Ten Jun Yu

A cystic adenomatoid tumor of the uterus simulating lymphangioma grossly.

We are reporting a rare case of an adenomatoid tumor of the uterus having multicystic gross appearance. A 32‐year‐old woman complaining of dysmenorrhea had multicystic mass lesions on the posterior wall of the right cornual region of the uterus. The specimen showed a honeycomb appearance with mucoid content. Microscopically, numerous gland‐like spaces lined with low cuboidal cells were observed beneath the serosa, and mucopolysaccharide material accumulated in the cystic spaces forming honeycomb‐like lesions surrounded by myometrial tissue.

Uterine tumor resembling ovarian sex-cord tumor with osteoid metaplasia.

A rare uterine tumor showing sex‐cord‐like differentiation and marked osteoid metaplasia was found in a 33‐year‐old female. The tumor, occupying the uterine fundus, was multilobular, fleshy, and yellowish white, with punctations and poorly defined tumor margins into the subserosa. The tumor nodules were mostly composed of small, round, rather regular neoplastic cells with scanty cytoplasm and prominent nuclei. Epithelioid neoplastic cells with striking ovarian sex‐cord‐like arrangement, surrounded by fibrous tissue, were noticed. Polygonal neoplastic cells with marked osteoid metaplasia were also detected. The authors introduce an infrequent variant of uterine tumor resembling ovarian sex‐cord tumor with osteoid metaplasia, probably of endometrial stromal cell origin. Because of deep myometrial infiltration without vascular invasion, malignant potential is considered. The patient is now alive without evidence of local recurrence or distant metastasis after abdominal total hysterectomy. ACTA PATHOL. JPN. 36: 1391–1395, 1986.

ISOLATED WELL‐FORMED INTESTINAL TISSUE IN THE UMBILICAL CORD: A Variant of Cyst of Omphalomesenteric Duct

An extremely rare abnormality, a variant of omphalomesenteric duct, was observed in the umbilical cord 1 cm from the entry point into the abdominal wall, which itself was as an isolated mass of well‐formed intestinal tissue free of structural defects. This intestinal tissue seems to be the remnant of an intestinal loop from caudal limb of midgut following physiological herniation during the third month of gestation.

Malignant endometrioid adenofibroma of the ovary with serous cystadenoma.

This is a case report of malignant endometrioid adenofibroma of the ovary with serous cystadenoma in a 42‐year‐old female. It was classified as FIGO serous IA (2) ovarian tumors. Serous epithelium transformation into endometrioid glandular epithelium was disclosed. The patient is now in good condition and followed‐up periodically.

Circumscribed endometrial stromatosis of the uterus with marked epitheliogenesis

A 75-year-old female suffered from continuous abnormal genital bleeding; endometrial biopsy was interpreted as stromal hyperplasia. Simple total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. A circumscribed tumor covered by atrophic endometrium was found in the uterine fundus, bulging into the endometrial cavity; histological pictures revealed endometrial stromatosis with marked epitheliogenesis having a papillary formation and sex-cord-like differentiation. No recurrence or metastasis was detected postoperatively.

Primary ovarian pregnancy in a cystic teratoma

&NA; Hemoperitoneum was identified by culdocentesis in a 26‐year‐old woman suffering acute abdominal pain. A pregnancy test was positive. Operation indicated a ruptured ovarian pregnancy, and histologic examination revealed primary intrafollicular ovarian pregnancy in a cystic teratoma. Ovarian pregnancy in an ovarian tumor is exceedingly rare. (Obstet Gynecol 64:52S, 1984)

Endolymphatic stromal myosis of the uterus with metastasis to ovary and recurrence in vagina.

A 24‐year‐old woman underwent a supracervical hysterectomy with findings of an endolymphatic stromal myosis (ESM) with vascular invasion as a submucosal tumor of the uterine fundus. Four years later, metastasis of ESM in the right ovary was found after salpingo‐oophoréctomy. Parametrial masses and a tumor infiltrated cervical stump revealed the same structure of ESM after operation. Though subtotal excision of the pelvic and vaginal recurrences nine years after the first operation for ESM and in spite of oral administration of danazol and duphaston (hydrogesterone), a recurrent vaginal tumor developed after the fourth operation and local application of chemotherapy with 5‐fluorouracil was given. At present, the patients condition is stable without distant metastasis.

Proliferative Brenner tumor of the ovary.

A 72‐year‐old woman was admitted with abdominal distention and a hard mass in the pelvis. Abdominal laparotomy was performed, and a large solid left ovarian tumor was found. Left salpingo‐oophorectomy was carried out. Histology showed cords and nests of stratified high cellular epithelium with dense eosinophilic material in epithelial nests and dense fibrous stroma identified as a Brenner tumor of the ovary. Because mild to moderate cytologic atypia with mitotic activity was present, a diagnosis of proliferative Brenner tumor was made. After the operation, the patient was in good condition with no recurrence or metastasis so far.

Malignant clear cell cystadenoma of the ovary.

A 50‐year‐old female had suffered from abdominal distension and a lower abdominal mass for 3 months. Ultrasonographic examination demonstrated a myoma uteri pattern with a large cystic ovarian tumor. Laparotomy was done on August 30, 1983 and simple total hysterectomy with bilateral salpingo‐oophorectomy was carried out FIGO stage IIC ovarian cancer was stated clinically. Histologically, clear cell cystadenoma of right ovary having benign, prollferative and malignant epithelial elements without dense ovarian stroma was found and diagnosed as malignant clear cell cystadenoma. In spite of Cisplatin therapy, the patient expired on April 6, 1984.