Cases reported "Carcinoma, Squamous Cell"

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1/56. Alternative medicine in gynecologic oncology: A case report.

    A patient with Stage IIB squamous cell cancer of the cervix presented 10 days into her primary radiation therapy with neutropenic fever and diarrhea requiring hospitalization and delay in treatment. The patient's history revealed extensive use of alternative therapies including potential toxic botanicals. This case raises the possibility that a patient's use of alternative therapies may have caused toxicity and delayed primary therapy. Gynecologic oncology patients may be using alternative therapies justifying the need for incorporating this classification into the historical exam.
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2/56. Laparoscopic port-site recurrence following surgery for a stage IB squamous cell carcinoma of the cervix with negative lymph nodes.

    BACKGROUND: Port-site metastases are commonly reported after laparoscopic surgery for ovarian cancer, but have also been reported in patients with cervical or endometrial cancer with positive lymph nodes. Recently, a case of port-site recurrence after laparoscopic surgery for a patient with node-negative early-stage adenocarcinoma of the cervix was reported. We report the first case of port-site metastasis in a patient with stage IB squamous cell carcinoma of the cervix with negative lymph nodes. CASE: A 31-year-old woman had a laparoscopy for pelvic pain. Under anesthesia, she was noted to have a grossly abnormal-looking cervix and a biopsy revealed squamous cell carcinoma. She was referred to a gynecological oncologist and underwent radical hysterectomy and pelvic lymph node dissection through a transverse lower abdominal incision 6 weeks later. Nineteen months postoperatively, she presented with a soft tissue mass in a suprapubic laparoscopic trocar site. CONCLUSION: It is postulated that cells dislodged at the time of cervical manipulation and biopsy may have passed through the fallopian tubes and implanted in the laparoscopic port site due to the "chimney effect" caused by the pneumoperitoneum.
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keywords = gynecologic
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3/56. Fatal recurrent ureteroarterial fistulas after exenteration for cervical cancer.

    BACKGROUND: Ureteroarterial fistula (UAF) is a rare occurrence. It can be difficult to diagnose with a high mortality. We report a case of a recurrent UAF. CASE: A 38-year-old women diagnosed with cervical cancer had undergone pelvic exenteration for severe radiation-induced necrosis with a vesicovaginal and rectovaginal fistula after primary radiation therapy. hemorrhage into the urinary tract necessitated surgical intervention and vascular repair with a femoral-femoral bypass. Although these measures were effective, the patient died 6 months later following an acute hemorrhage into her conduit. Arteriogram revealed a second UAF. CONCLUSION: When urinary tract bleeding occurs in patients previously diagnosed with a gynecologic malignancy and treated with radiation therapy and extensive surgery with urinary diversion, UAF should be considered in the differential diagnoses.
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4/56. 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.
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5/56. Cutaneous metastasis from carcinoma of the cervix at the drain site.

    BACKGROUND: Metastasis to the skin occurs rarely in gynecologic cancer, especially in cervical carcinoma. Although carcinoma of the cervix is the second to the fourth most common malignancy in women, cutaneous involvement originating from cervical cancer is particularly unusual, even in the terminal stage of the disease. CASE: We present a case of cervical cancer recurrence with skin metastasis. The extensive skin lesion on the abdominal wall occurred 4 years after radical surgery and postoperative radiotherapy. This was a biopsy-proven metastasis from the patient's primary cervical carcinoma. CONCLUSION: As far we know this is the second case (after Copas et al., Gynecol Oncol 1995;56:102-4) of skin and subcutaneous tissues metastasis from cervical carcinoma at the drain site. Palliative chemotherapy and radiotherapy have a useful role in controlling symptoms.
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6/56. 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.
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keywords = gynecologic
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7/56. Two cases of coincident carcinomas of the head and neck and the uterine cervix.

    BACKGROUND: Human papillomavirus (HPV) is an independent risk factor for select head and neck carcinomas and most uterine cervix carcinomas. We report two patients with synchronous diagnoses of cervical cancer and HPV-related head and neck cancer. CASE: One patient was a 53-year-old woman with regionally metastatic tonsillar carcinoma treated surgically and with adjuvant radiation. Abnormal vaginal bleeding developed. Gynecologic examination showed advanced cervical carcinoma. The other patient was a 78-year-old woman surgically treated for carcinoma of the left anterior nose. Five months later, symptoms of recurrent nasal carcinoma and concurrent vaginal bleeding developed. Gynecologic examination showed advanced cervical carcinoma. CONCLUSIONS: These cases of coincident tumors demonstrate possible systemic susceptibility to the carcinogenic effects of HPV. The common association of HPV with both uterine cervix cancers and select head and neck cancers should prompt early evaluation of gynecologic or upper aerodigestive tract symptoms for patients with known HPV-related cancers.
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8/56. anaphylaxis to cisplatin following nine previous uncomplicated cycles.

    anaphylaxis to cisplatin is an infrequent life-threatening complication which may occur even in patients who have received prior treatment with cisplatin. We report here a patient with carcinoma of the cervix with recurrent abdominal and thoracic disease who was previously treated with concurrent cisplatin and radiation for local control of pelvic disease. After nine previous uncomplicated cycles she developed severe anaphylaxis to cisplatin. The anaphylactic reaction was managed successfully with corticosteroids, nebulization with beta(2) agonists, and isotonic fluid support. With the extensive use of platinum-based chemotherapy regimens, either alone or in combination with radiation therapy in the management of gynecological malignancies, this uncommon complication should be kept in mind for early detection and successful management.
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keywords = gynecologic
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9/56. Uterine papillary serous carcinoma after pelvic radiation therapy for cancer of the cervix.

    The carcinogenic effect of ionising radiation in humans has well documented in both atomic bomb survivors and patients exposed to therapeutic radiation. patients irradiated for cancer of cervix have frequently been studied for the later development of secondary malignancies because treatment is relatively successful and many patients survive long enough to be at risk for late complications of radiotherapy. Most investigations have revealed an increased incidence of uterine sarcoma following pelvic radiation therapy for a variety of gynecologic disorders (Norris and Taylor, 1965; Fehr and Prem, 1974). Wagoner, in a review of over 1800 women treated with ionising radiation for invasive cervical cancer, reported a fourfold increase in risk for the later development of uterine sarcoma (Wagoner, 1984). In this paper we report the case of uterine papillary serous carcinoma 16 years after pelvic x-ray therapy for cervical cancer.
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10/56. Long-lasting complete remission of a patient with cervical cancer FIGO IVB treated by concomitant chemobrachyradiotherapy with ifosfamide and cisplatin and consolidation chemotherapy--a case report.

    The treatment of women with already metastasized cervical cancer at initial diagnosis represents a challenge to gynecologic oncologists. We report on a 63-year-old patient with locally advanced squamous cell carcinoma of the cervix uteri with an isolated metastasis to the left ovary. Following treatment with concomitant chemoradiotherapy with ifosfamide and cisplatin and three cycles of consolidation chemotherapy with the same drug combination a complete clinical remission could be documented. At present, 35 months after her disease was diagnosed, she is still without any evidence of disease. The very promising outcome of this patient might suggest that combined chemoradiation which is the standard treatment of locally advanced cervical cancer is justified as well in the metastatic setting, provided the metastatic lesion is covered within the usual radiation field.
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