ABSTRACT
El rabdomiosarcoma es un tumor complejo y de gran malignidad que se origina en las células del mesénquima embrionario con capacidad para diferenciarse en células musculares esqueléticas. Este es el tumor maligno de tejido blando más frecuente. Representa aproximadamente 3,5 por ciento de los casos de cáncer en niños de 0 a 14 años de edad. La presentación clínica del rabdomiosarcoma embrionario variedad botrioides es, en general, una masa que protruye por la uretra o el introito vaginal, o por la presencia de flujo fétido o sangrado vaginal en niñas menores de 2 años. Se presenta el caso de un rabdomiosarcoma botrioides de la vagina diagnosticado es una paciente de 16 años y virgen. El apoyo diagnóstico con inmunohistoquímica es de vital importancia y la evaluación médica multidisciplinaria precoz y oportuna permitirá siempre establecer un diagnóstico y tratamiento adecuados que mejoren el pronóstico de quienes padecen esta enfermedad(AU)
Rhabdomyosarcoma is a complex tumor of great malignity that originates in the embryonary mesenchymal cells with the capacity of differentiating into skeletal muscle cells. This is the most frequent malignant tumor in the soft tissue. It roughly represents 3.5 percent of cancer in children aged 0 to 14 years. Generally, the clinical presentation of botryoid-type embryonary rhabdomyosarcoma is a mass that protrudes from the urethra or the vaginal introit or the presence of fetid fluid or vaginal bleeding in girls under 2 years-old. This is the case of a 16 years-old virgin female patient diagnosed with botryoid rhabdomyosarcoma of the vagina. The diagnostic support with immunohistochemistry is of vital importance in addition to the early and timely multidisciplinary medical assessment for setting adequate diagnosis and treatment that improve the prognosis of persons suffering this disease(AU)
Subject(s)
Humans , Female , Adolescent , Physical Examination/methods , Rhabdomyosarcoma/metabolism , Vagina/metabolism , Vaginal Neoplasms/surgery , Rhabdomyosarcoma/diagnosisABSTRACT
A neoplasia intraepitelial de vagina (NIVA) é uma condição pré-maligna rara do epitélio vaginal, sua incidência corresponde a 0,2 casos por 100.000 mulheres, classifica-se em NIVA I, II, III esta última tem um potencial de invasão de 9 a 12%. O diagnóstico é feito pela citologia, colposcopia, histopatologia. Todos os métodos terapêuticos tem uma taxa razoável de sucesso e a taxa de recorrência varia entre 10 e 42%. O tratamento pode ser: cirúrgico, ablativo, radioterápico, clínico e expectante. O excisional tem preferência por fornecer peça para análise histopatológica excluindo a doença invasiva apresentando as melhores taxas de sucesso entre 66% a 83% . A ablação é indicada quando a suspeita de invasão foi afastada e é a modalidade de eleição nas mulheres jovens, a eficácia varia entre 69 a 87%. A radiação tem uma taxa de sucesso entre 69 a 100%; porém, as complicações giram em torno de 36%. Pela sua praticidade o tratamento feito com os agentes tópicos tem ganhado espaço terapêutico na abordagem da NIVA. Não existe evidência científica quanto a melhor forma e o tempo de seguimento das mulheres com NIVA. Qualquer que seja a opção de tratamento utilizada um seguimento longo deve ser preconizado.(AU)
Vaginal intraepithelial neoplasia (VAIN) is an uncommon premalignant condition of the vaginal epithelium, its incidence is found to be 0.2 per 100.000 women, this condition is classificated in VAIN I, II and III, the lifetime risk of transformation to invasive carcinoma has been reported as 9 to 12%. The diagnosis was done by cytology, colposcopy and histology. All the therapeutics modalities have a successful cure rate and the recurrence ranges are between 10 to 42%. The treatment modalities are: excisional, ablative, radiotherapic, clinical and expectante. Excisional has preference as it could exclude invasion disease and has the best success rate, 66 to 83%. Ablation has preference in young women with no suspect of invasion, with efficacy ranging between 69 to 87%. The cure rate of radiotherapy is high as 69 to 100% but this modality has 36% morbidity rate. Treatment with topical agents constitutes a promising option in VAIN management. There is no scientific evidence of what kind follow-up is better. Whatever treatment modality is used long-term follow-up is essential.(AU)
Subject(s)
Female , Vaginal Neoplasms/surgery , Vaginal Neoplasms/diagnosis , Vaginal Neoplasms/drug therapy , Vaginal Neoplasms/radiotherapy , Vaginal Neoplasms/epidemiology , Treatment Outcome , Trichloroacetic Acid/therapeutic use , Databases, Bibliographic , Colposcopy , Ablation Techniques , Fluorouracil/therapeutic use , Neoplasm Recurrence, LocalABSTRACT
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
Subject(s)
Humans , Female , Vaginal Neoplasms/surgery , Vaginal Neoplasms/etiology , Vaginal Neoplasms/radiotherapy , Epidemiology, Descriptive , Longitudinal Studies , Retrospective StudiesABSTRACT
Objetivo: Presentar la experiencia en el tratamiento de la neoplasia intraepitelial de vagina (VAIN) utilizando el láser de CO2. Método: 19 pacientes con el diagnóstico histológico de VAIN fueron tratadas con esta técnica. Se utilizó un diámetro del punto de helio-neón de 1,5 a 2 mm y un poder de densidad de 400 a 500 W/cm2. Toda la lesión detectable más un margen de al menos 5 mm de tejido circundante aparentemente normal fueron vaporizados a una profundidad de 2 mm. Resultados: 12 de las 14 pacientes evaluables lograron una respuesta completa inicial (86 por ciento), de éstas 12 hubo 2 recidivas posteriores (17 por ciento), obteniendo una curación en 10 de las 14 evaluables (71 por ciento). No hubo complicaciones y se preservó una función vaginal normal. Conclusión: La vaporización con láser es una buena modalidad terapéutica en VAIN, particularmente en mujeres jóvenes en que se ha descartado razonablemente la coexistencia de cáncer invasor.
Subject(s)
Female , Adult , Middle Aged , Humans , Carcinoma in Situ/surgery , Laser Therapy , Carbon Dioxide/therapeutic use , Vaginal Neoplasms/surgery , Follow-Up Studies , Treatment Outcome , VolatilizationABSTRACT
This is a case report of a 32-year-old female patient with a neoplasia mimicking a urethral tumor. Following anterior pelvic exanteration, vulvectomy, bilateral inguinal lymphadenectomy, the pathological study established the diagnosis of aggressive vaginal angiomyxoma, CD-34 labeled.
Subject(s)
Adult , Female , Humans , Myxoma/diagnosis , Urethral Neoplasms/diagnosis , Vaginal Neoplasms/diagnosis , /analysis , Diagnosis, Differential , Disease-Free Survival , Follow-Up Studies , Immunohistochemistry , Myxoma/surgery , Biomarkers, Tumor/analysis , Vaginal Neoplasms/surgeryABSTRACT
Pseudosarcoma botryoides is an infrequent vaginal tumor with benign evolution. Its importance lies in to distinguish of sarcoma botryoides, what is usually fatal. A case of vaginal polyp during pregnancy is presented. After cesarean section, polyp was excised and diagnosis of sarcoma botryoides was made. Patient was referred to ION for treatment and her diagnosis was changed to pseudosarcoma by revision of histologic plates. Patient doesn't need further treatment but previous excision, and she is asymptomatic twelve months later. Histologic findings of both tumors are described and confusion between them are noted
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications, Neoplastic/diagnosis , Fibroma/diagnosis , Vaginal Neoplasms/diagnosis , Pregnancy Complications, Neoplastic/pathology , Pregnancy Complications, Neoplastic/surgery , Diagnosis, Differential , Fibroma/pathology , Fibroma/surgery , Vaginal Neoplasms/pathology , Vaginal Neoplasms/surgery , Rhabdomyosarcoma, Embryonal/diagnosis , Vagina/pathology , Vagina/surgeryABSTRACT
A case of stage II vaginal carcinoma treated with chemotherapy and surgery is presented. It is emphasized the complete response of the tumor to chemotherapy and intra-operatory vaginal reconstruction, in order to permit complete psychosocial readaptation of the patient
Subject(s)
Humans , Female , Middle Aged , Bleomycin/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Cisplatin/therapeutic use , Vaginal Neoplasms/drug therapy , Vincristine/therapeutic use , Bleomycin/administration & dosage , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Cisplatin/administration & dosage , Neoplasm Staging , Preoperative Care , Vaginal Neoplasms/pathology , Vaginal Neoplasms/surgery , Vincristine/administration & dosageABSTRACT
O adenocarcinoma de células claras de vagina é uma entidade rara, embora sua incidência tenha se elevado em decorrência da exposiçäo intra-uterina das pacientes ao hormônio Dietilestilbestrol. Na maioria dos casos relatados na literatura, o diagnóstico foi feito precocemente, o que concorreu para o bom prognóstico das pacientes. A recidiva, na maioria das vezes, ocorreu locorregionalmente. Näo há relato de acometimento de medula óssea pelo tumor. No presente trabalho, relatamos o caso de uma paciente de 52 anos que apresentou uma recorrência fulminante de um adenocarcinoma de células claras de vagina tratado satisfatoriamente com cirurgia e radioterapia, com acometimento maciço de medula ossea e pancitopenia, o que levou ao óbito por sangramento do SNC. A correlaçäo do aparecimento do tumor com a exposiçäo materna ao Dietilestilbestrol näo pode ser feita.
Subject(s)
Humans , Female , Middle Aged , Spinal Cord Neoplasms , Vaginal Neoplasms/surgery , Adenocarcinoma/surgery , Pancytopenia , Recurrence , Vaginal Neoplasms/complications , Vaginal Neoplasms/radiotherapy , Adenocarcinoma/complications , Adenocarcinoma/radiotherapy , Diethylstilbestrol/adverse effectsABSTRACT
El fibroma vaginal es una neoplasia benigna poco frecuente. Puede aparecer en cualquier parte de la vagina pero especialmente en el tercio superior de la pared anterior; su consistencia puede ser desde sólida hasta quística. Puede ser asintomaticos o causar dolor o síntomas urinarios. Se presenta un caso de una paciente de 27 años que consultó por dispareunia y presentaba una tumoración quística en la pared anterior de vagina. Se practicó enunciación de la tumoración; el estudio anatomo-patológico diagnóstico un leiomioma vaginal. Se reporta el caso lo poco frecuente de la patología. Se revisa bibliografía nacional
Subject(s)
Adult , Humans , Female , Vaginal Neoplasms/surgery , Vaginal Neoplasms/therapy , Leiomyoma/therapyABSTRACT
E relatado um caso de sarcoma da vagina, neoplasia extremamente rara, que , analisada sob seus principais aspectos anatomopatologicos, clnicos e terapêuticos. O caso, em fase inicial e bem localizado, da variedade leiomiossarcomatosa, foi tratado apenas pela cirurgia, com evoluçao extremamente favor vel após cinco anos.
Subject(s)
Humans , Female , Adult , Leiomyosarcoma/pathology , Vaginal Neoplasms/pathology , Leiomyosarcoma/surgery , Vaginal Neoplasms/surgeryABSTRACT
Os autores relatam um caso de sarcoma botrióide de vagina, descrevendo os aspectos ultrasonográficos pouco conhecidos, já que na literatura mundial existe descrito somente um caso
Subject(s)
Child, Preschool , Humans , Female , Sarcoma , Vaginal Neoplasms/surgeryABSTRACT
La endometriosis externa de ubicación vagino perineal, constituye una rareza en cuanto a la localización externa de la endometriosis, aún cuando se ofrecen muchas posibilidades de implantación de tejido endometrial en la atención del parto al practicar episiotomías, perineotomías o bien, desgarros vagino perineales. En revisiones de la literatura extranjera (carecemos de datos nacionales), constituyen el 0,2%. Se estudian 7 pacientes cuyo foco endometrioso asentaba en 6, en la cicatriz de una episiotomía. En cada una de ellas se realiza anamnesis, examen físico, ginecológico, proctológico, extirpación quirúrgica del foco. Estudio histopatológico, tratamiento y control. Seis pacientes mejoraron, pero una continuó con sus molestias por una resección incompleta del foco inicial. Se concluye que el tratamiento médico inicial no mejoraría la endometriosis vagino perineal. El tratamiento debería ser la extirpación completa del foco, con eventual tratamiento hormonal posterior