1/74. skin metastases of gynecologic adenocarcinomas affect serum levels of hCGbeta but not those of SCC antigen.Squamous cell carcinoma antigen (SCC-Ag) has been shown to be elevated in patients with epidermoid carcinoma of the cervix but also in patients with benign tumors of epithelial origin and in benign skin disorders. Elevated serum levels of the free beta subunit of human chorionic gonadotropin (hCGbeta) have been observed in patients with cancer of different types, and cancer aggressiveness is related to hCGbeta expression. Therefore, we expected that extensive metastatic skin dissemination of gynecologic malignancies would cause a rise in the serum levels of SCC-Ag and hCGbeta. The serum levels of SCC-Ag, hCGbeta and CA 125 were monitored in 2 patients with extensive skin dissemination of ovarian and endometrial adenocarcinoma. skin metastases had no effect on serum levels of SCC-Ag but they caused an increase in serum levels of hCGbeta. SCC-Ag is not a marker for metastatic skin lesions of gynecologic carcinomas of nonepidermoid origin. hCGbeta expression is associated with aggressiveness of cancer and may be a useful marker indicating therapy resistance.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/74. Clear-cell epithelioid leiomyoma of the round ligament.A case of clear-cell epithelioid leiomyoma of the round ligament in a 69-year-old woman is described. The neoplasm presented as a firm left inguinal mass. A preoperative computed tomography (CT) scan demonstrated an enhancing lesion extending extra-abdominally from the region of the external inguinal ring. The surgical resection specimen was tan-white, well-circumscribed, and measured 5.8 cm in maximum dimension. Microscopic examination revealed a well-demarcated neoplasm comprised of polygonal cells with abundant clear cytoplasm arranged in clusters and single files with abundant intervening hyalinized stroma. There was minimal nuclear atypia and mitotic figures were rare. periodic acid-Schiff with diastase demonstrated intracytoplasmic glycogen. Immunohistochemical stains for pan-actin, smooth muscle actin, desmin, bcl-2, and vimentin were positive in the tumor cells, whereas stains for CD34, carcinoembryonic antigen, cytokeratin, epithelial membrane antigen, S100 protein, and neurofilaments were negative. Electron microscopy demonstrated features of smooth muscle differentiation including longitudinally oriented fine filaments with focal condensations, pinocytotic activity, and subplasmalemmal densities. This case illustrates the ubiquitous distribution of epithelioid smooth muscle neoplasms and highlights the potential pitfalls for diagnosis when they occur in an unusual location.- - - - - - - - - - ranking = 0.60610917947987keywords = neoplasm (Clic here for more details about this article) |
3/74. Intravascular occlusive therapy: use of interventional radiology in cancer patients.Selective transcatheter intravascular occlusion in the treatment of cancer patients is a valuable extension of interventional diagnostic radiology. Intra-arterial embolization may be performed with various substances, including autologous clot, autologous subcutaneous tissue, Gelfoam, and stainless steel coil. Clinical applications in cancer patients include control of gastrointestinal and genitourinary hemorrhage, preoperative reduction of tumor vascularity, control of local symptoms, and therapeutic reduction of tumor bulk. The technique has been used for preoperative and palliative treatment of neoplasms of the head and neck, kidney, liver, spleen, and soft tissue and bone. Transcatheter intravascular occlusion should be performed only by radiologists experienced in angiographic techniques. Inadvertent occlusion of a normal vessel and thromboembolism are possible complications.- - - - - - - - - - ranking = 2.2156797936522keywords = cancer, neoplasm, spleen (Clic here for more details about this article) |
4/74. Cytology of clear cell carcinoma of the female genital tract in fine needle aspirates and ascites.OBJECTIVE: To define the cytomorphologic features of clear cell carcinoma (CCC) of the female genital tract. STUDY DESIGN: The study consisted of four CCCs of the female genital tract in which clinical and histologic confirmation had been done. Cytologic findings were evaluated with May-Grunwald-Giemsa (MGG) stain of three cases of fine needle aspiration (FNA) material and peritoneal fluid cytology. All the FNA materials were obtained from metastatic supraclavicular lymph nodes. RESULTS: We report here the cytomorphologic features of three FNA biopsies and peritoneal fluid cytology from four patients. Primary tumors from patients with aspiration material from supraclavicular lymph nodes were located in the ovary in two patients and vagina in one. The peritoneal fluid cytology was obtained from a patient with uterine cervical tumor. Cytologic findings were similar in all preparations. The cells had abundant, pale, finely vacuolated cytoplasm with indistinct cytoplasmic membranes. The nuclei were round to oval, with fine chromatin. The characteristic feature of CCC of the genital tract was basement membrane-like substance. This hyaline extracellular material stained pinkish to purple-red in MGG preparations and was frequently observed within the cancer cell clusters. In ascitic fluid, psammoma bodies were also observed. CONCLUSION: The cytomorphologic characteristics of CCC of the genital tract are distinctive, and the entity may easily be diagnosed even at metastatic locations.- - - - - - - - - - ranking = 0.33333333333333keywords = cancer (Clic here for more details about this article) |
5/74. Chronic administration of single-agent paclitaxel in gynecologic malignancies.OBJECTIVE: There are currently limited published data available on the safety and feasibility of the prolonged administration of paclitaxel. The goal of this study was to review the cumulative toxicity associated with the continuous long-term administration of this agent to women with gynecologic cancers. methods: Eleven patients with gynecologic malignancies of varying histologic subtypes who received >15 consecutive courses of paclitaxel were identified in a retrospective review of individuals treated between 1994 and 1999 in the Gynecologic Oncology Program of the Cleveland Clinic Taussig Cancer Center. The analysis excluded paclitaxel delivered as a component of an initial chemotherapy regimen for the cancer. paclitaxel was administered at doses ranging from 80 to 175 mg/m(2) every 3-4 weeks as a 3-h infusion. RESULTS: In general, the patients included in this report were heavily pretreated and were continued on therapy either as a result of documentation of an objective response or with evidence of stabilization of disease (e.g., physical examination, radiographic evaluation, ca-125 antigen level) and the maintenance of a satisfactory quality of life. In the 11 patients, the median duration of therapy was 20 cycles (range: 16-36 cycles). alopecia was observed in all patients. A single patient experienced grade 3 anemia and grade 4 neutropenia. Of note, there was 1 case of grade 2 and no cases of grade 3 peripheral neuropathy in this population. CONCLUSION: Prolonged delivery of paclitaxel for >15 consecutive cycles can be safely administered to carefully selected patients with persistent or recurrent advanced gynecologic cancers.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
6/74. Hereditary nonpolyposis colorectal cancer with gynecologic malignancies: report of two families in taiwan.Hereditary nonpolyposis colon cancer (HNPCC), also known as Lynch syndrome, is characterized by germline and somatic mutations of dna mismatch repair genes with dominant inheritance of site-specific colorectal cancer or colorectal cancer plus cancers of extracolonic sites. We describe two Taiwanese HNPCC families with members who had predominantly gynecologic malignancies. In one family, the 53-year-old proband was found to have five synchronous and metachronous tumors of the genitourinary system, which included endometrial adenocarcinoma, cervical squamous cell carcinoma, ureteral and bladder transitional cell carcinoma, and ovarian teratoma. Fourteen of her first- and second-degree relatives were victims of genitourinary and gastrointestinal malignancies. The other family was characterized by four sisters who developed endometrial adenocarcinomas at young ages (36-42 yr). Their father died of both stomach cancer and colon cancer at age 47. The diagnosis of HNPCC was confirmed in this family by genetic analysis. A heterozygous germline mutation (G5 to G6 frame-shift at 183-187) of the hMSH2 (human MutS homolog 2) gene was identified in white blood cells of all the affected family members. The frequent presentation of genitourinary cancers in HNPCC highlights the importance of family-history taking in patients with gynecologic cancers and a genetic diagnosis of HNPCC.- - - - - - - - - - ranking = 4keywords = cancer (Clic here for more details about this article) |
7/74. Simultaneous squamous cell carcinomas of the uterine cervix and upper genital tract: loss of heterozygosity analysis demonstrates clonal neoplasms of cervical origin.Five cases of cervical squamous cell carcinoma with synchronous superficial squamous cell carcinoma in the upper genital tract were genetically analyzed to demonstrate the possibility of a clonal neoplastic process. In these cases, the cervical lesions were squamous cell carcinoma in situ (cases 1, 2, and 3) and invasive squamous cell carcinoma (cases 4 and 5). loss of heterozygosity (LOH) analyses with a panel of microsatellite markers revealed a monoclonal process in four of the five cases. Homogeneous LOH throughout the microdissected lesions was most frequently detected on 6p and 6q (3 cases), followed by 11p and 11q (2 cases), loci known to be commonly lost in typical cervical squamous cell carcinoma. In two cases, genetic progression in terms of additional LOH was found in the upper genital tract but not in the cervix. Most of these squamous cell carcinomas were monoclonal neoplasms originating from the cervical mucosa with subsequent superficial migration of the tumor clone to the upper genital mucosa, and in some cases, genetic progression.- - - - - - - - - - ranking = 1.0101819657998keywords = neoplasm (Clic here for more details about this article) |
8/74. Large pelvic accessory spleen mimicking an adnexal malignancy in a teenage girl.A large pelvic accessory spleen in a teenage female is rare and may be misdiagnosed as an adnexal tumor. A 17-year-old girl, gravida 0, had suffered from intermittent and dull pain in the lower abdomen for 1 month. Laboratory evaluation showed a low platelet count (136,000/microL). Abdominal sonography showed a large solid mass situated at the right pelvis, containing abundant vascular supply with low resistant blood flow. At laparotomy, an accessory spleen fed by a tortuous vascular pedicle from the omentum was found and then excised. Histopathologic examination revealed congestive accessory splenomegaly. Follow-up platelet count returned to normal levels (374,000/microL). The importance of including accessory spleen in the differential diagnosis of a solid adnexal tumor with thrombocytopenia is emphasized.- - - - - - - - - - ranking = 0.095503803445933keywords = spleen (Clic here for more details about this article) |
9/74. The nature of tamoxifen action in the control of female breast cancer.tamoxifen, now in use in the breast cancer clinic worldwide, was a study subject of controversy showing an estrogenic property on one occasion and an anti-estrogenic property on another occasion. The outcomes of 4 case-control studies of tamoxifen use were disclosed through 4 publications in 1998. The contents of these reports were intriguing, not only to surgeons of breast cancer clinics, but also to researchers of oncological science in general. The results of 4 research groups, being compatible with each other, were summarized in succession as follows: a) long-term use of tamoxifen reduced the occurrence of estrogen receptor (ER)-positive tumors by 69%, but no difference in the occurrence of ER(-) tumors was seen; b) the incidence of endometrial cancer was increased in the tamoxifen group; c) in women who did not have breast cancer and who had had a hysterectomy, there was no difference of breast cancer occurrence between the placebo- and tamoxifen-arms. Nevertheless, there was a statistically significant reduction of breast cancer among women receiving tamoxifen who also used hormone-replacement therapy during the trial; d) there was also no case-control difference of breast cancer occurrence between tamoxifen- and placebo-groups, when tested in a healthy population with a strong family history; e) the beneficial effect of long term use of tamoxifen in patients with early breast cancer, as assessed in terms of recurrence reduction, survival improvement and suppression of a contralateral tumor growth, was restricted to ER( ) patients; f) there was a positive correlation between the duration of tamoxifen use and the occurrence of endometrial cancer. All these observations provide strong support to the concept of the steroid criminal theory of human carcinogenesis in general. On the basis of both tamoxifen data and other information surrounding the hormonal aspect of human carcinogenesis of multiple tumors including breast cancer, we propose that the steroid generating system, as linked to the ever changing environment, plays a cardinal role as the transmitter of steroidal signals that can be taken as a "go" sign by the local oncogene-tumor suppressor gene complex of one target tissue and as a "stop" sign by that of another target tissue. The fitness of the tamoxifen data to the steroid carcinogenesis concept was discussed in the light of experimental pathology of chemical carcinogens, including the mammocarcinogen 7,12-dimethyl-benz(a)anthracene.- - - - - - - - - - ranking = 4.6666666666667keywords = cancer (Clic here for more details about this article) |
10/74. disseminated intravascular coagulation in gynecologic cancer.Disturbances in the blood coagulation mechanism are seen by the obstetrician and gynecologist as rare complications of abruptio placentae, retained dead fetus syndrome, amniotic fluid embolism, toxemia, saline amnioinfusion, and septic abortion. Two cases of disseminated intravascular coagulation complicating gynecologic malignancy are presented. Laboratory studies showed thrombocytopenia, hypofibrinogenemia, and increased fibrin degradation products. Derangements of hemostasis in patients with malignancy are discussed from a clinical viewpoint.- - - - - - - - - - ranking = 1.3333333333333keywords = cancer (Clic here for more details about this article) |
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