Publications by authors named "Carlos Parra-Herran"

Gastric-type endocervical adenocarcinomas (GAS) are aggressive HPV-independent neoplasms with molecular alterations in TP53 , STK11 , CDKN2A, and SMAD4 . Claudin-18 (CLDN18) has emerged as a useful marker to distinguish GAS from HPV-associated neoplasia. Its role in separating GAS from benign proliferations and exuberant endocervical glands is unknown.

View Article and Find Full Text PDF

Squamous cell carcinoma of the vulva (vSCC) is currently categorized either as human papillomavirus (HPV) associated or independent. Immunohistochemical stains, p16INK4a (p16) and p53 are helpful biomarkers to support the designation of vSCC into 1 of the 3 tumor pathways: (1) HPV-associated, (2) HPV-independent, TP53 mutant, or (3) HPV-independent, TP53 wild type. Recently, a framework of p53 expression patterns in vSCC was proposed.

View Article and Find Full Text PDF
Article Synopsis
  • * Methods: Researchers conducted a retrospective cohort study at a tertiary care institution, examining data from patients with high-grade endometrial cancer who underwent related surgeries between 2015 and 2020, focusing on demographics, surgical management, and outcomes.
  • * Results: Out of 110 patients, a notable percentage had different cancer grades and stages. About 5.8% with pelvic SLNs negative still had positive PA nodes, and among 75
View Article and Find Full Text PDF

Objective: To report the New England Trophoblastic Disease Center (NETDC) experience with atypical placental site nodules (APSN).

Methods: The NETDC registry was reviewed from 2005 to 2022 and clinical data abstracted. Expert pathologists in GTD reviewed available slides with concurrent immunohistochemical analysis.

View Article and Find Full Text PDF

Aims: Areas of gland crowding that do not fulfil diagnostic criteria of endometrioid intra-epithelial neoplasia (EIN) are often encountered in endometrial biopsies. In this study, we document the prevalence of neoplastic outcome in patients with these subdiagnostic lesions (SL) and assess the utility of morphological features and a three-marker immunohistochemistry panel (PAX2, PTEN, beta-catenin) to predict outcome.

Methods And Results: Of 430 women with SL on endometrial sampling at Brigham and Women's Hospital between 2001 and 2021 with available follow-up biopsy, 72 (17%) had a neoplastic outcome (EIN or endometrioid carcinoma).

View Article and Find Full Text PDF

Journal clubs (JCs) are a common format used in teaching institutions to promote trainee engagement and develop skills in seeking out evidence-based medicine and critically evaluating literature. Digital technology has made JC accessible to worldwide audiences, which allows for increased inclusion of globally diverse presenters and attendees. Herein we describe the experience of the first 2 years of a virtual gynecologic pathology JC designed with the goal of providing mentorship and increasing inclusivity.

View Article and Find Full Text PDF

Pathological examination of surgical specimens and compilation of a surgical pathology report comprises a series of events which includes macroscopic examination and tissue sampling, either complete or selected. This step is critical but often overlooked in the literature and not given the attention it deserves. In this review, we discuss the macroscopic examination and grossing of gynaecological pathology specimens, with reference to national and international protocols.

View Article and Find Full Text PDF
Article Synopsis
  • Verruciform acanthotic vulvar intra-epithelial neoplasia (vaVIN) is a rare condition that does not associate with HPV and presents unique challenges in diagnosis, particularly when differentiating it from non-neoplastic lesions.
  • The study evaluated the diagnostic effectiveness of three immunohistochemical markers—CK17, SOX2, and GATA3—across 16 vaVIN cases and 34 similar, non-neoplastic conditions, revealing that these markers are significantly more prevalent in vaVIN cases.
  • Findings suggest that utilizing a combination of these markers can increase the sensitivity, specificity, and accuracy of vaVIN diagnosis, aiding pathologists in distinguishing it from benign hyperplastic lesions.
View Article and Find Full Text PDF

Placental trophoblastic site tumor (PSTT) is a rare type of gestational trophoblastic neoplasia (GTN). PSTT has a higher mortality than other types of gestational trophoblastic disease (GTD), with a rate of 16.1%, due to its relatively unpredictable behavior and reduced response to chemotherapy.

View Article and Find Full Text PDF

Introduction: The aim of this study is to document the distribution of classic versus non-classic presentation of Placenta Accreta Spectrum (PAS) disorders as well as grading categories by the Society for Pediatric Pathology (SPP) and FIGO systems in an institutional cohort of gravid hysterectomies. We also document the prevalence of uterine scar as a histologic correlate for uterine scar dehiscence, a phenomenon raised by some as central to PAS pathogenesis.

Methods: PAS cases were assigned grade and designated as classic (anterior lower uterine segment implantation, prior C-section) or non-classic (implantation away from anterior lower uterine segment and/or no prior C-section).

View Article and Find Full Text PDF

An updated International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial carcinoma was introduced in June 2023. The new system represents a significant departure from traditional endometrial and other gynecological carcinoma staging systems which are agnostic of parameters such as tumor type, tumor grade, lymphovascular space invasion, and molecular alterations. The updated system, which incorporates all of these 'non-anatomical' parameters, is an attempt to make staging more personalized and relevant to patient prognostication and management, and to align with the European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) risk stratification.

View Article and Find Full Text PDF

Aims: The invasive pattern in HPV-associated endocervical adenocarcinoma (HPVA) has prognostic value. Non-destructive (pattern A) HPVA has excellent prognosis mirroring adenocarcinoma in-situ (AIS). However, the rare occurrence of ovarian spread in these tumours suggests aggressiveness in a subset of patients with these otherwise indolent lesions.

View Article and Find Full Text PDF

The (forkhead box L2) gene is located on chromosome 3 and encodes for forkhead box (FOX) family of transcription factors which play a critical role in various biological processes. Germline mutations have been identified in blepharophimosis/ptosis/epicanthus inversus syndrome. The somatic missense mutation in ( C134W) is now known to be the defining molecular feature of adult-type granulosa cell tumour of the ovary, present in over 90% of cases of this tumour type.

View Article and Find Full Text PDF

Vulvar leiomyosarcoma is a rare malignant smooth muscle tumor and the most common type of vulvar sarcoma. It can mimic benign tumors, and misdiagnosis may delay appropriate treatment. A 35-year-old woman presented to the outpatient gynecology clinic at the Mirebalais Teaching Hospital for a right vulvar mass.

View Article and Find Full Text PDF

STK11 adnexal tumor is a recently described entity with less than 25 cases reported to date. These aggressive tumors typically occur in paratubal/paraovarian soft tissues, have characteristically striking morphologic and immunohistochemical heterogeneity, and harbor pathognomonic alterations in . These occur almost exclusively in adult patients, with only one reported in a pediatric patient (to our knowledge).

View Article and Find Full Text PDF

Introduction: Maternal vascular malperfusion (MVM) is one of four main patterns of placental injury defined by the Amsterdam consensus statement and is associated with adverse fetal and maternal outcomes. Laminar decidual necrosis (DLN), extravillous trophoblast islands (ETIs), placental septa (PS), and basal plate multinucleate implantation-type trophoblasts (MNTs) are lesions attributed to decidual hypoxia, excess trophoblast, and shallow implantation, but are not included in the current MVM diagnostic criteria. We aimed to investigate the relationship between these lesions and MVM.

View Article and Find Full Text PDF

Aims: Our understanding of dedifferentiated endometrial carcinoma (DEC), a rare and aggressive malignancy, mainly reflects undifferentiated carcinomas (UC) arising in the setting of low-grade endometrial cancer (DEC-LG). However, cases of UC arising in the setting of high-grade EC (DEC-HG) have been noted in the literature. Our knowledge of the genomics of DEC-HG is limited.

View Article and Find Full Text PDF

Background: The aim of the study was to evaluate the safety of fertility-sparing surgery in invasive mucinous ovarian carcinomas (MOC).

Methods: Retrospective review was performed of MOCs diagnosed between 1999 and 2019 at two tertiary cancer centers. Pathology was reviewed to rule out metastasis from gastrointestinal tract.

View Article and Find Full Text PDF
Article Synopsis
  • LEPP is a type of growth in the lining of the uterus that happens during pregnancy; it's uncommon but usually not harmful.* -
  • Researchers studied 9 cases of LEPP and found it often appears after early pregnancy loss and looked at its size, shape, and changes under a microscope.* -
  • The findings showed that these lesions are generally benign, meaning they aren't cancerous, and over time, patients did not experience serious problems from them.*
View Article and Find Full Text PDF