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Slide Seminar 13 - Sarcomas of the Female Genital Tract
Tuesday, September 19, 2006 14:00 - 17:30
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Moderator:
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Dr. Marisa Nucci
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Disclosure:
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In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Slide Seminar) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. Faculty members for this Slide Seminar have indicated they have no disclosures to make.
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Clinical histories are displayed below.
Click on the case numbers to display the text and references for each case.
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- Endometrial Stromal Sarcoma
Submitted by: Javier Arias-Stella Jr, M.D.
A 59 year old woman presented to her physician with complaints of menometrorrhagia of 2 months duration. After clinical workup, she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy
Case 1 - Slide 1
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- Sarcoma Botryoides of the Uterine Cervix in Young Women
Submitted by: Dean Daya, M.D.
A 25-year-old woman presented with vaginal bleeding. On clinical examination, a 6.0 cm myxoid, hemorrhagic mass was protruding from the cervix. Subsequently, radical hysterectomy and pelvic lymphadenectomy was performed. The patient was alive and well six years post-operatively.
Case 2 - Slide 1
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- "Peripheral-type" Primitive Neuroectodermal Tumor (PNET) of the Ovary
Submitted by: Yoshiki Mikami M.D.
A 48-year-old female (para-1, gravida-1) presented with constipation and abdominal fullness, and was referred to the hospital because of an intrapelvic mass and ascites. Ultrasonography and computed tomography (CT) revealed massive ascites and a solid and cystic mass measuring 12x19 cm in the ventral side of the pelvic cavity. A tumor marker study showed CA125 495.9 U/ml, CA19-9 11.9 U/ml, and CEA 1.1 ng/ml of serum. A clinical diagnosis of ovarian cancer with peritoneal carcinomatosis was made, and an emergency laparotomy was performed because of progressive respiratory distress due to massive ascites. The laparotomy disclosed a left ovarian mass invading the retroperitoneum and small intestine. Disseminated tumors were identified on the omentum and peritoneum. Cytologic examination of the peritoneal washing was positive for malignant small round cells, suggesting small cell undifferentiated carcinoma or sarcoma. Grossly, the tumor was fragile and was too widely spread to be resected completely. Tissue was sampled from the ovarian mass for pathologic examination. Postoperative chemotherapy was given, but the patient died one month after surgery.
Case 3 - Slide 1
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- Low-grade Mesodermal Adenosarcoma with Sarcomatous Overgrowth Arising in the Colon
Submitted by: Esther Oliva, M.D.
A 50-year-old woman presented with blood in her stool. On colonoscopy a 9 x 5 cm polypoid mass was found to protrude into the lumen showing focal ulceration. Relevant prior clinical history included previous hysterectomy and bilateral salpingo-oophorectomy for leiomyomas and resection of extensive pelvic endometriosis 5 years ago. The initial colon biopsy only showed benign colonic mucosa. The patient underwent segmental resection of the rectosigmoid colon.
Case 4 - Slide 1
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- Pleomorphic Rhabdomyosarcoma of the Uterus
Submitted by: W Glenn McCluggage, M.D.
A 67 year old woman presented with postmenopausal bleeding and an abdominal mass was discovered on clinical examination. Hysterectomy, bilateral salpingo-oophorectomy and debulking of abdominal tumour was done.
Case 5 - Slide 1
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- Uterine Leiomyosarcoma with HMB 45 Positive Clear Cell Areas
Submitted by: W Glenn McCluggage, M.D.
A 60-year-old woman underwent hysterectomy for a fibroid uterus. Gross examination revealed a 6 cm necrotic myometrial mass.
Case 6 - Slide 1
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- Myxoid Leiomyosarcoma of Uterus
Submitted by: Marisa R. Nucci, M.D.
A 33-year-old woman presented with pelvic pain and abnormal uterine bleeding. Clinical examination revealed a large uterine mass and the patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. On gross examination, the uterus was asymmetrically distorted by a 6.5 cm intramural mass, which on section was multinodular, white-grey and had a soft, gelatinous consistency with areas of hemorrhage.
Case 7 - Slide 1
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