Hanna G. Kaspar

Wilkes Barre VA Medical Center

Background: Cases of malignant ovarian tumors consisting of Clear Cell Carcinoma (CCC) and Yolk Sac Tumor (YST) are decidedly rare. Case: We herein report the case of a 58-year-old woman with an ovarian tumor, of which approximately 70 percent was composed of CCC and 30 percent YST. The plan was to utilize a chemotherapeutic regimen of 4 cycles of...

Introduction: Lynch syndrome (LS) is characterized by an increased risk for colorectal cancer (CRC) and endometrial cancer (EC). Half of patients present with a gynecologic malignancy as their sentinel cancer. Screening LS patients can find precancerous lesions and prevent cancer morbidity and mortality. Implementation of universal Lynch Syndrome s...

This chapter is an overview of frequently used markers in the differential diagnosis of both common and less common tumors of the ovary, with a focus on the effective markers employed to differentiate epithelial surface tumors, sex cord-stromal tumors and germ cell tumors. Useful panels in the differential diagnosis of mucinous tumors, germ cell an...

Context: Immunohistochemistry has assumed an increasing role in the identification and characterization of gynecologic disorders including lesions with deceptively bland morphology, uncommon and underdiagnosed neoplasms, and neoplasms with specific genetic alterations associated with overexpression or loss of expression of specific proteins. The d...

This chapter is an overview of frequently used markers in the differential diagnosis of both common and less common tumors of the uterine cervix and corpus, with a focus on the effective markers employed to differentiate adenocarcinoma of the endocervix vs. endometrium, low-grade vs. high-grade endometrial neoplasms, benign vs. malignant mimics of...

Background Yes-associated protein (YAP) is a transcriptional co-activator and regulates cell proliferation and apoptosis. We investigated the clinical and biological significance of YAP in endometrial cancer (EMCA). Methods YAP expression in 150 primary tumor tissues from patients with EMCA was evaluated by immunohistochemistry and its association...

To report a rare case of Transglottic Basaloid Squamous cell carcinoma of the larynx and review the pathologic features of these lesions. A 64 year old male, heavy smoker and alcohol abuser, presented with a 6 month history of hoarseness. Laryngoscopy revealed a right transglottic lesion involving the epiglottis, aryepiglottic fold, ventricle and t...

Squamous metaplasia in endometrioid adenocarcinoma of the endometrium may be interpreted as solid growth pattern of the tumor resulting in upgrading the FIGO grade of the tumor. Conversely, a solid growth pattern of the endometrioid tumor may be construed as squamous metaplasia resulting in downgrading of the FIGO grade. The purpose of this study i...

This chapter is an overview of frequently used markers in the differential diagnosis of both common and rare tumors of the adrenal gland, with a focus on the effective markers employed for differentiating primary adrenal tumors and their mimics including metastatic renal cell carcinoma, hepatocellular carcinoma, and malignant melanoma. Other useful...

This chapter is an overview of frequently used markers in the differential diagnosis of both common and less common tumors of the uterine cervix and corpus, with a focus on the effective markers employed to differentiate adenocarcinoma of the endocervix vs. endometrium, low-grade vs. high-grade endometrial neoplasms, and benign vs. malignant mimics...

Desmoid tumors of the female pelvis are rare. The efficacy of the available treatment modalities in improving survival and decreasing recurrence remains controversial. A 32-year-old woman presented with an asymptomatic large ischeorectal mass. Computed tomography scan revealed a large tumor adherent to the pubic bone and impinging on the bladder ne...

Beta thalassemia is an autosomal recessive disorder characterized by reduced (β+) or absent (β0) beta-globin chain synthesis. In Lebanon it is the most predominant genetic defect. In this study we investigated the religious and geographic distribution of the β-thalassemia mutations identified in Lebanon, and traced their precise origins. A total of...

Placental site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic diseases. We report a 40-year-old woman who presented initially after a year of secondary infertility with prolonged menstrual flow. Her last pregnancy ended in a suction dilation and curettage at 8 weeks' gestation for a missed abortion. A hysterosalpingogram...

Placental site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic diseases. We report a 40-year-old woman who presented initially after a year of secondary infertility with prolonged menstrual flow. Her last pregnancy ended in a suction dilation and curettage at 8 weeks' gestation for a missed abortion. A hysterosalpingogram...

Beta-thalassemia is the most common genetic disorder in the Lebanese population. Of the 200 different mutations in the beta-globin gene that leads to thalassemia, the IVSI-110 (29.87%), IVSI-6 (20.74%), IVSI-1 (14.07%), IVSII-1 (9.13%), Cd29 (9.13%), and Cd30 (3.95%) mutations are the most frequent among Lebanese thalassemic patients. These mutatio...

Leiomyomas are benign tumors of smooth muscle origin that can occur at any location in the urinary tract. Although rare, they are the most common mesenchymal neoplasms of the urethra. They are more frequent in females than in males. Only 3 cases of leiomyomas of the male urethra and multiple cases in the female have been reported in the English-lan...

Sickle cell disease (SCD) is an inherited autosomal recessive disorder of the beta-globin chain. Despite the fact that all subjects with SCD have the same single base pair mutation, the severity of the clinical and hematological manifestations is extremely variable. This study examined for the first time in Lebanon the correlation between the clini...

To determine the prevalence of reproduction-related illnesses in a rural community in Lebanon. Data were collected through interviews with women in their homes, physical examinations and history taking by physicians in a clinic in the community, and laboratory tests. A total of 557 ever-married women aged 15-60 years were selected randomly. Just ov...

The purpose of this study was to determine the prevalence of human papillomavirus (HPV), and more specifically of HPV 16, in a group of Lebanese women. Type-specific prevalence of cervical HPV and the presence of cytological abnormalities were determined in a cohort of Lebanese women. The population included 1,026 women, 18-76 years, seeking routin...

To evaluate the immediate neonatal outcome and the presence of various placental lesions in 96 pregnancies with meconium-stained amniotic fluid. The patients were divided into a group with acute (N = 41) and subacute and chronic (N = 55) meconium staining of the placenta. Apgar scores, arterial cord pH and admission to the neonatal intensive care u...

Objective.The purpose of this study was to prospectively follow a group of women with breast cancer, on tamoxifen, for the development of endometrial pathologies.Materials and methods. Eighty women with breast cancer, on tamoxifen, were prospectively followed every 6 months with pelvic examination, Pap smear, vaginal ultrasound, and endometrial bio...

Objective.The purpose of this study was to prospectively follow a group of women with breast cancer, on tamoxifen, for the development of endometrial pathologies.Materials and methods. Eighty women with breast cancer, on tamoxifen, were prospectively followed every 6 months with pelvic examination, Pap smear, vaginal ultrasound, and endometrial bio...

A 74-year-old woman presented with vaginal spotting secondary to transitional cell carcinoma six years following cystectomy for invasive, yet localized, transitional cell carcinoma of the bladder. This represents primary, not metastatic, tumor of the vagina.

We compared the DNA content (DI) by cell image analysis with the karyotype and morphological phenotype of paraffin-embedded tissues from 51 spontaneous abortions. The study included 21 cases with triploid, 19 cases with diploid, and 11 cases with aneuploid (monosomic, trisomic, or mosaic) karyotype. Measurements were performed by image analysis on...

The objective of this study was to investigate the sequence of alterations in the structure of the right ventricular wall in the setting of sustained pulmonary hypertension. Pulmonary Hypertension in the rat was initiated and sustained by a single subcutaneous injection of 80 mg/kg of Monocrotaline (MCT). Right ventricular wet weight (RV), left ven...

We determined the intrauterine insemination (IUI) pregnancy outcome in the same group of patients when applying different methods of ovulation induction. A group of patients with unexplained (no. 46) and male factor infertility (no. 101) consented to have the following treatment protocol at the American University of Beirut-Infertility Center: IUI...

The clomiphene citrate challenge test (CCCT), a means of assessing ovarian reserve, was shown by several studies to have an excellent predictive value for achieving conception in natural cycles, during ovulation induction and in-vitro fertilization cycles. Accordingly we elected to study the cycle to cycle variability of CCCT so as to determine the...

A 58-year-old woman underwent abdominal hysterectomy and bilateral salpingo-oophorectomy for stage Ib, grade 2 endometrial adenocarcinoma followed by external pelvic irradiation. Five years later she presented with a 7 cm solitary infraumbilical incisional tumor recurrence that was resected. Histology of the tumor implant was similar to that of the...

DNA quantitation by flow cytometry was used in this study to determine prognosis in stage I adenocarcinoma of the uterine cervix with negative pelvic lymph nodes. DNA content and proliferation index were determined by flow cytometry on formalin-fixed, paraffin-embedded tissue from 29 patients with stage I, pelvic lymph node-negative adenocarcinoma...

Epithelial ovarian tumors commonly occur after menopause. They are uncommon before 20 years of age and rarely occur before puberty. While Norris and Jensen (1) found no epithelial tumors among 54 patients with ovarian tumors aged less than nine years and one among 82 patients aged 10 to 14 years, there are few individual case reports of ovarian cys...

Very large cervical polyps are rarely reported. A giant cervical polyp, 17 x 10 x 5 cm, protruded through the vaginal introitus in a 27-year-old, sexually inactive woman. Although carcinomatous change occurs in 1.7% of cervical polyps, malignant degeneration did not occur in the six reported cases. Thus, biopsy of these tumors before excision may n...

Primary malignant lymphoma of the female urethra is a rare entity. Five cases of non-Hodgkin's lymphoma of the female urethra have been previously reported. We report another case presenting with a urethral caruncle. A review of the literature is included.

To evaluate the prognostic significance of three-dimensional determination of tumor size in stage I cervical adenocarcinoma. Tumor volume was measured using hematoxylin and eosin-stained sections of cone biopsy and hysterectomy specimens from 36 patients with stage I adenocarcinoma of the cervix. The volume was then correlated with pelvic lymphatic...

Ectopic pregnancy is suspected when a pregnancy test is positive and an Arias-Stella phenomenon with decidua is seen on endometrial curettings in the absence of chorionic villi and trophoblast. We performed immunoperoxidase stains for beta-hCG, hPL, placental alkaline phosphatase, and keratin (AE1/AE3) on endometrial curettings of 72 patients with...

Rapidly increasing testosterone levels were observed in a patient presenting with sudden onset of virilization. Exploratory laparotomy revealed a placental site trophoblastic tumor in the uterus. Wedge biopsies of the ovaries showed extensive luteinization of the ovarian stroma in both ovaries. Concentrations of testosterone, dihydrotestosterone, a...