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Large or giant lipoleiomyoma of the uterine corpus is a rare condition. A 70-year-old Japanese woman consulted our hospital because of a pelvic mass and abnormal uterine bleeding. Physical examination showed a mass in the pelvis. Blood laboratory test showed anemia and leukocytosis. Cholesterol, triglyceride, glucose, and hemoglobin A1c were normal. Tumor markers (CEA, CA19-9, CA125, SCC, and CA72-4) were normal. Imaging modalities including ultrasound and computed tomography revealed a characteristic large (8 × 8 × 9 cm) tumor in the posterior aspect of the uterine body. The tumor was characteristic, and the opacity was heterogenous. Radiologists' diagnosis was angiomyolipoma. Simple hysterectomy and bilateral salpingo-oophorectomy were performed. During the operation, it was found that the mass originated from the posterior aspect of the uterine body. Grossly, the resected mass was heterogenous and whitish yellow. It measured 10 × 9 × 9 cm. The tumor originated from the myometrium and assumed features of subserosal leiomyoma. Histologically, the tumor was composed of adipose tissue and smooth muscle cells. The adipose tissue was mature, and there were no atypical cells or lipoblasts. The smooth muscle areas were composed of red spindle smooth muscle cells. No atypia was seen in the smooth muscles. Mitotic figures were not recognized. Vascular proliferation was not seen. The adipose tissue element accounted for 20% in area; and the smooth muscle element, 80%. Immunohistochemically, the adipose tissue element was positive for vimentin and S100 protein, and negative for pancytokeratins (AE1/3, CAM5.2), α-smooth muscle actin, desmin, CD34, HMB45, p53, MDM2, CDK4, and KIT. The smooth muscle element was positive for vimentin, desmin, and α-smooth muscle actin, but negative for pancytokeratins (AE1/3, CAM5.2), S100 protein, CD34, HMB45, p53, MDM2, CDK4, and KIT. The Ki-67 labeling was approximately 0.3% in the smooth muscle element and approximately 0.2% in the adipose tissue element. The pathological diagnosis was large lipoleiomyoma of the uterine body. The patient is now free of the tumor 2 years after the operation.

Verrucous carcinoma (VC) of the skin is relatively rare. The author reports 5 Japanese cases of VC of the skin. The age ranged from 63 to 91 years with a median of 70 years. The locations were hand in 1 case, lip in 1, face in 1, and foot sole in 2. The size ranged from 0.8 cm to 30 mm with a median of 1.5 cm. Grossly, all the cases showed elevated verrucous tumors. Histologically, the tumors were composed of squamous epithelial cells with minimal cellular atypia arranged in a verrucous pattern. One case showed koilocytosis. Neutrophilic abscesses were seen in 3 cases. Microinvasion was recognized in 2 cases. Focus of less differentiated squamous cell carcinoma was seen in the VC in 1 case. Actinic karatosis or squamous cell carcinoma in situ contiguous to VC was seen in 1 case. Definite precedent lesions were not recognized in any of the cases. Immunohistochemically, VCs of the skin were negative for human papilloma virus antigens in the 2 cases examined. p53 protein was expressed in all the VCs and accentuated in the basal and microinvasive parts. The Ki-67 antigen was also expressed in all the VCs, and it was mainly observed in the basal and microinvasive areas. These findings suggest that (1) VC of the skin can occur in any skin sites, (2) VC of the skin can transform into less differentiated squamous cell carcinoma, and (3) VC of the skin may be associated with squamous cell carcinoma in situ.

Immunohistochemical studies of atypical polypoid adenomyoma (APA) of the uterus are very rare. Five cases of APA were retrieved from the surgical cases of our laboratory. The ages were 38, 41, 54, 65, and 77 years (mean ± SD, 55 ± 14.6 years). The diameters of APA were 1.2, 1.9, 2.3, 3.2, and 7.0 cm (mean ± SD, 3.12 ± 2.00 cm). Histologically, APA consisted of complex glandular element and mesenchymal fibromuscular element. No endometrial stroma was present. Mucins were found in the glands but not in the mesenchyma. The glands were consistently positive for pancytokeratin (AE1/3, CAM5.2), cytokeratin (CK) 7, CK8, CK18, CK19, vimentin, CA125, estrogen receptor, progesterone receptor, MUC1, and MUC6. The glands were consistently negative for CK14, CK20, CEA, epithelial membrane antigen, S100 protein, p53, CD10, MUC2, and MUC5AC. Some cases were positive for CK34βE12 (4/5), CK5/6 (4/5), and CA19-9 (4/5). The Ki-67 labeling ranged from 3% to 10%. The mesenchymal element was consistently positive for vimentin, α-smooth muscle actin, estrogen receptor, progesterone receptor, and CD10, while consistently negative for pancytokeratin (AE1/3, CAM5.2), CK34βE12, CK5/6, CK7, CK8, CK14, CK18, CK19, CK20, CEA, epithelial membrane antigen, S100 protein, CA125, CA19-9, p53, MUC1, MUC2, MUC5AC, and MUC6. Some cases were positive for desmin (2/5). Ki-67 labeling ranged from 1% to 8%. In conclusion, the immunoprofile of APA was reported. The findings provide basic knowledge of APA of the uterus.

An 85-year-old Japanese woman was admitted to our hospital because of abdominal fullness. Computed tomography revealed multiple nodules in the liver; the interpretation was metastatic carcinoma. Serum laboratory test revealed extremely elevated α-fetoprotein (AFP) (8820 ng/mL; normal