The occurrence of pulmonary metastasis only, its number (1-3) and size (mean size = 2.8 cm), and no lymph node metastasis are important prognostic factors. For these patients, active surgical resection of the pulmonary lesion(s) and further chemotherapy are recommended in order to improve their prognosis.

Since patients with endometrial carcinoma tend to be elderly, obese, diabetic and hypertensive, individualization of treatment is very important. The therapy for each patient with endometrial carcinoma should be individualized and determined by the stage and factors predisposing to extrauterine spread of the tumor. Such risk factors include the grade of the tumor and depth of myometrial invasion. Unfortunately, staging based on pelvic examination is inaccurate in endometrial carcinoma and the depth of myometrial invasion cannot be assessed preoperatively. In order to assess its uses in the staging and treatment planning of endometrial cancer, CT was performed in 28 previously untreated patients with endometrial cancer. Twenty patients subsequently underwent surgery and the CT findings were correlated with the surgical and pathologic findings. CT proved to be useful in determining the depth of myometrial invasion and whether cervical involvement is present or not. Such information provided by CT helps to plan treatment more adequately and accurately for the individual patients.

Immunohistochemical characteristics of undifferentiated carcinomas of the ovary were examined using formalin-fixed, paraffin-embedded tissues with an avidin-biotin staining approach. Eight cases were collected from the pathology files of our Institute from a total of 214 recorded malignant ovarian tumors. For immunostaining, antibodies reacting with epithelial membrane antigen (EMA), pankeratin, vimentin, CA 125, CA 19-9, carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), alpha-1-antitrypsin (AT), epidermal growth factor receptor (EGFR), c-erbB-2, bcl-2 and p53 proteins were used. All the cases examined were positive for EMA and pankeratin, specific markers for epithelial tumors, negative for the non-epithelial tumor marker, vimentin, and also positive for EGFR. Interestingly, only one case was positive for CA 125, despite it being one of the commonest reported indicators of ovarian cancer. CA 19-9 was positive in 7 cases, CEA in 5, AFP in 2, AT in 6 and c-erbB-2 protein in 4. Two cases were positive for p53 protein, and in 1 of these positive staining for bcl-2 was also observed. These results indicate that the epithelial nature is well preserved in undifferentiated ovarian carcinomas, although consistently positive reactions were not observed within the cases for some antigens. They further clearly show that a negative signal for CA 125 can not be considered to exclude the possibility of a primary ovarian tumor.

Cancer patients with this familial high-risk factor should be carefully and regularly followed up by monitoring at every anatomic site, especially the breast, stomach, and colon, in order that the development of a second primary carcinoma can be detected as early as possible, and not be overlooked in examinations.

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