Primary Papillary Serous Carcinoma Research Articles

Bilateral primary papillary serous carcinoma of the fallopian tube – A rare case scenario

Bilateral primary fallopian tube carcinoma is a very rare case scenario. Approximately, its incidence is 0.02% of all the gynecological malignancy. A 40-year-old female patient visited the hospital with complaints of lower abdominal pain for 3 months. Ultrasound of the pelvis shows complex bilateral adnexal lesions with ORADS score 4 – intermediate risk. The serum CA-125 is elevated. The provisional diagnosis of bilateral pyosalpinx was made. The uterus with bilateral ovaries and fallopian tubes was removed. On histopathology, thus, the final diagnosis of primary bilateral papillary serous carcinoma of the fallopian tube was made. Bilateral primary fallopian tube carcinoma is a very rare case scenario. Intraoperative frozen study is to be done to diagnose this entity. The high degree of suspicion is required to diagnose a case of bilateral fallopian tube carcinoma as it is a very rare case scenario and usually confused for pyosalpinx.

Primary papillary serous carcinoma presenting as acute ovarian torsion in postmenopausal woman: a case report

A 51-year-old postmenopausal woman, with an uneventful past gynecologic history, was admitted to the present hospital with a diagnosis of severe pelvic pain due to a suspected ovarian torsion treated with different drugs intravenously without any improvement of symptoms. As a consequence of the increasing pelvic pain, a laparoscopic surgical treatment was decided: a left necrotic ovarian mass and pelvic peritoneal carcinomatosis were visualized and the procedure was converted from laparoscopy to laparotomy that confirmed a diagnosis of primary ovarian papillary serous carcinoma and permitted an adequate treatment. This is a rare case in literature of severe pelvic pain due to an acute ovarian torsion that permitted a prompt diagnosis and treatment of malignancy.

Primary Papillary Serous Carcinoma of the Fallopian Tube Presenting as a Vaginal Mass: A Case Report and Review of the Literature

Patient: Female, 41Final Diagnosis: Serous papillary carcinomaSymptoms: Vaginal discharge • weaknessMedication: —Clinical Procedure: Total abdominal hysterectomySpecialty: Obstetrics and GynecologyObjective:Unusual clinical courseBackground:There is now evidence to support that some cases of high-grade serous papillary carcinoma arise from the fallopian tubes rather than the ovaries. Common symptoms at presentation include abdominal pain and swelling, vomiting, altered bowel habit and urinary symptoms. To our knowledge, this is the first case of serous papillary carcinoma presenting as a vaginal mass lesion.Case Report:A 41-year-old woman was referred to the Bnai-Zion Medical Center with the main complaint of irregular vaginal bleeding, vaginal mucous discharge, and suspected pelvic mass. Physical examination showed a soft, painless mass, measuring about 10 cm in diameter located mainly in the recto-vaginal septum, but not involving the uterus. Ultrasound examination showed no abnormal ovarian or uterine findings. Transvaginal biopsies of the mass showed a poorly differentiated serous papillary carcinoma of ovarian, tubal, or peritoneal origin. The physical examination and imaging findings strongly indicated an inoperable tumor, and the patient was treated with neoadjuvant (pre-surgical) chemotherapy. Pre-operative computed tomography (CT) imaging showed the partial involvement of the colon, and so surgical treatment included total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, partial vaginectomy, anterior rectal resection, and lymph node dissection. Histopathology of the surgical specimens showed a poorly differentiated serous carcinoma originating from the fimbria of the right fallopian tube.Conclusions:To the best of our knowledge, this is the first report to describe primary fallopian tube papillary serous carcinoma presenting as a vaginal mass. Therefore, physicians should be aware of this possible diagnosis.

Complications of Acute Pancreatitis Misdiagnosed as Primary Serous Papillary Carcinoma

Complications of Acute Pancreatitis Misdiagnosed as Primary Serous Papillary Carcinoma

Carcinoma Seroso Papilar Peritoneal Primario: serie de casos Hospital Clínico Universidad de Chile 2010-2015

The primary peritoneal cancer is a low prevalence disease, within which primary papillary serous carcinoma of the peritoneum is the most frequent with an incidence of 6.78 cases per million inhabitants. Predominates in females and its main differential diagnosis is advanced ovarian papillary serous carcinoma, for which immunohistochemis­try and clinical and pathological classifications are the way to differentiate base on the World Health Organization classification for tumor lesions. Objective: Describe the immunohistochemical results of a series of cases studied in Universidad de Chile Clini­cal Hospital and to compare them with the literature. Material and Methods: Descriptive retrospective study based on analysis of biopsies from 12 cases between January 2010 and March 2015 classifying them according to age, sex and biopsy register. Routine histological te­chnique was performed in addition to the immunohistochemical staining for WT1, cytokeratin and other reagents according to the differential diagnoses. Results: The age distribution was 47 to 75 years, mean 60 years, 100% of cases female. Immunohistochemical reagents were predominant WT1 (53.8%) and cytokeratin-7 (38.5%). Conclusion: This carcinoma is a rare entity in routine clinical practice, with similarities to ovarian serous carci­noma. There is consensus on the diagnosis of this condition, which must be oriented according to the criteria of the Gynecologic Oncology Group. Clinical suspicion can lead the pathologist to perform immunohistochemical study and thus have an accurate diagnosis to determine the therapeutic approach of the surgeon.

Primary Papillary Serous Carcinoma of the Peritoneum

Primary papillary serous carcinoma of peritoneum (PPSCP) is a rare type of primary peritoneal adenocarcinoma and is clinico-histopathologically indistinguishable from primary ovarian papillary serous carcinoma. A 70 -year- female presented with pain abdomen of 4 months duration. On examination partially mobile vague mass was present in the suprapubic region. Exploratory laparotomy revealed normal right ovary and the left ovary showed simple cyst. Nodular, firm tumour was seen arising from omentum and measured 20x13x9.3 cm. Microscopically tumour was composed of large sheets of polygonal cells having large hyperchromatic and pleomorphic nuclei and moderate amount of eosinophilic cytoplasm forming cribriform pattern and papillae. It has similar prognosis as that of ovarian malignancy. This case of extraovarian papillary serous carcinoma of peritoneum (EPSCP) is presented here for its rarity.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 60-62 DOI: http://dx.doi.org/10.3126/njog.v8i2.9774

Primary papillary serous carcinoma of the peritoneum

Primary papillary serous carcinoma of the peritoneum (PSCP) is a rare malignant neoplasm of epithelial origin seen only in women, and closely mimics serous ovarian papillary carcinoma except for the absence of ovarian involvement in PSCP on imaging. It is primarily a peritoneal disease with imaging findings simulated by other conditions that have a predominant peritoneal involvement.

Primary Papillary Serous Carcinoma of Cervix: A Rare Variant of Cervical Malignancy

Papillary serous carcinoma of the uterine cervix is a very rare tumour, and is a recently described variant of cervical adenocarcinoma. It is an aggressive tumour with unpredictable course and poor prognosis. The incidence of cervical adenocarcinoma is 5–15%. This variant accounts for less than 50 cases in literature, has bimodal age distribution with one peak occurring less than 40 years and other occurring greater than 65 years age groups. Here, we present a 53 year-old woman presented with severe low backache and lump abdomen of 4 months duration. Per vaginal examination showed endophytic growth high up in the cervix. Pap smear and cervical biopsy done. Histopathological examination of cervical biopsy revealed papillary serous adenocarcinoma. Later, we received hysterectomy specimen with regional lymph nodes, which showed tumour limited to endocervix.

Primary serous carcinoma of peritoneum: A case report

Introduction: Primary serous papillary carcinoma of the peritoneum (PSPCP) is a rare malignant epithelial tumor that is histologically indistinguishable from papillary serous carcinoma of the ovary (PSCO). It is defined as primary tumor of peritoneum that diffusely involves the peritoneal surface but spares or only superficially invades the ovaries. Better recognition of this entity in recent years has contributed to an increasing diagnostic frequency. Case Report: A case of 50­year­old female who was presented with abdominal distension and pain is reported. Ascitic fluid cytology showed malignant cells favoring papillary serous adenocarcinoma. Preoperative serum CA­125 was markedly elevated. CECT scan showed omental thickening with normal uterus and ovaries. Exploratory laparotomy revealed massive ascites with extensive peritoneal deposits and normal sized ovaries. Histopathology confirmed diagnosis of PSPCP with surface involvement of both the ovaries. Conclusion: PSPCP is a rare neoplasm, histologically indistinguishable from PSCO. We presented this case report to emphasise that peritoneum, can also be a primary site of malignancy and that it presents and is managed just like primary ovarian cancer. Pre­op diagnosis of this entity is difficult. Histopathology is mandatory to confirm the diagnosis.

Rare form of extraovarian primary peritoneal papillary serous carcinoma with solitary cystic lesion mimicking a liver tumor; report of a case.

Extraovarian primary peritoneal serous papillary carcinoma (EOPPC) has a similar clinical presentation to that of ovarian cancer in advanced stages, such as peritoneal dissemination and a large amount of ascites, while EOPPC with a solitary tumor is very rare. We report here a 47-year-old Japanese woman with solitary form of EOPPC mimicking a liver tumor. Ovaries of both sides had no malignant lesion, which was histologically confirmed. Histological examination revealed that the tumor was located at the right diaphragm and partially invaded into the liver, and papillary or ductal proliferation of the tumor cells with an occasional appearance of psammoma bodies was detected. Immunohistologically, the tumor cells were positive for CA 125 and Ber-EP4 and negative for D2-40 or calretinin, ruling out the possibility of mesothelioma, and the diagnosis of the tumor was EOPPC. After the operation, the patient received chemotherapy with carboplatin and paclitaxel, but died 10months later due the progression of recurrence. The present case is very rare form of EOPPC without any ascites or peritoneal dissemination.

Expression of tumor necrosis factor-α in ovarian carcinoma ascites and its meaning

Objective To investigate the relationship of ovarian cancer and the ascites levels of TNF-a, and to determine the value of elevated TNF-a ascites level on discriminating the feature of ascites. Methods Ascites levels of TNF-a of 59 specimens of epithelial ovarian tumor, 9 specimens of peritoneal primary serous papillary carcinoma （PPSPC） and 6 specimens of endometriosis cyst were detected via ELISA. Results Ascites levels of TNF-a of patients with EOC, PPSPC, BOT were significantly higher than those with BET and EM, and they were related to the clinical stage, tissue differentiation, lymph node metastasis and volume of ascites. Conclusion Aseites levels of TNF-a have the high sensitivity and specificity for diagnosis of ovarian cancer. It might be the tumor marker of ovarian cancer. Key words: Tumor necrosis factor-or; Tumor necrosis factor receptor- I ; Enzyme linked immunosor-bent assay ; Ovarian tumor

術前に大腸原発腫瘍が疑われた腹膜原発漿液性乳頭状癌の１例

背景 : 腹膜原発漿液性乳頭状癌 (primary serous papillary carcinoma of the peritoneum : PSCP) は組織学的に卵巣の漿液性乳頭状腺癌に類似する腹膜原発腫瘍である.今回, 術前に大腸粘膜下腫瘍が疑われた PSCP の 1 例を術中腹水および捺印細胞診で経験したので報告する.症例 : 78 歳, 女性. 腹部膨満感を主訴に来院. 精査にて下行結腸の狭窄を伴った粘膜下腫瘍と肝内に腫瘤を認め, 狭窄をきたした大腸粘膜下腫瘍に対して低位前方切除術を施行した. 開腹所見にて粘膜下腫瘤の子宮および卵巣への直接浸潤を認め, 子宮付属器が追加切除された. 術中腹腔洗浄細胞診および腫瘍捺印細胞診において, 腫瘍細胞は乳頭状集塊を形成し, 砂粒体を伴っていた. 摘出された大腸の肉眼像は大腸の漿膜から粘膜下にかけての腫瘤が主病変で, 両側卵巣は正常大であった. 大腸粘膜下の腫瘤は組織学的に卵巣の漿液性乳頭状腺癌に類似しており両側卵巣は正常大であったことから PSCP と診断した.結論 : 臨床的に明らかな卵巣腫大を認めず腹水細胞診において漿液性乳頭状腺癌に類似した細胞所見がみられた場合は, PSCP も念頭に置き診断すべきである.

Coexistence of tuberculous peritonitis and primary papillary serous carcinoma of the peritoneum: A case report and review of the literature

A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies. We present a case of an elderly woman complaining of abdominal pain accompanied with nausea and vomiting, and failure to pass gas or stools. Anti-tuberculosis drugs were used to relieve her abdominal pain, and a needle biopsy of the peritoneal cavity showed evidence of primary papillary serous carcinoma of the peritoneum (PSCP). This is a rare description of tuberculosis in the setting of PSCP. This report illustrates the potential complex nature of malignancies, and emphasizes the need to consider coexistence of malignancy and infection in patients, especially in those with risk factors for malignancy who fail with antibiotic therapy.

Endobronchial Metastasis from Primary Papillary Serous Carcinoma of the Peritoneum

A 59-year-old woman was admitted to our hospital with a left lower lobe opacity and mediastinal shift on the chest X-ray. She had been complaining of intermittent nonproductive cough and exertional dyspnea. Chest computed tomography (CT) showed an endobronchial tumor of the left main to the lower bronchus, atelectasis of the left lower lobe, and mediastinal shift. Bronchoscopy revealed a polypoid tumor at the distal portion of the left main bronchus that occluded the bronchus. Biopsy specimens from the endobronchial tumor were shown to be serous papillary adenocarcinoma. Since the patient had been treated surgically for primary papillary serous carcinoma of the peritoneum (PSCP) 10 years earlier, immunohistochemical examinations were performed. The diagnosis of endobronchial metastasis of PSCP was confirmed by immunohistochemical staining with cancer antigen 125 (CA125), vimentin, and Wilms tumor-1 (WT-1). This is a rare case of endobronchial metastasis from PSCP.

A Case of Primary Papillary Serous Carcinoma of the Peritoneum in a Man

Purpose: Immunohistological and electron microscopic examinations at autopsy were performed to confirm a diagnosis of a patient, who was clinically diagnosed as poorly differentiated adenocarcinoma by percutaneous biopsy of thickening part of peritoneum. Methods: Enhanced CT scan showed distended stomach and rectum, broad intestinal wall thickening, thickening peritoneum, enlarged mesenteric lymph nodes, small amount of ascites, mild hydronephrosis and thrombosis of innominate and jugular vein. The echo-guided biopsy of the thickening part in the peritoneum was performed, and the lesion was diagnosed as poorly-differentiated adenocarcinoma. However, immunohistological analysis and additional imaging studies could not determine a primary lesion. At autopsy, immunohistochemical studies were performed using primary antibodies for pancytokeratin, epithelial membrane antigen, carcinoembryonic antigen, CA125, neuron-specific enolase, calretinin, D2-40, WT1, cytokeratin 7, cytokeratin 20, BerEP4, LeuM1, CA19-9, chromogranin, synaptophysin, and thyroglobulin. Electron microscopic examination was further performed. Results: Histological examination revealed invasive growth of neoplastic cuboidal or columnar cells with eccentric nuclei forming papillary and glandular structures. Psammoma bodies were found. These microscopic features were highly reminiscent of ovarian/peritoneal serous adenocarcinoma of women. Tumor invasion was observed in subcutaneous tissue of the abdominal wall. The tumor also invaded the right ureter, resulting in hydronephrosis of the right kidney. No tumor was found in paratesticular regions. Metastasis of the tumor was found in lymph nodes (mesenteric, paraaortic, and paratracheal), left adrenal gland, and bilateral lungs. The lungs showed marked lymphangitis carcinomatosa and tumor emboli in the pulmonary artery branches. Venous thrombi containing metastatic tumor cells filled the lumina of the left jugular vein and left renal vein. No primary tumor was found in the visceral organs. The tumor cells were positive for pancytokeratin, EMA, monoclonal CEA, CA125, and NSE. They were negative for calretinin, D2–40, WT1, cytokeratin 7, cytokeratin 20, BerEP4, LeuM1 (CD15), CA19-9, chromogranin, synaptophysin, and thyroglobulin. In electron microscopic examination of the tumor cells, no apparent microvillus was found, although a small number of irregular short cytoplasmic processes were observed. Bundles of intermediate filaments were not seen in these cells. These findings indicated that the tumor was papillary serous adenocarcinoma of the peritoneum in a man. The diagnosis of peritoneal malignant mesothelioma was unlikely. Conclusion: This report is the third case of PSCP in male.

Primary papillary serous carcinoma of the peritoneum diagnosed by video-assisted thoracoscopic surgery: Report of a case

A 53-year-old woman who had end-stage renal disease and hypertension presented with back pain. Chest radiographs and chest computed tomography (CT) showed right pleural effusion with bilateral pleural masses. The patient underwent video-assisted thoracoscopic surgery (VATS) for a biopsy of the right pleural mass and for an evaluation of pleural effusion. A frozen section specimen suggested a papillary adenocarcinoma, which was confirmed to be metastatic primary papillary serous carcinoma of the peritoneum by immunohistochemistry, an elevated serum cancer antigen (CA-125) level, and abdominal CT findings. We found that the patient had been unfortunately misdiagnosed to have advanced colon cancer 11 years previously and thus had undergone a right hemicolectomy which was followed by six cycles of 5-fluorouracil chemotherapy. Despite this, she survived more than 10 years and was later correctly diagnosed by VATS of the pleural lesions and based on a review of the previous pathology. The patient was transferred to an oncologist to receive the proper chemotherapy with paclitaxel and carboplatin.

Neoplastic and Nonneoplastic Conditions of Serosal Membrane Origin: CT Findings

Computed tomography (CT) is an important imaging modality for diagnosis and follow-up of neoplastic or nonneoplastic conditions of the serosal membrane. The characteristic CT findings of malignant pleural mesothelioma include unilateral pleural effusion, thickening of the mediastinal pleura, and circumferential and nodular pleural thickening of greater than 1 cm. Malignant peritoneal mesothelioma manifests as a large mass or diffuse peritoneal thickening without a definable mass and is difficult to differentiate from peritoneal carcinomatosis or tuberculosis. The imaging features of primary serous papillary carcinoma of the peritoneum resemble those of peritoneal carcinomatosis; however, the ovary is usually of normal size. The possibility of desmoplastic small round cell tumor should be considered in children or young adults with multiple peritoneal masses and no identifiable primary malignancy. The CT findings of secondary tumors include a variable amount of fluid in the serosal cavity, thickening of the serosal lining (irregular and nodular), and serosal implants. Nonneoplastic conditions manifest as focal or diffuse thickening of the serosal membrane, a variable amount of fluid in the serosal cavity, and a soft-tissue mass at CT. Although the CT findings of some of the conditions overlap, knowledge of the typical findings is helpful in narrowing the differential diagnosis.

A case of primary serous papillary carcinoma with unusual clinical presentation: distant lympho nodes metastasis without peritoneal dissemination

A 50-year-old woman with primary serous papillary carcinoma (PSPC) of peritoneal origin located in the posterior uterine serosa and cul-de-sac without peritoneal dissemination. No peritoneal dissemination was detected but the tumor metastasized to para-aortic and supraclavicular lymph nodes. After first chemotherapy course, pericardial effusion occurred. A pericardiectomy was performed to prevent cardiac failure. Subsequent chemotherapy with paclitaxel and carboplatin was effective against this tumor In general, a typical type of PSPC usually develops distant metastasis with diffuse peritoneal dissemination; the present case shows unusual clinical behavior.

Peritoneal disseminated recurrence and lung metastasis after surgery for stage IA uterine papillary serous carcinoma of the endometrium: a case report

We describe a case of synchronous peritoneal dissemination and multiple lung metastases after surgery for stage IA primary uterine papillary serous carcinoma (UPSC) of the endometrium, revealed by an uncontrollable retention of ascites. She was initially treated with a hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy after initial presentation. Tumor recurrence, diagnosed 12 months later, has been treated with six cycles of Paclitaxel 175 mg/m(2) and Carboplatin [area under the curve 5 (Calvert Formula)] every 3 weeks and showed an advantage of this regimen. Early recurrences of the stage IA UPSC can occur and continued close surveillance is recommended. We report herein the case about this entity.

Primary serous papillary carcinoma of the retroperitoneum: magnetic resonance imaging findings with pathologic correlation

The incidence of a primary serous papillary carcinoma of the retroperitoneum is extremely rare. We present a case of the tumour in an adult simulating an adrenal mass with MRI findings and histopathological correlation.