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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carcinoma of the cervix or endometrium was evaluated in 1,021 patients at the Joint Center for Radiation Therapy, Boston, between July 1968 and December 1977. The patients were retrospectively evaluated for the presence of lung metastases, appearing initially or during their disease course. On chest radiography, 42 patients were found to have metastases. Lung metastases were seen in 5.1% of patients with carcinoma of the cervix and in 3.6% of patients with carcinoma of the endometrium. Median time from initial disease staging to detection of lung metastases was 12 months. Once pulmonary spread was discovered, 80% of patients expired within 1 year. Lung nodules varied greatly in size. In 11 patients they were solitary; five patients had pleural effusions; three had mediastinal or hilar adenopathy; and none had excavation.
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PMID:Lung metastases in cervical and endometrial carcinoma. 11 20

Screening chest radiographs do not reduce mortality from lung cancer. Should an incidental noncalcified pulmonary parenchymal nodule be discovered, chest CT will demonstrate one third of such patients to, in fact, have the multiple nodules of metastatic disease. CT is very helpful to guide fine needle aspiration biopsy of lung lesions and to assist in evaluation for resectability. MR can be helpful in special circumstances, including the definition of the extent of paravertebral, superior sulcus, and diaphragmatic lesions. Endorectal ultrasound is not sensitive enough to function as a screening tool for prostate cancer but is used routinely to guide biopsies. CT and MR are rarely helpful in staging this disease. Given the highly characteristic trait of bone metastasis in prostate cancer, a bone scan is mandatory in all patients. Double contrast barium enema can be used as an adjunct or alternative to sigmoidoscopy for colorectal cancer screening, in the preoperative evaluation of patients, and in postoperative surveillance. CT and MR can detect macroscopic adenopathy and liver metastases; CT is generally the preferred study. Screening mammography can have a major impact in reducing breast cancer mortality. It is recommended that a baseline study be obtained at age 35. Annual or biannual examinations should commence at age 40. Any palpable lesion, whether or not it is demonstrated mammographically, must be subjected to biopsy. Ultrasound is the most useful initial imaging study for evaluating pelvic masses. MR will, on occasion, identify the origin of a mass not determinable from ultrasound scan. MR is particularly valuable to identify parametrial spread (inoperability) of cervical cancer, and has been underused for this purpose. Surgery remains the mainstay for the staging of ovarian and endometrial cancer, although CT can be helpful to identify macroscopic relapse, ascites, or liver metastases. Bone scan and liver CT remain the standard procedures for detecting metastases in these respective organ systems. MR can be invaluable in the imaging of epidural metastasis and spinal cord compression in patients with vertebral metastatic disease. Contrast-enhanced MR is more sensitive than contrast-enhanced CT for detecting brain metastases, but the latter remains a useful tool. Chest CT can improve the detection of pulmonary metastases when this is of crucial importance.
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PMID:Diagnostic imaging in cancer. 146 83

In order to assess the role of lymphography in the postoperative management of carcinoma of the endometrium, 57 consecutive cases were analysed retrospectively. Forty-eight patients had undergone definitive surgery and bipedal lymphography was performed in 41 cases (85%). Unilateral pelvic lymphadenopathy was detected in three cases (7%); two stage I, one stage II. In no case did the result of lymphography alter management, based on histological criteria, with either intracavitary radiotherapy alone or in combination with external beam therapy to the pelvis. In a short median follow-up of 11 months (range 2-19 months), four cases have relapsed but all had normal lymphography at initial postoperative staging. Bipedal lymphography has no role in the routine management of carcinoma of the endometrium.
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PMID:The role of lymphography in the management of carcinoma of the endometrium. 248 69

Diagnostic imaging is important in differentiating benign and malignant pelvic tumors and in staging malignant tumors. Many imaging techniques are now available. We describe computed tomographic (CT) and magnetic resonance imaging (MRI) features of gynecologic tumors. The following nine CT parameters were evaluated in 251 cases of cervical cancer (the incidence of each feature is given in parentheses): 1) enlargement of the cervix (58%), 2) low density area(s) (LDA) in the cervical region (28%), 3) presence of a necrotic cavity (11%), 4) pyometra (16%), 5) irregularity or indistinctness of the cervical margin (20%), 6) abnormalities of the parametrium (41%), 7) tumor extension to the vagina (9%), 8) tumor extension to the bladder (20%), 9) lymphadenopathy (8%). The more advanced the stage, the more features tended to be present. On T2-weighted MRI, cervical cancer appeared as a high intensity image. There was a positive correlation (r = 0.79) between MRI and pathologic findings concerning the thickness of the residual cervical myometrium. MRI was distinctly useful in both the staging of cervical cancer and the determination of the extent of tumor invasion of the vagina and bladder. We used three criteria to classify patients with endometrial cancer, which appeared as LDA within the uterus on contrast enhanced CT: 1) LDA occupied less than 50% of the uterine region, 2) the minimum thickness of the normal myometrium was over 0.5 cm, 3) the ratio of maximum to minimum thickness of the normal myometrium was over 0.5. Patients who fulfilled all three criteria constituted group A (n = 33), and those who failed to meet all three were designated group B (n = 30). The rates of myometrial invasion through more than one third the thickness of the uterine wall were 15% in group A and 90% in group B. The rates of lymphatic or vascular invasion were 15% and 57%, respectively, and of extrauterine invasion or metastasis 9% and 47%. Each of these differences was significant (p less than 0.01). Metastasis was detectable by CT in four group B patients. On T2-weighted MRI, endometrial cancer exhibited high intensity. A positive correlation (r = 0.94) was obtained between MRI data and pathologic findings concerning the thickness of residual normal myometrium. Preoperative differentiation of benign and malignant ovarian tumors is important.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Role of X-ray CT and magnetic resonance imaging in the diagnosis of gynecological malignant tumor]. 280 44

MRI of 54 patients with endometrial and cervical carcinoma was performed on a 0.6-T superconducting magnet. In 18 of 24 cases of surgically proved endometrial carcinoma, MRI accurately showed the depth of myometrial invasion. MRI was superior to CT scan for defining the primary site and extent of the tumor in 14 of 24 cases. Of 25 patients with cervical carcinoma studied, MRI was superior to CT scan in 15 of 19 cases with CT correlation for localizing the primary site. MRI showed parametrial extension and invasion of surrounding structures but is probably less reliable than CT scan for detection of adenopathy because of false positive findings from volume averaging with bowel.
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PMID:MRI in staging of endometrial and cervical carcinoma. 358 83

The potential of magnetic resonance (MR) imaging in the detection of endometrial carcinoma and in the assessment of its extent was evaluated prospectively in 51 patients clinically suspected of having the disease. MR imaging findings were compared with the results of surgical-pathologic staging and lymph node sampling following hysterectomy. Histologic findings showed 45 patients to have endometrial carcinoma, three to have no residual tumor after dilatation and curettage, and three to have adenomatous hyperplasia of the endometrium. MR imaging demonstrated an endometrial abnormality in 43 of the 51 patients (84%). Endometrial carcinoma could not be differentiated from adenomatous hyperplasia or blood clots. Therefore, MR imaging was not specific for tumor detection, and histologic diagnosis remains essential. The overall accuracy of MR imaging in staging endometrial carcinoma was 92%; its overall accuracy in demonstrating the depth of myometrial invasion was 82%. Demonstration of lymphadenopathy and adnexal or peritoneal metastases by MR imaging was suboptimal.
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PMID:Endometrial carcinoma staging by MR imaging. 379 41

Since the wide acceptance of serous carcinoma as a distinct subtype of endometrial carcinoma, almost all endometrial carcinomas with psammoma bodies have been classified as such. We describe eight cases of endometrioid endometrial adenocarcinoma with psammoma bodies and discuss their clinicopathologic features. The patients ranged in age from 37 to 79 years. Psammoma bodies were present in the curettage material in three and in the hysterectomy specimens in all cases. The tumors were well to moderately differentiated with at least focal squamous metaplasia. Four of eight cases also showed a focal villoglandular architecture. Inflammation and necrosis were present in all cases, and four had features of pyometra. Deep myometrial invasion was present in six cases. Diffuse lymphatic invasion was present in six, and one showed perivascular lymphocytic infiltrate in the absence of myometrial invasion. The tumors metastasized to lymph nodes in four of eight cases. One case showed intranodal psammoma bodies in the absence of endosalpingiosis or tumor. Intra-abdominal recurrence was present in only one case and was endometrioid with rare psammoma bodies. All patients are alive, six with no evidence of disease, one with stable periaortic lymphadenopathy, and one with progressive disease. This report suggests that endometrioid endometrial carcinoma may rarely be associated with psammoma bodies, the formation of which is most likely due to inflammation and necrosis. It also suggests that endometrioid carcinoma with psammoma bodies has a higher surgical stage and is more likely to have lymphatic invasion and lymph-node metastases and hence require surgical staging. The pattern of spread appears to be different from uterine papillary serous carcinoma, and the rate of survival is similar to stage-matched endometrioid carcinoma without psammoma bodies.
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PMID:Endometrioid endometrial adenocarcinoma with psammoma bodies. 913 Sep 86

This retrospective study was aimed at assessing Computed Tomography (CT) capabilities in identifying low- and high-risk groups of clinical stage I endometrial carcinoma patients. CT of the pelvis was performed on 125 endometrial carcinoma patients who were divided into two groups based on T (stage and depth of myometrial invasion) and N (lymph node status) parameters. All patients had histologic evidence of well/moderately-differentiated adenocarcinoma (G1-G2). The low-risk group consisted of stage I patients with superficial myometrial involvement and no lymphadenopathy, while the high-risk group consisted of the patients with deep myometrial invasion and/or stage II and/or positive lymph nodes. All patients were operated on-i.e., total abdominal hysterectomy with vaginal cuff, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. The patients were followed-up for 36 months at least. On the basis of CT findings, 85 patients were included in the low-risk group, but 11 misstaged cases were found at surgery in which lymphadenectomy never changed the factor risk. Only four relapses (4.7%) were observed in this group. Forty patients were included in the high-risk group: CT misstaged 20 cases and 12 relapses (30%) were observed. This study demonstrates the clinical value of CT in the assessment of radiologic risk factors in stage I endometrial carcinoma; CT findings can be used as guidelines for different treatments.
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PMID:Clinical usefulness of CT in the treatment of stage I endometrial carcinoma. 925 40

The objective of this study was to evaluate the potential survival benefit of debulking macroscopic adenopathy and other clinical prognostic factors among patients with node-positive endometrial carcinoma. Demographic, operative, pathologic, and follow-up data were abstracted retrospectively for 41 eligible patients with FIGO stage IIIC endometrial cancer. Survival curves were generated using the Kaplan-Meier method and statistical comparisons were performed using the log rank test, logistic regression analysis, and the Cox proportional hazards regression model. All patients had positive pelvic lymph nodes and 20 patients (48.8%) had positive para-aortic lymph nodes. Postoperatively, all patients received whole pelvic radiation therapy, 17 received extended-field radiation therapy, and 15 patients received chemotherapy. The median disease-specific survival (DSS) time for all patients was 30.6 months (median follow-up 34. 0 months). Patients with completely resected macroscopic lymphadenopathy had a significantly longer median DSS time (37.5 months), compared to patients left with gross residual nodal disease (8.8 months, P = 0.006). On multivariate analysis, independent predictors of DSS were gross residual nodal disease (HR 7.96, 95% CI 2.54-24.97, P < 0. 001), age > or = 65 years (HR 6.22, 95% CI 2.05-18.87, P = 0.001), and the administration of adjuvant chemotherapy (HR 0.22, 95% CI 0.07-0.76, P = 0.016). We conclude that in patients with stage IIIC endometrial carcinoma, complete resection of macroscopic nodal disease and the administration of adjuvant chemotherapy, in addition to directed radiation therapy, are associated with improved survival.
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PMID:FIGO stage IIIC endometrial carcinoma: resection of macroscopic nodal disease and other determinants of survival. 1467 52

We report a rare case of primary lymphoma of fallopian tube in a 68-year-old woman who underwent total hysterectomy and bilateral salpingo-oophorectomy for endometrial carcinoma. The specimen showed a well-differentiated endometrioid adenocarcinoma with superficial myometrial invasion. The left fallopian tube revealed a 1 cm nodule that histologically showed diffuse lymphoid follicles consisting of small cleaved lymphocytes and occasional larger cells. The cells were immunopositive for CD20, BCL-2, and BCL-6 but negative for CD3 and CD43. Polymerase chain reaction confirmed a monoclonal B-cell population. Fluorescence in-situ hybridization revealed at (14, 18) translocation. The patient had absent lymphadenopathy and negative CT scan of chest, abdomen, and pelvis. The findings were consistent with a primary low grade follicular lymphoma of fallopian tube. She did not receive chemotherapy and remained disease free for 13 months after surgery. Our case suggests that primary lymphoma of fallopian tube may be associated with a favorable prognosis.
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PMID:Primary follicular lymphoma of the fallopian tube found incidentally in a patient treated for endometrial carcinoma: a case report. 2058 6


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