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The article presents several case studies concerning periotoneal cystic and malignant mesotheliomas in women presented with abdominal pain or discomfort. It states that all cases have presented immunohistochemical and histological characteristics which are consistent with mesothelial origin tumors. The authors discuss several methods for mesothelioma treatment including Computed Tomography (CT), hyperthermal intraperitoneal chemotherapy (HIPEC), and radiotherapy.

The article presents a case study of six patients diagnosed with clear cell cervical adenocarcinoma (CCA) in the Pathology Laboratory of Aretaieion University Hospital in Athens Medical School. A retrospective review was conducted where four were classified as pure adenocarcinomas and two as mixed cell carcinomas with squamous and glandular elements. A nuclear and histological grading was performed on each neoplasm based on tumour architecture and the guidelines of Christopherson et al.

The article presents a retrospective study on the immunohistochemical characteristics of ovarian granulosa cell tumors (GCTs) relative to the GCT cases. The study examined the patients with GCT cases diagnosed at a pathology laboratory in which vimentin, inhibin and cytokeratin immunohistochemistry was carried out on archival paraffin blocks. The result manifests that there is no important relations between the immunohistochemical and pathologic parameters studied with the clinical outcome.

The article presents a case study of a 50-year-old postmenopausal white woman with a rapidly progressive hirsutism. She was diagnosed with Leydig-hilus cell tumor following the oophorectomy was performed. The article discusses the Leydig cell neoplasms and the importance of distinguishing these tumors.

The article presents case study of a 42-year-old Caucasian woman was presented with painless mass in the right vulvar region and was diagnosed with angiomyofibroblastoma (AMF). The patient underwent tumorectomy and neither hemorrhage nor necrosis was observed. The article also discusses the various types of mesenchymal tumors which include aggressive angiomyxoma, AMF, and superficial myofibroblastoma.

The article presents a case study of a 27-year-old pregnant woman who presented with signs of virilization without other endocrine symptoms. After administering a cesarean section due to fetal distress, it is revealed that both adnexa had large compact tumors and a diagnosis of Krukenberg tumor was made with extensive luteinization of the stroma. The article also discusses the characteristics, symptoms, and treatment of Krukenberg tumors.

The article presents a study on rare granular cell tumor cases which are diagnosed in the female genital system of five women. It emphasizes differential diagnoses from skin carcinomas, melanomas and other tumors involving soft tissue, and the use of additional immunohistochemical investigations. It states that pathologists and clinicians need to be aware of the disease with schwannomas, melanomas, and squamous cell carcinomas as their differential diagnoses.

Abstract Background Biliary papillomatosis (BP) is a rare disease entity with a strong malignant potential. It is characterized by multiple papillary adenomas involving both the intrahepatic and extrahepatic biliary tree. BP was considered in the past to be a disease with low malignant potential. However, a current review of the English literature revealed a high rate of malignant occurrence of approximately 41% and histological analysis along with the expression pattern of mucin core proteins (MUC) and mucin carbohydrate antigens suggests that BP is a borderline or low grade malignant neoplasm with a high malignant potential. Case presentation A 68 year-old male patient was referred to our hospital due to the presence of sudden right upper quadrant abdominal pain, nausea and dark urine. Imaging workup demonstrated dilatation of the left hepatic duct without the presence of a space-occupying lesion. A left hepatectomy and cholecystectomy were carried out and histological analysis revealed a moderately to poorly differentiated carcinoma of the left hepatic duct in the background of biliary papillomatosis. Postoperative course was uneventful. Unfortunately, two years after initial diagnosis the patient rapidly deteriorated and died from multiple pulmonary secondary deposits. Conclusion BP should not be considered to be a benign disease. The clinical behavior, the high recurrence rate and the even higher malignant transformation occurrence, as well as the presence of carcinogenetic indicators (K-ras mutation, overexpression of p53, MUC and Tn antigens) strongly support that BP is a low-grade neoplasm with high malignant potential.

Purpose: To present series of patients with large rare primary lesions of the adrenal glands that were operated in our department. The initial indication for surgery was decided based on their impressive similarity to other more sinister adrenal pathologies., Methods: The clinical records of the department and histopathology reports, covering the 1986-2015 period were assessed. Rare adrenal pathologies that preoperatively were clinically mimicking other adrenal tumors were included., Results: In total, 8 patients (age range 20-75 years) with rare tumors of the adrenal glands were found. Seven patients had a preoperative indication for adrenalectomy due to the possibility of malignancy. In one patient surgery was undertaken due to the possible diagnosis of adrenal hemorrhagic cyst. Among these patients 4 had a histopathologic diagnosis of hemangiomas, one of a lymphangiomatous cyst and 3 of myelolipomas., Conclusion: Rare benign tumors of the adrenal glands can present as very large lesions that can be either diagnosed incidentally or due to atypical symptoms. Though unusual, they should be considered in the differential diagnostic approach of adrenal lesions, because they share common clinical and radiological characteristics with more sinister and frequent lesions such as malignant tumors and also hematomas.

Background: Hepatobiliary cystadenocarcinoma represents a rare epithelial malignant tumor derived from the intrahepatic bile duct., Methods: A 71-year-old woman, who had undergone laparoscopic drainage of a cystic lesion of the right hepatic lobe, was misdiagnosed as having hepatic echinococcal disease, and received intracystic infusion of 95% ethanol four years ago. She was admitted to our hospital for further treatment., Results: Physical examination revealed dilated superficial veins across the right abdominal wall. After mapping the direction of blood flow in these vessels, we assumed that this was a sign of inferior vena cava obstruction. Abdominal ultrasound, computed tomography, magnetic resonance imaging combined with magnetic resonance angiography showed a large cystic mass in the right upper quadrant and epigastrium, displacing the adjacent structures, adherent to the inferior vena cava, which was not patent, resulting in dilation of superficial epigastric veins. The patient underwent an exploratory laparotomy. Total excision of the huge mass measuring 16X15 cm was possible under selective vascular exclusion of the liver. Removal of the tumor resulted in immediate restoration of flow in the inferior vena cava. On the basis of the pathology and findings of immunohistochemical analysis, a hepatobiliary cystadenocarcinoma was diagnosed., Conclusions: In the present case, hepatobiliary cystadenocarcinoma was accompanied by dilated superficial venous collaterals due to inferior vena cava obstruction. Selective vascular exclusion of the liver allowed a safe oncological resection of the tumor.

The case of a 20-year-old pregnant woman with a history of one previous cesarean section (CS) who developed a tumorous mass in the area of the CS scar is presented. The clinical diagnosis of endometriosis or fibromatosis was made but the histologic findings were confusing and the pathological diagnosis of an inflammatory type of liposarcoma was made. The case was referred to our Laboratory for re-evaluation and the diagnosis of gossypiboma was made based on histopathological features, the patient's age, her medical history and the exact location of the lesion. Gossypiboma is a foreign body-related inflammatory pseudotumor caused by retained non-resorbable or even resorbable substances, such as glue, surgical gause or sutures. It is an obscure lesion ignored by doctors of all specialties studying the differential diagnosis of a postoperative mass.

A rare case of synchronous angiomyolipoma and oncocytoma in the same kidney of a 70 year old man is presented. A left renal mass was found incidentally by ultrasound. Computerized tomography and magnetic resonance imaging revealed a 1,3 cm mass in the mid-portion of the left kidney, whereas on the lower pole of the same kidney, a 3,3 cm mass was also revealed, consistent with angiomyolipoma. A working diagnosis of renal cell carcinoma was made. A radical nephrectomy was performed. Microscopically, the tumor of the lower pole was found to be an angiomyolipoma, whereas the mid-portion tumor was an oncocytoma. Until now, only 16 cases of unilateral simultaneous presence of renal angiomyolipoma and oncocytoma have been reported. Of these cases, all except one were female and three were associated with the tuberous sclerosis complex. It is well worth remarking, that renal oncocytoma overlap with other renal neoplasms, therefore nephrectomy remains the treatment of choice.Renal angiomyolipoma and oncocytoma are uncommon neoplasms and their simultaneous presence in the same kidney is rare. Only 16 cases have been reported until now in the literature. The purpose of this paper is to present an additional case without evidence of tuberous sclerosis.

Introduction: Pancreatic tumors usually display either a ductal, an acinar or an endocrine differentiation. Mixed exocrine and endocrine pancreatic tumors are extremely rare. There have been a few reports of the rare entity of mixed acinar-endocrine carcinoma of the pancreas, where the endocrine cells represent more than 30% of the tumor. We herein describe a case of such a pancreatic tumor in an asymptomatic patient., Case Presentation: A 74-year-old male patient with no evident clinical symptoms was referred for surgical resection of a large mass located on the pancreatic head, which was confirmed by an abdominal U/S, CT and MRI. FNA of the mass under endoscopic ultrasound guidance showed the cytology specimen to comprise of cells with morphological and immunohistochemical characteristics of endocrine pancreatic neoplasms. The patient underwent a modified Whipple's procedure and his post-operative course was uneventful. Pathological examination of the tumor revealed a mixed acinar-endocrine carcinoma of the pancreas., Conclusion: Mixed tumors of the pancreas are extremely rare and their clinical features and pathogenesis remain unclear. The endocrine component seems to influence their prognosis favorably.Therefore, aggressive surgical therapy remains the only well established line of treatment for these tumors. Further accumulation of clinical cases will help clarify the clinical course and the optimal therapy for these unusual tumors.

Background: Extragenital carcinomas secondarily involving the uterus are very rare and they usually occur as a manifestation of widespread disease. When the metastases involve the endometrium in a diffuse, permeative pattern, sparing the glands, they may cause problems in the diagnosis., Case: A case of metastatic carcinoma to the endometrium with a decidua-like pattern is reported. The patient had a history of breast carcinoma and presented with vaginal bleeding. The pathologic findings in the uterine curettings raised the differential diagnosis between metastatic breast carcinoma and non-neoplastic stromal lesions. The presence of nuclear atypia and mitotic activity along with the appropriate immunohistochemical findings revealed the neoplastic nature of the endometrial lesion and confirmed its origin from the breast., Conclusion: Unusual uterine bleeding in a patient with breast cancer should alert the gynecologist to the possibility of metastatic breast disease. Furthermore, the metastasis to the uterus and to other organs of the genital tract can be considered as a preterminal event.

Aim: To study the association of the frequency and pattern of KIT and PDGFRA mutations and clinicopathological factors in a group of patients with gastrointestinal stromal tumors (GIST)., Methods: Thirty patients with GIST were examined. Exons 9, 11, 13, and 17 of the KIT and exons 12 and 18 of the PDGFRA gene were analyzed for the presence of mutations by PCR amplification and direct sequencing., Results: KIT or PDGFRA mutations were detected in 21 of the 30 patients (70%). Sixteen patients had mutations within KIT exon 11, three within KIT exon 9, and two within PDGFRA exon 18. GISTs with KIT exon 9 mutations were predominantly located in the small intestine, showed a spindle cell phenotype, and were assessed as potentially malignant. GISTs with KIT exon 11 mutations were located in the stomach and intestine, showed mainly a spindle cell phenotype, and were scored as potentially malignant (P < 0.05). Tumors with KIT exon 11 codon 557/558 deletion/insertion mutations were found to be associated with a potentially malignant clinical behaviour (P < 0.003). GISTs with PDGFRA mutations located in stomach showed a mixed cell phenotype and were classified as of very low or low moderate malignant potential., Conclusion: Determination of KIT and PDGFRA mutations should be additional parameters for the better prediction of GISTs clinical behaviour. Tumors with deletion/insertion mutations affecting codons 557/558 of the KIT gene seem to represent a distinct subset of malignant GISTs.

Congenital cystic adenomatoid malformations of the fetal lung (CCAM) are rare embryonic developmental abnormalities. They are considered as benign hamartomatous or dysplastic lung tumors characterized by overgrowth of the terminal respiratory bronchioles at the expense of the saccular spaces. A minority of cases may not be identified by prenatal imaging techniques and the pulmonary lesions are recognized postnatally. Two cases of congenital cystic adenomatoid malformation of the fetal lung diagnosed in our institution during the last four years are reported. The ultrasonographic and pathologic findings of these cases are discussed.

Purpose: To further study the clinicopathological features of synchronous ovarian and endometrial carcinomas., Methods: We retrospectively studied all cases of synchronous ovarian and endometrial carcinomas diagnosed in our laboratory over the last 15-year period. The pathological findings were correlated with the clinical records of the patients., Results: Seven cases of synchronous primary ovarian and endometrial carcinomas were retrieved. The most common presenting symptom was abnormal vaginal bleeding (5 cases, 71.4%). Five patients (71.4%) were postmenopausal and two (28.6%) were nulliparous. All seven patients had Stage I ovarian and endometrial carcinomas of endometrioid histology. Moreover, in all seven ovarian carcinomas endometriosis foci were observed, while atypical endometriosis was found in four of them. With the exception of one patient, who received adjuvant postoperative radiation, all remaining patients were treated with surgery alone. All patients were alive and free of disease at completion of the study., Conclusion: The correct classification of synchronous primary ovarian and endometrial carcinomas is often problematic because of the frequent confusion with their metastatic counterparts. Although the exact etiology remains unclear, endometriosis seems to be a major risk factor for their development.

Abnormal expression of cell cycle regulators may contribute to malignant transformation. However, the clinical significance of the expression of cyclin D3 in ovarian cancer remains undefined. We therefore conducted a retrospective investigation to address the role of this cell-cycle protein in this tumor. In our study, paraffin-embedded tissue from 109 nonbenign epithelial ovarian tumors, including 17 tumors of low malignant potential and 92 primary adenocarcinomas, was stained immunohistochemically for cyclin D3. Most of the cases had previously been stained for pRb, p21Cip1, p27Kip1, p53, and Ki-67 antigen. Expression of cyclin D3 was correlated with clinicopathologic features, the expression of other cell cycle regulators, and postoperative survival of patients. Cyclin D3 levels were significantly higher in tumors of low malignant potential than in adenocarcinomas (P = 0.0002). In the latter group, cyclin D3 expression decreased with increasing grade (P = 0.0004) and advancing stage (P = 0.0315). Cyclin D3 expression positively correlated with pRb, p21Cip1, and p27Kip1 levels (P = 0.0021; P = 0.0036; P < 0.0001, respectively) and negatively with p53 and Ki-67 (P = 0.0003; P < 0.0001). Absent cyclin D3 expression was an important indicator of poor survival in univariate analysis in the entire cohort (P > 0.00010) and in the platinum-treated patients (P = 0.001) and in multivariate analysis (P = 0.044). Our results demonstrate that absent or decreased cyclin D3 expression is adversely related to several clinicopathologic indicators of aggressiveness in ovarian adenocarcinomas and is combined with a better prognosis, suggesting that cyclin D3 may have a biological role distinct from that of other G1 cyclins which is possibly regulated through interaction with other cell cycle genes.

Aim: To investigate the incidence of KIT immunohistochemical staining in (GI) stromal tumors (GISTs), and to analyze the clinical manifestations of the tumors and prognostic indicators., Methods: We retrospectively analyzed 50 cases of previously diagnosed GISTs. Tissue samples were assessed with KIT (CD117 antigen), CD34, SMA, desmin, S-100, NSE, PCNA, Ki-67, and BCL-2 for immunohistochemical study and pathological characteristics were analyzed for prognostic factors., Results: Fifteen tumors (30%) were negative in KIT staining. A significant association was observed between gender (male patients: 14/15) and KIT-negative staining (P = 0.003).The patients's mean age was 56.6 years. Tumors developed in stomach (n = 8), small intestine (n = 5), large intestine (n = 1) and oesophagus (n = 1). The mean tumor size was 5.72 cm. The mitotic count ranged from 0-29/50 HPF (mean: 3.4) and 73% of tumors showed no necrosis. The majority of the tumors (67%) had dual or epithelioid differentiation. Tumors were classified as very low or low risk (n = 7), intermediate risk (n = 5), and high risk (n = 3) groups. Twelve (80%) patients were alive without evidence of residual tumor for an average period of 40.25 mo (12-82 mo); three patients developed metastatic disease to the liver and eventually died within 2-12 mo (median survival: 8.6 mo)., Conclusion: A small subgroup of GISTs fulfils the clinical and morphological criteria of these tumors, and lacks KIT expression. These tumors predominantly developed in the stomach, being dual or epithelioid in morphology, which are classified as low risk tumors and presented a better survival status than KIT-positive tumors. The ability to diagnose GISTs still depends on immunohistochemical staining but the research should extend in gene mutations.

Paraganglioma of the urinary bladder is a rare pathologic entity with no definitive histological, immunohistochemical or molecular features to determine its malignant potency. Malignancy is essentially determined by the presence of deep local invasion, invasion of adjacent structures, and lymph node or distant metastases. So far, up to 180 cases of paraganglioma have been reported, with less than 30 being malignant. We present a case of malignant paraganglioma of the urinary bladder in a 44-year-old woman. The patient's symptoms were painless hematuria and micturitional headache. The tumor presented the characteristic "zellballen" pattern of growth and immunohistochemically was positive for all neuroendocrine markers. The patient underwent partial cystectomy and the following two postoperative years were uneventful. The literature on paraganglioma of the urinary bladder, analyzing the histological, immunohistochemical and molecular characteristics, is reviewed.

Malignant eccrine poroma is a rare cutaneous neoplasm that originates from the intraepidermal portion of the eccrine gland. It affects mainly elderly people while its occurrence in younger adults is extremely rare. We present the first reported case of a malignant eccrine poroma in a pregnant woman, with emphasis on its pathologic and immunohistochemical features. Early diagnosis and treatment of eccrine neoplasms are of crucial importance when pregnancy coexists, because of their tendency to aggravate under the influence of gestation-related changes.

Background: Biliary papillomatosis (BP) is a rare disease entity with a strong malignant potential. It is characterized by multiple papillary adenomas involving both the intrahepatic and extrahepatic biliary tree. BP was considered in the past to be a disease with low malignant potential. However, a current review of the English literature revealed a high rate of malignant occurrence of approximately 41% and histological analysis along with the expression pattern of mucin core proteins (MUC) and mucin carbohydrate antigens suggests that BP is a borderline or low grade malignant neoplasm with a high malignant potential., Case Presentation: A 68 year-old male patient was referred to our hospital due to the presence of sudden right upper quadrant abdominal pain, nausea and dark urine. Imaging workup demonstrated dilatation of the left hepatic duct without the presence of a space-occupying lesion. A left hepatectomy and cholecystectomy were carried out and histological analysis revealed a moderately to poorly differentiated carcinoma of the left hepatic duct in the background of biliary papillomatosis. Postoperative course was uneventful. Unfortunately, two years after initial diagnosis the patient rapidly deteriorated and died from multiple pulmonary secondary deposits., Conclusion: BP should not be considered to be a benign disease. The clinical behavior, the high recurrence rate and the even higher malignant transformation occurrence, as well as the presence of carcinogenetic indicators (K-ras mutation, overexpression of p53, MUC and Tn antigens) strongly support that BP is a low-grade neoplasm with high malignant potential.

Objective: To study the histopathological features of mesenchymal tumors of the uterine corpus with heterologous and hematopoietic components, and review their histogenesis and differential diagnosis from other neoplastic and non-neoplastic lesions., Methods: Ten cases of mesenchymal tumors of the uterine corpus, massively infiltrated by hematopoioetic cells, or composed of other benign heterologous elements (adipose tissue in the present cases) were retrieved from the archival files of our laboratory and studied histopathologically. Immunohistochemistry was applied in selected cases., Results: Six of our studied cases were diagnosed as leiomyomas, two as lipoleiomyomas, one as a symplastic lipoleiomyoma, and one as an endometrial stromal tumor. The leiomyomas were massively infiltrated by lymphocytes (5 cases) or eosinophils (one case). Immunohistochemical study of the leiomyomas with massive lymphocytic infiltration revealed the presence of a predominantly B-cell population within the infiltrate, which was polyclonal in nature. The endometrial stromal tumor was severely infiltrated by histiocytes, and was positive for vimentin, CD10, PgR and negative for actin, desmin, ER and caldesmon., Conclusion: The presence of hematopoietic or heterologous elements within an otherwise bland uterine leiomyoma or endometrial stromal tumor may give rise to diagnostic difficulties. Regularity of the tumor margins, low mitotic activity and absence of nuclear atypia or necrosis should be established for the exclusion of a malignancy. In the presence of massive lymphocytic infiltration of a leiomyoma the clonality of the infiltrate may aid in differentiating it from a malignant lymphoma. The pathogenesis and clinical significance of these rare neoplasms remain to be clarified.

Vascular lesions comprise benign and malignant neoplasms as well as non-neoplastic conditions that may be located in various sites but only rarely in the pelvis or the retroperitoneum. In our study we describe five diverse and unusual cases of vascular lesions of the pelvis, retroperitoneum and colon in female patients: a case of retroperitoneal angiosarcoma, pelvic hemangioendothelioma, pelvic angiomyxoma, retroperitoneal lymphangioleiomyomatosis and a case of diffuse cavernous hemangiomatosis of the colon, with emphasis on their clinicopathological features and differential diagnosis. The recent literature on the subject is also briefly reviewed.

We report the case of a 57-year-old female patient with an ovarian neoplasm of insular carcinoid and mucinous cystadenoma of low malignant potential, arising in a cystic teratoma of the right ovary. Additionally, a mature teratoma of the left ovary was present. This is an extremely rare combination of primary tumors in the ovary. The possible common histogenesis of the afore-mentioned tumors is discussed.

The majority of ovarian masses in childhood and adolescence are non-epithelial in origin, with a predominance of germ cell tumors, while epithelial neoplasms comprise a small proportion of the total (approximately 15-20%). Mucinous cystadenomas in particular are only sporadically reported in this age group. We present a case of an ovarian mucinous cystadenoma with extended calcification in a premenarchal 11-year-old girl. Pediatric mucinous cystadenomas of the ovary may on rare occasions display extended calcification. Careful evaluation of the remaining pathological features of the tumor is needed in order to avoid misinterpreting this relatively non-specific finding as a feature of malignancy.

Breast hemangiomas are extremely rare neoplasms in the male population. We report a case of a 77-year old man with a breast hemangioma which was detected in physical examination as a small nodule ten years after a chest injury. The final histological diagnosis was hemangioma of the breast, 6 cm in the largest diameter. To our knowledge, this is the largest benign vascular breast neoplasm in a male patient reported up to date. The mammographic and pathologic findings in this case are presented. The rarity of the lesion and its differential diagnosis from angiosarcoma are discussed while the problems encountered in the correct diagnosis and classification of this tumor are also presented. The need for extreme caution in the interpretation of the histological characteristics of all palpable vascular tumors of the breast is emphasized.

Aim: To present the classification and diagnostic problems encountered between teratomas and other ovarian tumors as well as with other benign entities diagnosed and treated in our institution., Methods: We analysed retrospectively the clinical and pathological characteristics of 87 teratomas examined in our hospital during the last ten years., Results: Teratomas constituted 5% of all ovarian tumors. The age range was from 11-69 years old (median: 35). The most frequent symptom was lower abdominal pain in 68% of patients. A pelvic mass was noted in 3% of cases. A pregnancy was present in 3% of patients. In ten cases the tumors were bilateral. Tumor size ranged from 1-16 cm in diameter (median: 7.17 cm). The treatment consisted of cystectomy in 66% of the cases, oophorectomy in 23% or hysterectomy with both adnexa in 11% of cases. Fifty-seven cases presented with a histological diagnosis of mature teratoma, biphasic or triphasic type, three cases with monodermal teratoma, ten cases with ovarian neoplasms of mixed type, 15 cases with epidermal cysts, and two cases with benign cysts. Malignant changes within the teratomas were seen in 5% cases., Conclusion: Teratomas are common ovarian tumors at any age, especially during the reproductive age, with a low rate of complications and malignant transformation. The treatment should be based on patient age, fertility status, tumor size, the cystic or solid nature of the tumor and bilaterality.

The development of ectopic decidua is generally considered as a physiologic phenomenon of pregnancy, even though it has been occasionally noted in non-pregnant women. We present three cases of ectopic decidua located in the greater omentum and discuss the histopathologic characteristics, as well as the problems encountered in the differential diagnosis from metastatic lesions. Decidual transformation of the omentum could simulate, both grossly and microscopically, malignant neoplastic lesions such as malignant deciduoid mesothelioma, metastatic mucin-producing adenocarcinoma or even metastatic squamous carcinoma. The application of immunohistochemistry is essential for the establishment of the diagnosis, especially in the presence of deceptively atypical vacuolated cells resembling carcinoma cells. Ectopic decidua does not require any therapeutic intervention because it usually regresses postpartum without any complications.

Six cases of extraovarian cystic tumors of mullerian type are reported. Patient age ranged from 27-71 years. Tumor diameters were 5-11 cm and were located in the mesentery (4/6) and retroperitoneum (2/6). Four tumors were of mucinous type (1/4 of borderline malignancy) and two of serous type. These tumors clinically and histopathologically mimic other primary tumors of the peritoneum. The problems of differential diagnosis are discussed.

Aim: The aim of this study was to investigate the relationship between adenomyosis, endometrial adenocarcinoma, hyperplasia and uterine leiomyomas., Material and Methods: 135 consecutive hysterectomy specimens showing adenomyosis and 82 consecutive cases of endometrial adenocarcinoma were studied in our laboratory in the last 5-year period. The histological sections of all cases were reviewed and in the cases with adenocarcinoma, the type of cancer, the degree of differentiation and the depth of myometrial invasion were recorded. In the adenomyosis group the presence of any other lesions, the extension of adenomyosis and the morphology of the adenomyotic glands were recorded. In ten random cases of adenomyosis, the presence of estrogens and progesterone receptors was investigated by an immunohistochemical method of peroxidase-antiperoxidase and DAB chromogen. In ten cases of this group the expression of E-cadherin was studied immunohistochemocally by an avidin-viotin method and DAB chromogen., Results: In 47/135 cases of adenomyosis adenomatous hyperplasia coexisted (34.8%) and in 86/135 cases of leiomyomas (63.7%). In 31/82 cases of adenocarcinoma there was adenomyosis as well (37.8%), in 4/82 cases malignant changes in foci of adenomyosis were observed and in 1/82 cases the malignancy arose in a focus of adenomyosis. Immunohistochemical studies showed the presence of progesterone receptors in the glandular cells of adenomyosis in 9/10 cases and of estrogen receptors in 2/10 cases. In all study cases (10/10) a positive membrane immunoreaction was observed; focal (6/10) and extensive (4/10)., Conclusion: The high frequency of coexistence between adenomyosis and other hormone-dependent uterine lesions is indicative of the presence of a hormonal factor in the pathogenesis of adenomyosis.

Unlabelled: The aim of this study was to investigate the clinicopathological features of nine unusual vascular tumors of the female genital tract and to investigate the problems in the differential diagnosis from other genital lesions., Material-Methods: In a review of 15,000 specimens of the female genital system examined in our Laboratory during the last decade, nine cases of vascular tumors were found., Results: A capillary hemangioma of the endometrium, one capillary and one cavernous hemangioma of the cervix, six vulva lesions (one capillary, and one cavernous hemangioma and four angiokeratomas) and one hemangiosarcoma of the mons pubis in a 76-year-old patient were diagnosed., Conclusions: The differential diagnosis of the vascular tumors must be made mainly from endometriotic lesions and melanomas. Immunohistochemistry (S-100, CD31, CD34, CKS, EMA) aid in the diagnosis. Local excision is adequate for the benign vascular lesions.

Epidermoid carcinoma (PSCC) of the endometrium is a rare form of endometrial cancer that constitutes about 0.1% of all malignant epithelial tumors of the uterus. The diagnosis of PSCC is based on strict criteria and is made in the absence of a glandular component of the tumor. Squamous cell carcinoma of the endometrium should enter the differential diagnosis in postmenopausal patients in the presence of atypical squamous cells in the uterine curettage, while the cervical biopsies are negative for malignancy. The presence of HPV should be investigated as well, so that its pathogenetic relation is clarified. While no significant relation was found to p-53, C-NEU and EGFR expression this investigation must be continued because. HPV may interact with tumor suppressor genes.