A case of serous papillary cystadenocarcinoma of the ovary with hyperamylasemia

A case of serous papillary cystadenocarcinoma of the ovaries with hyperamylasemia has been studied immunohistochemically, electron microscopically, and biochemically. Cellular localization of amylase in the tumor tissue was determined by biochemical analysis, using an indirect immunoperoxidase method. Electron microscopy revealed electron-dense granules located in the peripheral region of the cytoplasm of most tumor cells.     

An amylase-producing serous cystadenocarcinoma of the ovary

A patient with an amylase-producing serous cystadenocarcinoma of the ovary had elevated serum and urine amylase levels and high levels of amylase in pleural and ascitic fluids. Serum and urine amylase levels reflected both surgical removal of tumor mass and response to chemotherapy. Tumor homogenates had pronounced amylase activity. Salivary type amylase isozyme patterns were found in electrophoresis of samples from all sources. Ascites tumor cells were successfully cultured and salivary type amylase was found in the culture media throughout 5 passages. The tumor was classified by light microscopy as poorly differentiated serous cystadenocarcinoma. Ultrastructural studies on the tumor were consistent with that diagnosis. Amylase was detected in the cells of the tumor examined by the immunoperoxidase technique.     

Primary papillary serous cystadenocarcinoma of broad ligament

A rare case of an advanced primary broad ligament carcinoma is discussed, with a review of the literature regarding its incidence, presentation and management. This patient showed a complete response to adjuvant cisplatin-based chemotherapy following panhysterectomy and is presently without any evidence of disease, 15 months after completion of her treatment.     

Characterization of a cell line derived from the ascites of a patient with papillary serous cystadenocarcinoma of the ovary

An established cell line derived from the ascites of a patient with serous cystadenocarcinoma of the ovary has been characterized. Features studied included morphology, ultrastructure, clonogenicity in soft agar, population doubling time, karyotype, and chemosensitivity. The results indicated that the cells growing in culture were malignant ovarian tumor cells. These cells retained the ability to form free-floating cysts in culture, which were also present in the original ascitic fluid. The cell line had a chromosome number of 80-92 with no distinct mode and 15 stable markers. At passage 4 the cell line showed resistance to doxorubicin [adriamycin (ADM)], phosphoramide mustard (PM), and cisplatin [cis-dichlorodiammineplatinum(II)] (CIS) but rapidly reverted to CIS sensitivity. At passage 25 the cell line was still resistant to ADM and PM, but by passage 59 sensitivity to these drugs appeared to have increased. Frozen cells from passage 15 onward are available.     

Osteosarcoma of the myometrium synchronous with bilateral papillary cystadenocarcinoma of the ovary and papillary adenocarcinoma of the cervix

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 synchronous 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.     

Mucinous cystadenocarcinoma in combination with hemangiosarcoma in the ovary

The ovary is the sixth most frequent site of cancer in women in Denmark with an incidence of approximately 600 cases per year. Carcinomas predominate whereas sarcomas are rare. We describe a case of the combination mucinous cystadenocarcinoma and hemangiosarcoma in a 37-year old woman, who had a right-sited oophorectomy because of a cyst. Clinically there was no suspicion of malignancy. The macro- and microscopic findings are described as well as the immunohistochemical stainings performed to confirm the diagnosis. The case shows the importance of careful sampling at the macroscopic examination, especially from areas with a striking appearance.     

卵巢外腹膜浆液性乳头状癌与卵巢浆液性乳头状癌比较分析

目的　探讨卵巢外原发腹膜浆液性乳头状癌 (EPSPC)的临床和治疗特点及预后。方法回顾性分析 12例EPSPC与 4 5例Ⅲ、Ⅳ期卵巢浆液性乳头状癌 (OPSC)的临床和随访资料 ,比较其临床及治疗特点、对一线化疗药物的敏感性及生存时间。结果　EPSPC与OPSC两组的症状、体征、CA12 5水平、无瘤期、复发时间、对一线化疗药物的反应及生存时间差异无统计学意义 ,而EPSPC组的完全缓解率 (2 5 .0 % )与OPSC组 (91.8% )比较 ,显著降低 (P <0 .0 1)。结论　EPSPC与OPSC临床过程类似 ,当治疗手段相同时 ,对一线化疗药物的敏感性及生存时间相近。     

Characteristics of the dissemination process in patients with serous cystadenocarcinoma of the ovaries

The terminal stage of the disease (tumor dissemination) was studied. Factors slowing down the process and therapy of patients with disseminated tumor are discussed.     

Krukenberg tumor of ovary with features of mucinous cystadenocarcinoma

An unusual case of bilateral Krukenberg tumors having a predominant multicystic mucinous component which on gross and microscopic examination resembled a mucinous cystadenocarcinoma is presented. It is important to distinguish between these two tumors as Krukenberg tumours have a significantly worse prognosis.     

A case of intratesticular endometrioid papillary cystadenocarcinoma

We report a case of intratesticular endometrioid papillary cystadenocarcinoma. A 73-year-old man was admitted for a painless right scrotal swelling. Ultrasonography and computed tomography revealed a large cystic mass in the right testis. Right scrotum puncture revealed xanthochromic fluid with negative cytology. Three months later, follow-up computed tomography showed enlargement of the cystic mass. Right high orchiectomy was performed because a testicular malignancy was suspected. The pathological diagnosis was endometrioid papillary cystadenocarcinoma, and the cells were strongly positive for the estrogen and progesterone receptors. Testicular neoplasms resembling common ovarian-type epithelial tumors are very rare. This is the first report of endometrioid papillary cystadenocarcinoma of the testis.     

A rare case of serous cystadenocarcinoma of the pancreas.

Serous cystadenocarcinoma of the pancreas, a rare disease, developed in a 63-year-old Japanese woman. Pathologic examinations of the pancreatic tumor at the subtotal pancreatectomy showed it to be serous cystadenoma with focal atypical lesions. Three years after the operation, however, metastatic liver nodules were found, and the histologic characteristics of these lesions were quite similar to those of the pancreatic neoplasm. Both primary and metastatic tumors were composed of multiple cysts separated by fibrous septa. The epithelium of cysts was cuboidal and had clear cytoplasm, which had positive results for periodic acid-Schiff (PAS) and negative results for PAS with diastase, Alcian blue, and mucicarmine. To the knowledge of the authors, serous cystic neoplasms of the pancreas have been uniformly benign in biologic behavior. Recently, however, serous cystadenocarcinoma of the pancreas has been reported as a new entity. The current case is the second reported case and might support the existence of serous cystadenocarcinoma of the pancreas.     

Peritoneal papillary serous carcinoma with long-term survival

Three cases of peritoneal papillary serous carcinoma with a complete response to chemotherapy and long-term disease free survival are reported. All three patients presented with multifocal or diffuse peritoneal involvement. Microscopic ovarian serosal surface involvement was demonstrated in two cases. The ovaries were uninvolved in one case. All patients were treated with combination chemotherapy consisting of Adriamycin (doxorubicin) and cisplatin, with or without cytoxan. All three patients survived for 5 years or longer with no clinical evidence of persistent or recurrent tumor.     

Clinical significance of p21(WAF1/CIP1) and p53 expression in serous cystadenocarcinoma of the ovary

There have been many reports indicating that the down-regulation of p21(WAF1/CIP1) is related to carcinogenesis and the development of various tumors; nevertheless, its association with epithelial ovarian cancer (EOC) remains controversial. In this study, we focused on serous ovarian cancer, which is the most prevalent histological type, and performed immunohistochemical analysis to examine the expression of p21(WAF1/CIP1) and p53 in 43 cases of serous-type EOC sourced from a single University Hospital: 14 stage I, 4 stage II, 21 stage III, and 4 stage IV. Positive p21(WAF1/CIP1) was found in 24 of 43 cases (56%), and positive p53 was detected in 21 of 43 cases (49%). Among stage III/IV cases, positive p21(WAF1/CIP1) staining was found in 11 of 25 cases (44%), and positive p53 staining was detected in 13 of 25 cases (52%). Univariate survival analysis for the entire cohort revealed that positive p21(WAF1/CIP1) was associated with a survival benefit. The 10-year survival rates of p21(WAF1/CIP1)-positive staining and p21(WAF1/CIP1)-negative staining were 82.4 and 39.5%, respectively, and there was a significant difference between the two groups (p<0.01). Overall survival for p21(WAF1/CIP1)-positive with p53-negative staining [p21(+)/p53(-)] was significantly different from p21(WAF1/CIP1)-positive with p53-positive [p21(+)/p53(+)], p21(WAF1/CIP1)-negative with p53-positive staining [p21(-)/p53(+)], and p21(WAF1/CIP1)-negative with p53-negative staining [p21(-)/p53(-)] (p<0.05). When only III/IV cases were evaluated, overall survival for [p21(+)/p53(-)] was significantly different from [p21(+)/p53(+)], [p21(-)/p53(+)], and [p21(-)/p53(-)] (p<0.05). These results suggested that the overexpression of p21(WAF1/CIP1) in conjunction with the loss of p53 expression was a stronger predictor of survival benefit than either molecule alone in Japanese serous-type advanced ovarian cancers with more than 10-year follow-up.     

Discrimination between uterine serous papillary carcinomas and ovarian serous papillary tumours by gene expression profiling

High-grade ovarian serous papillary cancer (OSPC) and uterine serous papillary carcinoma (USPC) represent two histologically similar malignancies characterised by markedly different biological behavior and response to chemotherapy. Understanding the molecular basis of these differences may significantly refine differential diagnosis and management, and may lead to the development of novel, more specific and more effective treatment modalities for OSPC and USPC. We used an oligonucleotide microarray with probe sets complementary to >10 000 human genes to determine whether patterns of gene expression may differentiate OSPC from USPC. Hierarchical cluster analysis of gene expression in OSPC and USPC identified 116 genes that exhibited >two-fold differences (P<0.05) and that readily distinguished OSPC from USPC. Plasminogen activator inhibitor (PAI-2) was the most highly overexpressed gene in OSPC when compared to USPC, while c-erbB2 was the most strikingly overexpressed gene in USPC when compared to OSPC. Overexpression of the c-erbB2 gene and its expression product (i.e., HER-2/neu receptor) was validated by quantitative RT-PCR as well as by flow cytometry on primary USPC and OSPC, respectively. Immunohistochemical staining of serous tumour samples from which primary OSPC and USPC cultures were derived as well as from an independent set of 20 clinical tissue samples (i.e., 10 OSPC and 10 USPC) further confirmed HER-2/neu as a novel molecular diagnostic and therapeutic marker for USPC. Gene expression fingerprints have the potential to predict the anatomical site of tumour origin and readily identify the biologically more aggressive USPC from OSPC. A therapeutic strategy targeting HER-2/neu may be beneficial in patients harbouring chemotherapy-resistant USPC.