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Brachytherapy 2022The aim of the study was to compare the dose to vaginal points between two intracavitary applicators used for HDR brachytherapy in Carcinoma Cervix METHODS AND... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The aim of the study was to compare the dose to vaginal points between two intracavitary applicators used for HDR brachytherapy in Carcinoma Cervix METHODS AND MATERIALS: Patients reporting to our center for Carcinoma cervix intracavitary brachytherapy were randomly allocated to treatment with either Manchester or Fletcher Suit Delclos (FSD) applicator. All patients received an EBRT dose of 50 Gy in 25 fractions along with weekly Cisplatin (40 mg/m). Brachytherapy was administered using CT based planning. All patients received a dose of 7 Gy to Point A one week apart for a total of three fractions. For vaginal dose reporting, the PIBS points (PIBS, PIBS+1, PIBS+2, PIBS-1, PIBS-2) and dose to vagina at the level of ovoids was compared between the two applicators RESULTS: A total of 30 Carcinoma cervix patients were randomly allocated to receive intracavitary brachytherapy with either Manchester or FSD applicator. The mean vaginal reference length for patients treated with Manchester applicator was 4.3 and for patients treated with FSD applicator was 4.4. On analyzing dose to different vaginal points, patients treated with Manchester applicator received significantly higher mean and median doses to all PIBS points (except PIBS-2 cm) as compared to FSD applicator. On analyzing dose to the upper vagina at the level of the ovoids, the Manchester applicator delivered higher antero-posterior doses as compared to FSD applicator.
CONCLUSIONS
Manchester applicator gives higher dose to the vagina as compared to FSD applicator for intracavitary brachytherapy in Carcinoma Cervix. The choice of using a particular applicator depends on the residual disease at the time of brachytherapy and patient anatomy.
Topics: Brachytherapy; Carcinoma; Cervix Uteri; Female; Humans; Radiotherapy Dosage; Uterine Cervical Neoplasms; Vagina
PubMed: 34756698
DOI: 10.1016/j.brachy.2021.09.004 -
Applied Immunohistochemistry &... Apr 2019This is a case of a 62-year-old woman with a remote history of acinic cell carcinoma of the parotid gland, who presented with a palpable vaginal mass, anterior vaginal...
This is a case of a 62-year-old woman with a remote history of acinic cell carcinoma of the parotid gland, who presented with a palpable vaginal mass, anterior vaginal wall prolapse, and stress urinary incontinence. A 2 cm firm mobile mass on the anterior vaginal wall was found on clinical examination. A computed tomographic scan revealed a mass between the vaginal vault and bladder that was eventually surgically excised. The histology, supported by the immunohistochemistry, revealed metastatic acinic cell carcinoma to the vagina after 37 years of her initial diagnosis. This is the first reported case in the literature to occur in the vagina.
Topics: Carcinoma, Acinar Cell; Female; Humans; Immunohistochemistry; Middle Aged; Neoplasm Metastasis; Parotid Neoplasms; Tomography, X-Ray Computed; Uterine Prolapse; Vagina; Vaginal Neoplasms
PubMed: 28800013
DOI: 10.1097/PAI.0000000000000570 -
Obstetrics and Gynecology Sep 1975A retrospective study has been carried out on 25 patients treated at the University of Michigan Medical Center for carcinoma in situ of the vagina. Intraepithelial...
A retrospective study has been carried out on 25 patients treated at the University of Michigan Medical Center for carcinoma in situ of the vagina. Intraepithelial carcinoma of the vagina occurred as a primary entity, following treatment for preinvasive and invasive carcinoma of the cervix, and following hysterectomy for benign disease of the uterus. These patients were treated with either radium implantation or some form of surgery. Five patients had recurrences. These 5 were all subsequently retreated and are alive and without evidence of further recurrent neoplasm. This series of carcinoma in situ of the vagina is compared to other reported series. Emphasis is directed toward the need for continued use of Papanicolaou smear cytology tests in posthysterectomy patients, regardless of the reason for hysterectomy.
Topics: Adult; Age Factors; Aged; Biopsy; Bowen's Disease; Carcinoma in Situ; Carcinoma, Squamous Cell; Cystadenocarcinoma; Female; Humans; Hysterectomy; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Ovarian Neoplasms; Papanicolaou Test; Retrospective Studies; Uterine Cervical Neoplasms; Uterine Neoplasms; Vagina; Vaginal Neoplasms; Vaginal Smears; Vulva
PubMed: 1161240
DOI: No ID Found -
Obstetrics and Gynecology Aug 1974
Topics: Aged; Biopsy; Carcinoma; Female; Fibroblasts; Genital Diseases, Female; Humans; Hysterectomy; Mucous Membrane; Muscles; Pain; Radiotherapy; Radium; Time Factors; Uterine Cervical Neoplasms; Vagina
PubMed: 4421514
DOI: No ID Found -
Obstetrics and Gynecology Jul 1976Sixty-six patients were seen at the Mayo Clinic from 1950 through 1974 with in situ carcinoma of the vagina following various forms of treatment for a similar lesion of...
Sixty-six patients were seen at the Mayo Clinic from 1950 through 1974 with in situ carcinoma of the vagina following various forms of treatment for a similar lesion of the cervix. Sixty-three patients have remained free of recurrent disease. One patient has been lost to followup, 1 patient required a second local excision, and 1 patient had recurrent carcinoma that progressed to invasive vaginal malignant disease. The recurrent malignant disease was usually asymptomatic; its presence was suggested by an abnormal Papanicolaou smear and confirmed by Schiller stain or colposcopically directed biopsy. Colposcopic examination of the vagina has greatly facilitated delineation of the lesion; this may allow relatively simple definitive therapy in some instances--that is, local excision or partial vaginectomy. Total vaginectomy, with or without skin graft vaginal reconstruction, must be carried out in patients who have multicentric lesions. The use of vaginal radium or external beam therapy should be limited to the elderly patients or those to whom a functional vagina is unimportant.
Topics: Adult; Aged; Carcinoma in Situ; Female; Humans; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Papanicolaou Test; Uterine Cervical Neoplasms; Vagina; Vaginal Neoplasms; Vaginal Smears
PubMed: 934575
DOI: No ID Found -
Fertility and Sterility Sep 2023To describe a feasible fertility preservation strategy in a woman with vaginal carcinoma.
OBJECTIVE
To describe a feasible fertility preservation strategy in a woman with vaginal carcinoma.
DESIGN
Video case report demonstrating the diagnostic work-up and laparoscopic oocyte retrieval performed under regional anesthesia.
SETTING
University tertiary care hospital.
PATIENT(S)
A 35-year-old nulliparous woman presented with vaginal bleeding and foul-smelling vaginal discharge. After a comprehensive diagnostic work-up, a final diagnosis of squamous cell carcinoma of the vagina stage II (Federation International Obstetrics and Gynecology classification) was made. As per the patient's desire, before undergoing chemoradiotherapy, the patient underwent oocyte cryopreservation. Transvaginal retrieval of oocytes was not feasible because of stenosis of the vaginal introitus and the potential risk of intracavitary tumor cell spillage. Transabdominal ultrasound-guided oocyte retrieval was not possible because of the body's habitus.
INTERVENTION(S)
The patient underwent ovarian stimulation for in vitro fertilization. To minimize estrogen levels, letrozole was used during controlled ovarian stimulation. Laparoscopic oocyte retrieval was performed under spinal anesthesia.
MAIN OUTCOME MEASURE(S)
Successful laparoscopic egg retrieval and cryopreservation in a woman with squamous cell carcinoma of the vagina.
RESULT(S)
A total follicular count of nine was estimated before the oocyte retrieval. Eight oocytes were retrieved at laparoscopy, and eight mature oocytes were successfully cryopreserved. No complications were encountered, and the patient was discharged on the same day of surgery.
CONCLUSION(S)
To our knowledge, this is the first published case of fertility preservation using the laparoscopic approach in a patient with vaginal cancer. Letrozole is a valuable strategy to reduce high estrogen in patients with gynecological cancer undergoing controlled ovarian stimulation. Laparoscopy oocyte retrieval, performed under regional anesthesia, can be performed in an ambulatory setting and should be considered an effective fertility preservation strategy in patients with large vaginal tumors.
Topics: Adult; Female; Humans; Carcinoma, Squamous Cell; Cryopreservation; Estrogens; Fertility Preservation; Laparoscopy; Letrozole; Oocyte Retrieval; Oocytes; Ovulation Induction; Vagina
PubMed: 37302780
DOI: 10.1016/j.fertnstert.2023.06.007 -
International Journal of Gynecological... Mar 2019Lymphoepithelioma-like carcinoma (LELC) is an uncommon variant of squamous cell carcinoma, which is histologically identical to lymphoepithelial carcinoma of the...
Lymphoepithelioma-like carcinoma (LELC) is an uncommon variant of squamous cell carcinoma, which is histologically identical to lymphoepithelial carcinoma of the nasopharynx. LELCs have been reported at a variety of sites, including the stomach, salivary gland, thymus, cervix, endometrium, breast, skin, bladder, and lung. We report 2 LELCs of the vagina and 1 of the anal canal, the first report of LELC at the latter site. All 3 neoplasms were diffusely positive with p16 (block-type immunoreactivity) and the anal canal lesion contained high-risk human papillomavirus type 16; the 2 vaginal neoplasms underwent human papillomavirus testing but were unsuitable for analysis. All cases were Epstein-Barr virus negative. In reporting these cases, we highlight the potential for misdiagnosis and suggest an association with human papillomavirus infection similar to LELCs in the uterine cervix.
Topics: Aged; Aged, 80 and over; Anal Canal; Anus Neoplasms; Biomarkers, Tumor; Carcinoma, Squamous Cell; Female; Human papillomavirus 16; Humans; Male; Middle Aged; Nasopharynx; Papillomavirus Infections; Vagina; Vaginal Neoplasms
PubMed: 29257037
DOI: 10.1097/PGP.0000000000000483 -
Acta Medica Okayama Jun 1984Seventy patients with cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy were evaluated to assess spread to the vagina. The overall vaginal...
Seventy patients with cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy were evaluated to assess spread to the vagina. The overall vaginal invasion rate was 34.2% (24/70), with 36% (21/58) by squamous cell carcinoma, 25% (2/8) by adenocarcinoma and 25% (1/4) by adenosquamous carcinoma. A high vaginal invasion rate (45.7%) was noted in cases in which the cervical lesion was greater than 21 mm (p less than 0.05). Combined parametrial extention (45%) and combined lymph node metastasis (33.3%) were significantly higher in the vaginal invasion cases. The diagnostic accuracy of colposcopy and the Schiller test was 80% and 67% respectively. Histologically, the course of vaginal invasion by squamous cell carcinoma could be divided into : a) continuous invasion (16/21), b) incontinuous invasion via vessel permeation (3/21) and c) combined invasion (2/21). Both cases of vaginal invasion by adenocarcinoma were noted to spread by vessel permeation. Of the 7 cases of vessel permeation, colposcopic examination was positive in only one case. A high percentage of parametrial involvement and lymph node metastasis was noted in the vessel permeation type.
Topics: Adenocarcinoma; Adult; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Colposcopy; Female; Humans; Lymphatic Metastasis; Middle Aged; Neoplasm Invasiveness; Uterine Cervical Neoplasms; Vagina; Vaginal Neoplasms
PubMed: 6087622
DOI: 10.18926/AMO/30348 -
Clinical Obstetrics and Gynecology Jun 1981
Topics: Carcinoma in Situ; Female; Fluorouracil; Humans; Vagina; Vaginal Neoplasms
PubMed: 7307367
DOI: 10.1097/00003081-198106000-00011 -
The British Journal of Radiology Feb 2024Pathologies of the vagina are important causes of symptoms related to the genital tract in women. They can be missed on transabdominal ultrasonography (USG), which is...
Pathologies of the vagina are important causes of symptoms related to the genital tract in women. They can be missed on transabdominal ultrasonography (USG), which is the baseline modality used for evaluation of gynaecological complaints. Transperineal USG and MRI are the imaging modalities of choice for evaluation of the vagina. Diseases of the vagina can be grouped depending upon the age group in which they occur. In children and young adults, congenital anomalies like longitudinal or transverse vaginal septum, imperforate hymen, vaginal aplasia or atresia, and rectovaginal fistula can be seen. Malignant tumours can rarely occur in children, rhabdomyosarcoma being the most common one. Common diseases affecting adults include benign lesions like epidermoid, Gartner duct, and Bartholin cysts, and urogenital fistulas involving the vagina. Endometriosis and other benign tumours of vagina including leiomyoma, fibroepithelial polyp, and angiomyxoma are occasionally seen. Malignant tumours can be primary, the most common one being squamous cell carcinoma, or secondary, due to direct extension from cancers involving the adjacent organs. Characteristic morphological changes occur in the vagina after radiotherapy, which can be identified on imaging. Knowledge about the imaging appearances of these diseases is crucial in guiding appropriate management.
Topics: Child; Female; Humans; Vagina; Hymen; Vaginal Diseases; Genitalia, Female; Carcinoma, Squamous Cell
PubMed: 38419147
DOI: 10.1093/bjr/tqad052