has been clinically free of disease for 9 months since she received surgery. It is extremely rare that MASO of the uterine cervix is presented in premenopausal woman. Gynecologists and pathologists should be aware of the difficulties associated with a delay in the diagnosis of MASO when the tumor is present as a benign looking cervical polyp.     

Alveolar soft part sarcoma of the cervix: case report and literature review

Alveolar soft part sarcoma (ASPS) is a rare mesenchymal malignancy typically found in the extremities or chest of young adults. We present a case of an alveolar soft part sarcoma arising in the endocervix of a 38-year-old premenopausal woman. This cancer was treated by extrafascial hysterectomy. No evidence of metastatic disease was found after extensive surgical staging. Since treatment, she has since remained disease-free for more than 5 years without additional therapy. This is the second case of ASPS arising in the endocervix of which we are aware. Our observations suggest simple hysterectomy suffices for optimal clinical management of cervical ASPS and that surgical staging of this disease offers little prognostic benefit.     

Endometrial polyp size and polyp hyperplasia

Objective

To assess the correlation between the size of endometrial polyps and the histopathologic diagnosis of hyperplasia or cancer.

Methods

A retrospective study was conducted using databases of the outpatient clinic at Antonio Pedro University Hospital in Niterói, Brazil, and of a private hysteroscopy service. The analysis included 1136 asymptomatic patients with an endometrial polyp identified on hysteroscopy, with pathologic examination, during the period 1999–2012. The polyp size, the patients’ age, the indication for hysteroscopic examination, and the use of hormone medication were compared with the finding of hyperplasia in the pathologic examination.

Results

Only polyp size showed statistical significance among the variables analyzed (P < 0.05). Endometrial polyps greater than 15 mm showed a hyperplasia rate of 14.8%, compared with 7.7% in the group with smaller polyps (P < 0.05).

Conclusion

Endometrial polyps measuring more than 15 mm were associated with hyperplasia.     

Primary malignant melanoma of the cervix: report of a case

Background  To present a case of primary malignant melanoma of the cervix. Case   The patient was admitted with the complaint of vaginal bleeding. Gynecological examination revealed a dark, papillary mass on the posterior lip of the cervix. Histopathology showed a malignant neoplasm with increased vascularity, indicating the possibility of a primary uterine cervical melanoma. Diagnosis of malignant melanoma was confirmed with immunohistochemistry, which showed diffuse positive reactions for S-100 protein and HBM-45, with no reaction for epithelial markers, namely cytokeratin AE1/AE3 and epithelial membrane antigen. An extensive search for a melanotic lesion in skin and in uveal tract was performed to verify the distinct site of melanoma. The tumor was stage IB1 according to the International Federation of Gynecology and Obstetrics classification.The patient underwent radical Wertheim–Meigs hysterectomy, bilateral salpingo-oopherectomy, and retroperitoneal pelvic lympadenectomy. Radiotherapy or chemotherapy was not performed in the postoperative period. She is now free of the disease 10 months after the operation. Conclusion  Primary malignant melanoma of the cervix is a rare cervical malignancy.     

Adenomyomatous polyp of the endometrium: a case report

BACKGROUND: Adenomyomatous polyps of the endometrium are rare, pedunculated lesions that contain smooth muscle in addition to the usual components of an endometrial polyp. Grossly, adenomyomatous polyps have the same appearance as an ordinary endometrial polyp and are characterized histologically by the intertwining of smooth muscle, endometrial glands and endometrial stroma. CASE: A 32-year-old woman underwent a hysterectomy for refractory menometrorrhagia and was found to have a large, sessile, polypoid mass completely filling the endometrial cavity, consisting of multiple, thick-walled vessels; scant smooth muscle; and foci of endometrial glands and stroma. This lesion was diagnosed as an adenomyomatous polyp. No history of tamoxifen use was present in this case. The diagnosis of perivascular epithelioid cell tumor was ruled out. CONCLUSION: We found 1 other report of a similar lesion, which may have represented a hamartoma.     

A rare cause of severe dyspareunia: a case report and literature review

Gastrointestinal stromal tumors (GISTs) of the rectum are rare, and their clinical manifestations are variable. We report the case of a 23-year-old woman who was referred complaining of dyspareunia during coitus. We performed digital vaginal and rectal investigations, ultrasound, colonoscopy, and computed tomography. These examinations confirmed the presence of a lesion measuring about 6 × 5 × 5 cm in size attached to the posterolateral left rectum wall. We performed a circumanal excision, then arrived at the mass between the muscles of the pelvic floor. Pathological studies indicated that the tumor was a high-grade GIST, and was clear at the surgical margins. On follow-up, a GIST was found at the gastric fundus via an endoscopic biopsy. Imatinib treatment was initiated because the patient refused a second operation. The gastric lesion disappeared 6 months after imatinib treatment. Dyspareunia disappeared 1 month after operation.     

Unaware of a giant serous cyst adenoma: a case report

A case of 36-year-old nonmarried virgin woman presenting a giant ovarian serous cyst adenoma weighing 9.5 kg is reported here. Ovarian neoplasms may be divided by origin cell type into three main groups: epithelial, stromal and germ cell. Taken as a group, the epithelial tumors are by far the most common type. The single most common benign ovarian neoplasm is the benign cystic teratoma; however, according to some studies it is serous cyst adenoma. A 36-year-old nonmarried virgin woman was referred to our clinic from a local medical center. When she was seen first at our outpatient clinic, she looked like a 9-month pregnant woman. Her medical history was normal. She had no serious illness or operation before. On abdominal ultrasound, a giant cyst was found which encompassed the whole abdomen. At laparotomy, a giant, totally cystic, vascularized and smooth mass attached to the right ovary was encountered, lying between the symphysis and the xiphoid. Ooferectomy was performed. On the postoperative second day, she was discharged without any problem. Her pathology report disclosed a 35×20×16 cm³ serous cyst adenoma weighing 9.5 kg. This is the largest ovarian cyst that ever reported from our hospital and one of the largest among the reported cases in the literature.     

Fetus-in-fetu: a rare entity

Fetus-in-fetu is a malformed parasitic monozygotic diamniotic twin that is found inside the body of the living child or adult. A 3-year-old male child presented with a retroperitoneal mass, which on radiological examination showed retroperitoneal teratoma. Pathological examination revealed fetus-in-fetu with partially developed vertebral column.     

Metastatic breast ductal carcinoma detected in a toremifene-associated endometrial polyp: case report and literature review

Uterine metastases are rare events, but when they occur, the first extragenital neoplasm responsible is breast carcinoma. Toremifene, used in breast cancer hormonotherapy, has a partial estrogenic agonist effect in the endometrium, responsible for potential abnormalities, like polyps. A 53-year-old woman, receiving toremifene due to previously excised breast ductal carcinoma, presented with endometrial thickness during an abdominopelvic ultrasound follow-up. Hysteroscopy revealed an endometrial polyp, which was removed. Microscopic examination showed infiltration by a malignant ductal pattern neoplasm, with signet ring cells. The patient underwent hysterectomy and bilateral salpingo-oophorectomy. The final pathological diagnosis was metastatic breast carcinoma to the endometrium and cervix. This is the first reported case of breast metastases detected in a toremifene-associated endometrial polyp.     

Primary ovarian adenomyoma in a woman with endometrial polyp: a case report and review of the literature

Background  An adenomyoma presenting outside the uterus is an extremely rare entity and only three cases of primary ovarian adenomyoma have been reported up to date. Case report  We report the fourth case of ovarian adenomyoma in a 45-year-old woman with an endometrial polyp. Transvaginal ultrasonography revealed a solitary endometrial polyp with an enlarged left ovary which appeared heterogenous with isoechoic and mildly hyperechoic pattern. Conclusion  Total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed and histologic examination revealed an adenomyoma arising primarily in the ovary.