A Case of Metastatic Malignant Melanoma of the Ovary / 대한산부인과학회잡지

A case of metastatic malignant melanoma of ovary with malignant melanoma of skin is rare. The tumor was discovered 17months following excisional biopsy of left hand for malignant melanoma of the skin. Primary ovarian malignant melanomas are extremely rare and are thought to originate in teratomas. Ovarian melanoma without evidence of residual teratoma must be considered metastatic even in the absence of a previously identifiable cutaneous or mucocutaneous lesion. We had experienced a case of metastatic malignant melanoma of ovary and presented with a brief review of literature.

The Clinical Significance of High Risk HPV Infection and Positive Margin of LEEP in the Management of CIN III / 대한산부인과학회잡지

OBJECTIVE: To determine the significance of high risk human papilloma virus (HPV) infection and involvement of the resection margins of cervical cone biopsy specimens removed by loop electrosurgical excision procedure (LEEP) in the management of cervical intraepithelial neoplasia (CIN III). METHODS: Records of 506 LEEP procedures performed due to abnormal Pap result between December 1995 and December 1998 were reviewed. Among them, 232 cases with histologically proven as CIN III in LEEP and follow-up Pap smear more than 6 months was available were assessed. All patients were assigned according to HPV infection and resection margin involvement in LEEP, and recurrence rate in the follow-up was compared with reference to post-LEEP treatment regimen, observation or hysterectomy in each group. RESULTS: Of 232 cases reviewed, 10 cases(4.3%) were ASCUS, 19 cases(8.2%) were LSIL, 199 cases(85.8%) were HSIL, and 4 cases(1.7%) were invasive cancer in initial Pap smear. Abnormal Pap result in the follow-up was as follows: 4 cases of ASCUS, no case of LSIL, and 6 cases of HSIL. Excluding ASCUS, the overall recurrence rate in the follow-up was 2.6%(6/232). HPV positive was 164(70.7%) and HPV negative was 68(29.3%) in the LEEP specimen. Of 164 HPV positive, 41 were followed up without further treatment and 123 with hysterectomy. There was no significant difference in the recurrence rate between the two groups(P=0.41). Of 68 HPV negative, 27 were only followed up and in 41, hysterectomy was done. And also, there was no significant difference(P=0.32). Of 232 cases, resection margin was positive in 167(72.0%) and negative in 65(28.0%). Of 65 margin negative, 29 were followed up without further treatment and 36 with hysterectomy. There was no significant difference in the recurrence rate between the two groups(P=0.36). Among 167 margin positive, 39 were only followed up and in 128 hysterectomy was done. Recurrence rate was significantly higher in followed up only group(P=0.04). CONCLUSION: HPV infection in LEEP specimen was not helpful in deciding post LEEP treatment modality in CIN III patient. But, when resection margin was positive, hysterectomy should be performed because by doing so, recurrence rate was significantly lower than when only follow up was done.

The Programming of Chemotherapy Order System in Gynecology Oncology / 대한부인종양콜포스코피학회잡지

As a part of plan to construct a multifunctional hospital information system, we planned to develop a chemotherapy order system. First, a software developing team was established which is composed of gynecologic oneology staffs, special pharmacists and programmer who are responsible for OCS(Order Communication System). We set up and outline of this system after collecting various kinds of sources such as foreign examples, gathered protocol that are used for chemotherapy, and organized these protocol in programming the chemotherapy order system. This project is expected to provide accurate prescription, to shorten the time to prepare prescription, to standardize the protocol of chemotherapy within the medical center, to manage an effective dispensing schedule and to be used as a source for education and research.