Uterine Sarcoma: Analysis of Prognostic variables in 40 cases / 대한산부인과학회지

OBJECTIVE: Uterine sarcomas are rare tumors of mesodermal origin and constitute 2-6% of uterine malignancies. They are the most malignant group of uterine tumors and present difficult problems with regard to diagnosis and treatment. The aim of this study is to investigate the clinicopathologic finding and outcome of patients with uterine sarcoma. METHODS: From Jan. 1996 to Dec. 2004, 40 patients with histologically proven uterine sarcomas at Gospel Hospital were evaluated for their clinical profile and survival retrospectively. RESULTS: The age of patients with uterine sarcoma ranged 28 to 71 years, and the mean age was 48.0 years. The common presenting symptoms were abnormal uterine bleeding, abdominal pain and lower abdominal palpable mass. The overall 5-year survival rate of uterine sarcoma was 48.9% and the mean survival time was 73.6 months. The overall 5-year survival rate of 24 patients less than 50 years was significantly better than that of 16 patients more than 50 years, 69.1% vs 24.6% (P=0.0139). When classified according to histologic type, there were 21 cases (52.5%) of leiomyosarcoma (LMS), 8 cases (20.0%) of endometrial stromal sarcoma (ESS), 10 cases (25.0%) of malignant mixed mullerian tumors (MMMT) and 1 case (2.5%) of liposarcoma. The overall 5-year survival rate of MMMT was significantly worse than that of LMS and ESS, 26.7% vs 49.0% and 100.0%, respectively (P=0.0423). Classifying according to the FIGO surgical staging criteria, we found the following distribution; stage I of 26 cases (66.7%), stage II of 4 cases (10.3%), stage III of 5 cases (12.8%) and stage IV of 4 cases (10.3%). The overall 5-year survival rate of stage I and II was significantly better than stage III and IV, 61.8% vs 11.1% (P=0.0011). The overall 5-year survival rate of 14 patients less than 10 mitotic figures per 10 high-power microscopic fields had a tendency to good prognosis than that of 13 patients more than 10 mitotic figures per 10 high-power microscopic fields, 83.9% vs 38.5% (P=0.0568). The overall 5-year survival rate of 6 patients less than 35 U/mL of CA-125 had a tendency to good prognosis than that of 12 patients more than 35 U/mL of CA-125, 83.3% vs 20.8% (P=0.0580). However, menstrual status and treatment modality were not significant prognostic factors. CONCLUSIONS: Uterine sarcoma are aggressive tumors with a poor prognosis. Age, histologic type, and stage were statistically significant prognostic factors for overall survival in uterine sarcomas.

A Case of Pelvic Actinomycosis with Intestinal Fistula / 대한산부인과학회잡지

Pelvic actionomycosis is a chronic suppurative and granulomatous disease with multiple abscess and draining sinus tracts caused by Actinomyces, a Gram-positive, non-acid-fast, anaerobic bacterium. Actinomycosis is a rare disease, especially in the female genital tract, which is confused with malignancy and other inflammatory diseases because of its infiltrative nature and its tendency to invade normal anatomic barriers. We have experienced a case of pelvic actinomycosis with intestinal fistula and report it with brief review of literatures.

Intravenous Leiomyomatosis with Intracaval Mass, Intracardiac Extension, and Pulmonary Metastasis: A Case Report / 대한산부인과학회잡지

Intravenous leiomyomatosis (IVL) with intracaval mass, cardiac extension, and pulmonary metastasis is rare and it is characterized by nodular masses of smooth muscle proliferation that may extend to variable distances. We experienced a case of the intravenous leiomyomatosis originating from the uterus and extending to the ovarian veins, the iliac veins, the inferior vena cava, the right atrium and the lung. And it was diagnosed from the various preoperative studies and operated successfully through the single-stage approach. So we report it with a brief review of the literature.

A Case of Leiomyoma of the Vagina / 대한산부인과학회잡지

The leiomyoma of the uterus is most common benign genital tumor in women of reproductive age but occurs in the vagina rarely and may be confused with a variety of vaginal tumors. A preoperative diagnosis is seldom made. Recently we experienced a case of vaginal leiomyoma arising in the anterior vagina wall and concomitant uterine leiomyoma, so we report this case with a brief review of literature.