Aim: To identify surrogate prognostic markers in intrahepatic cholangiocarcinoma (IHCC). Methods: Thirty one cases of IHCC were graded and immunostained for FAT, Ki67, E-cadherin, b catenin, and HER 2/neu. Results: Twenty two cases were high grade and 27 had high Ki67 counts. Strong membranous staining of HER 2/neu was found in 10 tumours and reduced membranous E-cadherin and b catenin in 19 and 18 tumours, respectively. Nuclear localisation of b catenin was identified in five tumours and 22 showed weak cytoplasmic staining of FAT. Strong HER 2/neu and weak FAT immunoexpression were significantly correlated with high histological grade (p = 0.01) and high Ki67 index (p = 0.03). Upregulation of HER 2/neu was also significantly associated with nuclear localisation of b catenin (p = 0.01). Reduced membranous b catenin was significantly related to reduced membranous E-cadherin (p = 0.03), weak staining for FAT (p = 0.01), and nuclear translocation of b catenin (p = 0.04). Conclusions: Reduced immunoexpression of E-cadherin and FAT at their normal membranous location may be potential prognostic markers, and the overexpression of HER 2/neu and b catenin nuclear translocation may have a role in cholangiocarcinogenesis.

This is a case report of retroperitoneal mucinous cystadenocarcinoma which was operated on for a preoperative diagnosis of ovarian tumor. The tumor had no connection to other intra-abdominal organs including bilateral normal ovaries. Grossly, it was a well encapsulated, unilocular cyst containing mucous material. Histology revealed a typical area of benign, low malignant potential and malignant mucinous epithelium. No particular microscopic features suggested the origin of the tumor. We additionally performed total hysterectomy, bilateral salpingooophorectomy, and appendectomy after tumor resection and found no tumor elsewhere from these specimens. Prophylactic chemotherapy was also given. The patient was doing well 18 months postoperation. Due to its rarity, the prognosis and optimal treatment cannot be concluded with confidence at this time until more cases are reported.

This study endeavored to determine whether lymph node size is a reliable indicator in determining lymph node metastasis in common epithelial ovarian cancer. We reviewed pathologic sections of pelvic and para-aortic lymph nodes removed from 104 ovarian carcinoma patients who underwent either primary surgical staging or secondary surgery from January 1994 to July 2001. All sections of each individual node were measured in two dimensions. The different sizes of nodes were studied statistically to determine the optimal sensitivity and specificity in predicting cancer metastasis. A nodal size of 10 mm was a specific point of interest. Of 2069 total nodes obtained, 110 nodes (5.3%) had metastatic cancer. More than half (55.4%) of these positive nodes had a nodal long axis of 10 mm and less. The sensitivity and specificity of nodal size at 10 mm were 44.5% and 81.1%, respectively. We conclude that lymph node size is not a good indicator in determining epithelial ovarian cancer metastasis. Mere sampling of only the enlarged nodes does not reflect the true positive incidence of nodal metastasis. To avoid inaccurate staging and improper management, complete lymph node dissection is proposed as part of surgical staging for ovarian cancer.

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