ABSTRACT
Clear-cell carcinoma of the ovary is a highly malignant neoplasm. Survival of patients in the advanced stage is poor, and the best treatment is not clear. We report here a case of a 57-year-old woman who had Stage IIIb advanced clearcell carcinoma of the ovary. We performed abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lympho adenectomy and partial omentectomy. After the operation she was placed on induction and maintenance chemotherapy with a combination of irinotecan(CPT-11)(60 mg/m2, day 1, 15)plus cisplatin(CDDP)(60 mg/m2, day 1). Four years after surgery, a metastatic tumor was found in the brain. Considering the poor prognosis of clear-cell carcinoma, this regimen is thought to be effective for advanced clear-cell carcinoma of the ovary. It is important to check brain metastases under maintenance chemotherapy.
Subject(s)
Adenocarcinoma, Clear Cell/drug therapy , Adenocarcinoma, Clear Cell/pathology , Brain Neoplasms/drug therapy , Camptothecin/analogs & derivatives , Cisplatin/therapeutic use , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/pathology , Adenocarcinoma, Clear Cell/diagnostic imaging , Adenocarcinoma, Clear Cell/surgery , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/secondary , Camptothecin/therapeutic use , Female , Humans , Irinotecan , Middle Aged , Neoplasm Staging , Ovarian Neoplasms/diagnostic imaging , Ovarian Neoplasms/surgery , RadiographyABSTRACT
Clear cell carcinoma of the endometrium is a very rare and highly malignant neoplasm that accounts for less than 5% of endometrial carcinoma. Survival of patients in the advanced stage is poor, and the treatment of choice is not clear. We report the case of a 62-year-old woman who had Stage IVb advanced clear cell carcinoma of the endometrium with multiple lung metastases. The lesions were considered surgically incurable, so she was placed on neoadjuvant chemotherapy of combination carboplatin (CBDCA) (AUC 5, day 1) plus weekly paclitaxel (PTX) (70 mg/m(2), day 1, 8, 15). After 3 courses of chemotherapy, the uterine tumor was obviously reduced, and lung metastases had disappeared. Therefore, she underwent the operation. The current case suggests that combination CBDCA plus weekly PTX is effective against advanced clear cell carcinoma of the endometrium.
Subject(s)
Adenocarcinoma, Clear Cell/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Endometrial Neoplasms/drug therapy , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Adenocarcinoma, Clear Cell/secondary , Adenocarcinoma, Clear Cell/surgery , Carboplatin/administration & dosage , Combined Modality Therapy , Drug Administration Schedule , Endometrial Neoplasms/pathology , Endometrial Neoplasms/surgery , Female , Humans , Hysterotomy , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Paclitaxel/administration & dosage , Remission InductionABSTRACT
We report here a case of synchronous dermoid cyst with secondary malignant tumor and uterine endometrial adenocarcinoma that responded to UFT. A 35-year-old female complained of abdominal fullness and visited our hospital. She had an abdominal mass which was newborn-head size. We performed right salpingo-oophorectomy and partial omentectomy. The pathological findings were dermoid cyst with secondary malignant transformation. After the operation she had underwent cyclic chemotherapy with CDDP, CPA, THP and 5-FU. After three cycles of chemotherapy, a uterine recurrence was suspected from her uterine endocervical smear test. Then we performed a second operation, but radical surgery was impossible due to the presence of multiple metastases to pelvic lymph nodes. The pathological findings were primary uterine endometrial adenocarcinoma, not metastasis from dermoid cyst with secondary malignant tumor. After the second operation, she was treated with oral UFT (400 mg/day), as she refused chemotherapy and radiotherapy. Two months after the start of UFT, the tumor markers were reduced remarkably, and the patient maintained good QOL throughout the treatment without serious adverse events. We conclude that UFT might be benefical in the treatment of advanced gynecologic cancer.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/therapeutic use , Dermoid Cyst/drug therapy , Endometrial Neoplasms/drug therapy , Neoplasms, Multiple Primary , Ovarian Neoplasms/drug therapy , Tegafur/therapeutic use , Uracil/therapeutic use , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adult , Carcinoma, Adenosquamous/pathology , Combined Modality Therapy , Dermoid Cyst/pathology , Dermoid Cyst/surgery , Drug Combinations , Endometrial Neoplasms/pathology , Endometrial Neoplasms/surgery , Female , Humans , Hysterotomy , Neoplasms, Multiple Primary/pathology , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Ovariectomy , Quality of Life , SalpingostomyABSTRACT
Carcinosarcoma of the ovary is a very rare and highly malignant neoplasm that accounts for less than 1% of ovarian neoplasms. Survival of patients with advanced stage cancer is poor and the best treatment is not clear. We report the case of a 60-year-old woman who had Stage IV advanced heterogeneous ovarian carcinosarcoma with lung and liver metastases. The lesions were considered surgically incurable, so she was placed on neoadjuvant chemotherapy of combination CPT-11 (60 mg/m2, day 1, 15) and CDDP (60 mg/m2, day 1). Tumor markers of CA125 and LDH decreased remarkably to the normal level after 3 and 4 courses of chemotherapy, respectively. After 7 courses of chemotherapy, the ovarian tumor was obviously reduced, and the lung and liver metastases had disappeared. The patient was then able to undergo surgery. The current case suggests that combination CPT-11 and CDDP is effective against advanced ovarian carcinosarcoma.
