Fuyuki Eguchi

Proteolytic activation of heparin‐binding EGF‐like growth factor by membrane‐type matrix metalloproteinase‐1 in ovarian carcinoma cells

Increased expression of heparin‐binding EGF‐like growth factor (HB‐EGF) and membrane‐type matrix metalloproteinase‐1 (MT1‐MMP) is frequently associated with various types of malignant tumor. HB EGF‐like growth factor has been reported to promote the malignant progression of ovarian carcinoma. Based on this finding, inhibition of HB‐EGF activity with CRM197 is now under phase I clinical evaluation. On the other hand, MT1‐MMP expressed in ovarian carcinoma cells is thought to promote invasion and growth of tumor cells by degrading the extracellular matrix. However, we recently demonstrated that co‐expression of MT1‐MMP and HB‐EGF in gastric carcinoma cells leads to cleavage of HB‐EGF within its N‐terminal heparin‐binding region, converting it into a potent heparin‐independent growth factor. In this study, we evaluated the importance of regulation of HB‐EGF by MT1‐MMP in clinical samples of ovarian carcinoma. We detected co‐expression of HB‐EGF and MT1‐MMP in clear cell ovarian carcinoma tissues, particularly at the invasion front and in tumor cells that had disseminated into the ascites, whereas HB‐EGF alone was expressed in non‐invasive borderline ovarian tumor tissue. Furthermore, a soluble HB‐EGF fragment that corresponds to that processed by MT1‐MMP was detected in malignant ascites obtained from patients with metastatic ovarian carcinoma. Ovarian carcinoma cells that express MT1‐MMP and HB‐EGF exhibited enhanced cell growth in a 3D‐collagen matrix and anchorage‐independent growth in suspension. These results indicate that MT1‐MMP co‐expressed with HB‐EGF in ovarian carcinoma cells potentiates the activity of HB‐EGF to promote invasive tumor growth and spreading in vivo. (Cancer Sci 2011; 102: 111–116)

Choosing the uterine preservation surgery for placental polyp determined by blood flow evaluation: A retrospective cohort study

Background A placental polyp is an intrauterine polypoid mass or pedunculated mass occurring from residual trophoblastic tissue following abortion, cesarean section or vaginal delivery. Recently uterine preservation surgery represented by transcervical resection (TCR) has been performed for placental polyps. However TCR without intravascular intervention, including uterine artery embolization (UAE) may cause profound bleeding which necessitate emergency laparotomy. Methods Seventeen cases of placental polyp were retrospectively examined. We divided cases into two groups: strong vascularity group (n = 13) and weak vascularity group (n = 4). Mass extraction of polyp by TCR was conducted in 16 cases, 6 case without UAE and 10 cases with UAE. Results As for the weak vascularity group, one case was naturally resolved while planning surgery and 3 cases were treated with TCR without UAE without major intra- and/or postoperative bleeding. On the other hand in the strong vascularity group, 2 out of 3 cases of TCR without UAE resulted in major bleeding during and after the surgery, both needed transfusion and one needing postoperative UAE. Ten cases of strong vascularity group, TCR with UAE were performed and all of them were accomplished without major bleeding. TCR without UAE was safely performed in cases where there was absent or mild to moderate blood flow. Conclusions Our report suggests that adding UAE might be safer to treat placental polyps that have strong vascularity.

Malignant lymphoma of the uterine cervix presumptively diagnosed by Pap smear: A case report

Malignant lymphoma of the uterine cervix is exceedingly rare and is difficult to diagnose by cervical cytology. The current study presents a case of malignant lymphoma of the uterine cervix that was presumptively diagnosed by cervical cancer screening in which the patient had no clinical symptoms. The anterior lip of the uterine cervix was occupied by a macroscopic hemorrhagic tumor. The obtained tumor cells exhibited typical cytological features of malignant lymphoma and were positive for CD20. The final diagnosis was diffuse large B cell lymphoma of the uterine cervix, stage IIEA (Ann Arbor classification). The patient received 6 courses of R-CHOP chemotherapy and achieved complete remission. Despite its rarity, the possibility of malignant lymphoma should be considered while screening for cervical cancers using Pap smears. The Pap test screening may be useful for the early diagnosis of malignant lymphoma of the uterine cervix in certain cases. By reaching a rapid and accurate diagnosis, immediate treatment may be initiated and surgery may be avoided.

Positron Emission Tomography Findings in Atypical Polypoid Adenomyoma

Atypical polypoid adenomyoma (APAM) is a rare polypoid tumor of the uterus composed of atypical endometrial glands surrounded by smooth muscle. A 29-year-old nulligravida, was clinically diagnosed with endocervical myoma and underwent trans-uterine cervical resection with hysteroscope. The histopathological diagnosis of specimens was APAM. Eight months later, she diagnosed recurrent uterine tumor. The positron emission tomography (PET-CT) imaging showed an increased fluorodeoxyglucose uptake. She has performed hysterectomy and was diagnosed APAM. Therapy for APAM depends on multiple factors such as age at presentation and desire for childbearing among others. This is the first report of PET-CT findings in APAM.

Solitary transverse colon metastasis: A rare case of uterine cervical cancer recurrence

Cervical cancer is locally invasive, spreading primarily through direct extension. Advanced stages of cervical cancer is mainly metastases to lungs, liver, spleen, brain, and bone. We report a case of squamous cell carcinoma of the cervix metastatic to the solitary transverse colon causing palpable mass which can mimic primarily colon cancer. Because transverse colon metastases is rare, this case was initially thought to be of independent colon cancer, highlighting the importance of awareness of this site of metastases.

Monochorionic–diamniotic discordant growth in a twin pregnancy with one fetus affected by Ebstein's anomaly of tricuspid leaflets

Our patient was diagnosed as having discordant twin growth with Ebsteins anomaly in the larger fetus. Cardiac function was deteriorated in accordance with progression of gestational age. Our observation indicated cardiac failure of the larger fetus. The most important issue in this situation is management of the timing of delivery.