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Urology Case Reports Mar 2020A 92-year-old woman with history of right nephroureterectomy for low grade Ta urothelial carcinoma (UC) of the renal pelvis and proximal ureter and high grade Ta and...
A 92-year-old woman with history of right nephroureterectomy for low grade Ta urothelial carcinoma (UC) of the renal pelvis and proximal ureter and high grade Ta and carcinoma-in-situ of the bladder presented for surveillance cystoscopy in 2019. She was found to have no evidence of disease within bladder or upper tract, however demonstrated a large papillary lesion within the vagina. This lesion stained for p40+, p16 patchy+, and GATA3+, all markers of UC, and the same molecular makeup of her prior bladder tumor.
PubMed: 31890596
DOI: 10.1016/j.eucr.2019.101091 -
Asian Journal of Surgery Feb 2024
Topics: Female; Humans; Carcinoma, Squamous Cell; Vagina; Pelvis
PubMed: 38008629
DOI: 10.1016/j.asjsur.2023.11.012 -
Journal of Cancer Research and... 2023Carcinoma cervix is the fourth most commonly diagnosed cancer worldwide, with an estimated 604,000 new cases and 342,000 deaths worldwide in 2020. Carcinoma cervix is an...
BACKGROUND
Carcinoma cervix is the fourth most commonly diagnosed cancer worldwide, with an estimated 604,000 new cases and 342,000 deaths worldwide in 2020. Carcinoma cervix is an uncommon malignancy in Kashmir. In this retrospective study, we have tried to find clinicopathological characteristics of carcinoma cervix along with the survival rates at our tertiary care hospital.
MATERIALS AND METHODS
Case records of cervical cancer patients registered from January 1, 2015, to January 1, 2019, were retrieved. A total of 138 patients was registered. 22 had undergone surgery, and out of these 17 had received postoperative radiotherapy. 109 patients were treated with definitive chemoradiation and 13 with palliative radiotherapy. Descriptive statistics were used to summarize patient and treatment-related variables, and Kaplan-Meier analysis was performed for survival analysis.
RESULTS
A total of 138 cases that were registered from 2015 to 2019 were included in this study. The median age at the presentation was 56 years. Most of the patients had a performance status of 1 (98 patients (71.01)). Most of the patients 110 (79.71%) were married before 20 years of age, only 1 patient was unmarried, and 85 (61.59) patients were multiparous in our study group. Only 14 (10.14%) patients in our study group had a history of oral contraceptive use and most of them were non-smokers [124 (89.80%)]. Multiple marriages were present in 8 (5.79%) patients only. The most common presenting symptom was bleeding per vagina (78.26%), and the maximum number of patients fall in the post-menopausal group (67.39%). 116 patients had squamous cell carcinoma histology while 10 patients had adenocarcinoma histology. Most of the patients had stage II and stage III disease (85 patients). At last, follow up out of 138 patients 75 (54.35) were alive. 3 year disease-free survival was 54.34% and 3-year overall survival was 72.46%.
CONCLUSION
Carcinoma cervix is an uncommon malignancy in Kashmir because of different socio-cultural and religious practices but the response to treatment, toxicity profile, and survival are similar to the rest of the world.
Topics: Female; Humans; Middle Aged; Uterine Cervical Neoplasms; Cervix Uteri; Retrospective Studies; Carcinoma, Squamous Cell; Chemoradiotherapy; Neoplasm Staging
PubMed: 37787316
DOI: 10.4103/jcrt.jcrt_203_22 -
European Radiology Feb 2006Endometriosis corresponds to ectopic endometrial glands and stroma outside the uterine cavity. Clinical symptoms include dysmenorrhoea, dyspareunia, infertility, painful... (Review)
Review
Endometriosis corresponds to ectopic endometrial glands and stroma outside the uterine cavity. Clinical symptoms include dysmenorrhoea, dyspareunia, infertility, painful defecation or cyclic urinary symptoms. Pelvic ultrasound is the primary imaging modality to identify and differentiate locations to the ovary (endometriomas) and the bladder wall. Characteristic sonographic features of endometriomas are diffuse low-level internal echos, multilocularity and hyperchoic foci in the wall. Differential diagnoses include corpus luteum, teratoma, cystadenoma, fibroma, tubo-ovarian abscess and carcinoma. Repeated ultrasound is highly recommended for unilocular cysts with low-level internal echoes to differentiate functional corpus luteum from endometriomas. Posterior locations of endometriosis include utero-sacral ligaments, torus uterinus, vagina and recto-sigmoid. Sonographic and MRI features are discussed for each location. Although ultrasound is able to diagnose most locations, its limited sensitivity for posterior lesions does not allow management decision in all patients. MRI has shown high accuracies for both anterior and posterior endometriosis and enables complete lesion mapping before surgery. Posterior locations demonstrate abnormal T2-hypointense, nodules with occasional T1-hyperintense spots and are easier to identify when peristaltic inhibitors and intravenous contrast media are used. Anterior locations benefit from the possibility of MRI urography sequences within the same examination. Rare locations and possible transformation into malignancy are discussed.
Topics: Broad Ligament; Colon, Sigmoid; Diagnosis, Differential; Endometriosis; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Ovary; Rectum; Sensitivity and Specificity; Ultrasonography; Urinary Bladder; Uterus; Vagina
PubMed: 16155722
DOI: 10.1007/s00330-005-2882-y -
Papillomavirus Research (Amsterdam,... Jun 2018Vulvar and vaginal cancers are considered rare cancers in women. Human Papillomavirus is responsible for 30-76% of them. The aim of this study was to describe the burden... (Observational Study)
Observational Study
Hospitalization burden associated with malignant neoplasia and in situ carcinoma in vulva and vagina during a 5-year period (2009-2013) in Spain: An epidemiological study.
BACKGROUND
Vulvar and vaginal cancers are considered rare cancers in women. Human Papillomavirus is responsible for 30-76% of them. The aim of this study was to describe the burden of hospital admissions by malignant neoplasia (MN) and in situ carcinoma (ISC) of vulva and vagina from 2009 to 2013, in Spain METHODS: This observational, descriptive study used discharge information obtained from the national surveillance system for hospital data, Conjunto Mínimo Básico de Datos, CMBD, provided by the Ministry of Health.
RESULTS
From 2009-2013, we found 9,896 hospitalizations coded as MN or ISC of vulva and vagina. Mean age of hospitalization was 69.94 ± 15.16 years; average length of hospital stay (ALOS) was 10.02 ± 12.40 days, and mean hospitalization costs were 5,140.31 ± 3,220.61 euros. Mean hospitalization rate was 9.874 per 100,000 women aged >14 years old (95% CI: 9.689-10.058); mean mortality rate was 0.932 per 100,000 women aged >14 years old (95% CI: 0.872-0.991) and mean case fatality rate was 9.438% (95% CI: 8.862-10.014).
CONCLUSION
MN and ISC of vulva and vagina are responsible for a considerable hospitalization burden. Information about these hospitalizations could be useful for cost effectiveness analysis and monitoring of HPV vaccination effectiveness.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma in Situ; Cost of Illness; Female; Hospital Costs; Hospitalization; Humans; Incidence; Length of Stay; Middle Aged; Papillomaviridae; Retrospective Studies; Spain; Vagina; Vaginal Neoplasms; Vulva; Vulvar Neoplasms; Young Adult
PubMed: 29458181
DOI: 10.1016/j.pvr.2018.02.001 -
Cancer Medicine Dec 2022High-risk human papillomavirus (hrHPV) infection is a key factor that alters cervicovaginal microbiota patterns and causes cervical intraepithelial neoplasias (CINs) or...
BACKGROUND
High-risk human papillomavirus (hrHPV) infection is a key factor that alters cervicovaginal microbiota patterns and causes cervical intraepithelial neoplasias (CINs) or even cervical cancer. Although local excisional treatment can clear hrHPV infection and restore the cervicovaginal microbiota, it is unclear which cervicovaginal microbiota represents recovery. Our objective was to describe the cervicovaginal microbiota before and after treatments and to assess the association between the microbiota and HPV persistence.
RESULTS
A cohort of 91 participants was classified into four groups (healthy control women and HPV16-infected women with CIN I, CIN II/III, and squamous cell carcinoma [SCC]). Endocervical swabs were collected 3 months prior to treatment and at 3 months post-treatment for bacterial 16S rRNA gene pyrosequencing and for HPV DNA testing. There was an increase in the number of Lactobacillus bacterial species present after the clinical treatments, and the community state type (CST) profiles were shifted from dysbiotic CSTs II and IV to Lactobacillus-dominated CSTs I and III. Specifically, the composition of Geobacter and Prevotella before treatment and Lactobacillus secaliphilus after treatment might have been related to CIN I, the composition of Burkholderia before treatment and Lactobacillus iners after treatment might have been related to CIN II/III, and the composition of Atopobium and Aerococcus before treatment and Bacilli after treatment might have been related to SCC. Further functional predictions revealed that the composition differences were linked to infectious disease- and cancer-related genes.
CONCLUSION
Our study provides an illustration of the changes in CSTs and the cervicovaginal microbiota before and after HPV16 clearance in each disease state.
Topics: Humans; Female; RNA, Ribosomal, 16S; Human papillomavirus 16; Papillomavirus Infections; Vagina; Microbiota
PubMed: 35569127
DOI: 10.1002/cam4.4801 -
European Review For Medical and... Oct 2023Human papillomavirus (HPV), which is known to play a very important role in genital area (vulva, vagina, and cervix) cancers in women, is responsible for almost all...
OBJECTIVE
Human papillomavirus (HPV), which is known to play a very important role in genital area (vulva, vagina, and cervix) cancers in women, is responsible for almost all cervical cancers. However, a significant proportion of cervical carcinomas (approximately 7%) is HPV-negative. Therefore, there are still two important questions to be answered: 1. Why is HPV Deoxyribonucleic acid (DNA) not found in all cervical carcinomas? 2. Are HPV-DNA-negative cervical cancers a specific subgroup of cervical cancers with different biological behavior (worse prognosis)? In this article, we aimed to evaluate the clinicopathological characteristics and survival of patients with confirmed HPV-negative tumors in order to answer these two questions.
PATIENTS AND METHODS
A total of 97 patients who underwent HPV-DNA testing and received a histological diagnosis of cervical cancer were included in the study. 14 HPV-DNA negative and 83 HPV-DNA positive cervical carcinoma patients were detected. Demographic profiles, clinicopathological characteristics, progression-free, and overall survival of all patients were analyzed.
RESULTS
Women with HPV-negative tumors were diagnosed at an older age range (p=0.05), and their demographic data other than age range were similar to HPV-positive tumors. P16 staining pattern was not observed in any of the HPV-negative tumors (p=0.001), and a positive P53 staining pattern was detected in 35.7% of the HPV-negative tumors. Although disease-free survival (PFS) (p=0.224) and overall survival (OS) (p=0.219) were worse in the HPV-negative patient group, this difference was not statistically significant.
CONCLUSIONS
HPV-negative cervical cancers do not have a poor prognosis unlike their counterparts in other anatomical regions where HPV-associated tumors are present.
Topics: Humans; Female; Uterine Cervical Neoplasms; Papillomavirus Infections; Prognosis; Disease-Free Survival; Human Papillomavirus Viruses; DNA, Viral; Papillomaviridae
PubMed: 37843334
DOI: 10.26355/eurrev_202310_33948 -
American Journal of Veterinary Research Nov 2022To investigate typical computed tomography (CT) features for the differentiation of vaginal from the uterine origin in dogs.
OBJECTIVE
To investigate typical computed tomography (CT) features for the differentiation of vaginal from the uterine origin in dogs.
ANIMALS
7 healthy Beagles in the prospective study and 5 bitches in the retrospective study.
PROCEDURES
In the prospective study, dual-phase CT images were obtained from sexually intact female Beagles (n = 7) during anestrus and estrus. On the CT images, the vagina and uterine horns, body, and cervix were assessed for diameter, attenuation, and contrast enhancement pattern. In the retrospective study, CT features of large vaginal lesions (leiomyoma, leiomyosarcoma, adenocarcinoma, hematocolpos, and Gartner's duct cyst) were assessed in 5 bitches.
RESULTS
In normal bitches, the cervix was thicker with strong central enhancement compared to the uterus and vagina. The uterine artery, which enters the mesometrium at the level of the cervix, was clearly visualized and assisted in identifying the cervix. In bitches with large vaginal masses, uterine arteries were displaced by the lesions and could not be used to locate the cervix. In 4/5 dogs with vaginal masses, identification of the cervix allowed the determination of the organ of origin. In 1 dog with adenocarcinoma, CT vaginography was additionally required for determining the origin of mass.
CLINICAL RELEVANCE
Results from this study indicate that the cervix, recognized in CT as focal thickening of the uterus with central enhancement, may be used as a landmark for the differentiation between the uterus and vagina in bitches.
Topics: Animals; Female; Dogs; Retrospective Studies; Prospective Studies; Uterus; Vagina; Tomography, X-Ray Computed; Adenocarcinoma
PubMed: 36434761
DOI: 10.2460/ajvr.22.03.0052 -
BMC Microbiology Mar 2021High-risk human papilloma virus (hrHPV) is the main causal factor of cervical precancer and cancer when persistent infection is left untreated. Previous studies have...
BACKGROUND
High-risk human papilloma virus (hrHPV) is the main causal factor of cervical precancer and cancer when persistent infection is left untreated. Previous studies have confirmed the vaginal microbiota is associated with HPV infection and the development of cervical lesions. The microbiota at different parts of the female genital tract is closely related but different from each other. To analyze the distinction between the vaginal and cervical microbiota of hrHPV(+) women in China, one hundred subjects were recruited, including 10 patients with HPV16/18(+) and cervical carcinoma, 38 patients with HPV16/18(+) but no cervical carcinoma, 32 patients with other hrHPV(+) and 20 healthy controls with HPV(-). Vaginal and cervical microbiota were separately tested through next-generation sequencing (NGS) targeting the variable region (V3-V4) of the bacterial ribosome 16S rRNA gene.
RESULTS
HrHPV(+) subjects had higher percentages of vaginal douching history (P = 0.001), showed more frequent usage of sanitary pads (P = 0.007), had more sex partners (P = 0.047), were more sexually active (P = 0.025) and more diversed in ways of contraception (P = 0.001). The alpha diversity of the cervical microbiota was higher than that of the vagina. The cervical microbiota consisted of a lower percentage of Firmicutes and a higher percentage of Proteobacteria than the vagina at the phylum level. Sphingomonas, belonging to α-Proteobacteria, was almost below the detection limit in the vagina but accounted for five to 10 % of the bacteria in the hrHPV(-) cervix (P<0.001) and was inversely associated with hrHPV infection (P<0.05). Pseudomonas, belonging to γ-Proteobacteria, could hardly be seen in the normal vagina and shared a small percentage in the normal cervix but was significantly higher in the HPV16/18(+) (P<0.001) and cancerous cervix (P<0.05). No significant difference was shown in the percentage of BV associated anaerobes, like Gardnerella, Prevotella, Atopobium and Sneathia, between the cevix and vigina.
CONCLUSIONS
The proportion of Proteobacteria was significantly higher in the cervical microbiota than that of vagina. The hrHPV infection and cervical cancer was positively associated with Pseudomonas and negatively associated with Sphingomonas. It is of great improtance to deeply explore the cervical microbiota and its function in cervical cacinogenesis.
Topics: Cervix Uteri; China; Female; Humans; Microbiota; Papillomaviridae; Papillomavirus Infections; RNA, Ribosomal, 16S; Vagina
PubMed: 33765914
DOI: 10.1186/s12866-021-02152-y -
Pathology Oncology Research : POR Mar 2011Primary squamotransitional cell carcinoma (STCC) is rare squamous cell tumor variant resembling transitional cell carcinoma (TCC) of the urinary tract. STCC occurs... (Review)
Review
Primary squamotransitional cell carcinoma (STCC) is rare squamous cell tumor variant resembling transitional cell carcinoma (TCC) of the urinary tract. STCC occurs rarely in the vagina and its clinical and pathological correlates are poorly known. We report a unique case of a 66-year-old Italian woman with STCC of the vagina. A biopsy of the tumor was performed. The tumor qualified as a STCC. Following biopsy, the patient underwent radical hysterectomy (Piver's III-type) with bilateral salpingo-oophorectomy, upper colpectomy, appendicectomy, peritoneal cytology, and lymphadenectomy. The patient is now healthy without evidence of recurrence at 30 months after surgery. Pathologically, cytoarchitectural characteristics distinguish this histotype (STCC) from conventional squamous cell carcinoma of the genital tract. The cytokeratin staining pattern (CK7 positive and CK20 negative), the p63 expression and the positivity for p16ink4a and high-risk HPV are the main elements of differential diagnosis. We suggest that STCC of the vagina should be treated by radical surgery, possibly followed by adjuvant therapy based on staging results and should receive a long-term follow-up.
Topics: Aged; Carcinoma, Squamous Cell; Female; Humans; Vaginal Neoplasms
PubMed: 20512667
DOI: 10.1007/s12253-010-9280-8