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Biomedical subjects

D Miliaras

Publications and source records attributed to D Miliaras.

11 recordsLinked to original sources

Breast-like cancer of the vulva: primary or metastatic? A case report and review of the literature.

A 45-year-old white female presented a polypoid nodule in the vulva, one year after she was operated on for breast cancer. Histologic examination showed a poorly differentiated carcinoma that closely resembled the primary breast tumor. Eight similar cases have been previously described in the literature. This very rare event should be differentiated from primary adenocarcinoma of the mammary-like glands of the vulva. The recognition of such a lesion as primary or metastatic is very important, since it greatly influences management and prognosis.

Breast Neoplasms↗

Ovarian capillary hemangioma and stromal luteinization: a case study with hormonal receptor evaluation.

BACKGROUND: Ovarian hemangiomas are rare tumors, most of them asymptomatic, and of the cavernous type. Six of the reported cases were accompanied by stromal luteinization. There is a debate whether these luteinized cells promote the growth of the vascular lesion or just represent a stromal reaction. CASE: A 71-year-old female was incidentally found to have a small capillary hemangioma in her left ovary, surrounded by a rim of luteinized stromal cells. Immunohistochemical investigation revealed the presence of estrogen and progesterone receptors in the endothelial cells of the lesion. CONCLUSION: Our histological and immunohistochemical findings, as well as data from the literature, support the view that at least some vascular lesions may result from hormonal stimulation.

Adenocarcinoma↗

Volume-corrected mitotic index and p53 immunoreactivity in borderline and malignant epithelial ovarian tumors.

OBJECTIVE: To determine if there are differences in p53 immunoreactivity and proliferation rate using the volume-corrected mitotic (M/V) index between borderline and malignant ovarian tumors. STUDY DESIGN: Thirteen borderline (7 serous and 6 mucinous) and 17 malignant (14 serous and 3 mucinous) ovarian neoplasms were included in this study. M/V index was calculated according to the formula of Haapasalo et al. Formalin-fixed, paraffin-embedded tissue sections were immunostained with a monoclonal antibody against p53 protein using an avidin-streptavidin method. RESULTS: Carcinomas had a considerably higher M/V index (17.7 +/- 9.8) than borderline tumors (1.5 +/- 1.7, P < .001). The usual mitotic index was also higher in carcinomas than in borderline tumors (24.9 +/- 16.6 versus 1.6 +/- 1.9, P < .001). p53 Immunoreactivity was found in 5/17 carcinomas (29.4%), while all borderline tumors were negative. CONCLUSION: Even though the number of our cases was too small to draw definitive conclusions, our results suggest that M/V index and p53 immunoreactivity may be of some help in the differentiation between borderline and malignant ovarian epithelial tumors.

Adenocarcinoma, Mucinous↗

Paratubal cysts in young females as an incidental finding in laparotomies performed for right lower quadrant abdominal pain.

Paratubal cysts represent remnants of the paramesonephric or mesonephric duct, the former being more common. Most of them are asymptomatic, but they may rarely give rise to clinical problems due to enlargement or torsion. In this study, we looked for paratubal cysts or other pathological lesions of the right uterine adnexa in young females operated upon for right lower quadrant (RLQ) abdominal pain. Our material consisted of 338 white female patients aged 4-14 years. Laparotomy revealed only acute appendicitis in 283 cases, while 44 had acute appendicitis plus a coincidental paratubal cyst. Most of these cysts were smaller than 1 cm in diameter. However, 2 additional cases had torsion of a large paratubal cyst, while 5 had a ruptured corpus luteum. We suggest that a thorough search of the right adnexa for the presence of paratubal cysts during laparotomies performed for RLQ pain is a useful procedure. This approach also allows detection of other pathological lesions of the right adnexa that often produce symptoms similar to acute appendicitis.

Abdomen, Acute↗

Gross morphologic variations and histologic changes in cryptorchid testes

Cryptorchid testes are frequently accompanied by gross morphologic changes with regard to the size and shape of the testis, various degrees of detachment between the epididymis and testis, elongation of the caudal epididymis and vas deferens, as well as histologic changes. This study examined the gross and microscopic testicular, epididymal, and vas changes in relation to various parameters in 824 patients operated upon in our clinic during the last decade. The major findings were the following: (1) most patients (78.8%) were older than 4 years, and many older than 8 years (39.8%); (2) the frequency of abdominal undescended testes decreased with increasing age (P <0.1), while the frequency of suprascrotal testes increased with increasing age (P <0.001); (3) most of the undescended testes in a suprascrotal position were normal or had mild atrophy (78.7%), while those in intracanalicular, internal ring, and abdominal positions frequently presented moderate or severe atrophy (71,38%; (P <0.0001); and (4) most suprascrotal testes were either normal or had mild extension and looping of the epididymis (63.8%), while most of the intracanalicular, internal ring, and abdominal testes showed moderate or profound epididymal anomalies (63.4%; P <0.0001). We conclude that even though the necessity for early surgical correction of cryptorchidism is well established, these patients at least in our region, still tend to come very late to surgery, with consequent increased risks of infertility and malignant transformation.

Journal Article↗

Intrafollicular ovarian pregnancy after ovulation induction/intrauterine insemination: pathophysiological aspects and diagnostic problems.

Ovarian pregnancy is a rare variant of ectopic implantation. A case of an intrafollicular ovarian pregnancy after ovulation induction/intrauterine insemination is presented. The woman had primary infertility of 4 years. Diagnostic laparoscopy revealed endometriosis and adhesions. After adhesiolysis and laser vaporization of endometriotic implants, the patient underwent ovulation induction with artificial insemination by husband/intrauterine insemination; she conceived at her second attempt. The pregnancy proved to be an ovarian intrafollicular one. She was treated by right partial ovariectomy. Three months later she conceived spontaneously with an intrauterine pregnancy which is still ongoing. The diagnostic problems resulting from the coexistence of ovarian hyperstimulation and the intrafollicular development of pregnancy are discussed. A re-evaluation of the criteria for the diagnosis of ovarian pregnancy based on the currently available diagnostic methods is proposed. Moreover, the pathophysiology of ovarian and especially intrafollicular implantation is reviewed.

Adult↗

Gross morphologic variations and histologic changes in cryptorchid testes.

Cryptorchid testes are frequently accompanied by gross morphologic changes with regard to the size and shape of the testis, various degrees of detachment between the epididymis and testis, elongation of the caudal epididymis and vas deferens, as well as histologic changes. This study examined the gross and microscopic testicular, epididymal, and vas changes in relation to various parameters in 824 patients operated upon in our clinic during the last decade. The major findings were the following: (1) most patients (78.8%) were older than 4 years, and many older than 8 years (39.8%); (2) the frequency of abdominal undescended testes decreased with increasing age (P <0.1), while the frequency of suprascrotal testes increased with increasing age (P <0.001); (3) most of the undescended testes in a suprascrotal position were normal or had mild atrophy (78.7%), while those in intracanalicular, internal ring, and abdominal positions frequently presented moderate or severe atrophy (71,38%; (P <0.0001); and (4) most suprascrotal testes were either normal or had mild extension and looping of the epididymis (63.8%), while most of the intracanalicular, internal ring, and abdominal testes showed moderate or profound epididymal anomalies (63.4%; P <0.0001). We conclude that even though the necessity for early surgical correction of cryptorchidism is well established, these patients at least in our region, still tend to come very late to surgery, with consequent increased risks of infertility and malignant transformation.

Adolescent↗

Two cases of ovarian tumours in women who had undergone multiple ovarian stimulation attempts.

Concerns have been raised recently about the possible association between superovulation and ovarian cancer. In order to contribute to the limited literature on this important issue, two cases of ovarian tumours in women who had undergone multiple ovulation inductions are presented. In the first case, the patient had secondary anovulatory infertility. She was treated with human menopausal gonadotrophin (HMG) alone and in combination with clomiphene citrate or buserelin for six cycles. She then underwent ovarian stimulation with buserelin/HMG in the long protocol for in-vitro fertilization (IVF) and embryo transfer. In preparation for a new IVF/embryo transfer attempt, 8 months later, the screening ultrasound revealed a cystic formation of the left ovary and an enlargement of the right. During laparotomy, both ovaries were found to bear large tumours (approximately 6 x 5 x 4 cm) which were removed. Histological examination showed that they were epithelial tumours (serous-papillary cystadenomas) of borderline malignancy. The patient conceived spontaneously 1.5 years after the operation. In the second case, the patient presented with secondary anovulatory infertility. She underwent ovulation induction with clomiphene/HMG and with buserelin/HMG in the long protocol, and intra-uterine insemination with husband's spermatozoa and conceived (singleton pregnancy). She was delivered by Caesarean section, during which a cystic tumour of the left ovary was removed. Histological examination revealed a benign mucous cystadenoma of the ovary.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Angiogenesis in invasive breast carcinoma: is it associated with parameters of prognostic significance?

Recent experimental and clinical studies suggest that tumour-induced angiogenesis may be an important step in the evolution of malignant tumours, and may be related to prognosis. In our study we examined 42 cases of breast carcinoma (mean age: 56.76 +/- 13.5), 21 with lymph node metastases and 21 without. Angiogenesis was evaluated after immunohistochemical staining of tumour vessels, using polyclonal antibody to factor VIII related antigen (VIIIR-Ag) and counting of the three most active areas of neovascularization. In the same manner we counted the microvessels in lymph node metastases. The mean vessel count of node-negative cases (51.16 +/- 19.32) did not differ significantly from node-positive cases (45.66 +/- 17.44). In contrast patients younger than 50 years had much higher mean vessel counts (54.04 +/- 16.47) than did patients older than 70 years (38.03 +/- 16.73) producing a P value of < or = 0.05. No association was found between tumour size and mean vessel count, nor was there any significant difference between grade I (45.94 +/- 16.54), grade II (53.13 +/- 23.22) and grade III tumours (51.71 +/- 20.64). When we compared the mean vessel count of primary tumours with those of node metastases, we found much lower counts in the latter (P < or = 0.01). The differences in our results from previous studies, probably reflect the heterogeneity which exists between different tumours in their ability to induce angiogenesis. Additionally, there is some evidence in our study that angiogenesis is possibly related to patient age and probably depends on differences in the tumour stroma.

Adult↗

[Castleman's pseudotumor in children. Apropos of an unusual case].

A case of abdominal pseudo-tumor of Castleman disease is reported in a nine year-old boy. The patient is well without evidence of recurrence three years following resection. Castleman's disease is a benign disorder of lymph nodes that occurs rarely in children. Since the first description by Castleman in 1954, 286 other cases have been published and we could find only four cases in the 10 year and younger age group in the literature and only one case in the same group with anemia, hypergammaglobulinemia fever and weight loss. The management requires surgical resection of the enlarged nodes both for diagnosis and therapy, since the enlarged nodes can mimic malignant tumors of the lymphoid system. After surgical excision no recurrences have been reported.

Abdominal Neoplasms↗