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1.
Gynecol Oncol ; 79(2): 220-4, 2000 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11063648

RESUMEN

OBJECTIVE: Immunocompromised patients, such as female renal transplant recipients, have an increased incidence of neoplasms involving the lower genital tract (i.e., cervix, vagina, vulva). The relationship between lower genital tract neoplasms and human papillomavirus (HPV) infection has been established and high-risk oncogenic subtypes have been identified (HPV 16, 18, 45, and 56). The purpose of this study is to evaluate HPV subtypes present in lower genital tract neoplasms of post renal transplant women and compare HPV subtypes found in these patients with immunocompetent patients having similar neoplasms and normal immunocompetent controls. METHODS: Twenty specimens from lower genital tract neoplasms of 16 renal transplant patients, 13 specimens from 13 immunocompetent patients with similar histology, and 13 patients with normal lower genital tract histology were analyzed for the presence of HPV using polymerase chain reaction. HPV primers including the L1 (late) region consensus primers and primers specific for the HPV E6 (early) region for subtypes 6, 11, 16, and 18 were amplified with DNA from the above patient samples. RESULTS: Overall, HPV was detected in 21/46 specimens tested. Thirteen of the HPV-positive specimens were from transplant patients, and 8 were from immunocompetent patients (5 immunocompetent with disease and 3 normal patients). This difference in the total number of HPV-positive cases was statistically significant between the transplant and immunocompetent group (P = 0.02). Although no difference in HPV 6 and/or 11 was detected between the two groups, HPV subtypes 16 and/or 18 approached statistical significant difference (P = 0.06). CONCLUSIONS: High-risk oncogenic HPV subtypes 16 and/or 18 were found at a higher rate in transplant patients compared with their immunocompetent counterparts. The combination of immunocompromise and increased HPV 16 and/or 18 positivity may place these patients at increased risk for aggressive lower genital tract neoplastic progression.


Asunto(s)
Neoplasias de los Genitales Femeninos/virología , Trasplante de Riñón/inmunología , Papillomaviridae/clasificación , Infecciones por Papillomavirus/virología , Infecciones Tumorales por Virus/virología , ADN Viral/genética , Femenino , Neoplasias de los Genitales Femeninos/inmunología , Neoplasias de los Genitales Femeninos/patología , Humanos , Inmunocompetencia , Terapia de Inmunosupresión/efectos adversos , Neoplasias Primarias Secundarias/inmunología , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/virología , Papillomaviridae/genética , Infecciones por Papillomavirus/inmunología , Adhesión en Parafina , Infecciones Tumorales por Virus/inmunología
2.
Arch Pathol Lab Med ; 124(10): 1539-41, 2000 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11035593

RESUMEN

We describe a case of a concomitant well-differentiated endometrial endometrioid adenocarcinoma and leiomyosarcoma of the uterus in a 66-year-old woman who presented with a 6-month history of vaginal bleeding. The patient underwent total hysterectomy for endometrial carcinoma diagnosed by endometrial biopsy. Gross examination of the specimen revealed an endometrial mass bulging into the endometrial cavity and an underlying well-circumscribed nodule separated from the endometrial mass by a myometrial band. Frozen section performed at the time of the total hysterectomy rendered a diagnosis of malignant mixed-müllerian tumor. Histologic examination of the permanent sections revealed well-differentiated endometrial endometrioid adenocarcinoma clearly separated from a high-grade leiomyosarcoma. Differential diagnosis included malignant mixed-müllerian tumor. However, no admixture of carcinomatous and sarcomatous elements was present. There were no heterologous elements. To the best of our knowledge, no similar case has been described in the English literature.


Asunto(s)
Carcinoma Endometrioide/patología , Neoplasias Endometriales/patología , Leiomiosarcoma/patología , Neoplasias Primarias Múltiples/patología , Anciano , Biomarcadores de Tumor/análisis , Carcinoma Endometrioide/química , Carcinoma Endometrioide/cirugía , Neoplasias Endometriales/química , Neoplasias Endometriales/cirugía , Femenino , Humanos , Inmunohistoquímica , Leiomiosarcoma/química , Leiomiosarcoma/cirugía , Proteínas de Neoplasias/análisis , Neoplasias Primarias Múltiples/química , Neoplasias Primarias Múltiples/cirugía
3.
Arch Pathol Lab Med ; 124(3): 431-4, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10705401

RESUMEN

Female adnexal tumor of probable wolffian origin is a rare neoplasm that can present diagnostic difficulties. We report herein a case of a 60-year-old woman with female adnexal tumor of probable wolffian origin arising within the leaves of a broad ligament and, 5 years later, presenting with metastasis to the liver. The morphologic, immunohistochemical, ultrastructural, and DNA ploidy findings of the original and metastatic tumor, differential diagnoses, and the results of the English-language literature review are presented.


Asunto(s)
Adenoma/patología , Neoplasias Hepáticas/secundario , Neoplasias Ováricas/patología , Conductos Mesonéfricos/patología , Adenoma/química , Adenoma/genética , Biomarcadores de Tumor/análisis , Cistadenocarcinoma Papilar/patología , ADN de Neoplasias/análisis , Errores Diagnósticos , Femenino , Humanos , Inmunohistoquímica , Neoplasias Hepáticas/química , Neoplasias Hepáticas/genética , Persona de Mediana Edad , Neoplasias Ováricas/química , Neoplasias Ováricas/genética , Neoplasias Ováricas/cirugía , Ploidias , Posmenopausia , Conductos Mesonéfricos/química
4.
Gynecol Oncol ; 76(3): 388-96, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10684716

RESUMEN

OBJECTIVE: The objective of this study was to evaluate expression of fos and jun proto-oncogenes in benign human uterine tissue compared with malignant uterine tissue. METHODS: Forty-two endometrial tissue specimens were obtained at the time of hysterectomy. Tissue samples from different phases of the menstrual cycle and from postmenopausal patients were stained using immunohistochemical methods to detect Fos and Jun proteins, estrogen and progesterone receptor status, and Ki67 (detects a nuclear antigen associated with proliferating cells). Tissue was examined microscopically for nuclear staining in endometrial epithelium and stroma. The endometrium was based on the patient's last menstrual period, pathologic dating, and proliferative versus nonproliferative status as determined by Ki67. Benign and malignant specimens were subjected to Northern blot analysis to evaluate levels of expression of c-fos, c-jun, and jun-B mRNA. The pattern of c-fos mRNA expression in malignant samples was further evaluated using in situ hybridization. RESULTS: In proliferative, secretory, postmenopausal, and progesterone-influenced, uterine specimens immunohistochemically stained and examined, the endometrial and stromal nuclei stained for both Fos and Jun in varying intensities. However, no pattern was found in the variation of intensity according to the phase of the endometrium. Similarly, in malignant and benign endometrial tissue examined by Northern blot and in situ hybridization analyses, expression of proto-oncogene mRNAs was readily detectable, but no statistical correlation between type of tissue examined, grade of adenocarcinoma, and stage of endometrial cancer was found in this study. CONCLUSIONS: In rodent models, control of uterine cell proliferation is related to change in expression of fos and jun proto-oncogenes. Our results indicate that hormonal control is likely to be different in human endometrium and probably involves genes other than the proto-oncogenes under study. Expression of Fos and Jun do not correlate with endometrial cancer stage and grade.


Asunto(s)
Adenocarcinoma/metabolismo , Neoplasias Endometriales/metabolismo , Endometrio/metabolismo , Proteína Oncogénica p65(gag-jun)/metabolismo , Proteínas Oncogénicas v-fos/metabolismo , Adenocarcinoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Northern Blotting , Neoplasias Endometriales/patología , Endometrio/patología , Femenino , Humanos , Inmunohistoquímica , Hibridación in Situ , Ciclo Menstrual , Persona de Mediana Edad , Estadificación de Neoplasias , Proto-Oncogenes Mas , ARN Mensajero/análisis
5.
J Low Genit Tract Dis ; 4(2): 72-5, 2000 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25950891

RESUMEN

OBJECTIVES: To compare the double-LEEP cone procedure with cold-knife conization to treat cervical intraepithelial neoplasia; to evaluate the specimen adequacy regarding resection margins and residual disease. METHODS AND MATERIALS: Of 137 patients with cervical intraepithelial neoplasia, 60 patients had cold-knife cone and 77 had double-LEEP cone procedure. The indications were the same for both groups. The average follow-up time was 6 months. RESULTS: Therapeutic failure (incomplete excision) rate was 14% for double-LEEP cone procedure and 13% for cold-knife conization (p = 0.87). Recurrent cervical intraepithelial neoplasia rate was 16% for double-LEEP cone procedure and 7% for cold-knife conization (p = 0.44) at 6 months. Rates of bleeding complication were 2.6% for double-LEEP cone procedure and 3.3% for cold-knife conization (p = 0.80). These figures were not statistically significant. Thermal artifact was 10% of double-LEEP cone procedure specimens with only one with severe thermal damage preventing accurate grading of cervical intraepithelial neoplasia. CONCLUSION: There was no significant difference between double-LEEP cone procedure (86%) and cold-knife conization (87%) (p = 0.8). It appears that double LEEP performed as an outpatient procedure can be an acceptable alternative to cold-knife conization in patients with cervical intraepithelial neoplasia.▪.

6.
Gynecol Oncol ; 75(3): 349-55, 1999 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-10600288

RESUMEN

OBJECTIVE: The aims of this study were to assess the early and late toxicities of multiple-daily-fraction whole pelvic radiation plus concurrent chemotherapy with either hydroxyurea or 5-fluorouracil (5-FU)/cisplatin and to determine the maximum tolerated external radiation dose in conjunction with brachytherapy, when given with either of these drug regimens, as treatment for locally advanced carcinoma of the cervix. METHODS: The first study (GOG 8801) of 38 patients utilized hydroxyurea as a single oral dose of 80 mg/kg to a maximum of 6 g at least 2 h prior to a radiation treatment twice every week. In the second study (GOG 8901) of 30 patients, cisplatin and 5-FU were used concomitantly with radiotherapy. Fifty milligrams per square meter of cisplatin was administered on days 1 and 17 of external radiation. 5-FU was given by continuous intravenous infusion at a dose of 1000 mg/m(2)/day for 4 consecutive days on days 2, 3, 4, 5, and 18, 19, 20, and 21 of external radiation therapy. Both studies utilized external radiation given by an accelerated hyperfractionated regimen of 1.2 Gy per fraction, two fractions per day. All patients were treated 5 days per week with a minimum of 4 h between fractions. RESULTS: Acute toxicity was manageable on both protocols but nausea, vomiting, and myelosuppression were more severe with hydroxyurea. Chronic toxicity was primarily enteric and appeared to be dose-related. There was no obvious correlation seen between pelvic failure rates and the radiation dose or between the chemotherapy regimens used. CONCLUSIONS: The defined maximal tolerated dose of whole pelvic radiation was 57.6 Gy in 48 fractions which could be delivered in a hyperfractionated setting with concomitant chemotherapy, followed by brachytherapy. Follow-up is now sufficient that further adverse events should be rare.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Fraccionamiento de la Dosis de Radiación , Neoplasias del Cuello Uterino/terapia , Adulto , Anciano , Braquiterapia , Terapia Combinada , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Persona de Mediana Edad , Radioterapia , Tasa de Supervivencia , Neoplasias del Cuello Uterino/mortalidad
7.
Obstet Gynecol ; 94(5 Pt 2): 836-8, 1999 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10546749

RESUMEN

BACKGROUND: Among gynecologic malignancies, the coexistence of ovarian cancer and dermatomyositis is most frequent. CASE: A 75-year-old woman presented with dermatomyositis, and a search for underlying malignancy found an otherwise asymptomatic ovarian carcinoma with para-aortic lymph node metastases. After resection and chemotherapy, the muscle weakness and skin lesions relating to dermatomyositis began to improve. CONCLUSION: Dermatomyositis can be the only presenting symptom of ovarian cancer, so an evaluation for suspected underlying malignancy should be done.


Asunto(s)
Dermatomiositis/patología , Neoplasias Ováricas/patología , Síndromes Paraneoplásicos/patología , Anciano , Femenino , Humanos
8.
Gynecol Oncol ; 73(1): 119-20, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10094891

RESUMEN

OBJECTIVE: The aim of this study was to determine the frequency of invasive cancer found from specimens removed by surgical excision on patients with diagnosis of VIN 3. METHODS: Seventy-eight patients with biopsy-proven vulvar intraepithelial neoplasia 3 (VIN 3) were treated by surgical excision. RESULTS: Sixteen patients (20.5%) were found to have invasion in the excised surgical specimen. Superficial invasion was seen in 7 patients (9%), 9 were noted to have >1 mm invasion (11.5%), and 1 patient had in situ Paget's disease (1.3%). CONCLUSION: Surgical excision should be considered a preferable method in management of patients with VIN 3.


Asunto(s)
Carcinoma in Situ/patología , Neoplasias de la Vulva/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma in Situ/epidemiología , Carcinoma in Situ/cirugía , Femenino , Humanos , Persona de Mediana Edad , Invasividad Neoplásica , Neoplasias de la Vulva/epidemiología , Neoplasias de la Vulva/cirugía
10.
Arch Pathol Lab Med ; 119(11): 1044-9, 1995 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-7487405

RESUMEN

OBJECTIVE: To report two cases of malignant mixed müllerian tumor of the extraovarian secondary müllerian system and to identify cases reported in the English literature. DESIGN: Two cases are described and discussed along with cases reported previously in the English literature. SETTING: The University of Cincinnati Medical Center. PATIENTS: (1) A 62-year-old woman with a bilateral ovarian poorly differentiated endometrioid adenocarcinoma with multiple peritoneal metastasis and a malignant mixed müllerian tumor with heterologous elements arising from the pelvic peritoneum. (2) An 83-year-old woman with a malignant mixed müllerian tumor with heterologous elements arising from the cecal peritoneum. RESULTS: Seventeen previously reported cases were identified in the English literature. CONCLUSIONS: The malignant mixed müllerian tumor of the extraovarian secondary müllerian system is a rare disease with only 17 cases reported to date to our knowledge. The prognosis is poor. Of 12 patients with follow-up information available, 10 died within 1 year and 2 within 2 years after diagnosis. The histogenesis of the tumor remains unclear; however, data exist that support transformation of epithelial neoplastic cells into sarcomatous cells (metaplastic theory) and origin from a single totipotential cell. It is possible that both situations may occur.


Asunto(s)
Neoplasias del Ciego/patología , Neoplasias de los Genitales Femeninos/patología , Tumor Mixto Maligno/patología , Tumor Mulleriano Mixto/patología , Neoplasias Peritoneales/patología , Adenocarcinoma/patología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Mesodermo/patología , Persona de Mediana Edad
11.
J Reprod Med ; 39(10): 777-80, 1994 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-7837123

RESUMEN

Seventy-seven women with subclinical cervicovaginal human papillomavirus (HPV) changes associated with cervical condylomata and/or mild or moderate cervical dysplasia were studied. All patients were treated with the CO2 laser for cervical lesions (condylomata and/or dysplasia) and, subsequently, based on their contraceptive history, were treated either with 5-fluorouracil (5-FU) cream or trichloroacetic acid (TCA). Those who did not wish to be treated were followed similarly to those who were treated. Overall there was no significant difference between those who had no treatment and those who received TCA or 5-FU. Those treated with 5-FU did more poorly as compared to the other two treatment groups with cervical condylomata and dysplasia at the three- and six-month follow-up (P < .05), and the results for TCA were not different from those in women who were observed and underwent no treatment. It appears that the treatment modalities used in this study did not have any beneficial effect on associated subclinical HPV infections.


Asunto(s)
Condiloma Acuminado/tratamiento farmacológico , Fluorouracilo/uso terapéutico , Enfermedades de los Genitales Femeninos/tratamiento farmacológico , Papillomaviridae , Infecciones por Papillomavirus/tratamiento farmacológico , Ácido Tricloroacético/uso terapéutico , Displasia del Cuello del Útero/tratamiento farmacológico , Adolescente , Adulto , Condiloma Acuminado/cirugía , Condiloma Acuminado/virología , Femenino , Enfermedades de los Genitales Femeninos/cirugía , Enfermedades de los Genitales Femeninos/virología , Humanos , Terapia por Láser , Persona de Mediana Edad , Infecciones por Papillomavirus/cirugía , Recurrencia , Resultado del Tratamiento , Displasia del Cuello del Útero/cirugía , Displasia del Cuello del Útero/virología
12.
J Soc Gynecol Investig ; 1(2): 173-7, 1994.
Artículo en Inglés | MEDLINE | ID: mdl-9419767

RESUMEN

OBJECTIVE: This study determined levels of cathepsin D activity in tissue components of normal human ovary to establish a basis for comparison with human ovarian adenocarcinomas. METHODS: Cathepsin D activity per mg tissue, per microgram protein, and per microgram DNA was determined in human ovarian tissues (cortex, follicle, corpus luteum, corpus albicans) from patients of various ages and during the menstrual cycle. Levels of cathepsin D activity were also determined in ovarian adenocarcinomas and other pathologic tissues. RESULTS: Cathepsin D levels (per mg tissue) were significantly greater (P < .001) in ovarian follicle and corpus luteum compared with cortex. Although there was not a clear correlation between enzyme activity in the cortex and day of the menstrual cycle or patient age, levels of enzyme activity appeared to decrease with each parameter. Cathepsin D levels per mg tissue in ovarian adenocarcinoma were 40% higher than in postmenopausal ovarian cortex, but the difference was not statistically significant. CONCLUSION: The diversity of cathepsin D levels in normal ovarian tissue compartments indicates that specific tissues must be used in comparisons with ovarian tumors.


Asunto(s)
Adenocarcinoma/química , Biomarcadores de Tumor/análisis , Catepsina D/análisis , Factores Inmunológicos/análisis , Neoplasias Ováricas/química , Ovario/química , Adulto , Anciano , Catepsina D/fisiología , Femenino , Humanos , Factores Inmunológicos/fisiología , Persona de Mediana Edad , Pronóstico
13.
Gynecol Oncol ; 52(3): 326-31, 1994 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-8157190

RESUMEN

From November 1983 to October 1992, 22 patients with invasive cervical cancer stage IB through stage IIIB with metastasis to para-aortic nodes were entered in this study. Five patients were excluded. Of 17 remaining evaluable patients, 5 (29%) were stage IB, 6 (35%) were stage IIB, and 6 (35%) were stage IIIB. Four (24%) had grade 1, 5 (29%) had grade 2, and 8 (47%) had grade 3 tumor. Lymph node metastases were microscopic in 8 (47%) and macroscopic in 9 (53%) patients. All patients received 2 courses of chemotherapy concomitant with radiation as a sensitizer. They were randomized to receive either cisplatin (regimen A) or combination of cisplatin with 5-FU infusion (regimen B). This was followed by maintenance chemotherapy with cisplatin for a maximum of 10 additional courses. Of 17 patients, 7 (41%) received 4-6 courses, 4 (24%) received 6-8 courses, and 6 (35%) received 8-10 courses of maintenance chemotherapy. For extended-field radiation, a panhandle technique was used. External radiation therapy was delivered via 10 or 18 MeV linear accelerator photons, followed by 1 or 2 intracavitary cesium applications. Patients were followed up 8-103 months (median 21 months). Progression-free interval (PFI) for all patients was 5-103 months (median 18 months). Patients with microscopic metastasis to para-aortic nodes had median PFI of 26.5 months compared to 14 months in those with macroscopic nodal metastasis. Seven of 17 patients (41%) are alive from 17 to 103 months with median survival of 32 months. Overall survival for the entire group was 8-103 months (median 21 months). Median survival for patients with microscopic and macroscopic nodal metastasis was 30 and 21 months, respectively. Two- and five-year survival for the entire group was 35 and 12%, respectively. The survival with microscopic metastasis to para-aortic nodes was 50 and 12% compared to survival of 22% at 2 years and 11% at 5 years respectively in those with macroscopic nodal metastasis. There was no significant difference between regimen A and B for local disease control. Maintenance chemotherapy with cisplatin did not appear to significantly improve the 5-year survival. Distant metastases were the predominant sites of failure.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias del Cuello Uterino/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/radioterapia , Cisplatino/administración & dosificación , Terapia Combinada , Femenino , Fluorouracilo/administración & dosificación , Estudios de Seguimiento , Humanos , Metástasis Linfática , Persona de Mediana Edad , Proyectos Piloto , Dosificación Radioterapéutica , Tasa de Supervivencia , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/radioterapia
14.
Int J Gynecol Cancer ; 4(1): 61-65, 1994 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11578386

RESUMEN

Twenty-two patients with invasive cervical cancer had ovarian transposition. Fifteen patients received whole pelvic external radiation therapy via a teletherapy unit, and nine patients also received one or two intracavitary insertions. Ovarian function was measured by serum gonadotropins, FSH, and LH. We were unable to measure gonadotropin levels in four patients because they were lost to follow-up after completion of radiation therapy. Five patients developed postmenopausal symptoms; in two the ovaries were not shielded and they received radiation by lateral ports with an average dose above 2500 cGY. Therefore, ovarian function was preserved in seven of 11 patients (64%), all of whom received

15.
J Urol ; 150(4): 1135-7, 1993 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-8371372

RESUMEN

Cystectomy remains one of the standard treatments for women with locally advanced (stage C) urethral cancer, or stage A or B lesions that have failed radiation therapy. Often, the urethral neoplasm does not invade the bladder. We treated 5 women with stage C urethral cancer by wide local excision with or without concomitant radiation therapy, while preserving the bladder. Local control was achieved in all patients with followup ranging from 4 to 75 months (median 42). We believe that bladder sparing treatment strategies should be considered for selected stage C tumors when the bladder is not invaded by the neoplasm.


Asunto(s)
Adenocarcinoma/cirugía , Carcinoma de Células Transicionales/cirugía , Uretra/cirugía , Neoplasias Uretrales/cirugía , Vejiga Urinaria , Adenocarcinoma/radioterapia , Anciano , Braquiterapia , Carcinoma de Células Transicionales/radioterapia , Terapia Combinada , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Uretrales/radioterapia
16.
Gynecol Oncol ; 46(1): 29-32, 1992 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-1634137

RESUMEN

Second-look laparotomy is performed to evaluate response to chemotherapy and to determine the need for additional treatment. The relationship between absolute levels of serum CA 125 less than 35 u/ml and disease status at second-look operation was evaluated in 95 patients with advanced-stage epithelial ovarian cancer. Eighty-six patients had Stage III disease and nine patients had Stage IV cancer. Residual tumor was documented at second-look laparotomy in 52 (55%) of the patients studied. Forty-nine percent of the 82 patients with serum CA 125 values less than 20 u/ml had residual disease. In contrast, 12 of 13 (92%) patients with serum CA 125 values of 20-35 u/ml had residual tumor at second-look laparotomy. All patients with serous cystadenocarcinomas and serum CA 125 values of 20-35 u/ml had residual tumor, and two-thirds of these cases had grossly visible disease. The positive predictive value of a serum CA 125 level of 20-35 u/ml was 0.92. These data suggest that second-look laparotomy should be deferred in patients with advanced-stage ovarian cancer until serum CA 125 values are less than 20 u/ml.


Asunto(s)
Antígenos de Carbohidratos Asociados a Tumores/sangre , Neoplasias Ováricas/cirugía , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Ováricas/sangre , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/patología , Valor Predictivo de las Pruebas , Pronóstico , Reoperación , Estudios Retrospectivos
17.
Gynecol Oncol ; 43(3): 237-41, 1991 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-1661262

RESUMEN

Records of 28 patients with invasive squamous cell carcinoma of the vulva were analyzed with regard to age-specific incidence rate, associated human papillomavirus (HPV) changes, multifocal and unifocal distribution of the lesions, and incidence of nodal metastasis. The presence of HPV changes (koilocytosis and condyloma) around the neoplastic epithelium correlated with a mean age group younger than that of those without HPV changes (47 vs 77 years). All multifocal cancers were associated with HPV changes while only 35% of unifocal lesions were so associated. Patients with multifocal disease were found to have a mean age younger than that of those with unifocal disease (44 vs. 67). When patients with microinvasion were excluded, no patients with multifocal invasive cancer and HPV changes were found to have nodal metastases. In contrast, nodal metastases were present in 59% of patients with unifocal invasive cancer.


Asunto(s)
Carcinoma de Células Escamosas/microbiología , Papiloma/microbiología , Papillomaviridae , Infecciones Tumorales por Virus/microbiología , Neoplasias de la Vulva/microbiología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Condiloma Acuminado/microbiología , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Persona de Mediana Edad , Papiloma/patología , Infecciones Tumorales por Virus/patología , Neoplasias de la Vulva/patología
18.
J Reprod Med ; 36(8): 619-21, 1991 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-1941806

RESUMEN

Adenocarcinoma developed in one horn of a bicornuate uterus. Making such a diagnosis is difficult, and hysteroscopy is helpful.


Asunto(s)
Adenocarcinoma/diagnóstico , Neoplasias Uterinas/diagnóstico , Útero/anomalías , Adenocarcinoma/complicaciones , Adenocarcinoma/terapia , Anciano , Terapia Combinada , Femenino , Humanos , Histerectomía , Ovariectomía , Radioterapia , Neoplasias Uterinas/complicaciones , Neoplasias Uterinas/terapia
19.
Gynecol Oncol ; 36(2): 192-9, 1990 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-2298409

RESUMEN

Clinical staging, tumor size, histologic differentiation, cytologic grading, depth of stromal invasion, and vascular channel involvement by tumor cells were studied in 42 patients with invasive squamous cell carcinoma of the vulva who were treated with radical vulvectomy and inguinal-femoral lymphadenectomy. All parameters were found to correlate well in predicting groin node metastasis. Cytological grading was found to be more significant compared to histologic grading in regard to nodal metastasis (P less than 0.02). No patient with cytologic or histologic grade 1 tumor and less than 5 mm stromal invasion was found to have nodal metastasis.


Asunto(s)
Carcinoma de Células Escamosas/patología , Neoplasias de la Vulva/patología , Adulto , Anciano , Anciano de 80 o más Años , Vasos Sanguíneos/patología , Femenino , Humanos , Ganglios Linfáticos/patología , Metástasis Linfática , Persona de Mediana Edad , Invasividad Neoplásica , Pronóstico
20.
Gynecol Oncol ; 35(3): 358-61, 1989 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-2599472

RESUMEN

A total of 108 patients with positive endocervical curettage who underwent cone biopsy were carefully examined to determine the accuracy of endocervical curettage (ECC) in predicting endocervical canal involvement with cervical intraepithelial neoplasia (CIN). The data suggest a 63% correlation between positive ECC and endocervical canal involvement: 72.4% of patients with CIN III on cervical biopsy had endocervical canal involvement compared to 27.3% who had CIN I. Two patients with positive ECC were found to have invasive cancer on cone biopsy.


Asunto(s)
Cuello del Útero/cirugía , Legrado , Neoplasias del Cuello Uterino/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cuello del Útero/patología , Epitelio/patología , Femenino , Humanos , Persona de Mediana Edad , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología
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