Clear cell carcinoma often arises from endometriosis, primarily from ovarian chocolate cysts and much less frequently from adenomyosis. We herein report a case of clear cell carcinoma arising from adenomyotic cyst in a 38-year-old woman, gravida 0, para 0, who was referred to our department with a diagnosis of a uterine tumor. Her medical history was unremarkable. Contrast-enhanced magnetic resonance imaging revealed a 13-cm uterine tumor with a predominantly hypointense signal on both T1- and T2-weighted images, accompanied by a hyperintense lesion in the center on T1-weighted images. Additionally, typical uterine leiomyomas were observed. Her serum CA125 (reference range: 0-35 units/ml) and CA19-9 (reference range: 0-37 units/ml) levels were elevated to 1,200 and 8,178 U/mL, respectively. Degenerated myoma was suspected preoperatively. Given the patient's desire to preserve her fertility, a myomectomy was performed. Macroscopically, the tumor was solid, white, and fibroid-like but contained chocolate-colored fluid. Pathological examination revealed clear cell carcinoma characterized by adenocarcinoma cells with clear and eosinophilic cytoplasm and nuclear atypia arranged in a tubulocystic pattern. Endometriosis was also found within the tumor. Subsequently, a hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy were performed. No malignancy was detected in the resected uterus or adnexa, but metastasis to a para-aortic lymph node was observed. Based on these findings, the patient was diagnosed with stage IIIC2 endometrial cancer (pT1bN2M0, clear cell carcinoma) and received postoperative adjuvant therapy with paclitaxel and carboplatin. Eighteen months later, her serum CA125 increased to 45 U/mL, and a contrast-enhanced computed tomography scan revealed multiple liver and left supraclavicular lymph node metastases. Five cycles of pembrolizumab and lenvatinib followed by four cycles of doxorubicin and cisplatin were ineffective. The patient died 13 months after the diagnosis of recurrence.
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http://dx.doi.org/10.7759/cureus.71503 | DOI Listing |
BMC Urol
December 2024
Prokarium Ltd, 2 Royal College St, London, NW1 0NH, UK.
Background: Urine biomarkers are crucial for monitoring patient responses in treating urological pathologies, including non-muscle invasive bladder cancer (NMIBC). Yet, analysing urine biomarkers poses several challenges, including ensuring specimen stability during transportation and analytical processing. This prospective feasibility study aimed to investigate how urinary leukocytes and proteins are impacted by storing and refrigerating urine.
View Article and Find Full Text PDFMicrob Pathog
December 2024
Department of Neonatology, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong Province, 518107, China. Electronic address:
Background: Streptococcus agalactiae poses a significant threat to neonatal health, causing morbidity and mortality when transmitted from the maternal vagina to the newborn's respiratory tract. Among its various strains, serotype III is predominant in severe neonatal infections in Asia. However, the mechanisms of pathogenesis and host responses underlying serotype-specific disease outcomes remain poorly understood.
View Article and Find Full Text PDFNeuron
December 2024
Roche Pharma Research and Early Development, Neuroscience and Rare Diseases, Roche Innovation Center, Basel, Switzerland. Electronic address:
Poor understanding of the cellular and molecular basis of clinical and genetic heterogeneity in progressive multiple sclerosis (MS) has hindered the search for new effective therapies. To address this gap, we analyzed 632,000 single-nucleus RNA sequencing profiles from 156 brain tissue samples of MS and control donors to examine inter- and intra-donor heterogeneity. We found distinct cell type-specific gene expression changes between MS gray and white matter, highlighting clear pathology differences.
View Article and Find Full Text PDFInt Immunopharmacol
December 2024
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:
Traumatic brain injury (TBI) is a disastrous phenomenon which is considered to cause high mortality and morbidity rate. Regarding the importance of TBI due to its prevalence and its effects on the brain and other organs, finding new therapeutic methods and improvement of conventional therapies seems to be vital. TBI involves a complex physiological mechanism, with inflammation being a key component among various contributing factors.
View Article and Find Full Text PDFBr J Dermatol
December 2024
The Pennsylvania State University College of Medicine, Department of Dermatology, Hershey, PA, USA.
Background: Therapeutic options for mild hidradenitis suppurativa (HS) represent a significant gap in the current treatment landscape, with no FDA approved therapies for early stage HS. Topical JAnus Kinase inhibitors (JAKi) are a compelling option due to the known upregulation of inflammatory JAK signaling in HS lesions and the recent success of systemic JAKi for moderate to severe HS.
Objectives: This is a pilot, single-site, open-label, prospective 24-week clinical trial with topical ruxolitinib (NCT04414514).
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