Vulvar pain and dyspareunia due to glomus tumor.
Reported is a patient with long standing vulvar pain and severe introital dyspareunia whose symptoms were cured by removal of a glomus tumor of the vulva.
Child↗
Biomedical subjects
M J Merino
Publications and source records attributed to M J Merino.
Are cytosol estrogen and progestin receptors of prognostic significance in the management of epithelial ovarian cancers?
Cystosol estrogen and progestin receptor levels in tumor samples from 101 patients with previously untreated primary epithelial ovarian cancers were correlated with patient survival. Patients with stage I and II disease whose tumors contained elevated levels of cytosol progestin receptors had an improved survival over patients with tumors containing low levels of cytosol progestin receptors. However, patients with advanced ovarian cancers and low cytosol progestin receptors had significantly longer survival. The four-year estimated duration of survival with advanced disease and cytosol progestin receptors less than seven was 82%, whereas if the cytosol progestin receptors were seven or more, the four-year estimated duration of survival was only 10%. The explanation for this dichotomy is not evident at this time. In this study cytosol estrogen receptor levels were not associated with survival. These results suggest that measurement of cytosol progestin receptors is of prognostic value in advanced epithelial ovarian cancers.
Cytosol↗
Pure dysgerminoma of the ovary with elevated serum human chorionic gonadotropin: diagnostic and therapeutic considerations.
Pure ovarian dysgerminomas with associated elevation of human chorionic gonadotropin (hCG) are rare, and their optimum management is unclear. We report here a 24-year-old woman with stage III dysgerminoma of the ovaries, with bulky intrapelvic disease, paraaortic adenopathy, and elevated pre- and postsurgical serum beta-hCG titers. Following administration of whole abdominal-pelvic and mediastinal irradiation therapy, the patient's adenopathy regressed, her serial beta-hCG titers returned to normal, and she has remained free of disease for the past 30 months. Histopathological studies revealed a pure dysgerminoma with scattered giant cells which were negative for hCG by immunoperoxidase staining. The literature is reviewed with reference to the significance of elevated hCG levels, the presence of giant cells in association with dysgerminoma of the ovary, and therapeutic implications. Serial determinations of beta-hCG titers may prove to be as valuable in the management of these patients as they are in patients with testicular tumors.
Adult↗
Sarcoidosis of the breast.
Breast involvement by sarcoidosis is rare, with only a few adequately documented cases reported in the literature. Differentiation from other granulomatous processes is important, so that the proper treatment method can be selected. One such case is described, and the current literature is reviewed.
Adult↗
Estrogen replacement therapy and fibrocystic breast disease in postmenopausal women.
The association between estrogen replacement therapy and fibrocystic breast disease was assessed in a hospital-based case-control study undertaken in Connecticut from 1979 to 1981. The cases were 143 postmenopausal women with biopsy-confirmed fibrocystic breast disease, and the controls were 355 postmenopausal women with other surgical conditions. Use of estrogen replacement therapy was positively associated with fibrocystic breast disease; the odds of disease increased with duration of use, reaching an approximately fivefold excess odds for those who had taken menopausal estrogens for 10 or more years. There was no evidence that the positive association between estrogen replacement therapy and the occurrence of fibrocystic breast disease could be explained by differential medical care utilization or other possible risk factors of biopsied fibrocystic breast disease.
Adult↗
Appendiceal carcinoma metastatic to the ovaries and mimicking primary ovarian tumors.
Primary appendiceal carcinomas are a rare source of metastases to the ovaries. Three cases are reported here, and 25 others are reviewed from the English literature. The recognition of this entity is important, since the metastases may mimic an ovarian primary tumor clinically, and because of the propensity for a recognized appendiceal carcinoma to relapse in the ovaries. Therapeutic implications dictate that the appendix should always be carefully examined during exploration for ovarian masses, and prophylactic appendectomy should be considered, as part of the treatment of ovarian carcinomas.
Adult↗
Cigarette smoking and benign breast disease.
The association between cigarette smoking and the occurrence of benign breast disease was assessed in a hospital-based case-control study conducted in Connecticut during 1979-81. Current smokers, but not former smokers, were at reduced risk for all benign breast diseases. The odds ratios associated with current smoking were 0.7 (95% confidence intervals = 0.6, 0.9) for fibrocystic breast disease, 0.6 (95% confidence intervals = 0.5, 0.9) for fibroadenoma, 0.6 (95% confidence intervals = 0.4, 1.0) for fibrocystic breast disease concomitant with fibroadenoma, and 0.6 (95% confidence intervals = 0.5, 0.9) for other benign breast disease. Adjustments for potentially confounding variables, including indices of medical care utilisation, affected these odds ratios only slightly. There was no convincing evidence of an association, either negative or positive, between current cigarette smoking and the degree of epithelial atypia of the fibrocystic lesions. However, the negative association between fibrocystic disease and current cigarette smoking was strongest for atypical lobular hyperplasia, which in turn has been associated with a particularly elevated risk of subsequent breast cancer.
Adenofibroma↗
Serous surface papillary carcinoma of the ovary: a clinical, pathologic, ultrastructural, and immunohistochemical study of 11 cases.
Explore the source record for details and available documents.
Adult↗
Risk factors for fibrocystic breast disease and its histopathologic components.
The relationship between various sociodemographic, reproductive, and other factors to the occurrence of fibrocystic breast disease was evaluated in a case-control study undertaken at five Connecticut hospitals from 1979 to 1981. The study groups comprised 590 women with biopsy-proven fibrocystic breast disease and 1,018 women with other surgical conditions. Among the premenopausal women, multivariate analysis suggested that high socioeconomic status, Jewish religion, low parity, a history of benign breast disease, a history of breast cancer in the mother or a sister, and low Quetelet index were associated with increased odds ratios (OR) for fibrocystic breast disease. Similar analysis for the postmenopausal women revealed increased OR for women with high socioeconomic status, a late age at menopause, and a history of benign breast disease. Current smokers as well as those who had had a tubal sterilization had significantly reduced odds of fibrocystic disease. There was no convincing evidence of linear trends according to degree of epithelial atypia for any of the variables considered. Although some variation in the OR emerged in the analysis according to selected histologic components, the results provided little evidence that women with biopsy specimens exhibiting gross cysts, sclerosing adenosis, papillary hyperplasia, or papillomatosis showed epidemiologic similarities with breast cancer patients.
Adult↗
Histopathologic correlations of estrogen and progestin receptor protein in epithelial ovarian carcinomas.
One hundred thirteen primary epithelial ovarian cancers were analyzed for estrogen and progestin receptor content and the results compared with multiple histologic parameters (grade, necrosis, fibrosis, lymphocyte infiltration, mitoses, tumor giant cells, psammoma bodies, stroma). Grade 4 cancers had a statistically greater likelihood of containing estrogen receptors (P = .03) than did lower grade cancers. However, grade 3 tumor samples containing abundant (3+ and 4+) mitoses had a significantly greater number of estrogen receptor negative cancers (P = .01) than did cancers containing none to moderate (0-2+) mitoses. The only histologic parameter that demonstrated any statistically significant association with progestin receptor content was the presence of lymphocyte infiltration. Samples demonstrating moderate (2+ and 3+) lymphocyte infiltration had a significantly (P = .005) greater chance of being progestin receptor negative than cancers containing none to minimal (0 to 1+) lymphocyte infiltration. This study suggests that estrogen and progestin receptor content of epithelial ovarian cancers is associated with grade and mitoses (estrogen receptor) and lymphocyte infiltration (progestin receptor). With the exception of these relationships, the estrogen and progestin receptor content of ovarian cancers appears independent of all of the histologic parameters examined.
Adult↗
Exogenous hormone use and fibrocystic breast disease by histopathologic component.
In a hospital-based case-control study of 590 women with biopsy-proven fibrocystic breast disease and 1,018 control women with other surgical conditions, no linear relationship was evident between the use of oral contraceptives or of estrogen replacement therapy and the degree of epithelial atypia of the fibrocystic lesions. Case-control and intracase comparisons suggested that oral contraceptive use might be associated with an increased occurrence of sclerosing adenosis among the premenopausal women and of gross cysts among the postmenopausal women. Estrogen replacement therapy, which was positively associated with fibrocystic breast disease as a whole among the post-menopausal women, was most frequently used among the cases whose biopsy specimens exhibited gross cysts, papillomatosis or papillary hyperplasia.
Adult↗
Oral contraceptive use and fibrocystic breast disease among pre- and postmenopausal women.
The association between use of oral contraceptives and fibrocystic breast disease was assessed among women aged 20-74 years in a hospital-based case-control study conducted between November 1979 and November 1981 in Connecticut. The study groups comprised 633 women with biopsy-proven fibrocystic breast disease and 1,062 controls who had been admitted, as inpatients or outpatients, to general surgical services. For the premenopausal women, there was no evidence that long-term use of oral contraceptives was associated with a decreased frequency of fibrocystic breast disease among either current or past users. For the postmenopausal women, previous oral contraceptive exposure was associated with an increased occurrence of cystic disease. These findings contradict previous investigations reporting a negative association between oral contraceptive use and the development of fibrocystic breast disease.
Adult↗
Plasmacytoma of the breast.
Extramedullary plasmacytomas are unusual tumors that generally represent the initial manifestation of systemic multiple myeloma. I studied a plasmacytoma of the breast in a patient who has remained free of symptoms nine years after initial diagnosis.
Aged↗
Caffeine consumption and fibrocystic breast disease: a case-control epidemiologic study.
In a hospital-based case-control study that included 634 women with fibrocystic breast disease and 1,066 comparison women in Connecticut, the occurrence of fibrocystic breast disease was positively associated with average daily consumption of caffeine. Women who consumed 31-250 mg of caffeine/day had a 1.5-fold increase in the odds of disease, whereas women who drank over 500 mg/day had a 2.3-fold increase in the odds. The association with caffeine consumption was especially high among women with atypical lobular hyperplasia and with sclerosing adenosis with concomitant papillomatosis or papillary hyperplasia, both of which have been associated with an increased breast cancer risk. The association was specific to fibrocystic breast disease in that there was no association of caffeine consumption with fibroadenoma or other forms of benign breast disease.
Adult↗
Adenocarcinoid (mucinous carcinoid) of the appendix.
Carcinoid tumors of the appendix are common incidental findings, but appendiceal tumors with histologic features of both carcinoids and adenocarcinomas are rare, and their biologic behavior is still unclear. We studied 10 such cases among 45 appendiceal tumors seen at Yale-New Haven Hospital between 1960 and 1982. The patients, ranging in age from 23 to 65 yr, were all clinically symptomatic [acute appendicitis (5); abdominal mass (5)]. Right colectomy was performed in 5 patients; the other 5 underwent appendectomy only. In 1 case, metastasis to a lymph node was detected; 2 patients had ovarian metastases, and 4 patients had cecal invasion. One of the 10 patients died of widely disseminated tumor, 2 are living with persistent disease, and 5 remained free of disease from 1 to 5 yr after initial surgery. Two cases were lost to follow-up. We conclude that the histology of these lesions is distinctive, enabling their differentiation from ordinary carcinoids. Because these lesions behave in a clinically more aggressive fashion than the usual appendiceal carcinoids, but are less virulent than adenocarcinoma, we support their classification as adenocarcinoids.
Adenocarcinoma↗
Intracystic papillary carcinoma of the breast. After mastectomy, radiotherapy or excisional biopsy alone.
Intracystic papillary carcinoma of the breast (IPC) was distinguished from the more common papillary intraductal carcinoma (DCIS) and infiltrating duct carcinoma with a papillary pattern. IPC was defined as a solitary tumor with a pattern recognizable as carcinoma which is confined to a dilated duct. A series of 41 such cases was collected from three institutions. Twenty-nine patients underwent mastectomy; 11 of them had axillary dissections. None of these patients had metastatic disease in the axillary lymph nodes or recurrence in the follow-up period which averaged five years. Eleven patients did not have mastectomy or radiotherapy. Eight of these patients (followed for an average of ten years) had no recurrence. The only patients who developed invasive carcinoma were those with DCIS as well as IPC in the excisional biopsy. The data suggest that IPC is much more likely to be cured by local treatment than is IPC accompanied by DCIS.
Adult↗
Angiosarcoma of the breast.
Primary angiosarcoma of the breast is an unusual neoplasm generally associated with a dismal prognosis. In order to determine if there is a relationship between the histological characteristics of angiosarcoma and the clinical behavior, we studied 15 such cases obtained from the Connecticut Tumor Registry between the years 1954 and 1980. Histologically the cases were classified in three types: well differentiated, moderately differentiated, and poorly differentiated. The results show that the histologic patterns of the tumors correlated closely with the prognosis. Four of the five patients with well-differentiated lesions have remained free of disease for as long as 24 years. Three of four patients with moderately differentiated lesions and three of the six patients with poorly differentiated tumors died of disease in intervals up to 4 years. We believe that careful histologic evaluation of these tumors may be of significance in the prognosis of the patients.
Adolescent↗
Coexistent endocervical adenocarcinoma and mucinous adenocarcinoma of ovary: a clinicopathologic study of four cases.
We present a series of four women with endocervical adenocarcinoma who were found to harbor synchronous mucinous neoplasms of the ovary. In each case, "in situ" components were found in each site, lending weight to the belief that the lesions represented separate primary lesions rather than metastatic disease. Atypical epithelial lesions in the fallopian tubes (two cases) and endometrium (one case) give further support for the lesions being expressions of "multifocal" neoplastic transformation in embryologically related epithelia.
Adenocarcinoma↗