ABSTRACT
@#Gestational trophoblastic neoplasia (GTN), a malignancy arising from trophoblastic tissue of pregnancy, is an aggressive disease process with a high probability of metastasis if left untreated. This is a case report on metastatic invasive mole arising from a molar pregnancy. Four months after suction curettage, a mass was noted in the left broad ligament on exploratory laparotomy with intact uterine serosa. Clinical presentation, biochemical, and radiological parameters led to a diagnosis of persistent trophoblastic disease. Histopathological findings also confirmed the diagnosis. Prompt chemotherapy was given after removal of the left intraligamentary mass, and subsequent response to treatment was documented. We report a case demonstrating a different clinical presentation of invasive mole and its potential to metastasize to the broad ligament without uterine perforation or direct extension.
ABSTRACT
Background@#Cervical cancer is the most common gynecologic malignancy in the Philippines despite being a preventable disease. Radical hysterectomy with pelvic lymphadenectomy is considered the standard surgical treatment of choice for patients with cervical cancer confined to the cervix up to the upper vagina. However, recent studies show that a less radical approach can be offered to these patients with comparable outcomes to radical hysterectomy, but with lesser perioperative and post-operative morbidity.@*Objectives@#The purpose of this study was to compare the outcomes in terms of recurrence and survival among cervical cancer patients who underwent simple hysterectomy and radical hysterectomy seen in a tertiary government hospital.@* Methods@#The records of all cervical cancer patients who underwent radical hysterectomy and simple hysterectomy for the past ten years were reviewed.@*Results@#The incidence of cervical cancer patients who underwent simple hysterectomy from 2009-2018 is 0.37 per 100 person years or 0.592:16, lower than 1:16 ratio from 1964-1974, as reported by Manalo and Sotto.1 Only 9 out of 42 patients who underwent simple hysterectomy had cervical cancer screening within 1 year prior to surgery.@*Conclusion@#The most common indication for surgery was myoma uteri. Those who underwent radical hysterectomy had better recurrence free survival and overall survival than those who had simple hysterectomy.
Subject(s)
Female , Uterine Cervical Neoplasms , HysterectomyABSTRACT
Background@#Early stage ovarian cancer may be managed with fertility-sparing surgery, to preserve the uterus and contralateral ovary, thus preserving future reproductive function. The aim of this study was to determine the reproductive outcome of early stage ovarian cancer managed conservatively by unilateral salpingooophorectomy, and to compare the survival and recurrence rate among those who had and did not have pregnancy after treatment. @*Methodology:@#A retrospective cohort study was conducted on 34 patients with early stage ovarian cancer who underwent fertility-sparing surgery from January 2005 to December 2018. Fertility outcome following treatment was determined. Survival and recurrence rate was analyzed between those who had and did not have pregnancy after surgery.@*Results@#A total of 34 out of 661 (5.14%) new cases of ovarian cancer who underwent fertility-sparing surgery were analyzed, with a mean age of 23.71 ± 5.57 years (range: 12-36 years old), with the most common complaints of increasing abdominal girth (11/34, 32.35%) or palpable abdominal mass (11/34, 32.35%). Successful pregnancy was seen in 9 cases (26.47%), with 2 of them currently pregnant. Overall recurrence and survival rates were 14.71% and 91.18%, respectively. There was no statistically significant difference in the survival rate (88.89% vs 92%, p-value 0.7778) and rate of recurrence (22.22% and 12%, p-value 0.4578) between those who got pregnant after fertility-sparing surgery for early stage ovarian cancer, FIGO Stage IA and IC, compared to those who did not get pregnant.@*Conclusions@#Fertility-sparing surgery can be effectively offered to young patients with early stage ovarian cancer, to preserve reproductive function, with 26.47% successful pregnancy rate. Pregnancy had no significant effect on recurrence and survival among FIGO stage IA and IC ovarian cancer who underwent fertility-sparing surgery by unilateral salpingooophorectomy.
Subject(s)
Fertility , Health Services , Ovarian NeoplasmsABSTRACT
@#Mucoepidermoid Carcinoma (MEC) is an epithelial malignant tumor that was first described as a salivary gland malignancy. Though common in salivary gland, it is extremely rare in the vulva with only 2 cases reported in the English language literature and none yet in the Philippines. Due to its low incidence, prognosis and definitive management is still unclear. This is a case of a 68-year-old woman with a history of vulvar pruritus and vulvar mass at the left labia majora. Punch biopsy and review of slides revealed Invasive Squamous Cell Carcinoma, Non-Keratinizing type. She underwent Radical Vulvectomy and Bilateral Lymph Groin Dissection; Wide Excision of Perineal Area; Protective Transverse Loop Colostomy; Gracilis Myocutaneous Flap with Identification of Right and Left Median Circumflex Artery with a final histopathology report of Primary Cutaneous MEC of the vulva with lymph node metastasis.