Serous Papillary Research Articles

Peritoneal Serous Papillary Adenocarcinoma at the Wound Site of Appendectomy

Peritoneal Serous Papillary Adenocarcinoma at the Wound Site of Appendectomy

Improved survival with adjuvant brachytherapy in stage IA endometrial cancer of unfavorable histology

PurposeWe evaluated the utilization of vaginal brachytherapy (BT) and the resulting impact on survival in stage IA endometrial cancer of clear cell (CC), papillary serous (PS), and carcinosarcoma (CS) histology. MethodsPatients with uterine cancer diagnosed from 2004 to 2015 were identified from the National Cancer Database. Patients underwent hysterectomy, showing FIGO stage IA disease with CC, PS, or CS histology. Logistic regression was used to evaluate predictors of BT utilization and to generate propensity scores. Survival was compared using log-rank test and Cox proportional hazards modeling, with propensity score adjustment. ResultsWe identified 5711 patients who underwent hysterectomy showing FIGO pT1a, N0 or NX endometrial cancer with CC, PS, or CS histology, of which 29.5% received BT. Multivariate predictors of increased receipt of BT were identified. With a median follow-up of 3.3 years, 3-year overall survival (OS) was 87% for those receiving BT versus 78% for those without (p < 0.001). A survival benefit to BT was maintained across histologies. Similar results were seen whether tumor was confined to endometrium or had <50% myometrial invasion. On multivariate analysis, receipt of BT was associated with increased survival (hazard ratio [HR] 0.75, 95% confidence interval 0.65–0.87, p < 0.001). The benefit of BT persisted after propensity score adjustment (HR 0.76, p < 0.001). ConclusionsIn this cohort of women with stage IA endometrial cancer of unfavorable histology, the use of BT was associated with improved survival. In this study, 29.5% of patients in our cohort received BT.

Ovarian serous surface papillary borderline tumor: characteristic imaging features with clinicopathological correlation.

To retrospectively evaluate the clinical, pathological, and imaging features of ovarian serous surface papillary borderline tumors (SSPBTs). Imaging features were analyzed, including the tumor size, laterality, tumor spread and the presence of ascites. Morphological nature (encased normal ovary, characteristics on MRI) and contrast enhancement (increased flow on Doppler ultrasound) were also evaluated. Clinical and pathological features, such as tumor markers (CA 125), treatment methods, outcomes on follow-up, and surgical staging, were analyzed. 10 tumors in 5 patients were evaluated. Mean largest tumor diameter was 45 mm. All patients had bilateral involvement and ascites. 40% of all patients showed peritoneal implants. 20% of patients evaluated had lymph node metastasis. These patients showed grossly normal ovaries that were encased in or surrounded by irregular solid tumors. They had a mostly hyperintense papillary architecture with hypointense internal branching on T2weighted MR images (90%). Contrast enhancement and serum levels of CA 125 were elevated in all cases evaluated. All patients underwent radical surgery, and 80% of patients evaluated were of low stage. No recurrence occurred, during follow-up. SSPBT of the ovary, which has a good prognosis, should be considered as a diagnosis for patients who have bilateral enhancing irregular solid masses with papillary architecture and internal branching, and encasing normal-appearing ovaries. Advances in knowledge: Serous surface papillary borderline tumor of the ovary is unique and has characteristic features. Knowledge of this specific ovarian tumor and radiological suspicion can have important implications for the patient to facilitate management including fertility-preserving surgery.

Development and characterization of carboxy-terminus specific monoclonal antibodies for understanding MUC16 cleavage in human ovarian cancer.

MUC16 is overexpressed in ovarian cancer and plays important roles in invasion and metastasis. Previously described monoclonal antibodies against cell surface expressed MUC16 recognize the N-terminal tandemly repeated epitopes present in cancer antigen 125 (CA125). MUC16 is cleaved at a specific location, thus, releasing CA125 into the extracellular space. Recent reports have indicated that the retained carboxy-terminal (CT) fragment of MUC16 might play an important role in tumorigenicity in diverse types of cancers. However, limited data is available on the fate and existence of CT fragment on the surface of the cancer cell. Herein, we characterize two monoclonal antibodies (mAbs) showing specificity to the retained juxtamembrane region of MUC16. For the first time, we demonstrate that MUC16 is cleaved in ovarian cancer cells (NIH:OVCAR-3 [OVCAR-3]) and that the cleaved MUC16 subunits remain associated with each other. Immunohistochemical analyses on different grades of ovarian tumor tissues indicated differential reactivity of CA125 and MUC16 CT mAbs. The CA125 (M11) mAb detected 32/40 (80%), while the CT mAb (5E6) detected 33/40 (82.5%) of total ovarian cancer cases. For serous and serous papillary cases, the CA125 (M11) mAb stained 27/31 cases (87%), while CT mAb (5E6) stained 29/31 cases (93.5%). The CT mAb(s) accurately predict expression of MUC16 since their epitopes are not tandemly repeated and their reactivity may not be dependent on O-linked glycosylation. These antibodies can serve as valuable reagents for understanding MUC16 cleavage and may also serve as potential therapeutic agents for treatment of ovarian cancer.

Complications of Acute Pancreatitis Misdiagnosed as Primary Serous Papillary Carcinoma

Complications of Acute Pancreatitis Misdiagnosed as Primary Serous Papillary Carcinoma

Paratesticular Serous Papillary Carcinoma of High Grade and Malignant Potential: A Rare Case with a Role for Adjuvant Therapy

Paratesticular serous papillary carcinomas are very rare, with less than 40 cases reported in the literature. These neoplasms are Müllerian in origin, and more commonly seen as epithelial-type ovarian cancer. Given the rarity of this tumor in men, staging and recommended treatment options do not exist. Herein, we present the case of a 35-year-old male with high-grade invasive serous papillary carcinoma. He was diagnosed after left radical orchiectomy for paratesticular mass and subsequently treated with adjuvant chemotherapy according to existing recommendations for its ovarian counterpart. Chemotherapy was well tolerated and surveillance imaging has shown no evidence of disease. This case suggests a potential role for adjuvant therapy in patients with high-grade paratesticular serous papillary carcinoma.

Serous Papillary Endometrial Carcinoma, Lower Uterine Segment: An Unusual Occurence

Serous Papillary Endometrial Carcinoma, Lower Uterine Segment: An Unusual Occurence

Open Versus Laparoscopic Staging for Uterine Papillary Serous Cancer: Analysis of Perioperative Complications and Survival

Abstract Objectives: The aim of this research was evaluation of perioperative, debulking, and survival outcomes in patients with uterine papillary serous cancer (UPSC) managed by open staging (OS) ...

258 - Single-Site Laparoscopic Interval Debulking Surgery for Late Stage Ovarian Cancer

A lady, aged 45, the pathological findings by MRI directed biopsy was High Grade Ovarian Serous Papillary Cystadenocarcinoma with Omentum involved.

The Clinical and Pathological Analysis of Ovarian Borderline Serous Papillary Epithelioma: A Report of Six Cases

Introduction: Ovarian borderline serous papillary epithelioma is a rare epithelial ovarian tumor between adenoma and carcinoma. This study was carried out to compare six cases of ovarian borderline serous papillary epithelioma. Case Presentation: This retrospective study was conducted on 6 patients with ovarian borderline serous papillary epithelioma regarding clinical symptoms, auxiliary examination, treatment process, and prognosis. These six patients were diagnosed with the disease from January 2010 to June 2013 in the People’s hospital of three Gorges university, Yichang, Hubei, China. Two patients were diagnosed with ovarian surface serous papillary epithelioma. One patient was diagnosed with ovarian surface serous papillary epithelioma transferred to bilateral fallopian tubes. One patient was diagnosed with ovarian borderline serous papillary epithelioma while parts of tissues had become cancerous. One patient was diagnosed with ovarian borderline serous papillary epithelioma with pelvic lymph node metastasis, which had transferred to bilateral fallopian tubes, omentum majus, and epityphlon. One patient was diagnosed with ovarian surface serous papillary epithelioma with epithelial hyperplasia. All the six patients received surgical resection. Conclusions: We recommend ovarian borderline serous papillary epithelioma evaluation for patients as preoperative observations, intraoperative careful exploration, and pathological diagnosis in order to find and timely treat ovarian borderline serous papillary epithelioma patients.

Clinical Outcome After Adjuvant Vaginal Brachytherapy for Stage I-II Papillary Serous Clear Cell Endometrial Cancer

Clinical Outcome After Adjuvant Vaginal Brachytherapy for Stage I-II Papillary Serous Clear Cell Endometrial Cancer

SEROUS SURFACE PAPILLARY ADENOCARCINOMA: A RARE VARIANT OF SEROUS CARCINOMA - REPORT OF TWO CASES

Serous tumors constitute about 25% of all ovarian tumors. Serous adenocarcinomas are the commonest form of the malignant epithelial ovarian tumors accounting for 26% of the cases. The commonest morphologic form is the cystadenocarcinoma. Serous surface papillary adenocarcinoma is a very rare morphologic entity which is often bilateral and highly aggressive. Reports showing an exact incidence are not available in literature. We present a case of serous surface papillary adenocarcinoma confined to ovary. Keywords: Ovary, Serous Carcinoma, Serous Surface Papillary Adenocarcinoma

Expression and utility of IMP3 in the differential diagnosis of atypical glandular cells and adenocarcinoma in liquid-based cervical cytology

Atypical glandular cell (AGC) interpretation in gynecological cytopathology presents many diagnostic challenges. We evaluated the expression of IMP3 in liquid-based cervical cytology and its utility in differentiating premalignant/malignant glandular lesions from benign/reactive processes. Additionally, we tried to determine whether IMP3 may be useful in differentiating among the types of uterine adenocarcinomas. Our cohort included 82 cases; 59 diagnosed with AGC and 23 with adenocarcinoma (Ac). IMP3 immunocytochemical stain was performed on ThinPrep slides and the results correlated with subsequent biopsy findings. IMP3 positivity was assessed by strong (2+ and 3+) granular cytoplasmic staining in at least one group of three epithelial cells. In the AGC group, IMP3 was positive in 14 (73.7%) of 19 cases that on histologic follow-up were confirmed Ac, and 39 (98.6%) of 40 non-glandular lesions/benign cases were negative. In the Ac group, IMP3 was expressed in 16 (69.6%) of 23 cases, of which 16 (72.2%) of 21 were uterine Ac. By combining the two groups, and excluding the 2 extrauterine carcinomas, IMP3 was positive in 30 (75%) of 40 uterine Ac, most of which (86.7%) were in situ/invasive endocervical Ac, and type II endometrial Ac (Papillary Serous and Clear Cell Carcinoma), and only 40% endometrioid Ac. In ThinPrep slides with AGC, IMP3 positivity predicts the presence of a significant endocervical or endometrial lesion on subsequent histology, and may also be a potential diagnostic tool useful in differentiating among the types of adenocarcinomas of the female lower genital tract.

Evaluation of Toxicities in Women With Uterine Papillary Serous Carcinoma (UPSC) Following Intensity Modulated Radiation Therapy (IMRT) and High-Dose-Rate (HDR) Vaginal Brachytherapy

Evaluation of Toxicities in Women With Uterine Papillary Serous Carcinoma (UPSC) Following Intensity Modulated Radiation Therapy (IMRT) and High-Dose-Rate (HDR) Vaginal Brachytherapy

An immunohistochemical study on the expression of sex steroid receptors, Ki-67 and cytokeratins 7 and 20 in feline endometrial adenocarcinomas.

BackgroundEndometrial adenocarcinomas are a rare type of tumour in cats. Though different morphologies have been reported, the most frequent histological type of feline endometrial adenocarcinoma (FEA) is the papillary serous. Characterization of molecular markers expression in FEA may contribute to clarify the pathogenesis of these tumours and to assess the differences between normal endometrium and FEA regarding the expression pattern of several proteins. Therefore, this study aimed to evaluate the immunohistochemical profile of a wide panel of antibodies (specific for ER-α, PR, Ki-67, CK7 and CK20) in twenty-four cases of FEA. Comparisons were made between FEA and feline normal cyclic endometrium in follicular (n = 13) and luteal (n = 10) stages. Except for Ki-67, all other molecular markers were assessed independently for the intensity of immunolabeling and for the percentage of cells expressing the protein.ResultsThis study showed that in FEA a loss of expression occurs for ER-α (P ≤ 0.0001) and less markedly also for PR. The lost in sex steroid receptors concerns a decrease in both the proportion of labelled cells and the intensity of immunolabelling (P = 0.002 and P = 0.024, respectively). Proliferative activity, estimated via Ki-67 immunoreaction, significantly increased in FEA as compared to normal endometrium (P ≤ 0.0001). Feline endometrial adenocarcinomas maintained the CK7+/CK20+ status of normal endometrium. However, FEA showed decreased CK7 intensity of labelling compared to normal endometria (P ≤ 0.0001) and loss of CK20 expression, both in intensity (P ≤ 0.0001) and in percentage of positive cells (P = 0.01), compared to normal tissues.ConclusionsData gathered in this study suggest that proliferation in FEA accompanies ER-α down-regulation, possibly following activation of pathways mediated by local growth factors. Moreover, FEA retains combined expression of CK7 and CK20, as evidenced in normal endometrial epithelia, although a decrease in CK7 expression was observed.

Abstract AS05: Metabolomic signatures in sera from early stage ovarian cancer patients

Abstract PURPOSE: Lack of symptoms as well as the deficiency of highly specific biomarkers has resulted in only a quarter of ovarian cancer cases being diagnosed in stage I. Early detection combined with conventional therapies has resulted in 5-year survival rates up to 90%, while 5-year overall survival is less than 30% for women with advanced stage ovarian cancer. An effective screening strategy for early diagnosis would be particularly advantageous for ovarian cancer patients. Investigation into characteristic metabolomic patterns for disease has the potential to detect changes in cells, tissues, and biofluids that can aid in diagnosis at an early stage. METHODS: Serum samples were collected from early-stage serous papillary or endometrioid ovarian cancer (n=26) and normal patients (n=40) and analyzed using ultra high performance liquid chromatography coupled with high resolution mass spectrometry (UPLC-MS) and tandem mass spectrometry (MS/MS). Metabolites were extracted from blood serum by precipitating proteins with methanol, lyophilization, and solvent reconstitution prior to MS analysis in both positive and negative electrospray ionization modes. Metabolic features were extracted with MZmine software. Untargeted multivariate statistical analysis employing support vector machine (SVM) learning methods, genetic algorithms and recursive feature elimination (RFE) selected a panel of metabolites that differentiates between the age-matched samples with better than 92% sensitivity and 91% specificity in all cases tested. RESULTS: Comparison of metabolic phenotypes of ovarian cancer with normal metabolic signatures revealed unique metabolite patterns for ovarian cancer. From multivariate statistical analysis, panels consisting of 17-35 metabolic features from serum samples were found to differentiate between early stage cancer and normal with very high accuracy, sensitivity, and specificity. CONCLUSIONS: Poor early diagnosis complicates collection of large patient cohorts for more detailed studies. Our preliminary work demonstrated that metabolites in serum samples may be useful for detecting early-stage ovarian cancer and support conducting larger, more focused studies. (Grant support: Marsha Rivkin Ovarian Cancer Challenge Grant; Ovarian Cancer Research Fund (OCRF)) Citation Format: David A. Gaul, Christina M. Jones, Maria Eugenia Monge, Long Q. Tran, Martin M. Matzuk, John F. McDonald*, Facundo M. Fernandez*. Metabolomic signatures in sera from early stage ovarian cancer patients [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr AS05.

Lympho-vascular space invasion indicates advanced disease for uterine papillary serous tumors arising from polyps.

Uterine papillary serous tumors are rarely seen and behave aggressively. Our aim was to evaluate uterine papillary serous tumors arising from polyps. Clinicopathological data of patients with uterine serous cancer arising from a polyp at the Gynecological Oncology Department of Zekai Tahir Burak Women's Health Education and Research Hospital were reviewed retrospectively. We analyzed patients according to FIGO 2009 staging system as stage 1A and higher than stage 1A (3 and 6, respectively). All the patients were postmenopausal. Mean CA-125, CA-19.9 and CA15.3 levels were elevated in higher than stage 1A group. However we did not find a statistical difference between age, parity, polyp size, CA-125, CA-15.3, CA-19.9 and CEA levels. Lympho-vascular space invasion (LVSI) showed predictivity for advanced disease (p=0.025). The histopathologic nature of uterine serous carcinoma is a unique entity. LVSI is a prognosticator for defining an advanced stage uterine papillary tumor.

Breast Metastasis of Serous Ovarian Papillary Carcinoma: A Report of Two Cases Diagnosed by Fine-Needle Aspiration

Breast metastases from gynecologic cancer are infrequent and are mainly from the ovary. They usually appear in advanced stages and have poor survival rates after diagnosis. Two cases of breast metastasis of serous ovarian carcinoma are presented. In both cases fine-needle aspiration (FNA) study of breast revealed a lesion with morphologic characteristics of serous carcinoma, while one of them was with immunocytochemical study. Origin was confirmed by histological examination of this lesion.

Primary Testicular Serous Papillary Carcinoma With Extensive Calcification on CT and FDG PET/CT

A 67-year-old man with a swollen right testicle also had dry cough for 3 months. Computed tomography of the chest showed multiple calcified lung nodules and lymph nodes in the hilum. FDG PET/CT revealed elevated FDG activity not only in the right testicle mass but also calcified thoracic lesions. Histologic examination after testicle biopsy demonstrated primary testicular papillary serous carcinoma.

OC03.07: Ultrasound diagnosis of serous surface papillary borderline ovarian tumor: a case series

<scp>OC</scp>03.07: Ultrasound diagnosis of serous surface papillary borderline ovarian tumor: a case series