RESUMO
OBJECTIVE: The purpose of this study was to investigate the clinical feasibility of FDG-PET scan in selection of patients with pelvic recurrence of cervical cancer for surgical treatment. METHODS: From Jun. 2001 to Oct. 2002, whole body FDG-PET scan findings were compared with findings of CT, MRI, and pathologic reports in 24 patients with pelvic recurrence of cervical cancer. PET scan was obtained with a GE Advance PET scanner, beginning at 60 minutes after injection of 370-555 MBq (10- 15 mCi) of 18F FDG. Regional scan was also obtained if needed. Uptake exceeding 2.5 SUV was determined as a positive finding. RESULTS: Among these 24 patients, 10 patients had metastatic lesions at pelvic lymphnodes (4), para- aortic lymphnodes (3), mediastinal lympnnodes (1), lung (4), and bone (1). Among 14 patients with no metastasis, 10 patients underwent surgical treatment but the operations were abandoned in 2 patients due to lymphnodes metastasis and pelvic peritoneal spreads that confused as normal FDG uptake of the intestines pre- operatively. Among 8 patients whom the operation was completed, 3 patients received pelvic exenteration, 2 patients received CORT, and 3 patients received LEER. CONCLUSION: FDG-PET is clinically feasible in selection of patients with pelvic recurrence of cervical cancer for surgical treatment.
Assuntos
Humanos , Intestinos , Pulmão , Imageamento por Ressonância Magnética , Metástase Neoplásica , Exenteração Pélvica , Tomografia por Emissão de Pósitrons , Recidiva , Neoplasias do Colo do ÚteroRESUMO
OBJECTIVE: To characterize the clinical features of platinum compounds (cisplatin plus carboplatin) associated hypersensitivity reactions. METHODS: Medical records of 102 patients with gynecologic malignancy who received chemotherapy based on platinum at Center for Uterine Cancer from Jun. 2001 to Nov. 2002 were analyzed. Platinum hypersensitivity reaction was classified as acute and delayed reaction according to the time of onset, also mild and severe reaction according to the severity of symptoms and signs. RESULTS: Among the 102 patients treated with platinum compounds during this period, 20 (20%) developed hypersensitivity reaction. The median number of platinum courses for the first episode was 7 (range 4-9) and it concentrated at 7, 8, 9th cycles. Fourteen patients developed acute reaction and six patients experienced delayed reaction. Ten patients experienced severe symptoms including dyspnea. Acute reaction developed from a few minutes to 30 minutes after the initiation of the platinum infusion. Delayed reaction developed after discharge of patients with mild intensity. CONCLUSION: Platinum hypersensitivity reactions develop in patients who have been extensively pre- treated with these agents. As platinum compounds are increasingly used as neoadjuvant, initial, second-line chemotherapy of ovarian cancer and concurrent chemoradiation, palliative setting of cervical cancer, it can be anticipated that hypersensitivity reactions to these drugs will happen more frequently, at the same time it might be a important issue for clinicians engaged in chemotherapy.
Assuntos
Humanos , Carboplatina , Cisplatino , Tratamento Farmacológico , Dispneia , Hipersensibilidade , Prontuários Médicos , Neoplasias Ovarianas , Platina , Compostos de Platina , Neoplasias do Colo do Útero , Neoplasias UterinasRESUMO
To report cases of metastasectomy for metastatic gynecologic malignancies, we reviewed the medical records of all patients who have undergone metastasectomy for metastatic gynecologic malignancies in Center for Uterine Cancer from June 2001 to October 2002. Six patients were identified with median age of 55 years (range 52-66 years). The metastatic sites and primary sites were as follows: 3 liver metastasis from ovary; 1 abdominal wall metastasis from uterus (endometrial cancer), 1 brain metastasis from ovary, 1 lung metastasis from uterus (sarcoma). The median disease free interval was 48 months (range 10 months-13 years). There was no perioperative mortality. Postoperative morbidity was tolerable with 1 case of bile leakage. In three patients with hepatectomy, one patient was dead of disease after 15 months, one patient is alive with disease at 20 months of follow up, one patient have no evidence of recurrence at 7 months follow up. The patient with brain metastasis was dead due to lung metastsis after 9 months later postoperatively. Remaining two patients with abdominal wall and lung metastasis have no evidence of tumor recurrence at 4, 7 months follow up respectively. Metastasectomy for metastatic gynecologic malignancies can be performed safely and may help prolong survival in carefully selected patients.
Assuntos
Feminino , Humanos , Parede Abdominal , Bile , Encéfalo , Seguimentos , Hepatectomia , Fígado , Pulmão , Prontuários Médicos , Metastasectomia , Mortalidade , Metástase Neoplásica , Ovário , Recidiva , Neoplasias Uterinas , ÚteroRESUMO
Mixed endometrial stromal and smooth-muscle tumor is one of the uncommon forms of uterine sarcoma. Only a few cases of endometrial stromal tumors showing smooth muscle differentiation have been reported in the literature. We experienced a case of low grade endometrial stromal sarcoma with smooth muscle differentiation in a 44-year-old woman, so we report this case with brief review of literatures.
Assuntos
Adulto , Feminino , Humanos , Tumores do Estroma Endometrial , Músculo Liso , Sarcoma , Sarcoma do Estroma EndometrialRESUMO
Although well-differentiated papillary mesothelioma (WDPM) is usually classified as benign, the natural history of this lesion has not been clearly established. We present a case of WDPM in 60-year old woman developing malignant mesothelioma with seeding mass on the trocar insertion site over a period of 2 years. The initial symptom exhibited by the patient was abdominal distension from massive ascitic fluid. With an impression of peritoneal carcinomatosis, we performed a diagnostic laparoscopy. On the laparoscopic finding, a small whitish nodule was found on the liver surface and the pathologic result revealed reactive mesothelial hyperplasia. At exploro-laparotomy, multiple small nodules were found on the omentum and a biopsy revealed well-differentiated papillary mesothelioma of the peritoneum. The patient underwent pelvic lymphadenectomy and omentectomy of the colon and was followed for 2 years without any further treatment. Subsequently, she presented with abdominal distention with massive ascites and palpable abdominal wall mass at the previous trocar insertion site. Malignant mesothelioma was confirmed histologically via re- exploration. The rare transformation of well-differentiated papillary mesothelioma into a typically malignant diffuse mesothelioma and the unusual seeding on trocar insertion site prompted us to report this case.