Nguyen, Christine P.
(Department of Gynecology and Obstetrics, The Johns Hopkins Hospital, Baltimore, Maryland, 21287)
,
Levi, Angelique W.
(Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, 21287)
,
Montz, F.J.
(Department of Gynecology and Obstetrics, The Johns Hopkins Hospital, Baltimore, Maryland, 21287)
,
Bristow, Robert E.
(Department of Gynecology and Obstetrics, The Johns Hopkins Hospital, Baltimore, Maryland, 21287)
Abstract Objective. The purpose of this article is to report a case of coexisting uterine choriocarcinoma and uterine malignant mixed mesodermal tumor (MMMT). The relevant literature is reviewed and possible pathogenesis discussed. Methods. The clinical course and histopathology of the case were ...
Abstract Objective. The purpose of this article is to report a case of coexisting uterine choriocarcinoma and uterine malignant mixed mesodermal tumor (MMMT). The relevant literature is reviewed and possible pathogenesis discussed. Methods. The clinical course and histopathology of the case were reviewed and a Medline literature search for other cases was performed. Results. The patient's uterine tumor contained syncytiotrophoblastic and cytotrophoblastic cells that stained positively for the beta subunit of human chorionic gonadotrophin consistent with uterine choriocarcinoma. Pathology also revealed a second distinct neoplasm composed of adenocarcinoma admixed with sarcoma, compatible with a uterine MMMT. The patient experienced metastatic choriocarcinoma to her lungs, lymph nodes, and brain. She suffered a complicated clinical course and died 7 months after her initial diagnosis. The literature search revealed that various gynecologic and nongynecologic carcinomas with trophoblastic differentiation have been described, but an association with uterine MMMT has not been previously reported. Conclusions. Trophoblastic differentiation and choriocarcinoma associated with gynecologic and nongynecologic tumors is rare. We document the presence of uterine MMMT coexisting with uterine choriocarcinoma that followed an aggressive clinical course and review the possible pathogenesis of this lesion.
Abstract Objective. The purpose of this article is to report a case of coexisting uterine choriocarcinoma and uterine malignant mixed mesodermal tumor (MMMT). The relevant literature is reviewed and possible pathogenesis discussed. Methods. The clinical course and histopathology of the case were reviewed and a Medline literature search for other cases was performed. Results. The patient's uterine tumor contained syncytiotrophoblastic and cytotrophoblastic cells that stained positively for the beta subunit of human chorionic gonadotrophin consistent with uterine choriocarcinoma. Pathology also revealed a second distinct neoplasm composed of adenocarcinoma admixed with sarcoma, compatible with a uterine MMMT. The patient experienced metastatic choriocarcinoma to her lungs, lymph nodes, and brain. She suffered a complicated clinical course and died 7 months after her initial diagnosis. The literature search revealed that various gynecologic and nongynecologic carcinomas with trophoblastic differentiation have been described, but an association with uterine MMMT has not been previously reported. Conclusions. Trophoblastic differentiation and choriocarcinoma associated with gynecologic and nongynecologic tumors is rare. We document the presence of uterine MMMT coexisting with uterine choriocarcinoma that followed an aggressive clinical course and review the possible pathogenesis of this lesion.
참고문헌 (10)
Arch Pathol Lab Med Knapp 106 507 1982 Primary embryonal carcinoma and choriocarcinoma of the mediastinum
Cancer McKechnie 27 694 1971 10.1002/1097-0142(197103)27:3<694::AID-CNCR2820270327>3.0.CO;2-H Choriocarcinoma and adenocarcinoma of the esophagus with gonadotropin secretion
Gynecol Oncol Savage 26 257 1987 10.1016/0090-8258(87)90283-6 Adenocarcinoma of the endometrium with trophoblastic differentiation and metastases as choriocarcinoma: a case report
Carnegie Inst Washington Contrib Embryol Witschi 32 67 1948 Migration of the germs cells of human embryos from the yolk sac to the primitive gonadal folds
Moore, K, L, The beginning of human development, in, Moore, K, L, (ed), The Developing Human, Philadelphia, PA, Saunders, 1988, pp, 13, - 35
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