1
|
Zhao M, Zhou L, Sun L, Song Y, Guo Y, Zhang X, Zhao F, Wang P, Yue J, Niu D, Li Z, Huang X, Kang Q, Jia L, Lai J, Cao D. GATA3 is a sensitive marker for primary genital extramammary paget disease: an immunohistochemical study of 72 cases with comparison to gross cystic disease fluid protein 15. Diagn Pathol 2017; 12:51. [PMID: 28693610 PMCID: PMC5504764 DOI: 10.1186/s13000-017-0638-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/26/2017] [Indexed: 02/08/2023] Open
Abstract
Background GATA-binding protein 3 (GATA3) has been identified as a sensitive marker for breast carcinoma but its sensitivity in primary genital extramammary Paget diseases (EMPDs) has not been well studied. Methods Here we investigated immunohistochemical expression of GATA3 in 72 primary genital EMPDs (35 from female, 37 from male; 45 with intraepithelial disease only, 26 with both intraepithelial disease and invasive adenocarcinoma including 14 also metastasis, 1 with metastatic adenocarcinoma only for study). We also compared GATA3 to gross cystic disease fluid protein 15 (GCDFP15) for their sensitivity. Results Positive GATA3 staining was seen in all 71 (100%) intraepithelial diseases, 25/26 (96%; female 10/10, male 15/16) invasive adenocarcinomas and 14/15 (93%; female 3/3, male 11/12) metastatic adenocarcinomas, respectively. Positive GCDFP15 staining was seen in 46/71 (65%; female 28/34 or 82%, male 18/37 or 49%) intraepithelial diseases, 20/26 (77%; female 9/10, male 11/16) invasive adenocarcinomas, and 12/15 (80%; female 2/3, male 10/12) metastatic adenocarcinomas, respectively (GATA3 versus GCDFP15: p < 0.01 for both intraepithelial disease and invasive adenocarcinoma, p = 0.28 for metastatic adenocarcinoma). In positive-stained cases, GATA3 stained more tumor cells than GCDFP15 (79% versus 25% for intraepithelial disease, 71% vs 34% for invasive adenocarcinoma, 73% vs 50% for metastatic adenocarcinoma, p < 0.01 for all 3 components). Conclusions Our findings indicate that GATA3 is a very sensitive marker for primary genital EMPDs and is more sensitive than GCDFP15.
Collapse
Affiliation(s)
- Ming Zhao
- Department of Pathology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Lixin Zhou
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital (Beijing Cancer Hospital), Beijing, China
| | - Li Sun
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital (Beijing Cancer Hospital), Beijing, China
| | - Yan Song
- Department of Pathology, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China
| | - Yunquan Guo
- Department of Pathology, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, China
| | - Xun Zhang
- Department of Pathology, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Zhao
- Department of Pathology, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, China
| | - Peng Wang
- Department of Pathology, Beijing Ditan Hospital, Beijing, China
| | - Junqiu Yue
- Department of Pathology, Hubei Cancer Hospital, Wuhan, China
| | - Dongfeng Niu
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital (Beijing Cancer Hospital), Beijing, China
| | - Zhongwu Li
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital (Beijing Cancer Hospital), Beijing, China
| | - Xiaozheng Huang
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital (Beijing Cancer Hospital), Beijing, China
| | - Qiang Kang
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital (Beijing Cancer Hospital), Beijing, China
| | - Lin Jia
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital (Beijing Cancer Hospital), Beijing, China
| | - Jinping Lai
- Department of Pathology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Dengfeng Cao
- Department of Pathology and Immunology, Washington University School of Medicine, 660 S South Euclid Avenue Campus Box 8118, Saint Louis, MO, 63110, USA.
| |
Collapse
|
2
|
Heller DS, Lambert WC. Syringomatous Eccrine Carcinoma of the Vulva. J Gynecol Surg 2016. [DOI: 10.1089/gyn.2016.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Debra S. Heller
- Department of Pathology & Laboratory Medicine, Rutgers–New Jersey Medical School, Newark, NJ
- Department of Obstetrics, Gynecology, and Women's Health, Rutgers–New Jersey Medical School, Newark, NJ
| | - W. Clark Lambert
- Department of Pathology & Laboratory Medicine, Rutgers–New Jersey Medical School, Newark, NJ
| |
Collapse
|
3
|
Effects of imiquimod on vulvar Paget's disease: a systematic review of literature. Gynecol Oncol 2015; 139:165-71. [PMID: 26193428 DOI: 10.1016/j.ygyno.2015.07.097] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 07/14/2015] [Accepted: 07/16/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To examine the effectiveness of topical imiquimod therapy for vulvar Paget's disease. METHODS A systematic literature search was conducted using three public search engines with entry keywords "Paget's disease" and "imiquimod". Case reports describing imiquimod treatment for vulvar Paget's disease were examined for demographics, treatment patterns, and outcome (63 cases). RESULTS Median age was 68, and nearly a half of cases were recurrent disease (50.8%) with surgical resection being the most common prior treatment modality (62.5%). All cases used 5% imiquimod and the median treatment duration was 4months. The most common initial treatment frequency was 3-4times/week (68.3%) followed by 5-7 (17.4%) and 1-2times/week (14.3%). Frequency-reduction due to adverse effects was seen in 9.5% with the initial 5-7times/week regimen being associated with the highest reduction rate (1-2, 3-4, and 5-7times/week: 0%, 2.3%, and 81.8%, p<0.01). In 46 (73.0%) cases, a complete remission (CR) to imiquimod therapy was reported, with 2, 4, and 6-month cumulative CR rates being 9.8%, 31.1%, and 71.6%, respectively. With median follow-up duration of 12months after the completion of imiquimod treatment, 2 (5.7%) of the 35 women who had a CR developed disease recurrence. Age, disease status (primary versus recurrent), and treatment frequency after dose reduction were not associated with CR rates (all, p>0.05). CONCLUSION Our results suggested that imiquimod therapy may be an effective possible treatment option for vulvar Paget's disease, especially for women who have experienced recurrence after multiple surgical resections or who are with poor surgical candidates.
Collapse
|
5
|
Kajal B, Talati H, Daya D, Alowami S. Apocrine adenocarcinoma of the vulva. Rare Tumors 2013; 5:e40. [PMID: 24179652 PMCID: PMC3804815 DOI: 10.4081/rt.2013.e40] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 05/27/2013] [Accepted: 05/28/2013] [Indexed: 11/22/2022] Open
Abstract
Cutaneous vulvar carcinomas are predominantly of squamous cell carcinoma type. Primary vulvar adenocarcinomas are rare with a poorly understood histogenesis. They are classified into extramammary Paget’s disease, sweat gland carcinomas, and breast-like adenocarcinomas of the vulva. Adenocarcinomas, originating from Bartholin glands, can also present as vulvar adenocarcinoma. Rare adenocarcinomas with apocrine features have been described in the literature. The origin of these neoplasms from the native apocrine sweat glands or from anogenital mammary-like glands is still debatable. We report herein a case of a 67 year old female with a rare primary apocrine carcinoma of the vulva.
Collapse
Affiliation(s)
- Babita Kajal
- Department of Pathology and Molecular Medicine, Mc Master University , Hamilton, Ontario, Canada
| | | | | | | |
Collapse
|
6
|
Baker GM, Selim MA, Hoang MP. Vulvar Adnexal Lesions: A 32-Year, Single-Institution Review From Massachusetts General Hospital. Arch Pathol Lab Med 2013; 137:1237-46. [DOI: 10.5858/arpa.2012-0434-oa] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—Because the skin and modified mucosal surfaces of the vulvar region contain dense apocrine glands and anogenital mammary-like glands, in addition to eccrine glands and folliculosebaceous units, benign as well as malignant lesions derived from these adnexal structures are, not surprisingly, found in the vulva. However, their incidence occurring in the vulva has not been reported, to our knowledge.
Objective.—To determine the incidence of various vulvar adnexal lesions.
Design.—We performed a retrospective review (1978–2010) of the cases at our institution.
Results.—A total of 189 vulvar adnexal lesions were identified. Most of these lesions were benign (133 of 189; 70%), with hidradenoma papilliferum being the most common, followed by syringoma and various types of cysts. Rare cases of tubular adenoma, poroma, spiradenoma, hidradenoma, cylindroma, sebaceoma, and trichoepithelioma were identified. Malignant adnexal neoplasms comprised the remaining 30% (56 of 189) of the cases. Extramammary Paget disease was the most common (49 of 56), and 29% (14 of 49) demonstrated an invasive component. Rare cases of basal cell carcinoma, sebaceous carcinoma, apocrine carcinoma, adenoid cystic carcinoma, and spiradenocarcinoma were identified.
Conclusions.—In this retrospective review, we identified several benign entities that have not been previously reported on the vulva, namely pilomatricoma, poroma, spiradenoma, and sebaceoma. Hidradenoma papilliferum and extramammary Paget disease were the most common benign and malignant adnexal neoplasms, respectively. The spectrum of various vulvar adnexal lesions appears to reflect the frequency of the underlying glandular elements.
Collapse
Affiliation(s)
- Gabrielle M. Baker
- From the Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Boston (Drs Baker and Hoang); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Selim)
| | - M. Angelica Selim
- From the Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Boston (Drs Baker and Hoang); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Selim)
| | - Mai P. Hoang
- From the Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Boston (Drs Baker and Hoang); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Selim)
| |
Collapse
|