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Ruiz-Echeverría FR, Beltrán-Salazar MI, Caicedo-Páez LM, Palencia-Palacios M, Salazar-Silva C, Viveros-Carreño D. Uterine collision tumor. Case report and review of the literature. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGIA 2023; 74:225-236. [PMID: 37937912 PMCID: PMC10652777 DOI: 10.18597/rcog.4011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/14/2023] [Indexed: 11/09/2023]
Abstract
Objectives To report the case of a patient with a uterine collision tumor and to conduct a review of the literature. Material and methods A 76-year-old patient who presented to the national cancer referral center in Bogota (Colombia), where she was diagnosed with a uterine collision tumor consisting of a seroustype endometrial adenocarcinoma and a cervical adenosarcoma. The patient underwent surgical treatment followed by chemotherapy and supplemental radiotherapy, and died 16 months later. A search was conducted in the Medline via PubMed and Embase databases, including reports and case series of women with a diagnosis of uterine collision tumor, with retrieval of information regarding diagnosis, treatment and prognosis. A narrative summary of the findings was made. Results The search identified 36 titles, of which 14 studies with 17 patients were included. The most frequent histopathological diagnosis was endometrial adenocarcinoma and high and low grade endometrial sarcoma (47 %). Primary treatment was surgery and adjuvant treatment with chemotherapy and radiotherapy (15 %) was performed in close to 50 % of cases. One-year survival was 75 %. Conclusions No cases of uterine collision tumors with the histopathology or in the location of the reported case were found in the literature. If this reported case is taken into account, 2-year mortality is 28 %. Further studies to describe the immunohistochemistry, treatment and prognosis of this condition are needed.
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Yanagita T, Hikichi T, Waragai Y, Shimizu H, Takahashi Y, Abe N, Hashimoto C, Kumakawa H, Kobayakawa M, Ohira H. Mixed high-grade serous and large cell neuroendocrine carcinoma arising from rectal endometriosis 11 years after hysterectomy. Clin J Gastroenterol 2023; 16:366-371. [PMID: 36763235 DOI: 10.1007/s12328-023-01769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023]
Abstract
The malignant gastrointestinal endometriosis transformation is represented by endometriosis-associated intestinal tumors. Endometrioid adenocarcinoma and clear cell adenocarcinoma are most common among the endometrial cancers of all organs. Only four cases of mixed serous carcinoma and large cell neuroendocrine carcinoma have been reported, and all these cases originated from the uterus. A 59-year-old woman with a month's history of bloody stools was admitted. She was stable until the hematochezia occurred but is 11 years post-hysterectomy. A circumferential type-3 advanced upper rectum tumor was seen on colonoscopy. Adenocarcinoma was revealed from the forceps biopsies of the type-3 tumor component. Computed tomography showed narrowed lumen with a thickened rectum wall, a continuing mass, and a component on the anorectal side. Swollen lymph nodes were observed around the rectum, but no distant metastatic lymph nodes or organs were found. To treat the lesion, rectal surgical resection with D3 lymph node dissection was performed. Histological examination revealed combined high-grade serous and large cell neuroendocrine carcinomas. Tumor was contiguous to the endometrium in the sub-serosa. Endometriosis was determined to be the origin of both carcinomas. Therefore, endometriosis-associated intestinal tumors should be included in the differential diagnosis when rectal tumors with cystic structures are found post-hysterectomy.
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Affiliation(s)
- Takumi Yanagita
- Department of Gastroenterology, Soma General Hospital, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
| | - Yuichi Waragai
- Department of Gastroenterology, Soma General Hospital, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hiroshi Shimizu
- Department of Gastroenterology, Soma General Hospital, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuta Takahashi
- Department of Gastroenterology, Soma General Hospital, Fukushima, Japan
| | - Naoto Abe
- Department of Gastroenterology, Soma General Hospital, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Choichiro Hashimoto
- Department of Gastroenterology, Soma General Hospital, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiromi Kumakawa
- Department of Gastroenterology, Soma General Hospital, Fukushima, Japan
| | - Masao Kobayakawa
- Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
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Application of Pelvic Magnetic Resonance Imaging Scan Combined with Serum Pyruvate Kinase Isozyme M2, Neutrophil Gelatinase-Associated Lipocalin, and Soluble Leptin Receptor Detection in Diagnosing Endometrial Carcinoma. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:7197505. [PMID: 35655724 PMCID: PMC9148236 DOI: 10.1155/2022/7197505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022]
Abstract
Objective To explore the application value of pelvic magnetic resonance imaging (MRI) scan combined with serum pyruvate kinase isozyme M2 (PKM2), neutrophil gelatinase-associated lipocalin (NGAL), and soluble leptin receptor (sOB-R) detection in diagnosing endometrial carcinoma (EC). Methods The clinical data of 45 patients with pathologically confirmed EC treated in our hospital from May 2019 to May 2020 were retrospectively analyzed. All patients received pelvic MRI scan, serum PKM2, NGAL and sOB-R detection was performed, and the combination of the two was performed so as to analyze the diagnostic application value of the three modalities. Results Compared with the joint detection, the number of true positive cases, sensitivity, specificity, and accuracy rate obtained by a single application of pelvic MRI or serum PKM2, NGAL, and sOB-R detection were obviously lower; the area under the ROC curve of the joint detection was obviously larger than that of single detection; the results of the joint detection were better than those of single detection (P < 0.05); the combined diagnosis obtained the highest sensitivity. Conclusion Combining pelvic MRI with serum PKM2, NGAL, and sOB-4 detection can effectively promote the diagnostic accuracy for EC, presenting significant clinical diagnostic value.
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Du R, Jiang F, Wang ZY, Kang YQ, Wang XY, Du Y. Pure large cell neuroendocrine carcinoma originating from the endometrium: A case report. World J Clin Cases 2021; 9:3449-3457. [PMID: 34002157 PMCID: PMC8107915 DOI: 10.12998/wjcc.v9.i14.3449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/10/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Large cell neuroendocrine carcinoma (LCNEC) of the endometrium is an uncommon and highly aggressive tumor that has not been comprehensively characterized. We report a case of pure endometrial LCNEC and review the current literature of similar cases to raise awareness of the histological features, treatment, and prognosis of this tumor.
CASE SUMMARY We report the case of a 73-year-old woman who presented with irregular postmenopausal vaginal bleeding. Ultrasonography showed an enlarged uterus and a 5.1 cm × 3.3 cm area of medium and low echogenicity in the uterine cavity. Biopsy by dilatation and curettage suggested poorly differentiated carcinoma. Magnetic resonance imaging revealed a heterogeneously enhanced uterine tumor with diffuse infiltration of the posterior wall of the uterine myometrium and enlarged pelvic lymph nodes. The patient underwent a hysterectomy and bilateral adnexal resection. Gross observation revealed an ill-defined white solid mass of the posterior wall of the uterus infiltrating into the serosa with multiple solid nodules on the serous surface. Microscopically, the tumor cells showed neuroendocrine morphology (organoid nesting). Immunohistochemistry revealed the tumor cells were diffusely positive for the neuroendocrine markers CD56, chromogranin A, and synaptophysin. Thus, the tumor was diagnosed as stage IIIC endometrial LCNEC.
CONCLUSION Pathologic findings and immunohistochemistry are essential in making a diagnosis of endometrial LCNEC.
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Affiliation(s)
- Ran Du
- Department of Pathology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
| | - Feng Jiang
- Department of Thoracic Surgery, Liaocheng Tumor Hospital, Liaocheng 252000, Shandong Province, China
| | - Zheng-Yan Wang
- Department of Pathology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
| | - Yan-Qing Kang
- Department of Radiology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
| | - Xiu-Yu Wang
- Department of Pathology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
| | - Ying Du
- Department of Pathology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
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Update on Endometrial Stromal Tumours of the Uterus. Diagnostics (Basel) 2021; 11:diagnostics11030429. [PMID: 33802452 PMCID: PMC8000701 DOI: 10.3390/diagnostics11030429] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/12/2022] Open
Abstract
Endometrial stromal tumours (ESTs) are rare, intriguing uterine mesenchymal neoplasms with variegated histopathological, immunohistochemical and molecular characteristics. Morphologically, ESTs resemble endometrial stromal cells in the proliferative phase of the menstrual cycle. In 1966 Norris and Taylor classified ESTs into benign and malignant categories according to the mitotic count. In the most recent classification by the WHO (2020), ESTs have been divided into four categories: Endometrial Stromal Nodules (ESNs), Low-Grade Endometrial Stromal Sarcomas (LG-ESSs), High-Grade Endometrial Stromal Sarcomas (HG-ESSs) and Undifferentiated Uterine Sarcomas (UUSs). ESNs are clinically benign. LG-ESSs are tumours of low malignant potential, often with indolent clinical behaviour, with some cases presented with a late recurrence after hysterectomy. HG-ESSs are tumours of high malignant potential with more aggressive clinical outcome. UUSs show high-grade morphological features with very aggressive clinical behavior. With the advent of molecular techniques, the morphological classification of ESTs can be integrated with molecular findings in enhanced classification of these tumours. In the future, the morphological and immunohistochemical features correlated with molecular categorisation of ESTs, will become a robust means to plan therapeutic decisions, especially in recurrences and metastatic disease. In this review, we summarise the morphological, immunohistochemical and molecular features of ESTs with particular reference to the most recent molecular findings.
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