Glaucia A. Magnani Landell

Pulmonary tumor embolism from squamous cell carcinoma of the vulva

Involvement of the pulmonary vessels by tumor emboli has been described from different primary sites of malignancy. A case of pulmonary tumor embolism due to squamous cell carcinoma of the vulva is reported. This form of pulmonary involvement has not previously been described in cases of vulvar carcinoma and it is rare in gynecologic neoplasms. The development of dyspnea with rapid clinical deterioration and fatality associated with multiple pulmonary emboli and histologic signs of pulmonary hypertension is well shown by this case.

A PROSPECTIVE STUDY OF THE MORPHOLOGICAL ASPECTS OF TUMOR INVOLVEMENT OF THE PULMONARY VESSELS

Summary A prospective morphological study of tumor involvement of the pulmonary vessels (Tipv) was undertaken on 203 consecutive autopsy cases of malignancies. The lungs were removed as a block and 15 sections (3 from each lobe) were analyzed. Site of origin, histological type and staging of the tumor, topographic distribution of the tumor emboli in the lungs, right ventricular hypertrophy and dilatation, pulmonary infarct, pulmonary vascular sclerosis and lung metastases were recorded in each case. Tipv was detected in 84 (41.4%) cases, the highest frequency reported until now. In 28 cases, Tipv was considered to be the main cause of death. The breast, liver, and pancreas were primary sites in more than 50% of the cases in which Tipv was observed. Tipv was more prevalent in epithelial neoplasms and showed a strong correlation with advanced disease. There was no significant difference among topographic regions of the lungs. The cases with Tipv were correlated with a high frequency of right ventricular hypertrophy and dilatation, vascular sclerosis and pulmonary metastases but not with pulmonary infarcts.

Giant perineal leiomyoma incidentally manifested at a recent episiotomy site: case report.

Benign leiomyomas are common soft tumors, arising especially in the female genital tract; unlike uterine leiomyomas, they rarely occur in perineal regions. They can develop wherever smooth muscle is present. Herein is reported the case of a large perineal leiomyoma in a 36-year-old woman who noted a palpable mass close to the rectum 1 year after she had delivered vaginally, in the same region of as a mediolateral episiotomy. Complete surgical excision was performed. Histopathologic findings were compatible with benign leiomyoma. At postoperative follow-up, no signs of anal dysfunction were noted. There was no pathologic correlation between formation of the leiomyoma and the episiotomy despite a possible association between the presence of fibrosis and development of leiomyomas, which was found during a literature review. Microarray analysis will be necessary to elucidate this hypothesis.