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Pseudomyxoma peritonei associated with colloid carcinoma of the pancreas.

A case of pseudomyxoma peritonei associated with a mucin-rich, "colloid" adenocarcinoma of the pancreas is described. This previously unreported association was characterized by an extremely rapid clinical course, transerosal spread of the neoplastic process, and the consistent presence of intracytoplasmic lumina in all cells, an ultrastructural feature thought to characterize malignant lesions.

Adenocarcinoma, Mucinous↗

Ovarian teratoma with gliomatosis peritonei.

Gliomatosis peritonei (GP) is a rare occurrence associated exclusively with ovarian teratoma (OT), in which numerous metastatic nodules composed mainly of mature glial tissue are studded on the peritoneum, omentum, and bowel wall. Two female patients (aged 5 years and 14 years) are reported. Various preoperative examinations confirmed a large abdominal teratoma with normal alpha-fetoprotein and beta-HCG. The OT was excised and partial omentectomy and incidental appendectomy were performed to remove as many metastatic nodules as possible. Pathological examinations including immunostains for glial fibrillary acidic protein showed predominantly mature glial tissue in the OT and in the metastatic nodules. An addition, chemotherapy was given to one of them, but both were well without recurrent diseases 17 months and 12 months postoperatively, respectively. The outcome of these two cases, in contrast to advanced malignancy in widespread intraperitoneal metastases of any other kind, supports the concept of benign nature of GP and a conservative surgical approach to this rare disorder.

Adolescent↗

Alpha-fetoprotein in ovarian teratoma with glial implants on the peritoneum.

A case of ovarian teratoma with glial implants on the peritoneum associated with alpha-fetoprotein (AFP) in the blood is reported. After repeated surgical excision the AFP became negative. The AFP can also be considered as a tumor marker in case of ovarian teratoma. The literature concerning ovarian teratoma with glial implants on the peritoneum is reviewed. The pathogenesis of glial implantation on the peritoneum and the association with AFP is discussed.

Child↗

Immature teratoma with gliomatosis peritonei associated with pregnancy.

Immature teratoma is a malignant form of teratoma that contains immature structures resembling those of the embryo. It is rare and accounts for less than 1% of all ovarian cancers. It occurs most frequently in young women but it is very rarely reported in association with pregnancy.

Adult↗

Use of a long-acting GnRH agonist for benign cystic mesothelioma.

BACKGROUND: Benign cystic mesothelioma, a tumor characteristically found in women during the reproductive years, is rare after bilateral oophorectomy or menopause, suggesting hormonal sensitivity. CASE: We treated a 17-year-old woman with a rapidly increasing and symptomatic benign cystic mesothelioma with a long-acting GnRH agonist. A rapid and continued reduction in volume corresponded to the induction and maintenance of a hypoestrogenic state over a 6-month period. However, the subsequent addition of a combination of estrogen and progestin (known as add-back therapy) resulted in a gradual increase in cyst volume, which progressed after discontinuation of all therapy. Resumption of GnRH-analog therapy alone reduced cyst volume again, and the patient underwent surgical removal. CONCLUSION: Long-acting GnRH agonists may have a role in the conservative management of these rare neoplasms. The reduction in volume concomitant with a hypoestrogenic state and regrowth with addition of add-back therapy further suggest extreme sensitivity of this tumor to one or both hormones.

Adolescent↗

Successful treatment of pseudomyxoma peritonei of ovarian origin with cis-platinum, doxorubicin, and cyclophosphamide.

Pseudomyxoma peritonei is a rare disease characteristically secondary to mucin-producing adenocarcinomas of the ovary and appendix. Though, as a rule, not invasive or metastatic, death occurs secondary to gastrointestinal dysfunction. This is the first case of pseudomyxoma peritonei secondary to an ovarian primary possibly cured by systemic cis-platinum, doxorubicin, and cyclophosphamide.

Antineoplastic Combined Chemotherapy Protocols↗

Coexistent immature teratoma of the uterus and endometrial adenocarcinoma complicated by gliomatosis peritonei.

A 37-year-old nulliparous woman presented with severe vaginal bleeding due to a primary immature teratoma of the uterus (Grade II on the Norris scale). The subsequent hysterectomy specimen showed well-differentiated endometrial adenocarcinoma. Mature glial implants were present on both ovaries and throughout the omentum. Postoperative recovery was uneventful and the patient received a course of pelvic radiotherapy. She has remained well with no evidence of recurrence. Primary benign solid teratoma of the uterus is rare. This appears to be the first reported case of primary immature uterine teratoma.

Adenocarcinoma↗

Gliomatosis peritonei with endometriosis externa.

A case of gliomatosis peritonei developed 9 years after the removal of an immature ovarian teratoma is reported. An unique association of gliomatosis with endometriosis externa was found without the usual symptoms of endometriosis. The prognosis of gliomatosis is generally excellent and depends on the histological grade of the primary tumor and on the presence of organ metastasis or immature tumor elements in the implants. Pathogenetical aspects of both lesions are discussed briefly.

Child↗

Benign teratoma of the omentum and ovary coexistent with an ovarian neoplasm.

Benign cystic teratoma of the omentum is a rare abdominal tumor. Review of the literature describes seven reported cases of omental teratomas in association with ovarian teratomas. Our patient is a 68-year-old woman who presented with an asymptomatic abdominal mass and uterine prolapse. Ultrasound revealed a right-sided, cystic and solid pelvic mass. CT scan revealed a second mass with calcifications situated along the right iliac crest. This is the first description of an omental teratoma in association with a benign ovarian cystic teratoma coexistent with a malignant neoplasm. Possible etiologies of the present case are discussed and additional literature investigated.

Aged↗

Malignant hemangiopericytoma of the omentum presenting as an ovarian tumor.

Malignant hemangiopericytomas are usually found in the musculature of the extremities, the retroperitoneum, and the pelvis. Malignant hemangiopericytoma arising in the omentum is extremely rare. We recently experienced such a case, in which a malignant ovarian tumor was suspected preoperatively on the basis of the sonogram, CT scan, magnetic resonance image, and increased CA-125 value. Microscopically, the tumor showed many mitoses, increased cellularity, and cytologic atypia. The patient was treated with CAP combination therapy following resection of the tumor; however, an intraperitoneal recurrence probably due to implantation was recognized 11 months later.

Diagnosis, Differential↗