Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study of 1513 vulval and vaginal biopsy specimens was undertaken to determine the frequency of non-gynaecological metastases to the vulva and the vagina; 7 cases were found. These were reviewed and an attempt was made to determine the mode of spread.
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PMID:Non-gynaecological metastases to the vulva and vagina. 334 Sep 38

We studied 39 patients with stromal invasion exceeding 1 mm. Among them 3 underwent emivulvectomy and 8 simple vulvectomy; all had selective inguinal lymphadenectomy of one side the first and bilaterally the others. 17 women underwent radical vulvectomy and inguinal lymphadenectomy while 11 had radical vulvectomy and inguino-pelvic lymphadenectomy. Out of 21 patients with lymph nodal metastases, 11 had one side inguinal metastases, 2 had a single metastasis, 2 had double metastases, 1 had three metastases and 2 multiple ones. Survival rate decreased from 54.5% to 20.0% when patients had more than 3 monolateral inguinal metastases or bilateral ones, with increase of pelvic lymph nodal metastases; therefore, in those cases, pelvic lymphadenectomy can be associated to inguinal lymphadenectomy or, when the carcinoma is situated in the clitoridis, Bartolino's gland or vagina (the same could be done for melanoma of the vulva). The usefulness of radiotherapy is limited by the small response of vulvar tissue. In a series of 45 patients with clinical diagnosis of inguinal metastases, who could not undergo operation, only therapy, with electron beam therapy (9 meV) associated to inguinal fields (15 meV), had positive influence in 27% of the cases.
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PMID:Radical vulvectomy and inguinal lymphadenectomy versus inguino-pelvic lymphadenectomy combined with radical vulvectomy and the role of radiotherapy. 334 88

Adjuvant combination chemotherapy with cyclophosphamide, doxorubicin and cisplatin was administered to 36 patients after cystectomy for bladder cancer. Therapy was tolerated well except for 1 patient who suffered a fatal chemotherapy complication. Indications for adjuvant chemotherapy included vascular invasion of the primary tumor, perivesicular tumor involvement, invasion of adjacent pelvic viscera (vagina and prostate) and nodal metastases. There were 53 concurrently treated patients who did not receive adjuvant chemotherapy despite similar unfavorable pathological indications (high risk control group). Survival rates (61 and 73 per cent, respectively) were not significantly different for those patients treated with adjuvant chemotherapy and an additional group of 158 patients who underwent cystectomy during the study period but who had no adverse pathological findings (low risk control group). Survival rates differed significantly between the low risk (73 per cent) and high risk (38 per cent) control groups (p less than 0.001). Patients with unfavorable histological findings who received adjuvant chemotherapy had a significant survival advantage over the high risk control groups (61 versus 38 per cent, p equals 0.03). These data confirm the predictive value of post-cystectomy pathological findings and suggest that adjuvant chemotherapy with cyclophosphamide, doxorubicin and cisplatin not only prolongs the survival free of disease for patients at high risk for recurrence but it also may ultimately increase the cure fraction of such patients.
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PMID:Adjuvant chemotherapy of bladder cancer: a preliminary report. 337 89

The potential of magnetic resonance (MR) imaging in the detection of vaginal tumors and the assessment of their extent was evaluated retrospectively in 87 patients in whom primary, metastatic, or recurrent vaginal cancer was clinically suspected. MR findings were compared with the results of surgery and/or biopsy. Results of histopathologic study verified a normal vagina in 51 patients, benign cysts in two, primary tumor in four, metastatic cancer in 22, and recurrent tumor in eight. MR imaging demonstrated the two benign cysts, correctly depicting their size and location, and demonstrated and enabled correct staging of the four primary tumors. MR accuracy for demonstrating metastatic cancer was 92%, sensitivity was 95%, and specificity was 90%. Tumor extension to the vagina was reliably excluded (negative predictive value = 97%), but false-positive interpretations occurred (positive predictive value = 84%) primarily because inflammation (n = 2) and congestion (n = 2) could not be distinguished from tumor invasion. An additional role of MR imaging was the ability to differentiate tumor from fibrotic tissue in patients with suspected recurrent vaginal carcinoma. The overall accuracy of MR imaging for recurrent vaginal cancer was 82% (14 of 17).
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PMID:Vagina: evaluation with MR imaging. Part II. Neoplasms. 342 Feb 57

There is a 100-fold increase in the incidence of carcinomas of the vulva and anus in renal transplant recipients compared with the general population. Anogenital (anus, perianal skin, and external genitalia of both sexes) carcinomas occurred in 65 of 2150 renal transplant recipients who presented with 2298 different types of malignancy. Two-thirds of the patients were female and one-third male. They were much younger than persons with similar tumors in the general population. The average age of the females at the time of diagnosis was 37 years (range, 20-64) and of the males, 45 years (range, 34-62). The neoplasms occurred late after transplantation, an average of 88 months (range, 9-215), compared with an average of 56 months (range, 1-225.5) for all other post-transplant malignancies. The lesions involved the vulva, penis, scrotum, anus, or perianal area. Two patients also had involvement of the urethral meatus. In several female patients, there was a "field effect" with multiple tumors of the squamous epithelium of the anogenital area, vagina, or uterine cervix. Lesions ranged from in situ carcinomas (in one-third of the cases) to those with invasion of adjacent organs and lymph node metastases. Treatment varied from local excisions to radical vulvectomy, abdominoperineal resection, or penile resection, sometimes combined with excision of the inguinal lymph nodes. In several patients, there was a previous history either of condyloma acuminatum or herpes genitalis, suggesting a possible viral etiology of these tumors.
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PMID:Cancers of the anogenital region in renal transplant recipients. Analysis of 65 cases. 352 88

Data were obtained retrospectively on 1005 patients with histologically proven endometrial carcinoma from January 1960 to December 1976 inclusive. The 5- and 10-year actuarial survivals for all stages were 83 and 80% respectively. Recurrent disease developed in 14% of patients. The site of first recurrence was vaginal vault in 2.5%, lower vagina in 1.1%, pelvis in 5.7%, and lungs in 1.9%. Thirty-eight patients (27%) had multiple sites of metastatic disease at the time of first relapse. The only significant independent prognostic variables for clinical Stage I adenocarcinoma treated with surgery and radiation were no myometrial penetration and poorly differentiated tumors.
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PMID:Prognostic variables in endometrial carcinoma. 359 47

The malignant malignoma originates from the neutral tube and can be found in nearly every part of the body. Middle-aged women are most frequently affected. Histopathologically the melanoma can be subdivided into lentigo maligna melanoma, superficial spreading melanoma, nodular melanoma and non-classifiable melanoma. The histopathological classification as suggested by Clark and Breslow, completed by the "Prognosis-Index" of Schmoeckel and Braun-Falco, is of prognostic and therapeutic value. 3-5% of all melanomas are localised in the vulva at an average age of 60 years. The vagina is rarely affected, and, if so, at an earlier age. The tumour must be removed in total. Diagnostic biopsy is generally accepted, if followed by adequate therapy. Therapeutic possibilities are discussed. The influence exercised by pregnancy on the formation and evolution of a malignant melanoma is still controversial. Diaplacentar metastases are described. As long as the malignant melanoma remains limited to the upper chorium and the diameter does not exceed 1.5 mm, pregnancy can be tolerated with close supervision without influencing the further evolution of the tumour. Total excision should be performed regardless of the pregnancy stage.
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PMID:[Melanoma in gynecology]. 381 7

In advanced tumors, the imaging techniques such as ultrasound, computer tomography or magnetic resonance imaging are at the forefront. In order to plan surgical procedure, lymphography is indicated as a supplementary diagnostic measure mainly in tumors of the corpus and the cervix uteri, especially in the early and middle stages. In tumors of the ovary, the vagina and the vulva, diagnostic assistance in deciding on therapy is to be expected only in occasional cases. The indication for lymphography should not only be established in relation to the tumor stage, but also tumor grading, since a very much higher local regional metastatic spreading is to be reckoned with in increasing grading, so that the choice of therapeutic procedure is crucially affected. In using preoperative diagnostic measures, the postoperative morphological follow-up should be considered: Examinability of the removed lymph nodes, especially in preoperative suspicion of metastases. Behavior of the lymph nodes in the post-therapeutic phase with consideration of recurrence diagnostics. Planning of radiotherapeutic target volume considering collateral circulations and atypical lymphatics.
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PMID:[Value of lymphography in the preoperative diagnosis of gynecologic cancers]. 382 42

This report describes six patients with endodermal sinus tumor of the vagina and cervix, a polypoid friable tumor whose clinical presentation in girls younger than age 3 years simulates the presentation of sarcoma botryoides. In four of the six patients, the referring diagnosis was sarcoma botryoides. Five patients were treated with excisional surgery, and all six with chemotherapy. One patient with pulmonary metastases maintained a complete clinical response to vincristine, actinomycin-D, and cyclophosphamide (VAC) for 11 months. This is the first report of such a response. One patient with a vaginal lesion remains clinically free of disease 2 years after local excision and 18 months of VAC chemotherapy. This is the first report of apparently successful therapy that allowed retention of childbearing potential. Four of the six patients have been disease-free from 2 to 23 years. After examining the world literature, it is concluded that a combination of chemotherapy and surgery offers a reasonable prospect of cure with a minimum of serious side effects.
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PMID:Endodermal sinus tumor of the vagina and cervix. 388 65

A mixed intestinal adenocarcinoma-argentaffin carcinoma of the vagina in a 32-year-old woman is reported. Special stains showed the argentaffin and argyrophil reactions of the small cell population of this tumor. The small cells also contained serotonin as demonstrated by immunocytochemistry. Electron microscopy revealed characteristic cytoplasmic neurosecretory granules. The large cells were columnar and contained mucin droplets similar to those in Goblet cells in the intestines. The observations suggest that the tumor was mixed intestinal adenocarcinoma-argentaffin carcinoma (malignant carcinoid), which probably arose in aberrant intestinal epithelial cells in the vagina. The patient died with metastases of pure argentaffin carcinoma in 1 year.
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PMID:Mixed intestinal adenocarcinoma-argentaffin carcinoma of the vagina. 395 26


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