Mesenchymal tumors of the uterus. I. A clinical and pathological study of 53 endometrial stromal tumors

Norris, Henry J.; Taylor, Herbert B.

doi:10.1002/1097-0142(196606)19:6<755::aid-cncr2820190604>3.0.co;2-u

Cited by 379 publications

(161 citation statements)

References 15 publications

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“…The majority appear to be leiomyosarcomas but liposarcomas have also been reported (1-7). True carcinosarcomas have been reported at a variety of sites including the bladder (15, 16), uterus (17,18), and lung (19). Similar tumors showing a mixture of adenocarcinomatous and sarcomatous components do not appear to have been reported in the pancreas.…”

Section: Discussionmentioning

confidence: 98%

Malignant Islet Cell Tumor with Sarcomatous Differentiation

et al. 2001

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Malignant mesenchymal neoplasms of the pancreas are rare and malignant islet cell tumors with sarcomatous dedifferentiation are rarer still. We present a case of malignant islet cell tumor with sarcomatous differentiation, which to our knowledge is only the second reported case showing such a combination of morphologic features. Clinically, the neoplasm was not hormonally active and immunohistochemical staining was negative for gastrin, glucagon, insulin and somatostatin. The sarcomatous component strongly reacted with an antibody directed against vimentin, and a minority of cells stained strongly with antisera directed against desmin and smooth muscle actin. Primary sarcomas of the pancreas are rare (1-7), with fewer than a dozen leiomyosarcomas and a single liposarcoma being reported in the English language literature. Rarer still are malignant islet cell tumors with sarcomatous differentiation. Only a single case report of such a combined neoplasm has to our knowledge appeared in the English language literature (8).The histomorphologic spectrum of carcinoid tumors is wide with glandular morphologies, papillary structures, oncocytic changes, squamous and osseous metaplasia and spindle cell patterns being recognized (9 -14). The spindle cell pattern described by Rosai et al. (14) appears to be unrelated to the sarcomatous changes seen in our case and that described by Ferreiro et al. (8). We report a case of pancreatic carcinoid (islet cell tumor) with focal myosarcomatous differentiation, which is to our knowledge only the second such case reported in the English language literature. CASE REPORTThe patient, a 61-year-old Caucasian female, was followed at the University of Utah for gastroesophageal reflux of long duration controlled by Prilosec. An ultrasound of the abdomen was obtained 3 months before admission to investigate the patient's complaint of vague abdominal pain. A lesion was visualized around the liver, and endoscopy was performed, which revealed a Barrett's esophagus without dysplasia. A follow-up CT scan demonstrated a 10 cm heterogenous mass in the tail of the pancreas (Fig. 1) and three lesions in her liver. The patient's clinical history was otherwise unremarkable except for back pain, most noticeable when lying in bed. Physical examination failed to reveal icterus or lymphadenopathy. The patient underwent exploratory laparotomy with intraoperative biopsy and frozen section of the largest of the liver lesions. Frozen section revealed a hemangioma, and the pancreatic mass was then resected. The postoperative course was unremarkable, and no metastatic lesions have been detected in the immediate postoperative period. METHODSRepresentative tissue sections were taken from the specimen, fixed in 10% neutral buffered forma-

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Section: Discussionmentioning

confidence: 98%

Malignant Islet Cell Tumor with Sarcomatous Differentiation

et al. 2001

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“…Endometrial stromal neoplasms are composed of cells with inconspicuous cytoplasm and round to oblong nuclei that, in the usual case, are lightmicroscopically ultrastructurally and immunohistochemically identical to the endometrial stromal cells found in proliferative endometria (22)(23)(24)(25). Characteristically, this monotonous proliferation of cells is interrupted by a regular network of delicate ramifying small vessels resembling spiral arteries and capillaries (Fig.…”

Section: Endometrial Stromal Neoplasmsmentioning

confidence: 95%

“…Endometrial stromal neoplasms are divided into two classes, stromal nodule and stromal sarcoma, based on the presence of infiltrating margins or vascular intrusion in the latter and circumscribed margins in the former (24,26). Other than infiltration and vascular intrusion, the two lesions are indistinguishable histologically.…”

Section: Endometrial Stromal Neoplasmsmentioning

confidence: 99%

“…Traditionally, endometrial stromal sarcomas have been stratified on the basis of the mitotic index into a low-grade group (Ͻ10 mf/10 hpf) and a high-grade group (Ͼ10 mf/10 hpf) because of perceived differences in outcome (24). Evans challenged this concept.…”

Section: Clinicopathologic Correlationmentioning

confidence: 99%

“…These findings greatly diminish the usefulness of the mitotic index as a predictor. Accordingly, we no longer use the high grade/low grade distinction advocated by Norris and Taylor, although we append the label "low grade" to all endometrial stromal sarcomas in our diagnosis line to indicate that as uterine sarcomas go, endometrial stromal sarcomas are relatively low grade (22,24).…”

Section: Clinicopathologic Correlationmentioning

confidence: 99%

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