摘要:

Immunosuppressed organ homograft recipients have a 5 to 69% incidence ofde novomalignancies at some time after transplantation. Gynecologic cancers were encountered in 21 of 224 patients (9%) with these tumors. The predominant lesion was carcinoma of the cervix (18 cases), of which 16 were intraepithelial and 2 were invasive. Gynecologic malignancies have also been encountered in non-transplant patients who were treated with immunosuppressive agents or cancer chemotherapy. All such individuals require gynecologic examination before commencement of treatment and at regular intervals thereafter so that malignancies may be diagnosed at an early stage and treated effectively. Most neoplasms respond well to conventional cancer therapy, but high-grade malignancies may necessitate reduction or cessation of immunosuppressive therapy as well.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Eight cases of clear cell adenocarcinoma treated at The M. D. Anderson Hospital are reviewed. Six such lesions were primarily vaginal carcinomas and 2 involved the cervix. Five patients with early carcinomas were treated entirely with a transvaginal cone or interstitial irradiation and 4 are living and well, 2 to 8 years after completion of therapy. We believe that this experience justifies further treatment of early clear cell carcinomas with conservative radiation. This form of therapy is particularly important since the DES-exposed patients represent an identifiable high-risk group which should augment the chances for early diagnosis.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

One hundred and seven patients with lichen sclerosus et atrophicus (LS&A) of the vulva were studied to determine the malignant potential of the LS&A. Five patients had coexisting invasive carcinoma of the vulva or perineum with the LS&A, and 1 patient had coexisting intraepithelial vulvar carcinoma on the clitoris. None of these, however, was known to have LS/A prior to the biopsy for carcinoma of the vulva. The high association of carcinoma and LS&A is probably a result of selection of 2 unusual lesions sent for consultation and evaluation. Squamous hyperplasia in the vulva occurred in association with LS&A in 37 (35%) patients, but only G patients had areas of dysplasia coexisting with LS&A. These areas of dysplasia, like the 5 invasive carcinomas, occurred in an area of the vulva where the LS&A was minimal or absent. Follow-up data were obtained on 92 patients with LS&A. Only 1 developed carcinoma of the vulva, which occurred 12 years after identification of the LS&A. When carcinoma arises in the vulva in a patient with vulvar LS&A, it tends to arise in areas of minimal LS&A or isolated areas of relatively normal vulvar skin. This study did not provide evidence of carcinoma arising from LS&A. Five of the 92 patients developed 6 malignant neoplasms in other sites, including carcinoma of the endometrium (3 patients), lung (1 patient), and simultaneous carcinomas of the colon and cervix

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Unexpected hysterographic findings were encountered in 42 or 105 patients with postmenopausal bleeding or endometrial carcinoma. These included the extent and location of tumor, size and position of the uterus, uterine perforations or fistulas, and undetected myomas, congenital defects, or adnexal pathology. The findings proved of sufficient value in clinical management that hysterography, using water soluble medium, has been adopted as a routine procedure in such cases, especially if radium or cesium packing is employed. There was no statistically significant correlation between the histologic grade of the tumor and the hysterographic appearance of well-circumscribed or diffusely infiltrating lesions. Intravasation of contrast media occurred in 9 patients, lymphatic uptake was observed in 8, and peritoneal spillage of dye in 31 patients. There was no significant morbidity, and results to date show no evidence of tumor spread from the procedure.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Proliferative epithelial lesions of the oviduct have been called adenomatous hyperplasia or carcinomain situ. In order to assess the incidence and significance of these lesions, we sectioned entire oviducts from 124 nonselected hysterectomies. We found 23 cases (18.5%) with lesions corresponding to those described in the literature. We have found no justification for diagnosing and treating these lesions as carcinomain situ. There appears to be an association with salpingitis.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

In the period 1950 through 1966, 357 patients with cancer metastatie to the ovaries were treated at the Mayo Clinic. The majority of primary tumors arose in the gastrointestinal tract. Factors influencing survival included the site of the primary cancer, histologic grade of the neoplasm, menstrual status, and the type of treatment. Patients whose cancers originated in the genital tract had the lowest mean death rate. Although analyses of survival confirm the observation that cancer metastatic to the ovaries has a poor overall prognosis, 21 of the 357 patients were still living at 10 years and 7 of these patients survived for at least 20 years. The continued development of improved technics of radiation therapy and of more effective rhemotherapeatic agents should facilitate intensive therapy for patients with metastatic cancer of the ovaries and result in improved survival.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Despite recent advances in the systemic chemotherapy of patients with malignant trophoblastic disease, there remains a small group of patients who fail to achieve remission with this type of treatment. The present study presents 19 patients with malignant trophoblastic disease who underwent a total of 25 arteriographic studies for localization of persistent malignant lesions and 8 patients who underwent arterial infusional chemotherapy after they had failed to achieve remission by standard administration of systemic methotrexate or actinomycin D. Patients underwent pelvic, pulmonary, carotid, and multiple abdominal selective arteriograms with a high correlation of positive findings and the later documented presence of persistent malignant disease. Findings included prominent uterine arteries, arteriovenous shunts, hypervascularity, irregular vessels, and tumor staining within the tumor. Arterially infused chemotherapy with methotrexate or actinomycin D was used in 8 patients whose disease was resistant to systemic chemotherapy. Technics of arterial infusion are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Since its original description in 1963, the pregnancy luteoma has been a controversial entity both clinically and pathologically. The most important questions which have been asked are: Is the luteoma a true neoplasm or does it represent simply an abnormal response to the hormones of pregnancy? What is the relation between the tumor and certain endocrinopatheies that are associated with these lesions? This study of 20 cases collected from the flies of the Emil Novak Ovarian Tumor Registry and the Pathology Section of the Baltimore City Hospitals directs its attention to these critical clinicopathologic features.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Thirty-four pregnant women with acute appendicitis presented at Parkland Memorial Hospital during a 15-year period. Abdominal pain, usually accompanied by nausea with or without vomiting, was the most common presenting symptom. Anorexia was less constant, and its occurrence decreased with advancing gestation. Physical findings usually included direct abdominal tenderness and, less often, rebound tenderness. Leukocytosis and/or a “left shift” were common laboratory findings, and the urinalysis was normal in most cases. Diagnosis was increasingly difficult as gestation progressed. This was reflected both by the increasing severity of the disease process found at surgery and by increasing fetal loss. If the diagnosis of appendicitis is suspected in the gravid patient, immediate surgical intervention is indicated to prevent the catastrophic complications associated with procrastination in diagnosis and treatment.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Using a random selection procedure, 100 patients were evaluated in order to determine the value of prophylactic antibiotics in cesarean section. All patients were evaluated for febrile morbidity, and specific infection sites were recorded. Significant differences were found between the treated and control groups and between cesarean sections performed prior to the onset of labor and after the onset of labor.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID