[Bolen test in malignant neoplasms of the uterus].
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Leiomyosarcomas primary in the skin and subcutaneous tissue are rare neoplasms. Metastatic leiomyosarcomas in general are exceptional. The authors present herein clinical, histopathological, and ultrastructural findings in a case of several metastases to the scalp and back from a leiomyosarcoma primary in the uterus.
Levels of FSH, LH and E2 were evaluated by means of EIA methods in 62 post-menopausal women qualified for operation treatment. In 46 cases neoplasms of uterus body and in 16 cases neoplasms of uterus cervix and an ovary were stated. Higher level of estradiol and lower levels of gonadotrophins were shown in cases with uterus body neoplasms and opposite, lower estradiol levels and higher gonadotrophins values in cases with cervix and ovarian neoplasms. The outcome suggests possibility of function of hypothalamic-hypophysial-ovarian axis in post-menopausal period. Level of estradiol can be also used as a diagnostic marker to uterus body neoplasms.
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The aim of this study was to elucidate the clinicopathologic features, the differential diagnostic problems, and the prognostic consequences of patients with metastatic extragenital malignancies to uterus. The patients with metastatic extragenital malignancies to the uterus were evaluated. We considered the metastases in non-genital tract organs at diagnosis of primary neoplasm, the distribution of the metastases in the uterus, and the presence of concomitant metastases in other genital and non-genital tract organs. There were four cases of metastatic extragenital malignancies to the uterus. The breast was the most frequent primary site (two cases: 50%). The other two primary tumors were adenocarcinoma of the cecum and malignant melanoma of the skin. The diagnosis was facilitated by clinical history, revealing the previous primary neoplasm, and by specific immunohistochemical study. Almost all the patients died from disseminated disease. Thus, the prognosis of metastatic extragenital malignancies to the uterus alone or simultaneously to the uterus and other organs of the genital tract is poor. Thus, the metastases to the uterus and to other organs of the genital tract can be considered a preterminal event.
To discuss the diagnosis of uterine leiomyosarcoma and leiomyoma of cellular and bizarre type, we reviewed 51 cases and carried out P53 and desmin immunohistochemical staining on 43 cases. We found that in most cases leiomyosarcoma is accompanied by nuclear mitosis, cell atypia and margin infiltration. In a small number of cases, though mitotic figures are scarce, high cell atypia and marked margin infiltration were present. Leiomyoma variants may have high cellular density and bizarre nuclears but have no margin infiltration. Leiomyosarcoma has a high incidence of P53 expression, while no P53 expression was detected in leiomyoma variants. Desmin expression is closely correlated with the differentiation of smooth muscle neoplasms of the uterus. We conclude that nuclear mitotic activity is an important but not independent criteria in the diagnosis of uterine leiomyosarcoma. Cellular atypia and margin infiltration should be considered. P53 and desmin expression can be applied as accessary criteria.
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