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Biomedical subjects

R E Scully

Publications and source records attributed to R E Scully.

At least 181 records · Page 10Linked to original sources
PubMed1988

Mucinous ovarian tumors associated with mucinous adenocarcinomas of the cervix. A clinicopathological analysis of 16 cases.

Sixteen cases of mucinous adenocarcinoma of the cervix that were associated with a mucinous tumor of one or both ovaries are reported. The patients ranged from 25 to 70 (average, 44) years of age; two of them had the Peutz-Jeghers syndrome. Eight patients complained of abdominal swelling; most of the remainder had symptoms of uterine origin. Twelve patients had bilateral and four had unilateral ovarian tumors, which were typically large and cystic. Microscopic examination of most of the ovarian tumors revealed various combinations of benign-appearing, borderline, and carcinomatous mucinous epithelium within the same specimen. Most of the cervical tumors were deeply invasive; 10 of them were of the adenoma malignum type. Although there were varying degrees of uncertainty in individual cases, consideration of several features including the extent and distribution of disease in the abdomen, the comparative histology of the tumors, and the pattern of ovarian involvement suggested that 10 of the ovarian tumors were independent primary tumors, three were metastatic from the cervix, and in three cases the ovaries contained both primary and metastatic tumors.

Adenocarcinoma, Mucinous↗
PubMed1988

Serous papillary cystadenoma of borderline malignancy of broad ligament. A report of 25 cases.

The clinical and pathological features of 25 serous papillary cystadenomas of borderline malignancy of the broad ligament were analyzed. The ages of the patients ranged from 19 to 67 (average, 32) years. The clinical presentation was lower abdominal pain, pelvic pain or both in five cases, accompanied by menometrorrhagia or amenorrhea in three cases. One patient was thought to have an acute abdominal disorder. The tumors of the remaining 19 patients were discovered either on routine gynecological examination or during an evaluation of the pregnancy status of the patient. In 14 cases the tumor was located in the left broad ligament and in 11 cases it was on the right side; all the tumors were entirely separated from the ipsilateral ovary. On gross examination the tumors were 1-13 cm in greatest dimension, had smooth outer surfaces, and contained straw-colored, watery fluid. The inner lining bore single or multiple 0.3-2.5 cm excrescences. Microscopic examination revealed that the cyst walls and their excrescences were lined by simple to pseudostratified, cuboidal to columnar, focally ciliated epithelium. Slight nuclear atypism, very rare mitotic activity, and focal psammoma body formation were also found. The stroma resembled ovarian stroma but no primary follicles or follicular derivatives were identified. Twenty-three of the patients were alive and well from 0.5 to 11 years after excision of the tumor, one patient was disease-free for 8.5 years but died of an open-heart surgical procedure; and two patients were lost to follow-up examination.

Adnexa Uteri↗
PubMed1988

Idiopathic postmenopausal decidual reaction of the endometrium. A clinicopathologic analysis of four cases.

The clinical and pathological features of four cases of endometrial decidual reaction in postmenopausal women are described. There was no evident exogenous or endogenous source of progesterone excess in any of the patients. The pathological findings, including bulky polypoid tissue, necrosis, cellular pleomorphism, signet-ring-like decidual cells, and glandular atypia, raised the possibility of a malignant tumor in two of the cases. This report appears to be the first documenting an idiopathic decidual reaction in the endometrium of a postmenopausal patient.

Aged↗
PubMed1988

Urothelial and ovarian carcinomas of identical cell types: problems in interpretation. A report of three cases and review of the literature.

Three women, 51-69 years of age with carcinomas of the urinary bladder or ureter, had ovarian tumors of identical cell types 2 to 7 years apart. In two cases the tumors were transitional-cell carcinomas and in the third case, signet-ring-cell carcinomas. It was difficult in the cases of transitional-cell carcinoma to determine whether the ovarian tumors were metastatic or independent primary tumors. Consideration of a variety of features of our two cases and of four similar cases reported in the literature led us to the conclusion that the ovarian tumors were probably metastatic in one case, probably primary in two cases, and of unknown nature in three cases, but some degree of doubt existed in all the cases. The signet-ring-cell tumor in the ovary had the typical features of a Krukenberg tumor. Four of 11 women with signet-ring-cell carcinomas of the bladder have had ovarian metastases.

Adenocarcinoma, Mucinous↗
PubMed1988

Cysts (cystadenomas) and tumors of the rete ovarii.

Cysts and tumors of the rete ovarii have been described only rarely and little is known of their pathology. We describe herein 16 cases of cysts (cystadenomas), 2 solid adenomas, and 1 adenocarcinoma of rete ovarii origin. The patients with the cysts were 23-80 years of age (mean age, 59 years). The cysts averaged 8.7 cm in diameter and were characterized by a location in the hilus; a flat, cuboidal, or columnar, usually nonciliated-lining epithelium; crevices along the inner surfaces; and a fibromuscular wall that often contained hyperplastic hilus cells. The cysts showed many similarities to microscopic dilatations of the rete. The rete adenomas were incidental microscopic findings in two women 45 and 68 years of age. They were located in the hilus and were composed of cords and tubules lined by cells resembling closely those of the normal rete. The rete adenocarcinoma occurred in a 52-year-old woman, was bilateral, and could be partly localized to the hilus. Microscopic examination revealed retiform spaces containing papillae and nests of transitional-like epithelium. Criteria for distinguishing cysts and tumors of rete origin from other ovarian tumors are discussed.

Adenocarcinoma↗
PubMed1988

Calcified thecomas in young women. A report of four cases.

Four young women, all of whom were less than 30 years of age and had a variety of menstrual irregularities, had ovarian thecomas that were remarkable because of the presence of extensive calcification. The calcification was visible on x-ray examination of the abdomen in one case and was appreciated grossly in all four. Microscopic examination revealed that the calcification was the most striking microscopic feature in all the cases; in one case it was psammomatous. One tumor also exhibited extensive adipose metaplasia. Only two other extensively calcified thecomas have been reported in detail in the literature; one of them also occurred in a young woman. Extensively calcified thecomas appear to occur in younger women more often than thecomas that are not calcified or minimally calcified, and enter into the differential diagnosis in a patient with adnexal calcification on x-ray examination of the abdomen.

Adolescent↗
PubMed1988

Uterine tumors with mixed epithelial and mesenchymal elements.

The clinical and pathologic features and the differential diagnosis of uterine tumors containing mixed epithelial and mesenchymal elements are reviewed. The malignant mullerian mixed tumor (MMMT) is the most common neoplasm in this group, which also includes the mullerian adenofibroma and adenosarcoma, endometrial stromal neoplasms with focal epithelial differentiation, uterine tumors resembling ovarian sex cord tumors, and adenomyomas, including the atypical polypoid adenomyoma.

Adenofibroma↗
PubMed1988

Proliferations and tumors of intermediate trophoblast of the placental site.

The clinical and pathologic features of proliferations and tumors of intermediate trophoblast of the placental site are reviewed. These lesions include the exaggerated placental site reaction, which is a florid form of the process that occurs normally at the placental site; a hitherto undescribed variant of this lesion, which we have designated placental site nodule, and the neoplasm of intermediate trophoblast that has been termed placental site trophoblastic tumor. Problems encountered in distinguishing these lesions from one another and from nontrophoblastic lesions, particularly in endometrial biopsy specimens and curettings, are discussed.

Diagnosis, Differential↗
PubMed1988

Ovarian cystectomy for serous borderline tumors: a follow-up study of 35 cases.

We have investigated the frequency of persistence or recurrence of tumor in 35 patients with ovarian serous borderline tumors treated by unilateral cystectomy, bilateral cystectomy, or unilateral cystectomy with contralateral oophorectomy or salpingo-oophorectomy. Nineteen of the patients had stage Ia, ten had stage Ib, four had stage Ic, and two had stage III tumors. Tumor persisted or recurred only in the ovary that had been subjected to cystectomy in two (6%) of the 33 patients with stage I tumors, in both the ipsilateral and contralateral ovary in one patient (3%), and in the contralateral ovary only in one patient (3%). The frequency of ipsilateral persistence or recurrence of tumor per ovary subjected to cystectomy in this group of patients was 8%. Both patients with stage III tumors had persistence or recurrence of their tumors. Involvement of the resection margin of the cystectomy specimen and the removal of more than one cyst from an ovary were almost always associated with persistence or recurrence of tumor. Follow-up of the 35 patients showed that despite the occasional complication of persistence or recurrence of tumor, all were alive without evidence of disease 3-18 years after the initial operation, with an average follow-up of 7.5 and a median follow-up of 6.5 years.

Adolescent↗
PubMed1988

Intravenous leiomyomatosis of the uterus. A clinicopathological analysis of 16 cases with unusual histologic features.

We describe 16 cases of intravenous leiomyomatosis of the uterus with unusual histologic features. Most of the patients, who ranged in age from 28 to 76 years (median, 42 years), presented with abnormal uterine bleeding or pelvic pain. On pelvic examination, they had an enlarged uterus. Extension of tumor into the broad ligament was noted at operation in six patients; it was documented on pathologic examination in an additional three cases. Gross examination disclosed enlargement of the uterus by solitary or multiple masses; wormlike plugs of tumor within myometrial veins were noted on initial examination in only five cases. Histologic examination in each case revealed proliferations of benign-appearing smooth muscle within myometrial vessels, at least some of which were large veins. The tumors differed from typical intravenous leiomyomatosis (IVL). They were classified as cellular IVL (six cases), epithelioid IVL (four cases), IVL with bizarre nuclei (two cases), intravenous lipoleiomyomatosis (two cases), myxoid IVL (one case), and IVL with an endometrial component (one case). Of 13 patients with follow-up information, 11 are alive with no evidence of disease or have died of unrelated causes at postoperative intervals of 0.5 to 19 years. One patient underwent resection of pelvic recurrent tumor 2 years postoperatively and was alive with no evidence of disease 2 years later. Another patient had pulmonary metastases 9 years postoperatively, but was alive with stable disease after an additional 6 years. This analysis indicates that most of the histologic variants of benign uterine leiomyoma can exhibit the intravascular growth pattern of IVL. These variants of IVL, except for their cellular composition, resemble typical IVL in both their clinical and pathological features. They should be distinguished from other tumors, particularly endometrial stromal sarcoma and leiomyosarcoma, which differ in their behavior and management.

Adult↗
PubMed1988

The testicular "tumor" of the adrenogenital syndrome. A report of six cases and review of the literature on testicular masses in patients with adrenocortical disorders.

The clinical and pathological features of 40 cases in which testicular masses developed in patients with the adrenogenital syndrome are reviewed; this study was based on six personally observed cases and 34 other cases in the literature. The adrenal disorder was of the salt-losing form in two-thirds of the cases and the non-salt-losing form in the other third. Although the clinical diagnosis of the adrenogenital syndrome had been established prior to the discovery of the testicular lesion in most of the patients, in 18% of them the diagnosis was not made until or after the development of a testicular mass. Two-thirds of the masses were palpable (up to 10 cm); these cases were usually discovered in early adult life (average, 22.5 years). The remaining one-third were small (under 2 cm) and were usually found in children either at autopsy or on testicular biopsy. Eighty-three percent of the masses were bilateral. Eighty-six percent of the small lesions were located in the hilus. The larger lesions involved the testicular parenchyma in all but one case. They formed well-demarcated but unencapsulated brown-green masses, typically separated into lobules by prominent bands of fibrous tissue. Microscopical examination revealed sheets, nests, and (rarely) cords of cells with abundant eosinophilic cytoplasm separated by bands of fibrous tissue. Lipochrome pigment was identified in the cytoplasm in many cases, but crystals of Reinke were uniformly absent. The major pathological differential diagnosis is Leydig cell tumor; the associated clinical and laboratory features--including the high frequency of bilaterality and a decrease in the size of the tumor with corticosteroid therapy--are diagnostic of a testicular "tumor" of the adrenogenital syndrome. Although a variety of origins have been suggested for these lesions, in our opinion an origin from hilar pluripotential cells, which proliferate as a result of the elevated level of adrenocorticotropic hormone, is most likely.

Adrenal Hyperplasia, Congenital↗
PubMed1987

Hepatoid carcinoma of the ovary. A newly described tumor.

Five cases of ovarian carcinoma with hepatoid features, three of them primary and two probably primary, are described. The tumor cells were arranged predominantly in sheets and contained moderate to abundant amounts of eosinophilic cytoplasm; varying numbers of tumor cells stained immunohistochemically for alpha fetoprotein. In contrast to the much younger age range of patients with ovarian hepatoid yolk sac tumors, the ages of the five patients with hepatoid carcinomas ranged from 42 to 78 (average, 63 years), and none of them had gonadal dysgenesis or recognizable germ cell components within their tumors. All the tumors presented as adnexal masses; in four cases they were Stage III and in one case, Stage IIB; this last tumor spread to the upper abdomen within 4 years. In three cases the clinical course and pathology findings indicated that the tumor had originated in the ovary; in the remaining two cases the tumors were interpreted as only probably primary in the ovary. Hepatoid carcinomas must be distinguished from other ovarian neoplasms, especially from hepatoid yolk sac tumors.

Adult↗
PubMed1987

Ovarian yolk sac tumor arising from an endometrioid carcinoma.

A yolk sac tumor that arose within an ovarian endometrioid adenocarcinoma in a 50-year-old woman is described. The tumor had typical microscopic features, stained immunohistochemically for alpha-fetoprotein, and was associated with an elevated serum alpha-fetoprotein level when metastases appeared. This is the fourth case in which a yolk sac tumor has been reported to develop from a somatic carcinoma and the second in which this tumor has been associated with epithelium of endometrioid type. Tumor heterogeneity or neometaplasia may account for the origin of a tumor of germ cell type from a carcinoma of somatic origin.

Carcinoma↗
PubMed1987

Hepatocellular carcinoma metastatic to the testis.

A 57-year-old man had upper gastrointestinal signs and symptoms associated with testicular swelling and elevation of the serum alpha-fetoprotein level. Abdominal exploration revealed a large solitary liver mass and massively enlarged retroperitoneal lymph nodes, and a right scrotal exploration revealed a 4-cm testicular tumor. An orchidectomy and retroperitoneal biopsy were performed. The tumor was composed of nests, sheets, trabeculae, and clusters of polyhedral cells with eosinophilic cytoplasm and nuclei with prominent nucleoli. The tumor cells stained strongly for alpha-fetoprotein, alpha 1-anti-trypsin, and albumin by the immunoperoxidase technic. The clinical, light microscopic, and immunocytochemical features indicate that the testicular tumor was a metastatic hepatocellular carcinoma, only the second reported case of this type.

Albumins↗
PubMed1987

Oxyphilic clear cell carcinoma of the ovary. A report of nine cases.

Nine clear cell carcinomas (CCC) of the ovary with a prominent component of cells with abundant eosinophilic cytoplasm are reported. The majority of these tumors--which we have designated "oxyphilic clear cell carcinomas"--were misinterpreted by the referring pathologists as tumors of other types. Each specimen, however, had one or more features establishing it as a clear cell carcinoma, including tubules and cysts lined by cuboidal, hobnail, or flattened cells; nests and sheets of cells with abundant clear cytoplasm containing glycogen; and an adjacent adenofibromatous component. Two tumors were bilateral. The ages of the patients (average, 55 years), their clinical presentation, and the gross appearance of the neoplasms were similar to those of clear cell carcinomas in general. The diagnosis of clear cell carcinoma should always be considered in the differential diagnosis of an ovarian tumor with oxyphil cells, particularly if the patient is postmenopausal. Thorough sampling should be undertaken in such cases to identify other, more typical foci of clear cell carcinoma in order to avoid misdiagnosis.

Adenocarcinoma↗
PubMed1987

Endometrioid-like variant of ovarian yolk sac tumor. A clinicopathological analysis of eight cases.

The clinical and pathological features of eight ovarian yolk sac tumors with glandular patterns resembling those of endometrioid adenocarcinoma are described. The patients ranged in age from 11 to 34 years (mean, 22 years) and presented with abdominal pain or swelling. The serum alpha-fetoprotein (AFP) level was elevated at the time of presentation or later in all seven patients in whom it was measured. Seven tumors were unilateral, one was bilateral, and three had spread beyond the ovary. There was a contralateral streak gonad in two cases. The tumors were 6-35 cm in diameter; seven were solid and cystic, and one was a unilocular cyst with a small solid nodule in the wall. Microscopic examination revealed a prominent, and in two cases, pure endometrioid-like glandular pattern that often simulated that of an early secretory endometrium. Reticular, polyvesicular-vitelline, and hepatoid patterns of yolk sac tumor were also present in five tumors; minor teratomatous foci (squamous epithelium and cartilage) were present in one. Immunohistochemical staining revealed AFP, alpha-1-anti-trypsin (AAT), and carcinoembryonic antigen within the glandular epithelium; AFP and AAT were also present in areas showing the other patterns. Three patients died of recurrent or metastatic tumor 19-60 months postoperatively; in the remaining cases, there was a tumor-free follow-up of short duration. The endometrioid-like pattern reflects an unusual form of endodermal differentiation within yolk sac tumors that should be distinguished from endometrioid carcinoma.

Adolescent↗