Search Results (5)

Background: Metastases to the uterine cervix from extragenital malignancies represent uncommon clinical events, with breast invasive lobular carcinoma (ILC) documented as the predominant primary source in reported literature. Objectives/Aim: To characterize the clinicopathologic features of ILCs metastatic to the uterine cervix. Methods: We performed a PubMed search using several keywords. Results: A total of 29 studies were included in the final analysis. The mean age at presentation of cervical metastasis was 56.8 ± 2.0 years. The mean interval between the initial diagnosis of ILC and the detection of cervical metastasis was 55.6 ± 8.2 months. Clinical presentations included vaginal bleeding, pelvic pain, and unhealthy enlarged, indurated uterine cervix on local examination. The diagnosis was established via tissue biopsy and immunohistochemical stains (positive reactivity for CK7, ER, PR, E-Cadherin, GATA3, GCDP-15 and mammaglobin). There are no consensus treatment protocols, and therapy should be tailored individually based on the extent of disease. Combined surgical and systemic therapy was the most commonly used modality. Conclusions: Metastasis of breast ILCs to the uterine cervix poses a significant diagnostic challenge. A high index of clinical suspicion and detailed clinical history are essential for accurate diagnosis. Full article

Uterine angiomyolipoma (AML) is an exceptionally rare mesenchymal tumor of the perivascular epithelioid cell tumor (PEComa) family. Most cases are benign and exhibit a triphasic histologic pattern. Although extragenital PEComas typically show strong, diffuse HMB-45 reactivity, uterine AMLs/PEComas often exhibit weak or negative staining, thereby introducing diagnostic uncertainty. We describe a rare case of uterine AML with diffuse nuclear atypia in a postmenopausal woman, which mimicked a degenerative leiomyoma or leiomyosarcoma. A 49-year-old postmenopausal woman presented with the rapid enlargement of a uterine mass that had been followed for four years as a presumed leiomyoma. Imaging revealed a well-circumscribed uterine mass with heterogeneous enhancement, cystic degeneration, and restricted diffusion on MRI. A total hysterectomy was performed. Grossly, the tumor measured 8 cm. Microscopically, it consisted of pleomorphic epithelioid cells (70%), mature adipose tissue (20%), and thick-walled vessels. Immunohistochemistry revealed diffuse smooth muscle actin (SMA) positivity, while Human Melanoma Black (HMB)-45 and Melan-A were negative. Only one mitosis per 50 HPF was identified, with no atypical mitoses or necrosis, and the Ki-67 index was low (<5%). The patient has remained disease-free for 56 months post-surgery. This case represents the first documented HMB-45-negative uterine angiomyolipoma with diffuse nuclear atypia, characterized by a low mitotic index, low Ki-67 proliferation rate, and a benign 56-month follow-up. It broadens the morphologic spectrum of uterine AML, demonstrating that diffuse nuclear atypia can occur in HMB-45-negative tumors with benign behavior, and that atypia alone should not be interpreted as evidence of malignancy. Recognition of this rare variant is essential to avoid misdiagnosing it as leiomyosarcoma. Full article

Background: Adenomatoid tumor (AT) is a rare benign neoplasm of mesothelial origin, which mainly occurs in the male and female genital tracts. The most common site for AT occurrence in women is the uterus, which makes the presentation in the fallopian tube(s) a rarity with an incidence of approximately 0.5%. The reported extragenital sites include serosal surfaces, adrenal glands, and visceral organs, are even less common. Macroscopically, ATs present as white-grayish or yellowish irregular yet circumscribed firm nodules, often containing cystic components. Owing to a vast array of histomorphological growth patterns, ATs tend to mimic malignancy and trigger overresection. Such clinical situations have been described by several studies for the ovaries, uterus, and fallopian tubes, underlining the importance of differential diagnosis in order to avoid superfluous treatment. Methods: Herein, we report a presentation of an AT at the oviductal lumen, detected incidentally during prophylactic bilateral salpingo-oophorectomy in a 67-year-old patient with a BRCA1 mutation. Results: Immunohistochemical staining revealed a positive expression for calretinin, WT1, and cytokeratin 7, and negative expression for both PAX8 and CD34, thus confirming the diagnosis of AT and excluding tubal malignancy. Conclusions: This report, with a concise review of the global literature on tubal AT, brings attention to the solitary and asymptomatic nature of the tumor. With a clear diagnosis, no surgical radicality is necessary. Full article

This comprehensive study delves into the intricate landscape surrounding the role of human papillomavirus (HPV) in extragenital keratinocyte skin tumors, specifically exploring Bowen’s disease (BD) and in situ squamous-cell carcinoma (iSCC). Through a multifaceted examination, this research study elucidates the nuanced interplay of HPV, gender dynamics, anatomical site variations, and potential implications for the etiopathogenesis of these malignancies. Full article

Malignancies of extragenital origin very rarely metastasize to the uterine body. Endometrium-limited metastases may pose diagnostic challenges in endometrial curettage specimens as they may be misdiagnosed as primary endometrial tumors. We investigated the clinicopathological characteristics of seven cases with endometrial-limited metastases from carcinomas of the nasopharynx (n = 1), breast (n = 2), colon (n = 2), stomach (n = 1), and appendix (n = 1). The patients’ ages ranged from 36 to 71 (mean: 55.4) years. None of the patients had a remarkable gynecological history, and the presenting sign in all cases was abnormal uterine bleeding. Although myometrial involvement was absent, multiple metastases were already present in extrauterine locations such as the lung, liver, bone, abdominopelvic peritoneum, and omentum. All patients underwent ultrasonographic examination prior to endometrial curettage. The histologies of the endometrial metastases identified from the curettage specimens were identical to those of the corresponding primary tumors. Ancillary tests including immunostaining and Epstein–Barr virus-encoded RNA in situ hybridization confirmed the extragenital origin. Endometrium-limited metastases from extragenital malignancies are extremely rare. They present with abnormal vaginal bleeding and mimic endometrial carcinomas of endometrioid or poorly differentiated types. Since their clinical presentations and histological features are similar to those of primary endometrial tumors, pathologists should consider the possibility of metastases while evaluating endometrial curettage specimens obtained from patients with a history of extragenital malignancies. Full article