Clinical and Pathologic Characteristics of Uterine Sarcoma / 대한부인종양콜포스코피학회잡지

Uterine sarcomas are rare, characterized by rapid clinical progression and poor prognosis, and their management has been a challenge. The purpose of this study was to investigate the clinical and pathologic characteristics of patients with uterine sarcoma managed in the department of Obstetric and Gynecology, college of medicine, University of Ulsan, Asan Medical center, Seoul, Korea from June 1989 to August 1998. Data including clinical and histologic findings, treatment and outcome of nineteen patients were evaluated. The age of patients ranged 22 to 71 years (mean+/-S.D.; 46.9+/-13.1) and half of patients were postmenopausal and four patients were nulliparous. Palpable pelvic mass or abnormal uterine bleeding were the most common sign or symptom. Twelve patients (63.2%) had stage I disease and seven (36.8%) had stage III disease. There were 13 cases (68.4%) of leiomyosarcoma, 4 cases (21.1%) of endometrial stromal sarcoma, 2 cases (10.5%) malignant mixed mullerian tumor. All except one received hysterectomy (simple or radical) with or without bilateral salpingo-oophorectomy. Some received omentectomy or pelvic lymphadenectomy. Postoperative chemotherapy was administered in ten patients with regimen of VAC, VBP, VIC and etc. The mean follow-up duration was 29.3 (+/- 24.7) months and 5 patients died of the disease resulting 2-year survival of 68.1%. FIGO stage and mitotic count were considered to have prognostic significance, but without statistical confirmation. In conclusion, uterine sarcomas are aggressive tumors with a poor prognosis. Our data showed excellent outcome in early disease with surgery with or without adjuvant chemotherapy, whereas there was no long-term survivor in advanced disease despite postoperative chemotherapy.

Malignant Germ Cell Tumors of the Ovary: A Clinical and Pathological Study of 42 Cases / 대한부인종양콜포스코피학회잡지

From July, 1989 to June, 1998 forty-two patients with malignant germ cell tumors of the ovary treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center, were identified. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow-up of those patients were reviewed retrospectively. The patients with malignant germ cell tumor constituted 11.1% of all ovarian malignancies and 5.6% of all ovarian germ cell tumors ecountered during this period. The most common histologic subtype was dysgerminoma (26.2%) followed by endodermal sinus tumor (23.8%) and immature teratoma (19.0%). The age of the patients ranged from 8 to 64 years (mean+/-S.D.; 26.0+/-12.9) and the mean parity was 0.8 (+/-1.6). The most frequent initial symptoms were adbominal pain (33.3%) or abdominal distension (31.0%). Most had stage I(25 cases, 59.9%) or II(6 cases, 14.3%) diseases. Elevated level of serum alpha-FP was observed in all cases of endodermal sinus tumor and embryonal cell carcinoma, CA 125 was elevated in 63.9% of all malignant germ cell tumors. Thirty-one patients (73.8%) were treated by surgery and chemotherapy and 10 patients (23.8%) by surgery only. The major chemotherapeutic regimens were BEP (bleomycin +etoposide +cisplatin) and VAC (vincristine +actinomycin-D +cytoxan). The mean follow-up duration was 24.6 (+/-23.5) months and 2-year survival rate was 88.6% (+/-0.6).

Each Case of Benign and Malignant Mucocele of the Appendix / 대한부인종양콜포스코피학회잡지

Mucocele of the appendix is uncomrnon and rarely diagnosed preoperatively. The malignant rountpart-i.e. mucinous cystadenocarcinoma--has the same grross appearance and many micro scopic features in cornmon wilhe the benign form. It rnay be associated with ovarian mucinous cystadenoma of strikingly similar microscopic appearence. A serious complication is a rupture of the mucoeele resulting in pseudomyxoma peritonei. Each case of benign and malignant mucocelr of the appendix falsely diagnosecl as an oovarian tumor before laparotxumy are presented wilh a brief rieview of the literatures.