Mixed mesodermal tumors of the ovary: A clinicopathologic study of 14 cases

Dinh, Tung Van; Slavin, Richard E.; Bhagavan, Belur S.; Hannigan, Edward V.; Tiamson, Esperanza M.; Yandell, Roger B.

doi:10.1016/0020-7292(89)90769-8

Cited by 25 publications

(36 citation statements)

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“…Table I shows good correlation between PAP and histologic type of cancer. Cases 5,8,and 15 show endometrioid and case 6 shows serous type adenocarcinoma both by PAP smears 42 and in the carcinomatous component of the CS by histology. Case 14 shows squamous carcinoma and case 18 shows squamous dysplasia by PAP correlating with adenosquamous histology of carcinomatous component.…”

Section: Discussionmentioning

confidence: 97%

Cervicovaginal cytology in carcinosarcoma [malignant mixed mullerian (mesodermal) tumor] of the uterus

Costa

Tidd

Willis

1992

Diagnostic Cytopathology

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We examined the cervicovaginal cytology (PAP) findings in a series of 21 endometrial and 2 cervical carcinosarcomas (CS) [malignant mixed mullerian (mesodermal) tumors] (MMMT). Initial cytology diagnosis was positive for cancer in 14 of 23 cases (sensitivity of 61%); however, CS was correctly identified only 2 times. The remaining 12 cancer diagnoses were carcinomas: 10 adenocarcinomas (4 endometrial, 1 cervical, and 5 adenocarcinomas not otherwise specified), 1 squamous carcinoma, and 1 poorly differentiated carcinoma. Seventeen smears were available for review, all 8 false negative, one unsatisfactory, and 8 of 14 true positive smears. One false negative smear showed rare clusters diagnostic of adenocarcinoma. The remaining 7 false negative smears showed 3 high grade squamous dysplasias (two with additional findings: one showed atypical spindle cells and the other showed endometrial stromal cells), 2 extensive repair changes, and 2 negatives. The unsatisfactory smear showed atypical spindle cells. Review of the 8 true positive smears confirmed malignant spindle cells in the two cases originally identified as CS by cytology and in 3 other cases originally identified as adenocarcinoma. Of 9 smears positive for cancer available for review, 4 showed only carcinoma cells. PAP positive for cancer was associated with high stage at presentation (P less than .025) and recurrent disease (P less than .001) (even among stage I or II patients, P less than .025). PAP positive for cancer showed no association with depth of myometrial invasion, size, grade, or histologic type of carcinosarcoma. The results of this study demonstrate the importance of consultative cytology reporting in which recommendations for appropriate biopsy are included in the report.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 97%

Cervicovaginal cytology in carcinosarcoma [malignant mixed mullerian (mesodermal) tumor] of the uterus

Costa

Tidd

Willis

1992

Diagnostic Cytopathology

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“…The 5-year survival of patients with carcinosarcoma is reported to be 18% to 39%. [8][9][10] Hysterectomy with pelvic lymph node dissection is the standard treatment of choice, and systemic adjuvant therapies should often be considered in cases with extra-uterine tumor spread. 11) However, chemotherapies are usually insufficient to control the growth of the metastatic foci.…”

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confidence: 99%

Different expression patterns of KIT, EGFR, and HER‐2 (c‐erbB‐2) oncoproteins between epithelial and mesenchymal components in uterine carcinosarcoma

Sawada

Tsuda²,

Kimura³

et al. 2003

Cancer Science

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Uterine carcinosarcoma histologically comprises the components of epithelial and mesenchymal malignancies, and is known to be clinically highly aggressive. To reveal the significance of the expression of tyrosine-kinase-receptor-type oncoproteins in this tumor type, the incidence and distribution of the KIT, EGFR, and HER-2 (c-erbB-2) oncoproteins were immunohistochemically examined in 16 surgically resected cases. For 6 cases, the EGFR and HER-2 amplifications were also examined by fluorescence in situ hybridization (FISH). In the epithelial component, overexpressions of KIT, EGFR, and HER-2 were detected in 4 (25%), 5 (31%), and 9 (56%) cases, respectively, whereas these overexpressions in the mesenchymal component were detected in 6 (38%), 8 (50%), and 1 (6%) cases, respectively. KIT and EGFR were co-overexpressed in the mesenchymal component of 4 cases and in the epithelial component of 2 cases. However, HER-2 overexpression was mostly ancer of the uterine corpus is one of the most common gynecological malignancies in North America and North Europe, and its incidence is increasing in Asia and Africa. Most cases are detected at the early clinical stages and classified as histologically low-grade endometrioid carcinoma, and have an excellent clinical outcome after surgical treatment. On the other hand, a minor fraction of the cancer of the uterine corpus, comprising histologically high-grade endometrioid carcinoma, serous adenocarcinoma, clear cell adenocarcinoma, and carcinosarcoma, frequently shows metastasis and relapse after surgery.Carcinosarcoma, formerly called malignant mixed mesodermal tumor, or malignant mixed müllerian tumor, accounts for approximately 2% to 5% of all malignancies of the uterine corpus.1) It had been believed that the uterine carcinosarcoma originates from immature müllerian duct cells that have a potential to differentiate into both epithelial and mesenchymal cells. However, it is a widely accepted idea today that uterine carcinosarcoma is derived from a single cell clone of epithelial cells of endometrial glands [2][3][4][5][6][7] and that the sarcomatous cells emerge as a subclone from the carcinoma cells through mesenchymal metaplasia. 7)Uterine carcinosarcoma tends to be clinically diagnosed at the advanced stages. The 5-year survival of patients with carcinosarcoma is reported to be 18% to 39%.8-10) Hysterectomy with pelvic lymph node dissection is the standard treatment of choice, and systemic adjuvant therapies should often be considered in cases with extra-uterine tumor spread.11) However, chemotherapies are usually insufficient to control the growth of the metastatic foci.The overexpression of proto-oncogenes has been identified in various human cancers in recent years. The EGFR (HER-1, cerbB-1) proto-oncogene, located on chromosome arm 7p21, and the HER-2 (c-erbB-2) proto-oncogene, located on chromosome arm 17q11.2-q21, encode growth factor receptors with tyrosine kinase activity. The EGFR oncoprotein is frequently overexpressed in various spectra of carcinomas, 12, 13) w...

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“…Transplantation of DMH-induced uterine sarcoma into the uterine wall may provide a better test of the hypothesis. Human uterine sarcomas have a wide spectrum of metastatic sites, the most prominent being lung and peritoneum [6][7][8][9][10]. However, metastasis into the gastro-intestinal tract (particularly intestine) is also a frequent finding.…”

Section: Discussionmentioning

confidence: 99%

Sarcomatous lesions in CBA female mice treated with 1,2-dimethylhydrazine: independent primaries or metastases?

Trukhanova

Turusov

1995

Clin Exp Metast

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CBA female mice treated with 1,2-dimethylhydrazine (DMH) alone or in combination with oestradiol dipropionate (EP) or ascorbic acid (AA) developed, as expected, a high incidence of uterine sarcomas. In addition, sarcomatous lesions at unusual sites (mainly in the forestomach) were evident. The incidence of sarcomatous lesions at other sites was 53/220 in mice having uterine sarcomas and 0/186 in mice treated with DMH but without uterine sarcomas. The difference between the two groups was highly statistically significant (P < 0.001) and demonstrates non-coincidental association of the above sarcomatous lesions with uterine sarcomas. Uterine sarcomas which presented in association with lesions at other sites were of a larger size than those found in isolation, and the difference in weights in three out of four groups was statistically significant (P = 0.008, 0.035 and 0.011). Histologically, sarcomatous lesions were similar in structure to those of uterine sarcomas, i.e. were of a fibroblastic-histiocytic nature with admixture of giant cells. On the basis of the above data the sarcomatous lesions described appear to represent uterine sarcoma metastases rather than independent primary tumours. AA did not have any influence on carcinogenesis induced by DMH alone but inhibited the growth of uterine sarcomas (whether or not they were associated with other sarcomatous lesions) induced by DMH combined with oestradiol dipropionate.

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Mixed mesodermal tumors of the ovary: A clinicopathologic study of 14 cases

Cited by 25 publications

References 0 publications

Cervicovaginal cytology in carcinosarcoma [malignant mixed mullerian (mesodermal) tumor] of the uterus

Cervicovaginal cytology in carcinosarcoma [malignant mixed mullerian (mesodermal) tumor] of the uterus

Different expression patterns of KIT, EGFR, and HER‐2 (c‐erbB‐2) oncoproteins between epithelial and mesenchymal components in uterine carcinosarcoma

Sarcomatous lesions in CBA female mice treated with 1,2-dimethylhydrazine: independent primaries or metastases?

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