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Results for “Mixed Tumor, Mesodermal”

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PubMed1997

Uterine sarcoma: can it be differentiated from uterine leiomyoma with Doppler ultrasonography? A preliminary report.

Our objective was to evaluate whether intratumoral-blood flow analysis could differentiate uterine sarcoma from uterine leiomyoma. Color and pulsed Doppler findings obtained from 41 patients with histologically proven uterine leiomyoma and five with uterine sarcoma (four leiomyosarcoma, one mixed mesodermal tumor) were retrospectively assessed. Intratumoral blood flow velocity waveforms were recorded, and the resistance index (RI) and peak systolic velocity (PSV) were calculated. There was no significant difference between the RI (median 0.647; range 0.422-0.896) in the uterine leiomyomas and the RI (median 0.663; range 0.330-0.774) in the uterine sarcomas. The PSV (median 61.6 cm/s; range 40.0-124.0 cm/s) in the uterine sarcomas was significantly higher (median 21.6 cm/s, range 6.3-48.6 cm/s) than that in the uterine leiomyomas (p < 0.05). When a cut-off value for the PSV of 41.0 cm/s (mean PSV of the uterine leiomyomas plus 2 standard deviations) was considered, the detection rate for uterine sarcoma was 80.0%, and the false-positive rate was 2.4%. These results suggest that the PSV within the tumor detected by color and pulsed Doppler ultrasonography could be useful for the preoperative differential diagnosis of uterine sarcoma.

Adult↗

PubMed1984

Alpha-1-antitrypsin hematoxylin and eosin fluorescence: a rapid, useful screening technic.

Sections stained with hematoxylin and eosin from seven liver biopsies and two ovarian mixed mesodermal tumors containing alpha-1-antitrypsin globules were examined by fluorescent microscopy. Al-AT globules readily were seen in all biopsies and fluoresced brightly. Megamitochondria and acidophil bodies in liver biopsies also fluoresced but were distinguished easily by their morphology and topographic location. Normal liver biopsies contained no fluorescent bodies. It is concluded that examination of routine hematoxylin and eosin stained sections by fluorescent microscopy is a rapid convenient screening method for the detection of al-AT globules. Acidophil bodies and megamitochondria also are seen by this method.

Benzopyrans↗

PubMed1995

Impact on progression-free survival of adjuvant cyclophosphamide, vincristine, doxorubicin (adriamycin), and dacarbazine (CYVADIC) chemotherapy for stage I uterine sarcoma. A prospective trial.

To assess the impact on progression-free survival of the use of the multiagent chemotherapy regimen of cyclophosphamide, vincristine, doxorubicin (Adriamycin), and dacarbazine (CYVADIC) as adjuvant treatment for patients with stage I uterine sarcoma: 20 evaluable patients who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for stage I uterine sarcoma received adjuvant multiagent chemotherapy with vincristine sulfate 1 mg/m2 days 1 and 4, doxorubicin (Adriamycin) 40 mg/m2 and cyclophosphamide 400 mg/m2 day 2, and dacarbazine 200 mg/m2 days 1 through 4 for a total of 9 monthly cycles or until recurrence of disease was documented. Patients were followed for a median of 65 months (range: 5-116 months). Myelotoxicity was monitored by weekly complete blood counts, cardiac toxicity by monthly radionuclide angiography, and neurotoxicity by monthly physical examination. Survival and progression-free survival were calculated by the method of Kaplan and Meier (17). The Fisher exact test was employed to determine the significance of recurrence rates between histologic groups (18). These 20 patients received 172 of a planned 180 cycles of chemotherapy. Dose reductions in response to myelotoxicity were necessitated in four cycles among three patients. Mild neurotoxicity was observed in six patients (30%) and moderate neurotoxicity in one patient (5%). A decrease in cardiac ejection fraction of > 10% was observed in two patients (10%). No deaths ascribable to complications arising from chemotherapy were observed. Seven patients (35%) developed recurrence of disease. Recurrence rates for pure sarcomas and mixed mesodermal tumors did not differ significantly (P = .65). Progression-free survival for the population at 2 years was 80% and at 5 years was 65%. This study describes the largest prospective trial of adjuvant combination chemotherapy for patients with stage I uterine sarcoma reported to date. Adjuvant chemotherapy employing the combination of cyclophosphamide, vincristine, doxorubicin (Adriamycin), and dacarbazine (CYVADIC) failed to impact significantly on long-term survival in this group of patients with stage I uterine sarcoma.

Adult↗

PubMed2002

Endometrial polyps with atypical (bizarre) stromal cells.

Atypical stromal cells of the lower female gynecologic tract have been specifically described in the vagina, vulva, and cervix, predominantly in the context of polyps. Rare cases of atypical stromal cells have been documented in the endometrium. We report a series of 15 examples of atypical stromal cells in the endometrium: 13 in endometrial polyps and two within endometrial stroma in curettage/biopsy specimens unassociated with polyps. The patients ranged in age from 45 to 82 years. Immunohistochemical studies were performed to aid in the identification of the origin of these atypical cells. The differential diagnoses included adenosarcoma, endometrial stromal sarcoma, and, less likely, malignant mesodermal mixed tumor (MMMT/carcinosarcoma). Similar to atypical stromal cells reported in other gynecologic sites, such cells discovered in the endometrium also appear to have a benign clinical course after complete excision or polypectomy (follow-up ranging from 1 month to 44 months). Accurate recognition of this lesion is essential to avoid unnecessary surgical overtreatment. Because of their rarity, limited available data, and lack of significant long-term follow-up, continued clinical monitoring of these patients would be prudent.

Adenosarcoma↗

PubMed2001

Primary mullerian carcinosarcoma of the retroperitoneum: report of a case.

A müllerian carcinosarcoma or malignant mesodermal mixed tumor (MMMT) originated from the retroperitoneum of a 51-year-old woman; only two previous similar cases have been reported. The 1,040 gm tumor was found in the left retroperitoneal space; the center of the tumor was extensively liquified. The uterus, fallopian tubes, and ovaries were unremarkable. The histopathological features of the tumor were typical of MMMT, homologous type. The adenocarcinomatous component of the tumor was immunohistochemically positive for cytokeratin 7 and negative for cytokeratin 20. MMMTs arising in extragenital sites are rare, and most of them arise from the peritoneum. The histogenesis of extragenital MMMTs remains speculative, but the origin from the "secondary mullerian system" is most likely.

Carcinosarcoma↗

PubMed2004

Establishment and characterization of JHUCS-1 cell line derived from carcinosarcoma of the human uterus.

The cell line designed JHUCS-1 was established from a carcinosarcoma (malignant mixed mesodermal tumor) of the uterus that was surgically removed from a 57-year-old Japanese woman. We carefully examined the histopathology of the original tumor after the cell line was established and noted differentiation into a neuroendocrine carcinoma within the tumor's epithelial components. Immunohistochemical staining of the tumorous tissue that had been heterotransplanted was positive for Leu7. Additionally, secretary granules were observed in the grafted cells as determined by electron microscopy. These results support the existence of neuroendocrine cells within the JHUCS-1 cell line.

Animals↗

PubMed1988

Uterine sarcomas: a clinicopathologic study.

A series of 48 cases with initial diagnosis of uterine sarcoma was reviewed to evaluate the validity of histologic criteria. The influence of pathologic and clinical prognostic factors and treatment modalities were examinated. The 32 patients included in this retrospective study after pathologic review had 5-year overall survival rate of 13.1%. Surgical pathological staging was demonstrated to be a significant prognostic factor, since patients with FIGO stage I-II disease had 33.5% actuarial survival rate whereas no patient with stage III-IV disease was alive at 37 months. Histological type, age and menopausal status did not significantly influence survival. Presence of heterologous elements and lymphovascular invasion were associated with a poor prognosis in the subgroup of patients with mixed mesodermal tumors. Median survival for patients receiving adjuvant treatment was 25 months compared to 19 months for those undergoing no adjuvant therapy.

Adolescent↗

PubMed1989

Collagen type III formation and distribution in the uterus: effects of hormones and neoplasm development.

The amount and location of interstitial collagen in the endometrial stroma and the uterine wall as well as the effects of hormonal stimulation and neoplastic transformation were studied by light and electron microscopy and immunohistochemical methods using specific antibodies to aminoterminal propeptide type III procollagen (PIIIP). The results showed collagen deposition in atrophic mucosae and in the proliferative endometrium with a decrease in the secretory endometrium. In cystic glandular hyperplasia and adenomatous hyperplasia, PIIIP deposits were abundant. In well-differentiated endometrial adenocarcinoma, dense collagen type III aggregates were found in subepithelial positions, disintegrating with advancing malignancy and decreasing in hormonal-treated morphologically well-differentiated neoplasms. The even distribution of PIIIP around muscle cells and bundles in leiomyomas was disturbed and partly absent in leiomyosarcomas, and surrounded epithelial islets in mixed mesodermal tumors.

Adenocarcinoma↗

PubMed1995

Ifosfamide-induced nonconvulsive status epilepticus.

OBJECTIVE: To describe a patient with ifosfamide-induced nonconvulsive status epilepticus. CASE SUMMARY: A 71-year-old woman with a history of malignant mixed mesodermal tumor involving the uterus, cervix, and vagina was admitted because of local recurrence. After receiving 3 doses of ifosfamide/mesna, she was found to be unresponsive. Physical examination and laboratory data revealed no significant changes. An electroencephalogram was consistent with the diagnosis of nonconvulsive status epilepticus. The patient's mental status returned to baseline after treatment with intravenous phenytoin and discontinuation of ifosfamide therapy. DISCUSSION: Central nervous system (CNS) toxicity has been described with ifosfamide, with most cases reported in the pediatric population. Among CNS toxicities, generalized tonic-clonic seizures have been reported in both children and adults. This represents the first report of nonconvulsive status epilepticus induced by ifosfamide. CONCLUSIONS: There was a temporal relationship between the onset of nonconvulsive status epilepticus and initiation of ifosfamide infusion. No other identifiable factor contributed to the unresponsiveness.

Aged↗

PubMed2000

[Fibroepithelial polyp of the vagina. Report of a case].

Fibro epithelial polyp of the vagina is a rare lesion. Although benign, it can be confused with Sarcoma botryoides, rhabdomyosarcoma and mixed mesodermal tumor because of its bizarre histology. A case is reported of a women 27 years old with a great pedunculated polyp of the vagina which measured 8 x 12 cm. The microscopy examination revealed fibro epithelial polyp of the vagina. Treatment is simple local excision. Recurrence is uncommon.

Adult↗

PubMed2001

BARX2 induces cadherin 6 expression and is a functional suppressor of ovarian cancer progression.

The human homeobox BARX2 is located at 11q24-q25, within a minimal region associated with frequent loss of heterozygosity and adverse survival in epithelial ovarian cancer. BARX2 is a transcription factor that regulates transcription of specific cell adhesion molecules in the mouse. We show that BARX2 and cadherin 6 are expressed in normal human ovarian surface epithelium. BARX2 and cadherin 6 both have significantly lower expression in a clinical sample of endometrioid and clear cell ovarian cancers, as compared with serous or mixed mesodermal tumors. In a series of ovarian cancer cell lines, BARX2 expression showed a significant direct correlation with cadherin 6 expression. In OAW42, an ovarian cancer cell line that does not endogenously express BARX2, in vitro transfection of human BARX2 cDNA induced cadherin 6 expression. Transfection of BARX2 into OAW42 inhibited Matrigel invasion, haptotactic cellular migration to a collagen IV signal, and adhesion to collagen IV-coated plates. Our data demonstrate that BARX2 is expressed in the ovarian surface epithelium and has functional suppressor properties in ovarian cancer cells.

Adenocarcinoma, Clear Cell↗

PubMed2002

[Tamoxifen and breast cancer].

Tamoxifen is a selective estrogen receptor modulator (SERM) with pro- and anti-estrogenic properties. Currently it is the most widely used agent for first line treatment against hormone sensitive metastatic breast cancer and the only approved hormonal agent for adjuvant treatment of organ confined breast cancer. Furthermore, its uses have been extended for the treatment of intraductal breast carcinoma patients. In such settings the most worrisome side effect of tamoxifen is its ability to increase the rates of uterine cancers. It has been claimed that most of these cancers are found at an early stage because of vaginal bleeding. Moreover, it has been shown that for most women transvaginal ultrasound is an ineffective screening method for the early detection of uterine carcinomas. It is important, however, to notice that long term tamoxifen treatment can cause metastatic uterine cancer--not only carcinomas but also sarcomas (mainly malignant mixed mesodermal tumors. It should be noted that, at least for the special population of BRCA mutation carriers, transvaginal ultrasound can increase our ability for the earlier discovery of ovarian cancer. Thus, we believe that there is still a place for the use of transvaginal ultrasound in special populations. This is specifically for long term tamoxifen users (more than the usually recommended five years), women with a higher chance of having uterine carcinomas (namely very high body weight, strong family history) and women with a high index of suspicion as carriers of a BRCA mutation. Until new second generation SERMs and aromatase inhibitors are shown to possess better anti-cancer abilities than tamoxifen, this drug will remain in wide use, however, we must not overlook its possible rare side effects.

Antineoplastic Agents, Hormonal↗

PubMed1992

Intrinsic resistance to methotrexate in human soft tissue sarcoma cell lines.

A human fibrosarcoma cell line, HT-1080, and four new cell lines (HS-16, HS-28, HS-30, and HS-42) were established from untreated patients with mesenchymal chondrosarcoma, peripheral nerve sheath sarcoma, malignant hemangiopericytoma, and mixed mesodermal tumor, respectively, and were used for analysis of mechanisms of intrinsic resistance to methotrexate. All four new cell lines were resistant to methotrexate as determined by inhibition of thymidylate synthase in whole cells and by growth inhibition, as compared with HT-1080, a methotrexate sensitive cell line. Methotrexate uptake, level of dihydrofolate reductase, and inhibition of this enzyme by methotrexate in the four cell lines were comparable to HT-1080 cells. However, levels of long chain polyglutamates (glu3-5) of methotrexate achieved after a 24-h incubation with this drug were much lower in the four new cell lines as compared to the HT-1080 cell line (5- to 20-fold lower). The low levels of methotrexate polyglutamates formed is likely the major cause of intrinsic methotrexate resistance in these new sarcoma cell lines.

Drug Resistance↗

PubMed1991

[Phase II study of 5'-DFUR in uterine cervical cancer and ovarian cancer].

A phase II study of 5'-DFUR was conducted in uterine cervical cancer and ovarian cancer by the cooperative study group consisting of 26 institutions. Forty-four cases with uterine cervical cancer and 40 cases with ovarian cancer were enrolled. A daily dose of 800-1,200 mg was administered orally for more than 8 weeks. In 34 evaluable cases with uterine cervical cancer, the overall efficacy rate was 20.6%: CR was shown in 2 cases, PR in 5 cases, MR in 2 cases, NC in 17 cases and PD in 8 cases. Histologically, the response rate was 27.3% in large cell non-keratinizing type, 20.0% in small cell non-keratinizing type and 15.4% in keratinizing type of squamous cell carcinoma. The overall response rate was 20.7% in squamous cell carcinoma, while 25.0% in adenocarcinoma. In 31 evaluable cases with ovarian cancer, the overall efficacy rate was 16.1%: PR was shown in 5 cases, MR in 3 cases, NC in 11 cases and PD in 12 cases. Histologically, the response rate was 16.7% in serous cystadenocarcinoma, 25.0% in endometrioid adenocarcinoma and 33.3% in undifferentiated carcinoma. No responses were observed in cases with mucinous cystadenocarcinoma, clear cell adenocarcinoma, mature cystic teratoma with malignant transformation and mesodermal mixed tumor. Some adverse effects were observed in 43.2% (32 out of 74 cases evaluated for adverse effects), but those of grade 4 were not observed. Most of them were gastro-intestinal disturbances such as diarrhea and anorexia. Diarrhea of grade 3 was observed in 12.2% and anorexia of grade 3 in 5.4%. Severe myelosuppression or hepatic toxicity was not observed. These results suggested that 5'-DFUR is a useful anticancer drug against uterine cervical cancer and ovarian cancer.

Adenocarcinoma↗

PubMed1991

Uterine müllerian adenosarcoma with histiocytic (xanthomatous) mesenchymal component.

We present an endometrial Müllerian adenosarcoma in which the sarcomatous component showed prominent nests of foamy cells that accounted for 50% of the neoplastic mesenchyma. Such foamy cells showed occasional cytological atypias and immunohistochemical features of histiocytic (macrophagic differentiation in the absence of changes that could substantiate the presence of an inflammatory infiltration of foamy histiocytes. These facts suggest histiocytic differentiation from neoplastic mesenchymal cells. Such differentiation has been reported in association with malignant mixed mesodermal tumor, but not in Müllerian adenosarcoma.

Biomarkers, Tumor↗

PubMed1991

Gynecologic malignancies.

The combination of cisplatin and cyclophosphamide remains the preferred regimen for the primary treatment of advanced stage epithelial ovarian cancer. Maximal dose intensity, particularly that of cisplatin, is generally accepted as critical for optimal results, but the concept has not yet been rigorously validated by prospective, randomized trials. Since higher doses of cisplatin are associated with renal and neurologic toxicity, the accumulating evidence of equivalent response rates with the less toxic platinum analogue, carboplatin, is encouraging. Salvage chemotherapy remains unsatisfactory, although the remarkable responses observed this year in heavily pre-treated and platinum-resistant patients with the novel new agent taxol is promising. Further trials with this unique drug in combination with other agents in previously untreated patients, as well as in salvage settings, is eagerly anticipated. Although experience with intraperitoneal therapy is rapidly accumulating, the precise role for this route of delivery has yet to be demonstrated in prospective trials. The management of early stage ovarian cancer has become increasingly clarified. Several trials have now demonstrated that a subgroup of patients at low risk for recurrence do well with surgery alone, while a high-risk subgroup clearly benefits from adjuvant therapy. The identification of optimal regimens awaits further trials. In cervical carcinoma, trials utilizing a variety of radiation-sensitizing agents have failed to demonstrate superiority over that of hydroxyurea, which has been shown to improve survival in advanced disease. Preliminary experience with neo-adjuvant regimens administered prior to surgery or radiation therapy is promising, but survival advantages utilizing this approach have yet to be demonstrated. In endometrial cancer, cisplatin was shown to achieve response rates similar to those attainable with single agent doxorubicin, and in uterine mixed mesodermal tumors, ifosfamide was found to have significant activity.

Antineoplastic Agents↗

PubMed1990

Gynecologic Oncology Group experience with ifosfamide.

In July 1985, the Gynecologic Oncology Group initiated a series of phase II trials with ifosfamide/mesna in advanced or recurrent gynecologic malignancies. Previously untreated patients received ifosfamide 1.5 g/m2/d intravenously (IV) for 5 days. Mesna was given IV every 4 hours for three doses after ifosfamide administration at a dose of 20% of the daily ifosfamide dose. All patients with ovarian cancer and 87% of those with cervical cancer had had prior platinum-based therapy. Because of the toxicity encountered in previously treated patients with ovarian carcinoma, the dose of ifosfamide was reduced to 1.2 g/m2/d in those who had had prior chemotherapy or radiotherapy. In epithelial ovarian carcinoma, responses were observed in eight (20%) of 41 evaluable patients, with three (7%) complete responses (CRs). Response duration was 2.1 to 20.3+ months (median, 6.9+ months). In squamous carcinoma of the cervix, 3 (11.1%) of 27 evaluable patients had partial responses (PRs) of 1.8-, 2.2-, and 3.1-month duration. Of 26 untreated patients with mixed mesodermal tumors of the uterus, 5 (19.2%) had CRs and 3 (11.5%) had PRs, for an overall response rate of 30.7%. Response duration was 1.4+ to 8.6 months, with a median of 3.8 months. Toxicity included two deaths from renal insufficiency and a third related to neurologic impairment. Hematologic toxicity was manageable. Ifosfamide/mesna has activity in a wide range of gynecologic malignancies.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1989

Phase II experience with ifosfamide/mesna in gynecologic malignancies: preliminary report of Gynecologic Oncology Group studies.

The Gynecologic Oncology Group initiated a series of phase II trials of ifosfamide/mesna in women with advanced or recurrent gynecologic malignancies in July 1985. Previously untreated patients received ifosfamide, 1.5 g/m2/d, intravenously (IV) for five days. Mesna was given IV in three doses every four hours after ifosfamide; each dose was 20% of the daily ifosfamide dose (ie, 300 mg/m2). All patients with ovarian and 87% of those with cervical cancer had undergone platinum-based therapy previously. Because of the toxicity encountered in previously treated ovarian cancer patients, the dose of ifosfamide was reduced to 1.2 g/m2/d in patients who had received prior chemotherapy or radiotherapy. In epithelial ovarian carcinoma, responses were observed in eight (21.6%) of 37 evaluable patients with three (8.1%) complete responses. Response duration was 2.1 to 20.3+ months with a median of 6.9+ months. In squamous carcinoma of the cervix, three (11.1%) of 27 evaluable patients had partial responses of 1.8, 2.2, and 3.1 months' duration. Of 29 untreated patients with mixed mesodermal tumors of the uterus, five (17.9%) had complete and four (14.3%) had partial responses for an overall response rate of 32.2%. Response duration was 1.4+ to 8.6 months with a median of 3.8 months. Toxicity included two deaths from renal insufficiency and a third related to neurologic impairment. Hematologic toxicity was manageable. Ifosfamide/mesna has activity in a wide range of gynecologic malignancies.

Antineoplastic Combined Chemotherapy Protocols↗