bromochloroacetic-acid and Cystadenocarcinoma--Mucinous

Primary retroperitoneal mucinous cystadenocarcinomas (PRMCs) are rare. This is the first reported case in the literature in English of PRMC in a man. The 64-year-old man presented with a large retroperitoneal cystic tumour measuring 24 x 20 x 16 cm3, which was removed intact. Areas ranging from a benign mucinous cyst to borderline mucinous tumour to mucinous cystadenocarcinoma were observed on microscopy. Strong patchy staining for cytokeratins 7 and 20 and strong diffuse staining for MUC2 and MUC5AC core peptides, similar to staining patterns in ovarian mucinous tumours, were shown in the benign and atypical epithelium. Staining for CA19.9 and carcinoembryonic antigen was also shown by both components. The theory of its origin from the mucinous metaplasia of peritoneal (mesothelial) inclusion cysts, rather than from ectopic ovarian tissue or ovarian teratomas, is supported by the occurrence of such a tumour in a male patient.

Topics: Cystadenocarcinoma, Mucinous; Humans; Keratins; Male; Middle Aged; Mucins; Neoplasm Proteins; Retroperitoneal Neoplasms

A rare case of ovarian mucinous cystadenocarcinoma with sarcoma-like mural nodules is reported. Macroscopically, nodular or granular lesions were scattered over the inner surface of a huge, multilocular tumor in the left ovary. The histopathological features were consistent with those of previously documented cases, except significant squamous metaplasia in the present case. The pleomorphic sarcoma-like cells showed a positive reaction for vimentin and alpha-antichymotrypsin but were negative for carcinoembryonic antigen and common epithelial membrane antigen by immunohistochemistry. Electron microscopically, the tumor cells had neither desmosomes nor secretory granules, but they possessed abundant intermediate filaments. Both immunostaining and ultrastructure suggested that the sarcoma-like nodules were derived from reactive proliferation of fibrohistiocytic cells. The fibrohistiocytic reaction seemed to occur in response to hemorrhage, because hemorrhage was reported to be associated with the mural nodules in most of the previous cases as well as ours.

Topics: Cystadenocarcinoma, Mucinous; Female; Humans; Immunohistochemistry; Keratins; Microscopy, Electron; Middle Aged; Ovarian Neoplasms; Sarcoma

A primary retroperitoneal mucinous cystadenocarcinoma (PRMC) is an extremely rare lesion. To date, only 49 cases have been reported. The presence of mural nodules in a PRMC may indicate a worse prognosis. We report the case of a 40-year-old Japanese woman with a PRMC with mural nodules. Microscopic examination revealed that the stromal cells of the nodules were spindle-shaped and varied in size. The nodules were immunoreactive for vimentin but negative for cytokeratin and EMA, and the nuclei of the stromal cells were pleomorphic and strongly Ki-67 immunoreactive. The nodules were diagnosed as true sarcoma. To the best of our knowledge, this is 11th published case report of a PRMC with mural nodules.

Topics: Adult; Cystadenocarcinoma, Mucinous; Female; Humans; Keratins; Prognosis; Retroperitoneal Neoplasms; Sarcoma; Vimentin

Primary retroperitoneal mucinous tumors (PRMTs) are uncommon neoplasms occurring almost exclusively in women. PRMTs are divided into mucinous cystadenoma (MC), mucinous borderline tumors or tumors of low malignant potential (MLMP), and mucinous carcinomas (MCas). In this retrospective study, we present the clinicopathologic features of 18 such cases, the largest series to date. All patients were women, ranging in age from 20 to 63 years (mean 38.6 y). All except 2 patients presented with an enlarged mass during a routine examination or by self-palpation. All tumors were located exclusively in the retroperitoneum, with histologic or clinical confirmation of the lack of ovarian involvement. The tumors ranged from 7 to 26 cm (mean 13.2 cm). The gross appearance was variable: unilocular cyst with a thin wall (4 cases), predominantly cystic with papillary areas or nodule(s) (8 cases), multiloculated cyst with or without nodules (1 case each), and predominantly solid with cystic areas (4 cases). Histologically, there were 2 cases of MC, 7 of MLMP (7 cases; 3 of them with intraepithelial carcinoma and 1 with microinvasion), and 9 of MCas (9 cases, 5 of them associated with MLMP and 1 associated with MC). Three of the MCas had areas of anaplastic or sarcomatoid carcinoma whereas 1 had an associated sarcoma. Immunohistochemical studies were performed in 6 cases. Cytokeratin 7 was diffusely positive in all cases studied, whereas cytokeratin 20 and cytokeratin 17 were focally positive in 4 and 2 cases, respectively. All patients underwent surgical resection of the entire tumor. Two patients with MCa and sarcoma or sarcomatoid carcinoma received chemotherapy. Follow-up was available in 16 cases, ranging from 1 to 148 months (mean 40 mo, median 22 mo). Two patients died of disease at 5 and 9 months; both had MCa with anaplastic carcinoma or sarcoma. Three patients with MCa were alive with disease at 14, 26, and 58 months. The remaining patients were alive with no evidence of disease. In this study, MLMP and MCa were more common than MC. PRMTs seem to be nonaggressive neoplasms, except in cases containing anaplastic carcinoma or sarcoma.

Topics: Adult; Biomarkers, Tumor; Cystadenocarcinoma, Mucinous; Cystadenoma, Mucinous; Disease-Free Survival; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Retroperitoneal Neoplasms; Retrospective Studies; Treatment Outcome; Young Adult

Topics: Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Cystadenocarcinoma, Mucinous; Female; Humans; Immunohistochemistry; Keratin-7; Keratins; Osteosarcoma; Retroperitoneal Neoplasms

Primary cystadenocarcinoma that arises in the broad ligament is extremely rare, especially when it is mucinous. We report the case of a 59-year-old woman with a cystic mass of the right broad ligament who underwent a complete excision of the mass (7 x 7 x 3 cm) with hysterectomy, right salpingo-oophorectomy, omentectomy, appendicectomy, and peritoneal biopsies. Pathologic examination showed a low-grade cystadenocarcinoma with a mucinous component limited to the broad ligament. Despite the chemotherapy (cisplatinum and cyclophosphamide) performed, early tumor recurrence occurred after approximately 6 months. Our observation revealed an abundant mucin production with pools of mucin similar to those of pseudomyxoma peritonei and an inflammatory infiltrate with prominent lipid phagocytosis. Immunohistochemical analysis demonstrated a strong and diffuse positivity for both cytokeratin 7 and epithelial membrane antigen. A less extensive staining with carcinoembryonic antigen and a focal unequivocal positivity with cytokeratin 20, particularly in mucin-secreting cells, were also observed. This finding could indicate a metaplastic process toward colonic phenotype similar to primary ovarian tumors.

Topics: Broad Ligament; Cystadenocarcinoma, Mucinous; Female; Humans; Immunohistochemistry; Keratin-7; Keratins; Middle Aged; Mucin-1; Urogenital Neoplasms

Topics: Cystadenocarcinoma, Mucinous; Diagnosis, Differential; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Mucin 5AC; Mucin-2; Mucins; Testicular Neoplasms

Ten mucinous cystic ovarian tumors that contained sarcoma-like mural nodules are described. The nodules were studied by conventional and immunohistochemical methods. The sarcoma-like mural nodules occurred predominantly in middle-aged women, were multiple and sharply demarcated from the adjacent mucinous tumor, had small size, and exhibited a heterogeneous cell population. Distinction of these lesions from true sarcomatous nodules and foci of anaplastic carcinoma is important because of the worse prognosis of the two latter tumors compared with the favorable behavior of the sarcoma-like mural nodules. Six of the eight patients with follow-up information were alive and clinically free of recurrence at a mean follow-up interval of 12 years. Two patients died of other causes (thyroid and breast carcinomas). The nature of the nodules is not clear. Sarcoma-like mural nodules probably represent a reactive and self-limited phenomenon within a neoplasia. Their coexpression of vimentin and cytokeratins is consistent with an origin from submesothelial mesenchymal cells, which undergo partial transformation into epithelial cells.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma; Combined Modality Therapy; Cystadenocarcinoma, Mucinous; Diagnosis, Differential; Disease-Free Survival; Female; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Ovarian Neoplasms; Sarcoma; Vimentin

Topics: Adult; Cystadenocarcinoma, Mucinous; Female; Giant Cell Tumors; Humans; Immunohistochemistry; Keratins; Lymph Nodes; Lymphatic Metastasis; Neoplasm Recurrence, Local; Osteoclasts; Pancreatic Neoplasms; Tumor Suppressor Protein p53; Vimentin

Topics: Aged; Breast Neoplasms; Carcinoembryonic Antigen; Cystadenocarcinoma, Mucinous; Female; Humans; Immunohistochemistry; Keratin-7; Keratins; Mucin-1; Mucins

Four unusual cases of primary mammary mucinous cystadenocarcinoma composed predominantly of tall columnar cells with abundant intracytoplasmic mucin are reported; they were multicystic and appeared virtually identical to mucinous cystadenocarcinomas of the ovary and pancreas. Three of the women were white and one was black, they ranged in age from 49 to 67 years (average 58), and they had tumors that ranged from 0.8 to 19 cm in diameter. Microscopically, the tumors were characterized by cystic spaces lined by predominantly bland-appearing columnar mucinous cells with stratification, tufting, and papillary formations. Varying degrees of cytologic atypia were focally evident, with gradual loss of the intracytoplasmic mucin and transformation to an eosinophilic squamoid cell population. Multifocal invasion generally emanated from these eosinophilic, squamoid areas in all cases. All four tumors displayed immunoreactivity for MIB-1 (Ki-67) in a relatively high percentage of cells and failed to show immunoreactivity for estrogen receptors and progesterone receptors. All four stained positively with cytokeratin 7 (CK7) but were negative with cytokeratin 20 (CK20). Mastectomy and axillary lymph node dissection were performed in three cases and lumpectomy with lymph node dissection in the remaining case. Lymph node metastases, identified in only one patient, retained the distinctive morphology. Three of the patients are alive without evidence of disease 11, 22, and 24 months after the diagnosis; the fourth is a recent case. These tumors are a rare, clinicopathologically distinct type of primary breast carcinoma that should be distinguished from typical mucinous (colloid) carcinomas of the breast and, more importantly, metastases from other sites.

Topics: Aged; Antigens, Nuclear; Biomarkers; Breast Neoplasms; Cystadenocarcinoma, Mucinous; Female; Humans; Immunohistochemistry; Keratin-7; Keratins; Ki-67 Antigen; Middle Aged; Nuclear Proteins

To assess the role of cytokeratin 7 monoclonal antibody in the differential diagnosis of primary ovarian carcinoma and metastatic ovarian carcinoma originated from the gastrointestinal tract.. Immunohistochemical study using cytokeratin 7 monoclonal antibody and ABC kit.. All the 46 cases of primary ovarian carcinoma were CK 7 positive, while in the metastatic ovarian carcinoma of intestinal origin, all cases remained negative for CK7. Half of the 34 cases of metastatic ovarian carcinoma of gastric origin were CK 7 positive. The positive result of CK7 was significantly higher in the primary ovarian carcinoma than in each group of the metastatic ovarian carcinoma (P < 0.001).. CK 7 is seemed to be a useful antibody in the differential diagnosis of ovarian carcinoma.

Topics: Antibodies, Monoclonal; Carcinoma, Endometrioid; Cystadenocarcinoma, Mucinous; Cystadenocarcinoma, Serous; Diagnosis, Differential; Female; Humans; Intestinal Neoplasms; Keratin-7; Keratins; Ovarian Neoplasms; Stomach Neoplasms

Multinucleated giant cells in the pancreas (five giant cell carcinomas, a mucinous cystadenocarcinoma attended with many osteoclast-like giant cells, 42 invasive ductal carcinomas and 29 chronic pancreatitises) were examined. Three types of multinucleated giant cell were identified: epithelial type, coexpressive type, mesenchymal type. Epithelial type expressed epithelial markers, such as keratin and EMA in 23 ductal carcinomas. Coexpressive type expressed both epithelial markers and mesenchymal marker vimentin was in four ductal carcinomas. Mesenchymal type expressed mesenchymal markers, vimentin and CD68 in four osteoclastoid type giant cell carcinomas, the mucinous cystadenocarcinoma, six ductal carcinomas and ten chronic pancreatitises. Epithelial and coexpressive type were considered to be epithelial neoplastic origin, those had bizarre appearance and transitional area from definite adenocarcinoma area. Vimentin expression is associated with sarcomatous proliferation. Mesenchymal type was considered to be nonneoplastic and a certain type of macrophage polykaryons.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers; Carcinoma, Ductal, Breast; Carcinoma, Giant Cell; Chronic Disease; Cystadenocarcinoma, Mucinous; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Mucin-1; Pancreatic Neoplasms; Pancreatitis; Vimentin

Topics: Aged; Carcinoembryonic Antigen; Carcinoma; Cystadenocarcinoma, Mucinous; Female; Humans; Immunoenzyme Techniques; Immunohistochemistry; Keratins; Microscopy, Electron; Neoplasms, Multiple Primary; Pancreatic Neoplasms; Vimentin

Cytokeratin 7 (CK-7) is a simple epithelial keratin that may be used to investigate the site of origin of adenocarcinomas. In fact, CK-7 is present in ovarian epithelial neoplasms but is generally absent in colonic carcinomas. This pattern of CK-7 expression may aid in elucidating the genesis of mucinous tumors occurring simultaneously in the ovary and appendix, accompanied by psuedomyxoma peritonei. Five such cases were immunostained with anti-CK-7, and all showed a concordant staining pattern of the appendiceal, ovarian, and peritoneal lesions. Two cases showed a negative reaction for CK-7 and thus would appear to represent ovarian and peritoneal metastases from an appendiceal primary tumor. Three cases were CK-7 positive, and the nature of these mucinous lesions remains open to debate; they may either represent independent primary tumors or originate from the appendix. For comparison, five Stage I mucinous borderline tumors of the ovary and their normal appendices were also stained with anti-CK-7. These ovarian tumors were all CK-7 positive, whereas the appendices were negative. It is concluded that CK-7 is capable of distinguishing a group of tumors that can reliably be classified as primary appendiceal neoplasms metastatic to the ovaries and peritoneum.

Topics: Adult; Aged; Aged, 80 and over; Appendiceal Neoplasms; Cystadenocarcinoma, Mucinous; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Ovarian Neoplasms; Peritoneal Neoplasms; Pseudomyxoma Peritonei

In an attempt to assess and improve the histological classification of ovarian tumors the value of immunohistochemical techniques has been examined in 50 ovarian tumors. A panel of six immunohistochemical markers (two cytokeratins, EP4, EMA, CEA, and vimentin) seems to have no additional value in differential diagnosis and typing of ovarian tumors.

Topics: Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Biomarkers, Tumor; Brenner Tumor; Carcinoembryonic Antigen; Carcinoma, Endometrioid; Cystadenocarcinoma, Mucinous; Cystadenocarcinoma, Serous; Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Middle Aged; Mucin-1; Mucins; Ovarian Neoplasms; Vimentin

Fifteen cases of papillary adenocarcinoma of the kidney are presented. The lesions were polycystic in gross appearance. Histologically, they were subdivided into three types: papillary cystadenocarcinoma, papillary oncocytic cystadenocarcinoma and papillary mucinous cystadenocarcinoma. Immunohistochemically, the tumor cells demonstrated positive reactivity for high molecular weight keratin and glandular lumina membrane positivity for EMA, which support a collecting duct origin for the tumor. Most of the tumors were large (average diameter 9.6 cm) and invasion of perinephric tissues was observed in 80% of the cases, an indication of its aggressive behavior. As most of the tumors occurred in the medulla and invaded the collecting ducts, the clinical manifestations were different from those of renal cell carcinomas.

Topics: Adolescent; Adult; Child; Cystadenocarcinoma, Mucinous; Cystadenocarcinoma, Papillary; Female; Humans; Immunohistochemistry; Keratins; Kidney Neoplasms; Kidney Tubules, Collecting; Male; Middle Aged; Neoplasm Invasiveness