Intralesional injection of triamcinolone acetonide for cavernous hemangiomas: A case report.

RATIONALE: Cavernous hemangiomas referred to as venous malformations (VMs), are not true vascular tumors. The treatment of cavernous hemangiomas is controversial. PATIENT CONCERNS: A five-year-old girl with a cavernous hemangioma on her right buttock had undergone surgery but recurred 1 month after the operation. DIAGNOSES: Cavernous hemangioma was diagnosed on the basis of physical examination, magnetic resonance imaging (MRI) and postoperative pathologic examination. INTERVENTIONS: We treated her with intralesional injection of triamcinolone acetonide (TCA) for 8 times. OUTCOMES: She was cured and had no recurrence during the 3-month follow-up. LESSONS: This prompts that TCA may provide a more effective and safer choice for the treatment of cavernous hemangiomas.

[Analysis of recurrence pattern and prognosis of patients with cervical carcinoma and pelvic lymph node metastasis].

OBJECTIVE: To investigate the pattern of disease relapse and prognostic risk factor of patients with cervical carcinoma and pelvic lymph node metastasis. METHODS: A total of 124 cases of International Federation of Gynecology and Obstetrics (FIGO) Ib1-IIa cervical carcinoma with pelvic node metastasis who were treated at the Cancer Center of Sun Yat-sen University during January 1994 to December 2001 were selected for this study. Prognosis and recurrence were retrospectively analyzed using the clinico-pathological data RESULTS: The overall 5 year survival and 5 year disease-free survival were 63.3% and 61.4%, respectively. Overall recurrence rate was 39.5% (49/124), among which intra-pelvic relapse (61.0%, 25/41) was significantly more common than extra-pelvic relapse (31.7%,13/41; P=0.008). Multivariate analysis identified involvement of common iliac node as an independent prognostic factor (P=0.035). According to this factor, node-positive patients could be divided into low risk group (without common iliac node involvement, 104 cases) and high risk group (with common iliac node involvement, 20 cases). The 5 year disease-free survival were 69.4% and 24.5% respectively, with a significant difference (P=0.003). Intra-pelvic relapse was observed in 22.1% (23/104) of low risk and 25.0% (5/20) of high risk group respectively, with no significant difference (P>0.05). However extra-pelvic relapse was seen in 7.7% (8/104) of low risk and 40.0% (8/20) of high risk group, with a significant difference (P<0.01). CONCLUSIONS: Common iliac node involvement is a significant factor influencing the prognosis of patients with cervical carcinoma and pelvic lymph node metastasis. Patients with positive common iliac nodes have significantly decreased 5 year disease-free survival and higher extra-pelvic disease recurrence rates compared with those whose common iliac nodes are negative. These findings provide important data for design of individualized treatment mode.

[Clinical analysis of 12 cases of uterine carcinosarcoma].

BACKGROUND & OBJECTIVE: Uterine carcinosarcoma, also known as malignant mixed mullerian tumors, is an uncommon neoplasm that carries a poor prognosis. This study was to analyze the clinical manifestation, diagnosis, treatment and prognosis of this disease. METHODS: Clinical data of 12 uterine carcinosarcoma patients, diagnosed in Cancer Center of Sun Yat-sen University from 1978 to 2004, were analyzed. RESULTS: Of the 12 cases of uterine carcinosarcoma, 2 were in the cervix, 10 in the corpus uteri. The main clinical manifestation of cervical carcinosarcoma was contact vaginal bleeding. Carcinosarcoma in the corpus uteri manifested abnormal vaginal bleeding and postmenstrual bleeding. Diagnosis depended on pathology. Twelve patients undergone operation. Eight patients received chemotherapy and 2 received radiotherapy after operation. One cervical carcinosarcoma patient died within 2 year. The 1-, 3-, and 5-year survival rates of the 12 patients were 80.0%, 50.0%, and 50.0%,respectively. CONCLUSIONS: Primary surgery is the main treatment for uterine carcinosarcoma. The prognosis of uterine carcinosarcoma is associated with surgicopathologic stage and treatment modalities.

[Diagnostic value of multiple tumor marker detection for mature and immature teratoma of the ovary].

BACKGROUND & OBJECTIVE: It is difficult to differentially diagnose mature cystic teratoma (MCT) and immature teratoma (IT) of the ovary before operation. This study was to evaluate the value of multiple tumor marker detection in differential diagnosis of ovarian MCT and IT. METHODS: Clinical data of 272 patients with ovarian teratoma, diagnosed pathologically and treated at Cancer Center of Sun Yat-Sen University from Jan. 1995 to Dec. 2005, were reviewed. Of the 272 patients, 254 had MCT and 18 had IT. The serum levels of carbohydrate antigen 125 (CA125), CA153, CA199, neuron-specific enolase (NSE), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) in MCT and IT were compared. RESULTS: Of the 254 patients with MCT, the median age was 30, the mean serum levels of CA125, CA153, CA199, NSE, AFP and CEA were 25.5 x 103 u/L, 11.8 x 103 u/L, 106.6 x 103 u/L, 12.6 microg/L, 2.7 microg/L and 2.5 microg/L. Of the 18 patients with IT, the median age was 23, the mean serum levels of these tumor markers were 140.3 x 103 u/L, 16.8 x 103 u/L, 112.0 x 103 u/L, 18.0 microg/L, 369.5 microg/L and 3.2 microg/L. Both the serum levels and positive rates of CA125, CA153 and AFP were significantly higher in IT than in MCT (P<0.05). When detected alone to differentially diagnose MCT and IT, the specificity of CA125, CA153, AFP were high, and the sensitivity of CA125 was the best (50.0%). The sensitivity was elevated to 71.4% by combined detection of CA125, CA153 and AFP. CONCLUSION: Combined detection of tumor markers, especially CA125, CA153 and AFP, may be helpful for differential diagnosis of ovarian MCT and IT.