Assessment of gynecologic malignancies: A multi-center study in Tehran (1995-2005).

Objective: The observed differences in cancer incidence are mainly due to different individuals and social risk factors. This study aims to demonstrate the characteristics of female genital malignancies according to the pathological records in Tehran, Iran. Materials and Methods: In this cross-sectional study, all records of pathological specimens categorized as ovarian, uterine corpus or uterine cervix cancers from 1995 to 2005, in five teaching hospitals in Tehran, were studied. Age, marriage, parity, menopausal status, smoking, oral contraceptive usage, pathological staging, and histological grading were reviewed by a trained general practitioner. SPSS 14 was used for statistical analysis. Result: Mean age (SD) at the time of diagnosis was 50 (15). Fifty-nine percent of ovarian, 33.9 and 47.7% of uterine corpus and uterine cervix malignant patients were premenopausal. About 90% of all were nonsmokers and 82.7% were multiparae. Various types of gynecologic malignancies included ovarian (55.5%), uterine corpus (24.9%), and uterine cervical cancers (19.6%) were diagnosed. In tumors of the uterine corpus and uterus cervix, the most frequent stage of diagnosis was stage IIA. Conclusion: Ovarian cancer was the most frequently occurring gynecologic tumor. Although distribution of age in ovarian cancer was similar to that mentioned in the literature, occurrence of the cancer was more frequent in the premenopausal state.

Cáncer de riñón con metástasis a colon: un sitio poco frecuente de metástasis / Renal cell carcinoma with colon metastases: an infrequent site for metastases

BACKGROUND: Renal cell carcinoma (RCC) represents approximately 3% of malignant tumors in adults and occurs in a M:F ratio of 1.5:1.0. Although in most cases it occurs in persons 50 to 70 years of age, there are also reports in children. Clear cell carcinoma is the most frequent histological type, and 30% of renal carcinomas have metastasized at the time of diagnosis. The objective of the present study is to report colon metastasis of clear cell carcinoma that required surgery and chemotherapy. CLINICAL CASE: We report the case of a 60-year-old male with a history of metastatic RCC. His treatment consisted of cytoreductive radical nephrectomy and interferon because of pulmonary disease. He was followed-up for 8 years. Nevertheless, he presented with hematochezia and underwent colonoscopy where a splenic flexure tumor was demonstrated. Biopsy reported a clear cell tumor. We performed a left hemicolectomy. Pathology report was clear cell carcinoma with involvement of the colon from the mucosa to serosa. The patient again received interferon. Currently, there is no evidence of tumor activity and the patient is being followed-up. CONCLUSIONS: RCC metastases are most frequent in lung, liver, and bone and less frequent in brain, skin, and soft tissue. Metachromic metastases are identified in the first to second year after nephrectomy in most cases. Survival of patients who present metastasis <1 year after nephrectomy is 33 months vs. patients who present metastasis after 1 year from nephrectomy (55 months). Metastatic clear cell carcinoma requires surgery and immunotherapy. Surgery is the first step for disease control and metastatecomies are indicated in localized disease or when one organ is affected and surgically accessible.

Metástase vaginal como manifestação inicial de carcinoma de células renais / Vaginal metastasis as initial manifestation of renal cell carcinoma

A ocorrência de metástases de carcinoma de células renais para a vagina é rara. Ocorre principalmente em mulheres na pós-menopausa e o principal fator prognóstico é se essa metástase apresenta-se ou não isolada. Poucos casos foram relatados na literatura mundial e a maioria destes envolve metástases originadas no rim esquerdo. Os autores apresentam um caso de metástase vaginal de carcinoma de células renais em uma paciente de 53 anos de idade cuja apresentação clínica inicial foi de uma massa pediculada com bordas irregulares na parede posterior da vagina. Realizou-se a retirada cirúrgica da lesão que revelou tratar-se de adenocarcinoma de células claras. A ultrasonografia abdominal evidenciou presença de massa incidental no rim esquerdo e foi realizada a nefrectomia deste rim. O estudo imunoistoquímico realizado demonstrou tratar de lesão neoplásica primária do rim com metástase para a vagina. A paciente, então, recebeu radioterapia adjuvante na vagina e na pelve. Após oito meses do início do tratamento, realizou-se imunoterapia com interferon 2 devido ao aparecimento de metástase também para ofígado. A paciente encontra-se viva 17 meses após a cirurgia.