Eleven patients with uterine adenosarcoma diagnosed between 1970 and 1995 were evaluated according to DNA ploidy, S-phase fraction, p53 and mdm-2 expression, and traditional clinical and pathological prognostic factors, such as tumor stage, grade and mitotic index. DNA flow cytometric analysis and immunohistochemical staining for p53 and mdm-2 were performed on paraffin-embedded archival tissue from the uterine tumors. The patients ranged in age from 41 to 90 years (median, 76 years). Only one patient was premenopausal at the time of diagnosis and five (45%) were nulliparous. One patient had received previous pelvic irradiation for anal squamous carcinoma. Six of the tumors (55%) were pure adenosarcoma and five (45%) were adenosarcoma with sarcomatous overgrowth. Nine patients had a stage I tumor and two had a stage II tumor. Among the six adenosarcomas we found three DNA diploid tumors, two DNA aneuploid tumors, and one DNA multiploid tumor. All adenosarcomas had an S-phase fraction less than 10%, except one that was not assessable. None was p53 positive and only one overexpressed mdm-2. All five adenosarcomas with sarcomatous overgrowth were DNA aneuploid, three (60%) had an S-phase fraction > 10%, two (40%) were p53 positive, and one (20%) overexpressed mdm-2. Five of the eleven patients suffered recurrences, and three (60%) of these developed lung metastases. During the observation period four (36%) patients (2 adenosarcomas and 2 adenosarcoma with sarcomatous overgrowth) died of disease, three patients died of intercurrent disease without recurrence, and the remaining four are alive with no evidence of disease. The overall five-year survival rate for all stages was 69%; for patients with AS it was 80%, while for those with adenosarcoma with sarcomatous overgrowth it was 50%. There were no variables which correlated with survival. In conclusion, we found hat the typical adenosarcoma had a tendency to be of low stage, have a lower mitotic rate and an S-phase fraction <10%. On the other hand, adenosarcomas with sarcomatous overgrowth were of high grade, had a high mitotic rate, and were DNA aneuploid with an S-phase fraction >10%. None of the variables studied correlated with survival. Tumors that were p53-positive or overexpressed mdm-2 did not behave worse than their negative counterpart. All patients who recurred with distant metastases died of disease.
Background. The morphologic spectrum of ovarian mucinous tumors is well known, but the features that predict aggressive behavior are still controversial.
Methods. Ninety‐two cases of primary ovarian mucinous tumors with atypical epithelial proliferation and/or stromal invasion were analyzed histologically and by DNA flow cytometry, and the results were correlated with clinical findings.
Results. The authors reviewed 57 intestinal mucinous borderline tumors (IMBT), 3 endocervicallike mucinous borderline tumors (EMBT), 21 noninvasive mucinous carcinomas (IMC). and 11 invasive mucinous carcinomas (IMC). The 5‐year survival rate for Stage I tumors was: IMBT 100%, EMBT 100%, NIMC 94% and IMC60%. The 5‐year survival of Stage II‐IV tumors was: IMBT 50%, NIMC 33% and IMC 0%. Forty‐four IMBTs were diploid, and 4 were aneuploid. All six high stage IMBTs were diploid. Two EMBTs were diploid, and one was aneuploid. There were seven diploid, four polyploid, and six aneuploid NIMCs. Two of the three lethal NIMCs were aneuploid. Four IMCs were diploid, and four were aneuploid. Of these, only the diploid Stage I IMCs were nonlethal. All NIMCs that recurred or presented with metastases had been sampled inadequately. High stage tumors with pseudomyxoma peritonei (PP)‐type lesions of ten were associated with pseudomyxoma ovarii of the cellular type.
Conclusions. Mucinous tumors with stromal invasion or presenting with PP had a definite malignant behavior. All other atypical mucinous tumors, when confined to the ovary and optimally sampled, had an excellent prognosis. DNA ploidy analysis may prove useful in determining the risk of progression, especially in Stage IIMCs.
Undifferentiated embryonal sarcoma of the liver (UESL) is a primitive hepatic neoplasm that presents in a variety of forms on ultrasonography, computed tomography, and magnetic resonance imaging. In this case report, we present an UESL with fluid-fluid cysts mimicking a radiographic presentation commonly seen in venolymphatic malformation on magnetic resonance imaging. This is the first described case of UESL, with this radiographic presentation and outlines, the importance of considering this malignant lesion when evaluating liver tumors in children.
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