DEPARTMENT OF PATHOLOGY

Andres A. Roma, M.D.

Andres A. Roma, M.D.

  • Associate Professor
  • M.D. – Buenos Aires University, 1998
  • Residency Training:
    • Center of Medical Education and Clinical Investigation, Anatomic Pathology (1999-2003)
    • Cleveland Clinic, Anatomic and Clinical Pathology (2003-2007)
  • Fellowship: MD Anderson cancer Center, Gynecological Pathology (2007-2008)
  • Board Certifications: Anatomic and Clinical Pathology
  • Clinical Specialty: Gynecologic, Genitourinary, Breast and Soft Tissue Pathology

Research Interests

My primary area of specialization is gynecological pathology, while my clinical focus includes also genitourinary pathology and soft tissue sarcomas. I have participated in single or multi-institutional studies primarily conducting translational-type research on gynecologic tract neoplasms. In the past, I have conducted research in uterine and ovarian lesions, including endometrial carcinoma, ovarian serous neoplasms, mesonephric lesions and mucinous and Brenner ovarian tumors amongst other gynecological lesions.

Recently, my interest has been devoted to study endocervical carcinoma and in developing a new risk stratification system to better predict the risk of lymph node metastasis in patients with these tumors, as well as demonstrate that patients with some of these tumors can be treated with conservative modalities, hence decreasing the morbidity and complications of lymphadenectomy.

In brief, endocervical adenocarcinoma can be stratified based on the morphological pattern of invasion into 3 groups: tumors characterized by well-demarcated glands with rounded contours, frequently forming clusters or groups and sometimes showing relatively well preserved lobular architecture are designated as pattern A. These tumors demonstrate a pushing or expansile pattern of invasion and behave in an indolent fashion. Tumors with early or limited, localized destructive invasion, defined as individual or small clusters of tumor cells or fragments of glands within a desmoplastic, edematous, or inflamed stroma adjacent to an intact gland are designated pattern B. These tumors have focal or multifocal areas characteristic of pattern B in a background of pattern A type glands.  Lymphovascular invasion may be seen in pattern B tumors. Less than 5% of patients with these tumors develop lymph node metastasis. While the tumors with more aggressive features, including diffusely infiltrative glands, usually associated with extensive, diffuse desmoplastic response are designated pattern C. Tumor glands show a destructive (or tentacular) pattern with angulated and often incomplete glands and open to the stroma. Most lymph node metastasis, recurrences and death due to disease occurred in patients with these tumors.

Representative Publications

  1. Diaz De Vivar A, Roma AA, Park KJ, Alvarado-Cabrero I, Rasty G, Chanona-Vilchis JG, Mikami Y, Hong SR, Arville B, Teramoto N, Ali-Fehmi R, Rutgers JK, Tabassum F, Barbuto D, Aguilera-Barrantes I, Shaye-Brown A, Daya D, Silva EG. Invasive Endocervical Adenocarcinoma: Proposal for a New Pattern-based Classification System With Significant Clinical Implications: A Multi-institutional Study. Int J Gynecol Pathol. 2013 Nov;32(6):592-601
  2. Roma AA, Masand R. Ovarian Brenner Tumors and Walthard Nests: A Histologic and Immunohistochemical study. Hum Pathol. 2014 Dec;45(12):2417-22.
  3. Roma AA, Masand RP. Different Staining Patterns of Ovarian Brenner Tumor and the Associated Mucinous Tumor. Ann Diagn Pathol. 2015 Feb;19(1):29-32.
  4. Roma AA, Diaz De Vivar A, Park KJ, Alvarado-Cabrero I, Rasty G, Chanona-Vilchis JG, Mikami Y,  Hong SR, Teramoto N, Ali-Fehmi R, Rutgers JKL, Barbuto D, Silva EG. Invasive Endocervical Adenocarcinoma - New Pattern-Based Classification System with Important Clinical Significance. Am J Surg Pathol. 2015 May;39(5):667-72
  5. Roma AA, Goyal A and Yang B. Differential Expression Patterns of GATA3 in Uterine mesonephric and Non-Mesonephric Lesions.  Int J Gynecol Pathol. 2015 Sep;34(5):480-6.
  6. Roma AA, Rybicki LA, Barbuto D, Euscher E, Djordjevic B, Frauenhoffer E, Kim I, Hong SR, Montiel D, Ali-Fehmi R, Malpica A, Silva EG. Risk Factor Analysis of Recurrence in Low-Grade Endometrial Adenocarcinoma. Hum Pathol. 2015 Oct;46(10):1529-39.
  7. Roma AA, Barbuto DA, Samimi SA, Stolnicu S, Alvarado-Cabrero I, Chanona-Vilchis J, Aguilera-Barrantes I, de Peralta-Venturina M, Malpica A, Rutgers JK, Silva EG. Vascular invasion in uterine sarcomas and its significance. A multi-institutional study. Hum Pathol. 2015 Nov;46(11):1712-21
  8. Roma AA. Patterns of Invasion of Cervical Adenocarcinoma as Predicators of Outcome. Adv Anat Pathol. 2015 Nov;22(6):345-54.
  9. Goyal A, Massand R, Roma AA. Value of PAX-8 and SF-1 Immunohistochemistry in the Distinction between Female Adnexal Tumors of Probable Wolffian Origin and its Mimics. Int J Gynecol Pathol. 2016 Mar;35(2):167-75.
  10. Roma AA, Mistretta TA, Diaz De Vivar A,  Park KJ, Alvarado-Cabrero I, Rasty G, Chanona-Vilchis JG,  Mikami Y, Hong SR, Teramoto N, Ali-Fehmi R, Barbuto D, Rutgers JKL, and Silva EG. New Pattern-Based Personalized Risk Stratification for Endocervical Adenocarcinoma with Important Clinical Implications and Surgical Outcome. Gynecol Oncol. 2016 Apr;141(1):36-42.
  11. Rutgers JK, Roma AA, Park KJ, Zaino RJ, Johnson A, Alvarado I, Daya D, Rasty G, Longacre TA, Ronnett BM, Silva EG. Pattern classification of endocervical adenocarcinoma: reproducibility and review of criteria. Mod Pathol. 2016 Jun 3. doi: 10.1038/modpathol.2016.94. [Epub ahead of print]

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Biography

Dr Roma earned his medical degree at the Buenos Aires University and completes Anatomic Pathology residency in his home country of Argentina. He continued his training in Anatomic and Clinical Pathology at the Cleveland Clinic followed by a Fellowship in Gynecological Pathology at the MD Anderson Cancer Center.

After two years as an attending at Washington University in St Louis, Dr. Roma was recruited back to Cleveland Clinic and stayed as an attending there for 6 years with clinical duties and research interests in Gynecological and Genitourinary Pathology. There he was promoted to Associate Professor of Pathology, was author of numerous publications and gave several lectures at national and international meetings including USCAP, ASCP, CAP and IAP/ESP.

Dr Roma was recently recruited to the University of California San Diego as an Associate Professor of Pathology and Associate Director of Surgical Pathology and continues his clinical duties as well as research endeavors.

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