Advertisement

Central European Journal of Medicine

, Volume 1, Issue 1, pp 87–98 | Cite as

Multiple primary malignant neoplasms — case report

  • Cornelia Amalinei
  • Raluca Balan
  • Luminita Ivan
  • Razvan Socolov
  • Demetra Socolov
  • Coriolan Cotutiu
Case Report
  • 76 Downloads

Abstract

The synchronous occurence of primary carcinomas of endometrium and ovary is well recognized. Malignant peripheral nerve sheath tumours (MPNSTs) may also rarely occur in patients diagnosed with malignancies of the female genital tract. We report a rare case of synchronous primary carcinomas of endometrium and ovary, followed by a metachronous retroperitoneal MPNST. Ascites cytology and endometrial biopsy, followed by hysterectomy and bilateral adnexectomy, were performed to remove the synchronous tumors. Histology was suggestive of synchronous endometrial endometrioid carcinoma and ovarian mucinous adenocarcinoma. After the removal of the retroperitoneal tumor, a MPNST was diagnosed by immunohistochemistry. The patient developed two consecutive vaginal tumors diagnosed as metastases of the previously diagnosed endometrial carcinoma. Although synchronous tumors of endometrium and ovary were relatively early staged and consequently had a favorable prognosis, subsequently occuring implants along the lower genital tract and the metachronous MPNST added up to a poor prognosis.

Keywords

Synchronous primary carcinomas of endometrium and ovary Ovarian mucinous adenocarcinoma Immunohistochemistry Metastatic tumor Malignant peripheral nerve sheath tumor (MPNST) 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. [1]
    G.J. Beattie, J.R. Livingstone, M.A. Cornbleet, J.F. Smyth and K.M. McLaren: “Mucinous endometrial carcinoma in a patient with previous ovarian endometrioid adenocarcinoma presenting some 18 years after initial bilateral ovariectomy: a case report”, Scott. Med. J., Vol. 36(6), (1991), pp. 181–182.PubMedGoogle Scholar
  2. [2]
    C.D.M. Fletcher (Ed.): Diagnostic Histopathology of Tumors, Vol. 2, Churchill Livingstone, Edinburgh, 2000.Google Scholar
  3. [3]
    P. Kleiheus and W.K. Cavenee (Eds.): WHO Classification of Tumors, Pathology and Genetics of Tumors of the Nervous System, IARC Press, Lyon, 2000.Google Scholar
  4. [4]
    R.J. Kurman (Ed.): Blaustein’s Pathology of the Female genital Tract, 5th ed., Springer-Verlag, New York, 2002.Google Scholar
  5. [5]
    K.R. Lee and R.E. Scully: “Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with „pseudomyxoma peritonei“”, Am. J. Surg. Pathol., Vol. 24, (2000), pp. 1447–1464.PubMedCrossRefGoogle Scholar
  6. [6]
    K.R. Lee and R.H. Young: “The distinction between primary and metastatic mucinous carcinomas of the ovary: gross and histologic findings in 50 cases”, Am. J. Surg. Pathol., Vol. 27, (2003), pp. 281–293.PubMedCrossRefGoogle Scholar
  7. [7]
    R.L. Levine, C.B. Cargile, M.S. Blazes, B. van Rees, R.J. Kurman and L.H. Ellenson: “PTEN mutations and microsatellite instability in complex atypical hyperplasia, a precursor lesion to uterine endometrioid carcinoma”, Cancer Res., Vol. 58, (1998), pp. 3254–3258.PubMedGoogle Scholar
  8. [8]
    M. Mandai, I. Konishi, H. Kuroda, T. Komatsu, S. Yamamoto, K. Nanbu, K. Matsushita, M. Fukumoto, H. Yamabe and T. Mori: “Heterogenous distribution of K-ras mutated epithelia in mucinous ovarian tumors with special reference to histopathology”, Hum. Pathol., Vol. 29, (1998), pp. 34–40.PubMedCrossRefGoogle Scholar
  9. [9]
    C. Mawrin, E. Kirches, C. Boltze, K. Dietzmann, A. Roessner and R. Schneider-Stock: “Immunohistochemical and molecular analysis of p53, RB, and PTEN in malignant peripheral nerve sheath tumors”, Virchows Arch Springer-Verlag, Vol. 440(6), (2002), pp. 610–615.CrossRefGoogle Scholar
  10. [10]
    G.L. Mutter: “Pten, a protean tumor suppressor”, Am. J. Pathol., Vol. 158, (2001), pp. 1895–1898.PubMedGoogle Scholar
  11. [11]
    G.L. Mutter, T.A. Ince, J.P. Baak, G.A. Kust, X.P. Zhou and C. Eng: “Molecular identification of latent precancers in histologically normal endometrium”, Cancer Res., Vol. 61, (2001), pp. 4311–4314.PubMedGoogle Scholar
  12. [12]
    R.R. Raju, W.R. Hart, D.K. Magnuson, J.R. Reid and D.G. Rogers: “Genital tract tumors in Proteus syndrome: report of a case of bilateral paraovarian endometrioid cystic tumors of borderline malignancy and review of the literature”, Mod. Pathol., Vol. 15(2), (2002), pp. 172–180.PubMedCrossRefGoogle Scholar
  13. [13]
    F.A. Tavassoli and P. Deville (Eds.): WHO Classification of Tumors of the Breast and Female Genital Organs, IARC Press, Lyon, 2003.Google Scholar
  14. [14]
    J.D. Woodruff and C.G. Julian “Multiple malignancy in the upper genital canal”, Am. J. Obstet. Gynecol., Vol. 103, (1969), pp. 810–822.PubMedGoogle Scholar
  15. [15]
    R. Zaino, C. Whitney, M.F. Brady, K. DeGeest, R.A. Burger and R.E. Buller: “Simultaneously detected endometrial and ovarian carcinomas—a prospective clinicopathologic study of 74 cases: a gynecologic oncology group study”, Gynecol. Oncol., Vol. 83(2), (2001), pp. 355–362.PubMedCrossRefGoogle Scholar

Copyright information

© Central European Science Journals Warsaw and Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • Cornelia Amalinei
    • 1
  • Raluca Balan
    • 1
  • Luminita Ivan
    • 2
  • Razvan Socolov
    • 3
  • Demetra Socolov
    • 3
  • Coriolan Cotutiu
    • 1
  1. 1.Pathology DepartmentUniversity of Medicine and Pharmacy IasiRomania
  2. 2.Pathology LaboratoryMilitary Hospital IasiRomania
  3. 3.Obstetrics and Gynecology DepartmentUniversity of Medicine and Pharmacy IasiRomania

Personalised recommendations