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Πέμπτη 10 Μαρτίου 2022

Papillary mucinous metaplasia: a distinct precursor of mucinous adenocarcinoma of the endometrium

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Int J Clin Exp Pathol. 2022 Feb 15;15(2):83-87. eCollection 2022.

ABSTRACT

Mucinous adenocarcinoma of the endometrium is heterogeneous, consisting of endometrioid adenocarcinoma composed of >50% mucinous cells, low-grade mucinous adenocarcinoma, microglandular adenocarcinoma, and gastric (gastrointestinal)-type adenocarcinoma. Previous studies have reported that papillary mucinous metaplasia is a possible precancerous lesion of mucinous adenocarcinoma with frequent KRAS mutations. Recently, we encountered a case of pure mucinous adenocarcinoma of the endometrium with concurrent papillary mucinous metaplasia in a 35-year-old woman. She underwent 6-month hormonal therapy for atypical endometrial hyperplasia. A follow-up biopsy led to a diagnosis of mucinous adenocarcinoma; therefore, total hysterectomy was performed. The tumor showed abundant intracytoplasmic mucin and mild-to-moderate cytologic atypia with papillary architectu re. KRAS mutation analysis revealed a point mutation from GGT to GTT in codon 12. Although papillary mucinous metaplasia showed an overexpression of p16INK4, especially in the intragrandular papillary tufts, and a low MKi67 labeling index, overt mucinous adenocarcinoma with a loss of P16INK4a expression showed a high proliferating index of MKI67. The mass presented with stage ІA disease. During follow-up, the patient was stable and showed no recurrence. Considering the histologic similarity and incidence of KRAS mutations between papillary mucinous metaplasia and mucinous adenocarcinoma, papillary mucinous metaplasia may be a precancerous lesion for a subset of mucinous adenocarcinoma of the endometrium.

PMID:35265257 | PMC:PMC8902477

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Possible Association between Lenvatinib Use and Primary Adrenal Insufficiency: Additional Studies Very Much Needed

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Clinical Thyroidology, Volume 34, Issue 3, Page 132-135, March 2022.
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The Role of a Computer-Aided Diagnosis System in the Interpretation of Thyroid Nodules with Challenging Sonographic Features

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Clinical Thyroidology, Volume 34, Issue 3, Page 112-115, March 2022.
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Minipterional Approach for Middle Fossa Skull Base Lesions: Technical Note

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J Neurol Surg B Skull Base
DOI: 10.1055/s-0042-1743464

Surgical access to the middle fossa can be technically challenging. As neurosurgery evolves to minimally invasive approaches, the objective of this study is to demonstrate the extension of the Minipterional approach to access the middle fossa. We present a new surgical approach to the middle fossa for the treatment of secondary trigeminal neuralgia. Three cases are reported to illustrate the following techniques: a patient with petrotentorial meningioma and trigeminal neuralgia, a patient with an arachnoid cyst compressing the fifth nerve, and a patient with a middle cerebral artery aneurysm and a long history of TN (trigeminal neuralgia) refractory to medical and surgica l treatments. All three experienced full symptom controls with no permanent neurological deficits. Therefore, the Minipterional technique might represent a feasible, effective, and safe option to treat refractory secondary TN. It also allows approaching these lesions when the posterior fossa approach is compromised by anatomical distortion and enables the simultaneous treatment of secondary trigeminal neuralgia and other lesions, such as aneurysms and meningiomas.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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