Gynecologic Oncology Reports最新文献_第9页

Impact of molecular and immune signature on endometrial biopsies with atypical hyperplasia with and without concurrent endometroid carcinoma 分子和免疫特征对不典型增生伴或不伴子宫内膜样癌的子宫内膜活检的影响

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-19 DOI: 10.1016/j.gore.2025.101959

Terrence Wong , Joellen Fresia , Nicholas Adzibolosu , Logan Corey , Sharon Wu , Larissa Mattei , Joanne Xiu , Kurt Hodges , Matthew Oberley , Premal H. Thaker , Rami Musallam , Mira Kheil , Sudeshna Bandyopadhyay , Ira Winer , Robert Morris , Rouba Ali-Fehmi

Objective

Patients with a biopsy diagnosis of atypical endometrial hyperplasia (AEH) or endometrial intraepithelial neoplasia (EIN) have a significant underlying risk of concurrent endometrial cancer (EC). We sought to determine whether molecular and/or immune signatures can be utilized to differentiate between pre-operative, premalignant lesions with and without concurrent occult endometrioid adenocarcinoma.

Methods

A single-institution database was queried for patients diagnosed with AEH/EIN on pre-operative sampling who then underwent subsequent hysterectomy. Whole exome and whole transcriptome sequencing of tissue samples were performed by CARIS Life Sciences. Quantification of immune cells from RNA sequencing data was estimated using quanTIseq.

Results

We identified 34 patients with matched pre-operative and hysterectomy specimens: 19 patients (56 %) with AEH/EIN only and 15 patients (44 %) with EC. Forty-four pathologic specimens (65 %) were successfully profiled. The most frequent genomic alterations in the EC cohort were PTEN (83.3 %), MSI-H (22.2 %), PIK3R1 (22.2 %), and CTNNB1 (16.7 %). There were no MSI-H or CTNNB1 alterations in the AEH/EIN cohort. Median expression of all ten immune checkpoint genes analyzed (CD80, CD86, CD274, CTLA4, HAVCR2/TIM3, IFNG, IDO1, LAG3, PDCD1, PDCD1LG2) were numerically higher for pre-operative biopsies in the EC cohort. Infiltrates of pro-tumorigenic regulatory T cells (+2.42 %) and tumor-suppressing neutrophils (+11.75 %) and CD8 + T cells (+2.39 %) trended higher (p < 0.05) in this same cohort – absolute fractions of tumor-suppressing NK cells and M1 macrophages were also greater.

Conclusions

Pre-operative AEH/EIN biopsy specimens exhibit different molecular and immune profiles depending on the coexistence of concurrent EC. Further characterization of these signatures may lead to advances in diagnostic precision and prognostic capability.

活检诊断为非典型子宫内膜增生（AEH）或子宫内膜上皮内瘤变（EIN）的患者具有并发子宫内膜癌（EC）的显著潜在风险。我们试图确定分子和/或免疫特征是否可以用于区分术前、癌前病变伴和不伴隐匿性子宫内膜样腺癌。方法对术前抽样诊断为AEH/EIN并行子宫切除术的患者进行单机构数据库查询。组织样本的全外显子组和全转录组测序由CARIS生命科学公司进行。利用quanTIseq从RNA测序数据中估计免疫细胞的定量。结果我们确定了34例术前和子宫切除术标本相匹配的患者：19例（56%）仅患有AEH/EIN， 15例（44%）患有EC。44例病理标本（65%）被成功分析。EC队列中最常见的基因组改变是PTEN（83.3%）、MSI-H（22.2%）、PIK3R1（22.2%）和CTNNB1（16.7%）。在AEH/EIN队列中没有MSI-H或CTNNB1的改变。在EC队列中，术前活检分析的所有10个免疫检查点基因（CD80、CD86、CD274、CTLA4、HAVCR2/TIM3、IFNG、IDO1、LAG3、PDCD1、PDCD1LG2）的中位表达量均较高。在同一队列中，促肿瘤调节性T细胞（+ 2.42%）、肿瘤抑制中性粒细胞（+ 11.75%）和CD8 + T细胞（+ 2.39%）的浸润率呈上升趋势（p < 0.05），肿瘤抑制NK细胞和M1巨噬细胞的绝对比例也更高。结论术前AEH/EIN活检标本表现出不同的分子和免疫特征，这取决于并发EC的共存。这些特征的进一步表征可能导致诊断精度和预后能力的进步。

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引用次数: 0

Scholarly productivity during gynecologic oncology fellowship: A cross-sectional survey of graduates from 2020 to 2024 妇科肿瘤学奖学金期间的学术生产力：2020年至2024年毕业生的横断面调查

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-16 DOI: 10.1016/j.gore.2025.101958

Glenn P. Boyles , Chelsey I. Vranes , Leslie H. Clark , Kimberly Dessources , J. Michael Straughn Jr

Objectives

To characterize the scholarly accomplishments and attitudes regarding scholarly productivity among recent gynecologic oncology (GYO) fellowship graduates and identify factors which may influence academic productivity.

Methods

A 21-item web-based survey was distributed to individuals who had graduated from GYO fellowship within the past five years (2020–2024). Data on demographics, fellowship program characteristics, and scholarly accomplishments were collected. Descriptive statistics and univariate logistic regression were performed.

Results

115 individuals participated in the survey yielding a response rate of 31.2 %. The median number (min, max) of first-author published manuscripts was 4 (0, 18), conference posters was 4 (0, 30), and oral plenaries was 1 (0, 10). Graduates from programs with larger GYO clinical divisions were more likely to publish 4 or more first-author manuscripts compared to those from smaller divisions (OR 2.50; 95 % CI 1.09–5.74). The factors most frequently cited as supporting scholarly productivity were positive mentorship (65.4 %), access to existing databases (33.7 %), and timing of research year(s) (32.7 %). Reported barriers included clinical volume (63.5 %), inadequate technical support (36.5 %), and lack of mentorship (29.8 %). Fellows who had a clinical year prior to their dedicated research time were more likely to view timing of their research year(s) as contributory to their scholarly productivity (OR 2.89; 95 % CI 1.19–7.02).

Conclusions

This study provides valuable descriptive data on the scholarly accomplishments of recent GYO fellows. Clinical division size and timing of research year(s) seem to positively impact scholarly productivity.

目的了解妇科肿瘤科应届毕业生的学术成就及对学术生产力的态度，探讨影响学术生产力的因素。方法对近5年（2020-2024年）毕业的GYO奖学金毕业生进行21项网络调查。收集了人口统计、奖学金项目特点和学术成就方面的数据。进行描述性统计和单变量逻辑回归。结果共有115人参与调查，回复率为31.2%。第一作者发表稿件的中位数（min, max）为4(0,18)，会议海报为4(0,30)，口头全体会议为1（0,10）。与来自较小科室的毕业生相比，来自较大GYO临床科室的毕业生更有可能发表4篇或更多的第一作者手稿（or 2.50; 95% CI 1.09-5.74）。最常被引用的支持学术生产力的因素是积极的指导（65.4%），对现有数据库的访问（33.7%）和研究年度的时间安排（32.7%）。报告的障碍包括临床数量（63.5%）、技术支持不足（36.5%）和缺乏指导（29.8%）。在专门研究时间之前有临床一年的研究员更有可能将其研究年的时间安排视为对其学术生产力的贡献（OR 2.89; 95% CI 1.19-7.02）。结论本研究为近年来GYO研究员的学术成就提供了有价值的描述性数据。临床部门的规模和研究年份的时间似乎对学术生产力有积极的影响。

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引用次数: 0

Primary Ewing’s sarcoma of the vagina: A rare case report and literature review 阴道原发性尤文氏肉瘤一例罕见病例报告及文献复习

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-13 DOI: 10.1016/j.gore.2025.101949

Die Fan , Xiaoxia Jiang , Lin Wu , Yujie Hao , Chengbin Lu , Zheng Li

Background

Ewing’s sarcoma (ES) is an aggressive malignancy affecting bone and soft tissues, predominantly occurring in the skeletal system. The occurrence of Ewing’s sarcoma (ES) or primitive neuroectodermal tumor (PNET) with in the female genital tract is rare. Even rarer is its occurrence in the vagina, with only 22 cases reported to date. Accurate diagnosis necessitates a multifaceted approach that includes morphology, immunohistochemistry, and molecular pathology; the gold standard for diagnosis is next-generation sequencing (NGS), which is characterized by chromosomal translocations resulting in FET-ETS gene fusions.

Case description.

We present an exceptionally rare case of Ewing’s sarcoma in a 35-year-old woman of childbearing age. She exhibited a painless vaginal mass measuring approximately 2.5 × 2 × 0.9 cm, and according to the existing literature, our case represents the smallest tumor documented in primary vaginal Ewing’s sarcoma. Immunohistochemistry (IHC) revealed membrane positivity for CD99, along with positive expression of NKX2.2, FLI-1, and VIM. Furthermore, next-generation sequencing (NGS) conducted at the Affiliated Cancer Hospital of Fudan University identified an EWSR1-FLI1 gene fusion, thereby confirming the diagnosis of vaginal Ewing’s sarcoma.

Conclusion

Vaginal Ewing’s sarcoma is characterized by the absence of specific clinical manifestations and signs, along with a high rate of recurrence and metastasis. The management of these tumors primarily involves optimal local surgical intervention, followed by adjuvant therapies such as radiotherapy and/or chemotherapy.

杜温氏肉瘤（ES）是一种侵袭性恶性肿瘤，影响骨骼和软组织，主要发生在骨骼系统。尤因氏肉瘤（ES）或原始神经外胚层肿瘤（PNET）发生在女性生殖道是罕见的。更罕见的是发生在阴道，迄今为止只有22例报告。准确的诊断需要多方面的方法，包括形态学，免疫组织化学和分子病理学；诊断的金标准是下一代测序（NGS），其特点是染色体易位导致FET-ETS基因融合。案例描述。我们报告一例罕见的尤因氏肉瘤病例，患者为35岁育龄妇女。她表现出一个无痛的阴道肿块，大小约为2.5 × 2 × 0.9 cm，根据现有文献，我们的病例是原发性阴道尤文氏肉瘤中最小的肿瘤。免疫组化（IHC）显示CD99膜阳性，NKX2.2、fl -1和VIM阳性表达。此外，在复旦大学附属肿瘤医院进行的下一代测序（NGS）发现了EWSR1-FLI1基因融合，从而确认了阴道尤文氏肉瘤的诊断。结论阴道尤文氏肉瘤无特异性临床表现和体征，复发转移率高。这些肿瘤的治疗主要包括最佳的局部手术干预，其次是辅助治疗，如放疗和/或化疗。

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引用次数: 0

Treatment preferences of patients with recurrent or metastatic cervical cancer: a discrete choice experiment in the US 复发性或转移性宫颈癌患者的治疗偏好：美国的离散选择实验

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-13 DOI: 10.1016/j.gore.2025.101947

Premal H. Thaker , Hui Lu , Yitong J. Zhang , Myrto Trapali , Paul Swinburn , Nicolas Krucien , Doris White , Joslyn Chaiprasert-Paguio , Bhavana Pothuri , Jie Ting

Objective

This study assessed treatment preferences of patients with recurrent/metastatic cervical cancer, a disease with poor prognosis.

Methods

A survey with two discrete choice experiments was completed by 150 patients with recurrent/metastatic cervical cancer in the US. Discrete choice experiment 1 included treatment attributes, and discrete choice experiment 2 included risk mitigation plan attributes.

Results

Participants valued 12-month overall survival rate as the most important attribute, followed by disease control rate; both efficacy attributes were rated as more important than the risk of side effects such as peripheral neuropathy and corneal side effects. Participants’ willingness to accept a treatment profile requiring a risk mitigation plan was influenced by the number of clinic visits and out-of-pocket costs.

Conclusions

Patients with recurrent/metastatic cervical cancer prioritize overall survival and disease control rate as the most important attributes. These findings can be used to inform shared decision-making and treatment discussions among patients, clinicians, and the care team.

目的探讨复发/转移性宫颈癌患者的治疗选择，这是一种预后不良的疾病。方法对美国150例复发/转移性宫颈癌患者进行两项离散选择实验。离散选择实验1包括处理属性，离散选择实验2包括风险缓解计划属性。结果受访患者最看重的是12个月总生存率，其次是疾病控制率；这两种疗效属性都被认为比周围神经病变和角膜副作用等副作用的风险更重要。参与者接受需要降低风险计划的治疗方案的意愿受到诊所就诊次数和自付费用的影响。结论宫颈癌复发/转移患者优先考虑总生存率和疾病控制率。这些发现可用于患者、临床医生和护理团队之间的共同决策和治疗讨论。

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引用次数: 0

Immunotherapy-associated capillary leak syndrome in endometrial cancer: a case report and review of the literature 子宫内膜癌免疫治疗相关毛细血管渗漏综合征1例报告及文献复习

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-12 DOI: 10.1016/j.gore.2025.101955

Katherine Lambert , Quinn Kistenfeger , Julia Chalif , Jason M. Prosek , Floor Backes

Background

Capillary leak syndrome is a rare immune-adverse related event. There are only 3 reported cases of capillary leak syndrome in patients receiving pembrolizumab, all of which are patients with non-gynecologic squamous cell carcinomas. Here, we present a case report of capillary leak syndrome in a patient with recurrent endometrial carcinoma receiving pembrolizumab.

Methods

This is a case report and review of relevant literature. Patient consent was obtained prior to initiation of the report and submission to the journal.

Objectives

We describe a 65-year-old female with recurrent mismatch repair deficient (dMMR) FIGO grade 2 endometrioid adenocarcinoma on pembrolizumab maintenance therapy, who presented to the hospital with fatigue, lower extremity vasculitis, anasarca, and fevers of unknown origin. She was found to have hypoalbuminemia and hyponatremia. A broad workup was performed, which was overall unrevealing. She was diagnosed with capillary leak syndrome as a diagnosis of exclusion. The patient was treated with corticosteroids and IVIG with resolution of her symptoms. The patient is not currently on any maintenance therapy and there are no plans to resume pembrolizumab.

Conclusion

Our case is the first reported case of capillary leak syndrome secondary to pembrolizumab in a patient with a gynecologic malignancy. Capillary leak syndrome is a diagnosis of exclusion and is treated via immunosuppression with agents such as corticosteroids and IVIG. Expanded awareness of this immune-related adverse event is vital to prompt recognition and treatment.

背景：毛细血管渗漏综合征是一种罕见的免疫不良相关事件。在接受派姆单抗治疗的患者中，仅报道了3例毛细血管渗漏综合征，均为非妇科鳞状细胞癌患者。在这里，我们提出一个病例报告毛细血管渗漏综合征的患者复发子宫内膜癌接受派姆单抗。方法结合病例报告和相关文献进行复习。在开始报告和提交给期刊之前获得患者同意。我们描述了一名65岁的女性，她患有复发性错配修复缺陷（dMMR） FIGO 2级子宫内膜样腺癌，接受派姆单抗维持治疗，她以疲劳、下肢血管炎、疼痛和不明原因的发烧来医院就诊。她被发现有低白蛋白血症和低钠血症。进行了广泛的检查，总体上没有发现任何问题。她被诊断为毛细血管渗漏综合征作为排除诊断。患者接受皮质类固醇和IVIG治疗，症状得到缓解。该患者目前没有接受任何维持治疗，也没有恢复使用派姆单抗的计划。结论本病例是首例报告的派姆单抗继发于妇科恶性肿瘤患者的毛细血管渗漏综合征。毛细血管渗漏综合征是一种排除性诊断，并通过免疫抑制药物治疗，如皮质类固醇和IVIG。扩大对这一免疫相关不良事件的认识对于及时识别和治疗至关重要。

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引用次数: 0

Long-term disease-free survival after bilateral video-assisted thoracoscopic resection of multiple pulmonary metastases from endometrial stromal sarcoma: An 8-year follow-up case report 双侧胸腔镜切除子宫内膜间质肉瘤多发肺转移瘤后的长期无病生存：8年随访病例报告

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-11 DOI: 10.1016/j.gore.2025.101954

Eitetsu Koh , Yasuo Sekine , Tadao Nakazawa , Kenzo Hiroshima

Background

Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy prone to late recurrence and distant metastasis, most commonly to the lungs. Bilateral multiple pulmonary metastases are exceedingly uncommon, and optimal management remains unclear.

Case presentation

A 51-year-old woman underwent total abdominal hysterectomy for LG-ESS at age 43. Eight years later, routine chest radiography revealed multiple bilateral pulmonary nodules. Computed tomography showed three well-circumscribed nodules (7–9 mm) in the left S4, left S8, and right S8 segments. Positron emission tomography showed minimal fluorodeoxyglucose uptake. Bilateral video-assisted thoracoscopic wedge resections were performed, achieving complete removal of all lesions. Histopathology confirmed metastatic LG-ESS (CD10/ER/PR positive). The patient received oral medroxyprogesterone acetate for five years. The therapy was discontinued following subarachnoid hemorrhage due to a ruptured posterior-circulation intracranial aneurysm and treated by surgical clipping; she has no residual neurological deficits. She remains disease-free a total of eight years after metastasectomy.

Conclusion

Complete resection of bilateral multiple pulmonary metastases from LG-ESS, combined with hormonal therapy, can achieve durable long-term disease control in carefully selected patients.

背景：低级别子宫内膜间质肉瘤（LG-ESS）是一种罕见的晚期复发和远处转移的子宫恶性肿瘤，最常见于肺部。双侧多发肺转移非常罕见，最佳治疗方法尚不清楚。一例51岁女性在43岁时接受了全腹部子宫切除术。8年后，常规胸片显示双侧多发肺结节。计算机断层扫描显示左侧S4，左侧S8和右侧S8节段三个界限清晰的结节（7 - 9mm）。正电子发射断层扫描显示微量的氟脱氧葡萄糖摄取。进行双侧胸腔镜楔形切除，完全切除所有病变。组织病理学证实转移性LG-ESS （CD10/ER/PR阳性）。患者口服醋酸甲孕酮5年。由于颅内后循环动脉瘤破裂导致蛛网膜下腔出血，并通过手术夹持治疗，该治疗停止；她没有残留的神经缺陷。她在转移瘤切除术后的八年里一直没有患病。结论经精心挑选的患者，完全切除双侧多发性肺转移灶，结合激素治疗，可实现持久、长期的疾病控制。

{"title":"Long-term disease-free survival after bilateral video-assisted thoracoscopic resection of multiple pulmonary metastases from endometrial stromal sarcoma: An 8-year follow-up case report","authors":"Eitetsu Koh , Yasuo Sekine , Tadao Nakazawa , Kenzo Hiroshima","doi":"10.1016/j.gore.2025.101954","DOIUrl":"10.1016/j.gore.2025.101954","url":null,"abstract":"<div><h3>Background</h3><div>Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy prone to late recurrence and distant metastasis, most commonly to the lungs. Bilateral multiple pulmonary metastases are exceedingly uncommon, and optimal management remains unclear.</div></div><div><h3>Case presentation</h3><div>A 51-year-old woman underwent total abdominal hysterectomy for LG-ESS at age 43. Eight years later, routine chest radiography revealed multiple bilateral pulmonary nodules. Computed tomography showed three well-circumscribed nodules (7–9 mm) in the left S4, left S8, and right S8 segments. Positron emission tomography showed minimal fluorodeoxyglucose uptake. Bilateral video-assisted thoracoscopic wedge resections were performed, achieving complete removal of all lesions. Histopathology confirmed metastatic LG-ESS (CD10/ER/PR positive). The patient received oral medroxyprogesterone acetate for five years. The therapy was discontinued following subarachnoid hemorrhage due to a ruptured posterior-circulation intracranial aneurysm and treated by surgical clipping; she has no residual neurological deficits. She remains disease-free a total of eight years after metastasectomy.</div></div><div><h3>Conclusion</h3><div>Complete resection of bilateral multiple pulmonary metastases from LG-ESS, combined with hormonal therapy, can achieve durable long-term disease control in carefully selected patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101954"},"PeriodicalIF":1.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Navigating dual risks: Ovarian cancer prevention and cardiovascular health in patients with hereditary cancer syndromes 导航双重风险：遗传性癌症综合征患者的卵巢癌预防和心血管健康

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-09 DOI: 10.1016/j.gore.2025.101940

Laura Keenahan , Muhammad Danyal Ahsan , Alicia Mecklai , Melissa K. Frey

引用次数: 0

Neoadjuvant chemoimmunotherapy in HPV-associated vulvar and vaginal squamous cell carcinoma with PD-L1 CPS < 1:Dual pCR evidence PD-L1 CPS < 1的hpv相关外阴和阴道鳞状细胞癌的新辅助化疗免疫治疗：双pCR证据

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-08 DOI: 10.1016/j.gore.2025.101952

Enyu Tang , Jia Zeng , Yangchun Sun

Background

While surgery and radiotherapy remain primary treatments for HPV-associated vulvar/vaginal squamous cell carcinoma (SCC), the significant complications and impaired quality of life underscore the need for alternative approaches. We report two cases achieving pathological complete response (pCR) with neoadjuvant chemoimmunotherapy.

Cases

Two biopsy-confirmed HPV-associated vulvar/vaginal SCC cases with inguinal lymph node metastases (both PD-L1 CPS < 1) received three cycles of neoadjuvant camrelizumab plus nab-paclitaxel/cisplatin. Subsequent imaging demonstrated marked tumor regression, permitting urethra-preserving resection. Histopathological analysis confirmed pCR, with no recurrence at 6-month follow-up.

Conclusion

Neoadjuvant chemoimmunotherapy may be an effective treatment for HPV-associated vulvar/vaginal SCC, potentially independent of PD-L1 CPS status, while improving post-treatment quality of life compared to conventional therapies.

虽然手术和放疗仍然是hpv相关外阴/阴道鳞状细胞癌（SCC）的主要治疗方法，但明显的并发症和生活质量下降强调了替代方法的必要性。我们报告两例实现病理完全缓解（pCR）与新辅助化疗免疫治疗。两例活检证实hpv相关外阴/阴道SCC伴腹沟淋巴结转移（均为PD-L1 CPS <； 1）的病例接受了三个周期的新辅助camrelizumab加nab-紫杉醇/顺铂。随后的影像学显示肿瘤明显消退，允许保留尿道的切除。组织病理学分析证实pCR，随访6个月无复发。结论新辅助化疗免疫治疗可能是hpv相关外阴/阴道SCC的有效治疗方法，可能与PD-L1 CPS状态无关，同时与常规治疗相比，可改善治疗后的生活质量。

引用次数: 0

An unusual pelvic mass 不寻常的盆腔肿块

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-08 DOI: 10.1016/j.gore.2025.101948

Marie-Véronique Poirier, Vikram B. Chakravarthy, Floor Backes

Background

The differential diagnosis for a solid pelvic mass is broad and includes non-gynecologic masses such as retroperitoneal schwannoma. Theses benign nerve-sheath tumors can be mistaken for adnexal masses or cause non-specific bulk symptoms, which may lead patients to present to their Ob/Gyn or ultimately be referred to gynecologic oncologists for evaluation and possible resection.

Cases

We discuss two cases of pelvic schwannoma: a 79-year-old woman who initially presented with a two-year history of left lower extremity cramping, paresthesia, and back pain, and a 40-year-old woman with right-sided flank pain and worsening dysmenorrhea, who presented with initial concern for adnexal mass.

Conclusion

The differential diagnosis for a smooth, fixed, pre-sacral or sidewall mass on pelvic exam includes pelvic schwannoma. These nerve sheath tumors are typically benign; however, can cause a variety of symptoms due to regional mass effect and may significantly impact quality of life. Associated symptoms, if present, may be non-specific or difficult to localize (i.e. pelvic pain/fullness, urinary symptoms, constipation, and radiculopathy), which can lead to a delay in diagnosis if a comprehensive pelvic exam is not performed or if suspicion for an etiology of non-gynecologic origin is not considered. Recommended workup includes pelvic MRI followed by CT-guided biopsy. Management is guided by the patient’s symptoms; if surgery is warranted, a minimally invasive, interdisciplinary approach is strongly preferred.

背景：实性盆腔肿块的鉴别诊断很广泛，包括非妇科肿块，如腹膜后神经鞘瘤。这些良性神经鞘肿瘤可能被误认为附件肿块或引起非特异性大块症状，这可能导致患者向他们的妇产科医生或最终转到妇科肿瘤科医生进行评估和可能的切除。我们讨论两例盆腔神经鞘瘤：一名79岁女性，最初表现为两年的左下肢痉挛、感觉异常和背部疼痛史；另一名40岁女性，右侧疼痛和痛经加重，最初表现为附件肿块。结论盆腔检查中平滑、固定、骶前或侧壁肿块的鉴别诊断包括盆腔神经鞘瘤。这些神经鞘肿瘤通常是良性的；然而，由于局部质量效应，可引起各种症状，并可能严重影响生活质量。相关症状，如果出现，可能是非特异性的或难以定位的（如盆腔疼痛/丰满，泌尿系统症状，便秘和神经根病），如果不进行全面的盆腔检查或不考虑非妇科病因的怀疑，这可能导致诊断延误。推荐的检查包括盆腔MRI和ct引导下的活检。治疗以患者症状为指导；如果手术是必要的，微创，跨学科的方法是强烈首选。

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引用次数: 0

Human epidermal growth factor receptor-2, nectin-4, and trophoblast cell surface antigen-2 expression in endometrial carcinosarcoma 人表皮生长因子受体-2、连接素-4和滋养细胞表面抗原-2在子宫内膜癌肉瘤中的表达

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-09-08 DOI: 10.1016/j.gore.2025.101951

Shih-Yao Lin , Chung-Ting Chang , Ren-Chin Wu , Chiung-Ru Lai , Yi-Jen Chen

Objective

To characterize the immunohistochemical expression of human epidermal growth factor receptor-2 (HER2), nectin-4, and trophoblast cell surface antigen-2 (TROP2) in endometrial carcinosarcoma (ECS), with particular attention to compartment-specific expression patterns and potential therapeutic implications.

Methods

We retrospectively analyzed 56 ECS cases and performed immunohistochemistry for HER2, nectin-4, and TROP2 on representative tumor sections. Expression levels were semi-quantitatively scored and compared between the carcinomatous and sarcomatous components. Associations with clinicopathological features were also assessed.

Results

HER2 overexpression (3+) was identified in 4 cases (7.1 %), with an additional 6 cases (10.7 %) showing equivocal (2+) staining. HER2 2+/3+ expression was significantly associated with serous carcinoma differentiation (31.0 % vs. 3.7 %, P = 0.012) and was largely confined to the carcinomatous component (P < 0.001). Nectin-4 was expressed in 39.3 % of cases, predominantly weak in intensity, with significantly higher expression in the carcinomatous than in the sarcomatous component (P < 0.001). TROP2 expression was observed in 62.5 % of cases, also confined to the carcinomatous component, with no strong expression detected. No significant correlations were found between marker expression and other clinicopathological variables beyond serous differentiation.

Conclusions

HER2, nectin-4, and TROP2 are preferentially expressed in the carcinomatous component of ECS. HER2-targeted antibody–drug conjugates may be a promising therapeutic strategy for ECS with serous carcinoma differentiation. Further investigation is warranted to determine the clinical relevance of targeting nectin-4 and TROP2 in ECS.

目的表征人表皮生长因子受体-2 （HER2）、连接素-4和滋养细胞表面抗原-2 （TROP2）在子宫内膜癌肉瘤（ECS）中的免疫组织化学表达，特别关注室特异性表达模式和潜在的治疗意义。方法回顾性分析56例ECS病例，对代表性肿瘤切片进行HER2、nectin-4、TROP2免疫组化检测。对癌性成分和肉瘤性成分的表达水平进行半定量评分和比较。还评估了与临床病理特征的关系。结果4例（7.1%）发现sher2过表达（3+），另有6例（10.7%）显示模棱两可（2+）染色。HER2 2+/3+表达与浆液性癌分化显著相关（31.0%对3.7%,P = 0.012），且主要局限于癌性成分（P < 0.001）。39.3%的病例中有Nectin-4表达，且表达强度较弱，癌组织中Nectin-4的表达明显高于肉瘤组织（P < 0.001）。在62.5%的病例中观察到TROP2表达，也局限于癌成分，未检测到强表达。除浆液分化外，标志物表达与其他临床病理变量之间无显著相关性。结论sher2、connectin -4、TROP2在ECS癌变组分中优先表达。her2靶向抗体-药物偶联物可能是一种很有前途的治疗策略，用于浆液性癌分化的ECS。需要进一步的研究来确定靶向nectin-4和TROP2在ECS中的临床相关性。

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引用次数: 0