1/13. Radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation and subsequent pregnancy in the treatment of early invasive cervical cancer.BACKGROUND: Recently, pregnancies in patients after radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy have been reported. Radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation has been previously described; however, subsequent outcome and pregnancy has not. methods: Three patients with cervical carcinoma, 1 with stage IA1 with lymph-vascular space invasion and 2 with stage IA2, were treated with radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation. RESULTS: All patients underwent the planned procedure with no significant intraoperative or postoperative complications. All patients had return to normal menstrual function. One patient had a successful pregnancy delivered at 39 weeks by cesarean section and is now subsequently pregnant with a second pregnancy. CONCLUSION: Radical abdominal trachelectomy is a technically feasible operation that uses operative techniques familiar to the American-trained gynecologic oncologist and results in wider parametrial resection than radical vaginal trachelectomy. In young patients desiring to retain fertility, successful pregnancies after radical abdominal trachelectomy are possible. Intraoperative and postoperative complications are likely to be lower with an abdominal versus a vaginal approach. Long-term survival of patients treated with radical trachelectomy for early invasive cervical cancer are yet to be determined.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
2/13. Primitive neuroectodermal tumor of the cervix: a clinicopathologic and immunohistochemical study of two cases.Two cases of primary primitive neuroectodermal tumors of the cervix are presented. The two female patients are 35 and 51 years of age who presented with abnormal uterine bleeding of several weeks' duration. On gynecologic examination, a mass in the cervical area was palpated and a biopsy was obtained. The initial biopsy was interpreted as possible small cell carcinoma in both women. A radical hysterectomy was performed in both patients. Grossly, in both cases, the uterine cervix showed an ill-defined tumor involving the ectocervix and endocervix, measuring 3.0 and 4.0 cm in greatest dimension, respectively, and showing areas of necrosis and hemorrhage. Histologic sections showed the presence of a malignant neoplasm arranged in cords and with a vague nesting pattern. Areas of hemorrhage and necrosis were also present. The neoplastic cells were characterized by having indistinct cell borders, small round to oval nuclei, and inconspicuous nucleoli. Mitotic figures were easily identified. In one patient, the tumor had metastasized to lymph nodes. Immunohistochemical studies revealed the neoplastic cells to be positive for antibodies for CD99 and focally for synaptophysin, while keratin, chromogranin, smooth muscle actin, desmin, and neurofilament protein were negative. Both patients received adjuvant chemotherapy and remain alive 5 and 18 months after initial diagnosis, respectively. The present cases highlight the importance of keeping primitive neuroectodermal tumors in the differential diagnosis of small cell neoplasms of the uterine cervix.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
3/13. Duodenal complications of gynecological malignancies.Isolated para-aortic lymph node metastasis leading to intestinal complications is uncommon and diagnosis may therefore be delayed. In the present report duodenal bleeding, obstruction and perforation due to isolated para-aortic lymph node metastasis from stage I uterine malignancies are described. knowledge of these potential problems may lead to early recognition and planning of treatment.- - - - - - - - - - ranking = 4keywords = gynecologic (Clic here for more details about this article) |
4/13. Management of advanced-stage primary carcinoma of the fallopian tube: case report and literature review.Primary carcinoma of the fallopian tube is a very unusual gynecologic malignancy that accounts for less than 1% of all malignancies of the female genitalia. A 55-year-old, gravida 7, para 3 woman presented with no gynecologic complaints other than backache. TVS demonstrated a 35 x 25 mm heterogeneous mass that was not clearly separated from the left ovary, and another 31 x 14 mm cystic septated lesion in the left ovary region. Pelvic MRI demonstrated a 35 x 35 x 20 mm left adnexal mass that enhanced with contrast and a neighboring tubular-cystic mass. Upper and lower gastrointestinal endoscopy revealed no malignancy. serum CA 125-level was merkedly elevated at 369 U/ml (normal < 35 U/ml). laparotomy revealed left hydrosalpinx and a papillary-fimbrial mass. Pelvic lymph node metastases were observed. Frozen-section analysis identified the mass as a serous adenocarcinoma. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, appendectomy, omentectomy, pelvic and para-aortic lymph node dissection, and peritoneal washing were performed. The definitive histopathological diagnosis was primary serous adenocarcinoma of the fallopian tube with six of 25 lymph node biopsies showing metastasis. Six cycles of paclitaxel (175 mg/m2) plus cisplatin (75 mg/m2) combinatin chemotherapy were administered with 3-week intervals between cycles. Second-look laparotomy was performed; there was no evidence of disease. At the time of writing 12 months after the second-look laparotomy, she was still disease-free.- - - - - - - - - - ranking = 2keywords = gynecologic (Clic here for more details about this article) |
5/13. Non-Hodgkin's lymphoma involving the uterine cervix after treatment for hodgkin disease.The occurrence of second malignancies is an important late event following the treatment of Hodgkin's disease (HD). Occurrence of a non-Hodgkin's lymphoma (NHL) involving the uterine cervix after treatment for HD has not been previously reported. We describe a rare case of a 34-year old woman, with NHL involving the uterine cervix 7.5 years after treatment for HD. The follow-up of patients treated for HD should also include regular gynecological evaluation. In cases of abnormal findings, accurate diagnosis can only be made histologically.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
6/13. Pitfalls in the sentinel lymph node procedure in vulvar cancer.OBJECTIVES: There is an increasing interest among gynecologic oncologists to implement the sentinel lymph node (SLN) procedure in vulvar cancer patients in clinical practice. However, the safety of this promising method of staging still has to be proven in a randomized trial. MATERIALS AND methods: Two vulvar cancer patients are reported to illustrate pitfalls in the sentinel lymph node procedure. RESULTS: The phenomena of bypassing the sentinel lymph node and confusion about the number of removed sentinel lymph nodes are presented and discussed. CONCLUSION: Gynecological oncologists who perform the sentinel lymph node procedure in vulvar cancer patients should perform this technique by following a strict protocol and within the protection of a clinical trial.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
7/13. Ectopic (pelvic) kidney mimicking bulky lymph nodes at pelvic lymphadenectomy.BACKGROUND: Ectopic (pelvic) kidney is the most common congenital renal anomaly with an incidence of 1 in 500 to 1 in 2000. A pelvic kidney can be encountered at pelvic or paraaortic lymphadenectomy. case reports: In two patients undergoing pelvic lymphadenectomy, lobulated tumors near the pelvic brim were initially interpreted as bulky lymph node conglomerates. Further dissection showed the ureter to originate from the masses, leading to a diagnosis of pelvic kidney. CONCLUSION: Pelvic kidneys mistaken for bulky lymph nodes are a potential intraoperative pitfall in patients with gynecologic malignancies. Keys to recognition include an index of suspicion, identifying the course of the ureter and origin of the renal vessels, and confirming absence of a kidney at the normal location.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
8/13. Claudication as a rare symptom of recurrent cervical carcinoma.diagnosis of recurrent cervical cancer can be very difficult in the heavily irradiated pelvis. sciatica and lymphedema are well-known symptoms of disease recurrent to the side wall. The isolated symptom of claudication is reported as an early sign of recurrence. Two patients are presented in whom claudication was the only early presenting symptom. This symptom in a patient with a history of a gynecologic malignancy should lead to an evaluation for recurrent cancer as well as the routine vascular studies.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
9/13. Benign glandular elements and decidual reaction in retroperitoneal lymph nodes.Among 70 patients with gynecologic malignancies who underwent surgical staging and pelvic and periaortic lymphadenectomy, five were found to have benign glandular and/or stromal elements in the retroperitoneal lymph nodes. In three instances, these were originally diagnosed as metastatic cancer. The literature on this subject is reviewed and its significance is discussed.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
10/13. Neoplastic and non-neoplastic mesothelial proliferations in pelvic lymph nodes.knowledge of gland-like inclusions in pelvic lymph nodes has existed since 1897. The histogeneses proposed to explain such alterations have included congenital rests, endometriosis, metastatic neoplasia, and mesothelial metaplasia. The correct interpretation of the lymph node involvement is important in order to institute appropriate therapy. In the present study, there were 12 examples of benign mesothelial inclusions found in routine sections from pelvic lymph nodes removed in the treatment of 337 cases of gynecologic cancer. In an additional 4 cases, an intraabdominal neoplasm was present. The variations in the histologic patterns are described as is the clinical course of the disease.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
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