Uterine leiomyoma with tubules
Tóm tắt
We report two cases of "uterine leiomyoma with tubules" as a new pathological entity. Since these are biphasic neoplasms (composed by epithelial and mesenchimal elements), the differential diagnosis is between mixed mullerian tumors and uterine tumors resembling ovarian sex cord tumors (UTROSCTs). In the differential diagnosis, the mixed mullerian tumors are easily excluded because of histological and immunohistochemical features. UTROSCTs are similar to the lesions we reported, and the differential diagnosis requires positivity for some immunohistochemical markers as inhibin, CD99, calretinin, Melan-A. Our conclusions are that to perform a diagnosis of UTROSCT at least two immunohistochemical marker have to be expressed; in the present case they didn't, so we call the lesion "leiomyoma with tubules".
Tài liệu tham khảo
Clement PB, Scully RE: Uterine tumors resembling ovarian sex-cord tumors. A clinicopathologic analysis of fourteen cases. Am J Clin Pathol. 1976, 66: 512-25.
World Health Organization classification of tumours: Pathology & Genetics, Tumours of the Breast and Female Genital Organs. Tavassoli & Peter Devilee. Edited by: Fattaneh A. 2003, IARC Press, Lyon
Tang CK, Toker C, Ances IG: Stromomyoma of the uterus. Cancer. 1979, 43: 308-16. 10.1002/1097-0142(197901)43:1<308::AID-CNCR2820430145>3.0.CO;2-G.
Lillemoe TJ, Perrone T, Norris HJ, Dehner LP: Myogenous phenotype of epithelial-like areas in endometrial stromal sarcomas. Arch Pathol Lab Med. 1991, 115 (3): 215-9.
McCluggage WG, Date A, Bharucha H, Toner PG: Endometrial stromal sarcoma with sex-cord-like areas and focal rhabdoid differentiation. Histopathology. 1996, 29: 369-374. 10.1111/j.1365-2559.1996.tb01421.x.
McCluggage WG, Shah V, Walsh MY, Toner PG: Uterine tumour resembling ovarian sex-cord tumour: evidence for smooth muscle differentiation. Histopathology. 1993, 23: 83-85. 10.1111/j.1365-2559.1993.tb01188.x.
Fukunaga M, Miyazawa Y, Ushigome S: Endometrial low-grade stromal sarcoma with ovarian sex cord like differentiation: report of two cases with an immunohistochemical and flow cytometric study. Pathol Int. 1997, 47: 412-415.
Zamecnik M, Michal M: Endometrial stromal nodule with retiform sex cord-like differentiation. Pathol Res Pract. 1998, 194: 449-453.
Fekete PS, Vellios F, Patterson BD: Uterine tumor resembling an ovarian sex-cord tumor: report of a case of an endometrial stromal tumor with foam cells and ultrastructural evidence of epithelial differentiation. Int J Gynecol Pathol. 1985, 4: 378-387.
Mazur MT, Kraus FT: Histogenesis of morphologic variations in tumors of the uterine wall. Am J Surg Pathol. 1980, 4: 59-74.
Baker RJ, Hildebrandt RH, Rouse RV, Hendrickson MR, Longacre TA: Inhibin and CD99 (MIC2) expression in uterine stromal neoplasms with sex cord like elements. Hum Pathol. 1999, 30: 671-679. 10.1016/S0046-8177(99)90093-X.
Nogales FF, Isaac MA: Functioning uterine sex cord tumour. Histopathology. 2002, 41: 277-279. 10.1046/j.1365-2559.2002.13675.x.
Kantelip B, Cloup N, Dechelotte P: Uterine tumor resembling ovarian sez cord tumors: report of a case of an endometrial stromal tumor with ultrastructural study. Hum Pathol. 1986, 17: 91-94. 10.1016/S0046-8177(86)80161-7.
Krishnamurthy S, Jungbluth AA, Busam KJ, Rosai J: Uterine tumors resembling ovarian sex cord tumors have an immunohenotype consistent with true sex cord differentiation. Am J Surg Pathol. 1998, 22: 1078-1082. 10.1097/00000478-199809000-00006.
McCluggage WG: Uterine tumors resembling ovarian sex cord tumours: immunohistochemical evidence for true sex cord differentiation. Histopathology. 1999, 34: 375-376. 10.1046/j.1365-2559.1999.0669b.x.
Hauptmann S, Nadjari B, Kraus J, Turnwald W, Dietel M: Uterine tumor resembling ovarian sex cord tumor – a case report and review of the literature. Virchows Arch. 2001, 439: 97-101. 10.1007/s004280100455.
Kabbani W, Deavers MT, Malpica A, Burke TW, Liu J, Ordoñez NG, Jhingran A, Silva EG: Uterine tumor resembling ovarian sex cord tumor: report of a case mimicking cervical adenocarcinoma. Int J Gynecol Pathol. 2003, 22: 297-302. 10.1097/01.PGP.0000070846.25718.97.
Riopel MA, Perlman EJ, Seidman JE, Kurman RJ, Sherman ME: Inhibin and epithelial memabrane antigen immunohistochemistry assist in the diagnosis of sex cord stromal tumors and provide clues to the histogenesis of hypercalcemic small cell carcinoma. Int J Gynecol Pathol. 1998, 17: 46-53.
Oliva E, Young R, Amin M, Clement PB: An immunohistochemical analysis of endometrial stromal and smooth muscle tumors of the uterus: a study of 54 cases emphasizing the importance of using a panel because of overlap in immunoreactivity for individual antibodies. Am J Surg Pathol. 2002, 26: 403-412. 10.1097/00000478-200204000-00001.
Oztekin O, Soylu F, Yigit S, Sarica E: Uterine tumor resembling ovarian sex cord tumors in a patient using tamoxifen: report of a case and review of literature. Int J Gynecol Cancer. 2006, 16: 1685-1697. 10.1111/j.1525-1438.2006.00647.x.
Sutak J, Lazic D, Cullimore JE: Uterine tumors resembling an ovarian sex cord tumor. J Clin Path. 2005, 58: 888-890. 10.1136/jcp.2004.022616.
Irving JA, Carinelli S, Prat J: Uterine tumors resembling ovarian sex cord tumors are polyphenotypic neoplasms with true sex cord differentiation. Modern Pathology. 2006, 19: 17-24. 10.1038/modpathol.3800475.
Motiwala N, Shih H, Chen L, Lin JH: A 63-year-old woman with chronic pelvic pain. Arch Pathol Lab Med. 2006, 130: 74-76.
Kommoss F, Oliva E, Bhan K, Young RH, Scully RE: Inhibin expression in ovarian tumors and tumor like lesions: an immunohistochemical study. Mod Pathol. 1998, 11: 656-664.
Motiwala N, Shih H, Chen L, Lin JH: A 63-year-old woman with chronic pelvic pain. Arch Pathol Lab Med. 2006, 130: 74-76.
Movahedi-Lankarani S, Kurman RJ: Calretinin a more sensitive but less specific marker than a-inhibin for ovarian sex cord stromal neoplasms. An immunohistochemical study of 215 cases. Am J Surg Pathol. 2002, 26: 1477-83. 10.1097/00000478-200211000-00010.
Hurrell DP, McCluggage WG: Uterine tumors resembling ovarian sex cord tumour is an immunhistochemically polyphenotypic neoplasm which exhibits coexpression of epithelial, myoid and sex cord markers. J Clin Pathol. 2007, 60 (10): 1148-54. 10.1136/jcp.2006.044842.
Suzuki C, Matsumoto T, Fukunaga M, Itoga T, Furugen Y, Kurosaki Y, Suda K, Kinoshita K: Uterine tumors resembling ovarian sex cord tumors producing parathyroid hormone-related protein of the uterine cervix. Pathol Int. 2002, 52: 164-168. 10.1046/j.1440-1827.2002.01319.x.