Endocervical curettage: does it contribute to the management of patients with abnormal cervical cytology?

Routine endocervical curettage has been advocated in the colposcopic evaluation of patients with abnormal cervical cytology. To assess the usefulness of this procedure, we reviewed the records of 518 patients referred to the Colposcopy Clinic with abnormal Pap smears. Data was reviewed retrospectively in 411 patients and collected prospectively in 107 patients. Dysplasia was present in 1.4% of ECC specimens obtained in patients with conclusive colposcopic examinations, and in 25.7% of specimens in patients with inconclusive examinations. Invasive cancer was not detected in any ECC specimen. Eighty patients with inconclusive colposcopic examinations underwent conization of the cervix; in this group, the final pathologic diagnosis was CIN III in 51.2%, microinvasive cancer in 2.5%, and invasive cancer in 1.2%. In patients with conclusive colposcopic examinations, the final pathologic diagnosis was CIN III in 17.2%, and no cases of microinvasive or invasive cancer were present. When the colposcopic examination is conclusive, the incidence of positive ECC is low and may not warrant performing ECC in all patients. When the examination is inconclusive, ECC rarely obviates the need for diagnostic conization as ECC rarely yields a diagnosis of invasive cancer.

Endocervical neoplasia in long-term users of oral contraceptives: clinical and pathologic observations

Adenocarcinoma of the cervix has been associated with oral contraceptive use, often prolonged. The clinicopathologic features of seven cases of endocervical neoplasia in long-term combination pill users, all 33 years of age or younger, were reviewed and compared with seven cases in nonusers. Duration of drug use ranged from 4.5 to nine years. Adenocarcinoma in situ was found in all cases either in pure form or associated in invasive adeno- or adenosquamous carcinoma; squamous carcinoma in situ (CIS) was seen in two cases, one of which showed focal microinvasion. Hypersecretory changes were seen in adjacent endocervix in two cases but the morphology of neoplastic lesions was similar to that unassociated with pill use. The possible role of chronic hormonal stimulation in cervical carcinogenesis is discussed in light of these findings and current epidemiologic data.

Sclerosing stromal tumor and bilateral teratomas: an unusual association

Sclerosing stromal tumor is an uncommon ovarian neoplasm that has only recently been defined and distinguished from fibrothecoma. This case report describes a 17-year-old patient who presented with a large sclerosing stromal tumor and a smaller mature teratoma in the left ovary. Eighteen months later, an immature teratoma was discovered in the contralateral ovary and microscopic spread outside the ovary was documented at staging laparotomy. Mature and immature teratomas have been observed in opposite ovaries in a small number of patients. However, sclerosing stromal tumor, in over 60 published cases, has not been associated with other forms of ovarian neoplasia. Gonadal stromal differentiation, in fact, has not been convincingly demonstrated in teratomas. The observations in this case, therefore, appear to be unique.

Association of a 97 kilodalton glycoprotein with human ovarian carcinoma

The association of a 97 kilodalton glycoprotein (97k-GP) with human ovarian epithelial tumors is reported. The 97k-GP has been found to be present in elevated levels in all the 8 serous cystadenocarcinoma specimens tested. This glycoprotein is present in small amounts in endometrial tumors and either absent or present in trace amounts in control ovaries. Subcellular localization of this glycoprotein indicates that it is a component of plasma membrane.

Extragenital malignant mixed Müllerian tumor. Case report and review of the literature

The second case of extragenital malignant mixed Müllerian tumor, heterologous type, occurring in the posterior peritoneum, and confirmed at autopsy, is presented. The histogenesis of this tumor is discussed.

Malignant mixed mesodermal tumors and carcinosarcoma of the ovary: report of eight cases and review of literature

Eight cases of malignant mixed mesodermal tumors and carcinosarcoma of the ovary from our files and 193 cases from the literature were reviewed. An attempt is made to analyze these cases in regard to clinical feature, treatment results, and their outcome. A detailed review of the histogenesis is presented. These tumors grow very rapidly and are usually in advanced stages when diagnosed. Most patients are postmenopausal. Surgery, radiation therapy, and chemotherapy, either alone or in combination, have been used to treat this neoplasm, but 77.6 per cent of the patients are dead of their disease within 1 year. Limited data suggests that patients treated with surgery and combination chemotherapy survive longer. However, further investigation in finding new combination therapy is desired.

Synthesis of catechol estrogens by human uterus and leiomyoma

Homogenates of human endometrial, myometrial and leiomyoma tissues were incubated with (2,4,6,7-3H)-estradiol and tritiated catechol estrogens were isolated and identified. Though 2- and 4-hydroxylations were about the same in endometrium, 4-hydroxylation was two to four fold higher than 2-hydroxylation in myometrium and leiomyoma. However, endometrium showed greater capacity to form both 2- and 4-hydroxyestrogens than the other two tissues. Both 2- and 4-hydroxylations were significantly less than in myometrium. In view of the reports indicating that inhibitors of catechol 0-methyl transferase (COMT) might act as antineoplastic agents due to their interference with t-RNA methylases and since catechol estrogens inhibit COMT, the present results suggest that endogenous synthesis of catechol estrogens may play an important role in the pathophysiology of uterine leiomyoma.