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[PMID]:29390294
[Au] Autor:Fedus T; Ras R; Ksiazek M; Filipowska J; Kaznowska E; Skret A; Skret-Magierlo J; Barnas E
[Ad] Endereço:Clinical Department of Urology and Urology Oncology.
[Ti] Título:Primary vaginal squamous cell carcinoma with bladder involvement in uterine prolapsed patient: Case report.
[So] Source:Medicine (Baltimore);96(50):e8993, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Primary vaginal squamous cell carcinoma (SCC) is a rare disease. Primary SCC in prolapsed vagina is extremely rare. In the presented case additional bladder involvement was found. PATIENTS CONCERNS: Primary vaginal SCC may be misinterpreted as decubitus in prolapsed vagina and it may delay proper diagnosis and treatment. DIAGNOSES: Diagnosis was confirmed by the vaginal ulceration biopsy and cystoscopic biopsy of the involved bladder. INTERVENTIONS: In the case presented percutaneous nephrostomy was the only possible treatment of hydronephrosis. OUTCOMES: In advanced primary SCC (Figo IVA) with nodal involvement palliative treatment is only option. LESSONS: Primary SCC mimicking decubitus which appeared in prolapsed vagina, may be accompanied by bladder involvement.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/patologia
Neoplasias da Bexiga Urinária/patologia
Prolapso Uterino/patologia
Neoplasias Vaginais/patologia
[Mh] Termos MeSH secundário: Idoso
Biópsia
Diagnóstico Diferencial
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008993


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[PMID]:27777126
[Au] Autor:Luxembourg A; Kjaer SK; Nygard M; Ellison MC; Group T; Marshall JB; Radley D; Saah A
[Ad] Endereço:Merck & Co., Inc., Kenilworth, NJ, USA. Electronic address: alain_luxembourg@merck.com.
[Ti] Título:Design of a long-term follow-up effectiveness, immunogenicity and safety study of women who received the 9-valent human papillomavirus vaccine.
[So] Source:Contemp Clin Trials;52:54-61, 2017 01.
[Is] ISSN:1559-2030
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The 9-valent human papillomavirus (HPV) (9vHPV) vaccine targets four HPV types (6/11/16/18) also covered by the quadrivalent HPV (qHPV) vaccine and five additional types (31/33/45/52/58). Vaccine efficacy to prevent HPV infection and disease was established in a Phase III clinical study in women 16-26years of age. A long-term follow-up (LTFU) study has been initiated as an extension of the Phase III clinical study to assess effectiveness of the 9vHPV vaccine up to at least 14years after the start of vaccination. It includes participants from Denmark, Norway and Sweden and uses national health registries from these countries to assess incidence of cervical pre-cancers and cancers due to the 7 oncogenic types in the vaccine (HPV 16/18/31/33/45/52/58). Incidences will be compared to the estimated incidence rate in an unvaccinated cohort of similar age and risk level. This LTFU study uses a unique design: it is an extension of a Phase III clinical study and also has elements of an epidemiological study (i.e., endpoints based on standard clinical practice; surveillance using searches from health registries); it uses a control chart method to determine whether vaccine effectiveness may be waning. Control chart methods which were developed in industrial and manufacturing settings for process and production monitoring, can be used to monitor disease incidence in real-time and promptly detect a decrease in vaccine effectiveness. Experience from this innovative study design may be applicable to other medicinal products when long-term outcomes need to be assessed, there is no control group, or outcomes are rare.
[Mh] Termos MeSH primário: Neoplasia Intraepitelial Cervical/prevenção & controle
Imunogenicidade da Vacina
Infecções por Papillomavirus/prevenção & controle
Vacinas contra Papillomavirus/uso terapêutico
Lesões Pré-Cancerosas/prevenção & controle
Neoplasias do Colo do Útero/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Adulto
Neoplasia Intraepitelial Cervical/epidemiologia
Neoplasia Intraepitelial Cervical/virologia
Ensaios Clínicos Fase III como Assunto
Dinamarca/epidemiologia
Feminino
Seguimentos
Seres Humanos
Incidência
Noruega/epidemiologia
Infecções por Papillomavirus/epidemiologia
Infecções por Papillomavirus/virologia
Vacinas contra Papillomavirus/imunologia
Lesões Pré-Cancerosas/epidemiologia
Lesões Pré-Cancerosas/virologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Suécia/epidemiologia
Resultado do Tratamento
Neoplasias do Colo do Útero/epidemiologia
Neoplasias do Colo do Útero/virologia
Neoplasias Vaginais/epidemiologia
Neoplasias Vaginais/prevenção & controle
Neoplasias Vaginais/virologia
Neoplasias Vulvares/epidemiologia
Neoplasias Vulvares/prevenção & controle
Neoplasias Vulvares/virologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Papillomavirus Vaccines)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161108
[St] Status:MEDLINE


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[PMID]:29187473
[Au] Autor:Rapi V; Dogan A; Schultheis B; Hartmann F; Rezniczek GA; Tempfer CB
[Ad] Endereço:Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
[Ti] Título:Melanoma of the Vagina: Case Report and Systematic Review of the Literature.
[So] Source:Anticancer Res;37(12):6911-6920, 2017 12.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary melanoma of the vagina (PMV) is a rare entity. The prognosis of women with PMV is poor and there is no standardized therapy for this type of malignancy. We present the case of a 72-year-old woman with PMV (cT2, pN0, M0). CASE REPORT: Imaging studies showed no evidence of regional or distant metastases. Molecular analysis demonstrated wild-type B-Raf proto-oncogene, serine/threonine kinase (BRAF). Staging laparoscopy with pelvic lymphadenectomy and subsequent radiotherapy with 60 Gy delivered as pelvic teletherapy and vaginal brachytherapy was applied. Systematic literature review: A total of 805 cases of PMV were identified. Most lesions were melanotic (65%) and localized (66%), whereas amelanotic (35%) and primary advanced lesions (34%) were only seen in a minority of patients. BRAF mutation was detected in none out of 33 cases, tumor protein 53 (TP53) mutations and mast/stem cell growth factor receptor CD117 (KIT) amplification were identified in one case each. The most common treatment was surgery, reported in 43% of cases. Surgery combined with adjuvant radiotherapy, adjuvant immunotherapy (mostly with interferon-alpha), or adjuvant chemotherapy were given in 35%, 8%, and 3% of cases, respectively. Radiotherapy or chemotherapy as sole treatments were used in 5% and 1% of patients, respectively. Among patients with recurrence, chemotherapy (mostly dacarbazine) alone or in combination with surgery, radiotherapy or immunotherapy was the most common treatment in 61% of cases. The mean durations of recurrence-free and overall survival were 16.4 and 22.2 months, respectively. CONCLUSION: PMV is a rare malignancy with a poor prognosis. Surgery, radiotherapy, and immunotherapy with interferon-alpha are the mainstay of treatment for localized disease, while chemotherapy with dacarbazine is mostly used for unresectable and recurrent disease. No data on the clinical value of immune checkpoint inhibitors in PMV have been published.
[Mh] Termos MeSH primário: Melanoma/patologia
Neoplasias Vaginais/patologia
[Mh] Termos MeSH secundário: Idoso
Quimiorradioterapia
Feminino
Seres Humanos
Laparoscopia
Excisão de Linfonodo
Melanoma/cirurgia
Melanoma/terapia
Recidiva Local de Neoplasia
Neoplasias Vaginais/cirurgia
Neoplasias Vaginais/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:29016495
[Au] Autor:Davidson ERW; Barber MD
[Ad] Endereço:Cleveland Clinic, Cleveland, Ohio; and Duke University, Durham, North Carolina.
[Ti] Título:A Gartner Duct Cyst Masquerading as Anterior Vaginal Prolapse.
[So] Source:Obstet Gynecol;130(5):1039-1041, 2017 Nov.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gartner duct cysts are embryologic remnants of the mesonephric ducts that may present as a vaginal mass or cyst. CASE: A patient was referred for surgical management of prolapse whose bulging anterior vagina was actually a Gartner duct cyst that required excision as a result of symptoms. Preoperative magnetic resonance imaging helped confirm the diagnosis. CONCLUSION: A Gartner duct cyst may present as a vaginal cyst that, if large, may mimic pelvic organ prolapse. The diagnosis should be considered when a patient's individual prolapse compartments are inconsistent or when physical examination is suggestive of another process.
[Mh] Termos MeSH primário: Cistos/diagnóstico
Prolapso Uterino/diagnóstico
Vagina/patologia
Neoplasias Vaginais/diagnóstico
Ductos Mesonéfricos/patologia
[Mh] Termos MeSH secundário: Cistos/patologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Meia-Idade
Vagina/diagnóstico por imagem
Neoplasias Vaginais/patologia
Ductos Mesonéfricos/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002315


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[PMID]:28841699
[Au] Autor:Ranhem C; Lillsunde Larsson G; Hedman H; Lindquist D; Karlsson MG; Hellström AC; Östensson E; Sorbe B; Hellman K; Andersson S
[Ad] Endereço:Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
[Ti] Título:Expression of LRIG proteins as possible prognostic factors in primary vaginal carcinoma.
[So] Source:PLoS One;12(8):e0183816, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary vaginal carcinoma (PVC) is a rare malignancy. Established prognostic factors include tumour stage and age at diagnosis. The leucine-rich repeats and immunoglobuline-like domains (LRIG)-1 protein functions as a tumour suppressor, but less is known about the functions of LRIG2 and LRIG3. The present study aimed to evaluate the expression of LRIG proteins and analyse their possible associations with clinical characteristics and survival in a cohort of PVC patients. METHODS: We used immunohistochemistry to investigate LRIG1, LRIG2, and LRIG3 expression in tumour samples from a consecutive cohort of 70 PVC patients. The association between LRIG protein expression and clinical characteristics and cancer-specific survival was investigated using univariate and multivariate analyses. RESULTS: The majority of PVC patients (72%) had >50% LRIG1- and LRIG2-positive cells, and no or low LRIG3-positive cells. HPV status was significantly correlated with LRIG1 expression (p = 0.0047). Having high LRIG1 expression was significantly correlated with superior cancer-specific survival in univariate and multivariate analyses. LRIG2 and LRIG3 expression did not significantly correlate with clinical characteristics or survival. CONCLUSION: LRIG1 expression might be of interest as a prognostic marker in PVC patients, whereas the role of LRIG2 and LRIG3 expression remains to be clarified.
[Mh] Termos MeSH primário: Glicoproteínas de Membrana/metabolismo
Neoplasias Vaginais/metabolismo
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Meia-Idade
Prognóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (LRIG1 protein, human); 0 (Membrane Glycoproteins)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183816


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[PMID]:28689666
[Au] Autor:Huo D; Anderson D; Palmer JR; Herbst AL
[Ad] Endereço:Department of Public Health Sciences, University of Chicago, Chicago, IL, United States. Electronic address: dhuo@health.bsd.uchicago.edu.
[Ti] Título:Incidence rates and risks of diethylstilbestrol-related clear-cell adenocarcinoma of the vagina and cervix: Update after 40-year follow-up.
[So] Source:Gynecol Oncol;146(3):566-571, 2017 Sep.
[Is] ISSN:1095-6859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Women exposed to diethylstilbestrol (DES) in utero are at increased risk for the development of vaginal and cervical clear cell adenocarcinoma (CCA) at younger age. It is unknown if a second peak will occur in later life, the ages when CCA developed spontaneously in the pre-DES era. The complete epidemiologic curve of CCA has not been reported, yet. METHODS: We reviewed 720 cases of CCA from the CCA registry at the University of Chicago through 2014. Incidence rates and cumulative risks for CCA were calculated based on white women born in the U.S. from 1948 through 1971. RESULTS: In 420 CCA cases there was documented evidence of prenatal DES exposure. 80% were among those between ages 15 and 31 but some occurred as late as age 55. A small second peak occurred around age 42. The risk of DES-related CCA was highest in the 1951-1956 birth cohort and this birth cohort effect closely correlated with DES prescriptions over time in the U.S. (r=0.98, P=0.005). By age 50, the cumulative risk of CCA was 1 per 750 exposed women. CCA cases without evidence of DES exposure had similar ages, year of diagnosis, and birth cohort patterns as the documented DES-exposed cases, suggesting that some negative cases were exposed. Their inclusion raises the cumulative risk of CCA to 1 per 520. CONCLUSION: With the largest data available, our results confirmed the association between prenatal DES exposure and clear cell adenocarcinoma. The study also refines the risks of DES-related CCA.
[Mh] Termos MeSH primário: Adenocarcinoma de Células Claras/epidemiologia
Dietilestilbestrol/efeitos adversos
Efeitos Tardios da Exposição Pré-Natal/epidemiologia
Neoplasias do Colo do Útero/epidemiologia
Neoplasias Vaginais/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Estudos de Coortes
Prescrições de Medicamentos/estatística & dados numéricos
Feminino
Seguimentos
Seres Humanos
Incidência
Meia-Idade
Gravidez
Medição de Risco
Fatores de Tempo
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
731DCA35BT (Diethylstilbestrol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE


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[PMID]:28624154
[Au] Autor:Hayes SC; Janda M; Ward LC; Reul-Hirche H; Steele ML; Carter J; Quinn M; Cornish B; Obermair A
[Ad] Endereço:School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. Electronic address: sc.hayes@qut.edu.au.
[Ti] Título:Lymphedema following gynecological cancer: Results from a prospective, longitudinal cohort study on prevalence, incidence and risk factors.
[So] Source:Gynecol Oncol;146(3):623-629, 2017 Sep.
[Is] ISSN:1095-6859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Cancer-related lymphedema is a debilitating condition that adversely influences function, health and quality of life. The purpose of this study was to assess the prevalence, incidence, and risk factors of lower-limb lymphedema pre- through to 24months post-surgery for gynecological cancer. METHODS: A clinic-based sample of women (n=408) with gynecological cancer participated in a prospective, longitudinal study (2008-2011) using self-reported measures (swelling in one or both legs) and objectively measured lymphedema (bioimpedance spectroscopy) at baseline (pre-surgery), six weeks-three months, 6-12months, and 15-24months post-surgery. RESULTS: At pre-surgery, 15% of women self-reported lymphedema and 27% had measurable evidence of lymphedema. By 24months post-surgery, incidence of new self-reported or measured lymphedema was 45% and 37%, respectively. Three-quarters of these new cases presented by 12-months post-treatment. While lymphedema was transient for some women, 60% had persistent lymphedema. More extensive lymph node dissection, receipt of chemotherapy and radiation therapy, increasing body mass index, insufficient levels of physical activity, diagnosis of vulvar/vaginal cancer and presence of pre-treatment lymphedema were identified as potential risk factors (p<0.05). CONCLUSION: Findings support the need for integration of pre-surgical assessment, and prospective, post-treatment surveillance of lymphedema into gynecological cancer care. Future research exploring the role of maintaining healthy body weight, regular physical activity and education about early detection of lymphedema to improve gynecological cancer survivorship is warranted.
[Mh] Termos MeSH primário: Neoplasias dos Genitais Femininos/cirurgia
Excisão de Linfonodo/efeitos adversos
Linfedema/epidemiologia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Antineoplásicos/uso terapêutico
Austrália/epidemiologia
Índice de Massa Corporal
Feminino
Seres Humanos
Incidência
Estudos Longitudinais
Extremidade Inferior
Meia-Idade
Pletismografia de Impedância
Período Pós-Operatório
Prevalência
Estudos Prospectivos
Radioterapia
Fatores de Risco
Estilo de Vida Sedentário
Autorrelato
Fatores de Tempo
Neoplasias Vaginais/cirurgia
Neoplasias Vulvares/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170619
[St] Status:MEDLINE


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[PMID]:28594725
[Au] Autor:Brown KGM; Solomon MJ; Koh CE
[Ad] Endereço:1 Surgical Outcomes Research Centre, Sydney, New South Wales, Australia 2 Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, New South Wales, Australia 3 Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia 4 University of Sydney, New South Wales, Australia.
[Ti] Título:Pelvic Exenteration Surgery: The Evolution of Radical Surgical Techniques for Advanced and Recurrent Pelvic Malignancy.
[So] Source:Dis Colon Rectum;60(7):745-754, 2017 Jul.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pelvic exenteration was first described by Alexander Brunschwig in 1948 in New York as a palliative procedure for recurrent carcinoma of the cervix. Because of initially high rates of morbidity and mortality, the practice of this ultraradical operation was largely confined to a small number of American centers for most of the 20 century. The post-World War II era saw advances in anaesthesia, blood transfusion, and intensive care medicine that would facilitate the evolution of more radical and heroic abdominal and pelvic surgery. In the last 3 decades, pelvic exenteration has continued to evolve into one of the most important treatments for locally advanced and recurrent rectal cancer. This review aimed to explore the evolution of pelvic exenteration surgery and to identify the pioneering surgeons, seminal articles, and novel techniques that have led to its current status as the procedure of choice for locally advanced and recurrent rectal cancer.
[Mh] Termos MeSH primário: Recidiva Local de Neoplasia/cirurgia
Exenteração Pélvica/história
Neoplasias Pélvicas/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/história
Derivação Urinária/história
[Mh] Termos MeSH secundário: Carcinoma/cirurgia
Neoplasias Colorretais/cirurgia
Feminino
História do Século XX
História do Século XXI
Seres Humanos
Masculino
Neoplasias Ovarianas/cirurgia
Cuidados Paliativos
Ossos Pélvicos/cirurgia
Exenteração Pélvica/métodos
Períneo/cirurgia
Neoplasias da Próstata/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Rabdomiossarcoma Embrionário/cirurgia
Derivação Urinária/métodos
Neoplasias do Colo do Útero/cirurgia
Neoplasias Vaginais/cirurgia
Neoplasias Vulvares/cirurgia
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000839


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[PMID]:28495482
[Au] Autor:Yahiaoui Y; Gabsi A; Doghri R; Ayadi M; Mrad K; Mezlini A
[Ad] Endereço:Service d'oncologie médicale, institut Salah-Azaiez, faculté de médecine de Tunis, université el-Manar, Beb Saadoun, 3099 Tunis, Tunisie.
[Ti] Título:[Recurrence of a glassy cell carcinoma of the vagina: An exceptional situation].
[Ti] Título:Récidive d'un glassy cell carcinoma du vagin : une situation exceptionnelle..
[So] Source:Cancer Radiother;21(4):301-304, 2017 Jun.
[Is] ISSN:1769-6658
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Glassy cell carcinoma is a rare neoplasm that occurs most frequently in the uterine cervix. We describe the second reported case of glassy cell carcinoma arising in the vagina. We present a case of a 24-year-old woman with a history of post-coïtal bleeding associated with menometrorrhagia. Different explorations have concluded in a glassy cell carcinoma arising in the vagina, with clinical staging III according to the International Federation of Obstetrics and Gynecology. The patient received three cycles of neoadjuvant chemotherapy with a good response. Then she had a para-aortic lymphadenectomy and ovarian transposition. Following the surgery, she had radiotherapy. The gynecological examination showed no budding lesion and the biopsy was negative. Six months later, the patient complained of a pelvic pain. The examination revealed a locoregional recurrence. Surgical revision was not possible and the patient was a candidate for a palliative chemotherapy. Although, glassy cell carcinoma runs an aggressive clinical course, an early diagnosis may help in a more effective management and offer a better prognosis.
[Mh] Termos MeSH primário: Carcinoma Adenoescamoso/terapia
Recidiva Local de Neoplasia/terapia
Neoplasias Vaginais/terapia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170513
[St] Status:MEDLINE


  10 / 4414 MEDLINE  
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[PMID]:28445274
[Au] Autor:He Y; Zhao Q; Geng YN; Yang SL; Yin CH; Wu YM
[Ad] Endereço:Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Dongcheng District, Beijing, China.
[Ti] Título:Clinical analysis of cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia.
[So] Source:Medicine (Baltimore);96(17):e6700, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this prospective cohort study is to evaluate the importance of screening and its diagnostic accuracy compared with the pathological diagnosis of cervical intraepithelial neoplasia (CIN) with vaginal intraepithelial neoplasia (VAIN).The prospective study enrolled 419 patients (pts) and was conducted between February 1, 2015 and January 31, 2016 at Beijing Obstetrics and Gynecology Hospital, Capital Medical University.All enrolled pts underwent multipoint biopsy of cervix and vaginal wall directed by colposcopy. All samples of biopsy underwent pathological examination. Among them, 201 pts (48.0%) were diagnosed with CIN, 218 pts (52.0%) were diagnosed with cervicitis, and 51 pts (12.2%) were diagnosed with VAIN. It was found that the incidence of CIN in pts was 4 times higher than that of VAIN. In all 419 patients enrolled, 218 pts had cervicitis with 13 pts (6.0%) of VAIN. There were 201 pts of CIN with 38 pts (18.9%) of VAIN: including 53 pts of CIN3 with 12 pts (22.6%) of VAIN; 49 pts of CIN2 with 9 pts of VAIN (18.4%), and 99 pts of CIN1 with 17 pts of VAIN (17.2%). The incidence of CIN with VAIN (18.9%) was significantly higher than cervicitis with VAIN (6.0%) (χ = 16.39, P = .00). Our results showed that there was a significant consistency between cervical lesions and vaginal lesions (χ = 135.91, P = .00), which indicated that the increase of CIN grades may be related to an increase of the VAIN grades. Our results also showed the significant (p < .05) increase of CIN and VAIN with age (<40 years Kappa = 0.04; 40-50 years Kappa = 0.11; >50 years Kappa = 0.28).This study showed that cytological test can be used as a routine screening method for cervical lesions and vaginal diseases. If the cytology result shows abnormality, and pathological examination confirms that there is no obvious abnormal cervical disease, colposcopy directed vaginal multipoint biopsy should be conducted to exclude vaginal disease. All patients of CIN should routinely undergo vaginal multipoint biopsy (1/3 upper vagina), especially in patients with high-grade CIN and age older than 50 years.
[Mh] Termos MeSH primário: Neoplasia Intraepitelial Cervical/diagnóstico
Neoplasia Intraepitelial Cervical/patologia
Neoplasias do Colo do Útero/diagnóstico
Neoplasias do Colo do Útero/patologia
Neoplasias Vaginais/diagnóstico
Neoplasias Vaginais/patologia
[Mh] Termos MeSH secundário: Adulto
Neoplasia Intraepitelial Cervical/complicações
Colposcopia
Detecção Precoce de Câncer
Estudos de Viabilidade
Feminino
Seres Humanos
Biópsia Guiada por Imagem
Meia-Idade
Estadiamento de Neoplasias
Estudos Prospectivos
Neoplasias do Colo do Útero/complicações
Cervicite Uterina/complicações
Neoplasias Vaginais/complicações
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006700



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