International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
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Int. J. Gynecol. Cancer · May 2006
Case ReportsIntravascular leiomyomatosis and benign metastasizing leiomyoma: an unusual case.
Benign metastasizing leiomyoma (BML) and intravascular leiomyomatosis (IVL) are rare variants of uterine leiomyomas. In our search of available literature, there have been only two reports of these conditions occurring in the same patient. We report a case of a 42-year-old female presenting with a left L4 nerve root lesion, left paravesical lesion, left ovarian cyst, multiple pulmonary metastases, and an intracaval lesion. ⋯ The remaining tumor was treated with a gonadotrophin-releasing hormone agonist, resulting in significant reductions in tumor size. It was concluded that the lesions in the lungs were an example of BML arising from the initial diagnosis of uterine leiomyoma, and the caval lesion was an IVL. Long-term follow-up is recommended, and familiarity with rare forms of benign smooth muscle uterine tumors is essential in avoiding misdiagnosis and overtreatment.
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Int. J. Gynecol. Cancer · May 2006
High-dose rate brachytherapy in the treatment of carcinoma of uterine cervix: twenty-year experience with cobalt after-loading system.
This retrospective analysis aims to report results of patients with cancer of uterine cervix treated with external-beam radiotherapy (EBR) and high-dose rate (HDR) brachytherapy, using manual treatment planning. From 1975 to 1995, 237 patients with FIGO stages IIB-IVA and mean age of 54.31 years were treated. EBR dose to the whole pelvis was 50 Gy in 25 fractions. ⋯ No treatment-related mortality was seen. This series suggests that 50 Gy to the whole pelvis together with three fractions of 10 Gy to point A with HDR brachytherapy is an effective fractionation schedule in the treatment of locally advanced cancer of cervix. To decrease the complications, newer devices and treatment planning may be beneficial.
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Int. J. Gynecol. Cancer · Jan 2006
Review Case ReportsLarge-cell neuroendocrine carcinoma of the cervix associated with cervical-type invasive adenocarcinoma: a report of case and discussion of histogenesis.
A case of cervical large-cell neuroendocrine carcinoma with mucinous-type cervical adenocarcinoma component adjacent to it is presented, and its histopathogenesis and clinical course are discussed under the light of the literature.
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Int. J. Gynecol. Cancer · Jan 2006
Comparative StudyRoutine computerized tomography scanning, groin ultrasound with or without fine needle aspiration cytology in the surgical management of primary squamous cell carcinoma of the vulva.
We set out to study whether computerized tomography (CT) scanning of the vulva and the groin and groin ultrasound scanning (USS) alone or with fine needle aspiration cytology (FNAC) (USS/FNAC) influenced or could influence the surgical management of primary squamous cell carcinoma of the vulva (SCCaV). Forty-four patients underwent surgery for primary SCCaV following radiologic imaging by one or more modalities. Patient details included the clinical assessment of the carcinoma, radiologic findings, the operation performed, and whether the decision regarding the type and extent of surgery for the vulval carcinoma and, in particular, for the groin node dissection was or could be influenced by the radiologic findings. ⋯ The data do not support the routine use of CT scanning in patients with primary SCCaV, either in assessment of the primary vulval carcinoma or in detecting groin nodal metastases. For the groin nodes, USS/FNAC is superior to CT in assessing disease status. In contrast to CT, USS/FNAC may have a useful clinical role in the management of the groin nodes in vulval carcinoma.
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Int. J. Gynecol. Cancer · Jan 2006
Insulin-like growth factor-1 genotype predicts breast volume after pregnancy and hormonal contraception and is associated with circulating insulin-like growth factor-1 levels: implications for risk of early-onset breast cancer in young women from hereditary breast cancer families.
BRCA1/2 mutations predispose to early-onset breast cancer, especially after oral contraceptive (OC) use and pregnancy. However, the majority of breast cancers might be due to more prevalent low penetrance genes that may also modify the risk in BRCA1/2 mutation carriers. The absence of the IGF1 19-CA repeat allele has been associated with high insulin-like growth factor-1 (IGF-1) levels during OC use in nulliparous women of four different ethnic groups. High IGF-1 levels are linked to an increased risk of early-onset breast cancer and to larger breast volumes in the general population. It has also been hypothesized that women whose breast size increases while exposed to OCs may be at increased risk of future breast cancer. ⋯ Our results suggest that absence of the IGF1 19-CA repeat allele modifies IGF-1 levels, breast volume, and possibly early-onset breast cancer risk after hormone exposure in young, high-risk women. These results warrant confirmation in a larger prospective cohort of high-risk women. If confirmed, the IGF1 genotype could be incorporated as an additional marker to improve risk estimates for early-onset breast cancer during genetic counseling of women from high-risk breast cancer families.