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Bosoteanu M, Deacu M, Aschie M, Vamesu S, Cozaru GC, Mitroi AF, Voda RI, Orasanu CI, Vlad SE, Penciu RC, Chirila SI. The Role of Pathogenesis Associated with the Tumor Microclimate in the Differential Diagnosis of Uterine Myocytic Tumors. J Clin Med 2023; 12:4161. [PMID: 37373854 DOI: 10.3390/jcm12124161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Myocytic tumors of the uterus present vast morphological heterogeneity, which makes differential diagnosis between the different entities necessary. This study aims to enrich the existing data and highlight new potential therapeutic targets regarding aspects related to the pathogenic process and the tumor microenvironment in order to improve the quality of life of women. We performed a 5-year retrospective study, including particular cases of uterine myocyte tumors. Immunohistochemical analyses of pathogenic pathways (p53, RB1, and PTEN) and tumor microclimate using markers (CD8, PD-L1, and CD105), as well as genetic testing of the PTEN gene, were performed. The data were statistically analyzed using the appropriate parameters. In cases of atypical leiomyoma, a significant association was observed between PTEN deletion and an increased number of PD-L1+ T lymphocytes. For malignant lesions and STUMP, PTEN deletion was associated with the advanced disease stage. Advanced cases were also associated with an increased mean CD8+ T cell count. An increased number of lymphocytes was associated with an increased percentage of RB1+ nuclei. The study corroborated clinical and histogenetic data, highlighting the importance of the differential diagnosis of these tumors to improve the management of patients and increase their quality of life.
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Affiliation(s)
- Madalina Bosoteanu
- Clinical Service of Pathology, Department of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Department of Pathology, Faculty of Medicine, "Ovidius" University of Constanţa, 900527 Constanta, Romania
| | - Mariana Deacu
- Clinical Service of Pathology, Department of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Department of Pathology, Faculty of Medicine, "Ovidius" University of Constanţa, 900527 Constanta, Romania
| | - Mariana Aschie
- Clinical Service of Pathology, Department of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Department of Pathology, Faculty of Medicine, "Ovidius" University of Constanţa, 900527 Constanta, Romania
- Academy of Medical Sciences of Romania, 030171 Bucharest, Romania
| | - Sorin Vamesu
- Clinical Service of Pathology, Department of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
| | - Georgeta Camelia Cozaru
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, "Ovidius" University of Constanţa, 900591 Constanta, Romania
- Clinical Service of Pathology, Department of Genetics, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
| | - Anca Florentina Mitroi
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, "Ovidius" University of Constanţa, 900591 Constanta, Romania
- Clinical Service of Pathology, Department of Genetics, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
| | - Raluca Ioana Voda
- Clinical Service of Pathology, Department of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, "Ovidius" University of Constanţa, 900591 Constanta, Romania
| | - Cristian Ionut Orasanu
- Clinical Service of Pathology, Department of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, "Ovidius" University of Constanţa, 900591 Constanta, Romania
| | - Sabina Elena Vlad
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, "Ovidius" University of Constanţa, 900591 Constanta, Romania
| | - Roxana Cleopatra Penciu
- Department of Obstetrics and Gynecology, Faculty of Medicine, "Ovidius" University of Constanţa, 900527 Constanta, Romania
| | - Sergiu Ioachim Chirila
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University, 900527 Constanta, Romania
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Boșoteanu M, Vodă RI, Așchie M, Bosoteanu LA, Bălțătescu GI. Morphological and Ancillary Features of Uterine Leiomyosarcoma: Case Report. CLINICAL PATHOLOGY 2022; 15:2632010X221105224. [PMID: 35782597 PMCID: PMC9240338 DOI: 10.1177/2632010x221105224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 05/17/2022] [Indexed: 11/15/2022]
Abstract
We report a rare case of giant uterine leiomyosarcoma in a postmenopausal woman, whose
diagnosis was initially suspected at the evaluation of the abdominal efusion, and
confirmed after the pathological examination of the uterus in association with the
ancillary tests. The evaluation of the abdominal fluid showed single or clusters of
malignant, round or spindle-shaped cells. On microscopic examination of the surgical
specimen, a dense cell proliferation of spindle cells, with moderate to severe nuclear
pleomorphism and significant mitotic activity was observed. Immunohistochemical evaluation
demonstrated the loss of myocytic differentiation by focal, weakly positive expression of
smooth muscle actin and desmin. The data presented in this case emphasize the relevance of
the cytological examination, although the latter has only indicative value, especially
since it is an aggressive tumor, frequently associated with mutant expression of p53. In
our case, the first indication of the presence of uterine sarcoma was given by the
presence of atypical cells in the peritoneal fluid.
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Affiliation(s)
- Mădălina Boșoteanu
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanţa, Romania
- Department of Pathology, Faculty of Medicine, “Ovidius” University of Constanţa, Constanţa, Romania
| | - Raluca Ioana Vodă
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanţa, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology – CEDMOG, “Ovidius” University of Constanţa, Constanța, Romania
| | - Mariana Așchie
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanţa, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology – CEDMOG, “Ovidius” University of Constanţa, Constanța, Romania
- Academy of Medical Sciences of Romania, Romania
| | - Luana-Andreea Bosoteanu
- Elias Emergency University Hospital, Dermatovenerology Department
- “Ovidius” University of Constanta, Institute of Doctoral Studies, School of Medicine
| | - Gabriela Izabela Bălțătescu
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanţa, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology – CEDMOG, “Ovidius” University of Constanţa, Constanța, Romania
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Korkmaz M, Eryılmaz MK, Kerimoğlu Ü, Karaağaç M, Demirkıran A, Demir ET, Artaç M. Vaginal metastasis in solid tumours: our four cases and review of the literature. J Egypt Natl Canc Inst 2021; 33:3. [PMID: 33538929 DOI: 10.1186/s43046-021-00058-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaginal metastasis should be kept in mind when evaluating the staging tests of all cancers, especially endometrial cancer. CASE PRESENTATION We present four patients with vaginal recurrence who recently applied to our clinic. Three cases were of endometrial cancer and one case of rectal cancer. All patients presented with vaginal bleeding. CONCLUSION Standard treatment for vaginal metastasis has not yet been established. Therapeutic options for vaginal metastasis-separately or in combination-are surgical resection, radiotherapy, and chemotherapy.
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Affiliation(s)
- Mustafa Korkmaz
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey.
| | - Melek Karakurt Eryılmaz
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
| | - Ülkü Kerimoğlu
- Department of Radiology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Mustafa Karaağaç
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
| | - Aykut Demirkıran
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
| | - Emine Türen Demir
- Department of Department of Obstetrics and Gynecology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Mehmet Artaç
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
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