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

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

This report describes a 64-year-old woman with a primary small cell carcinoma of the endometrium associated with adenosquamous carcinoma. The light microscopic features resembled those of small cell carcinoma of the lung and those of the uterine cervix, and foci of adenosquamous carcinoma lay scattered sparsely in the small cell carcinoma. Electron microscopy revealed cytoplasmic neurosecretory type granules. The neoplasm behaved in a very aggressive manner such that at 3 months after surgery a metastatic neoplasm appeared in the vagina. This case is a rare example of an endometrial carcinoma with differentiation toward endocrine as well as adeno and squamous cell carcinoma.
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PMID:Small cell carcinoma of the endometrium associated with adenosquamous carcinoma: a light and electron microscopic study. 302 7

Alkylating agents have caused acute nonlymphocytic leukemia (ANLL), probably bladder cancer, and possibly other solid tumors. Phenacetin also has enhanced risk of bladder cancer, and probably also carcinoma of the renal pelvis. Topical nitrogen mustard, potassium arsenite, tar ointments, and methoxsalene have been related to development of nonmelanotic skin cancers. Immunosuppression by azathioprine, usually with prednisone, has enhanced risks of non-Hodgkin's lymphomas, hepatobiliary cancers, and various mesenchymal tumors. Liver cancers have been reported in users of androgenic anabolic steroids, and both hepatic cell adenomas and carcinomas have been associated with use of combined oral contraceptives. These contraceptives reduce risks of endometrial and ovarian carcinomas. Estrogens increase risk of endometrial cancer. Exposure to diethylstilbestrol in utero can result in clear cell carcinomas of the vagina and cervix, and possibly testicular carcinomas.
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PMID:Steroid hormones and medications that alter cancer risks. 304 37

The endogenous genital flora is a major source of infections of the female genital tract, especially in patients with cervical or endometrial cancer. Until recently the "radiosterilisation of the vagina", respectively a prophylactic and/or therapeutic effect of irradiation (external high voltage as well as intracavitary-radium) concerning infections was postulated in the literature. This theory was disproved in a prospective clinical and bacteriological study covering 48 patients with advanced cervical cancer undergoing primary intracavitary radium-irradiation and 38 patients with inoperable endometrical cancer, undergoing primary Iridium-192-afterloading. Following intracavitary radium for cervical cancer some typical nosocomial pathogens like Streptococcus faecalis, Enterobacter, Klebsiella, Proteus and Pseudomonas were isolated significantly more frequently than before treatment. Likewise, the mean number of aerobic bacterial species increased significantly after irradiation. Also primary Ir-192 (afterloading) irradiation did not alter the frequency of isolation of the resident flora in endometrial cancer patients. Therefore, "radiosterilisation" of the vagina as result of radiotherapy does not exist.
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PMID:[Does radiosterilization of the vagina occur through therapeutic radiation dosages?]. 309 58

A retrospective analysis was performed on 93 patients who developed recurrent endometrial carcinoma in the pelvis, vaginal vault, and lower 1/3 vagina. There were 12 lower 1/3 vaginal recurrences, 24 vault recurrences and 57 pelvic recurrences from the 1005 patients treated between 1960 and 1976. Median time to recurrence was 30 months. Twenty-six patients had distant metastases also present at the time of recurrence in the sites mentioned above. Thirty-three percent of lower 1/3 vaginal recurrences, 12.5% of vault recurrences, and 5.3% of pelvic recurrences were salvaged with further treatment. The 10-year actuarial survival rates of isolated lower 1/3 vaginal, vaginal vault, and pelvic recurrences were 50%, 45%, and 24% respectively.
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PMID:The salvage of recurrent endometrial carcinoma in the vagina and pelvis. 318 20

We determined the concentrations of immunoreactive epidermal growth factor in the urine (U-irEGF) of 97 adult patients with various malignancies, including carcinomas of the urinary bladder, kidney, stomach, colon, rectum, breast, endometrium, uterine cervix, ovary, vagina, prostate, pancreas and thyroid, liposarcoma and skin melanoma. The relative U-irEGF concentrations (ng m-1 creatinine) were higher (P = 0.002) for the whole series of female patients than for healthy controls matched for sex and age. Such difference did not appear for male patients. The only specific group with a statistically supranormal U-irEGF concentration (P = 0.0005) comprised women with endometrial carcinoma of the uterus.
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PMID:Urinary epidermal growth factor concentrations in various human malignancies. 325 59

A survey of the literature over a 30-year period suggests that exenteration operations have not been widely accepted or perhaps not commonly reported except in the United States. Even in the United States, the series reported are usually of very small numbers. The reasons for this are difficult to explain except to say that the most widely indicated factor is carcinoma of the cervix and this has been decreasing in incidence as far as the more advanced stages are concerned. It is being detected at an earlier stage with a greater chance for cure without recurrence. Endometrial and ovarian cancer have been on the increase, with endometrial cancer being diagnosed early with excellent results and ovarian cancer occurring in an advanced stage with a presentation that does not lend itself readily to radical pelvic surgery. It must be stated that in cases where pelvic exenteration is indicated, and these are highly selective ones, there is no other equally curative form of therapy that exists for the distressing problem of recurrent pelvic cancer. With the new stapling techniques and the use of clips along the pelvic wall to control bleeding from the blood vessels in this area, it is possible to perform a pelvic exenteration with much less blood loss and in considerably less time than previously. The improved methods of monitoring these patients with a Swan-Ganz catheter and a better understanding of the metabolic and physiologic process has reduced the mortality rate to less the 5%. Having given these patients a quantity of life, it is important to give them a quality of life. These patients should be rehabilitated and, if needed, a vagina should be reconstructed and the patient encouraged to lead a normal life. Perhaps these patients cannot be described as happy, but at least given a second chance for life they can become well adjusted and make significant contributions to their family and the community.
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PMID:Pelvic exenteration. 331 12

We retrospectively studied 125 patients treated for carcinoma in situ of the vulva from 1961 through 1984, with follow-up ranging from one to 24 years. Patients' ages ranged from 24 to 90 years, with a mean age of 53 years. Multifocal disease was more common in women under age 40. Pruritus was the most common complaint, but 60% of the patients were asymptomatic. Twenty-five patients (20%) had other associated malignancies: carcinoma in situ of the cervix in ten patients, invasive carcinoma of the cervix in six, multifocal carcinoma in situ involving vulva, vagina, and cervix in five, vaginal carcinoma in situ in two, and endometrial carcinoma in two. Sixty-five patients were treated primarily with wide excision, 45 with total vulvectomy, seven with "subtotal" vulvectomy, three with skinning vulvectomy, and three with vulvectomy and bilateral groin node dissection; two patients refused treatment. Fifteen patients had a recurrence--recurrent carcinoma in situ in ten, and invasive carcinoma of the vulva in five. Whether the patient had had total vulvectomy or a lesser procedure appeared to make no difference in the recurrence rate. Thus a well planned excision of vulvar carcinoma in situ appears to be the treatment of choice. All recurrences were in patients over age 40, so although the lesion is histopathologically identical in the younger patients, its biologic behavior seems to be more benign. Since it is possible, however, that invasive disease will ultimately develop in some of the younger patients, careful follow-up is still required.
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PMID:Carcinoma in situ of the vulva: 24 years' experience in southwest Florida. 336 10

To determine whether the cytohormonal status of postmenopausal women with cancer involving the uterus and vagina differs from that of women free of cancer, 100 women 60 years of age or older with positive cervicovaginal smears were compared with an age-matched control group without malignant neoplasms. Epidermoid carcinoma was identified in 64 patients (average age: 67 years) and adenocarcinoma in 34 patients (average age: 69 years). One patient had leiomyosarcoma, and another had bladder carcinoma. The paucity of benign squamous cells in the smears precluded hormonal evaluation in 32% of the index cases; the smears from 10% of the controls were also indeterminate. Of the evaluable cases with epidermoid carcinoma of the cervix, a high maturation was noted in 46% as compared to 11% for the matched controls. In addition, high maturation was noted in 69% of those patients with endometrial adenocarcinoma as compared to 19% for the matched controls. None of the index cases were atrophic; 31% of the controls were. A history of exogenous estrogen usage was obtained in three patients with endometrial adenocarcinoma, all with high maturation, and in five controls, none with high maturation. These data appear to indicate a difference in the cytohormonal status of patients with cervical or endometrial carcinoma as compared to those without; consequently, cytologists should be especially attentive to smears showing high maturation from postmenopausal women.
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PMID:Comparison of cytohormonal status of postmenopausal women with cancer to age-matched controls. 345 12

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


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