DOCSLIB.ORG

Computed Tomography Imaging Features of Benign Ovarian Brenner Tumors

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Computed Tomography Imaging Features of Benign Ovarian Brenner Tumors ONCOLOGY LETTERS 16: 1141-1146, 2018 Computed tomography imaging features of benign ovarian Brenner tumors YUYING ZHAO, XINFENG MAO, LIDI YAO and JIAN SHEN Department of Radiology, Huzhou Central Hospital, Huzhou, Zhejiang 313003, P.R. China Received October 27, 2017; Accepted April 13, 2018 DOI: 10.3892/ol.2018.8766 Abstract. The present study aimed to describe the computed itself is very small or visually inseparable from the coexisting tomography (CT) imaging features of ovarian Brenner tumor cystic neoplasm (1). There is little information regarding their for diagnostic accuracy and disease understanding. The appearance on computed tomography (CT) examination (1,2). CT imaging features of 9 cases of ovarian Brenner tumor Although ovarian tumors have similar clinical and radiological confirmed by surgery and pathology were retrospectively features, predominant or specific imaging features may be analyzed and compared. Of the 9 cases of ovarian Brenner present in certain types of ovarian tumors. Characterization tumor, 3 were right located and 6 were left located with clear of an ovarian mass is of the utmost importance by CT in the borders; 7 with round or oval shapes, while 2 were with preoperative evaluation of an ovarian neoplasm (3). It enables irregular and lobulated morphology; 5 solid lesions presented the surgeon to anticipate carcinoma of the ovary prior to surgery with multiple scattered calcification shadows inside with so that adequate procedures are planned. Therefore, familiarity moderate enhancement, while 3 cystic lesions were presented with the clinical and imaging features of various ovarian with mixed solid and cystic composition, and significant tumors is important in determining the likelihood of a tumor enhancement was identified in the solid component, but not being benign or malignant. The aim of the present study was to in the cystic component. Furthermore, papillary projections describe the clinical and CT characteristics of Brenner tumors. inside and mild nodular enhancement were observed in one case of cystic lesion. The pathological analysis demonstrated Materials and methods that an epithelium nest composed the tumors with urothelial like cells and fibrous matrix. Of the 9 cases, 5 epithelial nests Patients. Patients with a histological diagnosis of a Brenner exhibited adeno-like cystic lumen without cell mitosis phase. tumor of the ovary who had undergone preoperative CT exam- All cases were diagnosed with benign ovarian Brenner tumor. ination prior to surgical removal of the mass between June Specific CT imaging features of ovarian Brenner tumor can 2003 and December 2012 from the clinical databases of the be identified and pathological examinations are required for Department of Obstetrics and Gynecology, Huzhou Central diagnosis confirmation. Hospital (Huzhou, China) were retrospectively analyzed. The study protocol was approved by the Institutional Review Board Introduction of Ethics Committee of Huzhou Central Hospital and written informed consent was obtained from all the patients. Brenner tumors are uncommon surface epithelial-stromal tumors of the ovary, frequently presented in women between CT examinations. CT examinations were performed with their fifth and seventh decades of life. The majority of Brenner Toshiba Aquilionor (Toshiba Medical Systems, Otawara, tumors are benign, and these tumors predominantly present as Japan) or Philips Brilliance 16-slice CT scanners (Philips solid on imaging and pathological examination, although in Medical Systems, Amsterdam, The Netherlands). All patients <30% of cases, serous and mucinous-associated cystadenomas were placed in the supine position and given an appropriate may account for the cystic appearance when the Brenner tumor amount of water to drink to fill the bladder prior to the scan. The CT scan covered the entire primary lesion from the illum attachment and ischial tuberosity attachment, and the scan range was adjusted according to the lesion size in certain cases. Contrast-enhanced CT images were obtained following the Correspondence to: Dr Xinfeng Mao, Department of Radiology, Huzhou Central Hospital, 198 Hongqi Road, Huzhou, injection of 80-100 ml of a nonionic iodinated contrast mate- Zhejiang 313003, P.R. China rial at a concentration of 370 mg/ml [iopamidol (Iopamiron E-mail: [email protected] 370; Bayer AG, Leverkusen, Germany)] or 300 mg/ml [iohexol (Omnipaque 300; Daiichi‑Sankyo Health Care, Tokyo, Japan)] Key words: ovarian tumor, Brenner tumor, computed tomography, at a rate of 2.5-3.0 ml/sec. The parameters of the CT scan were X-ray 120-150 kV, 120 mAs, slice thickness of 1.0-2.0 mm. Arterial and venous phase images were obtained during 25-30 sec and 65-80 sec delay, respectively. 1142 ZHAO et al: CT OF OVARIAN BRENNER TUMORS Figure 1. Bilateral ovarian Brenner tumor. (A-C) Left ovarian Brenner tumor. Round-like solid mass with clear border and multiple scattered amorphous calci- fication focus inside (indicated by the arrow). Moderate enhancement was observed following contrast medium administration. (A) Plain scan; (B) Arterial phase following enhancement; (C) Venous phase following enhancement. (D,E) Right ovarian Brenner tumor. Mass with cystic solid changes and oval shape. Moderate enhancement was observed following contrast medium administration in the solid part, but not in the cystic mass. (D) Plain scan; (E) Enhanced scan. Table I. Clinical features of the 9 cases of ovarian Brenner were 57.2 years, range, 24-80 years. The clinical manifestations tumor. were as follows: 2 cases were postmenopausal and presented Characteristics No. of patients (n=9) with irregular vaginal bleeding; 2 cases presented with abdom- inal swelling pain; 3 cases exhibited uterine leiomyomas; and Postmenopausal 2 2 were detected at the time of physical examination. Postmenopausal bleeding 2 Clinical features of ovarian Brenner tumors. All 9 cases Abdominal swelling pain 2 of ovarian Brenner tumor were unilateral lesions with clear Uterine leiomyomas 3 borders (Table II). Among these cases, 3 were located to the The mean age of patients was 57.2 years (range, 24-80 years). right and 6 were located to the left. Seven cases presented with round- or oval-shaped tumors, and 2 cases presented with irregular- and lobulated-shaped tumors. The largest and smallest size of lesions was 8.1x7.2x3.2 and 1.5x1.2x0.8 cm, respectively, and the mean size was 4.3 cm. Upon morpho- Pathological examination. Pathological samples were stored logical analysis, 2 cases presented with uterine enlargement in 4% paraformaldehyde solution at 4˚C overnight, dehydrated and endometrium thickening, 3 were combined with uterine through a series of graded ethanol solutions (70, 90, 95 and leiomyomas, 1 with uterine leiomyomas and endometrium 100% ethanol and each for 5 min at room temperature), thickening, 2 combined with an adeno-cystic mass, and cleared in xylene (3 times for 5-10 min each), embedded in 1 combined with an ovarian cyst. paraffin and cut into 5 µm thickness sections. Sections were then stained with hematoxylin (1% w/v; 1-2 min at room CT manifestation. The masses were classified according to the temperature) and eosin (0.5% w/v; 2-5 sec at room tempera- cystic and solid ratio inside the lesion as follows: i) 5 cases were ture) for general examination under a Leica microscope (Leica solid mass (Fig. 1). A small amount of low-density necrosis DMI3000 B; Leica, Solms, Germany; x100 magnification). All region was observed inside the lesions. Multiple scattered or the pathological sections were reviewed by a senior pathologist dot‑like calcification with evident enhancement was observed for diagnosis confirmation. The following histological param- in 3 cases of lesions. ii) Cystic-solid lesion in 3 cases (Fig. 1). eters were recorded on the basis of histological analysis and Similar ratios of the cystic and solid component were observed review of the original pathologic reports: Gross configuration in these cystic-solid mixed lesions. The CT value of the (solid or cystic); tumor size (in centimeters); gross tumor color; cystic part was 18‑20 HU and no enhancement was identified microscopic calcifications; and the presence of coexisting following contrast medium administration, whereas moderate ovarian neoplasms or tumor-like lesions. enhancement was observed in the solid part. iii) Cystic lesion in 1 case (Fig. 2). The CT manifestations included single cystic Results lesion with papillary projections and slight enhancement was observed following contrast medium administration. The Patient demographical data. Details of the demographical data detailed CT features of each case of ovarian Brenner tumor of these 9 patients are listed in Table I. The mean age of patients are listed in Table II. Table II. Detailed clinical features and computed tomography manifestation of the ovarian Brenner tumor. CT value of the solid mass (HU) ------------------------------------------------------------- Patient no. Age (years) Location Morphology Size (cm) Type Plain scan Arterial Venous Calcification Comorbidity 1 54 Left Oval 6.5x5 Solid 55 64 73 Multiple and Intramural and subserous uterine scattered shape leiomyomas combined with ONCOLOGY LETTERS 16: 1141-1146, 2018 ONCOLOGY LETTERS 1141-1146, 16: adenomyosis 2 51 Right Round 1.5x1.2x0.8 Solid 48 67 86 None Uterine leiomyomas 3 80 Left Oval 6x5x4.5 Solid 50 89 90 Dot-like shape Intramural leio leiomyomas, post menopausal endometrial hyperproliferation response 4 48 Left Lobulated 4.5x3.8x2.7 Solid 53 75 83 Multiple and Uterine adenomyosis and scattered shape endometrial hyperplasia 5 81 Right Oval 8.1x7.2x3.2 Cystic-solid 56 80 91 Dot- and Endometrial hyperproliferation disk-like shape response 6 41 Left Oval 6.1x5.3x4.7 Cystic-solid 46 68 73 None Left ovarian mucinous cystic adenoma 7 24 Right Lobulated 3.7x2.2x2.0 Cystic-solid 52 69 78 Dot-like shape Ovarian simple cyst 8 66 Left Oval 7.5x3.2x4.4 Cystic 30 38 60 None Right ovarian mucinous cystic adenoma 9 70 Left Oval 6.2x4.2x3.8 Solid 45 63 81 None Intramural uterine leiomyomas combined with adenomyosis HU, Hounsfield unit.
Load more

Recommended publications
  • A Rare Presentation of Benign Brenner Tumor of Ovary: a Case Report
    International Journal of Reproduction, Contraception, Obstetrics and Gynecology Periasamy S et al. Int J Reprod Contracept Obstet Gynecol. 2018 Jul;7(7):2971-2974 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182920 Case Report A rare presentation of benign Brenner tumor of ovary: a case report Sumathi Periasamy1, Subha Sivagami Sengodan2*, Devipriya1, Anbarasi Pandian2 1Department of Surgery, 2Department of Obstetrics and Gynaecology, Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu, India Received: 17 April 2018 Accepted: 23 May 2018 *Correspondence: Dr. Subha Sivagami Sengodan, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Brenner tumors are rare ovarian tumors accounting for 2-3% of all ovarian neoplasms and about 2% of these tumors are borderline (proliferating) or malignant. These tumors are commonly seen in 4th-8th decades of life with a peak in late 40s and early 50s. Benign Brenner tumors are usually small, <2cm in diameter and often detected incidentally during surgery or on pathological examination. Authors report a case of a large, calcified benign Brenner tumor in a 55-year-old postmenopausal woman who presented with complaint of abdominal pain and mass in abdomen. Imaging revealed large complex solid cystic pelvic mass -peritoneal fibrosarcoma. She underwent laparotomy which revealed huge Brenner tumor weighing 9kg arising from left uterine cornual end extending up to epigastric region.
    [Show full text]
  • Immunohistochemical and Electron Microscopic Findings in Benign Fibroepithelial Vaginal Polyps J Clin Pathol: First Published As 10.1136/Jcp.43.3.224 on 1 March 1990
    224 J Clin Pathol 1990;43:224-229 Immunohistochemical and electron microscopic findings in benign fibroepithelial vaginal polyps J Clin Pathol: first published as 10.1136/jcp.43.3.224 on 1 March 1990. Downloaded from T P Rollason, P Byrne, A Williams Abstract LIGHT MICROSCOPY Eleven classic benign "fibroepithelial Sections were cut from routinely processed, polyps" of the vagina were examined paraffin wax embedded blocks at 4 gm and using a panel of immunocytochemical immunocytochemical techniques were agents. Two were also examined electron performed using a standard peroxidase- microscopically. In all cases the stellate antiperoxidase method.7 The antibodies used and multinucleate stromal cells were as follows: polyclonal rabbit characteristic of these lesions stained antimyoglobin (batch A324, Dako Ltd, High strongly for desmin, indicating muscle Wycombe, Buckinghamshire), monoclonal intermediate filament production. In anti-desmin (batch M724, Dako Ltd), mono- common with uterine fibroleiomyomata, clonal anti-epithelial membrane antigen (batch numerous mast cells were also often M613, Dako Ltd), monoclonal anti-vimentin seen. Myoglobin staining was negative. (batch M725, Dako Ltd), polyclonal rabbit Electron microscopical examination anti-cytokeratin (Bio-nuclear services, Read- confirmed that the stromal cells con- ing) and monoclonal anti cytokeratin NCL tained abundant thin filaments with focal 5D3 (batch M503, Bio-nuclear services). densities and also showed the ultrastruc- Mast cells were shown by a standard tural features usually associated with chloroacetate esterase method using pararo- myofibroblasts. saniline,8 which gave an intense red cyto- It is concluded that these tumours plasmic colouration, and by the routine would be better designated polypoid toluidine blue method. myofibroblastomas in view of the above An attempt was made to assess semiquan- findings.
    [Show full text]
  • Fibro-Epithelial Polyp: Case Report with Literature Review
    ISSN: 2456-8090 (online) CASE REPORT International Healthcare Research Journal 2017;1(7):14-17. DOI: 10.26440/IHRJ/01_07/116 QR CODE Fibro-Epithelial Polyp: Case Report with Literature Review RATNA SAMUDRAWAR 1, HEENA MAZHAR2, MUKESH KUMAR KASHYAP3, RUBI GUPTA4 A Oral fibroma is the most common benign soft tissue tumor caused due to continuous trauma from sharp cusp of teeth or faulty dental B restoration. It presents as sessile or occasionally pedunculated painless swelling which can be soft to firm in consistency. Its incidence occurs mostly during third to fifth decade and shows preference for female. Its occurrence corresponds with intraoral areas that are S prone to trauma such as the tongue, buccal mucosa and labial mucosa, lip, gingiva. Even with conservative surgical excision, the T lesion may recur until the source of continuous irritation persists. This article presents a case of large size oral fibroma on left alveolar R region associated with ulceration along with literature review. A C KEYWORDS: Benign Connective Tissue Tumor, Fibro-epithelial Polyp, Irritation Fibroma, Traumatic Fibroma, Focal Fibrous T Hyperplasia. K INTRODUCTION Fibroma of the oral mucosa is the most common complaint of growth in left lower back region of benign soft tissue tumor of the oral cavity derived the mouth since 4 months. History elicited that from fibrous connective tissues (CTs).1 Its the a solitary, painless growth had been observed pathogenesis lies in the fact that due to continues in his left mandibular molar region which was local trauma, a type of reactive hyperplasia of initially small in size and then it gradually fibrous tissue occurs.2 Thus, “Focal fibrous enlarged to present size of oval shape, well- hyperplasia” (FFH) term was suggested by Daley defined, pedunculated lesion.
    [Show full text]
  • Germline Fumarate Hydratase Mutations in Patients with Ovarian Mucinous Cystadenoma
    European Journal of Human Genetics (2006) 14, 880–883 & 2006 Nature Publishing Group All rights reserved 1018-4813/06 $30.00 www.nature.com/ejhg SHORT REPORT Germline fumarate hydratase mutations in patients with ovarian mucinous cystadenoma Sanna K Ylisaukko-oja1, Cezary Cybulski2, Rainer Lehtonen1, Maija Kiuru1, Joanna Matyjasik2, Anna Szyman˜ska2, Jolanta Szyman˜ska-Pasternak2, Lars Dyrskjot3, Ralf Butzow4, Torben F Orntoft3, Virpi Launonen1, Jan Lubin˜ski2 and Lauri A Aaltonen*,1 1Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland; 2International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland; 3Department of Clinical Biochemistry, Aarhus University Hospital, Skejby, Denmark; 4Pathology and Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland Germline mutations in the fumarate hydratase (FH) gene were recently shown to predispose to the dominantly inherited syndrome, hereditary leiomyomatosis and renal cell cancer (HLRCC). HLRCC is characterized by benign leiomyomas of the skin and the uterus, renal cell carcinoma, and uterine leiomyosarcoma. The aim of this study was to identify new families with FH mutations, and to further examine the tumor spectrum associated with FH mutations. FH germline mutations were screened from 89 patients with RCC, skin leiomyomas or ovarian tumors. Subsequently, 13 ovarian and 48 bladder carcinomas were analyzed for somatic FH mutations. Two patients diagnosed with ovarian mucinous cystadenoma (two out of 33, 6%) were found to be FH germline mutation carriers. One of the changes was a novel mutation (Ala231Thr) and the other one (435insAAA) was previously described in FH deficiency families. These results suggest that benign ovarian tumors may be associated with HLRCC.
    [Show full text]
  • Soft Tissue Sarcoma Classifications
    Soft Tissue Sarcoma Classifications Contents: 1. Introduction 2. Summary of SSCRG’s decisions 3. Issue by issue summary of discussions A: List of codes to be included as Soft Tissue Sarcomas B: Full list of codes discussed with decisions C: Sarcomas of neither bone nor soft tissue D: Classifications by other organisations 1. Introduction We live in an age when it is increasingly important to have ‘key facts’ and ‘headline messages’. The national registry for bone and soft tissue sarcoma want to be able to produce high level factsheets for the general public with statements such as ‘There are 2000 soft tissue sarcomas annually in England’ or ‘Survival for soft tissue sarcomas is (eg) 75%’ It is not possible to write factsheets and data briefings like this, without a shared understanding from the SSCRG about which sarcomas we wish to include in our headline statistics. The registry accepts that soft tissue sarcomas are a very complex and heterogeneous group of cancers which do not easily reduce to headline figures. We will still strive to collect all data from cancer registries about anything that is ‘like a sarcoma’. We will also produce focussed data briefings on sites such as dermatofibrosarcomas and Kaposi’s sarcomas – the aim is not to forget any sites we exclude! The majority of soft tissue sarcomas have proved fairly uncontroversial in discussions with individual members of the SSCRG, but there were 7 particular issues it was necessary to make a group decision on. This paper records the decisions made and the rationale behind these decisions. 2. Summary of SSCRG’s decisions: Include all tumours with morphology codes as listed in Appendix A for any cancer site except C40 and C41 (bone).
    [Show full text]
  • Adnexal Masses in Pregnancy
    A guide to management Mitchel S. Hoffman, MD Professor and Director, Division of Adnexal masses in pregnancy Gynecologic Oncology, Department of Obstetrics and Gynecology, Forego surgery in most cases until delivery—or until University of South Florida, Tampa, Fla Robyn A. Sayer, MD the risky fi rst trimester has passed Assistant Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, CASE 1 An enlarging cystic tumor 16 × 12 × 4 cm and determined that it University of South Florida, Tampa, Fla was a corpus luteum cyst. The authors report no fi nancial relationships relevant to this article. A 20-year-old gravida 3 para 1011 visits the emergency department with persistent right Presence of mass raises questions fl ank pain. Although ultrasonography (US) Despite the rarity of malignancy, the dis- shows a 21-week gestation, the patient has covery of an ovarian mass during pregnan- had no prenatal care. Imaging also reveals a® Dowdency prompts several Health important Media questions: right-sided ovarian tumor, 14 × 11 × 8 cm, How should the mass be assessed? How that is mainly cystic with some internal can the likelihood of malignancy be deter- echogenicity. CopyrightFor personalmined as quickly use and only effi ciently as pos- At 30 weeks’ gestation, a gynecologic sible, without jeopardy to the pregnancy? oncologist is consulted. Repeat US reveals When is surgical intervention warranted? the mass to be about 20 cm in diameter and And when can it be postponed? Specifi - cystic, without internal papillation. The pa- cally, is elective operative intervention for IN THIS ARTICLE tient’s CA-125 level is 12 U/mL.
    [Show full text]
  • Rotana Alsaggaf, MS
    Neoplasms and Factors Associated with Their Development in Patients Diagnosed with Myotonic Dystrophy Type I Item Type dissertation Authors Alsaggaf, Rotana Publication Date 2018 Abstract Background. Recent epidemiological studies have provided evidence that myotonic dystrophy type I (DM1) patients are at excess risk of cancer, but inconsistencies in reported cancer sites exist. The risk of benign tumors and contributing factors to tu... Keywords Cancer; Tumors; Cataract; Comorbidity; Diabetes Mellitus; Myotonic Dystrophy; Neoplasms; Thyroid Diseases Download date 07/10/2021 07:06:48 Link to Item http://hdl.handle.net/10713/7926 Rotana Alsaggaf, M.S. Pre-doctoral Fellow - Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH PhD Candidate – Department of Epidemiology & Public Health, University of Maryland, Baltimore Contact Information Business Address 9609 Medical Center Drive, 6E530 Rockville, MD 20850 Business Phone 240-276-6402 Emails [email protected] [email protected] Education University of Maryland – Baltimore, Baltimore, MD Ongoing Ph.D. Epidemiology Expected graduation: May 2018 2015 M.S. Epidemiology & Preventive Medicine Concentration: Human Genetics 2014 GradCert. Research Ethics Colorado State University, Fort Collins, CO 2009 B.S. Biological Science Minor: Biomedical Sciences 2009 Cert. Biomedical Engineering Interdisciplinary studies program Professional Experience Research Experience 2016 – present Pre-doctoral Fellow National Cancer Institute, National Institutes
    [Show full text]
  • Actinomycosis Israeli, 129, 352, 391 Types Of, 691 Addison's Disease, Premature Ovarian Failure In, 742
    Index Abattoirs, tumor surveys on animals from, 823, Abruptio placentae, etiology of, 667 828 Abscess( es) Abdomen from endometritis, 249 ectopic pregnancy in, 6 5 1 in leiomyomata, 305 endometriosis of, 405 ovarian, 352, 387, 388-391 enlargement of, from intravenous tuboovarian, 347, 349, 360, 388-390 leiomyomatosis, 309 Acantholysis, of vulva, 26 Abdominal ostium, 6 Acatalasemia, prenatal diagnosis of, 714 Abortion, 691-697 Accessory ovary, 366 actinomycosis following, 129 Acetic acid, use in cervical colposcopy, 166-167 as choriocarcinoma precursor, 708 "Acetic acid test," in colposcopy, 167 criminal, 695 N-Aceryl-a-D-glucosamidase, in prenatal diagnosis, definition of, 691 718 of ectopic pregnancy, 650-653 Acid lipase, in prenatal diagnosis, 718 endometrial biopsy for, 246-247 Acid phosphatase in endometrial epithelium, 238, endometritis following, 250-252, 254 240 fetal abnormalities in, 655 in prenatal diagnosis, 716 habitual, 694-695 Acridine orange fluorescence test, for cervical from herpesvirus infections, 128 neoplasia, 168 of hydatidiform mole, 699-700 Acrochordon, of vulva, 31 induced, 695-697 Actinomycin D from leiomyomata, 300, 737 in therapy of missed, 695, 702 choriocarcinoma, 709 tissue studies of, 789-794 dysgerminomas, 53 7 monosomy X and, 433 endodermal sinus tumors, 545 after radiation for cervical cancer, 188 Actinomycosis, 25 spontaneous, 691-694 of cervix, 129, 130 pathologic ova in, 702 of endometrium, 257 preceding choriocarcinoma, 705 of fallopian tube, 352 tissue studies of, 789-794 of ovary, 390, 391 threatened,
    [Show full text]
  • Histogenesis of Ovarian Malignant Mixed Mesodermal Tumours J Clin Pathol: First Published As 10.1136/Jcp.43.4.287 on 1 April 1990
    J Clin Pathol 1990;43:287-290 287 Histogenesis of ovarian malignant mixed mesodermal tumours J Clin Pathol: first published as 10.1136/jcp.43.4.287 on 1 April 1990. Downloaded from T J Clarke Abstract embedded tumour tissue were cut at 4 im and The histogenesis of ovarian malignant stained with haematoxylin and eosin, periodic mixed mesodermal tumours, which acid Schiff (PAS) before and after diastase includes the concept of metaplastic car- treatment, Caldwell and Rannie's reticulin cinoma, is controversial. Four such stain, and phosphotungstic acid haematoxylin tumours were examined for evidence of (PTAH). Sequential sections were stained by metaplastic transition from carcinoma to the indirect immunoperoxidase technique sarcoma using morphology and reticulin using monoclonal antibodies directed against stains. Consecutive sections were stained cytokeratin (PKK1 which reacts with low immunohistochemically using cyto- molecular weight cytokeratins of44, 46, 52 and keratin and vimentin to determine 54 kilodaltons), vimentin, a-l-antitrypsin and whether cells at the interface between myoglobin. Appropriate positive and negative carcinoma and sarcoma expressed both controls, with omission of specific antisera in cytokeratin and vimentin. There was no the latter, were performed. Haematoxylin and evidence ofmorphological, architectural, eosin stained sections were examined for or immunohistochemical transitions secondary fluorescence using a Leitz Dialux from carcinoma to sarcoma in the four 20ES microscope and mercury vapour light tumours studied. This suggests that source epifluorescence. ovarian malignant mixed mesodermal Four patients, aged 68, 71, 72 and 73 presen- tumours are not metaplastic carcinomas ted with abdominal distension and discomfort but are composed of histogenetically dif- and were found to have an ovarian malignant ferent elements.
    [Show full text]
  • Angiotensin II Type 1 Receptor Expression in Ovarian Cancer and Its Correlation with Tumour Angiogenesis and Patient Survival
    British Journal of Cancer (2006) 94, 552 – 560 & 2006 Cancer Research UK All rights reserved 0007 – 0920/06 $30.00 www.bjcancer.com Angiotensin II type 1 receptor expression in ovarian cancer and its correlation with tumour angiogenesis and patient survival K Ino1, K Shibata1, H Kajiyama1, E Yamamoto1, T Nagasaka2, A Nawa1, S Nomura1 and F Kikkawa1 1 Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; 2 Division of Pathology/Clinical Laboratory, Nagoya University Graduate School of Medicine, Nagoya, Japan Angiotensin II, a main effector peptide in the renin–angiotensin system, acts as a growth-promoting and angiogenic factor via type 1 angiotensin II receptors (AT1R). We have recently demonstrated that angiotensin II enhanced tumour cell invasion and vascular endothelial growth factor (VEGF) secretion via AT1R in ovarian cancer cell lines in vitro. The aim of the present study was to determine whether AT1R expression in ovarian cancer is correlated with clinicopathological parameters, angiogenic factors and patient survival. Immunohistochemical staining for AT1R, VEGF, CD34 and proliferating cell nuclear antigen (PCNA) were analysed in ovarian cancer tissues (n ¼ 67). Intratumour microvessel density (MVD) was analysed by counting the CD34-positive endothelial cells. Type 1 angiotensin II receptors were expressed in 85% of the cases examined, of which 55% were strongly positive. Type 1 angiotensin II receptors expression was positively correlated with VEGF expression intensity and MVD, but not with histological subtype, grade, FIGO stage or PCNA labelling index. In patients who had positive staining for AT1R, the overall survival and progression-free survival were significantly poor (P ¼ 0.041 and 0.017, respectively) as compared to those in patients who had negative staining for AT R, although VEGF, but not AT R, was an independent prognostic factor on multivariate analysis.
    [Show full text]
  • Brenner Tumor of Ovary: an Incidental Finding: a Case Report
    International Journal of Reproduction, Contraception, Obstetrics and Gynecology Jodha BS et al. Int J Reprod Contracept Obstet Gynecol. 2017 Mar;6(3):1132-1135 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170600 Case Report Brenner tumor of ovary: an incidental finding: a case report Bhanwar Singh Jodha, Richa Garg* Department of Obstetrics and Gynecology, Umaid Hospital, Regional Institute of Maternal and Child Health, Dr. S. N. Medical College, Jodhpur, Rajasthan, India Received: 20 December 2016 Accepted: 31 January 2017 *Correspondence: Dr. Richa Garg, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Brenner tumor of the ovary is very rare, mostly benign, small, and unilateral. Malignant brenner tumor is much rarer. Malignant brenner tumor of ovary closely resembles the transitional cell carcinoma of ovary. These tumors are believed to arise from urothelial metaplasia of ovarian surface epithelium. However the latter has a worse prognosis. Here we present a case of Brenner tumor of ovary in a postmenopausal woman treated surgically and its features are briefly discussed. Keywords: Brenner tumor, Ovarian neoplasm, Ultrasonography INTRODUCTION bladder epithelium.7 The Brenner tumors are usually small, solid, firm grayish knots up to 2 cm in size, Ovarian tumors are common forms of neoplasia in however, they may also be quite big, and in such cases women and it accounts for about 30.0% of female genital they usually have cystic components as a result of cystic cancers.1 Ovarian carcinoma is the fourth most common degeneration and necrosis.
    [Show full text]
  • Adnexal Masses: Benign Ovarian Lesions and Characterization
    Adnexal Masses: Benign Ovarian Lesions and Characterization Benign Ovarian Masses Alexander Schlattau, Teresa Margarida Cunha, and Rosemarie Forstner Contents Abstract 1 Introduction .................................................... 000 Incidental adnexal masses are commonly iden- 2 Technical Recommendations tified in radiologists’ daily practice. Most of for Ovarian Lesion Characterization ........... 000 them are benign ovarian lesions of no concern. 3 Defining the Origin of a Pelvic Mass: However, sometimes defining the origin of a Adnexal Versus Extra-adnexal pelvic mass may be challenging, especially on Versus Extraperitoneal .................................. 000 ultrasound alone. Moreover, ultrasound not 4 Benign Adnexal Lesions ................................ 000 always allows the distinction between a benign 4.1 Non-neoplastic Lesions of the and a malignant adnexal tumor. Ovaries and Adnexa ......................................... 000 Most of sonographically indeterminate 4.2 Benign Neoplastic Lesions of the Ovaries ....... 000 adnexal masses turn out to be common benign 5 Functioning Ovarian Tumors........................ 000 entities that can be readily diagnosed by mag- 6 Ovarian Tumors in Children, Adolescents, netic resonance imaging. The clinical impact and Young Women ......................................... 000 of predicting the likelihood of malignancy is 7 Adnexal Masses in Pregnancy ....................... 000 crucial for proper patient management. The first part of this chapter will cover the References ...............................................................
    [Show full text]