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Harkenrider MM, Block AM, Alektiar KM, Gaffney DK, Jones E, Klopp A, Viswanathan AN, Small W. American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review. Brachytherapy 2017; 16:95-108. [PMID: 27260082 PMCID: PMC5612425 DOI: 10.1016/j.brachy.2016.04.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/30/2016] [Accepted: 04/08/2016] [Indexed: 11/29/2022]
Abstract
This article aims to review the risk stratification of endometrial cancer, treatment rationale, outcomes, treatment planning, and treatment recommendations of vaginal brachytherapy (VBT) in the postoperative management of endometrial cancer patients. The authors performed a thorough review of the literature and reference pertinent articles pertaining to the aims of this review. Adjuvant VBT for early-stage endometrial cancer patients results in very low rates of vaginal recurrence (0-3.1%) with low rates of late toxicity which are primarily vaginal in nature. Post-Operative Radiation Therapy in Endometrial Cancer 2 (PORTEC-2) supports that VBT results in noninferior rates of vaginal recurrence compared to external beam radiotherapy for the treatment of high-intermediate risk patients. VBT as a boost after external beam radiotherapy, in combination with chemotherapy, and for high-risk histologies have shown excellent results as well though randomized data do not exist supporting VBT boost. There are many different applicators, dose-fractionation schedules, and treatment planning techniques which all result in favorable clinical outcomes and low rates of toxicity. Recommendations have been published by the American Brachytherapy Society and the American Society of Radiation Oncology to help guide practitioners in the use of VBT. Data support that patients and physicians prefer joint decision making regarding the use of VBT, and patients often desire additional treatment for a marginal benefit in risk of recurrence. Discussions regarding adjuvant therapy for endometrial cancer are best performed in a multidisciplinary setting, and patients should be counseled properly regarding the risks and benefits of adjuvant therapy.
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MESH Headings
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Clear Cell/radiotherapy
- Advisory Committees
- Brachytherapy/methods
- Carcinoma, Endometrioid/pathology
- Carcinoma, Endometrioid/radiotherapy
- Carcinosarcoma/pathology
- Carcinosarcoma/radiotherapy
- Combined Modality Therapy
- Endometrial Neoplasms/pathology
- Endometrial Neoplasms/radiotherapy
- Female
- Humans
- Hysterectomy
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neoplasms, Cystic, Mucinous, and Serous/radiotherapy
- Radiotherapy, Adjuvant/methods
- Societies, Medical
- United States
- Vagina
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Affiliation(s)
- Matthew M Harkenrider
- Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL.
| | - Alec M Block
- Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL
| | - Kaled M Alektiar
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David K Gaffney
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Ellen Jones
- Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Ann Klopp
- Department of Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Akila N Viswanathan
- Department of Radiation Oncology, Brigham & Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - William Small
- Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL
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102
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Berezovskiy D, Vlasák P, Kosťun J, Bouda J, Presl J. [Carcinosarcoma of the endometrium with melanocytic differentiation, case report]. Ceska Gynekol 2017; 82:390-395. [PMID: 29020787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The case report presents a case of 60-year old woman with a rare malignant mixed Müllerian tumor with melanomatous differentiation diagnosed from a histology after cervical polyp ablation and curettage. DESIGN Case report. SETTING Department of gynecology and obstetrics, University Hospital in Pilsen. CONCLUSION Carcinosarcoma, previously malignant mixed Müllerian tumor, is a very rare aggressive endometrial carcinoma with low incidence, which typically occurs among older women and commonly affects the uterine body and cervix. Clinically, the carcinosarcoma is impossible to be distinguished from endometrial carcinoma or uterine sarcoma and the definitive diagnosis can only be made based on histological examination.
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Abstract
PATIENT CONCERNS We report a rare case of pancreatic carcinosarcoma involving a 44-year-old woman. The patient complained of discomfort associated with the upper abdomen and jaundice of skin and sclera for 1 week. DIAGNOSES After hospitalization, relevant examinations were completed. The disease was diagnosed as carcinoma of the pancreatic head. INTERVENTIONS Whipple procedure was conducted in May 2013. Intraoperative exploration indicated 2 components of the tumor: a fish-shaped gray matter and a hard structure similar to cancellous bone. Histopathological examination showed adenocarcinoma and osteosarcoma. After surgery, the patient received 8 cycles of chemotherapy with gemcitabine and raltitrexed. OUTCOMES Previous studies indicated poor prognosis for pancreatic carcinosarcoma. However, our patient survived for 31 months with no recurrence till date. LESSONS SUBSECTIONS Coexistence of pancreatic adenocarcinoma and osteosarcoma is very rare. Our case was also an exception in manifesting longer survival than expected.
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Affiliation(s)
- Zhe Jia
- Department of General Surgery
| | | | | | - XinGang Zhou
- Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing, P.R. China
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104
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Mjid M, Toujani S, Blibech H, Hedhli A, Ouahchi Y, Haouet S, Cherif J, Beji M. [A rare pulmonary tumor: Primary carcinosarcoma of the lung]. Rev Pneumol Clin 2016; 72:381-384. [PMID: 27789162 DOI: 10.1016/j.pneumo.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/29/2016] [Accepted: 09/06/2016] [Indexed: 06/06/2023]
Affiliation(s)
- M Mjid
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie; Service de pneumologie, hôpital La Rabta, bab Saadoun, 1007, Tunis, Tunisie.
| | - S Toujani
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - H Blibech
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - A Hedhli
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - Y Ouahchi
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - S Haouet
- Service d'anatomopathologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - J Cherif
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
| | - M Beji
- Unité de recherche 12SP06, service de pneumologie allergologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis, Tunisie
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105
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Howard SN, Bond WR, Hong IS, Foss RD. Right Maxillary Sinus Sarcomatoid Carcinoma (Sarcomatoid/Spindle Cell Carcinoma). Otolaryngol Head Neck Surg 2016; 137:355-7. [PMID: 17666274 DOI: 10.1016/j.otohns.2007.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Accepted: 03/02/2007] [Indexed: 10/23/2022]
Affiliation(s)
- Scott N Howard
- Department of ENT, Walter Reed Army Medical Center, Washington, DC, USA
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106
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Takeuchi M, Matsuzaki K, Harada M. Carcinosarcoma of the uterus: MRI findings including diffusion-weighted imaging and MR spectroscopy. Acta Radiol 2016; 57:1277-84. [PMID: 26787673 DOI: 10.1177/0284185115626475] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/24/2015] [Indexed: 01/20/2023]
Abstract
BACKGROUND Recently carcinosarcoma has become regarded as a subset of endometrial carcinoma. Because the clinical course of carcinosarcoma is aggressive with poor prognosis, it should be differentiated from endometrial carcinomas for the appropriate surgical management and adjuvant therapy. PURPOSE To clarify the magnetic resonance imaging (MRI) characteristics of uterine carcinosarcoma including diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement and MR spectroscopy (MRS) with quantitative metabolite evaluation. MATERIAL AND METHODS MRI findings of 12 pathologically diagnosed uterine carcinosarcomas obtained on 3T MRI were retrospectively evaluated. The mean and minimum ADCs, and the lipid and choline concentration levels were compared with those of pathologically diagnosed 38 endometrial carcinomas. RESULTS The mean and minimum ADCs in carcinosarcomas and endometrial carcinomas were not significantly different. The mean ADC of carcinosarcomas was significantly higher than that of higher grade (G2 and G3) endometrial carcinomas. The choline concentration in carcinosarcomas was significantly lower than that in endometrial carcinomas. High lipid peak was observed in 91% of carcinosarcomas and in 24% of endometrial carcinomas. CONCLUSION Large, exophytic heterogeneous endometrial mass containing strongly enhanced areas, which may exhibit "tumor delivery", is a suggestive of carcinosarcoma. Relatively high mean ADC and low choline concentration considering its highly malignant nature due to intra-tumoral heterogeneity with necrosis and epithelial cystic components, and the presence of necrosis-associated high lipid peak may be compatible with carcinosarcoma.
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Affiliation(s)
- Mayumi Takeuchi
- Department of Radiology, University of Tokushima, Tokushima, Japan
| | - Kenji Matsuzaki
- Department of Radiology, University of Tokushima, Tokushima, Japan Department of Radiological Technology, Tokushima Bunri University, Kagawa, Japan
| | - Masafumi Harada
- Department of Radiology, University of Tokushima, Tokushima, Japan
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107
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Mi S, Lin M, Brouwer-Visser J, Heim J, Smotkin D, Hebert T, Gunter MJ, Goldberg GL, Zheng D, Huang GS. RNA-seq Identification of RACGAP1 as a Metastatic Driver in Uterine Carcinosarcoma. Clin Cancer Res 2016; 22:4676-86. [PMID: 27121792 DOI: 10.1158/1078-0432.ccr-15-2116] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 04/04/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE Uterine carcinosarcoma is a rare aggressive malignancy frequently presenting at advanced stage of disease with extrauterine metastases. Median survival is less than 2 years due to high relapse rates after surgery and poor response to chemotherapy or radiotherapy. The goal of this study was to identify novel therapeutic targets. EXPERIMENTAL DESIGN We applied RNA-seq analysis to prospectively collected uterine carcinosarcoma tumor samples from patients undergoing primary surgical resection and for comparison, normal endometrial tissues from postmenopausal women undergoing hysterectomy for benign indications. Functional assays were done in primary carcinosarcoma cell lines developed from patients and in established cell lines, as well as a cell line-derived xenograft model. Validation was done by analysis of an independent cohort of patients with uterine carcinosarcoma from The Cancer Genome Atlas (TCGA). RESULTS Rac GTPase-activating protein 1 (RACGAP1) was identified to be highly upregulated in uterine carcinosarcoma. Functional assays showed that RACGAP1 mediates motility and invasion via regulation of STAT3 phosphorylation and survivin expression. RACGAP1 depletion or survivin inhibition abrogated motility and invasiveness of carcinosarcoma cells, while RACGAP1 overexpression conferred invasiveness to endometrial adenocarcinoma cells. In the TCGA cohort, RACGAP1 expression correlated with survivin expression and extrauterine spread of disease. CONCLUSIONS The RACGAP1-STAT3-survivin signaling pathway is required for the invasive phenotype of uterine carcinosarcoma and is a newly identified therapeutic target in this lethal disease. Clin Cancer Res; 22(18); 4676-86. ©2016 AACR.
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Affiliation(s)
- Shijun Mi
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Mingyan Lin
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York
| | - Jurriaan Brouwer-Visser
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Jennifer Heim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - David Smotkin
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Tiffany Hebert
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Gary L Goldberg
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York. Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York
| | - Deyou Zheng
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York. Departments of Neurology and Neuroscience, Albert Einstein College of Medicine, Bronx, New York
| | - Gloria S Huang
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York. Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York. Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, New York.
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108
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Abstract
This study conducted a retrospective multicenter analysis to investigate the clinicopathological features, optimal therapeutic strategy, and prognosis of spindle cell carcinoma (SpCC) of the esophagus.A total of 71 patients with esophageal SpCC from 3 large cancer centers in China were systematically analyzed. All patients received curative resection, 13 patients received adjuvant radiotherapy and 15 patients received adjuvant combination chemotherapy. Additionally, a total of 1852 patients with typical esophageal SCC (SCC) were selected as controls in this study.SpCC mostly presented as a polypoid appearance (66.2%), and the surrounding mucosa showed high-grade hyperplasia or superficial SCC in 31 cases (43.7%). Two patients even had extensive carcinoma in situ that spread to the resection margins. Patients in the SpCC group were more likely to present with stage I lesions compared with those in the typical SCC group (33.8% vs 8.0%, P < 0.001). Although the percentage of T1/2 lesions was higher in the SpCC group than in the typical SCC group (67.6% vs 29.7%, P < 0.001), both groups had similar rates of locoregional lymphatic metastases (45.1% vs 48.4%, P = 0.578). The median survival time and 5-year overall survival of the SpCC group was 43 months and 44.8%, respectively, higher than 37.5 months and 38.3%, respectively, for the typical SCC group (P = 0.044). In univariate analysis, the macroscopical type and pathological T, N, and TNM stages had a statistically significant impact on the prognosis of SpCC after curative resection. However, only the TNM stage (hazard ratio, 2.708; 95% confidence interval, 1.786-4.105, P < 0.001) was identified as an independent prognostic factor in multivariate analysis. The 5-year OS of SpCC in stages I (79.8%) and II (39.7%) were significantly longer than that of stages III/IV (16.2%) (P < 0.001 and P = 0.012). As those SpCC cases that received chemoradiotherapy were in more advanced stages, their prognosis was still worse than SpCC patients who did not receive chemoradiotherapy even after such treatment (P = 0.042, 0.010, respectively).SpCC shows a highly aggressive tendency of lymphatic spread, although it does not tend to infiltrate deeply into the esophageal wall. Compared with typical SCC that also underwent esophagectomy with extended lymphadenectomy, SpCC may achieve a better survival rate. Further investigation is warranted to examine the effect of postoperative chemoradiotherapy on the prognosis of SpCC.
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Affiliation(s)
| | - Qin Xiao
- The Department of Thoracic Radiotherapy
| | | | - Xu Li
- The 2nd Department of Thoracic Surgery
| | - Jun Hu
- The Department of Pathology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, CSU, Changsha, Hunan Province
| | - Yonggang Wang
- Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, BeijingThe People's Republic of China
- Correspondence: Yonggang Wang, Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences, Chaoyang District, Beijing, The People's Republic of China (e-mail: ); Wenxiang Wang, The 2nd Department of thoracic surgery, Hunan Cancer Hospital, Yuelu District, Changsha, China (e-mail: )
| | - Wenxiang Wang
- The 2nd Department of Thoracic Surgery
- Correspondence: Yonggang Wang, Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences, Chaoyang District, Beijing, The People's Republic of China (e-mail: ); Wenxiang Wang, The 2nd Department of thoracic surgery, Hunan Cancer Hospital, Yuelu District, Changsha, China (e-mail: )
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109
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Bossuyt V, Fadare O, Martel M, Ocal IT, Burtness B, Moinfar F, Leibl S, Tavassoli FA. Remarkably High Frequency of EGFR Expression in Breast Carcinomas with Squamous Differentiation. Int J Surg Pathol 2016; 13:319-27. [PMID: 16273187 DOI: 10.1177/106689690501300403] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The human epidermal growth factor receptor (EGFR) is reportedly overexpressed in 15-20% of breast carcinomas. EGFR overexpression is associated with reduced survival and is inversely correlated with expression of estrogen receptor (ER). This study assessed EGFR expression in breast carcinomas with squamous differentiation. The immunohistochemical (IHC) expression of EGFR was evaluated in 39 breast carcinomas with squamous differentiation (30 pure squamous, 6 adenosquamous, 3 carcinosarcomas) by use of the pharmDx assay (clone 2-18C9, DakoCytomation®). Cases were considered positive if at least 10% of the cells showed 1+ positivity in the squamous component. Squamous differentiation was confirmed with IHC for CK5-6 (clone D5/16B4, DakoCytomation®). ER, PR, and HER2 status as well as clinical information regarding treatment and outcome were correlated. As a control, a tissue microarray comprising 280 lymph node positive breast carcinomas was evaluated with the same EGFR assay. The 39 patients ranged in age from 33 to 77 years (mean 52). The tumors measured 1.3-30 cm (mean 4.8). Sentinel or full axillary lymph node dissection was performed in 28 patients. Fourteen patients had positive lymph nodes. At the time of initial diagnosis, 3 patients had distant metastasis. Follow-up was available for 16 patients (mean 45 months). Disease-free survival at 3 years was 70%. Among the 39 tumors 87% (34) were positive for EGFR (p<0.0001). Sixty-nine percent (27 of 39) showed >50% 2+ EGFR staining. EGFR-positive tumor cells (showing squamous morphology) were also found in 1 bone, 1 lung, and 8 of 11 lymph node metastases available for evaluation. All 11 lymph nodes showed squamous differentiation. All but 1 of the EGFR+ tumors examined were ER and PR negative. Six EGFR-positive tumors were HER2 positive. No statistically significant differences in HER2 status, size, lymph node status and disease-free survival were observed between EGFR+ and EGFR-cases, but the number of EGFR-negative tumors was quite small. Nine of 280 (3%) of lymph node-positive invasive carcinomas on the tissue microarray were EGFR+; review of the initial diagnostic slides failed to reveal squamous features in all but 1 of the 9 EGFR+ tumors. Breast carcinomas with squamous differentiation are a distinct subgroup of breast tumors with a very high frequency of EGFR positivity. Breast carcinomas of this type would be ideal candidates for a trial with EGFR inhibitors.
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Affiliation(s)
- V Bossuyt
- Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, USA
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110
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Luty M, Kwiecień E, Firlej M, Łabędź-Masłowska A, Paw M, Madeja Z, Czyż J. Curcumin augments the cytostatic and anti-invasive effects of mitoxantrone on carcinosarcoma cells in vitro. Acta Biochim Pol 2016; 63:397-401. [PMID: 27390785 DOI: 10.18388/abp.2016_1314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/24/2016] [Accepted: 05/06/2016] [Indexed: 11/10/2022]
Abstract
Numerous adverse effects limit the applicability of mitoxantrone for the treatment of drug-resistant tumors, including carcinosarcoma. Here, we estimated the additive effects of mitoxantrone and curcumin, a plant-derived biomolecule isolated from Curcuma longa, on the neoplastic and invasive potential of carcinosarcoma cells in vitro. Curcumin augmented the cytostatic, cytotoxic and anti-invasive effects of mitoxantrone on the Walker-256 cells. It also strengthened the inhibitory effects of mitoxantrone on the motility of drug-resistant Walker-256 cells that had retained viability after a long-term mitoxantrone/curcumin treatment. Thus, curcumin reduces the effective doses of mitoxantrone and augments its interference with the invasive potential of drug-resistant carcinosarcoma cells.
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Affiliation(s)
- Marcin Luty
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Edyta Kwiecień
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Magdalena Firlej
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Anna Łabędź-Masłowska
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Milena Paw
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Zbigniew Madeja
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Jarosław Czyż
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
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Abstract
Four cases of neoplasms in the heads of old dogs were studied. All the dogs showed both carcinomatous and sarcomatous malignant components in an admixed growing pattern. Histologic analysis of the tumors showed that the carcinomatous cells resembled squamous cell carcinoma in all dogs except one, where an adenoid arrangement of the neoplastic cells was also observed. The sarcomatous component showed osteoid matrix produced by pleomorphic poorly differentiated cells, which is regarded as a typical feature of osteosarcomas. Immunohistochemical analysis demonstrated that the components were positive only for cytokeratin (carcinomatous component) or vimentin (sarcomatous component). This observation led us to classify the neoplasms as true carcinosarcomas, thus providing evidence of a new preferential location for this unusual tumor in dog.
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Affiliation(s)
- J Sánchez
- Departamento de Anatomía y Anatomía Patológica Comparadas, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain.
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112
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Abstract
An adult male mixed breed dog developed pain, on swallowing, that lasted for 1 week. Physical exam and radiographs revealed a subcutaneous mass in the cervical area and three metastatic nodules in the lung. The cervical mass was surgically removed and fixed in 10% buffered formalin. Histopathologic diagnosis was carcinosarcoma supported by positive immunohistochemistry (IHC) results for cytokeratin and vimentin. IHC for thyroglobulin proved that the tissue of origin was the thyroid gland. This is the fifth canine case of thyroid carcinosarcoma to be documented, but the first one to be confirmed by specific cell markers. It is an extremely rare neoplasm that also occurs in people.
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Affiliation(s)
- B Grubor
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA 50011-1250, USA.
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113
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Cervoni G, Steffes WE, Kobraei KB, Church AA. Exophytic scalp tumor. Cutis 2016; 97:E9-E11. [PMID: 27163927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Gabrielle Cervoni
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | | | - Ann A Church
- Department of Dermatology, University of Florida, Gainesville, USA
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114
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Smadhi H, Ben Hamad W, Neffati O, Kammoun H, Braham E, Fekih L, Megdiche ML. [A rare cause of a posterior mediastinal mass]. Rev Pneumol Clin 2016; 72:160-162. [PMID: 26190341 DOI: 10.1016/j.pneumo.2015.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/04/2015] [Accepted: 04/30/2015] [Indexed: 06/04/2023]
Affiliation(s)
- H Smadhi
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie.
| | - W Ben Hamad
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - O Neffati
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - H Kammoun
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - E Braham
- Service d'anatomie pathologique, hôpital Abderrahman Mami Ariana, 2080, Tunisie; Faculté de médecine de Tunis, université Tunis Elmanar II, 1006 Tunisie
| | - L Fekih
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
| | - M L Megdiche
- Service de pneumologie Ibn Nafis, hôpital Abderrahman Mami, Ariana 2080, Tunisie
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115
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Páramo AA, Valverde DP, Campos PV, Santos EPG, Puche JLB, Guerrero PN, Delgado M, Fernindez JM. [Syncrhonous carcinosarcoma of the extrahepatic bile duct and gallbladder.]. Acta Gastroenterol Latinoam 2016; 46:30-34. [PMID: 29470881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Carcinosarcoma is a malignant neoplasm characterized for intermingled epithelial and mesenchymal components. CASE REPORT A preoperative suspected diagnosis will allow a radical therapy avoiding a very bad prognosis. We report on a male patient who was operated in our Service with diagnosis of synchronous carcinosarcoma of gallbladder and extrahepatic bile duct and a review of the Medical Literature. DISCUSSION A gallblader carcinosarcoma showing extension into common bile duct is very rare, a carcinosarcoma of the bile duct is exceptional, and a synchronous carcinosarcoma ofthe bile duct and gallbladder has not been reported previously.
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Inoue H, Takahashi H, Hashimura M, Eshima K, Akiya M, Matsumoto T, Saegusa M. Cooperation of Sox4 with β-catenin/p300 complex in transcriptional regulation of the Slug gene during divergent sarcomatous differentiation in uterine carcinosarcoma. BMC Cancer 2016; 16:53. [PMID: 26841870 PMCID: PMC4739330 DOI: 10.1186/s12885-016-2090-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 01/28/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Uterine carcinosarcoma (UCS) represents a true example of cancer associated with epithelial-mesenchymal transition (EMT), which exhibits cancer stem cell (CSC)-like traits. Both Sox and β-catenin signal transductions play key roles in the regulation of EMT/CSC properties, but little is known about their involvement in UCS tumorigenesis. Herein, we focused on the functional roles of the Sox/β-catenin pathway in UCSs. METHODS EMT/CSC tests and transfection experiments were carried out using three endometrial carcinoma (Em Ca) cell lines. Immunohistochemical investigation was also applied for a total of 32 UCSs. RESULTS Em Ca cells cultured in STK2, a serum-free medium for mesenchymal stem cells, underwent changes in morphology toward an EMT appearance through downregulation of E-cadherin, along with upregulation of Slug, known as a target gene of β-catenin. The cells also showed CSC properties with an increase in the aldehyde dehydrogenase (ALDH) 1(high) activity population and spheroid formation, as well as upregulation of Sox4, Sox7, and Sox9. Of these Sox factors, overexpression of Sox4 dramatically led to transactivation of the Slug promoter, and the effects were further enhanced by cotransfection of Sox7 or Sox9. Sox4 was also able to promote β-catenin-mediated transcription of the Slug gene through formation of transcriptional complexes with β-catenin and p300, independent of TCF4 status. In clinical samples, both nuclear β-catenin and Slug scores were significantly higher in the sarcomatous elements as compared to carcinomatous components in UCSs, and were positively correlated with Sox4, Sox7, and Sox9 scores. CONCLUSIONS These findings suggested that Sox4, as well as Sox7 and Sox9, may contribute to regulation of EMT/CSC properties to promote development of sarcomatous components in UCSs through transcriptional regulation of the Slug gene by cooperating with the β-catenin/p300 signal pathway.
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Affiliation(s)
- Hisako Inoue
- Department of Pathology, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Hiroyuki Takahashi
- Department of Pathology, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Miki Hashimura
- Department of Pathology, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Koji Eshima
- Department of Immunology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Masashi Akiya
- Department of Pathology, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Toshihide Matsumoto
- Department of Pathology, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Makoto Saegusa
- Department of Pathology, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
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Skyba VV, Hychka SH, Ivanko OV, Kuzyk PV, Lysytsia VV. [SURGICAL TREATMENT OF OVARIAN CARCINOSARCOMA THAT DEVELOPED IN GIANT CYSTIC TERATOMA]. Klin Khir 2016:77-78. [PMID: 27244929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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118
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Korsten H, Ziel-van der Made ACJ, van Weerden WM, van der Kwast T, Trapman J, Van Duijn PW. Characterization of Heterogeneous Prostate Tumors in Targeted Pten Knockout Mice. PLoS One 2016; 11:e0147500. [PMID: 26807730 PMCID: PMC4726760 DOI: 10.1371/journal.pone.0147500] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/05/2016] [Indexed: 11/18/2022] Open
Abstract
Previously, we generated a preclinical mouse prostate tumor model based on PSA-Cre driven inactivation of Pten. In this model homogeneous hyperplastic prostates (4-5m) developed at older age (>10m) into tumors. Here, we describe the molecular and histological characterization of the tumors in order to better understand the processes that are associated with prostate tumorigenesis in this targeted mouse Pten knockout model. The morphologies of the tumors that developed were very heterogeneous. Different histopathological growth patterns could be identified, including intraductal carcinoma (IDC), adenocarcinoma and undifferentiated carcinoma, all strongly positive for the epithelial cell marker Cytokeratin (CK), and carcinosarcomas, which were negative for CK. IDC pattern was already detected in prostates of 7-8 month old mice, indicating that it could be a precursor stage. At more than 10 months IDC and carcinosarcoma were most frequently observed. Gene expression profiling discriminated essentially two molecular subtypes, denoted tumor class 1 (TC1) and tumor class 2 (TC2). TC1 tumors were characterized by high expression of epithelial markers like Cytokeratin 8 and E-Cadherin whereas TC2 tumors showed high expression of mesenchyme/stroma markers such as Snail and Fibronectin. These molecular subtypes corresponded with histological growth patterns: where TC1 tumors mainly represented adenocarcinoma/intraductal carcinoma, in TC2 tumors carcinosarcoma was the dominant growth pattern. Further molecular characterization of the prostate tumors revealed an increased expression of genes associated with the inflammatory response. Moreover, functional markers for senescence, proliferation, angiogenesis and apoptosis were higher expressed in tumors compared to hyperplasia. The highest expression of proliferation and angiogenesis markers was detected in TC2 tumors. Our data clearly showed that in the genetically well-defined PSA-Cre;Pten-loxP/loxP prostate tumor model, histopathological, molecular and biological heterogeneity occurred during later stages of tumor development.
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MESH Headings
- Adenocarcinoma/chemistry
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Animals
- Apoptosis/genetics
- Biomarkers
- Biomarkers, Tumor
- Cadherins/analysis
- Carcinoma/chemistry
- Carcinoma/genetics
- Carcinoma/pathology
- Carcinosarcoma/chemistry
- Carcinosarcoma/genetics
- Carcinosarcoma/pathology
- Cellular Senescence/genetics
- Disease Progression
- Epithelial Cells/chemistry
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Inflammation/genetics
- Keratins/analysis
- Male
- Mesoderm/chemistry
- Mice
- Mice, Inbred Strains
- Mice, Knockout
- Neoplasm Proteins/analysis
- Neovascularization, Pathologic/genetics
- Neovascularization, Pathologic/pathology
- PTEN Phosphohydrolase/deficiency
- Prostatic Hyperplasia/genetics
- Prostatic Hyperplasia/pathology
- Prostatic Neoplasms/chemistry
- Prostatic Neoplasms/classification
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/pathology
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- RNA, Neoplasm/biosynthesis
- RNA, Neoplasm/genetics
- Stromal Cells/chemistry
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Affiliation(s)
- Hanneke Korsten
- Department of Pathology, Josephine Nefkens Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Wytske M. van Weerden
- Department of Urology, Josephine Nefkens Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Theo van der Kwast
- Department of Pathology, Josephine Nefkens Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan Trapman
- Department of Pathology, Josephine Nefkens Institute, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Petra W. Van Duijn
- Department of Pathology, Josephine Nefkens Institute, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Urology, Josephine Nefkens Institute, Erasmus Medical Center, Rotterdam, The Netherlands
- * E-mail:
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119
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Ezewuiro O, Grushko TA, Kocherginsky M, Habis M, Hurteau JA, Mills KA, Hunn J, Olopade OI, Fleming GF, Romero IL. Association of Metformin Use with Outcomes in Advanced Endometrial Cancer Treated with Chemotherapy. PLoS One 2016; 11:e0147145. [PMID: 26788855 PMCID: PMC4720394 DOI: 10.1371/journal.pone.0147145] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/29/2015] [Indexed: 02/04/2023] Open
Abstract
There is increasing evidence that metformin, a commonly used treatment for diabetes, might have the potential to be repurposed as an economical and safe cancer therapeutic. The aim of this study was to determine whether stage III-IV or recurrent endometrial cancer patients who are using metformin during treatment with chemotherapy have improved survival. To test this we analyzed a retrospective cohort of subjects at two independent institutions who received chemotherapy for stage III-IV or recurrent endometrial cancer from 1992 to 2011. Diagnosis of diabetes, metformin use, demographics, endometrial cancer clinico-pathologic parameters, and survival duration were abstracted. The primary outcome was overall survival. The final cohort included 349 patients, 31 (8.9%) had diabetes and used metformin, 28 (8.0%) had diabetes but did not use metformin, and 291 (83.4%) did not have diabetes. The results demonstrate that the median overall survival was 45.6 months for patients with diabetes who used metformin compared to 12.5 months for patients with diabetes who did not use metformin and 28.5 months for patients without diabetes (log-rank test comparing the three groups P = 0.006). In a model adjusted for confounders, the difference in survival between the three groups remained statistically significant (P = 0.023). The improvement in survival among metformin users was not explained by better baseline health status or more aggressive use of chemotherapy. Overall, the findings in this retrospective cohort of endometrial cancer patients with stage III-IV or recurrent disease treated with chemotherapy indicate that patients with diabetes who were concurrently treated with metformin survived longer than patients with diabetes who did not use metformin.
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Affiliation(s)
- Obiageli Ezewuiro
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Tatyana A. Grushko
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Masha Kocherginsky
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Mohammed Habis
- Department of Obstetrics and Gynecology, Gordon Center for Integrative Science, University of Chicago, Chicago, Illinois, United States of America
| | - Jean A. Hurteau
- Department of Obstetrics and Gynecology, NorthShore University Health System, Chicago, Illinois, United States of America
| | - Kathryn A. Mills
- Department of Obstetrics and Gynecology, Gordon Center for Integrative Science, University of Chicago, Chicago, Illinois, United States of America
| | - Jessica Hunn
- Department of Obstetrics and Gynecology, Gordon Center for Integrative Science, University of Chicago, Chicago, Illinois, United States of America
| | | | - Gini F. Fleming
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Iris L. Romero
- Department of Obstetrics and Gynecology, Gordon Center for Integrative Science, University of Chicago, Chicago, Illinois, United States of America
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Wongrakpanich S, Patnaik S, Morginstin M. An umbilical nodule in a patient with enlarged uterus. Eur J Intern Med 2016; 27:e3-4. [PMID: 26190790 DOI: 10.1016/j.ejim.2015.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 07/07/2015] [Indexed: 11/21/2022]
Affiliation(s)
| | - Soumya Patnaik
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Mark Morginstin
- Department of Hematology and Oncology, Einstein Medical Center, Philadelphia, PA, USA
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121
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Moláček J, Brůha J, Baxa J, Opatrný V, Třeška V. [Extragenital malignant Müllerian carcinosarcoma with invasion of inferior vena cava - a case report]. Rozhl Chir 2016; 95:45-47. [PMID: 26982192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED The authors present the case of a 57-year-old woman with a very rare extragenital malignant retroperitoneal Müllerian carcinosarcoma invading the inferior vena cava. Tumor resection with partial resection of the vena cava wall and resection of metastases in the pelvic area is described. The authors further discuss diagnostic options of metastases of this tumour and the recommended adjuvant chemotherapy. KEY WORDS extragenital Müllerian carcinosarcoma malignant mixed Müllerian tumour - diagnosis therapy.
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122
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Abu-Khalaf MM, Raza MA, Hatzis C, Wang H, Lin K, Higgins S, Ratner E, Silasi DA, Azodi M, Rutherford TJ, Santin AD, Schwartz PE. Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma. EUR J GYNAECOL ONCOL 2016; 37:199-203. [PMID: 27172745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE OF INVESTIGATION A retrospective study to evaluate six cycles of cisplatin 40 mg/m2 on day 1 and ifosfamide 1,200 mg/m2 daily on days 1 to 4 with Mesna every four weeks as first line treatment for 29 patients with a diagnosis of uterine carcinosarcoma. MATERIALS AND METHODS A total of 23 of 29 patients received high dose rate intracavitary vaginal cuff brachytherapy (VCBT) with two fractions of seven Gy each. Median age was 65 years (range 40-82); 13 (44.8%) had Stage I disease, three (10.3%) had Stage II, eight (27.6%) had Stage III, and five (17.2%) patients had Stage IV disease. RESULTS Most common toxicities were anemia grade 1 (35%)/grade 2 (45%), and neutropenia grade 3 (17%)/grade 4 (6.9%). Eleven dose modifications, four treatment discontinuations, and one patient withdrawal occurred. At a median follow up of 45 months (range 9 to 144), Progression free survival (PFS) was 20% and overall survival (OS) was 40% for Stage IV, PFS 75% and OS 62.5% for Stage III, compared to a PFS 75% and OS 72.2% for Stages I-II. Median OS for the entire group was 12.43 years (95% CI 3.69 to inf); for Stage I-III 12.4 years (6.1 to inf), and for Stage IV 15.6 months (95% CI 9.4 to inf). CONCLUSIONS Cisplatin and ifosfamide chemotherapy with VCBT was well tolerated and has promising activity in uterine carcinosarcoma.
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123
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Sun YQ, Chen P, Zhao Q. Pulmonary Carcinosarcoma with Intracardiac Extension: a Case Report. ACTA ACUST UNITED AC 2015; 30:193-5. [PMID: 26564420 DOI: 10.1016/s1001-9294(15)30046-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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124
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Xiang S, Chen YF, Guan Y, Chen XP. Primary combined hepatocellular-cholangiocellular sarcoma: An unusual case. World J Gastroenterol 2015; 21:7335-7342. [PMID: 26109824 PMCID: PMC4476899 DOI: 10.3748/wjg.v21.i23.7335] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 02/10/2015] [Accepted: 04/03/2015] [Indexed: 02/07/2023] Open
Abstract
Primary liver carcinosarcoma is rare. Here we report an unusual case of liver carcinosarcoma containing combined hepatocellular cholangiocarcinoma. A mass in the right liver lobe of a 45-year-old man was accidentally discovered by ultrasonic inspection and computed tomography (CT) scan. Surgical resection was performed following a diagnosis of primary liver cancer. Micropathologically, both carcinomatous and sarcomatous elements were present, and diagnosis of liver carcinosarcoma was confirmed. The carcinomatous element consisted of hepatocellular carcinoma and foci of cholangiocellular carcinoma. The sarcomatous element was composed of spindle cells and bizarre cells, as well as foci of osteosarcoma and chondrosarcoma. Hepatocellular carcinoma cells diffusely expressed both hepatocyte specific markers cytokeratin (CK) 8/18 and cholangiocyte specific markers CK19, and sarcoma cells were positive for vimentin. Interestingly, both carcinomatous and sarcomatous cells expressed epithelial membrane antigen. CD117-positive ductular reactions and small undifferentiated cells were observed. A liver progenitor cell origin of the liver carcinosarcoma was proposed.
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125
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Fatima N, Canter DJ, Carthon BC, Kucuk O, Master VA, Nieh PT, Ogan K, Osunkoya AO. Sarcomatoid urothelial carcinoma of the bladder: a contemporary clinicopathologic analysis of 37 cases. Can J Urol 2015; 22:7783-7787. [PMID: 26068625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Sarcomatoid urothelial carcinoma is a dedifferentiated biphasic tumor that exhibits morphological and/or immunohistochemical evidence of epithelial and mesenchymal differentiation. In this series, we analyzed the clinicopathologic features of this rare variant of urothelial carcinoma. MATERIALS AND METHODS A search was made through our surgical pathology files and consultation files of the senior author for cases of sarcomatoid urothelial carcinoma of the bladder from 2005-2014. All the slides were retrieved and re-reviewed, and clinical data was also obtained including follow up. RESULTS Thirty-seven cases of sarcomatoid urothelial carcinoma of the bladder were identified. Mean patient age was 71 years (range: 51 to 88 years). Twenty-six of 37 (70%) patients were male and 11/37 (30%) patients were female. Twenty-five cases were from cystectomy/cystoprostatectomy specimens, 8 cases from transurethral resection of bladder tumor specimens and 4 cases were from biopsy specimens. The mean tumor size was 5 cm (range: 1.4 cm to 13.0 cm). Four of 37 (10%) cases had focal heterologous components; 1 case with both chondroid and osteoid, 2 cases with chondroid and 1 case rhabdoid elements. Twenty-one of 37 (56%) patients died within a year of presentation. CONCLUSIONS Sarcomatoid urothelial carcinoma of the bladder is more prevalent in males, with the mean age of 71 years in our series. Smoking is an important risk factor. Sarcomatoid urothelial carcinoma is an aggressive variant of urothelial carcinoma which commonly presents at an advanced stage, and over 50% of patients in our series died of disease within 1 year of presentation.
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Affiliation(s)
- Nazneen Fatima
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
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126
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Gao S, Huang L, Dai S, Chen D, Dai R, Shan Y. Carcinosarcoma of the gallbladder: a case report and review of the literature. Int J Clin Exp Pathol 2015; 8:7464-7469. [PMID: 26261654 PMCID: PMC4525988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 05/27/2015] [Indexed: 06/04/2023]
Abstract
Carcinosarcoma of the gallbladder is a rare malignancy characterized by malignant epithelial and mesenchymal components. The disease usually presents at an advanced stage, and as a result, curative resection is uncommon. This report describes a case that underwent curative resection. We herein declare the case of a patient in a 62-year-old male, with carcinosarcoma of the gallbladder with chondroid differentiation. The patient is treated by a simple cholecystectomy, a wedge resection of the underlying liver tissue and the pericholedochal lymph nodes for a tumor which occupied the entire gallbladder. Histologically, the epithelial component of the tumor was composed of adenocarcinoma and the mesenchymal component was composed of fibrosarcoma. The tumor was identified as extend to the serosa tissue and to have metastasized to no lymph node. The prognosis of carcinosarcoma of the gallbladder remains poor despite curative resection, and thus, the authors recommend that effort should be made to improve surgical outcomes. The patient survived 13 months and is still alive today.
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Affiliation(s)
- Shengqiang Gao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, Zhejiang, P.R. China
| | - Lidong Huang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, Zhejiang, P.R. China
| | - Shuang Dai
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, Zhejiang, P.R. China
| | - Dongdong Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, Zhejiang, P.R. China
| | - Ruijie Dai
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, Zhejiang, P.R. China
| | - Yunfeng Shan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000, Zhejiang, P.R. China
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Glaser G, Weroha SJ, Becker MA, Hou X, Enderica-Gonzalez S, Harrington SC, Haluska P. Conventional chemotherapy and oncogenic pathway targeting in ovarian carcinosarcoma using a patient-derived tumorgraft. PLoS One 2015; 10:e0126867. [PMID: 25962155 PMCID: PMC4427104 DOI: 10.1371/journal.pone.0126867] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 04/08/2015] [Indexed: 11/18/2022] Open
Abstract
Ovarian carcinosarcoma is a rare subtype of ovarian cancer with poor clinical outcomes. The low incidence of this disease makes accrual to large clinical trials challenging. However, studies have shown that treatment responses in patient-derived xenograft (PDX) models correlate with matched-patient responses in the clinic, supporting their use for preclinical testing of standard and novel therapies. An ovarian carcinosarcoma PDX is presented herein and showed resistance to carboplatin and paclitaxel (similar to the patient) but exhibited significant sensitivity to ifosfamide and paclitaxel. The PDX demonstrated overexpression of EGFR mRNA and gene amplification by array comparative genomic hybridization (log2 ratio 0.399). EGFR phosphorylation was also detected. Angiogensis and insulin-like growth factor pathways were also implicated by overexpression of VEGFC and IRS1. In order to improve response to chemotherapy, the PDX was treated with carboplatin/paclitaxel with or without a pan-HER and VEGF inhibitor (BMS-690514) but there was no tumor growth inhibition or improved animal survival, which may be explained by a KRAS mutation. Resistance was also observed when the IGF-1R inhibitor BMS-754807 was combined with carboplatin/paclitaxel. Because poly (ADP-ribose) polymerase inhibitors have activity in ovarian cancer patients, with and without BRCA mutations, ABT-888 was also tested but found to have no activity. Pathogenic mutations were also detected in TP53 and PIK3CA. In conclusion, ifosfamide/paclitaxel was superior to carboplatin/paclitaxel in this ovarian carcinosarcoma PDX and gene overexpression or amplification alone was not sufficient to predict response to targeted therapy. Better predictive markers of response are needed.
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Affiliation(s)
- Gretchen Glaser
- Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - S. John Weroha
- Department of Oncology, Mayo Clinic, Rochester, MN, United States of America
- * E-mail:
| | - Marc A. Becker
- Department of Oncology, Mayo Clinic, Rochester, MN, United States of America
| | - Xiaonan Hou
- Department of Oncology, Mayo Clinic, Rochester, MN, United States of America
| | | | - Sean C. Harrington
- Department of Oncology, Mayo Clinic, Rochester, MN, United States of America
| | - Paul Haluska
- Department of Oncology, Mayo Clinic, Rochester, MN, United States of America
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Emoto M, Yano K, Choijamts B, Sakai S, Hirasawa S, Wakamori S, Aizawa M, Nabeshima K, Tachibana K, Kanomata N. Azaspirene analogs inhibit the growth of human uterine carcinosarcoma in vitro and in vivo. Anticancer Res 2015; 35:2739-2746. [PMID: 25964553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Uterine carcinosarcoma is a highly aggressive gynecological neoplasm that responds poorly to conventional chemotherapy and radiotherapy. Recent studies have shown high angiogenic activities of this tumor, hence anti-angiogenic approaches are expected to provide new treatment strategies for this tumor. In previous work, azaspirene was isolated from Neosartorya sp. fungi, and in vitro anti-angiogenic activities were shown. In the present study, the anti-angiogenic effects of azaspirene analogs, synthetic molecules with a shorter ethyl group replacing a hexadienyl side-chain of the natural compound, were assessed in vitro using human umbilical vein endothelial cells (HUVECs) co-cultured with FU-MMT-3 human uterine carcinosarcoma cells. The anti-tumor and anti-angiogenic effects of these analogs were also evaluated in vivo using FU-MMT-3 xenografted tumors in nude mice. The azaspirene analogs inhibited the tube formation of HUVECs induced by FU-MMT-3 cells in vitro and significantly suppressed tumor growth in vivo compared to the untreated group (control). A significant reduction of the microvessel density in tumors was observed, in comparison to the control. No apparent toxicity, including body loss, was observed in any mice treated in this study. These azaspirene analogs may be effective against uterine carcinosarcoma, possibly acting via potent anti-angiogenic effects.
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Affiliation(s)
- Makoto Emoto
- Department of Health and Welfare, International University of Health and Welfare, Fukuoka, Japan Division of Gynecology in Preventive Medicine, Fukuoka Sanno Hospital, Sawara-ku, Fukuoka, Japan
| | - Kyoko Yano
- Department of Pathology, Faculty of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan
| | - Batsuren Choijamts
- Department of Health and Welfare, International University of Health and Welfare, Fukuoka, Japan
| | - Shinnosuke Sakai
- Department of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda University, Shinjuku-ku, Tokyo, Japan
| | - Shun Hirasawa
- Department of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda University, Shinjuku-ku, Tokyo, Japan
| | - Shinnosuke Wakamori
- Department of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda University, Shinjuku-ku, Tokyo, Japan
| | - Mamoru Aizawa
- Department of Applied Chemistry, School of Science and Technology, Meiji University, Kawasaki, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan
| | - Katsuro Tachibana
- Department of Anatomy, Faculty of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan
| | - Nobuhiro Kanomata
- Department of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda University, Shinjuku-ku, Tokyo, Japan
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129
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Brown LC, Petersen IA, Haddock MG, Bakkum-Gamez JN, Lee LJ, Cimbak NC, Berkowitz RS, Viswanathan AN. Vaginal brachytherapy for early-stage carcinosarcoma of the uterus. Brachytherapy 2015; 14:433-9. [PMID: 25890795 DOI: 10.1016/j.brachy.2015.02.194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/07/2015] [Accepted: 02/12/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Uterine carcinosarcoma (CS) is an aggressive malignancy and the optimal adjuvant treatment is not well-established. We report outcomes with vaginal brachytherapy (VB) for women with early-stage CS. METHODS AND MATERIALS A multi-institutional retrospective study of Stage I-II CS treated with hysterectomy, surgical staging, and adjuvant high-dose-rate VB without external-beam pelvic radiotherapy was performed. Rates of vaginal control, pelvic control, locoregional control, disease-free survival, and overall survival were determined using the Kaplan-Meier method. RESULTS 33 patients were identified. Prescribed VB dose was 21 Gy in three fractions (n = 15 [45%]) or 24 Gy in six fractions (n = 18 [55%]). Eighteen patients (55%) received chemotherapy. Median followup was 2.0 years. Twenty-seven patients (82%) underwent pelvic lymphadenectomy, 5 (15%) had nodal sampling, and 1 (3%) had no lymph node assessment. Relapse occurred in 11 patients (33%), all of whom had lymph node evaluation. Locoregional relapse was a component of failure in 6 patients (18%), of whom 3 (9%) failed in the pelvis alone. Three patients (9%) had simultaneous distant and locoregional relapse (two vaginal, one pelvic). Five additional patients (15%) had distant relapse. Six of the 11 patients (55%) with disease recurrence received chemotherapy. Two-year vaginal control and pelvic control were 94% and 87%. Two-year locoregional control, disease-free survival, and overall survival were 81%, 66%, and 79%. CONCLUSIONS Despite having early-stage disease and treatment with VB, patients in this series had relatively high rates of local and distant relapse. Patients who undergo lymphadenectomy and VB remain at risk for relapse. Novel treatment strategies are needed.
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Affiliation(s)
- Lindsay C Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - Ivy A Petersen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | | | | | - Larissa J Lee
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - Nicole C Cimbak
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - Ross S Berkowitz
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - Akila N Viswanathan
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA.
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130
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Koskas M, Rouzier R, Amant F. Staging for endometrial cancer: The controversy around lymphadenectomy - Can this be resolved? Best Pract Res Clin Obstet Gynaecol 2015; 29:845-57. [PMID: 25817745 DOI: 10.1016/j.bpobgyn.2015.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 02/03/2015] [Indexed: 11/18/2022]
Abstract
Endometrial cancer remains the most common malignancy of the female genital tract. Lymph node metastasis is one of the most important prognostic factors, and stratification into pelvic lymph node invasion (stage IIIC1) and para-aortic lymph node invasion (stage IIIC2) improved the predictive value of the 2009 International Federation of Gynecology and Obstetrics (FIGO) classification. Radiological examination methods such as magnetic resonance imaging and positron emission tomography-computed tomography do not have good-enough sensitivity to avoid lymphadenectomy for the assessment of lymph node invasion. Prediction scores are becoming increasingly valuable to exclude lymph node metastasis in low-risk groups, and biomarkers could help to identify patients with high-risk lymph node metastatic probability. The therapeutic role of lymph node dissection remains a matter of debate. Several end points can be considered to evaluate the opportunity of lymphadenectomy in endometrial cancer. First, we compare survival according to the realization, the extent, and the numbers of nodes removed during lymphadenectomy. Second, we assess the opportunity of lymphadenectomy in order to tailor adjuvant treatment modalities. Third, we analyze the surgical complication rate after pelvic lymphadenectomy.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Adenocarcinoma/surgery
- Adenocarcinoma, Clear Cell/diagnosis
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Clear Cell/surgery
- Adenocarcinoma, Papillary/diagnosis
- Adenocarcinoma, Papillary/pathology
- Adenocarcinoma, Papillary/surgery
- Carcinoma, Endometrioid/diagnosis
- Carcinoma, Endometrioid/pathology
- Carcinoma, Endometrioid/surgery
- Carcinosarcoma/diagnosis
- Carcinosarcoma/pathology
- Carcinosarcoma/surgery
- Endometrial Neoplasms/diagnosis
- Endometrial Neoplasms/pathology
- Endometrial Neoplasms/surgery
- Female
- Humans
- Lymph Node Excision
- Lymph Nodes/diagnostic imaging
- Lymph Nodes/pathology
- Lymphatic Metastasis
- Magnetic Resonance Imaging
- Multimodal Imaging
- Neoplasm Staging
- Neoplasms, Cystic, Mucinous, and Serous/diagnosis
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neoplasms, Cystic, Mucinous, and Serous/surgery
- Pelvis
- Positron-Emission Tomography
- Prognosis
- Radiography
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Affiliation(s)
- Martin Koskas
- Department of Obstetrics and Gynaecology, APHP Hôpital Bichat, Paris, France; Paris Diderot University Paris 07, Paris, France
| | - Roman Rouzier
- Department of Gynaecology Institut Curie, Paris, France
| | - Frederic Amant
- Gynecologic Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Leuven, Belgium.
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Abstract
Tracheobronchial aspergillosis is a form of invasive aspergillosis limited to the airways. Its presence usually indicates an immunocompromised status or local dysfunction of airway immunity. We herein report a case of lung carcinosarcoma masked by tracheobronchial aspergillosis and discuss the clinical manifestations, diagnostic procedures and treatment of such cases. Tracheobronchial aspergillosis may also mask endobronchial carcinoma, leading to difficulties in determining the diagnosis and selecting subsequent treatment. Bronchoscopy is crucial for obtaining a definitive diagnosis and confirming the treatment. In particular, the combination of intravenous antifungal drug administration, localized antifungal application and interventional bronchoscopy is effective. Nevertheless, clinicians should always investigate the underlying disease carefully, including the potential occurrence of lung malignancy.
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Affiliation(s)
- Xiao-Ming Zhou
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, China
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132
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Visnovsky J, Kudela E, Slavik P, Krkoska M, Buocik P, Szepe P, Danko J. Survival and risk factors associated with uterine sarcomas and carcinosarcomas in stage I and II. Neuro Endocrinol Lett 2015; 36:750-757. [PMID: 26921575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 12/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Uterine sarcomas are rare mesodermal malignant tumors with an incidence between 0.5 and 3.3 cases per 100,000 females per year. Most sarcomas are aggressive tumors leading to poor overall survival rates and only limited therapeutic options. The aim of this study was to evaluate the risk factors for uterine sarcomas and carcinosarcomas, and to identify the factors influencing the survival rate. SUBJECTS AND METHODS We conducted a retrospective study with twenty-nine patients who were diagnosed with uterine sarcoma and thirty-four patients with carcinosarcoma between the years 1990 and 2006 at the Oncogynecologic center at the University Hospital in Martin, Slovakia. We focused on the analysis of the risk factors and survival rate of early stages I and II. RESULTS We confirmed highly statistically significant values for the inverse correlation between survival and tumor size, positive lymph nodes, high mitotic activity, vascular invasion, positive peritoneal cytology, elevated CA-125, smoking and BMI in sarcoma and carcinosarcoma group (p<0.001 for all factors). The use of lymphadenectomy had no effect on survival of all patients. DISCUSSION Sarcomas and carcinosarcomas are aggressive tumors leading to poor overall survival rates and only limited therapeutic options. As there is no consensus on specific treatment, an individual approach based on evaluation of known risk factors is essential.
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Affiliation(s)
- Jozef Visnovsky
- Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and University Hospital in Martin, Slovakia
| | - Erik Kudela
- Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and University Hospital in Martin, Slovakia
| | - Pavol Slavik
- Department of Pathologic Anatomy, Jessenius Faculty of Medicine, University Hospital Martin, Slovakia
| | - Milan Krkoska
- Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and University Hospital in Martin, Slovakia
| | - Pavol Buocik
- Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and University Hospital in Martin, Slovakia
| | - Peter Szepe
- Department of Pathologic Anatomy, Jessenius Faculty of Medicine, University Hospital Martin, Slovakia
| | - Jan Danko
- Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and University Hospital in Martin, Slovakia
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Abstract
Carcinosarcoma of the breast is an extremely rare and highly aggressive breast tumor.It has two distinct malignant cell lines involving epithelial (carcinomatous) and mesenchymal (sarcomatous) components. The literature on the topic is sparse. We report a rare case of carcinosarcoma of the breast containing a small fraction of a pancytokeratin positive sarcomatous-appearing cell population i.e. a metaplastic cell population. The patient was treated with a multidisciplinary approach.
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Affiliation(s)
- Marco Mele
- Breast and Endocrinal Surgery Department, Aarhus University Hospital, Aarhus, Denmark
| | - Lisbeth L Jensen
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Jonas Amstrup Funder
- Breast and Endocrinal Surgery Department, Aarhus University Hospital, Aarhus, Denmark
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134
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Kumei S, Onishi Y, Ogura T, Kusumoto C, Matsuno Y, Nishigami T, Maeda M, Harada M. Carcinosarcoma of the Extrahepatic Bile Duct Presenting with Stone-like Radiological Findings. Intern Med 2015; 54:1747-51. [PMID: 26179529 DOI: 10.2169/internalmedicine.54.3082] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 73-year-old woman was referred to our hospital due to epigastralgia and jaundice. The radiological findings showed a stone-like tumor in the extrahepatic bile duct. The patient was initially thought to have adenocarcinoma of the bile duct based on the findings of a pathological examination of the bile duct biopsy specimen and underwent pancreaticoduodenectomy; the final diagnosis of the lesion was so-called carcinosarcoma of the extrahepatic bile duct. She died of liver metastasis six months after the surgery. This case suggests that surgical resection is not adequate for achieving a radical cure, and the optimal treatment for extrahepatic bile duct carcinosarcoma should be established immediately.
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Affiliation(s)
- Shinsuke Kumei
- Department of Internal Medicine, IHI Harima Hospital, Japan
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135
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Magnuson WJ, Petereit DG, Anderson BM, Geye HM, Bradley KA. Impact of adjuvant pelvic radiotherapy in stage I uterine sarcoma. Anticancer Res 2015; 35:365-370. [PMID: 25550573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIM The optimal adjuvant therapy for stage I uterine sarcoma remains unresolved and may consist of radiotherapy (RT), chemotherapy, hormonal therapy or observation. We analyzed the impact of adjuvant pelvic RT on overall survival (OS), cause-specific survival (CSS), disease-free survival (DFS), pelvic control (PC) and patterns of failure. PATIENTS AND METHODS A retrospective analysis of 157 patients with International Federation of Gynecology and Obstetrics FIGO stage I uterine sarcoma was performed. RT was given postoperatively to a dose of 45-51 Gy in 28-30 fractions. RESULTS The 5-year OS, CSS, DFS and PC was 58%, 62%, 47% and 72%, respectively. Adjuvant RT significantly improved PC (85% for RT group vs. 64% for non-RT group; p=0.02) but did not impact OS, CSS or DFS. CONCLUSION The addition of adjuvant pelvic RT significantly improved PC for patients with stage I uterine sarcoma. As systemic therapies continue to improve, optimal locoregional control may result in improved patient outcomes.
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Affiliation(s)
- William J Magnuson
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A.
| | | | - Bethany M Anderson
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A
| | - Heather M Geye
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A
| | - Kristin A Bradley
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A
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136
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Takemoto Y, Ota T, Aoki Y, Ogura K, Ogishima D, Matsumoto T. Carcinosarcoma of the fallopian tube with disappearance of carcinoma cells by neoadjuvant chemotherapy: case study. EUR J GYNAECOL ONCOL 2015; 36:618-622. [PMID: 26513897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors report a case of carcinosarcoma (CS) of the fimbria of the fallopian tube in which carcinoma cells disappeared with neoadjuvant chemotherapy (NAC). A 74-year-old woman visited the present hospital with a large pelvic mass and pleural effusion. A magnetic resonance image of the tumor was highly suggestive of ovarian carcinoma. Due to the presence of both serous.adenocarcinoma cells in pleural effusion and pulmonary thrombosis, the patient was given NAC consisting of carboplatin plus paclitaxel (TC) and anticoagulant therapy with warfarin potassium. With six courses of NAC, the pleural effusion and pulmonary thrombosis disappeared, and the tumor decreased 36.2% in greatest diameter. Maximum debulking surgery was then performed. The tumor was found to be located in the fimbria of the right fallopian tube. Hysterectomy and bilateral salpingo-oophorectomy were performed, and histologic examination revealed chondrosarcoma with the presence of necrotic epithelial cells. The necrotic areas were interspersed with papillary structures, and immunohistochemical study showed positivity for CK7 and negativity for CK20, p53, and estrogen receptor (ER), indicating serous adenocarcinoma. Thus, heterologous CS with disappearance of viable carcinoma cells by NAC was diagnosed. The patient was given adjuvant chemotherapy consisting of three courses of TC, and there has been no evidence of disease for 20 months. The authors' experience in this case of gynecologic CS indicates that a serous adenocarcinomatous component of tubal CS can be well cured by TC-based NAC.
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137
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Hirano H, Kizaki T, Ito T, Okimura A, Yamanegi K, Nakasho K. Expression of adhesion molecules and the proliferative activity of carcinosarcoma of the ovary. Anticancer Res 2014; 34:7351-7356. [PMID: 25503171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND To clarify the mechanism underlying the formation of a sarcomatous component of ovarian carcinosarcoma, we investigated the expression of adhesion molecules and the proliferative activity of carcinosarcomas. MATERIALS AND METHODS We immunohistochemically examined the expression of E-cadherin and β-catenin, and the Ki-67 labeling index (Ki-67 LI) in six carcinosarcomas containing endometrioid carcinoma as a carcinomatous component. RESULTS The sarcomatous components of the carcinosarcomas did not express E-cadherin or β-catenin. All carcinomatous components expressed these molecules but the expression was reduced compared to that in endometrioid ovarian carcinomas. In five of the six carcinosarcomas, the Ki-67 LI of the sarcomatous component was less than that of the carcinomatous component. CONCLUSION The present results suggest that a carcinomatous component transforms more easily than an ordinary endometrioid carcinoma from the viewpoint of the cell adhesion, and cells in a carcinomatous component continuously transform into sarcomatous cells during the growth of carcinosarcoma.
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Affiliation(s)
- Hiroshi Hirano
- Department of Diagnostic Pathology, Sanda City Hospital, Sanda, Hyogo, Japan Department of Pathology, Steel Memorial Hirohata Hospital, Hyogo, Japan
| | - Tomohiko Kizaki
- Department of Diagnostic Pathology, Sanda City Hospital, Sanda, Hyogo, Japan
| | - Takashi Ito
- Department of Diagnostic Pathology, Sanda City Hospital, Sanda, Hyogo, Japan
| | - Akira Okimura
- Department of Pathology, Steel Memorial Hirohata Hospital, Hyogo, Japan
| | - Koji Yamanegi
- Department of Pathology, Hyogo College of Medicine, Hyogo, Japan
| | - Keiji Nakasho
- Department of Pathology, Hyogo College of Medicine, Hyogo, Japan
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138
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Cavallin F, Scarpa M, Alfieri R, Cagol M, Ruol A, Rugge M, Ancona E, Castoro C. Esophageal carcinosarcoma: management and prognosis at a single Italian series. Anticancer Res 2014; 34:7455-7459. [PMID: 25503187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Esophageal carcinosarcoma (ESC) is a rare malignant lesion of the esophagus with controversial characteristics and prognostic factors. PATIENTS AND METHODS Seventeen consecutive patients with esophageal carcinosarcoma were referred to the Center for Esophageal Diseases located in Padua from January 1, 1980 to December 31, 2011. Clinical characteristics, pathological features, treatment and outcome were retrospectively analyzed in a prospectively collected database. RESULTS Five patients received palliative treatment and one refused surgery; they died of unresected tumor or progression of disease within 0.6-43.5 months after diagnosis. Eleven patients underwent surgical treatment with complete tumor resection; recurrence rate was 80%, leading to death within 2 years after surgery. Only two resected patients are currently alive and free of disease over 20 years after surgery. CONCLUSION Our results did not support the better prognosis concept of esophageal carcinosarcoma and suggested the importance of radical esophagectomy with adequate lymph node dissection.
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Affiliation(s)
- Francesco Cavallin
- Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Marco Scarpa
- Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Rita Alfieri
- Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Matteo Cagol
- Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Alberto Ruol
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Massimo Rugge
- Department of Diagnostic Medical Sciences and Special Therapies, University of Padua, Padua, Italy
| | - Ermanno Ancona
- Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Carlo Castoro
- Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
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139
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Wang J, Du J. [Sinonasal teratocarcinosarcoma: clinicopathologic study and analysis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:1562-1564. [PMID: 25764753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To study the clinicopathologic features, immunophenotype, diagnosis and differential diagnosis of Sinonasal teratocarcinosarcoma (SNTCS). METHOD The clinical findings, morphologic features and immunohistochemical markers in one case of SNTCS were studied, and the relevant literatures were reviewed. RESULT The Tumor tissue is composed of three layers, with mature and immature squamous epithelium nests, neural epithelial cells and olfactory neuroblastoma-like cells derived of ectoderm; Sarcomatoid components and bone tissue derived of mesoderm; The glandular and tubular structures part of which is adenocarcinoma and respiratory epithelium derived of endoderm; The fetal clear cell squamous epithelium is typical. In addition, diffuse large cytoplasm-with high light and cytoplasm with dark light has no obviously boundery. Immunohistochemical staining showed immune markers of different germ layers corresponding, squamous epithelium, glandular epithelium and respiratory epithelium were positive for CK and EMA, neural epithelial cells and olfactory neuroblastoma-like cells were positive for S-100, NSE and Syn, sarcomatoid area was positive for Vim, light dye area was positive for Vim, CD99 and CK, dark area was positive for NSE and GFAP. CONCLUSION SNTCS is a rare malignant tumor with the features of teratoma and carcinosarcoma, its histopathological and immunohistochemical features were typical, should be more drawn and sliced to avoid misdiagnosis and missed diagnosis.
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140
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Semczuk A, Colas E, Walczyna B, Joźwik M, Pyra A, Semczuk-Sikora A, Rechberger T. Coexistence of homologous-type cervical carcinosarcoma with endometrioid-type G1 endometrial cancer: a case report with an immunohistochemical study. Int J Clin Exp Pathol 2014; 7:7191-5. [PMID: 25400816 PMCID: PMC4230135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 09/15/2014] [Indexed: 06/04/2023]
Abstract
Coexistence of two or even more independent primary tumors derived from the female genital tract organs is a unique event. The most common combination is the coexistence of synchronous tumors in the ovary and endometrium. In the present case study, we described a coincidence of homologous-type cervical carcinosarcoma (CS) with endometrioid-type G1 uterine adenocarcinoma (EC) arising on the basis of hyperplastic endometrium. A panel of immunohistochemical markers was applied, either in both CS components or in endometrioid-type EC, to assess possible differences between both uterine malignancies. We also presented a short overview of the coexistence of cervical carcinosarcomas with other female genital tract malignancies.
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Affiliation(s)
- Andrzej Semczuk
- II Department of Gynecology, Lublin Medical UniversityLublin, Poland
| | - Eva Colas
- Research Unit of Biomedicine and Translational Oncology, Vall d’Hebron University HospitalBarcelona, Spain
| | - Beata Walczyna
- Department of Clinical Pathology, Lublin Medical UniversityLublin, Poland
| | - Maciej Joźwik
- Department of Gynecology, Bialystok Medical UniversityBialystok, Poland
| | - Andrzej Pyra
- Obstetrics and Gynecology Chair, Municipal HospitalNowa Deba, Poland
| | - Anna Semczuk-Sikora
- Department of Obstetrics and Pathology of Pregnancy, Lublin Medical UniversityLublin, Poland
| | - Tomasz Rechberger
- II Department of Gynecology, Lublin Medical UniversityLublin, Poland
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141
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Desai PH, Hughes P, Tobias DH, Tchabo N, Heller PB, Dise C, Slomovitz BM. Accuracy of robotic sentinel lymph node detection (RSLND) for patients with endometrial cancer (EC). Gynecol Oncol 2014; 135:196-200. [PMID: 25175452 DOI: 10.1016/j.ygyno.2014.08.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/20/2014] [Accepted: 08/21/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Lymphadenectomy as a part of the staging for EC patients is controversial. Sentinel lymph node detection has been introduced to determine which patients would benefit from adjuvant therapy and to limit morbidities associated with a full pelvic nodal dissection. The purpose of this study is to evaluate diagnostic accuracy and detection rate of robotic sentinel lymph node detection (RSLND) as a part of the surgical staging for EC. METHODS A retrospective database of all patients who underwent intraoperative lymphatic mapping using cervical injection methylene blue followed by RSLND as a part of their procedure was reviewed. Sentinel lymph node (SLN) was initially examined by routine Hematoxylin and Eosin (H&E) and ultrastaging by immunohistochemistry (IHC). RESULTS Between 4/2011 and 6/2013, 120 patients with endometrial cancer underwent RSLND. The median age was 62years (25-87); median BMI was 32 (18-76). Out of 120 patients, only one patient underwent RSLND with fertility preservation; and 119 patients underwent robotic hysterectomy and surgical staging with RSLND. None of the cases was converted to an open procedure. At least 1 SLN was detected in 86% (103/120) of the patients. Bilateral SLNs were detected in 52% (62/120). Positive nodes were identified in 8% (10/120) of the patients. Of those with SLN (+), 50% (5/10) were by ultrastaging (IHC) alone. No patients had positive regional nodes without SLN (+). CONCLUSIONS RSLND using methylene blue cervical injection can identify SLN in most patients with EC. IHC ultrastaging improves the detection of node positive disease when compared to traditional pathological evaluation.
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Affiliation(s)
- Pranjal H Desai
- Department of Obstetrics and Gynecology and Women's Health, Morristown and Overlook Medical Center, Atlantic Health System, Morristown, NJ 07960, USA
| | - Patrick Hughes
- Department of Cellular and Molecular Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Daniel H Tobias
- Department of Obstetrics and Gynecology and Women's Health, Morristown and Overlook Medical Center, Atlantic Health System, Morristown, NJ 07960, USA; Women's Cancer Center, Carol G. Simon Cancer Center, Atlantic Health System, Morristown, NJ 07960, USA
| | - Nana Tchabo
- Department of Obstetrics and Gynecology and Women's Health, Morristown and Overlook Medical Center, Atlantic Health System, Morristown, NJ 07960, USA; Women's Cancer Center, Carol G. Simon Cancer Center, Atlantic Health System, Morristown, NJ 07960, USA
| | - Paul B Heller
- Department of Obstetrics and Gynecology and Women's Health, Morristown and Overlook Medical Center, Atlantic Health System, Morristown, NJ 07960, USA; Women's Cancer Center, Carol G. Simon Cancer Center, Atlantic Health System, Morristown, NJ 07960, USA
| | - Craig Dise
- Department of Clinical Pathology, Morristown Medical Center, Morristown, NJ 07960, USA
| | - Brian M Slomovitz
- Department of Obstetrics and Gynecology and Women's Health, Morristown and Overlook Medical Center, Atlantic Health System, Morristown, NJ 07960, USA; Women's Cancer Center, Carol G. Simon Cancer Center, Atlantic Health System, Morristown, NJ 07960, USA; Division of Gynecologic Oncology, Sylvester Cancer Center, University of Miami, Miller School of Medicine, Miami, FL 33154, USA.
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142
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Ishikura N, Kawada T, Mori M, Maegawa H, Ohta M, Imamura Y. Cytological Features of Carcinosarcoma ex Pleomorphic Adenoma of the Parotid Gland: A Case Report. Acta Cytol 2014; 58:419-26. [PMID: 25139671 DOI: 10.1159/000365272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/06/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Carcinosarcoma of the salivary gland is an extremely rare tumor composed of carcinomatous and sarcomatoid components. This report describes the cytological and pathological findings of a case of carcinosarcoma ex pleomorphic adenoma arising in the right parotid gland. CASE A 47-year-old female visited a hospital with swelling of the right parotid region, slight pain and facial palsy. Fine-needle aspiration smears showed both clustered epithelium-like cells and singly scattered cells in a necrotic background. The cells, especially the latter, exhibited significant cellular pleomorphism and had irregularly shaped nuclei. Myxoid stroma-like cell clusters without cellular atypism were also seen. The right parotid gland was resected, and the tumor tissue was histologically diagnosed as carcinosarcoma ex pleomorphic adenoma. CONCLUSION The cytological findings of carcinosarcoma ex pleomorphic adenoma have been reported in very few cases. In the present case, various components, including the presence of atypical epithelium-like cell clusters and singly scattered atypical cells with stromal components on cytological specimens, led to consideration of the diagnosis of carcinosarcoma ex pleomorphic adenoma.
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Affiliation(s)
- Naoyo Ishikura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
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Tsujiura M, Mazack V, Sudol M, Kaspar HG, Nash J, Carey DJ, Gogoi R. Yes-associated protein (YAP) modulates oncogenic features and radiation sensitivity in endometrial cancer. PLoS One 2014; 9:e100974. [PMID: 24972085 PMCID: PMC4074125 DOI: 10.1371/journal.pone.0100974] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 06/01/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Yes-associated protein (YAP) is a transcriptional co-activator and regulates cell proliferation and apoptosis. We investigated the clinical and biological significance of YAP in endometrial cancer (EMCA). METHODS YAP expression in 150 primary tumor tissues from patients with EMCA was evaluated by immunohistochemistry and its association with clinicopathological data was assessed. The biological functions of YAP were determined in EMCA cell lines through knockdown/overexpression of YAP. The role of YAP in modulating radiation sensitivity was also investigated in EMCA cells. RESULTS Increased nuclear YAP expression was significantly associated with higher grade, stage, lympho-vascular space invasion, postoperative recurrence/metastasis and overall survival in estrogen mediated EMCA, called type 1 cancer (p = 0.019, = 0.028, = 0.0008, = 0.046 and = 0.015, respectively). In multivariate analysis, nuclear YAP expression was confirmed as an independent prognostic factor for overall survival in type 1 EMCA. YAP knockdown by siRNA resulted in a significant decrease in cell proliferation (p<0.05), anchorage-dependent growth (p = 0.015) and migration/invasion (p<0.05), and a significant increase in the number of cells in G0/G1 phase (p = 0.002). Conversely, YAP overexpression promoted cell proliferation. Clonogenic assay demonstrated enhanced radiosensitivity by approximately 36% in YAP inhibited cells. CONCLUSIONS Since YAP functions as a transcriptional co-activator, its differential localization in the nucleus of cancer cells and subsequent impact on cell proliferation could have important consequences with respect to its role as an oncogene in EMCA. Nuclear YAP expression could be useful as a prognostic indicator or therapeutic target and predict radiation sensitivity in patients with EMCA.
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Affiliation(s)
- Masahiro Tsujiura
- Weis Center for Research, Geisinger Medical Center, Danville, Pennsylvania, United States of America
| | - Virginia Mazack
- Weis Center for Research, Geisinger Medical Center, Danville, Pennsylvania, United States of America
| | - Marius Sudol
- Weis Center for Research, Geisinger Medical Center, Danville, Pennsylvania, United States of America
- Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Hanna G. Kaspar
- Geisinger Medical Laboratories, Geisinger Wyoming Valley, Wilkes-Barre, Pennsylvania, United States of America
| | - John Nash
- Division of Obstetrics and Gynecology, Geisinger Medical Center, Danville, Pennsylvania, United States of America
| | - David J. Carey
- Weis Center for Research, Geisinger Medical Center, Danville, Pennsylvania, United States of America
| | - Radhika Gogoi
- Weis Center for Research, Geisinger Medical Center, Danville, Pennsylvania, United States of America
- Division of Obstetrics and Gynecology, Geisinger Medical Center, Danville, Pennsylvania, United States of America
- * E-mail:
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Nicolas MM, Nazarullah A, Guo CC. Sarcomatoid urothelial carcinoma with chondrosarcomatous differentiation of the ureter: a case report. Anal Quant Cytopathol Histpathol 2014; 36:111-116. [PMID: 24902363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Sarcomatoid urothelial cell carcinoma of the urinary tract has a poor prognosis. Most of the reported cases of sarcomatoid urothelial cell carcinomas are those from the urinary bladder. A limited number of these tumors originate from the ureter. CASE We describe a ureteral sarcomatoid urothelial carcinoma in a 63-year-old man who underwent nephroureterectomy with bladder cuff. The malignant epithelial elements consisted of undifferentiated polygonal cells and areas of glandular formation. Urothelial carcinoma in situ was present in the overlying mucosa. The mesenchymal components were pleomorphic spindle cells and atypical chondrocytes within lacunae with multinucleation and mitoses. The tumor extended beyond the muscularis into the periureteral adipose tissue. The tumor recurred after 6 months in the retroperitoneum and presacral area. The patient received chemotherapy and radiotherapy but died 16 months after the initial diagnosis. CONCLUSION Sarcomatoid urothelial carcinoma of the ureter is uncommon. Even rarer is the presence of malignant heterologous elements such as chondrosarcoma. The case described here underscores the aggressive nature of these neoplasms.
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Gao Y, Meng H, Zhang Y, Jiao T, Hui N. Retrospective analysis of 80 cases with uterine carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma in China, 1988-2007. Int J Clin Exp Pathol 2014; 7:1616-1624. [PMID: 24817958 PMCID: PMC4014242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/20/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Uterine sarcomas are rare gynecological malignancies with poor prognosis and high mortality. We provides clinical information of uterine sarcoma patients at Changhai Hospital of Secondary Military Medical University in Shanghai, China, over a 20-year period. DESIGN AND METHODS Satisfied the criteria for the study, a total of 80 female patients with uterine sarcomas were retrospectively evaluated. Overall survival was analyzed by Kaplan-Meier method. MAIN OUTCOME MEASURES The following information was extracted from our medical records: age, presentations, blood types, stages, ultrasonographic results, therapies and follow-up. RESULTS Of the 80 patients, the mean age of onset was 57.3±2.03 years, and the highest frequency occurred in 51-60 age group. Endometrial stromal sarcoma was the most common histological type (47.5%). Even population of these patients presented was with early stage (I&II) and advanced stages (III&IV). Among 79 patients underwent primary surgery, 74 cases was hysterectomy and bilateral salping-ooophorectomy. Equal to disease-specific survival, overall survival rates at 1-, 3- and 5-year were 81.3%, 62.5% and 40% respectively. Age, menopausal status, blood type, stage, and pathologic types were all proved to be correlated with the survival. CONCLUSION Our retrospective data in part reflect clinical characteristics of uterine sarcoma in China, and form the basis for further concerning researches.
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Affiliation(s)
- Yuan Gao
- Department of Gynecology and Obstetrics, Changhai Hospital of Secondary Military Medical UniversityShanghai, 200433, China
- Department of Gynecology and Obstetrics, General Hospital of PLABeijing, 100853, China
| | - Hao Meng
- Department of Orthopedics, Air Force General HospitalBeijing, 100142, China
- Department of Orthopedics, Military General Hospital of Beijing PLABeijing, 100700, China
| | - Yemin Zhang
- Department of Gynecology and Obstetrics, Changhai Hospital of Secondary Military Medical UniversityShanghai, 200433, China
| | - Tingting Jiao
- Department of Gynecology and Obstetrics, Changhai Hospital of Secondary Military Medical UniversityShanghai, 200433, China
| | - Ning Hui
- Department of Gynecology and Obstetrics, Changhai Hospital of Secondary Military Medical UniversityShanghai, 200433, China
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Kang Y, Kang S, Li Q, Zheng X. Mixed epithelial and mesenchymal metaplastic carcinoma (carcinosarcoma) of the breast: a case report. Eur J Med Res 2014; 19:14. [PMID: 24625319 PMCID: PMC3976087 DOI: 10.1186/2047-783x-19-14] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 02/07/2014] [Indexed: 02/07/2023] Open
Abstract
Metaplastic breast carcinoma (MBC) is an uncommon malignancy characterized by the co-existence of two or more cellular types, commonly a mixture of epithelial and mesenchymal components. A case of a female patient aged 46 years with MBC (carcinosarcoma) is presented, including mammographic, ultrasonic, gross examination, and pathological findings. After undergoing modified radical mastectomy of the left breast and subsequent six courses of adjuvant chemotherapy and endocrine therapy, the patient is now doing well with no recurrence and metastasis. Conventional treatments for invasive ductal carcinoma (IDC) may appear to be less effective. Patients with MBC would be appropriate candidates for innovative or targeted therapy regimens.
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Affiliation(s)
- Yu Kang
- Department of Breast Surgery, the First Affiliated Hospital, China Medical University, North Nanjing Street 155, Shenyang 110001, P.R. China
| | - Shu Kang
- Department of Ultrasonography, the First Affiliated Hospital, China Medical University, North Nanjing Street 155, Shenyang 110001, China
| | - Qingchang Li
- Department of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, North Nanjing Street 155, Shenyang 110001, China
| | - Xinyu Zheng
- Department of Breast Surgery, the First Affiliated Hospital, China Medical University, North Nanjing Street 155, Shenyang 110001, P.R. China
- Lab 1, Cancer Institute, China Medical University, North Nanjing Street 155, Shenyang 110001, China
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Li Z, Huang Z, Bi X, Yang L, Zhao J, Zhao H, Zhang Y, Cai J, Zheng X. [Clinical characteristics and prognosis of three rare and poor-prognostic subtypes of primary liver carcinoma]. Zhonghua Zhong Liu Za Zhi 2014; 36:207-211. [PMID: 24785282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To explore the clinicopathological features and prognostic factors of three rare and poor-prognostic pathological subtypes of primary liver carcinoma, and improve the clinical diagnosis and surgical treatment. METHODS A retrospective analysis of clinicopathological data of 69 patients with rare pathological subtypes of primary liver carcinoma, diagnosed by postoperative pathology in our hospital from October 1998 to June 2013 was carried out. The data of 80 cases of common poorly differentiated hepatocellular carcinoma treated in the same period were collected as control group. Kaplan-Meier method was used to analyze the survival rate, and Cox proportional hazards model was used for prognostic analysis in the patients. RESULTS Thirty-four cases were combined hepatocellular carcinoma and cholangiocarcinoma (CCC, 28 males, 6 females), with a median age of 52 years (range, 33 to 73). Ninteen cases were giant cell carcinoma (GCC, 16 males and 3 females), with a median age of 59 years (range, 38 to 66). Sixteen cases were sarcomatoid carcinoma (SC, 14 males and 2 females), with a median age of 57 years (range, 46 to 70). The survival analysis revealed that median survival time and the 1-, 3-, 5-year survival rates for these 3 groups were 20 months, 61.8%, 29.4%, and 20.6% in the CCC patients, 13 months, 52.6%, 31.6%, and 0% in the GCC patients, and 8 months, 31.3%, 0%, 0% in the SC patients, respectively. The median survival time and survival rate of the SC group were significantly lower than those of the other three groups (P < 0.05). However, in the SC group, the incidences of hilar lymph nodes metastasis, vascular tumor emboli and invasion of adjacent organs were significantly higher than those in the other three groups (P < 0.05). There were no statistically significant differences among the other three groups (P > 0.05). The levels of carcino-embryonic antigen were higher in the three rare subtype groups than that of the control group. The incidences of multiple tumors of the three rare subtype groups were higher than that of the control group (P < 0.05). Positive surgical margin was an independent unfavorable prognostic factor. CONCLUSIONS The combined hepatocellular carcinoma and cholangiocarcinoma, giant cell carcinoma and sarcomatoid carcinoma have a poor prognosis. Among them sarcomatoid carcinoma is the most malignant and poor prognostic one. Radical resection is recommended.
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Affiliation(s)
- Zhiyu Li
- Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Jewell EL, Huang JJ, Abu-Rustum NR, Gardner GJ, Brown CL, Sonoda Y, Barakat RR, Levine DA, Leitao MM. Detection of sentinel lymph nodes in minimally invasive surgery using indocyanine green and near-infrared fluorescence imaging for uterine and cervical malignancies. Gynecol Oncol 2014; 133:274-7. [PMID: 24582865 DOI: 10.1016/j.ygyno.2014.02.028] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 02/20/2014] [Accepted: 02/20/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Our primary objective was to assess the detection rate of sentinel lymph nodes (SLNs) using indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging for uterine and cervical malignancies. METHODS NIR fluorescence imaging for the robotic platform was obtained at our institution in 12/2011. We identified all cases planned for SLN mapping using fluorescence imaging from 12/2011-4/2013. Intracervical ICG was the fluorophobe in all cases. Four cc (1.25mg/mL) of ICG was injected into the cervix alone divided into the 3- and 9-o'clock positions, with 1 cc deep into the stroma and 1 cc submucosally before initiating laparoscopic entry. Blue dye was concurrently injected in some cases. RESULTS Two hundred twenty-seven cases were performed. Median age was 60 years (range, 28-90 years). Median BMI was 30.2 kg/m(2) (range, 18-60 kg/m(2)). The median SLN count was 3 (range, 1-23). An SLN was identified in 216 cases (95%), with bilateral pelvic mapping in 179 (79%). An aortic SLN was identified in 21 (10%) of the 216 mapped cases. When ICG alone was used to map cases, 188/197 patients mapped, for a 95% detection rate compared to 93% (28/30) in cases in which both dyes were used (P=NS). Bilateral mapping was seen in 156/197 (79%) ICG-only cases and 23/30 (77%) ICG and blue dye cases (P=NS). CONCLUSIONS NIR fluorescence imaging with intracervical ICG injection using the robotic platform has a high bilateral SLN detection rate and appears favorable to using blue dye alone and/or other modalities. Combined use of ICG and blue dye appears unnecessary.
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Affiliation(s)
- Elizabeth L Jewell
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA.
| | | | - Nadeem R Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA
| | - Ginger J Gardner
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA
| | - Carol L Brown
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA
| | - Yukio Sonoda
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA
| | - Richard R Barakat
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA
| | - Douglas A Levine
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA
| | - Mario M Leitao
- Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA
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