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Ovarian strumal carcinoid. An immunocytochemical and ultrastructural study of two cases.

Examination by immunoperoxidase methods showed that two strumal carcinoids contained thyroxine in the follicular epithelium and colloid. Ultrastructure showed features of thyroid epithelia. Granule-containing cells replaced some follicular epithelial cells at the colloid interface. The morphology of the granules of these cells resembled those of C-cells and foregut-hindgut carcinoids. Transition between thyroid and carcinoid occurred by proliferation of interfollicular cells which subtly formed trabecular structures. Immunoperoxidase for calcitonin was positive both in the interfollicular cells of one tumor and in cells near the transition from thyroid to carcinoid pattern of the other. We conclude that thyroid tissue is a proven component of strumal carcinoid but that follicular epithelial cells may be replaced by granule-containing parafollicular cells. We suggest that the transition from thyroid to carcinoid is accomplished through an intermediate stage of calcitonin-positive cell proliferation. We emphasize, however, that these neoplasms are types of teratomas which may show several forms of differentiation. The tumor of one patient had mid-gut carcinoid elements and represents the first described strumal carcinoid with the carcinoid syndrome.

Aged↗

Evidence of hybrid cell of thyroid follicular cell and carcinoid cell in strumal carcinoid.

A strumal carcinoid associated with mature cystic teratoma of the ovary in a 59-year-old was investigated immunohistochemically and electron microscopically. Histologically it was composed largely of trabecular and partly of insular carcinoid and individual thyroid follicles. Intensive argyrophilia was shown in both the cells of carcinoid tumor and follicular structure. Thyroglobulin was strongly positive in the follicular lining epithelium and weakly positive in the carcinoid cells adjacent to the follicular area. Immunoreactive cells for somatostatin and prostatic acid phosphatase were strongly detected in the carcinoid area and gradually blended to the follicular epithelium. Methionine-enkephalin, glicentin, and pancreatic polypeptide were focally detected in the carcinoid area. Whereas calcitonin-positive cells were sparsely observed in the follicular area, carcinoembryonic antigen and serotonin were absolutely negative. Electron microscopic findings revealed abundant neurosecretory granules, microfilaments, and colloid-like droplets in the same cells. We suggest that these hybrid cells are the origin of strumal carcinoid.

Carcinoid Tumor↗

Mixed strumal and mucinous carcinoid tumor of the ovary.

The first example of mixed strumal and mucinous carcinoid tumor of the ovary is reported. The vast majority of the tumor was composed of carcinoid cells arranged in a trabecular-insular configuration admixed with obvious thyroid follicles. In addition, glands lined by mucin-producing cells were seen in some areas. A transition from the strumal carcinoid component to the mucinous glands was seen. Immunohistochemical studies showed that the strumal and mucinous carcinoid components were positive for chromogranin A, serotonin, and vasoactive intestinal polypeptide, clearly demonstrating that both were neuroendocrine in nature.

Adenocarcinoma, Mucinous↗

Strumal carcinoid of the ovary associated with hyperinsulinaemic hypoglycaemia and cutaneous melanosis.

Using immunohistochemical techniques ovarian carcinoid tumours can be shown to contain a wide variety of neuro-hormonal peptides but clinical effects, apart from the carcinoid syndrome, are very rare. Non-islet cell tumours with documented hyperinsulinaemic hypoglycaemia are also rare. This is the first recorded case of an ovarian strumal carcinoid associated with hyperinsulinaemic hypoglycaemia. Concurrent skin hyperpigmentation is believed to have resulted from the effects of tumour derived alpha-melanocyte stimulating hormone or an antigenically similar, biologically active peptide.

Aged↗

Strumal carcinoid of the ovary. Ultrastructural and immunohistochemical study.

Strumal carcinoid of the ovary with mucinous cystadenoma of borderline malignancy is reported. A colloid-like material in the follicular structure contained thyroglobulin which was immunohistochemically demonstrated to confirm the thyroid element, whereas the carcinoid component, which showed argyrophilia and displayed neurosecretory granules, revealed an insular or trabecular structure. This confirmed the presence of colloid filled thyroid epithelium intimately admixed with the carcinoid. Electron microscopy revealed carcinoid cells expanding toward the inner layer of the follicles but thyroid epithelium almost always stretched its thin cytoplasmic processes to cover the colloidal lumen. No calcitonin was demonstrated but CEA was seen in some cells of the carcinoid. No amyloid was detected.

Carcinoembryonic Antigen↗

[Endometriosis of the efferent urinary pathways].

Two cases of ureteral endometriosis and 1 case of vesical endometriosis are reported and a short review of the literature is presented. The diagnostic problems, despite modern image procedures, and therapeutic modalities are discussed.

Adult↗

Amelanotic malignant melanoma arising in an ovarian cystic teratoma: a case report.

BACKGROUND: Malignant melanoma arising in a cystic teratoma is extremely rare. We report the clinicopathologic and cytopathologic features of an amelanotic malignant melanoma arising in an ovarian cystic teratoma. CASE: A 55-year-old woman presented with an asymptomatic right ovarian mass, showing features of cystic teratoma according to preoperative computed tomography and magnetic resonance imaging. The resected teratoma was suspected to include a nonepithelial malignancy in a touch preparation from a solid component. The tumor showed immunoreactivity for Melan-A, S-100 and HMB-45 in the absence of melanin granules, which established the diagnosis of amelanotic malignant melanoma arising in an ovarian cystic teratoma. CONCLUSION: Cytopathologic findings from touch preparations and immunohistochemical staining are useful for the diagnosis of amelanotic malignant melanoma arising in an ovarian cystic teratoma.

Female↗

Angiography in uterine and adnexal tumors.

A series of 106 patients with uterine or adnexal lesions is presented. Bilateral selective internal iliac angiography proved to be valuable in the preoperative diagnosis of gynecologic tumors regarding their origin and in the differential diagnosis between malignant and benign tumors.

Adenocarcinoma↗

Strumal carcinoid of the ovary: an immunohistochemical and electron microscopic study.

A case of strumal carcinoid of the ovary is reported. The follicles contained T4-immunoreactive substance, whereas the carcinoid component of the tumor had a trabecular structure and showed argyrophilic elements. Pancreatic-polypeptide and enteroglucagon were localized in these cells by an immunocytochemical method. The same cells displayed small electron-dense endocrine-like granules. A common precursor for the thyroid and carcinoid components is postulated.

Carcinoid Tumor↗

[Somatotropic pituitary tumor in a patient with a previous ovarian strumal carcinoid. Report of one case].

Strumal carcinoid is an unusual form of monodermal ovarian teratoma with thyroid-like follicles mixed with typical carcinoid tumor patterns. We report a 49 years old woman presenting with an acromegaly. At the age of 45, an ovarian strumal carcinoid was excised and at three years of follow up, she complained of finger and feet growth. Laboratory showed an elevated serum IGF-1 and a sella turcica magnetic resonance imaging showed an 8 mm microadenoma. She was subjected to a transphenoidal excision and the pathological study disclosed a solid acidophilic pituitary adenoma. Two months after surgery, there was a significant decrease in serum IGT-I levels.

Acromegaly↗

Strumal carcinoid of ovary. A case report with immunohistochemical investigations.

Clinical, histological and immunohistochemical findings in a rare ovarian tumor--strumal carcinoid--are presented. Neuropeptides detected by immunoreactions revealed the origin of tumor cells from the midgut. Immunohistochemical reaction revealed parathyroid hormone-related protein (PTHrp) in the carcinoid cells. After surgical resection of the tumor a decrease in serum calcium level was observed.

Carcinoid Tumor↗

[Side-effects of lithium therapy].

Side-effects and complications of lithium therapy were examined by evaluation of data registered from 73 patients. Transitory subjective complaints would often occur during the initial phase of therapy, but they do not require any additional therapy. Occasional development of struma and sometimes high increase of body weight require regular controls of these values. Disposing factors concerning the possible occurrence of epileptic seizures and extra-pyramidal disorders under lithium therapy are Melipramin as well as organic cerebral lesions.

Adult↗

[Malignant ovarian struma in pseuomucinous cystadenoma].

In a female aged 64, a large pseudomucinous cystadenoma was found, containing a predominantly follicular carcinoma originating in an ovarian goiter in the subcapsular portion of the ovary. The tumour invaded the surroinding tissues assuming a scirrhotic character. At operation, no peritoneal metastases were recorded. No other teratogenic components were found within the tumour.

Biopsy↗