Leiomiosarcoma primario vaginal en el embarazo. A propósito de un caso / Primary vaginal leiomyosarcoma in pregnancy. About A case

RESUMEN Los sarcomas primarios de vagina son extremadamente raros especialmente durante la gestación. Se presenta el caso de una gestante de 25+2 semanas que acude a urgencias con clínica de sangrado vaginal objetivándose a la exploración una formación nodular dependiente de pared vaginal derecha. Dada la clínica se reseca en quirófano con el hallazgo histopatológico de leiomiosarcoma. A la gestante se le realiza sin incidencias una cesárea en la semana 34 de gestación, previa maduración pulmonar fetal, completándose en el puerperio inmediato el estudio de extensión sin encontrarse ningún hallazgo relevante. Finalmente, se somete a la paciente a una histerectomía y salpinguectomía bilateral con preservación ovárica. El seguimiento y los controles sucesivos de la gestante en los meses posteriores muestran ausencia de enfermedad.

ABSTRACT Primary sarcomas of the vagina are extremely rare, especially during pregnancy. We report a case of a 25-week-pregnant who came to emergency room complaining of vaginal bleeding. Pelvic examination revealed a globular mass located on the right vaginal wall. Given the persistent bleeding, resection of the mass was performed. The specimen was sent to pathology and confirmed to be a leiomyosarcoma. At 34-weeks of pregnancy after fetal lung maturation a cesarean section is done. It was completed the extension study during immediate postpartum without any relevant finding. Finally, she had a totally hysterectomy and bilateral salpingectomy with ovarian preservation. Clinical follow-up over the following months shows no evidence of disease.

Carcinoma neuroendocrino primario de vagina. Revisión de literatura a propósito de un caso / Primary neuroendocrine carcinoma of the vagina. Literature review on the subject of a case

RESUMEN El carcinoma primario de vagina representa 1 a 2% de los cánceres ginecológicos, siendo la diferenciación histológica neuroendocrina de células pequeñas extremadamente infrecuente, sólo se han reportado 28 casos en la literatura, describiéndose en orden de frecuencia en cérvix, endometrio, ovario, vagina y vulva. Se observa con más frecuencia en mujeres postmenopáusicas. Se presenta el caso de paciente femenino, de 39 años de edad, quien acude a la consulta por presentar secreción genital serohemática, fétida, de 1 mes de evolución, evidenciándose al examen físico lesión exofítica, friable, renitente, de aproximadamente 4 cm de diámetro, en tercio superior y cara posterolateral izquierda de vagina, por lo que se realiza biopsia excisional de dicha lesión, siendo el diagnóstico anatomopatológico carcinoma neuroendocrino de células pequeñas, grado histológico: 3. A propósito de este caso, se realiza una revisión del tema, haciendo hincapié en la importancia de la exploración ginecológica exhaustiva que incluya tomas de citologías y colposcopias periódicas, tomando en cuenta la vagina y así, realizar diagnóstico precoz en vista que el riesgo de carcinoma en dicha zona es infrecuente, mejorando el pronóstico y sobrevida de las pacientes.

ABSTRACT The primary carcinoma of the vagina represents 1 to 2 % of gynecologic cancers, being the histological differentiation neuroendocrine of small cells extremely infrequent, only 28 cases have been reported in the literature, describing in order of frequency: in the cervix, endometrium, ovary, vagina and vulva. It is most commonly seen in postmenopausal women. We present the case of a female patient, 39 years old, who comes to medical consult due to serohematic, fetid, genital discharge of 1 month of evolution, evidencing at physical examination an exophytic lesion, friable, renitent, with a diameter of approximately 4 cm, in the upper third and posterolateral left side of the vagina, for which an excisional biopsy of said lesion is performed, being the anatomopathological diagnosis neuroendocrine carcinoma of small cells, histological grade: 3. A bibliography reviewed was made, emphasizing the importance of exhaustive gynecological exploration with periodic cytology and colposcopy examinations, including the vagina for early diagnosis in view of carcinoma risk in this area is uncommon, improving the prognosis and survival of patients.

Cervical cancer screening in young and elderly women of the Xingu Indigenous Park: evaluation of the recommended screening age group in Brazil / Rastreamento do câncer de colo uterino em jovens e idosas do Parque Indígena do Xingu: avaliação quanto à faixa etária preconizada no Brasil

Objective To analyze the occurrence of atypia in the cytology/histology examinations of young women under the age of 25 years and of elderly women aged over 64 years, in the Xingu Indigenous Park and to evaluate, in a subjective manner, if the age range for screening established by the Ministry of Health and the Instituto Nacional de Câncer is appropriate for this population. Methods The Xingu/UNIFESP Project, in partnership with the Center for Gynecological Disease Prevention, develops programs to prevent cervical cancer. The exploratory, retrospective and descriptive study of cytological and histopathological examinations of young (12-24 years) and elderly (aged 64 and over) women of the Xingu Indigenous Park, between 2005 and 2011. Results There was low occurrence of cytological atypia in the elderly female population, but there were occasional high-grade lesions in the indigenous youth. Conclusion Interrupting screening at the limit age of 64 years, as established by the Ministry of Health and the Instituto Nacional de Câncer is justified. However, screening of young women should begin at an earlier age. .

Objetivo Analisar a ocorrência de atipias nos exames citológicos e histológicos de jovens e idosas indígenas, e também avaliar se a faixa etária preconizada pelo Ministério da Saúde e pelo Instituto Nacional de Câncer em rastreamento do câncer de colo uterino é adequada para essa população. Métodos O Projeto Xingu/UNIFESP, em parceria com o Núcleo de Prevenção de Doenças Ginecológicas, desenvolve programas de prevenção do câncer do colo de útero. Foi realizado estudo exploratório, retrospectivo e descritivo de exames cito/histopatológicos em jovens do Parque Indígena do Xingu de 12 a 24 anos e em idosas a partir dos 64 anos, no período de 2005 a 2011. Resultados Em idosas, houve baixa ocorrência de atipias citológicas, mas nas jovens indígenas, ocorreram casos eventuais de lesão de alto grau. Conclusão Justifica respeitar o limite de 64 anos para a interrupção do rastreamento, como o estabelecido pelo Ministério da Saúde/Instituto Nacional de Câncer, mas, nas jovens, seria importante iniciar o rastreamento mais precocemente. .

Aggressive angiomyxoma of the vagina: a case report / Angiomiosarcoma agressivo da vagina: relato de caso

Aggressive angiomyxoma is a rare, slow-growing soft tissue tumor that usually arises in the pelvis and perineal regions of women in reproductive age, with a marked tendency to local recurrence. Because of its rarity, it is often initially misdiagnosed. Surgical resection is the main treatment modality of aggressive angiomyxoma. We describe a case of a vaginal aggressive angiomyxoma in a 47-year-old woman in which the diagnosis was only made after histological examination. The etiology, presentation, diagnosis and management of this rare tumor are outlined. Angiomyxoma of vulva and vagina refers to a rare disease. Pre-operative diagnosis is difficult due to rarity and absence of diagnostic features, but it should be considered in every mass in genital, perianal and pelvic region in a woman in the reproductive age. Thus, these cases should have complete radiological workup before excision, as pre-diagnosis can change the treatment modality and patient prognosis'.

O angiomixoma agressivo é tumor raro de tecidos moles, de lento crescimento e que geralmente ocorre na pelve e nas regiões perineais de mulheres em idade reprodutiva, com forte tendência à recorrência local. Devido à sua raridade, ele é frequentemente mal diagnosticado. A exerese cirúrgica é a modalidade principal para o tratamento do angiomixoma agressivo. Descrevemos aqui um caso de angiomixoma vaginal agressivo em mulher de 47 anos de idade, que foi diagnosticado apenas após exame histológico. Descrevemos também a etiologia e apresentação, bem como o diagnóstico e tratamento desse raro tumor. O angiomixoma da vulva e vagina constitui doença rara. Devido à raridade desse tumor e à ausência de elementos diagnósticos, o diagnóstico pré-operatório é difícil, mas deveria ser considerado na presença de qualquer massa na região genital, perianal e pélvica de mulheres em idade reprodutiva. Portanto, esses casos deveriam ser submetidos a propedêutica radiológica completa antes da exerese, uma vez que um pré-diagnóstico pode modificar a modalidade de tratamento e o prognóstico do paciente.

Linfoma no Hodgkin primario de vagina / Primary non Hodgkin's lymphoma of the vagina

La afectación primaria del tracto genital femenino de los linfomas no Hodgkin es poco frecuente (2 por ciento de los linfomas primarios extraganglionares). Los órganos más afectados son los ovarios seguidos del cérvix, siendo la localización endometrial y vaginal extremadamente rara. Presentamos el caso de una paciente de 44 años diagnosticada de linfoma primario de vagina, estadio IE A, con remisión completa tras tratamiento combinado quimioterápico y quirúrgico. Es importante tener presente estas raras aunque posibles localizaciones de linfomas para evitar que se puedan confundir con lesiones inflamatorias u otros tipos de tumores que nos lleven a un fracaso terapéutico.

Primary non-Hodgkin lymphomas rarely involve the female genital tract (2 percent of primary extranodal lym-phomas). The ovaries followed by the cervix are the most common affected sites while the involvement of the endometrium and vagina is extremely rare. We report the case of a 44 year old woman with a primary lymphoma of the vagina, stage IE A, with complete remission after combined chemotherapy and surgical treatment. These rare but possible locations must be kept in mind to avoid misdiagnosis with inflammatory lesions or other types of tumors which may lead us to a therapeutic failure.

Neoplasia vaginal intraepitelial / Vaginal intraepithelial neoplasia

Objetivo: actualizar los conocimientos disponibles sobre la neoplasia vaginal intraepitelial (VAIN) especialmente en el diagnóstico y tratamiento. Métodos: revisión de la literatura en Pubmed de los últimos 20 años, especialmente de los publicados desde 2005 hasta la actualidad y considerando sobre todo los ensayos clínicos aleatorizados. Resultados: su prevalencia real es desconocida, aunque es una patología rara generalmente en mujeres posmenopaúsicas. Su fisiopatología es similar a la neoplasia cervical intraepitelial, con el HPV como principal factor de riesgo, sobre todo el serotipo 16, pero su progresión a cáncer es menor. Un grupo importante es el de VAIN tras histerectomía, que supone el 48-70 por ciento del total de las VAIN. La colposcopia para el diagnóstico no es sencilla y se aconseja preparación con estrógenos en las pacientes menopáusicas y utilización de ácido acético y lugol para identificar las zonas sospechosas. Las tres opciones terapéuticas son la cirugía (excisional, láser, ultrasonidos), braquiterapia y tratamiento médico (imiquimod, 5-fluorouracilo, ácido tricloroacético). Se expone la técnica y las ventajas e inconvenientes de cada uno de ellos. Conclusión: aunque la VAIN es una entidad rara, es preciso tenerla en cuenta ante un diagnóstico de lesión citológica. Su diagnóstico a veces no es sencillo y el tratamiento dependerá del grado, la localización y el tamaño de la lesión y las circunstancias personales de la paciente. Se necesitan más ensayos aleatorizados que comparen la eficacia entre las distintas opciones terapéuticas y su repercusión en la calidad de vida de las pacientes.

Aims: update the knowledge about vaginal intraepithelial neoplasia (VAIN) with special emphasis on diagnosis and therapeutic management. Method: electronic search of Pubmed of all kinds of articles about the VAIN, for the last 20 years with special attention to those published from 2005 to the present and considering especially randomized clinical trials. Results: its prevalence is unknown, although it is a rare condition that usually occurs in postmenopausal women. The physiopathology is similar to cervical intraepithelial neoplasia, being HPV the main risk factor, particularly serotype 16, but its progression to cancer is lower. An important group is VAIN after hysterectomy, 48-70 percent of total VaIN. Colposcopy for the diagnosis is not easy and in patients with postmenopausal the preparation with local estrogen is necessary and use both of acetic acid and lugol to identify suspicious areas. The three treatment options are surgery (excisional, laser, ultrasound), brachytherapy and medical management (imiquimod, 5-fluorouracil, tricholoroacetic acid). The technique and the advantages and disadvantages of each are explained. Conclusion: although VAIN is rare, it must take it into account before a cytological diagnosis of dysplasia. Its diagnosis is sometimes not easy and the treatment depends on the extent, location and size of the lesion and the individual preferences of the patient. We need more randomized trials comparing different treatment options and also their impact on quality of life of patients.

Comparative study of the results from conventional cervico-vaginal oncotic cytology and liquid-based cytology / Estudo comparativo dos resultados obtidos pela citologia oncótica cérvico-vaginal convencional e pela citologia em meio líquido

OBJECTIVE: To compare two oncotic cervical cytology techniques, the conventional and the liquid-based cytology, in low risk patients for uterine cervical cancer. METHODS: Comparative prospective study with 100 patients who came to their annual gynecological exam, and were submitted simultaneously to both techniques. We used the McNemar test, with a significance level of p<0.05 to compare the results obtained related to adequacy of the smear quality, descriptive diagnosis prevalence, guided biopsy confirmation and histology. RESULTS: Adequacy of the smear was similar for both methods. The quality with squamocolumnar junction in 93% of conventional cytology and in 84% of the liquid-based cytology had statistical significance. As for the diagnosis of atypical cells they were detected in 3% of conventional cytology and in 10% of liquidbased cytology (p=0.06). Atypical squamous cells of undetermined significance were the most prevalent abnormality. The liquid-based cytology performance was better when compared with colposcopy (guided biopsy), presenting sensitivity of 66.7% and specificity of 100%. There was no cytological and histological concordance for the conventional cytology. CONCLUSIONS: Liquid-based cytology had a better performance to diagnose atypical cells and the cytohistological concordance was higher than in the conventional cytology.

OBJETIVO: Comparar duas técnicas de colpocitologia oncótica, a convencional e a em meio líquido, em pacientes de baixo risco para carcinoma de colo uterino. MÉTODOS: Trata-se de estudo prospectivo e comparativo, em que foram avaliadas cem mulheres que compareceram à consulta médica de rotina e foram submetidas simultaneamente à coleta pelas duas técnicas de citologia. Os resultados obtidos em relação à adequabilidade, à qualidade dos esfregaços, à prevalência nos diagnósticos descritivos e à confirmação com biópsia dirigida e histologia foram comparados pelo teste de McNemar, com nível de significância de p<0,05. RESULTADOS: A adequabilidade dos esfregaços mostrou-se semelhante. A qualidade, com presença de elementos da junção escamo-colunar em 93% das citologias convencionais e 84% das citologias em meio líquido, teve significância estatística. Nos diagnósticos de atipias, elas foram detectadas em 3% das citologias convencionais e em 10% das citologias em meio líquido (p=0,06), sendo as atipias em células escamosas de significado indeterminado a alteração mais prevalente. Quando comparadas à colposcopia com biópsia dirigida, o desempenho da citologia em meio líquido foi superior, com sensibilidade de 66,7% e especificidade de 100%, enquanto que, para a citologia convencional, não houve concordância cito-histológica. CONCLUSÃO: O desempenho em diagnosticar atipias e a concordância cito-histológica da citologia em meio líquido foram superiores ao da citologia convencional.

Mioepitelioma de vagina: neoplasia poco frecuente en esta localización, reporte de un caso / Myoepithelioma located in the vagina of a pregnant woman

Antecedentes: Los mioepiteliomas, son tumores poco frecuentes originados a partir de la proliferación de células mioepiteliales. La mayor parte localizados en las extremidades inferiores y en glándulas salivales. Existen ocasionales informes previos de MEP que involucren la vagina. Objetivo: Describir un caso de mioepitelioma localizado en vagina. Caso clínico: Embarazada de 29 años edad, quien presenta una masa vaginal de un año de evolución, localizada en el himen. El examen histopatológico muestra una lesión compuesta por células fusiformes con positividad inmunohistoquímica para vimentina, citoqueratinas (CK) AE1/ AE3, S100, CD10, receptores de estrógenos y progesterona, Bcl2 y calponina y negatividad para desmina, actina muscular especifica, actina de músculo liso y p63. Con los anteriores hallazgos se interpreta la lesión como un mioepitelioma primario vaginal. Conclusión: Los mioepiteliomas son tumores que requieren para su diagnostico, análisis con técnicas de inmunohistoquímica o ultraestructurales que permitan diferenciarlos de otros tumores.

Background: The myoepitheliomas are rare tumors arising from the proliferation of myoepithelial cells. Most tumors are located in the lower extremity and salivary glands. There have been only occasional myoepithelial neoplasms previously reported involving the vagina. Objective: Describe a case of myoepithelioma located in the vagina of a pregnant woman. Case report: A 29 years old pregnant female, who about 1 year prior has a vaginal mass, located in the hymen. At histopathological examination shows a mass composed of spindle cells with positivity immunohistochemical studies for vimentin, cytokeratin AE1/AE3, S100, CD10 and calponin and negative for desmin, actinmuscle specific (HHF35), smooth muscle actin and p63. With these findings it was established the diagnosis of myoepithelioma in the vagina. Conclusion: Myoepitheliomas are tumors requiring for diagnostic of immunohistochemistry or ultrastructural techniques that allow its differentiation from other tumors.

Round cell vaginal malignant melanoma. A rare entity

Malignant melanoma is predominantly a skin disease but in rare instances it may occur at other sites. A vaginal melanoma is a rare clinical entity and the round cell type is an uncommon variant. Although the present case was clinically diagnosed as a urethral caruncle, on histopathological examination and immunostaining it was diagnosed as a round cell pigmented malignant melanoma. The patient refused radical surgery and was given a full course radiotherapy treatment but died a year later. Malignant vaginal melanoma carries a very poor prognosis even when lesion is localised at the time of presentation. The five-year survival rate ranges from 10-20% with the prognosis being influenced by tumour size. A tumour size >/= 3cm has a poor prognosis. Age, mitotic count, stage, and location of the lesion do not influence survival rates

Opportunities for 2-18F Fluoro-2-Deoxy-D-Glucose PET/CT in Cervical-Vaginal Neuroendocrine Carcinoma: Case Series and Literature Review

OBJECTIVE: Neuroendocrine cervical carcinoma is a rare subtype of cervical cancer. These tumors exhibit an aggressive behavior with early regional lymph node and distant metastases. The purpose of our study was to describe five cases of neuroendocrine cervical-vaginal carcinoma and to discuss the potential of the 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan for the detection of this rare malignancy. MATERIALS AND METHODS: Five cases of cervical-vaginal neuroendocrine tumor were retrospectively collected, during a two year (from September 2009 to August 2011) period in our hospital. The clinical staging distributions were International Federation of Gynecology and Obstetrics (FIGO) stage IB2 (1 of 5), stage IIA (3 of 5) and stage IVA (1 of 5). RESULTS: Two cases (cases 1 and 4) were restaged after 18F-FDG PET/CT scan in the initial staging process. Post-treatment 18F-FDG PET/CT scans, in three patients, revealed positive findings for tumor recurrence or lymph node metastases. Two patients (cases 2 and 3) died of tumor within two years. CONCLUSION: 18F-FDG PET/CT scan is a useful tool in cervical-vaginal neuroendocrine tumor. In its initial staging, the 18F-FDG PET/CT scan may help assess the possible nodal involvement or early hematogeneous spreading. We can also use the 18F-FDG PET/CT to detect local recurrence and to evaluate the treatment response after clinical manipulation.

The effect of copaiba balsam on Walker 256 carcinoma inoculated into the vagina and uterine cervix of female rats / Efeito do óleo de copaíba no tumor de Walker 256 inoculado em vagina e colo de útero de ratas fêmeas

Purpose: To verify the copaiba balsam (Copaifera officinalis) effect on Walker 256 carcinoma inoculated into vagina and uterine cervix of rats. Methods: Eighteen female Wistar rats weighing between 180-250g were used, distributed into 2 groups (GCop, GC). On the 1st day of the experiment, 0.3 ml of Walker 256 carcinoma (2x10(6) concentration) was inoculated in both groups; on the 3rd day of the experiment, it was given 4.8 ml/kg of distilled water to the GC group, and 4.8 ml/kg of copaiba balsam to the GCop group. On the 12th day, euthanasia was performed and the tumor was grafted, being weighted and verified its volume. The data were submitted to statistical analysis with ANOVA test. Results: It was observed that copaiba balsam presented a negative inhibitory potential of 70 percent. Conclusion: The copaiba balsam stimulated the tumor growth.

Objetivo: Verificar o efeito do óleo de copaíba da espécie Copaifera officinalis no carcinoma de Walker 256 inoculado em vagina e colo de útero de ratas. Métodos: Foram utilizadas 18 ratas da linhagem Wistar, pesando entre 180-250g, distribuídas em dois grupos (CCop, GC). No 1º dia de experimento, em ambos os grupos foi inoculado 0,3ml de tumor de Walker 256 na concentração de 2x10(6); no 3º dia após essa inoculação, foi iniciada a administração de água destilada na dose de 4,8 ml/kg ao GC, e copaíba na dose de 4,8 ml/kg ao GCop. No 12º dia foi realizada a eutanásia das ratas e ressecado o tumor, sendo este pesado e averiguado seu volume. Os dados obtidos foram submetidos à análise estatística pelo método ANOVA. Resultados: Observou-se que o óleo de copaíba apresentou um potencial inibitório negativo de 70 por cento. Conclusão: O óleo de copaíba estimulou o crescimento tumoral.

Vaginal fibrosarcoma in cow [A case report]

A five-year-old Holstein cow with a history of vaginal prolapse was admitted to the Large Animal Clinic, Faculty of Veterinary Medicine, University of Tabriz. According to the owner, she had a 5-month history of vaginal prolapse and frequent sanguineous discharge from the vagina. Appetite was normal and its last parturition was two months ago. Clinical examination revealed a tumor like mass that attached to the vaginal roof and partly protruded through the vagina without any vaginal prolapse. After epidural anesthesia, the mass was surgically removed with some of the surrounding tissue. The dimensions of the mass were 5.2 x 4 x 3.4 cm. Macroscopically, it was relatively well circumscribed with a lobulated and ulcerated surface. In cut section, the mass was homogenously creamy in color. There were no foci of necrosis or hemorrhage. Microscopically, the growth was composed of spindle-shaped flbroblastic type tumor cells that formed interlacing and intersecting bundles. The neoplastic cells showed pleomorphism, karyomegaly and slight nuclear hyperchromatism. The mitotic index was less than five. Based on the site, biological behavior, immunohistochemistry results, macroscopic and microscopic characteristics, the mass was diagnosed as a well-differentiated fibrosarcoma. This is the first report of cow vaginal fibrosarcoma from Iran

The oophorectomy effect on Walker 256 tumor inoculated into the vagina and uterine cervix of female rats / Efeito da ooforectomia no tumor de Walker 256 inoculado em vagina e colo de útero de ratos fêmeas

PURPOSE: Verify the effect of oophorectomy on the evolution of the Walker 256 tumor inoculated into the vagina and cervix of female rats. METHODS: Ten Wistar, female rats were used, distributed into two groups with 05 animals each: Tumor group (TG): Rats inoculated with Walker 256 tumor; Oophorectomy group (OG): oophorectomized rats inoculated with Walker 256 tumor. The day before the tumor vaginal inoculation, acetic acid was inoculated into the vaginas of both groups of rats; the following day, the vaginal walls were scarified with an endocervix brush, and then Walker 256 tumor was inoculated. After 12 days, the tumor was removed together with the vagina and uterine horns for macro and microscopic analyses. The data were submitted to statistical analyses. RESULTS: There was no statistical difference between the two groups; however it was observed that the behavior of tumor growth on the OG group presented greater invasion, compromising the uterine horns. CONCLUSION: The results of the study on the GO group presented a macroscopic behavior different from the TG group, however, both of them presented similar development in terms of tumor mass.

OBJETIVO: Verificar o efeito da ooforectomia à inoculação do tumor de Walker 256 em vagina e colo de útero de ratas. MÉTODOS: Foram utilizadas 10 ratas Wistar, fêmeas, virgens, adultas, distribuídas em dois grupos de estudo com 05 animais cada: grupo tumor (GT): ratas inoculadas com tumor de Walker 256, e grupo Ooforectomia (GO): ratas ooforectomizadas e inoculadas com tumor de Walker 256. No dia anterior à inoculação vaginal do tumor, foram inoculados 0,3ml de ácido acético na vagina das ratas de ambos os grupos; no dia seguinte, foi realizada a escarificação da parede vaginal com uma escova de endocérvice e inoculado tumor de Walker 256. Após 12 dias, foi removido o tumor em bloco com vagina e cornos uterinos para análise macro e microscópica. Os dados foram submetidos à análise estatística. RESULTADOS: Não houve diferença estatística entre os dois grupos; no entanto, notou-se que o comportamento de crescimento do tumor no grupo GO apresentou maior invasividade em extensão, comprometendo cornos uterinos. CONCLUSÃO: Observou-se que o grupo GO apresentou comportamento macroscópico diferente ao grupo GT, no entanto, em termos totais de massa tumoral ambos apresentam desenvolvimento similar.

A clinicopathological study of malignant melanoma with special reference to atypical presentation.

Malignant melanoma is a tumor of melanocytic origin. Lymphatic and hematogenous metastases are common in this condition. Retrospective analysis was performed in 16 consecutive cases diagnosed histopathologically as malignant melanoma at the pathology department of a medial college in eastern India. 75% of the patients were male; majority of them was in their sixth decade. All (100%) the lesions were pigmented. The primary site was known in all cases, except two (12.5%). Out of the 14 cases with known primary site 11 (78.57%) were cutaneous melanomas, including one arising in labia minora, two (14.29%) were ocular and one (7.14%) was vaginal in origin. Among cutaneous melanomas, superficial spreading type was the commonest variety and mixed population of epithelioid and spindle cell was the commonest histopathological pattern. The commonest grade of invasion was grade III (Clark's). The clinical presentation of the case of vaginal melanoma and the two cases of secondary melanomas, including the one with obscure primary tumor, were bewildering and hence are discussed separately.

Experimental inoculation model of Walker 256 carcinoma into vagina and cervix uteri of female rats

PURPOSE: To establish an inoculation model of Walker 256 carcinoma on cervix uteri and vagina of rats. METHODS: Fifteen female rats were used, and assigned to three groups each one with five rats: group A - rats with 4x10(6) cells of Walker 256 carcinoma without acid acetic inoculation; group B - rats with 2x10(6) cells of Walker 256 carcinoma with acid acetic inoculation and group C: rats with 4x10(6) cells of Walker 256 carcinoma with acid acetic inoculation. The day before tumor cells inoculation the rats from groups B and C were anaesthetized with diethylether and 0,3 ml of acetic acid was inoculated into their vaginas. Tumor cell inoculation into the vagina and cervix was done under general anesthesia with diethylether. Then a endocervical brush was used to scrape the vaginal wall and after that 0,3 ml of the liquid containing tumor cells was inoculated on the vagina and cervix. For the tumor analysis, animals were euthanized at day 12 following tumor cell implantation by an excessive inhalation of diethylether. Tumor was resected entirely and weighed and the tumors were then sectioned and counter stained with hematoxylin and eosin for histopathologic evaluation. It was also calculated the percentage of tumor equivalent to the body weight by the formula: P= tumor weight / body weight x 100. Data were analyzed by one-way analysis of variance - ANOVA. P values < 0.05 were taken to indicate statistical significance. RESULTS: Implantation and growth on GB and GC was 100 percent and on GA 20 percent. There was no statistical difference between GB and GC averages. CONCLUSION: According to the methods used, the Walker 256 carcinoma inoculation model into vagina and cervix have an implantation and growth rate of 100 percent when associated with previous acid acetic inoculation and there is no behavioral difference between using 2x10(6) or 4x10(6) cells on its inoculation.

OBJETIVO: Estabelecer um modelo de inoculação de Tumor de Walker 256 em vagina e colo de útero de ratas. MÉTODOS: Foram utilizadas 15 ratas fêmeas, virgens, adultas, pesando entre 200-250g, distribuídas em três grupos de estudo com cinco animais cada: grupo A (GA): ratas com tumor de Walker 256 em concentração de 4x10(6) sem ácido acético; grupo B (GB): ratas com tumor de Walker 256 em concentração de 2x10(6) células com ácido acético; grupo C (GC): ratas com tumor de Walker 256 em concentração de 4x10(6) células com ácido acético. No dia anterior à inoculação do tumor, foi realizada a inoculação de 0,3 ml de ácido acético a 10 por cento na vagina das ratas de GB e GC; no dia seguinte, tanto estas como as ratas do grupo GA foram anestesiadas, feita a escarificação da parede vaginal com uma escova de endocérvice e inoculado 0,3ml de tumor na concentração de 4x10(6) células nos grupos GA e GC e 2x10(6) células no grupo GB. Após 12 dias, foi realizada a eutanásia e removido o tumor em bloco com vagina e cornos uterinos para análise, sendo pesado e averiguado seu volume e calculado as relações entre o seu peso e o peso final da rata e o seu volume e o peso final da rata. Os dados foram colhidos e submetidos à análise estatística pelo método ANOVA (um critério). RESULTADOS: A pega em GB e GC foi 100 por cento e em GA 20 por cento. Não houve diferença estatística entre as médias obtidas entre GB e GC. CONCLUSÃO: De acordo com a metodologia utilizada, o modelo de tumor de Walker 256 na vagina apresenta pega de 100 por cento quando associado a ácido acético e não há diferença de comportamento com a inoculação de 4x10(6)ou 2x10(6) células.

Secondary vaginal involvement following radical surgical treatment for a stage I ovarian adenocarcinoma arising in mature cystic teratoma.

BACKGROUND: Vaginal carcinoma represents 1-2% of all gynecologic malignancies. Most cases reported secondary involvement from adjacent organs including cervix, uterus, and colorectum. Vaginal involvement from adenocarcinoma arising in mature cystic teratoma (MCT) has never been reported. CASE: A 29-year-old female presented with postcoital vaginal bleeding. She had had a history of right ovarian adenocarcinoma arising in MCT, FIGO stage IC, for 18 months' duration. Incisional biopsy of the vaginal lesion revealed adenocarcinoma, morphologically and immunohistologically identical to the right oophorectomized specimen. She received three courses of paclitaxel and carboplatin chemotherapy; however, she developed massive right pleural effusion with superior vena cava syndrome and finally succumbed to the disease, three months later. CONCLUSION: Adenocarcinoma is rarely found in MCT. This is the first case of ovarian adenocarcinoma arising in MCT with secondary vaginal involvement, presenting as postcoital vaginal bleeding.

Primary leiomyosarcoma of the vagina. Case report and literature review

The vast majority of primary vaginal cancers are squamous cell carcinoma. The leiomyosarcoma of the vagina is extremely rare neoplasm. It comprising 2% to 3% of vaginal malignancies. Only 77 cases have been reported up to date in Anglo-Saxon literature. Report of a new case. We report a case of a patient 43 years old, single and presented a tumor of 7 cm to the detriment of the posterior wall of the vagina. The treatment consisted of a radical colpohysterectomy followed by postoperative radiotherapy. After 40 months, she is still alive without local or distant recurrence. This is a rare observation. The surgery is the basic treatment, the poor prognosis of these tumors remains linked especially to the histological grade

Primary non-hodgkin's lymphoma of vagina associated with pregnancy

We report a case of non-Hodgkin's lymphoma [NHL] in 23 years old, 36 weeks pregnant female, who presented with a swelling in the vagina. Biopsy of the lesion led to profuse haemorrhage and emergency caesarean-section along with bilateral ligation of internal iliac arteries were required. Recovery was smooth and she was discharged from the hospital on the 5th postoperative day. Histopathology revealed non-Hodgkin's lymphoma, diffuse large B cell type [DLBCL]. Further treatment by medical oncologist led to complete resolution of the tumour at three months