ABSTRACT
La nueva imagenología mamaria ha descubierto un grupo de lesiones no palpables que puede alcanzar hasta el treinta por ciento de los casos examinados
Subject(s)
Humans , Female , Biopsy, Needle/instrumentation , Breast Neoplasms/pathology , Biopsy/methods , Needles/statistics & numerical data , Breast/cytologyABSTRACT
La nueva imagenología mamaria ha descubierto un grupo de lesiones no palpables que puede alcanzar hasta el treinta por ciento de los casos examinados
Subject(s)
Humans , Female , Biopsy , Biopsy, Needle/instrumentation , Breast Neoplasms/pathology , Breast/cytology , Needles/statistics & numerical dataABSTRACT
A prospective randomized trial was carried out in patients with squamous carcinoma of the cervix uteri, stage Ib bulky. The protocol considers two arms: the control group (75 patients) and the neoadjuvant one (76 patients). All the patients were classified according to the FIGO staging system and in order to determine the tumor size objectively, an ultrasound scanning was done. After this a Wertheim-Meigs operation followed by adjuvant whole-pelvis irradiation was performed. In the neoadjuvant group the same procedures were carried out but three courses of chemotherapy with the "quick" VBP scheme were given before the treatment. The new therapeutic strategy proved to be very useful in bulky tumors in which the clinical examination showed a cervix increased in size and the ultrasound scanning a volume larger than 60 c.c. (> 4 x 4 x 4 cm). In those cases statistically significant differences were found between both groups when free disease interval and survival were considered. These were due to the fact that operability has been improved and the parametrial extension has been decreased as well as other risk factors such as vascular embolism, lymph node involvement, tumor-cervix quotient, and tumor volume. The use of this new strategy is not justified in small tumors (< 3-4 cm in diameter) because in those cases, survival is not improved with neoadjuvant therapy.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Uterine Cervical Neoplasms/drug therapy , Adult , Aged , Bleomycin/administration & dosage , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Chemotherapy, Adjuvant/adverse effects , Cisplatin/administration & dosage , Female , Humans , Middle Aged , Neoplasm Staging , Prospective Studies , Survival Rate , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/radiotherapy , Uterine Cervical Neoplasms/surgery , Vincristine/administration & dosageABSTRACT
One hundred and sixty-nine patients with squamous cancer of the cervix uteri treated with three courses of neoadjuvant chemotherapy with the modified VBP scheme are presented. All were subjected to a Wertheim-Meigs operation with paraaortic lymph-adenectomy. The incidence of lymph node metastases is analyzed according to clinical stage, tumor volume, residual tumor in the surgical specimen, and clinical response to neoadjuvant chemotherapy. A significant decrease in the incidence of lymph node involvement was observed in good responders. Survival rates, after 2 years of follow-up, improved in those cases with small residual tumor, negative parametria, and negative nodes.
Subject(s)
Lymphatic Metastasis , Uterine Cervical Neoplasms/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bleomycin/therapeutic use , Cisplatin/therapeutic use , Female , Humans , Prognosis , Survival Rate , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/mortality , Vinblastine/therapeutic useSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Uterine Cervical Neoplasms/drug therapy , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Clinical Trials as Topic , Combined Modality Therapy , Female , Humans , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/pathologyABSTRACT
Use of the colposcope for vulvar and vaginal examination in four cases of long-standing vulvodynia led to the identification of lesions with an unusual appearance. In the vulvar vestibule, epithelial projections resembling cactus, camel humps or stony colonial pavement were observed. In the vagina, the lesions looked more like cerebral folds. Biopsies of these lesions showed histopathologic changes diagnostic of human papillomavirus infection, scored according to Reid's criteria. In one case, capsid antigen was detected with the peroxidase technique in the nuclei of the superficial cells. Past history and positive findings in the sexual partners of some of the patients suggested long-standing herpesvirus activity in the lower genital tract. In some cases of recalcitrant vulvodynia, colposcopic examination of the vulva and vagina may lead to a viral explanation for symptoms previously considered psychosomatic in origin.
