Cases reported "Vaginal Neoplasms"

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11/98. Spontaneous regression of metastatic endometrial stromal sarcoma.

    Spontaneous regression of malignancy is rare and there appear to be no reports of spontaneous regression of endometrial stromal sarcoma. We report a rare case of metastatic endometrial stromal sarcoma that regressed spontaneously. A 58-year-old woman was admitted to hospital in January 1996 when her chest radiograph showed multiple nodular shadows in the left lower lung field. Computed tomography of the chest revealed bilateral nodules. Segmentectomy of the left lower lobe was performed by thoracoscopy. She had a past history of uterine myoma with metrorrhagia for which she had undergone a hystero-oophorectomy 10 years earlier. She also had a vaginal polyp removed 1 year earlier. The lung pathology was studied and the surgical specimens of the uterus and vagina were re-examined. The diagnosis was endometrial stromal sarcoma primarily arising in the uterus. The vaginal polyp and the pulmonary nodules were considered to be metastases. Samples of lung and vaginal tissues were positive for both estrogen and progesterone receptors. The patient was discharged without treatment in February 1996 and followed up in the outpatient clinic. The tumor shadow measuring 2 mm in diameter on admission was enlarged to 4 mm in diameter 1 year later. Surprisingly, spontaneous regression of the lung disease occurred at 33 months, the tumor size decreasing to 2 mm in diameter and to 1 mm at 46 months. No evidence of tumor enlargement was detected at the last follow-up in July 2001. Although the precise mechanism of tumor regression is unknown, metastatic endometrial stromal sarcoma may spontaneously regress.
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ranking = 1
keywords = sarcoma
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12/98. Bleeding from endometrial and vaginal malignant tumors treated with activated recombinant factor VII.

    The authors report two cases of successful employment of human recombinant activated factor VII in gynecological oncological patients (endometrial cancer and vaginal sarcoma) without pre-existing coagulopathy. They conclude that recombinant factor viia may be an important and effective drug in severe bleeding in gynecological oncology.
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ranking = 0.125
keywords = sarcoma
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13/98. Demonstration of human herpesvirus 8 in a case of primary vaginal epithelioid angiosarcoma by in situ hybridization, electron microscopy, and polymerase chain reaction.

    We demonstrate the presence of human herpesvirsus 8 (HHV-8) in a primary vaginal location of angiosarcoma (AS) by polymerase chain reaction (PCR), in situ hybridization, and ultrastructural direct visualization of viral particles. The latter two techniques for the first time confirm HHV-8 detection in an AS by PCR; these results contribute to the debate caused by the controversial data produced by the almost exclusive use of PCR for investigating the possible presence of HHV-8 in AS, and its possible implications. Moreover, the investigated AS is the seventh published primary vaginal one, and the fourth unrelated to radiotherapy. Interestingly, the affected patient had used a ring pessary for 10 years because of an uterovaginal prolapse.
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ranking = 0.625
keywords = sarcoma
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14/98. The first report of extraosseous Ewing's sarcoma in the rectovaginal septum.

    AIMS AND BACKGROUND: To report an extremely rare case of Ewing's sarcoma located in the rectovaginal septum. Ewing's sarcoma is a highly malignant neoplasm of bone, which usually occurs during childhood. Common extraosseous localizations of Ewing's sarcoma include the trunk, extremities, uterus, cervix and vagina. methods: A 45-year-old woman presented to us with a six-month history of pain in the lower abdomen during intercourse. Pelvic examination was performed and a palpable mass was found. The mass had a size of 9 x 6 cm, a soft tissue consistency, was partially movable and the patient felt the pain during palpation. Examination of the inguinal lymph nodes revealed no signs of inguinal adenopathy. The results of laboratory tests, rectoscopy, chest x-rays, barium enema and bone scan were normal. Computed tomography (CT) showed an inhomogeneous expansive mass in the rectovaginal septum measuring 8.7 x 6.1 cm, without any signs of rectum or bladder invasion. The vascular structures of the pelvis were normal. At laparotomy the process was judged inoperable and only biopsy of the tumor mass was carried out. histology showed a neoplasm with small, round to oval cells with scarce cytoplasm. Immunohistology with the monoclonal antibody CD99 (MIC-2 gene product, Ewing's sarcoma marker, clone 12E7, DAKO A/S, Glostrup, denmark) revealed an extraosseous Ewing's sarcoma. The patient was treated with chemotherapy followed by whole-pelvis external beam radiation and intracavitary brachytherapy. RESULTS: A residual mass measuring 3.5 x 2.5 cm was visible on a control CT scan 18 months after treatment; however, the patient was feeling well and refused surgery to remove the residual mass. CONCLUSIONS: To our knowledge this is the first reported case of extraosseous Ewing's sarcoma in the rectovaginal septum.
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ranking = 1.25
keywords = sarcoma
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15/98. Combined therapy to prevent complete pelvic exenteration for rhabdomyosarcoma of the vagina or uterus.

    Three children with rhabdomyosarcoma (sarcoma botryoides) of the vagina or uterus were managed by modified radical resection combined with pre- and/or postoperative chemotherapy and high-dose irradiation. This plan of therapy contrasts sharply with the conventional approach: i.e., pelvic exenteration consisting of cystectomy, hystovaginectomy, and oophorectomy, with urinary diversion by ureteroileostomy or ureterosigmoidostomy. Two patients had complete regressions of tumor following preoperative chemotherapy and irradiation. The third patient received no preoperative therapy, but was given postoperative radium implantation, irradiation, and chemotherapy. The surgical approach consisted of hystovaginectomy and oophorectomy without urinary diversion. These patients are free of tumor for 32, 44, and 54 months, respectively. There were no serious toxic reactions to the drugs, nor any significant postoperative urinary tract problems. The results reported here suggest that hystovaginectomy and oophorectomy coordinated with chemotherapy and irradiation is an acceptable alternative to pelvic exenteration in patients with sarcoma botryoides of the vagina or uterus.
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ranking = 0.875
keywords = sarcoma
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16/98. Primary carcinosarcoma of the vagina.

    Primary carcinosarcoma of the vagina is a very rare tumor, with only eight cases diagnosed as carcinosarcoma in the literature that we are aware of. We recently encountered a case of primary carcinosarcoma of the vagina in a 75-year-old woman. The patient had a history of hysterectomy and bilateral ovariectomy for uterine corpus cancer at 55 years of age. recurrence of the cancer was suspected 17 years after the operation and irradiation therapy was performed, but the patient died 3 years after the recurrence. autopsy revealed a mass lesion in the pelvic cavity that originated in the vagina. Histological examination showed that the tumor contained anaplastic carcinoma, rhabdomyosarcoma, leiomyosarcoma and chondrosarcoma components, and it was diagnosed as carcinosarcoma. The histological diagnosis of the uterine corpus cancer was well-differentiated adenocarcinoma, and there was no sarcomatous component. The carcinosarcoma occurred 17 years after the hysterectomy, and it was concluded to be a primary carcinosarcoma of the vagina. This is the first case of primary vaginal carcinosarcoma in which the epithelial and sarcomatous components were clearly identified histologically and immunohistochemically.
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ranking = 2
keywords = sarcoma
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17/98. Non-puerperal uterine inversion in association with uterine sarcoma: clinical management.

    Non-puerperal uterine inversion due to uterine sarcoma is a rare entity often diagnosed at the time of surgery. patients may present with pelvic pain, vaginal discharge, or hemodynamic shock. Clinically, the diagnosis may be suspected if there is a large vaginal mass and difficulty in palpating the cervix. Four surgical procedures have been described to manage non-puerperal uterine inversion, two by the abdominal route and two by the vaginal route. The Haultain procedure performed abdominally is preferred for uterine sarcomas as it facilitates reversion of the uterus vaginally or excision of the pedicle and removal of the prolapsed tumor vaginally. We describe a patient with this condition managed by the Haultain procedure.
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ranking = 0.75
keywords = sarcoma
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18/98. Vaginoscopic resection for rhabdomyosarcoma of the vagina: a case report and review of the literature.

    rhabdomyosarcoma is the most common soft-tissue sarcoma found in children. Genitourinary sites comprise 20% of the primary location of these tumors. A polypoid form of the embryonal type of rhabdomyosarcoma, sarcoma botyroides, is often found in girls under age 5. These tumors are usually localized to the anterior vaginal wall. Their superficial location and clinical symptoms lead to early diagnosis, and these tumors are therefore considered to be the easiest to treat and most likely to be cured. In the past 30 years we have seen a shift in treatment from radical surgery to conservative surgery with chemotherapy and radiation, with improved survival and preservation of normal anatomy and improved postoperative body imagery. Conservative excision in the past has been performed by sharp curettage of the anterior vaginal wall. We present a case of a 2-yr-old child with a RMS of the vagina for which we utilized vaginoscopy not only to determine the extent of the tumor but also for precise resection using a bipolar electrode with normal saline as the distension medium.
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ranking = 1
keywords = sarcoma
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19/98. Mullerian adenosarcoma of vagina arising in persistent endometriosis: report of a case and review of the literature.

    BACKGROUND: Primary adenosarcoma arising in vaginal endometriosis poses a diagnostic challenge, especially in superficial vaginal biopsies. CASE: A 56-year-old woman, with a prior diagnosis of ovarian endometriosis, presented with a rapidly enlarging mass of the vaginal vault. Two prior biopsies were benign and showed endometriosis. The third vaginal biopsy revealed benign endometriotic glands cuffed by a cellular stroma with moderate cytologic atypia, a histological appearance diagnostic of Mullerian adenosarcoma. A 16-cm vaginal mass that had infiltrated the pelvic structures was resected. CONCLUSIONS: Close clinical follow-up of extrauterine endometriosis and clinical-pathologic correlation is necessary. Histological features such as cellular stromal cuffing around benign endometriotic glands are critical in arriving at a timely diagnosis of adenosarcoma in patients with persistent extrauterine endometriosis, even in superficial vaginal biopsies.
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ranking = 0.875
keywords = sarcoma
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20/98. Vaginal metastasis from uterine leiomyosarcoma. magnetic resonance imaging features with pathological correlation.

    Vaginal metastases, though more frequent than primary vaginal tumors, are rare. Except for isolated reports of metastatic disease arising from extragenital organs, the vagina is typically a site for metastatic disease from genitourinary tract sites, especially cervix, endometrium, and kidney. We present herein a case of a 68-year-old woman presenting with a vaginal metastasis as the first manifestation of a uterine leiomyosarcoma. The magnetic resonance imaging features are described and correlated with the pathological findings. To the best of our knowledge, this is the first case of vaginal metastasis from uterine leiomyosarcoma described in the literature.
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ranking = 0.75
keywords = sarcoma
(Clic here for more details about this article)
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