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The Surgical Clinics of North America Jun 1950
Topics: Carcinoma; Cervix Uteri; Early Diagnosis; Female; Humans; Neoplasms; Uterus; Vagina
PubMed: 15418464
DOI: 10.1016/s0039-6109(16)33058-4 -
Journal of Lower Genital Tract Disease Apr 2008To describe ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) to increase awareness of this condition when treating patients with gynecological small cell...
OBJECTIVE
To describe ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) to increase awareness of this condition when treating patients with gynecological small cell carcinoma (SmCC).
MATERIALS AND METHODS
This is a review of a 61-year-old woman with primary vaginal SmCC and an atypical presentation of Cushing syndrome. This case describes the molecular rationale, caveats in clinical presentation, pathological diagnosis, and management options for patients with this rare syndrome.
RESULTS
After treatment with primary chemotherapy, the patient presented acutely with delirium and metabolic disturbances. This was associated with elevated ACTH and gastrin levels without any tumor staining for ACTH. The patient was initially managed with ketoconazole to control the EAS. Complications developed related to her Cushing syndrome, and she succumbed to complications of her disease.
CONCLUSIONS
Vaginal SmCC complicated by EAS is a rare paraneoplastic syndrome, and this case history outlines the management options for patients with this condition and reviews the pertinent literature.
Topics: ACTH Syndrome, Ectopic; Biopsy; Carcinoma, Small Cell; Diagnosis, Differential; Fatal Outcome; Female; Humans; Middle Aged; Rare Diseases; Tomography, X-Ray Computed; Vagina; Vaginal Neoplasms
PubMed: 18369310
DOI: 10.1097/LGT.0b013e31815cda1e -
Gynecologic Oncology Oct 1989Primary carcinomas arising in the neovagina are rare and this is the ninth reported case. Two adenocarcinomas and seven squamous cell carcinomas, including our own case,... (Review)
Review
Primary carcinomas arising in the neovagina are rare and this is the ninth reported case. Two adenocarcinomas and seven squamous cell carcinomas, including our own case, have been described. The type of carcinoma is related to the transplanted tissue. Although the optimal therapy is unclear, we would recommend surgical treatment rather than radiation therapy. This is based on our own experience and on observations reported in the literature. Regular follow-up of patients with an artificial vagina is mandatory.
Topics: Adult; Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Humans; Postoperative Complications; Surgery, Plastic; Vagina; Vaginal Neoplasms
PubMed: 2676753
DOI: 10.1016/0090-8258(89)90021-8 -
Acta Radiologica (Stockholm, Sweden :... Oct 2007The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI) - with its high-contrast resolution... (Review)
Review
The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI) - with its high-contrast resolution and multiplanar capabilities - is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation.
Topics: Carcinoma; Cysts; Female; Hematocolpos; Humans; Hydrocolpos; Leiomyoma; Magnetic Resonance Imaging; Paraganglioma; Rhabdomyosarcoma; Vagina; Vaginal Diseases; Vaginal Neoplasms; Vaginitis
PubMed: 17924224
DOI: 10.1080/02841850701552926 -
European Journal of Surgical Oncology :... Sep 2019Despite strong hereditary components, most cases of colorectal cancer are sporadic. The possibility to manipulate in the clinical setting the many presumed risk factors... (Review)
Review
Despite strong hereditary components, most cases of colorectal cancer are sporadic. The possibility to manipulate in the clinical setting the many presumed risk factors is almost impossible, and long-term epidemiological studies are the only reliable form for comparisons. We performed a systematic review to analyze the reports of de-novo adenocarcinoma arising in the transposed colon, used for conduit after esophagectomy, after total gastrectomy, and for vaginal reconstruction. In all these situations, the colon is transposed in different physiological conditions from its natural environment. We excluded patients in whom the colon was transposed as urinary conduit because the well known carcinogenic effect of the contact with urine. Overall 45 patients were identified with a de-novo adenocarcinoma arising in the transposed colon (36 after esophagectomy; 1 after total gastrectomy; 8 as neovagina). The only common risk factor in these different anatomic position was the possibility of active or chronic inflammation. There was not a close correlation between time after implantation and occurrence of the carcinoma. The occurrence of the de novo carcinoma was related to ageing, supporting the hypothesis of a major role of inflammation in facilitating deregulation of the immune system, associated with ageing.
Topics: Adenocarcinoma; Colon; Colonic Neoplasms; Esophagectomy; Female; Gastrectomy; Humans; Inflammation; Male; Neoplasm Staging; Postoperative Complications; Vagina
PubMed: 31118132
DOI: 10.1016/j.ejso.2019.05.012 -
Obstetrics and Gynecology May 1987A retrospective review was conducted of patients with squamous cell carcinoma of the vagina managed at one institution over a 14-year period. The 28 cases of squamous...
A retrospective review was conducted of patients with squamous cell carcinoma of the vagina managed at one institution over a 14-year period. The 28 cases of squamous cell vaginal carcinoma constituted 3.1% of all female genital tract cancers. Forty-six percent of the patients had undergone a previous hysterectomy for benign disease or for cervical intraepithelial neoplasia; 14.2% had had irradiation. Disease of stage III or greater occurred in 43% of the study group. The majority of patients were treated by radiation therapy. The overall survival was 42.8%. This review indicates that patients who have had a previous hysterectomy should remain under close surveillance.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Humans; Hysterectomy; Middle Aged; Neoplasm Staging; Radiotherapy Dosage; Retrospective Studies; Vagina; Vaginal Neoplasms
PubMed: 3574807
DOI: No ID Found -
American Journal of Clinical Pathology Aug 2016Our study examined accumulated data on vaginal cytology follow-up results of women treated for endometrial carcinoma (EmCa) by hysterectomy in a large academic women's...
OBJECTIVES
Our study examined accumulated data on vaginal cytology follow-up results of women treated for endometrial carcinoma (EmCa) by hysterectomy in a large academic women's hospital practice.
METHODS
This study analyzed cases of EmCa treated by hysterectomy from January 2006 to December 2008 with documented follow-up vaginal cytology and/or vaginal biopsy results available prior to September 2013.
RESULTS
Of 607 patients with EmCa who had documented hysterectomy findings, 420 had either follow-up vaginal biopsy or cytology results during a mean follow-up period of 42.5 months, and 414 (98.6%) had at least one vaginal cytology follow-up result. Of 414 patients followed with vaginal cytology results, 48 (11.6%) had biopsy results while 366 (88.4%) had only vaginal cytology results. Recurrent EmCa in the vagina was documented by biopsy in 11 patients, eight within 2 years of hysterectomy. Cytology findings of neoplastic glandular cells triggered diagnostic vaginal biopsies in two of 11 cases.
CONCLUSIONS
Vaginal recurrences of EmCa were diagnosed in 11 (2.6%) of 420 patients with documented vaginal follow-up testing. Abnormal vaginal cytology findings directly led to vaginal biopsy diagnoses of EmCa in two of the 11 patients. Vaginal cytology is no longer a recommended routine surveillance option for detection of vaginal cuff recurrence of EmCa.
Topics: Adult; Aged; Aged, 80 and over; Biopsy; Carcinoma; Endometrial Neoplasms; Female; Follow-Up Studies; Humans; Hysterectomy; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Vagina; Vaginal Smears
PubMed: 27371362
DOI: 10.1093/ajcp/aqw100 -
Cancer Research Communications Jun 2022The human microbiome has been strongly correlated with disease pathology and outcomes, yet remains relatively underexplored in patients with malignant endometrial...
The human microbiome has been strongly correlated with disease pathology and outcomes, yet remains relatively underexplored in patients with malignant endometrial disease. In this study, vaginal microbiome samples were prospectively collected at the time of hysterectomy from 61 racially and ethnically diverse patients from three disease conditions: 1) benign gynecologic disease (controls, n=11), 2) low-grade endometrial carcinoma (n=30), and 3) high-grade endometrial carcinoma (n=20). Extracted DNA underwent shotgun metagenomics sequencing, and microbial α and β diversities were calculated. Hierarchical clustering was used to describe community state types (CST), which were then compared by microbial diversity and grade. Differential abundance was calculated, and machine learning utilized to assess the predictive value of bacterial abundance to distinguish grade and histology. Both α- and β-diversity were associated with patient tumor grade. Four vaginal CST were identified that associated with grade of disease. Different histologies also demonstrated variation in CST within tumor grades. Using supervised clustering algorithms, critical microbiome markers at the species level were used to build models that predicted benign vs carcinoma, high-grade carcinoma versus benign, and high-grade versus low-grade carcinoma with high accuracy. These results confirm that the vaginal microbiome segregates not just benign disease from endometrial cancer, but is predictive of histology and grade. Further characterization of these findings in large, prospective studies is needed to elucidate their potential clinical applications.
Topics: Humans; Female; Endometrial Neoplasms; Vagina; Hysterectomy; Microbiota; Carcinoma
PubMed: 35928983
DOI: 10.1158/2767-9764.CRC-22-0075 -
Journal of Clinical Virology : the... Apr 2018In order to increase coverage in the organized cervical screening program, self-sampling with HPV analyses has been suggested. (Comparative Study)
Comparative Study
BACKGROUND
In order to increase coverage in the organized cervical screening program, self-sampling with HPV analyses has been suggested.
OBJECTIVES
The aim was to compare human papillomavirus (HPV) mRNA detection in vaginal and urine self-collected samples with clinician-taken cervical samples and the corresponding clinician-taken histological specimens.
STUDY DESIGN
Self-collected vaginal, urine and clinician-taken cervical samples were analyzed from 209 women with the Aptima mRNA assay (Hologic Inc, MA, USA). Cervical cytology, colposcopy, biopsy and/or the loop electrosurgical excision procedure (LEEP) were performed in every examination.
RESULTS
The sensitivity of the HPV mRNA test in detecting high-grade squamous intraepithelial lesions (HSIL)/adenocarcinoma in situ (AIS)/cancer cases was as follows: for the vaginal self-samples 85.5% (95% CI; 75.0-92.8), the urinary samples 44.8% (95% CI; 32.6-57.4), and for routine cytology 81.7% (95% CI; 70.7-89.9). For the clinician-taken cervical HPV samples the sensitivity of the HPV mRNA test in detecting HSIL/AIS/cancer was 100.0% (95% CI; 94.9-100.0). The specificity of the HPV mRNA was similar for the clinician-taken cervical HPV samples and the self-samples: 49.0% vs. 48.1%. The urinary HPV samples had a specificity of 61.9% and cytology had a specificity of 93.3%.
CONCLUSION
The sensitivity of the Aptima HPV mRNA test in detecting HSIL/AIS/cancer from vaginal self-samples was similar to that of routine cytology. The Aptima HPV mRNA vaginal self-sampling analysis may serve as a complement in screening programs.
Topics: Adult; Aged; Carcinoma in Situ; Cervix Uteri; Early Detection of Cancer; Female; Humans; Mass Screening; Middle Aged; Papillomaviridae; Papillomavirus Infections; Predictive Value of Tests; RNA, Messenger; RNA, Viral; Sensitivity and Specificity; Specimen Handling; Urine; Vagina; Young Adult; Uterine Cervical Dysplasia
PubMed: 29433016
DOI: 10.1016/j.jcv.2018.02.002 -
Plastic and Reconstructive Surgery Apr 1973
Topics: Adolescent; Adult; Carcinoma, Squamous Cell; Disorders of Sex Development; Female; Humans; Skin Transplantation; Transplantation, Autologous; Vagina; Vaginal Neoplasms
PubMed: 4570193
DOI: 10.1097/00006534-197304000-00025