Glassy Cell Carcinoma Research Articles

Conservatively treated glassy cell carcinoma of the cervix

BackgroundVery little data about the conservative treatment of early stage glassy cell cervical cancer have been reported.Case presentationA 30-year old patient, nulligravida was admitted to the Gynecologic Oncology Unit of the Catholic University of Campobasso for irregular post-coital vaginal bleeding. The patients was staged as having FIGO stage IB1 (tumor diameter = 2 cm) squamous cervical cancer. After extensive counseling of the patient and her family, laparoscopic pelvic lymphadenectomy and cold knife conization were performed. The final diagnosis was FIGO Stage IB1 glassy cell carcinoma. Currently, after a follow-up of 38 months, she has no evidence of disease.ConclusionWe reported a case of early stage glassy cell cancer patient, who was conservatively treated by conization and laparoscopic pelvic lymphadenectomy.

Glassy Cell Carcinoma of the Urethra

Glassy cell carcinoma is a poorly differentiated form of adenosquamous carcinoma that has never been reported in the urinary tract. We present the first case of primary glassy cell carcinoma of the urethra in a 48-year-old woman. She presented with a newly developed bulky mass protruding from her urethra. A biopsy of this mass revealed sheets of large polygonal cells with a "ground-glass" cytoplasm among a heavy inflammatory infiltrate, establishing the diagnosis of glassy cell carcinoma of the urethra. Treatment of her tumor included a combined surgical and chemotherapeutic approach.

Glassy cell carcinoma of the endometrium: A case report and review of the literature

Glassy cell carcinomas are composed of malignant cells showing a “ground glass” cytoplasm, distinct cell membranes, and large nuclei with prominent nucleoli. To our knowledge, only 12 cases of glassy cell endometrial carcinomas (EGCC) have been reported until now. A 63-year-old patient complaining of irregular vaginal bleeding underwent hysteroscopy-guided biopsy revealing a well-differentiated endometrial endometrioid adenocarcinoma. The patient underwent left salpingo-oophorectomy, total abdominal hysterectomy, and pelvic lymphadenectomy. The final diagnosis was FIGO stage IB poorly differentiated endometrial adenosquamous carcinoma with >90% of glassy tumor cells. The patient is alive, with no evidence of disease for 69 months after diagnosis. We describe an additional case of EGCC and review the data of the literature, emphasizing the need to strictly define the criteria for the diagnosis and the potential usefulness of assessing biologic parameters for the prognostic characterization of this rare entity.

Glassy Cell Carcinoma of the Cervix

To analyze the cytologic features, estrogen and progesterone receptors, and Her2/neu protein in glassy cell carcinoma (GCC) of the cervix.Cases were analyzed using various parameters, including age at presentation, stage, treatment and clinical course. Between 1990 and 2003, patients with primary cervical carcinomas were treated and cytopathologic analyses performed. Tests for estrogen receptor (ER), progesterone receptor (PR) and Her2/neu protein were performed on paraffin sections.GCC of the cervix is composed of large cells with abundant chromatin, which gives them their characteristic glassy appearance. Eleven cases were identified as GCC. One case (9.1%) was correctly diagnosed from the cervicovaginal smear. Among the GCC cases, ER, PR and Her2/neu were positive in 2 (18.1%), 1 (9.1%) and 5 (45.4%) cases, respectively.Cytology of GCC reveals characteristic features that differ from those of other carcinomas of the cervix. GCC has unique cytologic characteristics and causes diagnostic confusion, possibly leading to incorrect diagnoses. The reason for such low diagnostic precision in cytology might be due to the lack of differentiation and low frequency of this tumor. Our results, demonstrating Her2/ neu overexpression, may correlate with more aggressive behavior and a worse clinical outcome.

A case of glassy cell carcinoma of the uterine cervix that responded to neoadjuvant chemotherapy with paclitaxel and carboplatin

Glassy cell carcinoma of the uterine cervix is a rare tumor, and has a poor prognosis because of its aggressive clinical behavior and resistance to radiotherapy and chemotherapy. We report a case of bulky glassy cell carcinoma of the uterine cervix that effectively responded to paclitaxel and carboplatin in a neoadjuvant setting. The patient was a 30-year-old woman who became aware of vaginal bleeding and was referred to our hospital because of a cancerous tumor of the uterine cervix. Physical examination showed the cervical tumor to be approximately 8 cm in diameter with no involvement of the parametrium or vagina. The biopsy results suggested a diagnosis of glassy cell carcinoma. The final diagnosis was glassy cell carcinoma of the uterine cervix, stage 1b2. Neoadjuvant chemotherapy with paclitaxel and carboplatin was administered for downstaging. The response rate was 67.9% (partial response) under magnetic resonance imaging, and elevated serum cancer-related antigen 125 (119 U/ml) and squamous cancer cell antigen (34 ng/ml) were reduced to 34 U/ml and 3.3 ng/ml, respectively. Following neoadjuvant chemotherapy, she underwent radical hysterectomy and adjuvant chemotherapy with the same regimen. The clinical course was very good. We speculate that glassy cell carcinoma is a sensitive tumor to paclitaxel and carboplatin. Further evaluation concerning diagnosis and treatment, however, is needed to improve the prognosis of patients with glassy cell carcinoma.

Glassy cell carcinoma of the uterine cervix

15050 Background: Glassy Cell Carcinoma of the uterine cervix is a rare, aggressive form of cervical cancer accounting for only 1–5% of all cervical carcinomas. To date, there is no consensus on treatment modalities, but most advocate for a more aggressive treatment strategy including both radical surgery and radiation therapy. The objective of this study was to analyze the clinical features, treatment, and outcome of patients with Glassy cell carcinoma diagnosed at our institution. We hypothesized that such aggressive therapies yield survival benefits which approximate those of the more common squamous cell carcinomas of the cervix. Methods: In collaboration with the Department of Radiation Oncology at Rhode Island Hospital, a retrospective comprehensive chart review of all patients diagnosed with Glassy cell carcinoma of the cervix between the years 1993 and 2005 was undertaken at Women and Infant’s Hospital, Providence, RI. All cases were assessed for clinicopathologic features, treatment strategies, and outcome, including progression free survival and overall survival rates. Results: Twenty-eight patients with biopsy proven Glassy Cell Carcinoma of the cervix were identified. Eleven (39%) were less than age 40, and five (18%) were less than age 30. Of these, 19 were either stage IB or IIA, and 15/19 (79%) received multimodality therapy, a combination of radiation, chemotherapy, and surgery, as initial treatment. When survival was broken down by mode of treatment, 25% of patients who received single modality treatment (either surgery or radiation) were DF at two and five years. In contrast, those patients who were treated with bimodal therapy had a DFS of 93% at 2 years and 84% at 5 years. Thus the survival of patients with glassy cell histology treated at our institution with multimodality therapy approximates the survival of similar stage patients with squamous and adenocarcinoma, with a mean follow-up of greater than 5 years. This represents a distinct improvement when compared to national survival statistics. Conclusions: The favorable survival results of this aggressively treated population, supports the belief that multimodality therapy is preferable in patients with glassy cell carcinoma of the cervix even in early stage disease. However, optimal treatment regimens have yet to be determined and is a field for further study. No significant financial relationships to disclose.

A case of glassy cell carcinoma of the uterine cervix effectively responding to multimodal therapy

A case of glassy cell carcinoma of the uterine cervix effectively responding to multimodal therapy

Human Papillomavirus Typing of Rare Cervical Carcinomas

Most cervical tumors are classified as squamous cell carcinoma or adenocarcinoma, both of which are associated with persistent human papillomavirus (HPV) infection. Although other (rare) types represent less than 5% of all cervical carcinomas, it is necessary that these more unusual tumors be studied in the current era of papillomavirus vaccine development, especially in regions with high incidence of cervical cancer. To compare papillomavirus types found in histologically rare cervical carcinomas (n = 29) with those types found in common cervical carcinomas (n = 14) archived at the Institute of Cancer in Mexico City, Mexico. Paraffin-embedded tissues were received and sectioned at the Louisiana State University Health Sciences Center at Shreveport. One section for each block was stained and examined by 2 pathologists. Specific histologies were categorized into 2 broad groups: common (squamous cell carcinoma or adenocarcinoma) or rare (adenosquamous, papillary, villoglandular, anaplastic, transitional, spindle, adenoid basal, colloid, neuroendocrine, and glassy cell carcinomas). Papillomavirus typing results were based on Roche Molecular Systems line-blot assay. No significant difference was found for dual HPV types (21% of both groups), positivity for HPV-16 (66% of rare tumors and 71% of common tumors), or absence of HPV types 16 or 18, although the rare cancers had a greater tendency toward more unusual HPV types (8/29 rare tumors and 1/14 common tumors had no HPV- 16 or HPV-18 DNA). Non-HPV-16/18 types found only in rare tumors included HPV types 52, 84, 26, 35, and 58. Rare types of cervical carcinoma also are associated with papillomavirus, most with types similar to those found in common cervical neoplasias.

Conventional and array-based comparative genomic hybridization analyses of novel cell lines harboring HPV18 from glassy cell carcinoma of the uterine cervix

We established 2 novel human cell lines (GCCOT-1, GCCRK) from glassy cell carcinoma. Both cell lines showed dual tendencies of glandular and squamous differentiation, and thus possess the characteristics resembling reserve cells, the putative origin of most carcinomas arising from the uterine cervix. HPV type 18 DNA including E6-E7, which is commonly found in cell types other than squamous cell carcinoma of uterine cervix, was detected in both cell lines. We analyzed gene copy number alterations of the 2 cell lines using conventional comparative genomic hybridization (CGH) coupled with array-based CGH. Among the putative oncogenes demonstrating copy number gain in both cell lines, FGR(SRC2) at 1p36.2-1 and LAMC2 at 1q25-31 have not been reported to show amplification in previous analyses of conventional cervical cell lines. These oncogenes are thus speculated to be directly associated with oncogenesis of glassy cell carcinoma. On the other hand, among the putative suppressor genes demonstrating copy number loss in both cell lines, the 9q region, ATM at 11q22.3, and CYLD at 16q12-13 have not been reported to show loss in conventional cervical cancer cell lines. These sites are speculated to be important as tumor suppressors directly associated with oncogenesis of glassy cell carcinoma. This study suggests for the first time that together with the presence of HPV type 18, alterations at the above sites are closely associated with oncogenesis of glassy cell carcinoma, a special type of carcinoma in the uterine cervix.

Glassy cell carcinoma of the uterine cervix a rare histology. Report of three cases with a review of the literature

Glassy cell carcinoma is a poorly differentiated variant of adenosquamous carcinoma of the cervix associated with an aggressive course and a poor prognosis. We present three cases of glassy cell carcinoma of the cervix. Patients presented with a cervical growth which was biopsied. Histology the tumours showed nests of cells with a granular or clear cytoplasm, displaying marked pleomorphism and mitoses. Stroma showed an eosinophilic infiltrate. Two tumours showed a pure glassy cell pattern and one showed glandular differentiation with intracellular and extracellular mucin. Patients were treated with a combination of surgery, radiotherapy and chemotherapy but showed a poor response. Two patients died of the disease of pelvic or distant metastases within two years of diagnosis and one was lost to follow up. Although glassy cell carcinoma runs an aggressive clinical course, an early diagnosis may help in a more effective management and offer a better prognosis.

Microinvasive carcinoma of the cervix

BACKGROUND: Superficially invasive neoplasias of the uterine cervix are a matter of controversy in terms of their definition, prognostic factors and selection of treatment to minimize the risk of recurrences. METHODS: Forty-three women with invasive cervical carcinoma, operated from 1993 to 2003, were postoperatively staged as IA cervical carcinoma. There were 28 patients who were submitted to class III radical hysterectomy, 9 patients to class II hysterectomy, 2 patients to class I hysterectomy, and 2 patients to abdominal trachelectomy and pelvic lymph node dissection. Mean age of patients was 44 years (range, 27-64 years). RESULTS: Twenty-three patients (56.1%) were stage with IA1 and 18 (43.9%) with stage IA2 disease according to the 1995 FIGO classification. Tumor histology revealed squamous cell carcinoma in 38 (92.6%) cases, adenocarcinoma in 2 (4.8%) cases and glassy cell carcinoma in 1 (2.4%). The average number of examined lymph nodes was 17.4 (2-53). Lymphovascular space invasion was identified in 3 patients. None of the 41 patients had metastasis to the pelvic lymph nodes or developed recurrence of disease. CONCLUSION: The results suggest that patients with cervical cancer stage IA1 have an extremely low risk of pelvic lymph node metastasis and an excellent prognosis, so nonradical management that excludes pelvic lymph node dissection could be as effective as radical surgery in these patients. Stage IA2 invasive squamous carcinoma of the cervix should be treated with radical hysterectomy with lymph node dissection considering the presence of risk factors. The treatment should be individualized and based on an exhaustive pathological evaluation of an adequate cone biopsy specimen.

Glassy cell adenocarcinoma of the uterine cervix

Objective Glassy cell carcinoma of the cervix is a rare variant of cervical cancer accounting for a small percentage of cell types. This study was undertaken to review our experience with glassy cell adenocarcinoma. Study design Review of adenocarcinomas from the period 1970 to 1985 was undertaken. Pathology review and survival analysis was performed comparing the glassy cell adenocarcinomas with other adenocarcinoma cell types. Results Twenty-one patients with glassy cell adenocarcinoma were identified. The mean age was 44 years. The stage distribution showed stage I = 10, stage II = 8, stage III = 1, and stage IV = 2. The cumulative survival according to stage was stage I = 50%, stage II = 36%, stage III = 0%, and stage IV = 0%. A separate analysis was performed for stage I comparing glassy cell carcinoma with other stage I adenocarcinoma cell types. The survival for stage I nonglassy cell adenocarcinoma was 61% compared with glassy cell adenocarcinoma 48% (n = 10) ( P = .5). A separate subset for adenosquamous carcinoma alone was performed. The survival for stage I adenosquamous carcinoma (n = 30) was 58%. The survival for adenosquamous glassy cell (n = 5) was 30% ( P = .45). Conclusion Glassy cell adenocarcinoma is a small subset of adenocarcinoma. When compared with other adenocarcinomas, survival is not significantly decreased.

Endocervical adenocarcinoma and its variants: their morphology and differential diagnosis.

Adenocarcinoma of the uterine cervix and its variants account for a much greater number of cases in routine practice of histopathology than they did several decades ago. The varied morphology of these tumours results in diverse problems in differential diagnosis. The overall area of glandular pathology of the cervix, of which invasive adenocarcinoma is only one subset, is further complicated by the fact that there are many benign glandular proliferations of the cervix that can potentially be misinterpreted as adenocarcinoma. In this review the histopathology of endocervical adenocarcinoma and its variants is presented with the emphasis on evaluation of routinely stained sections, still the bedrock of routine practice, relatively little aid being provided by immunohistochemistry or other new techniques, contrary to what is sometimes implied in the literature. Description of the appearance of each subtype of adenocarcinoma or variant thereof is followed by a section on their differential diagnosis. Eighty percent of endocervical carcinomas are of the so-called usual type being characterized by cells with eosinophilic cytoplasm and generally brisk mitotic activity. It is sometimes stated that endocervical adenocarcinomas are mucinous but the usual form just noted often has little or no mucin. Pure or almost pure mucinous adenocarcinoma do occur, however, and have an important subtype, the so-called adenoma malignum (minimal deviation adenocarcinoma). Although treacherous because of its bland cytological features and sometimes deceptive pattern, a cone biopsy or hysterectomy specimen showing this neoplasm typically has easily recognizable features that indicate the presence of an infiltrative adenocarcinoma. An important variant of usual endocervical adenocarcinoma is the well differentiated villoglandular papillary adenocarcinoma, a designation that should be reserved for tumours with grade 1 cytologic features as usual endocervical adenocarcinoma, which is typically grade 2, may have papillae. In our opinion all other variants of pure adenocarcinoma, including endometrioid, are rare and include in addition to the latter clear cell, serous and mesonephric neoplasms. Tumours with a glandular and nonglandular component are also reviewed: adenosquamous carcinoma, glassy cell carcinoma, adenoid basal carcinoma, 'adenoid cystic' carcinoma and adenocarcinoma admixed with a neuroendocrine tumour.

Glassy cell carcinoma of the cervix revisited.

Glassy cell carcinoma (GCC) of the cervix has traditionally been characterized as an aggressive histologic subtype with poor outcomes. An earlier series from our institution supported a grim prognostic outlook, demonstrating a survival rate of only 55% in women with stage I disease. We present a comparison of a contemporary series of patients with GCC. All cases of GCC treated from 1993 to 1999 identified by our tumor registry were reviewed for a variety of clinicopathologic features, treatment strategies, and outcome. A total of 403 cases of invasive cancer of the cervix were identified. There were 22 patients with histologically confirmed GCC, representing only 5.4% of all cervical cancer diagnoses. Patients with GCC had an overall survival of 73% (16/22) and a disease-free survival of 64% (14/22). The incidence of stage I lesions was 64% (14/22). Overall survival of patients with stage I disease was 86% (12/14), with a disease-free survival of 71% (10/14) at a median follow-up of 28.5 months. Seven stage IB lesions were treated with surgery alone, whereas six received adjuvant radiation or chemoradiation following surgery. Two patients in each treatment group recurred, yielding an overall recurrence rate of 29% (4/14). However, of those who recurred with stage I disease, all 4 patients had two or more intermediate risk factors (lymph-vascular space invasion [LVSI], deep tumor invasion, or tumor size greater than 3 cm). Glassy cell carcinoma of the cervix appears to have a better prognosis than previously reported. We observed that intermediate risk histopathologic features identified in squamous cell cohorts are also predictive of a poorer outcome in patients with GCC. Thus, patients with LVSI, deep stromal invasion, and large tumor size are at the highest risk for pelvic relapse and should be candidates for adjuvant treatment.

施設検診で発見された子宮頚部ｇｌａｓｓｙ ｃｅｌｌ ｃａｒｃｉｎｏｍａの３例

背景:施設検診の細胞所見から, 腺扁平上皮癌と診断し, 追跡調査の結果, 子宮頸部glassy cell carcinomaと診断された3例を経験したので, その細胞所見を中心に報告する.症例:症例1; 55歳, 0妊0産, 閉経50歳, 閉経後出血を主訴とする. 特記すべき既往歴なし. 症例2; 47歳, 2妊1産, 水様性帯下を主訴とする. 特記すべき既往歴なし. 症例3; 49歳, 3妊2産, 不正性器出血を主訴とする. 特記すべき既往歴なし.3例ともClass V adenosquamous carcinomaと判定, 生検組織および術後摘出組織の病理組織はいずれも子宮頸部glassy cell carcinomaと診断され, 臨床進行期はそれぞれstage IIb, stage Ib1, stage Ib2であった.結論:3例の細胞像の検討の結果, 子宮頸部glassy cell carcinomaはいくつかの特徴的な細胞所見を有する事が判明し, 注意深い細胞標本の観察から細胞診によっても診断が可能であることが示唆された.

Glassy Cell Carcinoma of the Uterine Cervix

To identify the cytomorphologic features and investigate the expression of estrogen receptor (ER) and progesterone receptor (PR) in glassy cell carcinoma (GCC) of the uterine cervix. A retrospective analysis of nine GCCs encountered at Korea Cancer Center Hospital between January 1990 and April 1999 was undertaken. The cervical smears were obtained prior to histologic diagnosis of GCC. The cytomorphologic and clinical features were reviewed, and the expression of ER and PR was investigated immunohistochemically on histologic sections. Smears of GCC were hypercellular and remarkably cohesive. The tumor cells were large and characterized by abundant granular cytoplasm, distinct cell membranes and round to polygonal, large nuclei with prominent nucleoli. In the background tumor diathesis and numerous inflammatory cells containing eosinophils were present. The inflammatory cells (mainly eosinophils) were intimately associated with tumor cells to form "granuloepithelial complex." Immunohistochemically, ER was identified in two of the nine cases and PR in one of them. Cytology of GCC has characteristic features that differ from those of other carcinomas or atypical reparative cells. Although there are deceptive mimics of GCC, the characteristic cytologic findings should prompt a diagnosis of GCC. ER and PR positivity was found in two cases (22%) and one case (11%), respectively, of GCC, suggesting that this tumor might be hormonally responsive.

Glassy cell carcinoma of the uterine cervix: report of two cases with genetic analysis

Glassy cell carcinoma, a rare cervical malignancy, is a specific type of poorly differentiated adenosquamous carcinoma. Because of the rarity of such tumors, the genetic alterations associated with their development remain unclear. In this study we investigated the possible integration of human papillomavirus and genetic alterations in the p53 tumor-suppressor gene and in ras oncogenes in two patients with this tumor. The genomic DNA of human papillomavirus type 18 was detected by polymerase chain reaction in both tumors. One of the tumors was also positive for the genomic DNA of human papillomavirus type 16. In addition, a mutation in exon 5 of the p53 gene was identified in both tumors, while no mutations were found in the various ras genes examined. Mutation of the p53 gene together with infection by human papillomavirus appears to participate in the tumorigenesis of glassy cell carcinoma.

Response of glassy-cell carcinoma of the cervix to cisplatin, epirubicin, and mitomycin C

Among patients with uterine cervical cancer, glassy-cell carcinoma is very rare. The disease occurs mainly in younger patients, is rapidly progressive, and has a poor prognosis. We describe a case of glassy-cell carcinoma of the uterine cervix, in which preoperative intra-arterial chemotherapy was surprisingly effective.

Glassy cell carcinoma of the uterine cervix

Glassy cell carcinoma (GCC) of the uterine cervix is a rare and highly malignant tumor, accounting for only 1%-2% of all cervical carcinomas. The purpose of this study was to investigate the clinical findings, treatment, and outcome of patients with cervical GCC in the south of Israel.Data from the files of 5 patients with cervical GCC who were managed at the Soroka Medical Center, Beer-Sheva, Israel, between January 1961 and June 1999 were evaluated.Age at diagnosis ranged from 32 to 84 years, with 1 patient pregnant at the time of diagnosis. Vaginal bleeding was the prevailing presenting symptom. The cervical lesion was exophytic in 4 patients and endophytic ("barrel-shaped") in 1 patient. Mean tumor size was 3.9 cm. Three patients with stage IB(1) disease had radical hysterectomy and bilateral pelvic lymph node dissection followed by either external pelvic radiotherapy or brachytherapy or both. All 3 patients were alive without disease 4, 12, and 18 months after initial diagnosis, respectively. One patient with stage IIIB disease had external pelvic radiotherapy alone and died of disease 12 months after initial diagnosis. One patient with stage IVB disease refused treatment and died of disease 3 months after initial diagnosis.Cervical GCC is a rare variant of cervical cancer with distinct histologic features and an alleged aggressive clinical behavior. For early-stage disease, the treatment of choice seems to be radical surgery followed by chemoradiotherapy.

Glassy cell carcinoma of the uterine cervix.

Glassy cell carcinoma (GCC) of the uterine cervix is a rare and highly malignant tumor, accounting for only 1%-2% of all cervical carcinomas. The purpose of this study was to investigate the clinical findings, treatment, and outcome of patients with cervical GCC in the south of Israel. Data from the files of 5 patients with cervical GCC who were managed at the Soroka Medical Center, Beer-Sheva, Israel, between January 1961 and June 1999 were evaluated. Age at diagnosis ranged from 32 to 84 years, with 1 patient pregnant at the time of diagnosis. Vaginal bleeding was the prevailing presenting symptom. The cervical lesion was exophytic in 4 patients and endophytic ("barrel-shaped") in 1 patient. Mean tumor size was 3.9 cm. Three patients with stage IB(1) disease had radical hysterectomy and bilateral pelvic lymph node dissection followed by either external pelvic radiotherapy or brachytherapy or both. All 3 patients were alive without disease 4, 12, and 18 months after initial diagnosis, respectively. One patient with stage IIIB disease had external pelvic radiotherapy alone and died of disease 12 months after initial diagnosis. One patient with stage IVB disease refused treatment and died of disease 3 months after initial diagnosis. Cervical GCC is a rare variant of cervical cancer with distinct histologic features and an alleged aggressive clinical behavior. For early-stage disease, the treatment of choice seems to be radical surgery followed by chemoradiotherapy.