Cases of CHMCF following ART may also have higher malignant potential and higher risk of GTD development and become more aggressive biologically. The clinical course of CHMCF after ART seems to be almost the same as that without ART based on the results of literature review.
There are very few reported cases of the clinical course of exaggerated placental site, and a case of a placental polyp arising from an exaggerated placental site has not been reported previously. Here, we report a case of a 43-year-old woman whose chief complaint was of massive genital bleeding. She had undergone an operation for induced abortion in the first trimester 41 days previously. A placental polyp measuring 45 mm with an abundant blood flow could be detected by transvaginal color Doppler ultrasonography and enhanced magnetic resonance imaging. We performed a transabdominal simple total hysterectomy. At the anterior wall of the uterus, a protruding lesion into the uterine cavity was observed and a placental polyp was attached to the protruding lesion. The histological specimen of the protruding lesion, which was considered to be the implantation site, showed intermediate trophoblastic cells infiltrated into the myometrium. An exaggerated placental site was diagnosed, which might lead to a placental polyp.
A malignant solitary fibrous tumor arising from the omentum is extremely rare. To our knowledge, this is the first case of a malignant solitary fibrous omentum tumor coexisting with uterine corpus cancer. A 62-year-old woman presented to our hospital with vaginal discharge. Endometrioid adenocarcinoma was diagnosed by endometrial curettage. In addition, a solid tumor in front of the uterus was detected following computed tomography and/or magnetic resonance imaging, which was suspected to be a primary (or secondary) malignant tumor arising from the omentum. Hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymphadenectomy were performed. A malignant solitary fibrous tumor of the omentum and grade 3 endometrioid adenocarcinoma of the uterus were diagnosed by pathohistological analysis. Interestingly, the tumor cells were immunoreactive for p53. Adjuvant chemotherapy was administered for the uterine corpus cancer and the patient remains healthy 48 months after the surgery. These tumors may have become malignant due to the presence of p53 mutations.
To our knowledge, highly detailed findings of flexible hysterofiberscopy in patients with adenofibroma have not been described. A 75-year-old nulliparous asymptomatic woman presented with a uterine polyp, which exhibited punctate heterogeneous hyperintensity or islands of isointense-to-hypointense signals on T2-weighted magnetic resonance imaging (MRI), hypointense signals on T1-weighted images (T1WI), and a little enhancement on contrast-enhanced T1WI. Flexible hysterofiberscopy revealed a red-pink polyp with a white-yellow, cobblestone-like surface easily deformed by perfusion fluid. The tumor was diagnosed histologically as an adenofibroma. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The tumor in the uterus was necrotic macroscopically and histologically, and a residual adenofibroma could not be confirmed. At present, two years after surgery, the patient remains healthy. MRI and hysterofiberscopy can reveal the histological features of uterine adenofibromas and be useful for their diagnosis.
Gynaecology Case Reports 407Histological examination demonstrated that the polyp consisted of loose fi brous tissue surrounded by a hyperplastic stratifi ed squamous epithelial layer ( Figure 1K). Th e core of the polyp contained numerous ectatic, irregular, thin-walled blood vessels surrounded by a low density of scattered fusiform and stelliform cells with a low grade of atypia and no mitotic fi gures ( Figure 1L). A small number of proliferating, desmin-positive myofi broblasts were evident ( Figure 1I). Interstitial oedema with some areas of collagenisation, containing ER-positive cells, was also apparent ( Figure 1J). Our immunohistochemistry results satisfy the diagnostic standards established by the WHO for fi broepithelial polyps. However, polyps of this size (6.0 ϫ 4.0 ϫ 1.0 cm) are extremely unusual.Vaginal ultrasound was done to determine whether residual tumour remained in the vagina, as well as to rule out invasive vascular myxoma. No abnormality was detected. Follow-up examinations at 3, 6, and 12 months showed that the cervix of the patient was normal and there was no relapse ( Figure 1B).
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