Sexual precocity in a male due to thoracic polyembryoma.

A 7-year-old boy with sexual precocity of recent onset was found to have elevated levels of chorionic gonadotropin, alpha fetoprotein, and testosterone. Removal of a retropleural, posterior mediastinal mass with an intraspinous epidural extension was followed by prompt declines in the plasma concentrations of the tumor markers and cessation of adolescent development. The neoplasm proved to be a polyembryoma, unusual in the multiplicity of its embryoid bodies and extra gonadal location.

Precancerous lesions of the endometrium.

The existence of precancerous lesions of the endometrium is well established, but differences in terminology and difficulties in the interpretation of published studies have complicated quantitation of the malignant potential of the descibed subtypes. Clinical investigations, cellular studies, chromosome and DNA analyses, and animal experiments suggest that the malignant potential of cystic hyperplasia is low in contrast to that of the more complex types of hyperplasia. The significance of atypical secretory hyperplasia, squamous metaplasia, and endometrial polyps in the evolution of endometrial cancer has not been investigated adequately.

Age-incidence and risk of diethylstilbestrol-related clear cell adenocarcinoma of the vagina and cervix.

This study was based on cases accessioned in the Registry of Clear Cell Adenocarcinoma of the Genital Tract in Young Females to ascertain the incidence of diethylstilbestrol (DES)-related cancers by age and year of birth. For accuracy in estimating the size of the reference population for the incidence rates, calculations were restricted to 127 white residents of the United States who were exposed prenatally to DES or other nonsteroidal synthetic estrogens. The disease is exceedingly rare prior to age 14 when the incidence rate begins to rise rapidly.

Primary trabecular carcinoid of the ovary.

Eighteen cases of primary trabecular carcinoid of the ovary were analyzed from a clinicopathologic viewpoint. The patients ranged in age from 24 to 74 years and presented with symptoms of an ovarian mass; none had the carcinoid syndrome. Although the carcinoid always proved to be unilateral, the contralateral ovary was sometimes enlarged by a dermoid cyst.

Sex cord-stromal (gonadal stromal) tumors of the testis: a report of 5 cases.

Sex cord-stromal (gonadal stromal) tumors of the testis account for less than 4 per cent of the testicular tumors. The Leydig cell tumor in a child may produce isosexual virilization (case 3). In the adult it may have no endocrine manifestation (case 1) or gynecomastia and decrease in libidio may result from production of estrogens (case 2).

Intrauterine diethylstilbestrol exposure and its consequences: pathologic characteristics of vaginal adenosis, clear cell adenocarcinoma, and related lesions.

In 1971, the development of clear cell adenocarcinoma of the vagina in young females was first linked to a history of intrauterine exposure to diethylstilbestrol (DES). This communication reviews data on cases accessioned in the Registry of Clear Cell Adenocarcinoma of the Genital Tract in Young Females, findings in exposed female and male subjects without cancer, and discusses current concepts of the pathogenesis of the DES-related anomalies of the lower genital tract.

Cytology of 575 young women with prenatal exposure to diethylstilbestrol.

The vaginal and cervical cellular changes encountered in 575 postpubertal females exposed prenatally to diethylstilbestrol (DES) were compared with those of an unexposed population with particular reference to the role of cytology in the detection of vaginal adenosis and cervical ectropion (erosion). Several methods of obtaining specimens were utilized, the most effcacious of which was scraping of the vagina, especially the fornices, and the portio vaginalis of the cervix. With this technic, columnar cells of the mucinous type and metaplastic squamous cells were observed in 34% of the vaginal scrapes and 54% of the scrapes of the cervical portio.

Uterine tumors resembling ovarian sex-cord tumors. A clinicopathologic analysis of fourteen cases.

Uterine tumors with histologic resemblances to ovarian sex-cord tumors were encountered in 14 women in the fourth to sixth decades of life, most of whom had abnormal vaginal bleeding and enlarged uteri suggesting leiomyomas. The tumors in six cases (Group I) were identical to one or another form of well-recognized endometrial stromal tumor except for focal epithelial-like differentiation resembling that seen in sex-cord tumors. These tumors were mostly poorly circumscribed large mural masses.

Trophoblastic pseudotumor of the uterus: an exaggerated form of "syncytial endometritis" simulating a malignant tumor.

Twelve cases of a hitherto unrecognized pseudotumorous trophoblastic invasion of the myometrium are analyzed. Human chorionic gonadotropin (HCG) was identified by an immunoenzyme technique in the cytoplasm of the invasive cells. The lesion may be localized and only superficially invasive or deeply invasive and have a gross appearance suggesting a neoplasm in the excised uterus.

Glassy cell carcinoma of the cervix.

A clinicopathologic analysis of 13 cases of glassy cell carcinoma of the uterine cervix is presented. The glassy cell carcinoma is considered to be a poorly differentiated mixed adenosquamous carcinoma. Its histologic appearance is distinctive, being characterized by cells with a moderate amount of cytoplasm having a ground glass or finely granular appearance, a distinct cell wall that stains with eosin and PAS, and enlarged nuclei with prominent nucleoli.

Clear cell carcinoma of the endometrium: an analysis of 21 cases.

Twenty-one cases of clear cell carcinoma of the endometrium are analysed in an effort to characterize the histologic features and biologic behavior of this type of neoplasm in the uterus and thereby to shed further light on the histogenesis of clear cell carcinoma in the female genital tract. The clinical profile of the patients closely paralleled that of women with the usual types of carcinoma of the endometrium. Fifteen (71%) were stage I, five were stage II, and one was stage IV at diagnosis.

Cushing syndrome, sexual precocity, and polyostotic fibrous dysplasia (Albright syndrome) in infancy.

The sexual precocity of polyostotic fibrous dysplasia is occasionally accompanied by other endocrine disorders, but in only two previous instances has Cushing syndrome been reported. The history of a 6-month-old girl is presented, in whom this syndrome was complicated by congenital Cushings syndrome. Although endocrinopathies of polyostotic fibrous dysplasia have usually been ascribed to a central (hypothalamic) origin, the findings in this patient suggest autonomous hyperfunction of the peripheral endocrine glands, with the Cushing syndrome caused by hyperplastic nodules in the adrenal glands and the precocity by luteinized follicular cysts of the ovary.

World Health Organization classification and nomenclature of ovarian cancer.

A World Health Organization (WHO) committee of representatives from seven nations published a histologic typing of ovarian tumors in 1973. Their typing of common epithelial tumor was based largely on the classification by the International Federation of Gynaecology and Obstetrics (FIGO), and the single most important concept to emerge from the FIGO and WHO classifications was the distinction among common epithelial tumors between tumors of borderline malignancy and carcinomas. A second general category of ovarian tumors, some of which are clinically malignant, was designated by the WHO committee as sex cord-stromal tumors (neoplasms containing granulosa, theca, collagen-producing stromal, Sertoli, and/or Leydig cells).