Cases reported "Vaginal Neoplasms"

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1/38. Primary squamous cell carcinoma in a patient with vaginal agenesis.

    BACKGROUND: The development of a carcinoma in a neovagina constructed in patients with congenital vaginal agenesis is rare. CASE: To our knowledge, this is the first report of a squamous cell carcinoma developing in a neovagina that had been constructed by a simple cleavage technique without tissue transplantation. The latency period between reconstruction and tumor diagnosis was 20 years, during which the patient regularly used a prosthesis. The most important observation during this time was the repeated formation of granulation tissue and chronic inflammatory pseudopolyps in the neovagina, which were removed by cauterization. Despite pre- and intraoperative irradiation and radical surgery followed by chemotherapy, the prognosis is poor. CONCLUSION: patients with neovaginas, whatever the construction technique, need to be followed up regularly, as mechanical irritation from a prosthesis can add to other cancer risk factors, such as viral infection. Furthermore, the absence of transplanted tissue does not seem to protect from the risk.
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2/38. Endometrial stromal sarcoma of the vagina.

    Endometrial stromal sarcoma is a rare tumor and has unique histopathologic features. Most tumors of this kind occur in the uterus; thus, the vagina is an extremely rare site. A 34-year-old woman presented with endometrial stromal sarcoma arising in the vagina. No correlative endometriosis was found. Because of the uncommon location, this tumor was differentiated from other more common neoplasms of the vagina, particularly embryonal rhabdomyosarcoma and other smooth muscle tumors. Although the pathogenesis of endometrial stromal tumors remains controversial, the most common theory of its origin is heterotopic Mullerian tissue such as endometriosis tissue. Primitive cells of the pelvis and retroperitoneum are an alternative possible origin for the tumor if endometriosis is not present. According to the literature, the tumor has a fairly good prognosis compared with other vaginal sarcomas. Surgery combined with adjuvant radiotherapy appears to be an adequate treatment.
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3/38. Vaginal metastasis of colon cancer.

    True vaginal metastases from colonic cancer are exceedingly rare. This often signals an ominous prognosis. More frequently the vagina is synchronously involved by direct contiguous spread from the colonic lesion. We present a case of sigmoid carcinoma with true metastasis to the vagina that was discovered after an interval of 3 weeks when vaginal discharge became evident. To our knowledge, there are only two other papers in the English language previously documenting this phenomenon.
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4/38. Primary vaginal melanoma and long-term survivors.

    Vaginal melanoma is a rare and highly malignant disease. This report describes the characteristics and clinical course of all patients treated at one institute (Northern Gynaecological Oncology Centre, UK) over the last 25 years. Of a total of nine patients identified with a primary malignant vaginal melanoma, only one patient survived for more than five years. A literature review revealed only 21 reported cases with a survival greater than five years. The most important factor for survival appears to be the tumour size. Treatment modality varied equally within the group of long-term survivors (27% radical surgery, 27% wide local excision, 27% radiotherapy, 14% wide local excision and radiotherapy, and 5% unknown therapy). The prognosis of patients with primary malignant melanoma is poor, regardless of primary therapy (conservative or radical). Conservative treatment and accurate investigation of every discoloured lesion is recommended.
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5/38. melanosis of the vagina. A case report.

    BACKGROUND: melanosis is a term given to lesions in which melanin pigment is confined to the basal layer of squamous epithelium and on visual inspection may have an appearance similar to that of malignant melanoma. Although relatively common in the oral and gastrointestinal tract, melanosis is an uncommon finding in the female genital tract and especially rare in the vagina; most reported cases have been vulvar. CASE: A 43-year-old, nulliparous woman was noted to have a pigmented lesion at the vaginal cuff during a routine annual examination one year after a hysterectomy. On physical examination, the lesion appeared as a coalescence of several small, pigmented areas at the cuff. On palpation the lesion was flat, having the contour of normal vaginal mucosa, and was not indurated or tender. A biopsy revealed vaginal melanosis. The patient was followed conservatively, with annual examinations, which documented no change in color, size or contour of the lesion. At this writing the patient is six years from presentation and doing well. CONCLUSION: Vaginal melanosis may be difficult to distinguish clinically from malignant melanoma but carries a much different prognosis. A biopsy of any pigmented lesion is always indicated prior to determining the need for therapy versus observation.
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6/38. The ultrastructural and immunohistochemical heterogeneity of CD-30-positive neoplasms: so-called anaplastic large cell Ki-1 lymphomas.

    Anaplastic large cell lymphoma (ALCL), also referred to as Ki-1 lymphomas, was first recognized as an entity with characteristic light microscopic appearance in 1985. This tumor is composed of variably cohesive cells, often with large, markedly atypical, and multinucleated cellular forms. The recognition of ALCL resulted from the development of a monoclonal antibody in Kiel, germany, named Ki-1, which was initially believed to be a putative marker for reed-sternberg cells. This antibody was later found to be specific against the epitope CD-30. Attempts to create strict criteria to preserve this neoplasm as a specific entity have undergone evolution. However, it is now clear that included in this group are a variety of pleomorphic neoplasms with CD-30 immunoreactivity. Some of these neoplasms are nonlymphoid and show marked heterogeneity in their immunohistochemical and ultrastructural profiles. This article aims to highlight the ultrastructural spectrum of neoplasms exhibiting CD-30 positivity that are within the spectrum of ALCL. It remains to be determined if there are subgroups of these CD-30-positive neoplasms that can be segregated on the basis of ultrastructural and immunohistochemical criteria with corresponding clinical correlates that may impact on their management, treatment, and prognosis. We review here the heterogeneity of CD-30-positive neoplasms (so-called anaplastic large cell Ki-1 lymphomas).
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7/38. Primary invasive vaginal cancer. Report of 12 cases.

    The aim of this study was to describe the clinical features, methods of treatment and results of treatment among patients with primary invasive cancer. Twelve women in whom primary invasive cancer of the vagina was diagnosed between 1996 and 2001 were studied. The mean age of women with primary invasive vaginal cancer was 70.1 years. Half of the patients had advanced stage carcinoma at the time of the diagnosis and 85% of patients had not had a Pap-smear in the last 15 years. Treatment consisted of radiotherapy or a combination of surgery and radiotherapy. Four patients out of six with advanced stage disease died in 30 months. In conclusion, the present study confirms that early detection of the disease could lead to more successful management and therefore better prognosis.
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8/38. Malignant melanoma of the vagina: report of two cases.

    Two rare cases of malignant melanoma, (one amelanotic) arising in the vagina in middle-aged group are being reported. Clinical, histopathological and immunohistochemical studies supported the diagnosis. The neoplasm is highly malignant & carries a poor prognosis.
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9/38. Primary malignant melanoma of the vagina. Poor response to radical surgery and adjuvant therapy.

    Primary malignant melanoma of the vagina is an extremely rare condition usually found in postmenopausal women. It has a poor prognosis associated with a high rate of recurrences and rare long-term survivorship. We describe a case and review the literature emphasizing the importance of prognostic factors and elective treatment.
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10/38. Vaginal malignant melanoma: a case report and literature review.

    Vaginal melanomas are rare genital malignancies occurring mainly in the 6th and 7th decades of life. In general, they have a worse prognosis than cutaneous melanomas. In the past, various treatment modalities have been recommended including radical pelvic surgery. However, the prognosis is poor in spite of such radical approaches. More recently, more conservative treatment in the form of wide local excision combined with adjuvant chemotherapy, high-dose radiotherapy, and immunotherapy seem to have promising results. We describe a patient with vaginal malignant melanoma treated with conservative local excision as well as adjuvant radiotherapy, chemotherapy, and interferon.
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