Hector Tobon

Prostaglandin Content of Human Endometrium

Prostaglandin levels in 46 human endometrium specimens were determined and expressed as both total uterine content and on a dry weight basis. Concentrations of PGF2alpha and PGE did not differ significantly between specimens obtained during the proliferative or secretory phases of the menstrual cycle. There was, however, a fourfold higher total uterine content of prostaglandins during the secretory phase. There was also a more than fourfold higher level of PGF2alpha than of PGE during the secretory phase. The two types of prostaglandins were present in nearly equal amounts during the proliferative phase. Atrophic endometrium was characterized by a high concentration of prostaglandins, but a low total amount consisting of nearly equal amounts of PGF2alpha and PGE.

Polyps of the vagina: a clinicopathologic study of 18 cases.

Polyps of the vagina are benign, soft tissue tumors composed of loose connective tissue with myxoid changes and containing atypical, pleomorphic, hyperchromatic cells. Because of this bizarre microscopic configuration, they have been confused with sarcoma botryoides. Eighteen cases of polyps of the vagina included in the pathology files of Magee‐Womens Hospital from 1972‐1979 were compiled. Clinical and pathologic findings were reviewed. All patients except one were white, and median age was 48.5 years. The most common symptom was vaginal bleeding (ten patients) or vaginal “growth” (six patients). All lesions (except one in which only a biopsy was done) were treated with local resection.

Benign blue nevus of the vagina

Pigmented lesions of the vagina are very rare. A benign blue nevus of the vagina in a 73‐year‐old woman, diagnosed clinically as malignant melanoma, is presented. Although 15 cases of blue nevi of the uterine cervix have been reported, this is the first case of blue nevus located exclusively in the vagina. Cancer 40:3174‐3176, 1977.

Lobular carcinoma in situ. Some ultrastructural observations

Bilateral, multifocal areas of lobular carcinoma in situ in the breast of two women were examined by electron and light microscopy. A striking dilatation of the Golgi apparatus was observed in the hyperplastic epithelial tumor cells which contained granular material of varying electron density within the cisternae, suggesting a secretory and/or concentrating activity. Abundant tumor cells filled the dilated mammary ductules leaving small, irregular luminal renants and occasional “pseudo‐intracytoplasmic” lumens. The tumor cells related to each other by an intricate system of microvilli and well‐defined desmosomes; however, large intercellular cisternae were observed in some areas as if the cells had lost cohesiveness. Well‐defined myoepithelial cells at the periphery of the dilated ductules revealed vacuolation, and fragmentation of the cytoplasm. It is possible that lobular carcinoma in situ is mostly an epithelial lesion; the myoepithelial cells are not participating in the neoplastic process and they seem to be crowded and compressed by the proliferating tumor cells against the basement lamina.

Primary clear cell carcinoma of the ovary: An analysis of 15 cases with review of the literature

The clinical and pathological findings in 15 primary, “pure” clear cell carcinomas of the ovary included in the Magee‐Womens Hospital Tumor Registry from 1947 through 1974 are discussed. The ages of the patients ranged from 35 to 75 years (mean 53). The most common clinical finding was an abdominal mass in 14 cases. At surgery, five patients had extraovarian spread, one accompanied by ascitis. The tumors varied in diameter from 4 cm to 17 cm (mean 10.5 cm); grossly, about one‐third were cystic, one‐third solid and one‐third had combined cystic and solid areas. Microscopically, four basic patterns were seen: papillary, tubular, solid, and cystic, and in several an admixture of the above. Clear cells predominated in 48% of the cases and 23% displayed hobnail cells. Most patients were treated by TAH & BSO or variants thereof, some followed by radiation or chemotherapy. Four patients died with cancer within 35 months after diagnosis; two others died of unrelated causes three and 12 years later. The actuarial survival was computed as 55% at five years. Five patients were staged as IIb (FIGO classification); four died with tumor and the remaining patient is alive with recurrent tumor in the pelvis 18 months after the original diagnosis. Three patients with tumors displaying the cystic pattern are still alive; two with a predominantly papillary pattern and vascular permeation are dead. It is suggested that survival rates in these 15 cases may be related more to the extent of the lesion at the initial presentation than to the gross or microscopic pattern.

Mucinous Adenocarcinoma of the Endometrium: A Clinico-Pathological Review of 18 Cases

We reviewed 18 cases of mucinous adenocarcinoma of the endometrium seen at this hospital during 1969-1985. Tumor histology was studied in curettage and hysterectomy material; the Hospital Tumor Registry provided follow-up data. All women were postmenopausal, 47-89 years of age, and presented with vaginal bleeding; few had abdominal pain; four of the 18 were nulliparous. Eight patients had been receiving estrogen therapy. The disease was in Stage IA in 15 patients and Stage IB in three patients. All patients had total hysterectomy and salpingo-oophorectomy; six had preoperative radium implants, and four had postoperative radium plus progesterone treatment. Histologically the tumor was grade 1 in 13 (72%) women, only five being grade 2 or 3 (28%). All tumors were positive for mucicarmine and carcinoembryonic antigen (CEA). Only two cases showed adjacent benign endometrial mucinous metaplasia. Myometrial invasion varied from 5-60% and was absent in three cases. The degree of invasion did not appear to affect the rate of recurrence. The tumor recurred 54 weeks after treatment in one of 13 patients with grade 1, in none in grade 2 and in two of two patients with grade 3 within 10 months of diagnosis. In summary, mucinous endometrial carcinoma is a rare tumor (1% of endometrial carcinomas in our hospital) of postmenopausal women; it tends to be well differentiated and has a relatively good prognosis.

Polyps of the Vagina: A Clinicopathologic Study of 18 Cases

Polyps of the vagina are benign, soft tissue tumors composed of loose connective tissue with myxoid changes and containing atypical, pleomorphic, hyperchromatic cells. Because of this bizarre microscopic configuration, they have been confused with sarcoma botryoides. Eighteen cases of polyps of the vagina included in the pathology files of Magee-Womens Hospital from 1972-1979 were compiled. Clinical and pathologic findings were reviewed. All patients except one were white, and median age was 48.5 years. The most common symptom was vaginal bleeding (ten patients) or vaginal growth (six patients). All lesions (except one in which only a biopsy was done) were treated with local resection.