ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 classified into several subtypes, which are embryonal, alveolar, spindle cell/sclerosing, and pleomorphic. Methods: We present the case of alveolar rhabdomyosarcoma in a 34-year-old woman with vaginal bleeding. Magnetic resonance imaging revealed a cervical mass with several enlarged iliac lymph nodes without distant metastasis. Malignant neoplasm was suspicious and total hysterectomy was done after hormone therapy. Results: Microscopically, the cervical mass was composed of two distinct features; one with small discohesive cells and the other with larger cells with abundant eosinophilic cytoplasm. Immuno- histochemical stains showed positivity for vimentin, myogenin, and myo-D1 at both different features, but in different patterns, suggesting the diagnosis of mixed alveolar and embryonal rhabdo- myosarcoma. Fluorescence in situ hybridization (FISH) detected the FOXO1 translocation, supporting the diagnosis of alveolar rhabdomyosarcoma. The patient underwent the postoperative radiation and chemotherapy, but multiple node metastasis along para-aortic, mesenteric, aortocaval, and supraclavicular area was detected 6 months after surgery, and the patient died of the disease a year after surgery. Conclusion: FISH playes an important role in distinguishing sub- types of rhabdomyosarcoma, and it is important to recognize these different subtypes due to difference of overall survival. E-PS-09-010 Coexistence of mature cystic teratoma of the ovary with endometrioid adenocarcinoma arising from a site of endometriosis: a case report of an extremely rare combined ovarian lesion C. Gouta*, C. Nikolaidou, I. Venizelos *Department of Histopathology, Hippokration General Hospital of Thessaloniki, Greece Background & objectives: Both endometriosis and mature cystic teratoma tend to occur very frequently at reproductive ages. However, their coexistence is extremely rare, particularly in postmenopausal patients. The incidence of a synchronous ovarian endometrioid adenocarcinoma has hardly ever been reported. Methods: We report the case of a 63-year-old postmenopausal female with a history of non-Hodgkin’s lymphoma, who presented with an ovarian mass as an incidental finding during a CT scan follow-up. Additional imaging tests described the mass as partly solid and partly cystic. The patient underwent a total hysterectomy with bilateral salpingo-oophorectomy and a bilateral pelvic lymph node dissection. Results: Macroscopic examination showed an ovarian lesion measuring 8x7x3.8 cm, composed of both a thin-wall cystic element and a solid counterpart. The cystic part was filled with white soft material, hair and blood, while the solid one appeared whitish and elastic. Microscopically, the lesion displayed three different pathologic entities; an endometriotic cyst, from which a well-differentiated adenocarcinoma arose, and a mature cystic teratoma. The neoplastic cells were positive for CK7, PAX8 and CK15.3 and negative for CK20. p53 appeared mildly to moderately positive (wild type). Conclusion: To our knowledge, up until now there have been pub- lished only 4 case reports and one case series of simultaneous mature cystic teratoma and endometriosis since 1960, all of which occurred in women of reproductive age and not necessarily on the same ovary. Our case report contributes to the literature presenting an even rarer entity of a synchronous lesion coexisting unilaterally in the same ovary, raising questions about the succession of events and the pathophysiological mechanisms involved. E-PS-09-011 Gallbladder carcinoma recurs as uterine metastasis H. Trihia*, M. Terzi, L. Karelis, M. Karagianni, O. Tzaida, C. Iavazzo *Pathology Department Metaxa Cancer Hospital, Greece Background & objectives: Metastases to the female genital tract are rare, with metastatic disease restricted to the uterus being even less frequent. The primary tumour is most often intra-genital rather than extra-genital. We present a case of uterine metastasis of a gallbladder carcinoma. Methods: A 66-year-old woman was diagnosed with a 3,4cm lobu- lated mass, in the left parametrium, of mixed consistency, with no sign of endometrial tumour. There was no lymph node enlargement or ascites. Her past medical history was significant for gallbladder carcinoma, stage II, since 2,5 years, after laparoscopic cholocyst- ectomy for symptomatic cholethiliasis. She underwent TAH & BSO omentectomy and umbilicectomy. Results: On macroscopic examination the body of the uterus was occupied by a tumour mass measuring 3cm. In the left ovary there was a 1,9cm tumour, solid and cystic filled with serous-mucoid fluid and in the right ovary a cystic tumour of 1,8cm. The omentum had hard consistency of 6cm. In the left ovary a diagnosis of an adenosquamous carcinoma was made of billiary and intestinal type with squamous component of >25%, with areas of necrosis and LVIs and parasalpingeal extension. There was a full thickness infiltration of the uterine wall, of the right ovary, the omentum and umbilicus, by billiary type adenocarcinoma, consistent with metastasis from the gallbladder carcinoma (GBC). Conclusion: Metastases to the female genital tract are rare. When metastases from extragenital primaries occur, the ovaries are affected the most. Metastatic localization in the uterine corpus accounts for less than 10%. Concurrent metastatic disease in the ovaries is found in 65%. Among extragenital primary tumours metastasizing to the uterine corpus is GBC in 4,8%. Dissemination of GBC has a propensity for distant spread. Uterine metastasis has to be excluded in women with uterine/parametrial mass and a personal history of GBC. E-PS-09-012 Incidental primary (localized) extranodal ovarian follicular B-cell lymphoma (FL): a case report of a rare entity H. Trihia*, L. Karelis, E. Souka, M. Dadakaridou, D. Giannoulo- poulos, C. Iavazzo *Pathology Department Metaxa Cancer Hospital, Greece Background & objectives: Ovarian lymphomas are usually secondary and indication of disseminated disease. Primary ovarian lymphomas are rare and of better prognosis. We describe a primary ovarian follicular lymphoma in a 71-year-old woman who underwent surgery for a fibroma of the ovary. Methods: We received the uterus with left fallopian tube measur- ing 6cm long and 0,3cm maximum diameter and left ovary whose dimensions were 4,5X3,5X2cm. On sections the ovary was almost fully replaced by a mass with smooth, lobulated surface with solid, vaguely nodular, tan-white appearance and sclero-elastotic consistency. Results: Microscopic examination showed a B-cell proliferation arranged in follicular (75%) and diffuse distribution, consisting of numerous, variably-sized, non-polarized neoplastic follicles, with attenuated or absent mantle zones, expansile and typically arranged in a back-to-back fashion. Focal residual ovarian parenchyma was identified, confirming its ovarian origin. The neoplastic cells S258