Journal of Pathology and Translational Medicine

Case Study

Primary hepatic mixed germ cell tumor in an adult: Hyun-Jung Sung, Jihun Kim, Kyu-rae Kim, Shinkyo Yoon, Jae Hoon Lee, Hyo Jeong Kang; J Pathol Transl Med. 2021;55(5):355-359. Published online August 3, 2021; DOI: https://doi.org/10.4132/jptm.2021.06.16

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Primary hepatic mixed germ cell tumor (GCT) is very rare, and less than 10 cases have been reported. We report a case of mixed GCT composed of a choriocarcinoma and yolk sac tumor, which occurred in the liver of a 40-year-old woman. A large mass was detected by computed tomography solely in the liver. Serum β-human chorionic gonadotropin (hCG) was highly elevated, otherwise, other serum tumor markers were slightly elevated or within normal limits. For hepatic choriocarcinoma, neoadjuvant chemotherapy was administered, followed by right lobectomy. Histologic features of the resected tumor revealed characteristic choriocarcinoma features with diffuse positivity for hCG in the syncytiotrophoblasts and diffuse positivity for α-fetoprotein and Sal-like protein 4 in the yolk sac tumor components. Primary malignant GCT in the liver is associated with a poor prognosis and requires specific treatment. Therefore, GCT should be considered during a differential diagnosis of a rapidly growing mass in the liver.

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Testicular Seminoma in Prostate: Case Report and Review of Literature
Peter Lesko, Jana Obertova, Karol Kajo, Katarina Rejlekova, Zuzana Orszaghova, Viera Lehotska, Martina Ondrusova, Michal Chovanec, Dalibor Ondrus, Michal Mego
Clinical Genitourinary Cancer.2024; 22(2): 210. CrossRef

Original Articles

Uterine Malignant Mixed Müllerian Tumors Following Treatment with Selective Estrogen Receptor Modulators in Patients with Breast Cancer: A Report of 13 Cases and Their Clinicopathologic Characteristics: Byung-Kwan Jeong, Chang O. Sung, Kyu-Rae Kim; J Pathol Transl Med. 2019;53(1):31-39. Published online December 18, 2018; DOI: https://doi.org/10.4132/jptm.2018.11.16

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Abstract PDF

Background
Breast cancer treatment with selective estrogen receptor modulators (SERMs) increasesthe incidence of uterine malignant mixed Müllerian tumors (uMMMTs). We examine clinicopathologiccharacteristics and prognosis of SERM-associated uMMMTs (S-uMMMTs) and discusspossible pathogenetic mechanisms.
Methods
Among 28,104 patients with breast cancer, clinicopathologicfeatures and incidence of uMMMT were compared between patients who underwentSERM treatment and those who did not. Of 92 uMMMT cases that occurred during the same period,incidence, dose, and duration of SERM treatment, as well as overall survival rate, were comparedfor patients with breast cancer who underwent SERM treatment and those who did not (S-uMMMTvs NS-uMMMT) and for patients without breast cancer (de novo-uMMMT). Histopathologicalfindings and immunophenotypes for myogenin, desmin, p53, WT-1, estrogen receptor (ER) α, ERβ,progesterone receptor, and GATA-3 were compared between S-uMMMT and de novo-uMMMT.
Results
The incidence of S-uMMMT was significantly higher than that of NS-uMMMT (6.35-fold).All patients with SERM were postmenopausal and received daily 20–40 mg SERM. CumulativeSERM dose ranged from 21.9 to 73.0 g (mean, 46.0) over 39–192 months (mean, 107). Clinicopathologicfeatures, such as International Federation of Gynecology and Obstetrics stage andoverall survival, were not significantly different between patients with S-uMMMT and NS-uMMMTor between patients with S-uMMMT and de novo-uMMMT. All 11 S-uMMMT cases available forimmunostaining exhibited strong overexpression/null expression of p53 protein and significantlyincreased ERβ expression in carcinomatous and sarcomatous components.
Conclusions
SERMtherapy seemingly increases risk of S-uMMMT development; however, clinicopathologic featureswere similar in all uMMMTs from different backgrounds. p53 mutation and increased ERβ expressionmight be involved in the etiology of S-uMMMT.

Citations

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Uterine carcinosarcomas: A case series of 9 cases from a low-income country
Boubacar Efared, Halidou Hamadou Koura, Aïchatou Balaraba Abani Bako, Idrissa Boubacar, Habiba Salifou Boureima, Garba Mahamadou, Hassan Nouhou
Medicine.2024; 103(40): e39773. CrossRef
Uterine carcinosarcoma: Unraveling the role of epithelial‐to‐mesenchymal transition in progression and therapeutic potential
Mohan Shankar Gopinatha Pillai, Pallab Shaw, Arpan Dey Bhowmik, Resham Bhattacharya, Geeta Rao, Shailendra Kumar Dhar Dwivedi
The FASEB Journal.2024;[Epub] CrossRef
Tamoxifen/toremifene

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Molecular Basis of Tumor Heterogeneity in Endometrial Carcinosarcoma
Susanna Leskela, Belen Pérez-Mies, Juan Manuel Rosa-Rosa, Eva Cristobal, Michele Biscuola, María L. Palacios-Berraquero, SuFey Ong, Xavier Matias-Guiu Guia, José Palacios
Cancers.2019; 11(7): 964. CrossRef

Diagnostic Significance of Cellular Neuroglial Tissue in Ovarian Immature Teratoma: Yun Chai, Chang Gok Woo, Joo-Young Kim, Chong Jai Kim, Shin Kwang Khang, Jiyoon Kim, In Ah Park, Eun Na Kim, Kyu-Rae Kim; J Pathol Transl Med. 2017;51(1):49-55. Published online October 14, 2016; DOI: https://doi.org/10.4132/jptm.2016.09.19

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Abstract PDF

Background
Immature teratoma (IT) is a tumor containing immature neuroectodermal tissue, primarily in the form of neuroepithelial tubules. However, the diagnosis of tumors containing only cellular neuroglial tissue (CNT) without distinct neuroepithelial tubules is often difficult, since the histological characteristics of immature neuroectodermal tissues remain unclear. Here, we examined the significance of CNT and tried to define immature neuroectodermal tissues by comparing the histological features of neuroglial tissues between mature teratoma (MT) and IT.
Methods
The histological features of neuroglial tissue, including the cellularity, border between the neuroglial and adjacent tissues, cellular composition, mitotic index, Ki-67 proliferation rate, presence or absence of tissue necrosis, vascularity, and endothelial hyperplasia, were compared between 91 MT and 35 IT cases.
Results
CNTs with a cellularity grade of ≥ 2 were observed in 96% of IT cases and 4% of MT cases (p < .001); however, CNT with a cellularity grade of 3 in MT cases was confined to the histologically distinct granular layer of mature cerebellar tissue. Moreover, CNT in IT exhibited significantly higher rates of Ki-67 proliferation, mitoses, and necrosis than those in MT (p < .001). Furthermore, an infiltrative border of neuroglial tissue and glomeruloid endothelial hyperplasia were significantly more frequent in IT cases than in MT cases (p < .001).
Conclusions
Our results suggest that if CNT with a cellularity grade of ≥ 2 is not a component of cerebellar tissue, such cases should be diagnosed as IT containing immature neuroectodermal tissue, particularly if they exhibit an infiltrative border, mitoses, necrosis, and increased Ki-67 proliferation.

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An Atypical Presentation of a Pediatric Mature Teratoma: A Case Report and Review of the Literature
Ahmed M Othman, Abdulaziz A Abu Alnasr, Reem E Kordi, Shahad A Abu Alnasr
Cureus.2024;[Epub] CrossRef
Immature Teratoma: Diagnosis and Management—A Review of the Literature
Liviu Moraru, Melinda-Ildiko Mitranovici, Diana Maria Chiorean, Marius Coroș, Raluca Moraru, Ioan Emilian Oală, Sabin Gligore Turdean
Diagnostics.2023; 13(9): 1516. CrossRef
Congenital Immature Grade ΙΙΙ Teratoma of the Neck: A Case Report
Nazneen Liaqat, Israr Ud Din, Zeeshan Ali, Majid Rashid, Afsheen Liaqat
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Benign ovarian teratoma in the dog with predominantly nervous tissue: A case report
P Makovicky, AV Makarevich, P Makovicky, A Seidavi, L Vannucci, K Rimarova
Veterinární medicína.2022; 67(2): 99. CrossRef
Fascin as a Useful Marker for Identifying Neural Components in Immature Teratomas of Human Ovary and Those Derived From Murine Embryonic Stem Cells
Ryunosuke Umehara, Atsushi Kurata, Masakatsu Takanashi, Hirotsugu Hashimoto, Koji Fujita, Toshitaka Nagao, Masahiko Kuroda
International Journal of Gynecological Pathology.2019; 38(4): 377. CrossRef
Cerebellar Differentiation in Ovarian Teratoma: A Report of 6 Cases
Colin J.R. Stewart, Maxine L. Crook
International Journal of Gynecological Pathology.2018; 37(4): 316. CrossRef
Mitotic activity of epithelia of ectoand entodermal types in spontaneous and experimental teratomas of mice
Pavel A. Dyban
Medical academic journal.2018; 18(4): 42. CrossRef
Ovarian cystectomy in the treatment of apparent early-stage immature teratoma
Ting Zhao, Yan Liu, Xiao Wang, Hao Zhang, Yuan Lu
Journal of International Medical Research.2017; 45(2): 771. CrossRef

Case Study

A Pyloric Gland-Phenotype Ovarian Mucinous Tumor Resembling Lobular Endocervical Glandular Hyperplasia in a Patient with Peutz-Jeghers Syndrome: Eun Na Kim, Gu-Hwan Kim, Jiyoon Kim, In Ah Park, Jin Ho Shin, Yun Chai, Kyu-Rae Kim; J Pathol Transl Med. 2017;51(2):159-164. Published online August 22, 2016; DOI: https://doi.org/10.4132/jptm.2016.07.01

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Abstract PDF

We describe an ovarian mucinous neoplasm that histologically resembles lobular endocervical glandular hyperplasia (LEGH) containing pyloric gland type mucin in a patient with Peutz-Jeghers syndrome (PJS). Although ovarian mucinous tumors rarely occur in PJS patients, their pyloric gland phenotype has not been clearly determined. The histopathologic features of the ovarian mucinous tumor were reminiscent of LEGH. The cytoplasmic mucin was stained with periodic acid-Schiff reaction after diastase treatment but was negative for Alcian blue pH 2.5, suggesting the presence of neutral mucin. Immunohistochemically, the epithelium expressed various gastric markers, including MUC6, HIK1083, and carbonic anhydrase-IX. Multiple ligation-dependent probe amplification detected a germline heterozygous deletion mutation at exons 1–7 of the STK11 gene (c.1-?_920+?del) in peripheral blood leukocytes and mosaic loss of heterozygosity in ovarian tumor tissue. Considering that LEGH and/or gastric-type cervical adenocarcinoma can be found in patients with PJS carrying germline and/or somatic STK11 mutations, our case indicates that STK11 mutations have an important role in the proliferation of pyloric-phenotype mucinous epithelium at various anatomical locations.

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Ovarian Mucinous Tumor Presenting Atypical Lobular Endocervical Glandular Hyperplasia-Like Appearance in a Patient With Germline STK11 p.F354L Variant: A Case Report
Hiroshi Yoshida, Kengo Hiranuma, Mariko Nakahara, Mayumi Kobayashi-Kato, Yasuhito Tanase, Masaya Uno, Kouya Shiraishi, Mitsuya Ishikawa, Tomoyasu Kato
International Journal of Surgical Pathology.2024; 32(2): 394. CrossRef
Preoperative multimodal ultrasonic imaging in a case of Peutz-Jeghers syndrome complicated by atypical lobular endocervical glandular hyperplasia: a case report and literature review
Liwen Yang, Duan Duan, Ying Xiong, Tianjiao Liu, Lijun Zhao, Fan Lai, Dingxian Gu, Liuying Zhou
Hereditary Cancer in Clinical Practice.2024;[Epub] CrossRef
Gastric‐type glandular lesions of the female genital tract excluding the cervix: emerging pathological entities
Richard W‐C Wong, Karen L Talia, W Glenn McCluggage
Histopathology.2024; 85(1): 20. CrossRef
Gastric-phenotype Mucinous Carcinoma of the Fallopian Tube with Secondary Ovarian Involvement in a Woman with Peutz-Jeghers Syndrome: A Case Report
Mónica Bronte Anaut, Javier Arredondo Montero, Maria Pilar Fernández Seara, Rosa Guarch Troyas
International Journal of Surgical Pathology.2023; 31(1): 92. CrossRef
Molecular characterization of gastric-type endocervical adenocarcinoma using next-generation sequencing
Swati Garg, Teddy S. Nagaria, Blaise Clarke, Orit Freedman, Zanobia Khan, Joerg Schwock, Marcus Q. Bernardini, Amit M. Oza, Kathy Han, Adam C. Smith, Tracy L. Stockley, Marjan Rouzbahman
Modern Pathology.2019; 32(12): 1823. CrossRef
The developing spectrum of gastric-type cervical glandular lesions
Karen L. Talia, W. Glenn McCluggage
Pathology.2018; 50(2): 122. CrossRef

Brief Case Reports

Mixed Carcinoid-Mucinous Adenocarcinoma Arising in Mature Teratoma of Mesentery: Su-Jin Shin, Eun-Mi Son, Chang Ohk Sung, Kyu-Rae Kim; J Pathol Transl Med. 2015;49(1):61-65. Published online January 15, 2015; DOI: https://doi.org/10.4132/jptm.2014.09.17

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Prostate Type Malignancies Arising in Ovarian Teratomas – A Report of Two Patients
Shreeya Indulkar, Andres Matoso
International Journal of Surgical Pathology.2024;[Epub] CrossRef
Mixed neuroendocrine/Non-neuroendocrine neoplasm (MiNEN) of gastrointestinal lineage arising in an ovarian mature cystic teratoma
Sandhyarani Dasaraju, Khalid Amin, Molly E. Klein, Colleen Rivard, Jordan Mattson, Sarah Davidson, Mahmoud A. Khalifa
Gynecologic Oncology Reports.2022; 44: 101099. CrossRef
A Case of Mature Cystic Teratoma of the Mesentery
Ryogo Ito, Motoi Yoshihara, Atsuki Arimoto, Taro Aoba, Yoshihisa Shibata, Kazuhiro Hiramatsu, Takehito Kato
The Japanese Journal of Gastroenterological Surgery.2021; 54(5): 344. CrossRef
Synchronous colonic adenocarcinoma and well-differentiated neuroendocrine tumor arising in a mature cystic teratoma of ovary — rare presentation in a postmenopausal woman with literature review
Pavithra Ayyanar, Jasmina Begum, Subhashree Rout, Pritinanda Mishra
Indian Journal of Pathology and Microbiology.2021; 64(2): 385. CrossRef
Primary ovarian mixed strumal and mucinous carcinoid arising in an ovarian mature cystic teratoma
Na Rae Kim, Seung Yeon Ha, Jin Woo Shin, Soyi Lim, Chan Yong Park, Hyun Yee Cho
Journal of Obstetrics and Gynaecology Research.2016; 42(2): 211. CrossRef

Peritoneal Carcinosarcoma and Ovarian Papillary Serous Carcinoma Are the Same Origin: Analysis of TP53 Mutation and Microsatellite Suggests a Monoclonal Origin: Chang Gok Woo, Dae Shik Suh, Joo Young Kim, Chang Ohk Sung, Jene Choi, Kyu-Rae Kim; Korean J Pathol. 2014;48(6):449-453. Published online December 31, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.449

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A successfully treated primary peritoneal carcinosarcoma and serous carcinoma of stage IIIC rescued from hypovolemic shock due to tumor rupture
Che-Cheng Huang, Horng-Jyh Tsai, Shih Hsuan Huang, Victor C. Kok
Taiwanese Journal of Obstetrics and Gynecology.2019; 58(2): 296. CrossRef
Ovarian Carcinosarcoma and Concurrent Serous Tubal Intraepithelial Carcinoma With Next-Generation Sequencing Suggesting an Origin From the Fallopian Tube
Sharlene Helene C. See, Amir Behdad, Kruti P. Maniar, Luis Z. Blanco
International Journal of Surgical Pathology.2019; 27(5): 574. CrossRef
Progression inference for somatic mutations in cancer
Leif E. Peterson, Tatiana Kovyrshina
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Original Article

Primary Squamous Cell Carcinoma of the Upper Genital Tract: Utility of p16^INK4a Expression and HPV DNA Status in its Differential Diagnosis from Extended Cervical Squamous Cell Carcinoma: Su Hyun Yoo, Eun-Mi Son, Chang Okh Sung, Kyu-Rae Kim; Korean J Pathol. 2013;47(6):549-556. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.549

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Abstract PDF

Background

Primary squamous cell carcinoma (SCC) of the upper genital tract, including the endometrium, fallopian tubes, and ovaries, is extremely rare. It must be distinguished from the mucosal extension of primary cervical SCC because determination of the primary tumor site is important for tumor staging. However, patients with SCC of the fallopian tubes or ovarian surface have often undergone prior hysterectomy with inadequate examination of the cervix, making it difficult to determine the primary site.

Methods

We compared histologic findings, p16^INK4a expression, and human papillomavirus (HPV) DNA status in four patients with primary SCC of the upper genital tract and five patients with primary cervical SCC extending to the mucosa of the upper genital tract.

Results

All five SCCs of cervical origin showed strong expression of p16^INK4a, whereas all four SCCs of the upper genital tract were negative, although one showed weak focal staining. Three of the five cervical SCCs were positive for HPV16 DNA, whereas all four primary SCCs of the upper genital tract were negative for HPV DNA.

Conclusions

Although a thorough histological examination is important, immunonegativity for p16^INK4a and negative for HPV DNA may be useful adjuncts in determining primary SCCs of the upper genital tract.

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PAX8 Positivity, Abnormal p53 Expression, and p16 Negativity in a Primary Endometrial Squamous Cell Carcinoma: A Case Report and Review of the Literature
Daniela Fanni, Michele Peiretti, Valerio Mais, Elena Massa, Clara Gerosa, Francesca Ledda, Maria Luisa Fais, Gavino Faa, Stefano Angioni
International Journal of Gynecological Pathology.2022; 41(4): 431. CrossRef
Molecular Analysis of HPV-independent Primary Endometrial Squamous Cell Carcinoma Reveals TP53 and CDKN2A Comutations
Mark R. Hopkins, Doreen N. Palsgrove, Brigitte M. Ronnett, Russell Vang, Jeffrey Lin, Tricia A. Murdock
American Journal of Surgical Pathology.2022; 46(12): 1611. CrossRef
Primary squamous cell carcinoma of the endometrium—Case report with cytological characteristics in direct and indirect endometrial samples
Sanda Rajhvajn, Ana Barišić, Lada Škopljanac‐Mačina, Danijela Jurič, Vesna Mahovlić
Cytopathology.2021; 32(6): 823. CrossRef
Überraschung in der Abradatdiagnostik
U. Kellner, A. Kellner, U. Cirkel
Der Pathologe.2015; 36(3): 317. CrossRef
Retropharyngeal Lymph Node Metastasis in 54 Patients with Oropharyngeal Squamous Cell Carcinoma Who Underwent Surgery-Based Treatment
Eun-Jae Chung, Go-Woon Kim, Bum-Ki Cho, Sung-Jin Cho, Dae-Young Yoon, Young-Soo Rho
Annals of Surgical Oncology.2015; 22(9): 3049. CrossRef

Case Report

Cellular Pseudosarcomatous Fibroepithelial Stromal Polyp of the Vagina during Pregnancy: A Lesion That Is Overdiagnosed as a Malignant Tumor: Joon Seon Song, Dong Eun Song, Kyu-Rae Kim, Jae Y. Ro; Korean J Pathol. 2012;46(5):494-498. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.494

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Abstract PDF

Fibroepithelial stromal polyp (FSP) is a benign lesion that can occur at various sites, including the lower female genital tract. In rare cases, however, it may exhibit hypercellularity, bizarre cytomorphological features, and atypical mitoses resulting in an overdiagnosis as a malignant tumor despite its benign clinical course. Recently, we experienced one case of a 30-year-old pregnant woman with cellular pseudosarcomatous FSP that was initially diagnosed as a malignant fibrous histiocytoma at a primary clinic. In addition to describing the rare features of this case, we wish to increase awareness about this benign lesion which will be essential for avoiding unnecessary radical surgery or chemoradiation treatment.

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Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion
Efthymia Thanasa, Anna Thanasa, Gerasimos Kontogeorgis, Ektoras-Evangelos Gerokostas, Ioannis-Rafail Antoniou, Athanasios Chasiotis, Emmanouil M Xydias, Apostolos C Ziogas, Evangelos Kamaretsos, Ioannis Thanasas
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Recurrent fibroepithelial vaginal polyp in a two-year-old girl: A case report and review of the literature
Mohammad Hakam Shehadeh, Ahmad Abualrub, Waleed Malhes, Amar Msarweh, Wael Amro
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Ana Marta Pinto, Maria Boia Martins, Isabel Ferreira, Clara Moreira
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Muhammad Nour Alabdullah, Nagham Halaweek, Yasser Al Ghabra, Mohammad Hamdi, Mhd Ayham Abo Trab, Faysal Hajjar
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Joonghyun Yoo, Bo-Kyung Je, Suk Keu Yeom, Ye Sul Park, Kyung-Jin Min, Joo Han Lee
Journal of Pediatric and Adolescent Gynecology.2019; 32(1): 93. CrossRef
Cellular Pseudosarcomatous Fibroepithelial Stromal Polyp of the Cervix: A Lesion Mimicking as Sarcoma
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