ABSTRACT
Intravenous leiomyomatosis (IVL) is rare and it is characterized by intravascular nodular masses of benign smooth muscle that may extend to variable site such as uterus, pelvic veins, inferior vena cava, right sided heart and eventually lung. We experienced an unusual case of IVL originating from the uterus and extending to the lung parenchyma and treated by combined surgery, so we report it with a brief review of the literatures.
Subject(s)
Heart , Leiomyomatosis , Lung , Muscle, Smooth , Uterus , Veins , Vena Cava, InferiorABSTRACT
OBJECTIVE: The aim of this study is to determine the efficacy and toxicity of docetaxel in patients with recurrent or persistent epithelial ovarian cancer, previously treated with paclitaxel and platinum combination chemotherapy. METHODS: Forty patients with recurrent or persistent epithelial ovarian cancer, had been treated with docetaxel combination chemotherapy at Asan Medical Center from May 1989 to December 2006. They received docetaxel (75 mg/m2) only or docetaxel (75 mg/m2) and platinum (carboplatin AUC5 or cisplatin 75 mg/m2) on day 1. The administration was repeated every 3 or 4 weeks. The response of patients was evaluated with CA-125 response criteria and RECIST criteria. The toxicities were defined according to the NCI common toxicity criteria. RESULTS: Twenty patients had been evaluated by RECIST criteria and twenty patients had been evaluated by CA-125 response criteria. The overall response rate was 35% (14/40). Eleven patients were belonged to complete response (CR), and three patients were belonged to partial response (PR). The mean response duration (RD) was 11.29 months (4 to 20.7 months) and the mean time to progression (TTP) was 6.91 months (1 to 23 months). The response rate in the platinum-sensitive patients was 38.7% but in the platinum-resistant patients was 22.2%. The platinum-sensitive patients showed more favorable response rate, but that was not significant statistically. Heavily treated group, more than three prior regimens were used, had poor outcome. The common toxicities were alopecia and gastrointestinal toxicities (anorexia and nausea). Bone marrow suppression was the most serious drug toxicity, however, it was tolerable. CONCLUSION: The docetaxel is a considerable 2nd line chemotherapy with acceptable efficacy and toxicity in patients with recurrent or persistent epithelial ovarian cancer previously treated with paclitaxel and platinum combination chemotherapy.
Subject(s)
Humans , Alopecia , Bone Marrow , Cisplatin , Drug Therapy , Drug Therapy, Combination , Drug-Related Side Effects and Adverse Reactions , Ovarian Neoplasms , Paclitaxel , PlatinumABSTRACT
OBJECTIVE: To analyze the clinicopathologic characteristics, prognostic factors, and survival time of small cell carcinoma of the uterine cervix. METHODS: The medical records of 19 patients who were diagnosed with small cell carcinoma of the uterine cervix and whose initial treatment was between October 1996 and December 2004 were reviewed retrospectively. Clinicopathologic characteristics, FIGO stage (classification according to the International Federation of Gynecology and Obstetrics), tumor size, lymph node metastasis, treatments, and overall survival were analyzed. RESULTS: Mean age at diagnosis was 48.4 years. The overall survival time was 57.3 months, and 5-year survival rate was 52.6%. Twelve patients were in FIGO stage I or IIa and 7 were in FIGO stages IIb-IV. Immunohistochemical analysis showed positive staining for neuroendocrine marker, chromogranin and synaptophysin, in 17 patients, and negative in 2 patients. Tumor size at diagnosis was under 2 cm in 12 patients and over 2 cm in 7 patients. Disease recurred in 8 patients, and 9 patients died. Through analyzing Overall survival time, FIGO stage and tumor size were significant prognostic factors in small cell carcinoma of the uterine cervix. CONCLUSION: Our study found FIGO stage and tumor size were significant prognostic factors in small cell carcinoma of the uterine cervix.
Subject(s)
Female , Humans , Carcinoma, Small Cell , Cervix Uteri , Diagnosis , Gynecology , Lymph Nodes , Medical Records , Neoplasm Metastasis , Retrospective Studies , Survival Rate , SynaptophysinABSTRACT
OBJECTIVE: To evaluate the incidence, characteristics, and convalescence times of urinary tract injury after gynecological surgery, total abdominal hysterectomy (TAH), laparoscopic-assisted vaginal hysterectomy (LAVH), total vaginal hysterectomy (VH), radical hysterectomy (RH), and laparoscopic-assisted radical hysterectomy (LRH). METHODS: We retrospectively analyzed 109 patients with urinary tract injuries after total hysterectomy from May 1989 to April 2004. During the study period, 18,721 hysterectomies were carried out. RESULTS: The total incidence of urinary tract injury after total hysterectomy was 0.59%, as follows: TAH, 0.55%; LAVH, 0.64%; VH, 0.62%; RH, 0.69%; and LRH, 1.56%. The total incidence of bladder and ureteric injury was, respectively, 0.51 and 0.09%, as follows: TAH, 0.51 and 0.04%; LAVH, 0.57 and 0.07%; VH, 0.62 and 0%; RH, 0.21 and 0.49%; and LRH, 1.79 and 0.89%. There was no significant difference of the incidence of urinary tract injury type of operation with benign findings (P>0.05), but there was significant difference of the incidence of injury between type of operation with benign and malignant findings (P<0.05). The convalescence times were 10.3+/-8.7 days after bladder injury and 44.4+/-16.27 days after ureteric injury diagnosed intraoperatively, but 33.3+/-46.6 days after bladder injury and 69.0+/-16.4 days after ureteric injury diagnosed postoperatively. There was significant difference between both groups (P<0.05). CONCLUSION: In this study, total hysterectomy resulted in 0.59% incidence of urinary tract injury and repair of these injuries was successful in all cases. There was no significant difference for incidence of urinary tract injury between types of operation with benign findings, but there was significant difference between types of operation for benign and malignant findings. The convalescence times for intraoperatively recognized injuries were significantly shorter than those for injuries recognized postoperatively. 109, but significant difference between benign and malignant gynecological operations (P<0.05). Tintraoperatively recognized.
Subject(s)
Female , Humans , Convalescence , Gynecologic Surgical Procedures , Hysterectomy , Hysterectomy, Vaginal , Incidence , Retrospective Studies , Ureter , Urinary Bladder , Urinary TractABSTRACT
OBJECTIVE: Uterine papillary serous carcinoma (UPSC) is uncommon endometrial cancer, but clinically significant because of its poor prognosis. The aim of this study was to identify clinical and pathologic characteristics of patients with uterine papillary serous carcinoma and to evaluate the overall survival compared with endometrioid adenocarcinoma of uterus. METHODS: Twenty one patients with uterine papillary serous carcinoma and 332 patients with endometrioid adenocarcinoma who were surgically staged at the Asan medical Center between 1989 and 2004 were analyzed with review of clinical characteristics; pathologic findings, surgical stages, treatment modalities, prognosis and survival time from medical records and pathologic reports. RESULTS: In 21 patients with uterine papillary serous carcinoma, the median age at the time of diagnosis was 60.9 years (range, 38-81 years), which occurred in 18 postmenopausal women (85.7%) and usually presented with abnormal vaginal bleeding (75%). Obesity, diabetes, hypertension, or a history of hormone replace therapy, known as risk factors of endometrial cancer, were not so frequently associated. In 21 patients with uterine papillary serous carcinoma, there were 10 patients (47.6%) with stage I disease, 2 (9.5%) with stage II, 5 (23.8%) with stage III, and 4 (19.1%) with stage IV. The 3-year survival rate was 97.4% in endometrioid adenocarcinoma and 43.1% in uterine papillary serous carcinoma in all stages. Among 21 patients with uterine papillary serous carcinoma who had surgical staging, 3 patients received only operation and 9 patients received radiation therapy after surgery, 6 patients received chemotherapy and 3 patients received concurrent chemotherapy and radiation therapy. CONCLUSION: Patients with uterine papillary serous carcinoma showed a higher rate of abdominal metastasis and poor prognosis compared to patients of endometrioid adenocarcinoma. Therefore, complete surgical staging like in cases of ovarian cancer is vital in determining disease prognosis and vigorous adjuvant therapies are required.