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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinicopathologic findings of 13 patients having extramammary Paget's disease of the vulva are discussed with emphasis on its histogenesis and biological behavior. For the purpose of study and assessment of prognosis, these cases were divided into two groups, those with an underlying invasive cutaneous adnexal adenocarcinoma, and those lacking an underlying invasive lesion. Four cases contained invasive cutaneous adnexal adenocarcinoma; in one of these the invasion was superficial. Three of the cases with an invasive lesion and three other cases showed in situ adenocarcinoma of sweat glands. Surgical treatment is mandatory for both groups of patients. The prognosis was excellent for the patients having Paget's disease without an underlying invasive carcinoma. From the literature, the prognosis of those with an underlying invasive carcinoma of the vulva appears to be less favorable. Multiple surgical excisions may be required to control the recurrences and metastases. A frequent association with other internal malignancy was observed. In four cases, second malignancies were found. Of special interest was the demonstration in one case of columns of neoplastic cells extending from involved sweat glands to the surface epithelium via the intradermal sweat duct. Our study leads us to support the concept that the Paget's cells, in a number of cases, are derived from an underlying carcinoma in situ of sweat gland origin.
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PMID:Extramammary Paget's disease of the vulva. A clinicopathologic study of 13 cases. 19 67

This is a report on 120 cases of vulvar cancer. The mean age at diagnosis was 66.5 years. 25% were younger than 60, and 10% younger than 50 years. 95% were squamous cell carcinoma. The main site of the primary lesion were the labia (71%). 55 patients had palpable nodes in the groins. 12% of all women (=28% of those treated by radical vulvectomyl) had metastases in the groins. 54 (45%) were treated by radical vulvectomy, of which 23 (43%) received postsurgical radiation. 63 patients had minor operation with consecutive radiation in 51 (81%) of them. The overall 5 year survival rate was 43%. It was 65% in the group treated by radical surgery and 24% in the group of minor surgery and radiation. The radical vulvectomy with bilateral inguinal and femoral lymphonodectomy is recommended as treatment of choice in all suitable cases. The radiation cannot replace radical surgery.
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PMID:[Treatment of vulvar cancer (author's transl)]. 57 77

History and clinical findings of 18 cases of adenosquamous carcinoma of the skin appendages found among 135 cases of primary carcinoma of the vulva seen at the University of Minnesota Hospital between 1951 and 1970 were analyzed. In addition, two recent cases of this tumor were studied with conventional transmission electron microscopy. Adenosquamous carcinoma of the vulva showed poorer survival and a higher rate of lymph node metastases than squamous cell carcinoma of the corresponding stages (carcinoma in situ excluded). In four out of thirteen cases, the metastatic lesions in the lymph nodes retained glandular pattern. The ultrastructure showed mucin-producing columnar cells lining glandular lumina, and poorly differentiated squamous cells elsewhere; further, cells of the intermediate type between the two were present. This study indicates that adenosquamous carcinoma of the vulva is a distinctively separate entity from squamous cell carcinoma of the vulva, and possibly arises from mucin-producing cells of the skin appendages as suggested by Johnson and Helwig.
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PMID:Adenosquamous carcinoma of skin appendages (adenoid squamous cell carcinoma, pseudoglandular squamous cell carcinoma, adenocanthoma of sweat gland of Lever) of the vulva: a clinical and ultrastructural study. 70 34

During a 40 year period 374 patients with infiltrative carcinoma of the vulva were evaluated. Some form of radical surgery was the treatment chosen for 278 patients. The absolute 5 year survival rates for all clinical stages treated with some form of radical surgery was 66.8 per cent with a corrected rate of 73.9 per cent. The corrected 5 year survival rate for patients treated with radical vulvectomy and groin lymphadenectomy approximated 80 per cent and if the regional lymph nodes were negative, it approximated 93 per cent. The size of the primary lesion and the incidence of regional lymph node metastases seemed directly related. Lymph node involvement itself significantly reduced the chance for survival. Furthermore, the inaccuracy of preoperative evaluation of the groin lymph nodes approximated 25 per cent. The assumption that a lesion is "early" does not justify less than radical surgery. Conversely, the "advanced" lesion when geographically localized can be treated quite satisfactorily with pelvic exenteration. The treatment of choice is discussed.
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PMID:Infiltrative carcinoma of the vulva: results of surgical treatment. 94 50

Retrospective analysis of 22 cases of Stage I invasive carcinoma of the vulva showed 11 cases in which the depth of tumor invasion was 5 mm or less. All of these patients were treated with radical vulvectomy and lymphadenectomy. In 3 cases positive groin node metastases were discovered. A fourth patient with minimal stromal invasion (less than 5 mm) was prospectively managed with vulvectomy alone and subsequently developed groin node metastasis leading to death from disseminated tumor. Depth of the invasion alone, therefore, is not a reliable indicator of the likelihood of groin node involvement, and lymphadenectomy should continue to be considered for all patients with invasive squamous cell carcinoma of the vulva.
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PMID:Relevance of microinvasion in carcinoma of the vulva. 114 25

The treatment results and five-years survival are studied in 157 patients with invasive vulvar cancer treated for the period of 1979-1988 in Gynaecological Clinic of the National Oncological Center Institute in Sofia. The general five years survival is 59.2%. The highest is the survival of the patients with first clinical stage--79.55%. The best treatment results are by patients treated with radical vulvectomy and regional lymph node dissection, without histological founded metastases in the extirpated lymph nodes--69.24% five years survival. The authors show some better results because of the better early diagnosis of the disease and the improved therapeutical methods.
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PMID:[The posttherapy survival of patients with invasive cancer of the vulva]. 134 53

A new modification of radical vulvectomy and lymphadenectomy through separate groin incisions involves dissection of the intervening skin bridge and allows an en bloc dissection. The results in 26 women treated with this technique are compared with those of seven treated with separate incisions without an en bloc dissection. All 33 women had squamous carcinoma of the vulva and were treated between 1985-1989. The incidence of advanced disease was high, with nodal metastases present in 52% of cases. Dissection of the tissue beneath the skin bridge did not alter the morbidity of the procedure in terms of the incidence of wound infection, number of units of blood transfused, or duration of hospitalization. The only case of an isolated recurrence in the skin bridge occurred in a woman who did not have an en bloc dissection, although there was no significant difference in the overall local recurrence rate between the groups. Further evaluation with larger numbers is required, but we suggest that an en bloc dissection using separate incisions may reduce the risk of isolated recurrence in the skin bridge, particularly in patients with advanced disease.
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PMID:En bloc radical vulvectomy and lymphadenectomy with modifications of separate groin incisions. 157 5

59 (80%) of 74 patients with vulvar cancer treated at the University Department of Obstetrics and Gynecology in Ljubljana in the period 1973-85 underwent radical vulvectomy with bilateral inguinofemoral lymphadenectomy, and 15 (20%) patients single vulvectomy because of advanced age and poor general condition. Histologically there were 69 cases of squamous cell carcinoma, 1 adenocarcinoma, 3 malignant melanoma and 1 rhabdomyosarcoma. 52% of the patients were classified as Stage I, 41% Stage II and 7% Stage III. Positive inguinofemoral nodes were observed in 24% (6.5% in Stage I, 35% in Stage II and 80% in Stage III). The total 5 year survival rate was 70% (83% in Stage I, 61% in Stage II and 20% in Stage III). The 5 year survival rate in the patients with negative nodes was 80%, and in cases with positive nodes only 50% in spite of postoperative irradiation. None of the 3 patients with melanoma survived 2 years nor did the patient with rhabdomyosarcoma. There was no case of primary mortality. Nowadays the cure rate for vulvar cancer is higher especially owing to the improvement of operability. The problem of lymphatic and distant metastases still remains unresolved.
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PMID:Surgical treatment of vulvar cancer. 151 82

A patient with adenoid cystic carcinoma of the vulva treated primarily with surgery developed multiple local and distant recurrences in which radiotherapy repeatedly achieved complete local control. The patient survived 11.5 years from original diagnosis and 9.5 years from primary recurrence before dying of pulmonary metastases. Adenoid cystic carcinoma of the vulva is a highly radiosensitive tumor. Adjuvant radiotherapy should be considered as a part of the primary therapy, to improve local control, on the basis of the much larger experience with adjuvant radiotherapy with this tumor in the head and neck. Also on the basis of head and neck tumors, it is unlikely that radiotherapy will affect survival.
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PMID:Adenoid cystic carcinoma of the vulva: a radiosensitive tumor. 166 12

Neuroendocrine small cell carcinoma is a lethal, but rare, tumor that arises most frequently in the lung. Small cell cancer also rarely may occur in the female genital tract, usually in the cervix. This article concerns the fourth reported case of neuroendocrine small cell carcinoma of the vulva. Previously, small cell carcinoma of the vulva has been treated with regional therapy including surgery and radiation. Survival has been poor, however, due to the propensity of these tumors to metastasize early in the course of the disease. Recently, the median survival of patients with small cell carcinoma of the lung has been improved with the use of chemotherapy. The authors review the literature on the treatment of small cell carcinoma of the vulva and report on a patient who was treated successfully with vulvectomy and inguinal lymphadenectomy followed by adjuvant chemotherapy.
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PMID:Stage I small cell carcinoma of the vulva treated with vulvectomy, lymphadenectomy, and adjuvant chemotherapy. 184 50


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