Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy.
Abdomen ; Abdominal Wall* ; Carboplatin ; Diagnosis ; Drug Therapy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Ovum ; Paclitaxel ; Positron-Emission Tomography ; Postmenopause ; Prognosis ; Recurrence

Prolapse of the fallopian tube into the vaginal vault after hysterectomy is a rare phenomenon and it occurs more frequently after vaginal hysterectomy than abdominal hysterectomy. The exact incidence of tubal prolapse is unknown, because most of cases remain undiagnosed and may resolve before detection. The tubal prolapse may be suspected when granulation tissue or tender friable tissue are detected in vaginal cuff in women complaining lower abdominal pain, dysparenunia, vaginal discharge, or postcoital spotting. The definitive diagnosis of fallopian tube prolapse is made only by histologic confirmation. Reported methods of treatment have included transvaginal excision or transabdominal excision, cautery, and combined vaginal and laparoscopic salpingectomy. We experienced a case of fallopian tube prolapse after abdominal hysterectomy in a 40-year-old woman. We present this case with a brief review of the literature.
Abdominal Pain ; Adult ; Cautery ; Diagnosis ; Fallopian Tubes* ; Female ; Granulation Tissue ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Incidence ; Metrorrhagia ; Prolapse* ; Salpingectomy ; Vaginal Discharge

OBJECTIVE: Reduced tumor cell adhesion is associated with invasive growth and unfavorable prognosis. In endometrial carcinoma, the prognostic impact of adhesion marker such as E-cadherin is partly known. The purpose of this study is to investigate the correlation of the expression and the mutation of E-cadherin in endometrioid endometrial adenocarcinomas and endometrial hyperplasias and to correlate their results with various clinicopathological factors. METHODS: The expression of E-cadherin by using immunohistochemical staining (IHC) and the mutation of E-cadherin gene by using polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and sequencing were performed in tissues of 20 endometrial adenocarcinomas and 30 endometrial hyperplasias. The results were compared with previously known prognostic factors such as the stage, tumor grade and lymph node metastasis. RESULTS: Decreased expression of E-cadherin was detected in 13 of 30 (43.3%) endometrial carcinomas and in 1 of 20 (5%) endometrial hyperplasias (P=0.009). There was no statistical significance of the mutation of E-cadherin gene in between the endometrial carcinomas and endometrial hyperplasias (6.7%: 0%) (P=0.06). The incidence of the expression loss of E-cadherin in endometrial carcinomas also showed significantly higher with tumor grade 3, tumor stage above Ic or lymph nodal metastasis (P=0.01, P=0.02, P=0.03). CONCLUSION: Decreased expression of E-cadherin was detected significantly higher in endometrial carcinomas than endometrial hyperplasias. And the incidence of decreased expression of E-cadherin was more frequent in advanced stage, high histopathologic grade, and lymph nodal metasis. The mutation of E-cadherin gene was detected in only 2 cases. These results suggests that the expression of E-cadherin seems to be important in endometrial carcinomas and associated with aggressive subgroups. But the mutation of E-cadherin gene would not be related to endometrial carcinomas.
Adenocarcinoma ; Cadherins ; Cell Adhesion ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Female ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Schwannoma commonly arises from Schwann cells of the neural sheath, and is rare in the groin region. Here, we describe a vaginal schwannoma incidentally detected by magnetic resonance imaging (MRI) in a patient with thigh pain. A 43-year-old woman presented with thigh pain with burning and tingling sensations in the medial aspect of her left thigh. MRI revealed a mass lesion of heterogeneous intensity 5.2 x 5.7 cm in the left vaginal wall. The mass was resected and histology revealed schwannoma.
Adult ; Burns ; Diagnosis* ; Female ; Groin ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma* ; Schwann Cells ; Sensation ; Thigh* ; Vaginal Neoplasms

Malignant germ cell tumors of the ovary are uncommon neoplasms. Although 20-25% of all ovarian tumors are derived from germ cells, only about 3% of germ cell tumors are malignant. Mixed germ cell tumors contain at least two malignant germ cell elements. These lesions should be managed with combination chemotherapy, preferably BEP. Recently we experienced a case of mixed germ cell tumor with 6 components of germ cell and sarcomatous change in a 11 year old girl. Preoperative CA-125, B-hCG, aFP, LDH, a-1-antitrypsin were elevated and the final pathologic report was mixed germ cell tumor composed of endodermal sinus tumor, embryonal carcinoma, mature and immature teratoma, choriocarcinoma, dysgerminoma and sarcomatous change, Postoperative chemotherapy with 6 courses of BEP regimen was performed and all tumor markers became normal after 4 courses of chemotherapy. What we interested in this case was several components of germ cells and sarcomatous change and the sarcomatous change might be derived from the mature cystic teratoma component, so we present this case with a brief review of the literatures here.
Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy ; Teratoma ; Biomarkers, Tumor

OBJECTIVE: The incidence of endometrial cancer is increasing. We would like to report our institution's clinical data of endometrioid adenocarcinoma (EC) which is the most frequent type. METHODS: From 1998 to 2009, patients' clinical data were reviewed through medical records, retrospectively. RESULTS: For 11 years, there were 96 patients with EC. The average age was 51.1 years old and mean follow duration was 36.6 months. There were 73 patients with stage I, 10 patients with stage II, and 12 patients with stage III. 42 patients were treated by operation only and 46 patients were treated by operation and adjuvant radiotherapy. Among 95 patients who underwent operations, 32 patients did not get lymph node removal and 63 did, and 10 patients had malignant cells at the lymph nodes removed. 6 patients died of EC, 1 with stage I, 3 with stage II and 1 with stage III. CONCLUSION: This study had retrospective limitation but could show the profile of 96 patients with EC.
Adenocarcinoma ; Carcinoma, Endometrioid ; Endometrial Neoplasms ; Female ; Humans ; Incidence ; Lymph Nodes ; Medical Records ; Radiotherapy, Adjuvant ; Retrospective Studies

Endometrial cancer is the most common malignancy of the female genital tract. The cancer spreads by direct extension, transtubal dissemination, lymphatic dissemination, and/or by hematogenous spread, usually results in lung metastasis, but may less commonly involve liver, brain, and bone. Here, we describe a patient with stage IA endometrial cancer who developed liver recurrence 17 months after surgery.
Brain ; Endometrial Neoplasms ; Female ; Humans ; Liver ; Lung ; Neoplasm Metastasis ; Recurrence

OBJECTIVE: To assess the prognostic factors of early endometrial cancer. METHODS: Medical records of patients with endometrial cancer stage I and II were reviewed retrospectively between 1999 and 2005. Progress-free survival rates of each prognostic factor were obtained. RESULTS: The mean age of 45 patients was 49 (27-74). Thirty-nine patients had stage I, 6 patients had stage II of the disease. Most cases of histology were diagnosed with endometrioid adenocarcinoma (42 patients, 93.3%). Twenty-three patients had grade 1, 16 patients had grade 2, and 6 patients had grade 3 histology. Thirty patients had myometrial invasion of less than 50%, while 15 patients had myometrial invasion of more than 50%. Thirty-one patients showed no lympho-vascular space involvement (LVSI), and 14 patients were LVSI positive. All patients were primarily treated by surgery. Twenty-four patients received adjuvant radiotherapy, and 1 patient received concurrent chemotherapy and radiotherapy. In univariate analysis, FIGO stage (p=0.004), tumor grade (p=0.043), myometrial invasion (p=0.030), and LVSI (p=0.003) had statistical significance with PFSR. However, age, parity, menopause, lymphadenectomy, and histology did not. CONCLUSION: Stage, tumor grade, myometrial invasion, and LVSI seemed to be statistical prognostic factors in early endometrial cancer.
Carcinoma, Endometrioid ; Endometrial Neoplasms ; Female ; Humans ; Lymph Node Excision ; Medical Records ; Menopause ; Parity ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.
Adenomyosis ; Endometrium ; Female ; Humans ; Hysterectomy* ; Leiomyoma ; Uterus

Perivascular epithelioid cell tumors (PEComas) at the uterus are very rare tumors and about 30 cases have been reported as far as we know. As a case was experienced at our hospital, we would like to report it with a brief review of literature.
Epithelioid Cells* ; Perivascular Epithelioid Cell Neoplasms ; Uterus*