Epithelioid trophoblastic tumor (ETT) is a rare gestational trophoblastic tumor. Cases of ETT present as abnormal vaginal bleeding in women of reproductive age, with low human chorionic gonadotropin (hCG) levels. ETT can be a sequela of any gestational event and can present in both intrauterine and extrauterine sites. Metastasis and death have been reported. We present a case of a 44-year-old female incidentally diagnosed with ETT following laparoscopic-assisted vaginal hysterectomy. Postoperative evaluation for metastatic disease was negative. The patient has been closely followed and remains disease free 8 months postoperatively. ETT presents a diagnostic challenge due to its rarity and histologic resemblance to other pathologies. ETT is relatively chemoresistant and managed surgically. Misdiagnosis delays effective treatment and affects survival.

Robotic surgery has emerged as an alternative option in minimally invasive gynecologic surgery. The development of the dual-console da Vinci Si Surgical System® has enabled modification of the training atmosphere. We sought to investigate operative times and surgical outcomes while operating with the dual-console model in a training environment for our first fifty cases. We identified the first fifty patients who underwent robot-assisted total hysterectomy (TRH), with or without bilateral salpingo-oophorectomy (BSO), with or without pelvic and para-aortic lymph node dissection (PPALND), by use of the dual-console robotic system. Records were reviewed for patient demographics and surgical details. All surgery was conducted using the dual-console system and performed by staff physicians and fellows. Operative time was calculated from robotic docking until completion of the procedure. Cases were identified from November 2009 through July 2010. Mean age was 56.2 years (SD 13.35, 95 % CI 52.46–59.86). Mean BMI was 29.5 (SD 7.67, 95 % CI 27.35–31.61). Seventy-eight percent of these patients were considered overweight, including 12 defined as obese (BMI 30–34.9) and 10 patients classified as morbidly obese (BMI ≥ 35). Surgery completed included PPALND alone (n = 1); radical hysterectomy (n = 1); TRH only (n = 3); TRH/BSO (n = 25); and TRH/BSO/PPALND (n = 20). Mean total operating room time was 188.8 min (SD 55.31, 95 % CI 173.45–204.11). Mean total surgical time for all cases was 118.1 min (SD 44.28, 95 % CI 105.87–130.41). Two vascular injuries were encountered, with one requiring conversion to laparotomy. These results compare favorably with historically reported outcomes from single-console systems. Utilizing the dual-console enables use of an integrated teaching and supervising environment without compromising operative times or patient outcomes.

No abstract

Clinically significant CL was not different between treatment modalities in this study, but is underpowered. The results provide valuable information about treatment complications that will be useful for patient-centered counseling. Prospective evaluation of CL and its impact on quality of life is warranted.

To establish primary cell lines from uterine carcinosarcoma (CS) patient samples and to evaluate combination treatment with standard chemotherapy with or without the addition of an anti-IGF1R antibody. CS tumor tissue was obtained under IRB approval at the time of primary surgery. We reported the establishment of patient-derived xenografts elsewhere. Tissue pieces were minced extensively and digested by collagenase treatment. The single cell solution was then seeded in F-media containing EGF, insulin, hydrocortisone, adenine, cholera toxin and the Rock inhibitor Y-27632. A previously established carcinosarcoma cell line CS99 (Schulten et al, 2008) was used for comparison. To verify origin, Short Tandem Repeat (STR) profiles of the primary cell lines CS13, CS18, CS19, CS21 and CS22 were compared with the patient's tumor samples. Drug sensitivity to Taxol, cisplatin and carboplatin was determined individually or in combination using the sulforhodamine B (SRB) proliferation assay. The effect of IMC-A12 (anti-IGF1R antibody, Eli Lily / Imclone) alone or with chemotherapy was also determined with the SRB assay. Total and promoter-specific IGF2 mRNA levels were determined by reverse transcriptase quantitative PCR. All STR profiles of the primary cell lines matched their patient sample counterparts. IGF2 mRNA expression levels of the cell lines were similar to the patient samples, and over 10,000-fold higher than in CS99. IGF2 promoter-specific primers showed that the IGF2 mRNA transcripts of the primary cell lines were initiated at the oncofetal IGF2 promoters P3 and P4. For Taxol, the IC50 (inhibitory concentration of 50%) ranged from 4.7 nM for CS21 to 9.8 nM for CS22. For cisplatin, the IC50 ranged from 1.0 μM for CS99 to 4.8 μM for CS19. For carboplatin, CS99 cells had the lowest IC50 of 12.5 μM while CS19 had the highest IC50 of 58.1 μM. In the presence of 10 μg/ml IMC-A12, the primary cell lines CS19, CS21 and CS22 showed significant sensitization to Taxol (∼50% decrease in IC50), to carboplatin (∼65% decrease in IC50), and to combination Taxol/carboplatin treatment (∼50% decrease in IC50). We conclude that establishing primary cell lines of this rare cancer is a promising approach for testing sensitivity to current and novel chemotherapies and combination treatment strategies. We also found that high oncofetal promoter-driven IGF2 mRNA expression was observed in all CS samples tested and that IGF1R blockade sensitized the primary cell lines to standard chemotherapy. Citation Format: Jurriaan Brouwer-Visser, Eirwen Scott, Shijun Mi, Maria J. Cossio, Tiffany Hebert, Gloria S. Huang. Establishment of uterine carcinosarcoma primary cell lines for chemosensitivity testing and evaluation of targeted therapy. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5131. doi:10.1158/1538-7445.AM2015-5131

No abstract

No abstract

No abstract