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Ovarian Neoplasms/*diagnosis ; Magnetic Resonance Imaging/*methods ; Leiomyoma/*diagnosis ; Image Enhancement/*methods ; Humans ; Female ; Diagnosis, Differential ; Cystadenoma/*diagnosis ; Adenofibroma/*diagnosis

OBJECTIVE: We wanted to assess the MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma, and we wanted to find clues for making the differential diagnosis between them. MATERIALS AND METHODS: The MR images of 12 pathologically proven cystadenofibromas and two cystadenocarcinofibromas were reviewed, with a focus on the internal architecture, signal intensity and enhancement. RESULTS: All the tumors appeared as multilocular cysts, except for a single unilocular cystic mass and a single solid mass. The previously reported characteristic MR findings of cystadenofibroma (a multilocular cystic mass with a T2-dark-signal-intensity solid component containing small cystic locules) were found in only 43% of the tumors (6/14). Diffuse or partial thickening of the cyst wall with T2-dark signal intensity without a definite solid component was as common as the previous reported findings (6/14). Two cystadenocarcinofibromas showed more prominent solid portions with higher T2-signal intensities and stronger enhancement than did the cystadenofibromas. CONCLUSION: Diffuse or partial thickening of the cyst wall with dark-signal-intensity in multilocular cystic masses may suggest ovarian cystadenofibroma, and this type of appearance may be as common as the previously reported characteristic appearance. A prominent solid component with a higher T2-signal intensity and strong enhancement are the typical findings of cystadenocarcinofibroma.
Sensitivity and Specificity ; Reproducibility of Results ; Ovarian Neoplasms/*diagnosis ; Middle Aged ; Magnetic Resonance Imaging/*methods ; Leiomyoma/*diagnosis ; Image Enhancement/*methods ; Humans ; Female ; Diagnosis, Differential ; Cystadenoma/*diagnosis ; Adult ; Adenofibroma/*diagnosis

OBJECTIVE: To evaluate the feasibility and effectiveness of laparoscopic adnexal surgery in posthysterectomy patients and review clinical characteristics including comparison of the adhesion score of left with that of right adnexal mass. METHODS: From February 2004 to January 2007, we reviewed the medical records of 23 post-hysterectomy patients who received laparoscopic adnexal surgery including age, parity, type of hysterectomy, operative indications, histopathological diagnosis, operating time, size of the adnexal mass, adhesion score, change in the hemoglobin level, hospital stay, and any complications. RESULTS: The median age of patients was 48 years (range 35-69 years), and median parity was 2 (0-3). The median operating time was 100 minutes (range 35-180 minutes), and the median size of the adnexal mass was 7.1 cm (range 4-12 cm). The median change in hemoglobin level was 1.8 g/dL (range 0.6-4.1 g/dL). The median hospital stay was 4 days (range 3-19 days). The adhesion score was significantly higher in the left adnexal mass than in the right adnexal mass. Histopathological diagnosis included 6 cases of mucinous cystadenoma, 6 cases of functional cyst, 4 cases of hydrosalpinx, 3 cases of serous cystadenoma, 1 case of fibrothecoma, 1 case of mucinous adenofibroma, 1 case of endometrioma, and 1 case of tubo-ovarian abscess. There were no intraoperative complications or conversion to laparotomy. One case of postoperative ileus was noted. CONCLUSION: The skilled laparoscopic surgeon is capable of achieving successful result by performing laparoscopic surgery primarily to patients with adnexal mass for posthysterectomy patients who are expected to suffer severe adhesion. In posthysterectomy patients, left adnexal mass has more extensive adhesion than right adnexal mass, and these finding was represented as a high adhesion score of left adnexal mass.
Abscess ; Adenofibroma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Diagnosis ; Endometriosis ; Female ; Humans ; Hysterectomy ; Ileus ; Intraoperative Complications ; Laparoscopy ; Laparotomy ; Length of Stay ; Medical Records ; Mucins ; Parity

Adenofibroma ; pathology ; Adenosarcoma ; metabolism ; pathology ; surgery ; Aged ; Diagnosis, Differential ; Endometrial Neoplasms ; pathology ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Keratin-7 ; metabolism ; Middle Aged ; Mucin-1 ; metabolism ; Polyps ; pathology ; Postoperative Period ; Preoperative Period ; Uterine Neoplasms ; metabolism ; pathology ; surgery

Adenofibroma ; metabolism ; pathology ; Antigens, CD34 ; metabolism ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; surgery ; Nephroma, Mesoblastic ; metabolism ; pathology ; Sarcoma, Clear Cell ; metabolism ; pathology ; Stromal Cells ; metabolism ; pathology ; Vimentin ; metabolism

OBJECTIVETo study the clinicopathologic features and differential diagnosis of recurrent Müllerian adenofibroma (MAF) of the uterus.

METHODSClinicopathologic information of 7 cases of recurrent MAF of uterus was retrieved from January 1992 to April 2006 and compared with 12 cases of MAF without recurrence and 14 cases of low-grade Müllerian adenosarcoma (MAS). EnVision immunohistochemistry of estrogen receptor (ER), progesterone receptor (PR), smooth muscle actin (SMA), CD10, Ki-67 and p53 were performed in all cases.

RESULTSAll cases of recurrent MAF of the uterus were polypoid, lobulated, and broad based mass arising from the corpus or cervix. Microscopically, the tumor consisted of benign epithelial and mesenchymal components with low mitotic activity ( ≤ 1/10 HPF). The clinical and pathologic features of 3 recurrent tumors were similar to their primary tumors, while 4 cases of recurrent tumor presented with focally higher cellularity and mitotic activity, meeting the diagnostic criteria of adenosarcoma. The stromal expression patterns of ER, PR, SMA and p53 in recurrent MAF were similar to those of clinically benign MAF and low-grade MAS. Negative or focally positive stromal cell expression of CD10 was seen infrequently in recurrent MAF (1/7) and clinically benign MAF (1/12). In contrast, a moderate to strong CD10 staining was frequently seen in MAS (9/14, P < 0.05). The difference of Ki-67-labeling index between MAF and MAS did not reach a statistical significance (P > 0.05). Ki-67-labeling index increased in areas of periglandular stromal cuffing as compared with interglandular areas in all MAS cases, but it was not observed in either recurrent MAF or clinically benign MAF cases.

CONCLUSIONSRecurrent MAF may be associated with aggressive behavior. It is difficult to distinguish MAF from low-grade MAS. CD10 and Ki-67 staining pattern in stromal cells may be helpful for the differential diagnosis.

Adenofibroma ; metabolism ; pathology ; surgery ; Adenosarcoma ; metabolism ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; methods ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neprilysin ; metabolism ; Survival Rate ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Young Adult