Cytological study on uterine sarcoma

Between 1958 and 1985 (28 years), 53 cases of uterine sarcoma were seen at the Cancer Institute Hospital. Their cytological examination produced the following findings: 1) The positive rate in preoperative cytologic diagnostic tests was a low 21.7 percent for pure sarcoma and 70.0 percent for mixed mesodermal tumor. 2) The preoperative cytologic diagnosis and the final histologic diagnosis agreed in only 13.0 percent of pure sarcoma and 16.7 percent of mixed mesodermal tumor cases. 3) About one-half of the cases of mixed mesodermal tumor were diagnosed preoperatively as adenocarcinoma. 4) The positive rate in the cytologic diagnosis and the clinical stage were not correlated. 5) The positive rate in the cytologic diagnosis was high in cases of intracavity growth type sarcoma, but all cases of intramuscular localized type sarcoma were negative.     

Scar recurrence of uterine sarcoma: a case report

BACKGROUND: Uterine leiomyosarcoma is an aggressive tumor that has a propensity for recurrence. Most of the recurrences occur at either pelvic or distant sites, such as lung or liver. Recurrences in the laparotomy scar are extremely rare. CASE: A 52-year-old woman underwent hysterectomy for stage I, grade 2 uterine leiomyosarcoma. She did not receive any adjuvant treatment. She presented 2 years later with wound recurrence. She had no evidence of intraabdominal disease. She underwent radical resection with mesh repair. Pathology revealed high grade spindle cell sarcoma very similar to the previous cancer. After completion of 18 months of follow-up, she was disease free. CONCLUSION: Radical resection of isolated metastases may be of benefit for these patients.     

Endocrine cancer of the uterine cervix

There is reported about a woman with endocrine carcinoma of the uterine cervix. The histologic growth pattern and clinical course have been described. Because of the poor prognosis of the endocrine carcinoma in the uterine cervix when compared with adenocarcinoma of the cervix or carcinoid tumors of other localization, this report emphasizes the importance of correct diagnosis.     

Low-grade endometrial stromal sarcoma: A Turkish uterine sarcoma group study analyzing prognostic factors and disease outcomes

ObjectiveTo investigate factors associated with refractory disease, recurrence, or death as well as disease-free survival (DFS) and overall survival (OS) in low-grade endometrial sarcoma (LGESS).MethodsA multi-institutional, retrospective study was conducted in a total of 124 patients, who received a curative-intent surgery. The exclusion criteria were as follows: i) history of any other invasive disease; ii) neoadjuvant therapy; iii) fertility sparing surgery; iv) a different diagnosis after review of the slides.ResultsAll patients underwent hysterectomy, 96% had bilateral salpingo-oophorectomy, and 65% had lymphadenectomy. Twelve (14.8%) of 81 patients undergoing lymphadenectomy had lymph node (LN) metastasis. Of those, 8 (9.8%) had pelvic LN metastasis whereas 4 (5.6%) had isolated paraaortic LN metastasis. Six of 8 (75%) patients with positive pelvic LNs had concurrent paraaortic LN metastasis. Among 124 patients, 3 patients (2.4%) had refractory disease following primary therapy. During a median follow-up of 45.5 months, 27 (22.3%) of 121 patients who achieved complete remission after primary therapy developed recurrence, and 10 patients (8.1%) died of disease. The 3-year DFS and OS were 76.9% and 93.8%, respectively. Stage was the sole independent prognostic factor in the whole cohort. When analyzing factors within subgroups of stage I and stage ≥II, there was no significant prognostic factor for stage I; however, lymphadenectomy and adjuvant chemotherapy were significantly associated with disease outcomes for stage ≥II. While lymphadenectomy was related with improved DFS, chemotherapy was associated with poor DFS and OS.ConclusionThe risk of LN metastasis at pelvic as well as paraaortic lymphatic basins is not negligible to omit lymphadenectomy in stage ≥II LGESS. Moreover, lymphadenectomy provides significant DFS advantage in patients with extrauterine disease.     

乳酸脱氢酶亚基在子宫肌瘤及子宫肉瘤中的表达及意义

目的:研究乳酸脱氢酶LDH及其亚基(LDH-A、LDH-B、LDH-C、LDH-D)在子宫肌瘤、富于细胞型平滑肌瘤及子宫肉瘤组织中的表达及意义。方法:收集良性子宫平滑肌瘤26例、富于细胞型子宫肌瘤患者10例,子宫肉瘤患者30例。免疫组化法检测总LDH、LDH-A、LDH-B、LDH-C、LDH-D表达。结果:三组间LDH-A、LDH-D、LDH阳性表达率比较,差异有统计学意义(P0.05),子宫肉瘤中LDH-A、LDH-D、LDH阳性率及表达强度明显高于良性子宫肌瘤和富于细胞型子宫肌瘤(P0.05)。LDH-B、LDH-C在子宫肌瘤及子宫肉瘤中的表达比较,差异无统计学意义(P0.05)。结论:LDH-A、LDH-D及LDH高表达有利于进一步确认子宫肉瘤的病理学诊断,且为进一步研究LDH在子宫肉瘤的肿瘤代谢Warburg效应中的研究奠定基础。     

Endocrine aspects of trophoblastic neoplasia

The trophoblastic cells in both benign and malignant trophoblastic disease secrete a variety of steroid, polypeptide and hormonal agents. Those substances that are known to be elaborated by the neoplastic trophoblastic tissue include hCG, a substance with TSH-like activity, estrogens, progestogens and placental lactogen. The most well characterized of these is hCG, which can be assayed easily. The level of hCG plays an important role in the diagnosis, management and follow-up of patients with trophoblastic disease. Because of this, a sensitive assay that does not cross-react with LH would be ideal. It appears that some of the clinical signs and symptoms seen in these patients (including toxemia, theca lutein cyst, hyperthyroidism and thyrotoxicosis, and galactorrhea) are a direct manifestation or reflection of the level of hCG. There is very little information available at this time on the pathophysiologic role that hCG plays at the cellular level in causing these signs and symptoms. Many questions remain to be answered regarding the role of the other hormones in trophoblastic disease and how they affect the patient. Additionally, very little is known about the potential use of the other hormones in diagnosis, management and follow-up of patients with trophoblastic disease.