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Query: UMLS:C0033377 (prolapse)
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A vaginal leiomyoma with heterologous paragangliomatous elements is reported. The patient was a 62-year-old woman who presented with uterovaginal prolapse and an asymptomatic vaginal mass that had been present for many years. Histology of the excised mass showed a leiomyoma in a submucosal location, with irregularly shaped islands of chief cells scattered throughout the lesion. These cells were arranged in nests and were surrounded by S100 protein-positive sustentacular cells. The chief cells showed immunoreactivity with chromogranin, synaptophysin, and neuron-specific enolase. Although various heterologous elements are commonly encountered within uterine leiomyomata, such elements have not been described within vaginal leiomyomata. Furthermore, the occurrence of paragangliomatous tissue within leiomyomata has not been reported to date. Int J Surg Pathol 8(4):359-365, 2000
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PMID:Vaginal Leiomyoma with Heterologous Paragangliomatous Elements. 1149 18

A 68-year-old man presented to our hospital requesting an operation for an anal prolapse. However, because of appetite loss and general malaise, we performed screening gastroscopy that revealed a huge ulcerative lesion in the greater curvature of the middle stomach. Biopsy showed a solid tumor with marked dyskaryosis that was positive for synaptophysin on immunohistochemical staining. Abdominal computed tomography revealed a tumor measuring larger than 20 cm in diameter in the greater curvature of the stomach and two hepatic metastases. A preoperative diagnosis of neuroendocrine cell carcinoma (NEC) was made and the patient underwent surgery. The lesion displayed extraluminal growth and directly infiltrated the ileum and colon. We therefore performed distal gastrectomy with combined resection of the gallbladder, ileum, transverse colon, and sigmoid colon. However, despite transcatheter arterial chemoembolization for the liver metastases, the patient died 1 year 2 months after the initial surgery. Gastric NECs are rare and have poor outcomes, being associated with rapid progression of lymph node and liver metastases. Moreover, they rarely show extraluminal growth or invasion to other organs. We present a report of this case along with a review of the literature.
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PMID:[Giant gastric neuroendocrine cell carcinoma with extraluminal growth and direct invasion: a case report]. 2653 29