RESUMEN
Choriocarcinoma (CC) is characterized by earlier blood metastasis compared with other female genital tumors and a high incidence of massive hemorrhage. Vasculogenic mimicry (VM) is highly associated with metastasis, and syncytiotrophoblast is involved in the formation of VM in CC. Forskolin is a typical activator of the cAMP pathway, which is involved in the syncytiolization of trophoblastic cells. In the present study, to determine the effects and mechanism of forskolin on cell invasion and VM during syncytiolization in vitro and in vivo, JEG3 and JAR cell lines were treated with 100 µM forskolin for 48 h, and wound healing and invasion assays were used to verify cell migratory and invasive capacities. A 3D culture and tube formation assays were established to detect VM. Variation of morphology and markers of the epithelialtomesenchymal transition (EMT) were assessed, and the role of the Notch signaling pathway was investigated in CC cells treated with forskolin. The results of the present study demonstrated that 100 µM forskolin induced syncytiolization of trophoblastic cells and enhanced the migratory and invasive abilities of JEG3 and JAR cell lines. In addition, the capacity of VM was significantly increased, whereas tube formation ability was decreased by forskolin in vitro and in vivo compared with the respective control groups. The cellular morphology exhibited EMT during the syncytiolization process, which was further supported by the changes in EMT marker expression, including downregulation of Ecadherin and cytokeratin and upregulation of Ncadherin, vimentin and zinc finger Eboxbinding homeobox 1. The Notch1 signaling pathway was activated to induce EMT in forskolininduced VM process in CC cells, and VM and EMT could be reversed by using the γsecretase inhibitor DAPT to block the Notch1 pathway. Overall, the results of the present study demonstrated that forskolin enhanced the capacity of VM formation and metastasis through Notch1activated EMT in the syncytiolization of trophoblastic cells.
Asunto(s)
Coriocarcinoma/irrigación sanguínea , Colforsina/efectos adversos , Neovascularización Patológica/inducido químicamente , Transducción de Señal/efectos de los fármacos , Trofoblastos/patología , Neoplasias Uterinas/irrigación sanguínea , Animales , Técnicas de Cultivo de Célula , Línea Celular Tumoral , Movimiento Celular , Coriocarcinoma/inducido químicamente , Coriocarcinoma/metabolismo , Coriocarcinoma/patología , Transición Epitelial-Mesenquimal , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Ratones , Neovascularización Patológica/patología , Embarazo , Receptor Notch1/metabolismo , Trofoblastos/efectos de los fármacos , Neoplasias Uterinas/inducido químicamente , Neoplasias Uterinas/metabolismo , Neoplasias Uterinas/patologíaRESUMEN
Germ cell tumors, because they contain immature and mature elements, can differentiate into different tissue types. They can exhibit unusual imaging features or manifest in a syndromic fashion. The authors describe these features and assign them to one of the following categories: (a) unusual manifestations of metastatic disease (growing teratoma syndrome, choriocarcinoma syndrome, ossified metastases, and gliomatosis peritonei); (b) autoimmune manifestations (sarcoidlike reaction and paraneoplastic syndromes); (c) endocrine syndromes (sex hormone production, struma ovarii, and struma carcinoid); or (d) miscellaneous conditions (ruptured dermoid cyst, squamous cell carcinoma arising from a mature teratoma, Currarino triad, fetus in fetu, pseudo-Meigs syndrome, and pancreatitis). Rare conditions associated with germ cell tumors demonstrate characteristic imaging findings that can help lead to the appropriate diagnosis and management recommendations. When evaluating for potential metastatic disease, alternative benign diagnoses should be considered (eg, growing teratoma syndrome, ossified metastases, ruptured dermoid cyst, gliomatosis peritonei, and sarcoidlike reaction), which may impact management. Germ cell tumors may also lead to life-threatening complications such as extensive hemorrhage from choriocarcinoma metastases or the rupture of mature teratomas, cases in which timely diagnosis is crucial. Autoimmune and endocrine manifestations such as paraneoplastic encephalitis, autoimmune hemolytic anemia, and hyperthyroidism may occur owing to the presence of germ cell tumors and can create a diagnostic dilemma for clinicians. Knowledge of the syndromic and unusual imaging findings associated with germ cell tumors helps guide appropriate management. ©RSNA, 2019.
Asunto(s)
Neoplasias de Células Germinales y Embrionarias/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Canal Anal/anomalías , Canal Anal/diagnóstico por imagen , Enfermedades Autoinmunes/diagnóstico por imagen , Enfermedades Autoinmunes/inmunología , Carcinoma de Células Escamosas/diagnóstico por imagen , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/diagnóstico por imagen , Coriocarcinoma/secundario , Quiste Dermoide/diagnóstico por imagen , Anomalías del Sistema Digestivo/diagnóstico por imagen , Femenino , Feto/anomalías , Feto/diagnóstico por imagen , Humanos , Masculino , Neoplasias de Células Germinales y Embrionarias/secundario , Neoplasias Neuroepiteliales/diagnóstico por imagen , Neoplasias Neuroepiteliales/secundario , Neoplasias Primarias Secundarias/diagnóstico por imagen , Osificación Heterotópica/diagnóstico por imagen , Pancreatitis/diagnóstico por imagen , Pancreatitis/etiología , Síndromes Paraneoplásicos Endocrinos/diagnóstico por imagen , Síndromes Paraneoplásicos Endocrinos/etiología , Síndromes Paraneoplásicos/diagnóstico por imagen , Síndromes Paraneoplásicos/inmunología , Neoplasias Peritoneales/diagnóstico por imagen , Neoplasias Peritoneales/secundario , Embarazo , Recto/anomalías , Recto/diagnóstico por imagen , Sacro/anomalías , Sacro/diagnóstico por imagen , Siringomielia/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodosAsunto(s)
Taponamiento Cardíaco/etiología , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/secundario , Neoplasias Cardíacas/irrigación sanguínea , Neoplasias Cardíacas/secundario , Hemorragia/complicaciones , Neoplasias Testiculares/complicaciones , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundario , Taponamiento Cardíaco/diagnóstico , Coriocarcinoma/diagnóstico , Quimioterapia , Resultado Fatal , Neoplasias Cardíacas/diagnóstico , Hemorragia/diagnóstico , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/secundario , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundario , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/secundario , Neoplasias Testiculares/patologíaRESUMEN
Intratumor hemorrhage is a poor prognostic factor in pineal choriocarcinoma (PCCC). The aim of this study was to understand the relationship of tumor cells to the blood vessels to gain insights into the formation of intratumor hemorrhage in PCCC. The clinical data indicated that total tumor removal by surgical procedures followed immediately by radiotherapy and chemotherapy improved the prognosis in PCCC. The PCCC tissues removed from the patients were examined by histology and immunohistochemistry. Hematoxylin and eosin staining showed that the tumor stroma mainly consists of hemorrhagic tissues with tumor cells scattered inside. The pattern of distribution suggests that the tumor cells were possibly flushed and compressed by the bleeding. The tumor cells tended to form sinusoids that lacked CD34, but laminin expression provided evidence of vasculogenic mimicry. Interestingly, CD34-positive blood vessels were found connected to these sinusoids, suggesting that blood may flow from the tumor vasculature to the sinusoids. This may subsequently cause the enlargement of the sinusoids, blood clotting, the widening of the blood lakes, and eventually extensive hemorrhagic necrosis. Our study identified the key features of the PCCC vasculature. The findings add to the previous understanding of the formation of vascular channels, blood lakes, and extensive hemorrhagic necrosis. The intimate connections between the tumor-formed sinusoids and the blood vessels might be a major cause of severe hemorrhage in PCCC. The new information may be useful for the development of treatment strategies for managing PCCC.
Asunto(s)
Neoplasias Encefálicas/patología , Coriocarcinoma/patología , Hemorragias Intracraneales/patología , Neovascularización Patológica/patología , Glándula Pineal/patología , Adolescente , Antígenos CD34/metabolismo , Neoplasias Encefálicas/irrigación sanguínea , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/metabolismo , Niño , Preescolar , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/complicaciones , Coriocarcinoma/metabolismo , Humanos , Hemorragias Intracraneales/etiología , Hemorragias Intracraneales/metabolismo , Masculino , Neovascularización Patológica/complicaciones , Neovascularización Patológica/metabolismo , Glándula Pineal/irrigación sanguínea , Glándula Pineal/metabolismo , PronósticoRESUMEN
Choriocarcinomas are a rare form of cancer that develops in the uterus from tissue which would normally become the placenta. Choriocarcinomas are a trophoblastic gestational disease and have been studied largely to investigate conditions related to pregnancy such as preeclampsia. Choriocarcinomas are highly angiogenic and produce high levels of placental growth factor (PlGF) to promote the development of blood vessels. Upregulation of PlGF expression also occurs during the development of other human malignancies such as breast cancer and melanoma. Both tumor specimens and plasma samples have higher levels of PlGF than normal tissues. Hence, PlGF has emerged as a valid target for anti-angiogenic therapy. The cell lines BeWo, JAR and JEG-3, derived from human choriocarcinomas, were investigated in vitro and in vivo for suitability as PlGF-dependent models. BeWo, JAR and JEG-3 cells were characterized in culture and were implanted into immunodeficient mice to generate subcutaneous tumors. The PlGF and VEGF angiogenic profiles of the choriocarcinoma cells and tumors were investigated by ELISA and by immunohistochemical methods. Double immunofluorescence methods were applied to choriocarcinoma xenograft sections to characterize the cellular components of the blood vessels. sFLT01, a fusion protein that neutralizes PlGF, was assessed in cell culture experiments and xenograft studies. The novel results presented here validate the importance of human choriocarcinoma cell lines and xenografts in further exploring the role of PlGF in tumor angiogenesis, for evaluating PlGF as an anti-angiogenic target, and for developing therapies that may provide clinical benefit.
Asunto(s)
Antineoplásicos/farmacología , Coriocarcinoma/tratamiento farmacológico , Neovascularización Patológica/prevención & control , Proteínas Gestacionales/metabolismo , Proteínas Recombinantes de Fusión/farmacología , Neoplasias Uterinas/tratamiento farmacológico , Animales , Antineoplásicos/uso terapéutico , Línea Celular Tumoral , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/patología , Medios de Cultivo Condicionados/química , Femenino , Humanos , Estimación de Kaplan-Meier , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Factor de Crecimiento Placentario , Embarazo , Proteínas Recombinantes de Fusión/uso terapéutico , Carga Tumoral , Neoplasias Uterinas/irrigación sanguínea , Neoplasias Uterinas/patología , Factor A de Crecimiento Endotelial Vascular/metabolismo , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
Angiogenesis is a characteristic feature of solid tumors, which depend on the newly formed vasculature to prevent hypoxia and to sustain uncontrolled tumor cell proliferation. In this study, we investigated the blood supply system in 10 gestational choriocarcinomas on the basis of histopathological and immunohistochemical features. In all examined cases, morphological analysis demonstrated that blood channels within the center of choriocarcinomas were surrounded by neoplastic trophoblastic cells rather than by endothelial cells. Similarly, there was a lack of CD31 and CD34-positive endothelial cells within choriocarcinomas. In the periphery of choriocarcinomas, tumor cells invaded uterine stroma-derived blood vessels where trophoblastic cells replaced endothelial cells, forming anastomoses between endothelium-lined blood vessels and trophoblast-lined pseudovascular channels. Masson's trichrome staining revealed minimal amounts of connective tissue within choriocarcinomas. In contrast, CD31 and CD34-positive blood vessels were present in other types of gestational trophoblastic neoplasms including 8 placental site trophoblastic tumors and 12 epithelioid trophoblastic tumors. These findings provide cogent evidence that choriocarcinoma represents one of a few human tumor types that utilizes vasculogenic mimicry by tumor cell in supporting tumor development.
Asunto(s)
Coriocarcinoma/irrigación sanguínea , Endotelio Vascular/patología , Neovascularización Patológica/patología , Trofoblastos/patología , Neoplasias Uterinas/irrigación sanguínea , Adulto , Animales , Antígenos CD34/metabolismo , Biomarcadores/metabolismo , Línea Celular Tumoral , Coriocarcinoma/patología , Endotelio Vascular/metabolismo , Femenino , Humanos , Ratones , Ratones Desnudos , Trasplante de Neoplasias , Neovascularización Patológica/metabolismo , Molécula-1 de Adhesión Celular Endotelial de Plaqueta/metabolismo , Embarazo , Tumor Trofoblástico Localizado en la Placenta/irrigación sanguínea , Tumor Trofoblástico Localizado en la Placenta/patología , Neoplasias Uterinas/patologíaRESUMEN
OBJECTIVE: To evaluate the efficacy and safety of transcatheter arterial embolization (TAE) of the ovarian arteries (OA) additionally supplying the tumor of pelvic cavity. METHODS: TAE of OA was performed in 63 patients with a pelvic tumor additionally supplied by the OA. The mean age of those patients was 43.6 years (range, 16 - 66 years). In this series, there were 28 cervical carcinomas, 22 uterus fibroids, 6 ovarian cancers, 3 choriocarcinomas, 2 uterine sarcomas, 1 fibrosarcoma, and 1 rectal carcinoma infiltrating the uterus and adnexa. Emergency TAE was performed in 8 patients due to colporrhagia. The embolization materials consisted of polyvinyl alcohol particles (PVA) in 24 patients, gelatin sponge particles in 10 cases, PVA + gelatin sponge particles in 26; and PVA + gelatin sponge particles + microcoils in 3 cases. RESULTS: The OA embolization was successfully performed in all the 63 cases, including bilateral in 19 cases and unilateral in 44 cases (left 27, right 17). No complications related to the procedure were observed. Bleeding from the vagina in 8 patients ceased immediately after supplemental OA embolization, and no re-bleeding occurred in any of them during their hospital stay. CONCLUSION: Pelvic tumors may be supplied additionally by the ovarian arteries. Therefore, routine internal iliac artery/uterine artery chemoembolization or embolization may not effectively cure the tumors. Ovarian artery angiography should be routinely performed before interventional treatment. A supplementary selective ovarian artery chemoembolization or embolization is safe and effective in the management of pelvic tumors with additional blood supply from the ovarian arteries.
Asunto(s)
Neoplasias Ováricas , Ovario/irrigación sanguínea , Embolización de la Arteria Uterina/métodos , Neoplasias del Cuello Uterino , Neoplasias Uterinas , Adolescente , Adulto , Anciano , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/terapia , Femenino , Esponja de Gelatina Absorbible/uso terapéutico , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/irrigación sanguínea , Neoplasias Ováricas/terapia , Alcohol Polivinílico/uso terapéutico , Neoplasias del Cuello Uterino/irrigación sanguínea , Neoplasias del Cuello Uterino/terapia , Neoplasias Uterinas/irrigación sanguínea , Neoplasias Uterinas/terapia , Adulto JovenRESUMEN
In order to investigate the mechanisms and regulation of trophoblast vessel invasion, we established a model using malignant trophoblast cells grown in nude mice. The human choriocarcinoma cell line Jeg-3 established fast-growing tumours within 2 weeks after subcutaneous injection into nude mice. Interestingly, instead of neoangiogenesis the tumours were characterized by large blood-filled lacunae. Staining for hCG-beta and for mouse panendothelial antigen revealed that the majority of the lacunae were lined by trophoblast cells. The blood supply of the lacunae resulted from invasion of the choriocarcinoma cells into the host vessels at the junctional zone between tumour and mouse tissue. These large blood-filled lacunae led to a much faster expansion of tumours with less necrotic areas compared to tumours of non-trophoblastic origin (Hec-1A and HeLa), which revealed neovascularization. Jeg-3 choriocarcinoma cells eroded host vessels and replaced the endothelial lining in a similar way to trophoblast cells during the establishment of a haemochorial placenta. This model can be useful in investigating the cell biological mechanisms of trophoblast vessel invasion and replacement of the endothelium by trophoblast cells.
Asunto(s)
Coriocarcinoma/patología , Animales , Vasos Sanguíneos , División Celular , Coriocarcinoma/irrigación sanguínea , Gonadotropina Coriónica Humana de Subunidad beta/análisis , Neoplasias Endometriales/patología , Endotelio Vascular , Femenino , Células HeLa/patología , Humanos , Ratones , Ratones Desnudos , Trasplante de Neoplasias , Neovascularización Patológica , Factores de Tiempo , Trasplante Heterólogo , Trofoblastos/fisiología , Células Tumorales CultivadasRESUMEN
A 29 year-old woman presented with continuous metrorrhagia and a positive pregnancy test 3 1/2 months after vaginal birth. Transvaginal sonography showed a 3.5 x 4 x 4 cm mostly echogenic uterine mass with diffuse myometrial invasion in the right fundal region. Colour Doppler sonography revealed extensive low impedance flow in the periphery of the mass suggestive of a trophoblastic tumor. Histological examination of curettage specimens revealed a chorionic carcinoma. The tumor size as measured by magnetic resonance imaging correlated well with that by sonography. Trophoblastic disease after a normal pregnancy is rare. Early diagnosis can be facilitated by transvaginal colour Doppler sonography.
Asunto(s)
Coriocarcinoma/diagnóstico por imagen , Endosonografía , Trastornos Puerperales/diagnóstico por imagen , Ultrasonografía Doppler en Color , Neoplasias Uterinas/diagnóstico por imagen , Adulto , Velocidad del Flujo Sanguíneo/fisiología , Coriocarcinoma/irrigación sanguínea , Diagnóstico Diferencial , Femenino , Humanos , Invasividad Neoplásica , Embarazo , Neoplasias Uterinas/irrigación sanguíneaRESUMEN
Neoangiogenesis is a prerequisite for tumor growth and metastasis. In germ cell cancer patients with the disease limited to the testicle (stage A), tumor-associated neovascularization is predictive of metastatic disease (stage B). To investigate the molecular mechanisms underlying neovascularization in human germ cell tumors (GCTs), we analysed the expression of two angiogenic growth factors, vascular endothelial growth factor (VEGF) and placenta growth factor (P1GF), and of their receptors (FLT-1) and Flk-1/KDR) in a panel of testicular tumors. In this study we show a marked increase in VEGF expression in 36/44 (81.8%) primary testicular-derived GCTs, as compared to normal testis, that significantly correlates with a high density of intratumor microvessels (r = 0.72461, P < 0.001; n = 24). As determined by RT - PCR and/or Western blot, the predominant VEGF isoforms expressed in GCTs are the VEGF121 and VEGF165, which are more efficiently secreted by the cells, and thus more active in eliciting angiogenesis. Conversely, in the case of PIGF, only a weak correlation with the vascular density of tumors is observed (r = 0.26599, P < 0.05; n = 24). Northern blot analysis also revealed significant up-regulation of VEGF/ PIGF receptors in highly vascularized germ cell tumors, compared to normal testes. These findings suggest that VEGF may act in a paracrine manner to induce neovascularization, oedema extravasation and cyst formation in human germ cell tumors. The correlation between VEGF expression and the vascular density of tumors, suggest that the evaluation of VEGF expression may be of help in predicting patients at risk for metastatic diseases. Finally, we demonstrate that VEGF up-regulation may occur at the RNA level since no gene amplification is observed; conversely, in in vitro models such as the embryonal stem cell line NTERA-2 and the choricarcinoma JEG-3 cell line, VEGF (but not PIGF) mRNA expression is regulated by hypoxic stress.
Asunto(s)
Factores de Crecimiento Endotelial/biosíntesis , Germinoma/irrigación sanguínea , Linfocinas/biosíntesis , Neovascularización Patológica/metabolismo , Proteínas Gestacionales/biosíntesis , Neoplasias Testiculares/irrigación sanguínea , Secuencia de Bases , Western Blotting , Carcinoma Embrionario/irrigación sanguínea , Carcinoma Embrionario/metabolismo , Hipoxia de la Célula , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/metabolismo , Factores de Crecimiento Endotelial/genética , Germinoma/metabolismo , Humanos , Isomerismo , Linfocinas/genética , Masculino , Datos de Secuencia Molecular , Factor de Crecimiento Placentario , Reacción en Cadena de la Polimerasa , Proteínas Gestacionales/genética , ARN Mensajero/genética , ARN Mensajero/metabolismo , Proteínas Tirosina Quinasas Receptoras/biosíntesis , Proteínas Tirosina Quinasas Receptoras/genética , Teratocarcinoma/irrigación sanguínea , Teratocarcinoma/metabolismo , Neoplasias Testiculares/metabolismo , Transcripción Genética , Células Tumorales Cultivadas , Factor A de Crecimiento Endotelial Vascular , Factores de Crecimiento Endotelial VascularAsunto(s)
Coriocarcinoma/diagnóstico por imagen , Complicaciones Neoplásicas del Embarazo/diagnóstico por imagen , Neoplasias Uterinas/diagnóstico por imagen , Adulto , Coriocarcinoma/irrigación sanguínea , Femenino , Humanos , Neovascularización Patológica , Embarazo , Ultrasonografía Doppler en Color/métodos , Neoplasias Uterinas/irrigación sanguínea , Útero/irrigación sanguínea , Vagina/diagnóstico por imagenRESUMEN
The haemodynamics of the uterine arteries and myometrium were assessed using Doppler ultrasound in forty consecutive patients requiring treatment for invasive mole and choriocarcinoma. The investigations were performed prior to the commencement of chemotherapy and the subjects followed prospectively. The Doppler waveforms from the uterine arteries were analysed using the pulsatility index. It was found that patients with a pulsatility index of 1.1 or less were significantly more likely to develop drug resistance than those with a higher value (P < 0.04). There was no significant association between the pulsatility index and metastatic disease or uterine bleeding. Five out of eight patients who developed drug resistance could have avoided initial inadequate treatment if the Doppler findings were included in the scoring system for selecting chemotherapy for these tumours. It can be concluded that assessment of the uterine arteries using the pulsatility index prior to the treatment of patients with invasive mole and choriocarcinoma is of help in predicting those who will develop drug resistance.
Asunto(s)
Neoplasias Trofoblásticas/irrigación sanguínea , Ultrasonido , Neoplasias Uterinas/irrigación sanguínea , Útero/irrigación sanguínea , Arterias/diagnóstico por imagen , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/diagnóstico por imagen , Coriocarcinoma/tratamiento farmacológico , Gonadotropina Coriónica/análisis , Resistencia a Medicamentos , Femenino , Humanos , Mola Hidatiforme/irrigación sanguínea , Mola Hidatiforme/diagnóstico por imagen , Mola Hidatiforme/tratamiento farmacológico , Miometrio/irrigación sanguínea , Miometrio/diagnóstico por imagen , Embarazo , Estudios Prospectivos , Flujo Sanguíneo Regional/fisiología , Neoplasias Trofoblásticas/diagnóstico por imagen , Neoplasias Trofoblásticas/tratamiento farmacológico , Ultrasonografía , Neoplasias Uterinas/diagnóstico por imagen , Neoplasias Uterinas/tratamiento farmacológico , Útero/diagnóstico por imagenRESUMEN
The uterine circulation in 38 patients with invasive mole or choriocarcinoma were investigated using Doppler ultrasound. Twenty-six non-pregnant and 23 pregnant volunteers were assessed in a similar fashion to act as control groups. The pulsatility indices were significantly lower in the patients with trophoblastic disease when compared with the non-pregnant and pregnant groups (Student's t-test; P less than 0.001 and P less than 0.02 respectively). The uterine circulation in persistent trophoblastic diseases shows a characteristic Doppler profile suggesting the presence of large low resistance blood vessels. This may be useful in the initial assessment of these tumours before cytotoxic chemotherapy.
Asunto(s)
Coriocarcinoma/irrigación sanguínea , Mola Hidatiforme Invasiva/irrigación sanguínea , Miometrio/irrigación sanguínea , Neoplasias Uterinas/irrigación sanguínea , Adulto , Velocidad del Flujo Sanguíneo , Coriocarcinoma/tratamiento farmacológico , Femenino , Humanos , Mola Hidatiforme Invasiva/tratamiento farmacológico , Embarazo , Ultrasonografía , Neoplasias Uterinas/tratamiento farmacológicoRESUMEN
A case of primary choriocarcinoma of the stomach presenting as gastrointestinal hemorrhage in a 58-year-old postmenopausal woman is presented. Arteriographic features included a large hypervascular gastric mass and multiple liver masses with vascular poolings, mimicking those of cavernous hemangioma. Postcontrast CT including delayed scan showed a large central nonenhanced area with marginal peripheral contrast enhancement. Close observation of the angiographic findings revealed peripheral vascular poolings and central avascularity, which are characteristic of uterine choriocarcinoma. Human chorionic gonadotrophin (HCG) titer was significantly elevated, and extragenital choriocarcinoma of the stomach was confirmed by autopsy.
Asunto(s)
Coriocarcinoma/complicaciones , Hemorragia Gastrointestinal/etiología , Neoplasias Gástricas/complicaciones , Angiografía , Coriocarcinoma/irrigación sanguínea , Coriocarcinoma/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Estómago/irrigación sanguínea , Neoplasias Gástricas/irrigación sanguínea , Neoplasias Gástricas/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Fifty-three patients presenting with non-seminomatous germ cell tumours (NSGCT) of the testis were examined. Particular interest was directed towards the association of several morphological features of the primary tumour with metastatic disease, either at presentation or later in the course of the tumour. It is apparent from this study that the presence of vascular invasion in the primary tumour, high T stage (advanced local disease) and the presence of choriocarcinoma are poor prognostic signs in NSGCT. In such tumours presenting as clinical stage I, surveillance management may not be appropriate because of the high rate of relapse.
Asunto(s)
Coriocarcinoma/patología , Disgerminoma/patología , Neoplasias Testiculares/patología , Adulto , Coriocarcinoma/irrigación sanguínea , Disgerminoma/irrigación sanguínea , Estudios de Evaluación como Asunto , Humanos , Masculino , Invasividad Neoplásica , Estadificación de Neoplasias , Neoplasias de Células Germinales y Embrionarias/irrigación sanguínea , Neoplasias de Células Germinales y Embrionarias/patología , Orquiectomía , Pronóstico , Estudios Retrospectivos , Neoplasias Testiculares/irrigación sanguínea , Factores de TiempoRESUMEN
We have studied biologically active substances, tumor angiogenesis factors (TAF), which are supposed to be associated with the proliferation and metastases of choriocarcinoma cells. Eight human choriocarcinoma cell lines were used in the present study. TAF activity was assayed by bioassays using BALB/c mice subcutaneous tissue, chicken chorioallantoic membrane (CAM) and rabbit cornea in vivo and by proliferation of endothelial cells in vitro. 1. We found a positive correlation between the size of tumors developed in xenotransplantation and the number of blood vessels in the tumor tissues. A correlation between the number of blood vessels and TAF activity was also found. 2. With a gel-filtration method, TAF activity was observed in the common fractions in every cell line. The molecular weight of TAF was more than 10,000 daltons. 3. There was a heterogeneity of TAF activity among the cell lines. From these results, it appears that TAF initiates the choriocarcinoma cell-proliferation.
Asunto(s)
Inductores de la Angiogénesis/fisiología , Coriocarcinoma/patología , Sustancias de Crecimiento/fisiología , Neoplasias Uterinas/patología , Inductores de la Angiogénesis/aislamiento & purificación , Inductores de la Angiogénesis/metabolismo , Animales , Células Cultivadas , Embrión de Pollo , Coriocarcinoma/irrigación sanguínea , Cricetinae , Femenino , Humanos , Ratones , Trasplante de Neoplasias , Embarazo , Conejos , Neoplasias Uterinas/irrigación sanguíneaRESUMEN
The epidemiology, frequency and behaviour of hydatidiform moles, chorion adenomas and chorion carcinomas are summarised. The importance of angiography is stressed and illustrated by two examples. The value of the early correct diagnosis for the success of chemotherapy is pointed out.