bromochloroacetic-acid and Vaginal-Neoplasms

Topics: Adenocarcinoma; Female; Humans; Keratins; Mesonephroma; Middle Aged; Neprilysin; Vaginal Neoplasms

Primary small cell neuroendocrine carcinoma of the vagina is extremely rare, and its clinical behavior is aggressive. To our knowledge, 22 patients with this tumor have been reported in the English literature to date.. To investigate 3 patients with this tumor clinically and pathologically.. The pathology database at the University of Texas Medical Branch at Galveston was searched, and 3 cases of primary small cell neuroendocrine carcinoma of the vagina were found. The histologic, immunohistochemical, and ultrastructural profiles of the tumors were investigated. The medical charts of the patients were reviewed, and the patients were followed up.. Women with the diagnosis of primary small cell neuroendocrine carcinoma of vagina.. All 3 patients presented with advanced disease, and 2 patients died within 4 months of the initial diagnosis. One 38-year-old patient was newly diagnosed, and her clinical outcome had not yet been determined. The histologic features of all 3 tumors were similar to those of their pulmonary counterpart. All cases were positive for cytokeratin, chromogranin A, and synaptophysin. The expression pattern of thyroid transcription factor 1 was examined in all 3 patients, of whom 2 were negative and 1 was positive with negative clinical and radiologic thyroid or pulmonary findings. Ultrastructural evaluation showed scattered intracytoplasmic electron-dense neurosecretory granules.. Primary small cell neuroendocrine carcinoma of the vagina has histologic, immunohistochemical, and ultrastructural features similar to those of its pulmonary counterpart. Because thyroid transcription factor 1 can be positive, it should not be used to differentiate primary from metastatic disease. The current therapies have usually resulted in poor outcomes, and new therapeutic modalities should be explored.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Brachytherapy; Carcinoma, Small Cell; Chromogranin A; Chromogranins; Cisplatin; Combined Modality Therapy; Etoposide; Fatal Outcome; Female; Hemorrhage; Humans; Keratins; Middle Aged; Neoplasm Proteins; Nuclear Proteins; Radioisotope Teletherapy; Synaptophysin; Thyroid Nuclear Factor 1; Transcription Factors; Vaginal Diseases; Vaginal Neoplasms

A 1 cm polypoid lesion was encountered on the posterior vaginal wall in a 56-year-old woman with no history of diethylstilbestrol exposure that on microscopic examination was a moderately differentiated adenocarcinoma of intestinal type. The tumor was cytokeratin 20 and carcinoembryonic antigen positive and negative for cytokeratin 7. Mucin histochemistry demonstrated the presence of o-acetylated sialomucin, a specific marker of large intestinal differentiation. The initial interpretation favored a metastasis from a colonic adenocarcinoma, but clinical investigations showed no evidence of a primary gastrointestinal lesion. The morphology, histochemical, and differential cytokeratin profile led to the lesion being reinterpreted as a primary intestinal-type adenocarcinoma of the vagina arising from a tubular adenoma. Although a very rare tumor, awareness of this lesion is important as it must be distinguished from metastatic adenocarcinomas from other sites.

Topics: Adenocarcinoma; Adenoma; Carcinoembryonic Antigen; Fallopian Tubes; Female; Humans; Intestinal Neoplasms; Keratins; Middle Aged; Mucins; Omentum; Ovariectomy; Vaginal Neoplasms

Topics: Actins; Antigens, CD34; Biomarkers, Tumor; Carcinoma; Diagnosis, Differential; Female; Humans; Keratins; Mesoderm; Myxoma; Neoplasms, Germ Cell and Embryonal; Neprilysin; Proto-Oncogene Proteins c-bcl-2; Vaginal Neoplasms; Young Adult

Primary invasive squamous cell carcinoma of the vagina is rare, and the role of human papilloma virus in its pathogenesis remains unclear. The aims of our study were to determine the distribution of human papilloma virus genotypes in 21 cases of primary invasive squamous cell carcinoma of the vagina and to correlate human papilloma virus genotype with histological subtypes. Patients' clinical records were reviewed for demographic data and the stage of the disease. Tumors (n=21) were classified according to the World Health Organization criteria. Human papilloma virus genotyping (INNO-LiPA HPV Genotyping) was performed in the whole series, and statistical analysis was performed with Fisher's Exact Test and with Student's t-test. The patients' age ranged from 36 to 88 (mean 65) years. Six cases were keratinizing squamous cell carcinoma, and 15 cases were non-keratinizing squamous cell carcinoma (seven non-keratinizing not otherwise specified, three basaloid, and five warty types). The median age of patients with keratinizing squamous cell carcinoma was 73.8 years and that of non-keratinizing squamous cell carcinoma patients was 61.5 years (P=0.08). Human papilloma virus DNA was detected in 17 cases (81%): 13 non-keratinizing squamous cell carcinoma (87%) and four keratinizing squamous cell carcinoma (67%) (P=0.31). The human papilloma virus genotypes identified were: 6, 11, 16, 18, 31, 33, 35, 40, and 58, with human papilloma virus 16 DNA the most prevalent (33%). Invasive squamous cell carcinoma of the vagina is frequently associated with human papilloma virus infection, and human papilloma virus 16 is the most common genotype. Although without statistical significance, keratinizing squamous cell carcinoma is more frequent in older patients, whereas non-keratinizing squamous cell carcinoma more frequently affects younger women. All studied histological subtypes are strongly associated with human papilloma virus infection.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; DNA, Viral; Female; Genotype; Human papillomavirus 16; Humans; Keratins; Middle Aged; Neoplasm Staging; Papillomavirus Infections; Vaginal Neoplasms

Topics: Diagnosis, Differential; Female; Granuloma; Humans; Keratins; Magnetic Resonance Imaging; Middle Aged; Vaginal Diseases; Vaginal Neoplasms

Mixed tumors of the vagina (MTsV) are rare benign neoplasms characterized by an admixture of well-differentiated epithelial cells and stromal-type cells in various proportions. In contrast to mixed tumors in other anatomic sites, the histogenesis of the vaginal tumors is unclear. We studied the immunohistochemical profile of 13 examples to explore their histogenesis and determine whether their immunohistochemical profile might be useful in the differential diagnosis. The panel of antibodies used and the number of cases studied were: AE1/3 (12), cytokeratin 7 (CK7) (13), cytokeratin 20 (CK20) (13), epithelial membrane antigen (EMA) (13), muscle actin (MA) (12), desmin (11), h-Caldesmon (13), CD10 (13), CD34 (11), CD99 (8), and S-100 (7). Eight out of 12 tumors were positive for AE1/3, 7/13 for CK7, 2/13 for CK20, and 6/13 for EMA. MA was positive in 11/12 mixed tumors, desmin in 10/11 tumors and h-Caldesmon in 5/13. All tumors were extensively positive for CD10; CD34 was positive in 7/11; and none out of eight tumors showed membranous CD99 staining. Focal S-100 immunoreactivity was seen in 1/7 tumors. These results show that MTsV coexpress epithelial and mesenchymal markers. The expression of muscle actin (usually extensive), and focal desmin and h-Caldesmon positivity suggests the presence of a smooth muscle or myoepithelial component; however, the S-100 negativity and diffuse CD10 expression argue against it. Positivity for muscle markers does not help distinguish MTsV from smooth muscle or skeletal muscle tumors. The frequent expression of CD10 negates its use in the differential diagnosis with endometrial stromal tumors, and the CD10 and CD34 expression suggests that mixed tumors may arise from a primitive pluripotential cell. MTsV are positive for h-Caldesmon and CD10, two markers that have been used in gynecologic pathology primarily to aid in establishing the smooth muscle or endometrial stromal phenotype of a neoplasm.

Topics: 12E7 Antigen; Actins; Antigens, CD; Antigens, CD34; Calmodulin-Binding Proteins; Carcinoma; Cell Adhesion Molecules; Desmin; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratin-7; Keratins; Mucin-1; Muscle, Smooth; Neprilysin; S100 Proteins; Vaginal Neoplasms

We report a case of mixed tumor arising in the lower vaginal wall. The patient was a 20-yr-old nullipararous woman. The tumor was relatively well-defined with expansile margin, and showed solid sheets or fascicles of stromal-type spindle cells and ovoid epithelial cells with sparsely scattered nests of mature squamous epithelium and glands lined by mucinous epithelium. Cellular atypia was not conspicuous, however, mitosis was counted upto 6 per 10 high power fields. We examined this tumor immunohistochemically and ultrastructurally and reviewed the articles to identify the histogenesis. Positive reaction for vimenin and cytokeratin of stromaltype spindle cells and presence of desmosome-like structures and tonofilaments on electron microscopic examination suggested the epithelial origin of the stromaltype spindle cells.

Topics: Adult; Female; Humans; Immunohistochemistry; Keratins; Microscopy, Electron; Mitosis; Mixed Tumor, Malignant; Vagina; Vaginal Neoplasms; Vimentin

Endocervicosis is a rare condition, being one of the triad of non-neoplastic secondary mullerian lesions. This report describes a primary vaginal adenocarcinoma arising in endocervicosis. Histologic examination showed a mucin-secreting adenocarcinoma admixed with benign mucin-containing endocervical-type glands with a transition from dysplastic glands to obvious adenocarcinoma. There were bilateral groin lymph node metastases at presentation and the tumor recurred locally 9 and 12 months after treatment. This is the second reported case of vaginal endocervicosis and the first documented report of adenocarcinoma arising in endocervicosis at any site.

Topics: Adenocarcinoma; Biopsy; CA-125 Antigen; Carcinoembryonic Antigen; Cervix Uteri; Endometrium; Female; Humans; Keratins; Lymph Node Excision; Magnetic Resonance Imaging; Middle Aged; Mucins; Neoplasm Recurrence, Local; Tomography, X-Ray Computed; Vaginal Neoplasms; Vaginal Smears

Topics: Aged; Carcinoma, Papillary; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Cell Differentiation; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratin-7; Keratins; Vaginal Neoplasms

We describe an epithelioid trophoblastic tumor (ETT) metastatic to the vagina in a 30-year-old Japanese woman. A polypoid tumor in the vaginal orifice was composed of nests of intermediate trophoblastic cells that showed a striking epithelioid appearance. In the hysterectomy specimen, a tumor infiltrated through the myometrium and showed histologic findings similar to those of the vaginal tumor. The tumor cells were positive for cytokeratin, inhibin-alpha, and melanoma cell adhesion molecule (Mel-CAM, CD146) but were only focally positive for human placental lactogen. Electron microscopic examination revealed bundles of well-developed, intermediate-type filaments surrounding the nuclei.

Topics: Adult; Antigens, CD; Antigens, Surface; Biopsy; CD146 Antigen; Cell Nucleus; Cytoplasm; Epithelioid Cells; Female; Humans; Immunohistochemistry; Inhibins; Intermediate Filaments; Keratins; Membrane Glycoproteins; Microscopy, Electron; Myometrium; Neural Cell Adhesion Molecules; Placental Lactogen; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms; Vaginal Neoplasms

A distinctive variant of a papillary noninvasive transitional cell carcinoma (TCC) of the vagina removed from a postmenopausal woman is described. The neoplasm was evaluated by immunohistochemistry. The designation of this neoplasm as a TCC is supported by its morphological features and its coexpression for cytokeratin (CK) 7 and CK 20. Its main feature is pagetoid infiltration into adjacent vaginal epithelium. This is the second reported case involving a transitional cell metaplasia (TCM) of the vagina, a possible precursor lesion of the TCC.

Topics: Adult; Carcinoma, Transitional Cell; Female; Humans; Immunohistochemistry; Keratins; Metaplasia; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Postmenopause; Urinary Bladder Neoplasms; Vagina; Vaginal Neoplasms

Malignant mixed tumors in the vagina are extremely rare. We experienced a case of a malignant mixed tumor (synovioid variant). Surgical treatment was performed, followed by 3 courses of chemotherapy. Up to the present time, 4 years after the first treatment, no signs of recurrence have been observed.

Topics: Biopsy; Carcinoembryonic Antigen; Chemotherapy, Adjuvant; Female; Follow-Up Studies; Humans; Hysterectomy; Immunohistochemistry; Keratins; Middle Aged; Mixed Tumor, Malignant; Periodic Acid-Schiff Reaction; Vagina; Vaginal Neoplasms

A case of papillary squamotransitional carcinoma of the vagina is reported. The immunohistochemical profiles (cytokeratin-7 and -20) and the detection of human papillomavirus 16 support its close relationship to conventional squamous cell carcinoma. The lesion is compared to previously reported cases of papillary transitional cell carcinoma of the vagina and papillary squamotransitional cell carcinoma of the cervix.

Topics: Aged; Aged, 80 and over; Carcinoma, Papillary; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Female; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratin-7; Keratins; Papillomaviridae; Urethra; Vaginal Neoplasms

High-risk human papillomaviruses (HPVs), including type 16, have been identified as factors in cervical carcinogenesis. However, the presence and expression of the virus per se appear to be insufficient for carcinogenesis. Rather, cofactors most likely are necessary in addition to viral gene expression to initiate neoplasia. One candidate cofactor is prolonged exposure to sex hormones. To examine the possible effects of estrogen on HPV-associated neoplasia, we treated transgenic mice expressing the oncogenes of HPV16 under control of the human keratin-14 promoter (K14-HPV16 transgenic mice) and nontransgenic control mice with slow release pellets of 17beta-estradiol. Squamous carcinomas developed in a multistage pathway exclusively in the vagina and cervix of K14-HPV16 transgenic mice. Estrogen-induced carcinogenesis was accompanied by an incremental increase in the incidence and distribution of proliferating cells solely within the cervical and vaginal squamous epithelium of K14-HPV16 mice. Expression of the HPV transgenes in untreated transgenic mice was detectable only during estrus; estrogen treatment resulted in transgene expression that was persistent but not further upregulated, remaining at low levels at all stages of carcinogenesis. The data demonstrate a novel mechanism of synergistic cooperation between chronic estrogen exposure and the oncogenes of HPV16 that coordinates squamous carcinogenesis in the female reproductive tract of K14-HPV16 transgenic mice.

Topics: Animals; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Chloramphenicol O-Acetyltransferase; Delayed-Action Preparations; Estradiol; Female; Genes, Viral; Humans; Immunohistochemistry; In Situ Hybridization; Keratins; Mice; Mice, Transgenic; Oncogenes; Papillomaviridae; Proliferating Cell Nuclear Antigen; Promoter Regions, Genetic; RNA, Messenger; Uterine Cervical Neoplasms; Vaginal Neoplasms

A case of mixed tumor of the vagina or spindle cell epithelioma is presented and the literature on this rare type of tumor is reviewed. Immunohistochemical findings suggest an epithelial origin. Follow-up studies indicate benign behavior. However, recurrent tumors were reported suggesting careful follow-up observation after excision of extended primary tumors.

Topics: Adult; Biomarkers, Tumor; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Humans; Keratins; Mixed Tumor, Mullerian; Vagina; Vaginal Neoplasms

The association of clear cell adenocarcinoma of the vagina and vaginal adenosis with prenatal exposure to diethylstilbestrol (DES) is well-documented in the United States. In Europe, however, DES was never used in the therapy of threatened abortion and, therefore, clear cell adenocarcinoma and vaginal adenosis remained rare diseases. We report on the clinical and pathological features of a case of clear cell adenocarcinoma of the upper vagina in a 17-year-old German girl, who had a history of hypoplasia of the left kidney with an ectopic termination of the ureter in the upper vagina, removed surgically 2 years before. No previous report of a similar coincidence of vaginal clear cell carcinoma and a congenital disorder of the genitourinary tract exists. Congenital anomaly of the ureter interfering with the development and the differentiation of the distal Müllerian tract and its epithelium might have provided a similar histological basis for carcinogenesis in our patient to that in those provided exposed to DES.

Topics: Adenocarcinoma, Clear Cell; Adolescent; Biomarkers, Tumor; Carcinoembryonic Antigen; Choristoma; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Neoplasm Proteins; Nuclear Proteins; Receptors, Estrogen; Receptors, Progesterone; Ureter; Vaginal Diseases; Vaginal Neoplasms

A total of 28 examples of vaginal mixed tumors, a circumscribed tumor composed predominantly of spindle cells, but often admixed with minor glandular, and focal areas of squamous differentiation along with localized hyaline globules, were evaluated. In addition to the clinicopathologic correlation with light microscopy, 10 cases were analyzed immunohistochemically by a panel of antibodies for keratin, smooth muscle actin, S-100 protein, and glial fibrillary acidic protein; five cases were also evaluated for estrogen and progesterone receptors. Ultrastructural analysis was performed on two tumors. The results indicate an epithelial differentiation in the predominating spindle cells based upon an intense immunoreaction with cytokeratin in nine of 10 cases and the presence of tonofilaments and desmosomes at the ultrastructural level. Contrary to mixed tumors of salivary gland and breast origin, no evidence of a myoepithelial differentiation was identified in these tumors. The name vaginal spindle cell epithelioma is proposed for these neoplasms as being more descriptive of the true nature of these tumors.

Topics: Adult; Aged; Carcinoma, Basosquamous; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Vaginal Neoplasms

A vaginal squamous cell carcinoma was found to produce amyloid in the more differentiated portion of the tumor. The amyloid was identified by immunohistochemical technique as related to keratin proteins reactive with monoclonal antibodies AE1 and AE3 but not AE2.

Topics: Adult; Amyloid; Carcinoma, Squamous Cell; Female; Histocytochemistry; Humans; Immunochemistry; Keratins; Vaginal Neoplasms

An investigation was undertaken of the keratin polypeptides of various benign and malignant tumors of the human skin and vaginal epithelium by one and two dimensional gel electrophoresis. The keratin patterns of benign tumors were found to be similar to the patterns of normal epithelium or stratum corneum. The relative proportion of stratum-corneum associated keratin polypeptides to those polypeptides characteristic for the living layers corresponds to morphological features (e.g., hyperkeratosis, acanthosis). In contrast to benign tumors, epithelial carcinomas totally lack the group of high-molecular-weight keratins. This finding may be helpful in the diagnostic discrimination between benign and malignant epithelial lesions.

Topics: Electrophoresis; Electrophoresis, Polyacrylamide Gel; Epithelium; Female; Humans; Keratins; Peptides; Skin Neoplasms; Vaginal Neoplasms

Four cases of squamous cell carcinoma with sarcoma-like stroma located in the vulva (1), vagina (2) and cervix (1) of postmenopausal women are presented. The gross and microscopic features are very similar to those of similarly named tumors occurring in the upper respiratory and digestive tract and in the skin. Light microscopic, electron microscopic, and immunohistochemical examination provided convincing evidence that these tumors are composed solely of squamous cell carcinoma, which has undergone a spindle cell sarcoma-like transformation in the deeper portions. Follow-up revealed an aggressive clinical course in three of the four patients, who died of their tumor between 2 and 45 months after presentation. At the time of death, two of the patients had widespread metastases and the other had massive local recurrence.

Topics: Aged; Carcinoma, Squamous Cell; Carcinosarcoma; Diagnosis, Differential; Female; Fibroma; Follow-Up Studies; Genital Neoplasms, Female; Histocytochemistry; Humans; Keratins; Middle Aged; Sarcoma; Uterine Cervical Neoplasms; Vaginal Neoplasms; Vulvar Neoplasms