Solid teratomas and mixed Müllerian tumors of the ovary: A clinical histological, and immunocytochemical comparative study

Calame, J.J.; Schaberg, A

doi:10.1016/0090-8258(89)90555-6

Cited by 18 publications

(5 citation statements)

References 22 publications

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“…In comparison, the cancer rate for serologically negative neurologic patients evaluated in the Mayo Clinic Neuroimmunology Laboratory is 18% . Glial fibrillary acidic protein immunoreactivity has been reported in some neoplasm types identified in this study: teratoma, carcinoid (admixed with teratoma), salivary pleomorphic adenoma, prostate carcinoma, and melanoma . Cancer screening appropriate for age, sex, and risk factors is recommended for GFAP-specific IgG–positive patients.…”

Section: Discussionmentioning

confidence: 72%

“…Finding ovarian teratoma in 1 of 2 GFAP-specific IgG-positive cases who had NMDAR-specific IgG is consistent with the multiplicity of neural antigens in mature teratomas. 25 Astrocyte lineage heterogeneity is well recognized. 30 With maturation, ratios of GFAP isoforms to other intermediate filament proteins change.…”

Section: Discussionmentioning

confidence: 99%

“…Detection of a coexisting antibody (eg, NMDAR-specific IgG) may refine the cancer search. Finding ovarian teratoma in 1 of 2 GFAP-specific IgG–positive cases who had NMDAR-specific IgG is consistent with the multiplicity of neural antigens in mature teratomas …”

Section: Discussionmentioning

confidence: 99%

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Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy

et al. 2016

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IMPORTANCE A novel astrocytic autoantibody has been identified as a biomarker of a relapsing autoimmune meningoencephalomyelitis that is immunotherapy responsive. Seropositivity distinguishes autoimmune glial fibrillary acidic protein (GFAP) meningoencephalomyelitis from disorders commonly considered in the differential diagnosis.OBJECTIVE To describe a novel IgG autoantibody found in serum or cerebrospinal fluid that is specific for a cytosolic intermediate filament protein of astrocytes.DESIGN, SETTING, AND PARTICIPANTS Retrospective review of the medical records of seropositive patients identified in the Mayo Clinic Neuroimmunology Laboratory from October 15, 1998, to April 1, 2016, in blinded comprehensive serologic evaluation for autoantibody profiles to aid the diagnosis of neurologic autoimmunity (and predict cancer likelihood). MAIN OUTCOMES AND MEASURESFrequency and definition of novel autoantibody, the autoantigen's immunochemical identification, clinical and magnetic resonance imaging correlations of the autoantibody, and immunotherapy responsiveness. RESULTSOf 103 patients whose medical records were available for review, the 16 initial patients identified as seropositive were the subject of this study. Median age at neurologic symptom onset was 42 years (range, 21-73 years); there was no sex predominance. The novel neural autoantibody, which we discovered to be GFAP-specific, is disease spectrum restricted but not rare (frequency equivalent to Purkinje cell antibody type 1 [anti-Yo]). Its filamentous pial, subventricular, and perivascular immunostaining pattern on mouse tissue resembles the characteristic magnetic resonance imaging findings of linear perivascular enhancement in patients. Prominent clinical manifestations are headache, subacute encephalopathy, optic papillitis, inflammatory myelitis, postural tremor, and cerebellar ataxia. Cerebrospinal fluid was inflammatory in 13 of 14 patients (93%) with data available. Neoplasia was diagnosed within 3 years of neurologic onset in 6 of 16 patients (38%): prostate and gastroesophageal adenocarcinomas, myeloma, melanoma, colonic carcinoid, parotid pleomorphic adenoma, and teratoma. Neurologic improvement followed treatment with high-dose corticosteroids, with a tendency of patients to relapse without long-term immunosuppression.CONCLUSIONS AND RELEVANCE Glial fibrillary acidic protein-specific IgG identifies a distinctive, corticosteroid-responsive, sometimes paraneoplastic autoimmune meningoencephalomyelitis. It has a lethal canine equivalent: necrotizing meningoencephalitis. Expression of GFAP has been reported in some of the tumor types identified in paraneoplastic cases. Glial fibrillary acidic protein peptide-specific cytotoxic CD8 + T cells are implicated as effectors in a transgenic mouse model of autoimmune GFAP meningoencephalitis.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy

et al. 2016

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“…A previous study reported that GFAP was a coimmunogen in certain occult neoplasms, such as lymphoma, driving immune responses against this antigen [ 1 ]. GFAP immunoreactivity has also been reported in some neoplasms, including carcinoid, pleomorphic adenoma of the salivary gland, teratoma, prostate cancer and melanoma [ [1] , [16] , [17] , [18] ]. Antibodies to tumor markers and blood and CSF tests for paraneoplastic syndrome were negative in the current patient.…”

Section: Discussionmentioning

confidence: 99%

Organ donation after brain death from autoimmune glial fibrillary acidic protein astrocytopathy: A case report

Li,

Shen,

Chen

et al. 2024

Heliyon

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“…In a recent study of 40 patients treated in a single institution, the MS was only 8.7 months (2) , and the outcome was generally worse in patients with bulky residual disease and in those with advanced FIGO stage. Poor outcome has also been associated with the presence of heterologous elements (18,32,36) . However, in most studies, histology (homologous vs heterologous) had no clear influence on patient outcome (4,7–10,37,38) .…”

Section: Natural History and Prognosismentioning

confidence: 99%

Current management of ovarian carcinosarcoma

Mano

Rosa

Azambuja

et al. 2007

Int J Gynecol Cancer

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Ovarian carcinosarcomas (OCS), also known as malignant mixed müllerian tumors, are uncommon malignancies that carry a poor prognosis. The presentation of OCS is usually indistinguishable from that of epithelial ovarian cancer. Due to its low frequency, prospective trials have been difficult to perform, but there is evidence that OCS are sensitive to platinum-based chemotherapy. Recent studies have shown encouraging results with platinum-ifosfamide and platinum-taxane schedules, which are usually considered the treatment of choice. However, poor performance status at presentation is also a common problem, so that many patients may be unsuitable for combination chemotherapy but may still benefit from single-agent platinum or ifosfamide or, occasionally, from nonplatinum schedules such as ifosfamide plus paclitaxel. Aggressive cytoreductive surgery appears to have a positive impact on outcome and should probably be offered to most patients. However, this procedure has been associated with higher rates of complication in OCS and should only be attempted by experienced (gynecological) surgeons in centers with expertise in the management of gynecological malignancies.

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Solid teratomas and mixed Müllerian tumors of the ovary: A clinical histological, and immunocytochemical comparative study

Cited by 18 publications

References 22 publications

Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy

Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy

Organ donation after brain death from autoimmune glial fibrillary acidic protein astrocytopathy: A case report

Current management of ovarian carcinosarcoma

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