bromochloroacetic-acid and Adenomatoid-Tumor

Paratesticular tumors are rare. Most of them are benign, and adenomatoid tumors are most common. These tumors sometimes infiltrate the testicular parenchyma and require differential diagnosis with malignant tumors. In such cases, intraoperative biopsy allows for performing conservative surgery.. A retrospective study of nine patients with paratesticular adenomatoid tumors seen during a nine-year period (2000-2008) is reported.. Patient age (mean, 49.6 years) and most common initial signs (tender nodule) are reported. The tumor most commonly occurred as a small, usually oval, nodule in the tail of epididymis. Our series included a case each of intraparenchymal tumor of the testis and tumor of the tunica vaginalis. Diagnosis was initially made based on a ultrasound scan and subsequently confirmed by histology. Differential diagnosis and surgical treatment, performed in all patients, are reported, and also the pathological features of surgical specimens.

Topics: Adenomatoid Tumor; Adult; Calbindin 2; Diagnosis, Differential; Epididymis; Genital Neoplasms, Male; Humans; Keratins; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Proteins; Retrospective Studies; S100 Calcium Binding Protein G; Testis; Ultrasonography

Topics: Adenocarcinoma; Adenomatoid Tumor; Adenomyoma; Adult; Antibodies, Monoclonal, Murine-Derived; Biomarkers, Tumor; Calbindin 2; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Keratins; Leiomyoma; Lymphatic Vessel Tumors; Middle Aged; Uterine Neoplasms; Young Adult

A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.

Topics: Adenomatoid Tumor; Calbindin 2; Hemangioma; Hepatectomy; Humans; Keratins; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Neprilysin; S100 Calcium Binding Protein G; Tomography, X-Ray Computed; Vimentin

Adenomatoid tumors are rare benign neoplasms thought to be of mesothelial origin. Although most reported cases arise from the epididymis, rare cases have been reported in the spermatic cord, testicular tunica, ejaculatory ducts, prostate, and suprarenal recess. We describe a 4.5-year-old boy who presented with a relatively asymptomatic right testicular mass that was resected and confirmed to be adenomatoid tumor of the testis by histopathology. Because of its rarity, the clinical and histopathologic aspects are discussed.

Topics: Adenomatoid Tumor; Biomarkers, Tumor; Child, Preschool; Cryptorchidism; Diagnosis, Differential; Humans; Keratins; Male; Organ Sparing Treatments; Teratoma; Testicular Neoplasms; Ultrasonography; Vimentin

Adenomatoid tumors are benign mesothelial neoplasms most commonly found in the male and female genital tracts. Extragenital adenomatoid tumors are rare, most of them being solitary tumors. To our knowledge, only one case of multiple extragenital adenomatoid tumors, involving the liver and peritoneum, has been reported to date. Here we report another case of multiple extragenital adenomatoid tumors involving the mesocolon and omentum. A 47-year-old woman presented with a delayed menstrual period. Ultrasonography revealed a left adnexal mass, and surgical resection was attempted at a local hospital. The patient was transferred to our hospital without resection due to the intraoperative finding of multiple peritoneal tumors. At our hospital, an 8.0x7.5x6.0 cm tumor at the mesocolon of the sigmoid colon and three omental nodules measuring up to 2.5x2.0x1.7 cm were resected. Grossly, they were well circumscribed, gray-tan and elastic with small cystic spaces. Microscopically, they were composed of tubules and anastomosing channels lined by flattened or cuboidal cells with bland nuclei. Immunohistochemically, the tumor cells were positive for pan-cytokeratin AE1/AE3, vimentin, cytokeratin 5/6 and calretinin. The postoperative course was uneventful, and the patient was well 10 months after the operation. Despite their rarity, adenomatoid tumors should be included in the differential diagnosis of multiple intra-abdominal tumors.

Topics: Adenomatoid Tumor; Calbindin 2; Female; Humans; Keratins; Mesocolon; Middle Aged; Neoplasms, Multiple Primary; Omentum; Peritoneal Neoplasms; S100 Calcium Binding Protein G; Vimentin

An unusual primary adenomatoid tumour arising in the normal liver is described. Hepatectomy was performed, and the patient is alive and free of disease 1 year postsurgery. Grossly, the tumour showed a haemorrhagic cut surface with numerous microcystic structures. Histological examination revealed cystic or angiomatoid spaces of various sizes lined by cuboidal, low-columnar, or flattened epithelioid cells with vacuolated cytoplasm and round to oval nuclei. The epithelioid cells were entirely supported by proliferated capillaries and arteries together with collagenous stroma. Immunohistochemical studies showed that the epithelioid cells were strongly positive for a broad spectrum of cytokeratins (AE1/AE3, CAM5.2, epithelial membrane antigen and cytokeratin 7) and mesothelial markers (calretinin, Wilms' tumour 1 and D2-40). These cells were negative for Hep par-1, carcinoembryonic antigen, neural cell adhesion molecule, CD34, CD31 and HMB45. Atypically, abundant capillaries were observed; however, the cystic proliferation of epithelioid cells with vacuoles and immunohistochemical profile of the epithelioid element were consistent with hepatic adenomatoid tumour.

Topics: Adenomatoid Tumor; Adult; Biomarkers, Tumor; Calbindin 2; Hepatectomy; Humans; Immunohistochemistry; Keratins; Liver Neoplasms; Male; Neovascularization, Pathologic; S100 Calcium Binding Protein G; Tomography, X-Ray Computed

Adenomatoid tumour is a neoplastic process of discussed origin, but the immunohistochemical phenotype leads a mesothelial derivation. The preferential site of origin is the genital apparatus of both sexes, however extragenital cases have been described. The histological pattern varies from tubular formation, to solid growth, to cystic areas. In the present report we described a case of Adenomatoid tumour of the uterus body in a 46 years old patient.

Topics: Actins; Adenomatoid Tumor; Calbindin 2; Diagnosis, Differential; Female; Humans; Immunoenzyme Techniques; Keratins; Leiomyoma; Middle Aged; Neoplasm Proteins; S100 Calcium Binding Protein G; Staining and Labeling; Uterine Neoplasms

Adenomatoid tumor with intra-testicular localization is rare. Although most reported cases arise from the epididymis, rare cases have been reported in the testicular tunica, spermatic cord, ejaculatory ducts, prostate and suprarenal recess. Adenomatoid tumors occur in both sexes and are also found in the uterus, ovary and fallopian tubes of the female genital tract. Adenomatoid tumors are benign proliferations of mesothelial origin. We report the case of a 50-year-old male with an adenomatoid tumor of the left testis. Because of its rarity, the clinical, diagnostic and therapeutic aspects as well as the possibilities of testicular preservation are discussed.

Topics: Adenomatoid Tumor; Biomarkers, Tumor; Biopsy; Calbindin 2; Diagnosis, Differential; Humans; Keratins; Male; Middle Aged; Orchiectomy; Prognosis; S100 Calcium Binding Protein G; Testicular Neoplasms; Testis; Tomography, X-Ray Computed; Ultrasonography; Vimentin

Topics: Adenomatoid Tumor; Adult; Biomarkers, Tumor; Female; Humans; Hysterectomy; Keratins; Lymphangioma; Uterine Neoplasms; Vimentin

Sixty cases of uterine adenomatoid tumors (ATs) are reported. All except four were incidental findings in hysterectomy specimens, three of these being discovered preoperatively as large multicystic tumors. ATs were classified into two distinctive macroscopic patterns: small, solid tumors and large, cystic ones. The 56 small, solid ATs ranged from 0.2 to 3.5 cm, (average 2.1 cm); 48 were nodular and 8 diffuse. The four large, cystic tumors ranged from 7 to 10 cm. Inflammation occurred in 65% of the tumors, and a smooth muscle reaction, identified by an increased Ki-67 index, was present in most cases. Both types were histologically similar except for the presence of short papillae in cystic tumors, which also showed serosal involvement. Both were immunoreactive for cytokeratins, calretinin, HMBE-1, and vimentin. Estrogen and progesterone nuclear receptors and EMA were negative. These tumors represent a spectrum ranging from small and solid to large and cystic ATs in the female genital tract, whereas outside the genital tract they are morphologically similar to multicystic mesothelioma. Although a reactive origin for ATs often seems plausible, especially when inflammation is present, their neoplastic nature should not be ignored.

Topics: Adenomatoid Tumor; Adult; Aged; Calbindin 2; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Middle Aged; Mucin-1; Receptors, Estrogen; Receptors, Progesterone; Retrospective Studies; S100 Calcium Binding Protein G; Thrombomodulin; Uterine Neoplasms; Vimentin

To study the immunohistochemical feature and the differential diagnosis of adenomatoid tumors in uterus and ovaries.. Clinical pathological analysis and immunohistochemical studies were performed on 24 cases of adenomatoid tumors in the uterus and ovaries.. Of the 24 cases, 21 cases were in the uterus, 2 cases in the ovaries and 1 cases in both the uterus and the ovary. Grossly, the mean diameter of the 22 uterus tumors was 2.2 cm, ranging from 0.2 - 5.5 cm. 14 (63.6%) were located in the subserosa or near by the subserosa of the uterine cornua. The other 8 tumors located in the myometrium. The cut surface presented a nodular pattern with grayish white or yellowish in color, partially cystic. 3 ovarian tumors became all cystic, without a clear-cut margin from the surroundings. Microscopically, the tumor consisted of various gland-like structure or luminal spaces lined with flat, cuboidal or low columnar cells, similar to blood vessels in structure. Among the tumor cells, there were scattered vesicular cells with large or small vacuoles, but no nuclear atypia and mitotic figures detected. Immunohistochemical staining showed the tumor cells positive for vimentin, AE(1)/AE(3) and calretinin, but negative for F VIII-Rag. S-100 and EMA were positive in 20 (83.3%) and 4 (16.7%) cases respectively.. Adenomatoid tumor of the female genital tract is mesothelial in origin and uterus was considered as the most common site of occurance. Immunohistochemical phenotypes can be used as an important evidence for differential diagnosis. The biological behavior of adenomatoid tumor is benign and with a good prognosis.

Topics: Adenomatoid Tumor; Adult; Calbindin 2; Diagnosis, Differential; Female; Humans; Keratins; Middle Aged; Neoplasms, Multiple Primary; Ovarian Neoplasms; S100 Calcium Binding Protein G; S100 Proteins; Uterine Neoplasms; Vimentin

To investigate the histogenesis of paratesticular adenomatoid tumour by use of immunohistochemical markers for a variety of carcinomas and mesothelioma.. Immunohistochemical staining of sections from 12 cases of paratesticular adenomatoid tumour was undertaken using primary antibodies to antigens expressed by benign epithelial cells and carcinoma (cytokeratin AE1/AE3, cytokeratin 34ssE12, epithelial membrane antigen, MOC-31, Ber-EP4, CEA, B72.3, LEA.135, Leu M1), stromal and vascular markers (vimentin, CD34, factor VIII), and mesothelioma-associated antigens (thrombomodulin, HBME-1, OC 125) and p53 protein. There was absence of immunohistochemical expression of epithelial/carcinoma markers MOC-31, Ber-EP4, CEA, B72.3, LEA.135, Leu M1 and to factor VIII and CD34. All tumours expressed cytokeratin AE1/AE3, epithelial membrane antigen and vimentin, with weak expression of cytokeratin 34ssE12 in 25% of tumours. Each tumour showed expression of thrombomodulin, HBME-1 and OC 125 in a membranous distribution. p53 protein expression was not detected.. The immunohistochemical profile of paratesticular adenomatoid tumour is strongly supportive of a mesothelial cell origin.

Topics: Adenomatoid Tumor; Biomarkers, Tumor; CA-125 Antigen; Humans; Immunohistochemistry; Keratins; Male; Mesothelioma; Mucin-1; Testicular Neoplasms; Testis; Thrombomodulin; Vimentin

Topics: Adenomatoid Tumor; Adrenal Gland Neoplasms; Aged; Calbindin 2; Diagnosis, Differential; Humans; Immunohistochemistry; Keratins; Male; S100 Calcium Binding Protein G

We present rare case of a uterine adenomatoid tumor. In order to characterize the diversity of immunoreactive antigens associated with mesothelial differentiation, we immunohistochemically examined the tumor's epithelioid and myofibromatoid components, as well as the biphasic pattern of its adenomatoid changes. Immunostaining of tumor cells was positive for high- and low-molecular-weight cytokeratins and vimentin. Specific immunoreactions with antibodies against desmin, alpha-actin, and the S-100 protein also were observed. The present adenomatoid tumor can be explained in terms of various transformations and typical alterations in mesothelioma cells: (1) the mesothelial cells had differentiated to epithelial and stromal components, concomitant with the presence of predominant reactive foci; (2) intermediate cells expressed different types of cytoskeletal intermediate filament proteins (IMPs); and (3) the patterns of fibromatoid and leiomyoid differentiation resembled those of a benign mesothelioma of the ovarian or oviductal peritoneum. Our immunohistochemical investigations indicated that the present tumor exhibited the histogenesis of a true mesothelioma, an adenomatoid mesothelioma.

Topics: Actins; Adenomatoid Tumor; Adult; Antibodies, Monoclonal; Desmin; Epithelium; Female; Humans; Immunohistochemistry; Keratins; Mesothelioma; Microscopy, Electron; S100 Proteins; Uterine Neoplasms; Vimentin

We report two cases of the so-called adenomatoid tumor of the uterus, which have been detected in patients who underwent surgery for leiomyomas. The clinical signs, origin and immunohistochemical characteristics of the adenomatoid tumor are described. Adenomatoid tumors are slow growing epithelioid neoplasias with a co-expression of vimentin and cytokeratins. The characteristic cytokeratins are numbered 7, 8, 18, 19 and 5. The mesothelial histogenesis of the tumor can be confirmed. Our results rule out origins from Müllerian or mesonephrogenous ducts and angioma or adenoma. Considering our experiences, adenomatoid and leiomyoma cannot be distinguished macroscopically. The hysterectomy or salpingo-oophorectomy, primarily performed under other diagnoses, are the therapies of choice.

Topics: Adenomatoid Tumor; Adult; Biomarkers, Tumor; Diagnosis, Differential; Female; Humans; Hysterectomy; Keratins; Leiomyoma; Middle Aged; Neoplasms, Multiple Primary; Uterine Neoplasms; Uterus

We report a case of an adenomatoid tumor involving the heart. The lesion was found incidentally at the time of cardiac surgery, measured 1.0 cm, and was poorly demarcated from the adjacent myocardium. Microscopically, the tumor consisted of aggregates of relatively large, epithelioid cells that coalesced to form tubular spaces and occasionally branched into anastomosing channels. The neoplastic cells were strongly immunoreactive with antibodies against cytokeratin. The pathologic features of this unusual cardiac tumor are diagnostic of an adenomatoid tumor, a relatively rare benign neoplasm of mesothelial origin usually found in association with the genital tract. Although rare cases of adenomatoid tumors found outside of the genital tract have been described, including two recently reported pleural tumors, it has not been described to involve the heart.

Topics: Adenomatoid Tumor; Biomarkers, Tumor; Heart Neoplasms; Humans; Immunohistochemistry; Keratins; Male; Middle Aged

Adenomatoid tumors arising in the uterus are not well-recognized and sometimes mistaken for other benign or malignant neoplasms. This study describes three cases of uterine adenomatoid tumors with clinical, light microscopic, histochemical and electron microscopical studies. Four distinctive histologic patterns (solid, adenoid, angiomatoid, cystic) were identified. Acid mucopolysaccharide was present in three cases and was digested by hyaluronidase. Immunohistochemically, tumor cells were positive for cytokeratin and vimentin. Electron microscopy revealed microvilli, intermediate filaments and dilated intercellular spaces. This gives further support to a mesothelial origin of the adenomatoid tumor. Interestingly, one case showed that the adenomatoid tumor was multiple and one nodule was connected with leiomyomatous nodule. In the other case, the tumor was large 5 x 4 x 4.5 cm). These features were unusual.

Topics: Adenomatoid Tumor; Adult; Female; Glycosaminoglycans; Humans; Immunohistochemistry; Keratins; Microscopy, Electron; Middle Aged; Uterine Neoplasms; Vimentin

We report two cases of small pleural nodules showing the distinctive histologic appearance of adenomatoid tumor. Both lesions were discovered incidentally during surgery in patients undergoing lung resection for unrelated intrapulmonary masses: lung carcinoma in one case and histoplasmosis in the other. The tumors were composed of a focal proliferation of epithelioid cells forming vacuoles and tubular spaces in a fibrous stroma, as seen in adenomatoid tumors from other sites. The differential diagnosis in both cases included metastatic signet ring cell carcinoma. The mesothelial nature of the lesions was supported by immunohistochemical and ultrastructural evidence. The tumor cells in both cases were positive for cytokeratin but negative for carcinoembryonic antigen and LeuM1. One case was also negative for BER-EP4, B72.3, CD34, and Factor VIII. Electron microscopy in this case demonstrated well-developed basal laminae, desmosomes, and numerous slender microvilli along the luminal surfaces of the tumor cells. Adenomatoid tumors are regarded as a benign variant of mesothelioma. Despite the abundance of mesothelial cells in the pleura, adenomatoid tumors are apparently extremely rare in this location. Separation from malignant lesions such as adenocarcinoma and epithelioid hemangioendothelioma is important.

Topics: Adenomatoid Tumor; Aged; Basement Membrane; Breast Neoplasms; Carcinoma, Ductal, Breast; Cell Nucleus; Cytoplasm; Desmosomes; Female; Granuloma; Humans; Immunohistochemistry; Keratins; Lung Diseases; Microscopy, Electron; Microvilli; Middle Aged; Neoplasms, Second Primary; Pleural Neoplasms

A description of the clinical diagnosis, localisation and the histological structure of an adenomatoid tumour of the uterus is presented. The tumour was diagnosed during investigation of sterility and localised in the uterus wall. Fallopian tubes and ovaries can also be affected. Adenomatoid tumours are small, slow growing and of benign origin, and hence organ-preserving tumourectomy is an adequate therapy. Histogenesis of this kind of tumour has been established by means of immunological techniques as being of mesothelial origin.

Topics: Adenomatoid Tumor; Adult; Biomarkers, Tumor; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Immunoenzyme Techniques; Infant, Newborn; Infertility, Female; Keratins; Pregnancy; Uterine Neoplasms; Uterus

Peritoneal mesotheliomas are rare in women, compared to serous epithelial neoplasms with which they are often confused. We evaluated the clinicopathologic features of 19 true mesothelial neoplasms affecting the genital tract or peritoneum of women (other than adenomatoid tumors, benign multicystic mesotheliomas, and localized fibrous tumors) to characterize their clinicopathologic features and to determine their clinical behavior. Six tumors were localized to one anatomic site at presentation, and 13 involved more than one anatomic site. The six localized tumors were solitary, small (0.8-2.0 cm), polypoid or nodular lesions, five of which were incidental findings. All had a predominantly tubulopapillary pattern, either pure or mixed with adenomatoid-like or small solid foci. Nuclear grade ranged from 0 to 2. Mitotic figures (MF) were absent in two tumors. The mitosis count in the other four tumors was < 1 MF/10 high-power microscopic fields (HPF) (average method) and ranged from 1 to 3 MF/10 HPF (highest count method). Five patients were alive without recurrence after postoperative intervals ranging from 19 months to 9 years (median, 5 years); one patient died of metastatic gastric carcinoma at 14 months. Thirteen tumors involved more than one anatomic site and were classified as diffuse mesothelioma. Typically, these tumors were symptomatic and accompanied by ascites. The tumors had either a plaque-like or endophytic configuration. Eleven were purely epithelial mesotheliomas, and two had a minor sarcomatoid component. Tubulopapillary patterns were present in 10 tumors, usually admixed with focal adenomatoid-like or solid patterns, and three had a purely solid pattern. All 13 tumors had grade 3 nuclei. The mitosis count ranged from < 1 to 2 MF/10 HPF (average count method) with a range of 1-4 MF/10 HPF by the highest count method. Immunohistochemically, 13/13 tumors stained for cytokeratin (AE1/AE3). None were immunoreactive for polyclonal carcinoembryonic antigen (CEA), Leu-M1, or B72.3. One diffuse mesothelioma stained focally for Ber-EP4, and electron microscopy confirmed the mesothelial nature of this tumor. Nine patients died of tumor after postoperative intervals ranging from 1 month to 6 years. Eleven patients had received postoperative adjuvant intraperitoneal or systemic chemotherapy. One patient died with increased abdominal girth 8 years after operation and one course of intraperitoneal chemotherapy, though the role of mesothelioma in her death

Topics: Adenomatoid Tumor; Adult; Aged; Aged, 80 and over; Female; Fibroma; Follow-Up Studies; Genital Neoplasms, Female; Humans; Immunohistochemistry; Keratins; Mesothelioma; Mesothelioma, Cystic; Microscopy, Electron; Middle Aged; Mitosis; Peritoneal Neoplasms; Prognosis

In 2 cases of adenomatoid tumors of the uterus FVIII, keratin, vimentin and carcinoembryonic antigen (CEA) were observed by immunohistochemical method. No staining for FVIII and CEA were seen in the tumor cells but staining for keratin and vimentin were seen coexistent in the tumor cells. Electron microscopic finding showed tumor cells attached to one another by numerous long slender microvill. Adenomatoid tumors had typical mesothelial features. It suggests that adenomatoid tumor may be a mesothelioma.

Topics: Adenomatoid Tumor; Female; Humans; Keratins; Middle Aged; Uterine Neoplasms; Vimentin