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Sex cord stromal tumors are rare neoplasms, frequently diagnosed in young women often as early-stage disease. In patients who desire to preserve fertility, when possible, unilateral salpingo-oophorectomy with peritoneal surgical staging is a safe alternative to radical treatment. In this review, we analyze the available literature on the obstetrical outcomes after fertility-sparing surgery in a total of 255 patients with sex cord stromal tumors. We found that the spontaneous conception rate in granulosa cells tumor is encouraging (88.5%). In particular, juvenile granulosa cell tumors are associated with a more successful pregnancy rate than adult granulosa cells tumors (11/26 (42.3%) in juvenile granulosa cells tumors compared with 28.5% in adult granulosa cell tumors, respectively.) On the other hand, the results of obstetrical outcomes in Sertoli-Leydig cells tumors are less promising (7/36 (19.4%)). Unfortunately, no evidence on this topic is available for sex cord tumor with annular tubules due to the low incidence. Regarding the oncological outcomes of 900 cases of sex cord stromal tumors treated conservatively, data are reassuring with comparable outcomes between patients treated with conservative and radical surgery. Given the limited available data on this rare tumor, further studies are needed to evaluate the safety of conservative approaches and to define the obstetrical outcomes in this patient population.

Preliminary results of Immunohistochemical tumor markers evaluation in endometrial cancer patientsINTRODUCTION: The discovery of new histotype-specific and prognostic biomarkers for better stratification into higt- or low-risk of endometrial cancer (EC) seems to be needed in order to avoid over- or undertreatment of EC patients. Recent study have demonstrated new biomarkers assessed immunohistochemically (IHC), related to EC patient prognosis. MATERIAL AND METHODS The aim of this retrospective analysis is to evaluate the different tumor markers expression between all patients with diagnosis of endometrial cancer treated from Jan 2016 to April 2019 in our Division of Gynaecologic Oncology. The variables as histotype, LVSI, presence of myometrial infiltration as > 50% or < 50% and nodal status, were analyzed and correlated with the following Immunohistochemical markers: L1 Cell Adhesion Molecule (L1CAM), p53, u03b2-catenin, Ki67, Estrogen receptor (ER) and Progesterone receptor (PR). All of these were performed in formalin-fixed paraffin embedded whole tumor tissue sections. The data analysis is on going.RESULTS:To date we analyzed twenty-one patients with a median age of 58 years (range, 34-88 years). Final histology was endometrioid in 14 (66,6%) cases, clear cell in 1 (4,8%) case, serous in 5 (23,8%) cases, mixed in 1 (4,8%) case. Seven (33%) patients were L1CAM positive (cut off value 10%). L1CAM expression was associated with advanced age (74 years vs 67 years), non-endometrioid morphology and loss of ER and PR expression. An important association was found with p53-mutant tumors often showing diffuse L1CAM expression, mostly in the non-endometrioid subtype. Out of a total of 14 endometrioid endometrial cancer, only one was found to be p53 mutant positive and 13 p53 wild-type (wt) positive. All endometrioid endometrial cancer not expressed L1CAM. All non-endometrioid EC expressed p53 wt and L1CAM markers and 4/5 (80%) shows a L1CAM positivity > 75%. None association was found between L1CAM and Ki67 expression and depth of myometrial invasion, histologic grade, lymph vascular space invasion and metastatic node. Endometrioid and non-endometrioid subtype demonstrated diffuse u03b2-catenin staining, > 50%.CONCLUSIONS:In agreement with the literature, these preliminar datas confirmed that in high risk endometrial cancer patients L1CAM and p53 expression is more frequent. A hight association was found between L1CAM expression and mutant p53 expression in the non-endometrioid subtype. In contrast, L1CAM expression seems to be not associated with p53 expression in the endometrioid endometrial cancer. We are waiting for a complete analisys of the database.