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11/1600. Bilateral ureteric replacement with ileum.

    In connection with a report of a case, authors discuss in outline the possibilities of ureter replacement. If both the ureters are injured, they can be substituted with one single segment of the intestine, as it happened in their case. Authors raise the idea that a longer segment of the intestine used for substitution provides sufficient capacity and isoperistaltic function, and this may protect from the negative effects of possible vesicoileal reflux. In this case, the reflux does not spread to the kidneys even if the ureteroileal was not made with anti-reflux technique. ( info)

12/1600. Intra-abdominal angiosarcomatosis after radiotherapy.

    BACKGROUND: We report a case of a 61-year-old Japanese woman who developed intra-abdominal angiosarcomatosis 20 years after receiving radiotherapy for squamous cell carcinoma of the cervix. methods AND RESULTS: The surgically resected portion of the ileum showed diffuse proliferating angiosarcoma, with irregular channels lined by atypical vascular endothelial cells. Immunohistochemical studies showed that the tumour cells were positive for factor viii-related antigen and ulex europaeus agglutinin 1. At autopsy, the tumour had disseminated to the peritoneum and invaded into the right thoracic cavity. CONCLUSIONS: These findings were compatible with radiation-induced angiosarcomatosis. ( info)

13/1600. Cervical sarcoma botryoides. A case report.

    BACKGROUND: Sarcoma botryoides is a rare gynecologic malignancy. Reported treatment protocols range from localized resection of the tumor to radical surgery and adjuvant chemotherapy. Recently, limited excisional surgery combined with chemotherapy has contributed to excellent survival rates and preserved bladder and rectal function. CASE: We report a case of cervical sarcoma botryoides with minimal invasion. The patient had primary surgical treatment with complete resection of the tumor without adjuvant chemotherapy. Four months after surgery she presented with extensive metastatic retroperitoneal disease and died two weeks later. CONCLUSION: The clinical course of this patient suggests that complete surgical resection in cases of localized disease is not adequate therapy for sarcoma botryoides. Adjuvant chemotherapy should always be used, even at a very early stage. ( info)

14/1600. An unusual cervical carcinoma showing exception to epitheliotropism of human papillomavirus.

    Human papillomaviruses (HPV) infect epithelial tissues but have not been previously detected within mesenchymal cells. During a systematic investigation of FIGO stage Ib cervical cancers with colorimetric in situ hybridization, we detected HPV 16 dna within the stromal compartment of an unusual undifferentiated carcinoma. The mesenchymal nature of the HPV-containing cells was confirmed by immunohistochemistry and electron microscopy. No viral particles were identified. Sequencing the majority of the HPV 16 genome identified few changes from the revised reference clone; all previously reported in other HPV 16 variants. These viral changes are unlikely to explain the exceptional mesenchymal localization of the HPV 16 dna in this case. ( info)

15/1600. Pulmonary tumor embolism presenting as infarcts on computed tomography.

    Pulmonary tumor embolism is a rare cause of respiratory failure in patients with cancer and is only infrequently diagnosed during life. Chest radiographs are usually normal. Dilated and beaded peripheral pulmonary arteries may be present on computed tomography scans. The authors describe an unusual case of pulmonary tumor embolism presenting on computed tomography scans as bilateral, peripheral, wedge-shaped opacities. On autopsy, these opacities corresponded to areas of pulmonary infarction. ( info)

16/1600. Endometroid adenocarcinoma of the cervix in a 9-year-old girl.

    We present the first reported case of endometroid adenocarcinoma of the uterine cervix in a young girl. The differential diagnosis of a vaginal mass in this age group is usually rhabdomyosarcoma, although other, rarer tumours also occur. ( info)

17/1600. rhabdomyosarcoma (RMS) of the uterine cervix in two Ethiopian patients: case report.

    Most rhabdomyosarcomas (RMS) of the female genital tract occur in infants and young children as sarcoma botryoides. To our knowledge, RMS of the cervix has never been reported in ethiopia. Two patients with RMS of cervix in their second and third decades of life were seen in a short period of time span at Tikur Anbessa Hospital in the first half of 1996. Difficulties were encountered in reaching a diagnosis and appropriately managing the patients which necessitated the revision of previous biopsy result especially in the first patient. Both presented clinically with bloody vaginal discharge and cervical mass. RMS of the cervix deserves attention in a young patient with cervical mass and bloody vaginal discharge. The excised tissue should be subjected to histopathologic study. Treatment with polychemotherapy and/or radiation in addition to aggressive surgical approach should be made available to obtain good results. ( info)

18/1600. Papillary serous carcinoma of the cervix: ultrasonographic findings.

    BACKGROUND: Papillary serous carcinoma of the uterine cervix is a rare malignancy only recently described. Optimal treatment is unknown. CASE REPORT: A 65 year old white female, approximately 15 years postmenopausal, presented with a recent history of postmenopausal bleeding. Cervical cytology was negative for any abnormalities. ultrasonography of the pelvis revealed a thickened anterior endometrium with fluid present along with a papillary mass in the endocervix. hysteroscopy, dilatation and curettage revealed a low uterine segment mass consistent with a pathologic diagnosis of grade 2 endometrioid adenocarcinoma of the endometrium. A total abdominal hysterectomy, bilateral salpingo-oophorectomy and bilateral pelvic and paraaortic lymphadenectomy revealed a papillary serous carcinoma of the cervix metastatic to pelvic and paraaortic lymph nodes. CONCLUSION: Cervical papillary serous carcinoma can be discovered pre-operatively by ultrasonography. Because of its relatively recent description and relative rarity, optimal treatment is unknown. ( info)

19/1600. hematometra and extended vaginal haematoma after laser conization. A case report.

    A very rare case of haematometra and extended vaginal haematoma in a 53-year-old woman after laser conization is reported. The patient presented with amenorrhea and complete urinary retention. The possible pathogenesis of this complication is discussed. ultrasonography, combined with physical examination were very helpful in determining the diagnosis. Cervical dilation and protection of surrounding tissues from thermal damage is recommended during laser conization to avoid similar complications. ( info)

20/1600. Abnormal uterine bleeding as a presenting sign of metastases to the uterine corpus, cervix and vagina in a breast cancer patient on tamoxifen therapy.

    Metastases to the female genital tract from extragenital cancers are uncommon. The ovaries are most often affected with the breast and gastrointestinal tract being the most common sites of the primary malignancy. Metastases to the uterus from extragenital cancers are significantly rarer than metastases to the ovaries and in the majority of cases the ovaries are also involved. A case of metastases restricted to the uterine corpus, cervix and vagina from breast carcinoma, without involvement of the ovaries, is described. The patient who had been on tamoxifen therapy presented with postmenopausal bleeding. The diagnosis of uterine metastases was established during endometrial ablation and confirmed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. This case illustrates that abnormal uterine bleeding in a breast cancer patient, regardless of whether she is receiving or not receiving tamoxifen, should always alert the physician to consider the possibility of uterine metastases from breast carcinoma. ( info)
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