Epithelial Stromal Tumor Research Articles

Rare Seminal Vesicle Cystadenoma: Case Report and Literature Review

Abstract Introduction/Objective Primary neoplasms of seminal vesicles (SV) are rare, with the majority being metastatic tumors, often from prostatic carcinoma. SV cystadenoma is an exceedingly rare benign epithelial tumor that arises from the remnants of the Mullerian duct. The tumor formed of cysts of variable sizes lined by bland cuboidal epithelium. Herein we present a case of SV cystadenoma in a 38-year-old male, underscoring its rarity and risk of progression to higher grades, as outlined in literature review. Methods/Case Report A 38-year-old male with a history of left atrophic kidney and intermittent pelvic pain due to recurrent obstruction of the SV. Pelvic Magnetic Resonance Imaging revealed a 5.3 cm benign unilocular cyst within the SV, along the posterior aspect of the urinary bladder. The patient underwent successful laparoscopic excision of the left SV. Gross examination of the excised SV demonstrated a 3.5X 2.7X 1.5 cm cyst within the SV. Microscopic examination displayed a benign cyst lined by single to multiple layers of cuboidal epithelium, surrounded by unremarkable SV stroma. The epithelial lining cells exhibited round nuclei with inconspicuous nucleoli, lacking dysplasia. Immunohistochemistry revealed positive staining for cytokeratin 7 and PAX 8 in the epithelial cells, whereas prostatic specific antigen staining was negative. Results (if a Case Study enter NA) NA Conclusion Cystadenoma and mixed epithelial stromal tumors of the SV (MEST) are rare entities, with approximately 30 reported cases. This case demonstrates classic histologic features consistent with low-grade MEST, as per recently proposed grading criteria. Notably, a recent case report has suggested a potential for malignant transformation to high-grade dysplasia and adenocarcinoma in SV cystadenoma, as evidenced by focal epithelial dysplasia.

Diagnostic accuracy and replicability of Frozen section diagnosis in Ovarian Masses- A Tertiary health care institutional experience

Introduction: Ovarian neoplasms are a composite group of tumors including surface epithelial, germ cell and sex cord stromal tumors. A subgroup of neoplasms, borderline tumors are also present. The surgical management of each group of neoplasm is varied. Since preoperative diagnosis is arbitrary, the role of the intraoperative frozen section has become beneficial.
 Purpose: In our study, we aimed to evaluate the diagnostic accuracy of the frozen section by comparing it with the definitive histopathological report.
 Methods: This was a 5 years retrospective study (June 2018 to June 2023). Data of the patients have been retrieved from archives of Histopathology from the Department of Pathology. The specimens received, after gross examination few blocks have been prepared on the frozen section and finally processed for routine paraffin sections for the final histopathological report. Then the results of the frozen section and H&E sections were compared and categorized as benign, borderline and malignant to get the accuracy of frozen section.
 Results: Out of 75 frozen section diagnoses included in our study, benign contributed 58.7%, borderline- 13.3% and malignant- 28%. The final paraffin sections revealed benign tumors- 57.3%, borderline- 10.7% and malignant- 32%. There were 7 discordant cases among which 2 were overdiagnosed and 5 were underdiagnosed.
 Conclusion: The overall accuracy rate of our study was 93.7% which is within the limit of the accuracy range reported in the literature. Hence, the intraoperative frozen section is an important diagnostic tool for surgeons in determining the treatment of ovarian masses with certain limitations.

FRI686 Phenotypic Profiling And Molecular Mechanisms In Hyperparathyroidism-jaw Tumor Syndrome

Abstract Disclosure: R. Tora: None. J. Welch: None. J. Sun: None. S.K. Agarwal: None. D.A. Bell: None. M. Merino: None. L.S. Weinstein: None. W.F. Simonds: None. S. Jha: None. Background: Hyperparathyroidism-Jaw Tumor (HPT-JT) syndrome is a heritable form of primary hyperparathyroidism (PHPT) that is associated with tumors in the parathyroid, jaw, kidney, and uterus. We previously presented on the clinical characteristics of primary hyperparathyroidism in our cohort. Methods: We now expand on the report through review of uterine tumors, immunohistochemical staining for parafibromin, sequencing of parathyroid and kidney tumor tissue, and RNA-seq of parathyroid tumors. Results: We identified 68 patients (36 males, 32 females) from 29 kindreds with HPT-JT with median age at last follow-up of 39 [29-53] years. Of these, 7 patients were unaffected (2 males, 5 females). Among females, 12/32 (38%) developed uterine tumors with multiple adenomyomatous polyps, an unusual form of endometrial polyps seen in 10/24 tumors (42%). Given that these types of lesions are very rare in the general population, it is likely that such epithelial-mesenchymal uterine proliferations are a characteristic feature of HPT-JT syndrome.Solid kidney tumors were seen in 4/61 patients (7%). Three had surgery for the tumors - 2/3 were female and had mixed epithelial stromal tumor, while the third patient, a 6-year old male, had metastatic Wilm’s tumor as his initial disease-related manifestation. Among these, two had a germline CDC73 variant at the p.M1 residue while the third patient had the germline variant p.L95P; however, sequencing of his tumor tissue showed a “second hit” at the p.M1 residue resulting in loss of heterozygosity in the tumor. The fourth patient, a female with p.Y55S variant, is being conservatively managed with no kidney surgery yet. All three women with kidney tumors also had a history of uterine tumors. Parafibromin staining of 19 available CDC73 related parathyroid tumors (13 adenomas and 6 carcinoma) did not correlate with histology or genotype. Pathway analysis of 21 parathyroid tumors (8 HPT-JT-related adenomas, 6 HPT-JT-related carcinomas and 7 sporadic parathyroid carcinoma with wild-type CDC73) showed a significant association of HPT-JT-related parathyroid carcinoma with growth, transmembrane receptor protein tyrosine kinase signaling and mesodermal commitment pathways. Conclusion: Multiple, recurrent atypical adenomyomatous uterine polyps appear to be characteristic of HPT-JT syndrome. Our findings support germline testing at a young age in first-degree relatives of patients with HPT-JT given onset of manifestations as early as 6 years. Variants at M1 residue appear to predispose to genitourinary tumors. At present, there are no therapeutic approaches to compensate for CDC73 inactivation. Future research to identify standards of care and therapeutics targets are warranted for this rare disease. Presentation: Friday, June 16, 2023

Annual report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology: Annual Patient Report for 2020 and Annual Treatment Report for 2015.

To provide information including the trend of gynecological malignancies in Japan, we hereby present the annual patient report for 2020 and the Annual Treatment Report for 2015, on the outcomes of patients who started treatment in 2015. The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2020 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2015 was analyzed by using the Kaplan-Meier, log-rank, and Wilcoxson tests. Treatment was initiated in 2020 for 7689 patients with cervical cancer, 13 113 with endometrial cancer, 8004 with ovarian, tubal, and peritoneal cancer, 2152 with ovarian borderline tumors, and with the others (260 vulvar cancer, 157 vaginal cancer, 464 uterine sarcoma, 50 uterine adenosarcoma, 136 trophoblastic diseases). This clinicopathological information was summarized as the patient annual report. The 5-year survival rates of the patients with cervical cancer were 92.3%, 76.2%, 56.5%, and 32.2% for Stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with endometrial cancer were 93.9%, 87.6%, 71.4%, and 29.3% for Stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with ovarian cancer (surface epithelial-stromal tumors) were 91.7%, 80.6%, 50.8%, and 39.7% for Stages I, II, III, and IV, respectively. The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.

Mixed Epithelial Stromal Tumour Kidney: Report of Two Cases, Benign and with Malignant Transformation

Mixed Epithelial Stromal Tumor kidney (MESTK), is a rare renal tumor, with stromal as well as epithelial components. It is predominantly benign with rare malignant transformation as morphology resembling that of a stromal sarcoma, carcinosarcoma, rhabdomyosarcoma, chondrosarcoma, undifferentiated sarcoma, or malignant tumour with rhabdoid features. Here we present 2 cases of MEST of kidney both are middle aged females with history of episodes of hematuria. Radiology of both showed heterogenous lesion. Histopathological and IHC findings favoured a diagnosis of first case as MEST kidney benign entity and second case as MEST with malignant transformation.

A STUDY OF OVARIAN CYST MANAGED OPERATIVELY AT TERTIARY HOSPITAL, CIVIL HOSPITALAHMEDABAD

Ovarian neoplasm is the most common lesion seen in female of any age group. Ovarian cancer not an uncommon clinical entity among all [1] gynecologic tumors and is the most fatal gynecologic malignancy. Ovarian cyst can be physiological or pathological. Physiological cysts are mainly follicular cysts and luteal cysts which are benign in nature. Pathological cysts are mainly ovarian tumors which can be benign, [2] borderline or malignant. Benign diseases of ovary are commonest accounting for 90% of ovarian diseases. Benign lesions of ovary are two types non-neoplastic and neoplastic. Benign cysts are often asymptomatic and may be detected on ultrasound performed for some other cause or on routine scan. They may be symptomatic due to [3] complications or large size when they require treatment. Benign tumors are more common in young females and malignant tumors are [4] more common in elderly females. According to World Health Organization histological classication ovarian tumors are subdivided into surface epithelial stromal tumors, sex cord stromal tumors, germ cell tumors, malignant and not otherwise specied and metastatic non ovarian tumors from non-ovarian primary according to the tissue of origin. Germ cell tumors is the commonest benign tumor and epithelial [5] cell tumor is the commonest malignant one. However, diagnosis could be made only after the histopathological examination of ovarian cysts

Cervical Cancers: Varieties and the Lower Anogenital Squamous Terminology.

Carcinoma of cervix is classified as per the WHO classification into primary tumors which are predominantly epithelial tumors, mesenchymal tumors and tumor like lesions, mixed epithelial stromal tumors, melanocytic, germ cell, and lymphoid tumors. Secondary tumors are uncommon. Squamous cell carcinoma (SCC) in various morphological forms needs to be separated from other epithelial tumors for treatment modality selection. Majority of SCC are human papilloma virus (HPV) positive. The histological pattern, HPV type, and grading do not affect prognosis. Mixed mesenchymal and epithelial tumors are of Mullerian origin. Among sarcomas, Botryoid rhabdomyosarcoma needs to be looked for, as a small biopsy may miss it. Carcinoma cervix is not the only cancer caused by HPV. High-risk HPV is implicated in causation of various other cancers such as anal cancers, oropharyngeal cancers, vulval cancers, vaginal cancers, and penile cancers. Low-risk HPV viruses similarly cause infections of perianal and genital region in males and females. The terminology for these lesions has evolved before understanding of pathogenesis of low- and high-risk HPV. The lower anogenital squamous terminology (LAST), an acronym for LAST, incorporates the low- and high-grade squamous intraepithelial lesion (HSIL) terminology. In invasive cancers, a superficially invasive SCC is a well-defined entity. LAST outlines areas where p16 use is recommended. No benefit of addition of other biomarkers like p63 or ki67 is found in problem-solving in differentiation of HSIL from mimics or low-grade squamous intraepithelial lesion. Routine use of biomarkers is not advocated.

Annual report of the committee on gynecologic oncology, the Japan Society of Obstetrics and Gynecology: Annual patient report for 2019 and annual treatment report for 2014.

To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2019 and the Annual Treatment Report for 2014, on the outcomes of patients who started treatment in 2014. The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2019 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2014 was analyzed by using the Kaplan-Meier, log-rank, and Wilcoxson tests. Treatment was initiated in 2019 for 7983 patients with cervical cancer, 12 631 with endometrial cancer, 7737 with ovarian, tubal, and peritoneal cancer, 2222 with ovarian borderline tumors, and with the others (251 vulvar cancer, 148 vaginal cancer, 476 uterine sarcoma, 43 uterine adenosarcoma, 175 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients with cervical cancer were 92.5%, 76.8%, 58.6%, and 29.5% for stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with endometrial cancer were 94.5%, 87.3%, 70.2%, and 26.5% for stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with ovarian cancer (surface epithelial-stromal tumors) were 90.72%, 80.4%, 53.4%, and 31.6% for stages I, II, III, and IV, respectively. The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.

Influence of Estradiol-Producing Ovarian Tumors on the Maturation Index of Cervical Cytology in Postmenopausal Women

Introduction: The aim of the study was to evaluate the influence of estradiol-producing ovarian tumors, including surface epithelial-stromal tumors, on the cervical cytology of postmenopausal women. Methods: This case-controlled study included 160 postmenopausal women who underwent a gynecological surgery between January 2009 and December 2016. The relationship between serum estradiol levels and the maturation index of cervical cytology was examined. Patients with ovarian tumors and a high estradiol level (≥28 pg/mL) constituted the estradiol-producing ovarian tumor group (30 women, including 23 with surface epithelial-stromal tumors). The maturation index of this group was compared with that of the control group (130 women with normal estradiol levels [<28 pg/mL] with either ovarian tumors or uterine tumors). Results: For all patients, the serum estradiol levels were significantly correlated with the maturation index (p < 0.001, r = 0.65). The maturation index of the estradiol-producing ovarian tumor group was significantly higher than that of the control group (0.67 ± 0.21 vs. 0.075 ± 0.16, p < 0.001). The area under the receiver operating characteristic curve for the maturation index was 0.94. The best maturation index cut-off level for estradiol-producing ovarian tumors was 0.20. Using this cut-off, the sensitivity and specificity were 94% and 82%, respectively. Conclusion: Estradiol-producing ovarian tumors influence cervical epithelial maturation in postmenopausal women. An increased maturation index may trigger the early detection of asymptomatic ovarian tumors.

Granulomas associated with renal neoplasms: A multi-institutional clinicopathological study of 111 cases.

Formal depiction of granulomatous inflammation associated with renal neoplasms has mainly consisted of case reports. Herein, we investigate the clinicopathological features and potential significance of granulomas associated with renal tumours from a large multi-institutional cohort. One hundred and eleven study cases were collected from 22 institutions, including 57 partial nephrectomies and 54 radical nephrectomies. Patient ages ranged from 27 to 85 years (average = 60.1 years; male = 61%). Renal neoplasms included clear cell renal cell carcinoma (RCC; 86%), papillary RCC (8%), chromophobe RCC (3%), clear cell papillary RCC (1%), mixed epithelial stromal tumour (1%) and oncocytoma (1%). Granulomas were peritumoral in 36%, intratumoral in 24% and both in 40% of cases. Total granuloma count per case ranged from one to 300 (median = 15) with sizes ranging from 0.15 to 15 mm (mean = 1.9 mm). Necrotising granulomas were seen in 14% of cases. Histochemical stains for organisms were performed on 45% of cases (all negative). Sixteen cases (14%) had a prior biopsy/procedure performed, and eight patients had neoadjuvant immunotherapy or chemotherapy. Eleven patients (10%) had a confirmed diagnosis of sarcoidosis, including five in whom sarcoidosis was diagnosed after nephrectomy. Based on this largest case-series to date, peri-/intratumoral granulomas associated with renal neoplasms may be more common than initially perceived. The extent of granulomatous inflammation can vary widely and may or may not have necrosis with possible aetiologies, including prior procedure or immunotherapy/chemotherapy. Although a clinical association with sarcoidosis is infrequent it can still occur, and the presence of granulomas warrants mention in pathology reports.

Annual report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology: Annual Patient Report for 2018 and Annual Treatment Report for 2013.

To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2018 and the Annual Treatment Report for 2013, on the outcomes of patients who started treatment in 2013. The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2018 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2013 was analyzed by using the Kaplan-Meier, log-rank, and Wilcoxson tests. Treatment was initiated in 2018 for 7304 patients with cervical cancer; 11 230 with endometrial cancer; 7031 with ovarian, tubal, and peritoneal cancer; 2072 with ovarian borderline tumors; and with the others (222 vulvar cancer, 159 vaginal cancer, 413 uterine sarcoma, 54 uterine adenosarcoma, and 135 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients with cervical cancer were 93.1%, 75.9%, 59.1%, and 31.2% for Stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with endometrial cancer were 94.1%, 89.2%, 73.6%, and 25.8% for Stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with ovarian cancer (surface epithelial-stromal tumors) were 89.7%, 76.8%, 49.1%, and 32.4% for Stages I, II, III, and IV, respectively. The annual report is important to provide knowledge on gynecological malignancy trends in Japan.

HPV-Induced MiR-21 Promotes Epithelial Mesenchymal Transformation and Tumor Progression in Cervical Cancer Cells through the TGFβ R2/hTERC Pathway.

Cervical cancer (CC) is a common malignant tumor in women. It ranks first among the malignant tumors of woman reproductive organs and is one of the most important cancers in the world. Current studies suggest that human papillomavirus (HPV) infection, especially high-risk persistent infection, is the basic cause of cervical precancerous lesions and cervical cancer. MicroRNA-21 (miR-21) plays a role similar to oncogenes in the occurrence and growth of malignant tumors and can be developed as a potential target for treating malignant tumors. Recently, the study of the mechanism of malignant invasion and metastasis has made great progress. The current consensus is that the invasion and metastasis of malignant tumors is a complicated biological process with multistep and multigene control; the process of epithelial mesenchymal transition (EMT) may be the initial event of invasion and metastasis of epithelial malignant tumors. EMT means that epithelial cells obtain the characteristics of mesenchymal cells, which has main characteristics such as the loss of epithelial cell characteristics and the achievement of mesenchymal cell features, and then induce epithelial cells to acquire the ability of migration and invasion, and participate in many physiological and pathological processes of human body, including embryogenesis, organ differentiation, tissue inflammation, and wound healing. Research has proved that miR-21 is associated with the invasion and metastasis of cervical cancer, and its specific mechanism has not been completely clear; EMT exerts a significant effect on the invasion and metastasis of epithelial malignant tumors; we speculate whether miR-21 regulates the EMT process of cervical cancer cells. ELISA and RT-PCR studied HPV-induced cervical cancer cells, and it was found that HPV may induce miR-21 to pass through the TGF β R2/hTERC pathway which promotes epithelial stromal transformation and tumor progression of cervical cancer cells.

Mixed Epithelial and Stromal Tumor Family of Kidney (Adult Cystic Nephroma, Mixed Epithelial and Stromal Tumor): Retrospective Clinicopathological Evaluation.

Tumors belonging to the mixed epithelial stromal tumor family (MESTF) are rare; thus clinicopathological experience about them are limited. Each epithelial and stromal component shows different patterns in these tumors. Clinicopathological features of 11 MESTF cases that were diagnosed between 2000 and 2021 at a single center were evaluated. Ten of the 11 patients were female (F:M = 10:1). The mean age of the females was 47 (31-63) years; the male patient was 45 years old. The mean tumor diameter was 6.7 (3.5-19) cm. All tumors had varying proportions of cystic and solid components. Eight cases were well circumscribed, and the others had distinct but irregular borders. Two of the tumors with irregular borders were bulging into the renal sinus. The epithelial component was dominant in most cases. In the epithelial component, macrocyst, microcyst, and tubules were the most common patterns and the most common types of lining epithelium were flat, cuboidal and hobnail. The stromal component was variable in most cases and included hypocellular (mostly collagenous) and cellular areas. In most cases, the cellular stroma had an ovarian-like appearance. Among the other features observed, hyalinization and dystrophic calcification were common. The positivity for estrogen and progesterone receptor in the stromal component was observed in almost all female cases. MESTF, which has distinctive features, should be considered in the differential diagnosis of cystic kidney tumors.

Analysis of the malignant ovarian tumors incidence in the Sumy region in 2014-2018.

Background. Ovarian cancer is a very important pathology of the female reproductive system and tends to increase in incidence and mortality rates around the world. Despite the fact that ovarian cancer prevalence is lower than that of breast and cervical cancer, its mortality rate is three times higher. Aim. To analyze the incidence of ovarian cancer in the female population of Ukraine and the Sumy region in 2014–2018. Methods. Data from the National Cancer Register of Ukraine were used for this work. A statistical analysis of the incidence rates of ovarian cancer in the population of Ukraine and Sumy region was carried out. Results. The highest incidence of ovarian cancer in the Sumy region was detected in 2018 (12.5 cases per 100,000 women), and the lowest - in 2017 (10.4 cases per 100,000 women). This pathology occurs most often in women 60-79 years old. 91% of the tumors were epithelial-stromal tumors, of which 75% were serous ovarian adenocarcinomas. Ovarian cancer in most cases was diagnosed at the third stage of the disease (47% of cases), which indicates a low level of early diagnosis of this tumor. Conclusion. In the Sumy region, a high incidence rate of ovarian cancer was revealed, which exceeds the national one and has a significant age dependence. Serous ovarian adenocarcinoma is the most common type of ovarian cancer. This pathology is diagnosed mainly at the 3rd stage.

Fever and Abdominal Pain in a 10-year-old with Autism.

Fever and Abdominal Pain in a 10-year-old with Autism.

Cystadenoma of the seminal vesicle – Potential diagnostic pitfall: A case report and literature review

Background: Cystadenomas of the seminal vesicles are benign cystic tumours, currently classified into the group of mixed epithelial-stromal tumours (MEST). Primary tumours arising in the seminal vesicles are quite rare, benign tumours being rarer than malignant ones, with only a few cases reported in the English literature since 1944. Cystadenomas represent a potential diagnostic pitfall, as they can be clinically confused with malignant neoplasms and histologically with non-neoplastic inflammatory lesions or other cystic tumours, even malignant. Objective and methods: We report a case of a 23-year-old man presenting with a cystic mass of the seminal vesicle, clinically suspected to be a malignant neoplasm. On pathological examination, a diagnosis of cystadenoma was made. Diagnostic criteria to make a diagnosis of this tumour are questionable. Therefore, we carried out a literature review in attempt to compare clinico-pathological findings of 28 cases reported in the English literature as cystadenomas of the seminal vesicle. Results: Only 28 cases of cystadenomas of seminal vesicles were reported in the English literature. The available data show the difficulty to rule out malignancy preoperatively in a patient with a solid-cystic mass in the pelvic region, and that morphological findings observed were often reported incompletely. Conclusions: The current classification appears debatable, as well as histopathological criteria to diagnose a cystadenoma of the seminal vesicle. For the proper management of these lesions, a multidisciplinary approach is mandatory. Level of evidence: Not applicable

Annual report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology: Annual patient report for 2017 and annual treatment report for 2012.

To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2017 and the Annual Treatment Report for 2012, on the outcomes of patients who started treatment in 2012. The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2017 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial and ovarian cancer in 2012 was analyzed by using the Kaplan-Meier, log-rank and Wilcoxon tests. Treatment was initiated in 2017 for 7710 patients with cervical cancer; 11 120 with endometrial cancer; 7029 with ovarian, tubal and peritoneal cancer; 2164 with ovarian borderline tumors; and with the others (213 vulvar cancer, 139 vaginal cancer, 366 uterine sarcoma, 41 uterine adenosarcoma and 131 trophoblastic diseases). This clinicopathological information was summarized as the patient annual report. The 5-year survival rates of the patients with cervical cancer were 92.9, 75.5, 58.2 and 26.7% for stages I, II, III and IV, respectively. The 5-year survival rates for the patients with endometrial cancer were 93.6, 85.6, 72.6 and 27.3% for stages I, II, III and IV, respectively. The 5-year survival rates for the patients with ovarian cancer (surface epithelial-stromal tumors) were 92.5, 83.5, 49.5 and 30.8% for stages I, II, III and IV, respectively. The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.

Sonographic Evaluation of Serous Cystadenofibroma With Evidence of Intermittent Torsion

Serous cystadenofibromas are benign surface epithelial stromal tumors of the ovary. Many of the sonographic features of serous cystadenofibromas mimic what are traditionally considered possible characteristics of malignancy. Depending on the size of the ovarian neoplasm, there can be increased risk for ovarian torsion. Meticulous sonographic evaluation and appropriate optimization are critical for establishing the risk for malignancy and likelihood of torsion. This case describes how sonography was used to help identify a serous cystadenofibroma in a postmenopausal woman.

Intraluminal Colon Metastases from Ovarian Serous Adenocarcinoma: An Unusual Site for Metastatic Deposit

Surface epithelial stromal tumors are the most common tumors of the ovary. Hematogenous spread is responsible for the distant metastases. The most common sites of distant metastases are pleura, liver, lung, and bones. Some rare sites of metastases are eyes, skin, breast, CNS, heart, central airways, stomach, colon, and placenta. We report a case of 68-year-old female with serous adenocarcinoma of ovary and synchronous involvement of the colon by poorly differentiated ovarian carcinoma. The diagnosis was confirmed by immunohistochemistry. It is a rare occurrence and it was unusual presentation with ominous prognosis for the patient.

REPETITIVE OVARIAN TORSION AS WARNING SIGN OF SEROUS AND MUCINOUS CYSTADENOMA IN CHILDREN - REPORT OF TWO CASES

Cystadenomas are surface epithelial-stromal tumors. Although they are the most common type of ovarian tumor, seen mostly from late adolescent age, yet, they remain difficult to accurately diagnose clinically due to their diverse presentations similar to other diseases like functional cyst and appendicitis. We report the cases of two pediatric patients. The first one aged seventeen years and six months old with serous cystadenoma and the second patient aged seventeen years and three months old with mucinous cystadenoma, presenting with abdominal pain in the level of the right iliac fossa and abdominal pain in the inferior part of the abdomen respectively aiming to reveal some warning signs and particularities in diagnosis and management of female pediatric patients with ovarian cystadenomas. Conclusion: Recurrent ovarian torsion or recurrent cyst formation is a warning sign of mucinous cystadenoma and serous cystadenoma tumor requiring further investigations and treatment.