ABSTRACT
Schwannoma commonly arises from Schwann cells of the neural sheath, and is rare in the groin region. Here, we describe a vaginal schwannoma incidentally detected by magnetic resonance imaging (MRI) in a patient with thigh pain. A 43-year-old woman presented with thigh pain with burning and tingling sensations in the medial aspect of her left thigh. MRI revealed a mass lesion of heterogeneous intensity 5.2 x 5.7 cm in the left vaginal wall. The mass was resected and histology revealed schwannoma.
Subject(s)
Adult , Female , Humans , Burns , Diagnosis , Groin , Magnetic Resonance Imaging , Neurilemmoma , Schwann Cells , Sensation , Thigh , Vaginal NeoplasmsABSTRACT
El cáncer de vagina es una neoplasia rara, que constituye un 1% del cáncer genital femenino, aunque ha aumentado su incidencia en los últimos años. El manejo quirúrgico, adyuvante y reconstructivo resulta importante en el resultado oncológico y funcional de la enfermedad, pero puede comprometer la anatomía y función vaginal, y la de los órganos adyacentes. El avance en las terapias quirúrgicas y adyuvantes en pacientes más jóvenes ha conducido a una mayor supervivencia, implicando la necesidad de un mejor manejo del defecto anatómico de la lesión o de las secuelas de su tratamiento. Debe intentarse siempre que sea necesario un manejo multidisciplinario, desde la primera intervención, incluyendo la técnica reconstructiva correspondiente al defecto. Se presenta un caso de manejo conjunto oncológico y reconstructivo, mediante colgajo unilateral en flor de loto de un defecto vulvar crónico, originado tras el manejo de un cáncer vaginal primario previo.
Vaginal cancer is a rare neoplasm which makes up 1% of female genital cancer; however, its incidence has risen in the past few years. Adjuvant and reconstructive surgical management prove to be important in the oncologic and functional outcome of the disease, but may involve anatomy and function in the vagina, as well as in adjacent organs. Breakthroughs in surgical and adjuvant therapy have led to greater survival rates among younger patients, thus implying a greater need for improved management of the anatomical defect in the lesion or of treatment side effects. An effort should always be made towards interdisciplinary management, from the initial interven tion, including the corresponding reconstructive technique used on the defect. A case is presented on the combined oncologic and reconstructive management achieved by means of a lotus flower unilateral flap for a chronic vulvar defect brought about by previous primary vaginal cancer.
Subject(s)
Humans , Adult , Female , Surgery, Plastic/methods , Neoplasms, Squamous Cell , Vaginal Neoplasms/surgery , Surgical Flaps , Colombia , Chemotherapy, Adjuvant/methodsABSTRACT
El carcinoma primario de vagina es una neoplasia poco frecuente, representando solamente el 1-2 por ciento de todos los tumores malignos del área ginecológica. Según la FIGO solo se considera como cáncer primario de vagina a aquellas lesiones confinadas a la vagina sin invasión del cuello uterino o la vulva. El pronóstico depende principalmente del estadio en que se encuentra la enfermedad, pero la supervivencia se reduce en pacientes mayores de 60 años de edad, si son sintomáticos al momento del diagnóstico, tienen lesiones del centro y tercio inferior de la vagina o tienen tumores mal diferenciados. Los objetivos de este estudio fueron evaluar la experiencia en el manejo del cáncer primario de vagina, identificar variables demográficas y clínicas, mostrar la variedad histológica de presentación de esta neoplasia tan rara, así como el grado de diferenciación en cada caso. Igualmente relacionar estadio del cáncer, tratamiento y respuesta en cada una de las pacientes. Se trata de un estudio retrospectivo de cinco pacientes con cáncer primario de vagina atendidas en el Servicio de Patología de cuello del Hospital Ramón González Coro, durante el año 2008. La evaluación inicial consistió en una historia clínica completa, examen físico haciendo hincapié en el área ginecológica descartando lesiones en vulva o cuello uterino. A todas las pacientes se les realizó biopsia excisional del tumor, enviando la muestra al estudio histopatológico. Se les realizó cistoscopia, rectoscopia, urograma descendente, a aquellas pacientes con sospecha de infiltración de vejiga o recto, laboratorio, radiografía del tórax y se estadiaron según la clasificación de la FIGO
The primary vaginal carcinoma is a uncommon neoplasm present only in the 1-2 percent of all the malignant tumors of gynecology area. According to International Federation of Gynecology and Obstetrics only is considered as a primary vaginal cancer of those lesions confined to vagina without invasion of cervix or the vulva. The prognosis depends mainly on the disease stage, but the survival is reduced in patients aged over 60 if they are symptomatic at diagnosis, have lesions of the center and the inferior third of vagina or have ill-differentiated. The objectives of present study were to assess the experience in the vaginal primary cancer management, to identify demographic and clinical variables, to show the histological variety of presentation of this so rare neoplasm, as well as the differentiation grade of each case and to relate the cancer stage, the treatment and the response of each patient. It is retrospective study conducted in 5 patients presenting vaginal primary cancer seen in the Cervix Pathology Service of the am Ramon González Coro Gynecology and Obstetrics Hospital during 2008. The initial assessment included a complete medical record, physical examination with emphasis in the gynecological area ruling out vulva or cervix uteri lesions. All patients underwent excision biopsy of tumor with the corresponding histopathological study of the sample. A cystoscopy, rectoscopy descending urogram were carried out in those patients with a possible bladder or rectum infiltration, lab tests, thorax Rx staged according the International Federation of Gynecology and Obstetrics classification