Giant cell tumor of the uterus: case report and response to chemotherapy

Skubitz, Keith M.; Manivel, Js Carlos

doi:10.1186/1471-2407-7-46

Cited by 17 publications

(15 citation statements)

References 55 publications

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“…Earlier reports have highlighted the aggressive behavior of MGCT of the uterus, which is typically characterized by rapid progression and death (18,19). These tumors should be distinguished from leiomyosarcoma with OLGC and this is achieved through recognition of admixture of OLGCs with the background leiomyosarcoma that in all cases has been spindle cell type.…”

Section: Discussionmentioning

confidence: 97%

Leiomyosarcoma of the Broad Ligament With Osteoclast-like Giant Cells and Rhabdoid Cells

Clarke

Rahimi

Chetty

2010

International Journal of Gynecological Pathology

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In this report we document an unusual co-mingling of rhabdoid and osteoclast like giant cells in a leiomyosarcoma arising from the broad ligament. A 38-year old female was found to have a rapidly enlarging adnexal mass which was resected and histologically found to be a leiomyosarcoma with marked pleomorphism. Completion surgery, shortly thereafter showed spread to the ileum, which was also resected. The tumor now showed a prominent population of both osteoclast-like giant cells and rhabdoid cells. Interestingly, the immunophenotype of the tumor had also changed with complete loss of desmin, caldesmon and only focal expression of smooth muscle actin. This is the first documentation of the coexistence of rhabdoid and osteoclast-like giant cells within a gynecological tract leiomyosarcoma. This tumor was characterized by rapid clinical progression despite extensive surgery and chemotherapy. These two cells types have individually been implicated as harbingers of a poor prognosis in leiomyosarcomas. Their prominence in the recurrent tumor and the loss of muscle marker expression are in keeping with biologic progression.

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Section: Discussionmentioning

confidence: 97%

Leiomyosarcoma of the Broad Ligament With Osteoclast-like Giant Cells and Rhabdoid Cells

Clarke

Rahimi

Chetty

2010

International Journal of Gynecological Pathology

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“…24,[30][31][32][33] In a recent study, Mills et al 26 analyzed 44 LM-BN, 16 leiomyosarcomas, and 8 cellular LMs, and, although they observed increased p16 expression in leiomyosarcoma compared with LM-BN, the difference was not statistically significant. [36][37][38][39][40][41][42] Finally, even though anaplastic carcinoma may have giant cells, they typically form poorly cohesive sheets and nests admixed with mononucleated tumor cells with an epithelioid appearance associated with brisk mitotic activity and myometrial and lymphovascular invasion. Furthermore, the 2 LM-BN that recurred were p16 negative.…”

Section: Discussionmentioning

confidence: 99%

Uterine Leiomyomas With Bizarre Nuclei

Croce

Young

Oliva

2014

American Journal of Surgical Pathology

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Leiomyoma with bizarre nuclei (LM-BN) is an uncommon tumor with histologic features (mononucleated or multinucleated bizarre cells that may have a diffuse distribution, prominent nucleoli, and karyorrhectic nuclei that may mimic atypical mitoses) that often causes confusion with leiomyosarcoma. Fifty-nine LM-BNs were collected from our consultation files over the years 2000 to 2011. Features recorded included patient age, therapy, tumor size, border, gross appearance, density and distribution of BN, mitotic count, karyorrhectic nuclei, prominent nucleoli, cells with conspicuous dense eosinophilic cytoplasm (rhabdoid-like), vascular changes and type of vasculature, and presence of necrosis and its nature. Follow-up information was obtained for all patients. Patients ranged in age from 25 to 75 (average 45) years (11 patients between 25 and 35 y, 20 between 36 and 45 y, 22 between 46 and 55 y, and 6 between 56 and 75 y). Forty-two underwent hysterectomy and 17 myomectomy. For 51 tumors gross findings were known. Forty (78%) had a solid white and whorled cut surface and 11 (22%) a yellow appearance. Five (10%) neoplasms showed prominent cystic degeneration, and hemorrhage and/or necrosis was seen in 9 (18%). Forty-five LM-BNs had a pushing margin with the surrounding myometrium, whereas 1 showed irregular borders. Margins could not be ascertained in the slides available in 13 cases. Twenty-eight (48%), 19 (32%), and 12 (20%) LM-BN showed low, intermediate, and high BN density. Eighteen (30%) tumors showed diffuse, 26 (44%) showed multifocal, and 15 (26%) had focal BN distribution. Mitotic counts ranged from 0 to 7/10 high-power fields (HPF) (average 1 to 2/10 HPF). Thirty-seven (63%) had <2/10 HPF, 19 (32%) had 2 to 5 mitoses/10 HPF, and in 3 tumors (5%) mitotic counts were 6, 7, and 7/10 HPF (2 with focal and 1 with diffuse BN). All but 4 LM-BNs showed karyorrhectic nuclei, striking in 12 neoplasms, mimicking atypical mitoses. Nineteen (32%) LMs had prominent eosinophilic nucleoli surrounded by a clear halo. Ischemic necrosis was detected in 21 (36%) LM-BN. Rhabdoid-like cells were noted in 24 (41%) tumors. All patients had no evidence of recurrence, ranging from 1 to 13 years (overall average 6 y; in patients with myomectomy 6.3 y with a range of 2.6 to 11 y). Our results corroborate that LM-BN is associated with a favorable outcome even in those patients only treated by myomectomy and highlights that a conservative approach can be undertaken in these patients, as many of them are of reproductive age. Because of the favorable outcome, the term LM-BN is preferable to alternative terminology including "atypical leiomyoma."

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“…Osteoclast-like giant cell-rich neoplasms without clearly demonstrable epithelial or mesenchymal differentiation are very rare in the uterus. There have been 7 such cases previously reported in the world literature, [10][11][12][13][14][15][16] including 2 that were associated with, but topographically distinct from a uterine leiomyosarcoma. 15,16 Two of these cases are worthy of specific mention because of their similarities with our case.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9] Additionally, 7 cases of OLGC-rich neoplasms without clear epithelial or mesenchymal lines of differentiation have previously been described. [10][11][12][13][14][15][16] We describe herein a case of an OLGC-rich uterine tumor that was essentially indistinguishable at the morphologic and immunophenotypic levels, from typical GCT of bone, and discuss similarities and differences from the aforementioned cases.…”

Section: Introductionmentioning

confidence: 99%

Giant Cell Tumor of Uterus Resembling Osseous Giant Cell Tumor

et al. 2012

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Osteoclast-like giant cells (OLGCs) are multinucleated cells of histiocytic lineage and have been identified in a wide array of neoplasms. In the uterus, they have most frequently been reported in association with leiomyosarcomas. This article describes a case of an osteoclast-like giant cell-rich uterine tumor that was essentially indistinguishable at the morphologic and immunophenotypic levels, from typical giant cell tumor of bone. This is the first example of such a case that has been reported in the uterus to the authors' knowledge.

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Giant cell tumor of the uterus: case report and response to chemotherapy

Cited by 17 publications

References 55 publications

Leiomyosarcoma of the Broad Ligament With Osteoclast-like Giant Cells and Rhabdoid Cells

Leiomyosarcoma of the Broad Ligament With Osteoclast-like Giant Cells and Rhabdoid Cells

Uterine Leiomyomas With Bizarre Nuclei

Giant Cell Tumor of Uterus Resembling Osseous Giant Cell Tumor

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