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Biomedical subjects

G Cormio

Publications and source records attributed to G Cormio.

At least 55 records · Page 3Linked to original sources
PubMed1998

Non-Hodgkin lymphoma in a gynecologic service. A report of three cases.

Primary lymphoma arising in female genital tract organs is extremely rare. We report three cases of non-Hodgkin lymphoma which were encountered during a four-year period at our gynecologic department. One patient presented with an inguinal mass; another had a primary lymphoma of the vagina and the third had massive pelvic and para-aortic lymphomatous involvement. The gynecologists should be aware that, although rarely, lymphomas may arise in the genital tract, and that a massive involvement of inguinal, pelvic or para-aortic nodes may be related to a lymphoproliferative disease.

Adult↗
PubMed1997

Serous papillary cystadenoma of borderline malignancy of the broad ligament.

Serous papillary cystadenoma of borderline malignancy arising in the broad ligament is extremely rare. We report the case of a 28-year-old female with a cystic mass in the broad ligament, who underwent complete excision of the mass, right salpingo-oophorectomy, omentectomy and multiple peritoneal biopsies. Pathology showed a serous papillary cystadenoma of borderline malignancy of the broad ligament, without peritoneal and omental involvement. A review of the literature about this rare pathologic condition is reported.

Adnexal Diseases↗
PubMed1997

Transvaginal color Doppler sonography in predicting the response to chemotherapy in advanced cervical cancer.

The role of Doppler ultrasonography in the diagnosis of advanced cervical cancer continues to be controversial. This study was designed to assess the clinical value of the technique in terms of predicting the response to chemotherapy in patients with advanced cervical cancer. Twenty-three patients with cancer of the cervix (FIGO stages Ib bulky-IIIb) and 20 healthy women underwent transvaginal color Doppler assessment of the uterine arteries (both ascending and descending branches) and the intracervical vessels. Statistical analysis was performed by Student's t test for paired and unpaired data. The intracervical vessels were the only site to show significant differences both in the resistance and in velocity parameters. A subgroup of 14 patients, scheduled for neoadjuvant chemotherapy, were evaluated before and at the completion of treatment. A significant increase in resistance and pulsatility index values and a decrease in peak systolic velocity were observed in the ten patients who responded to chemotherapy. Preliminary results of our study suggest that Doppler parameters can be clinically useful in the evaluation of the response to neoadjuvant chemotherapy. More patients, sampled in a prospective way in order to increase the number of non-responders, would be necessary to assess the possible role of Doppler ultrasound in predicting which patients will respond to chemotherapy.

Aged↗
PubMed1997

Treatment of fallopian tube carcinoma with cyclophosphamide, adriamycin, and cisplatin.

Primary carcinoma of the fallopian tube is uncommon; optimal primary treatment is still not well defined, and little information is available about the efficacy of cisplatin-based combination chemotherapy. Thirty-eight patients with fallopian tube carcinoma were treated with cyclophosphamide (500 mg/m2), Adriamycin (50 mg/m2), and cisplatin (50 mg/m2) (CAP). Thirty-two patients received the combination chemotherapy as first-line treatment after cytoreductive surgery, whereas six subjects were treated for recurrent disease. The patients received a median of six cycles of therapy (range, four to nine). At the initiation of chemotherapy, 24 patients had measurable lesions. In this group of patients, 15 had a clinical complete response (CR), four had a partial response (PR), three had stable disease (SD), and two had progressive disease (PD) after chemotherapy. The overall clinical response rate (CR + PR) was 80%. Ten of the 14 CR patients who were submitted to second-look operation (SLO) were found free of disease, in pathologic complete response (pCR). Three pCR patients relapsed, and two of them died despite second-line treatment. Nine patients achieving PR, SD, and PD after first-line chemotherapy were further treated (five with chemotherapy, two with radiotherapy, two with progesteron), but none responded to second-line treatment and all died (median survival, 9 months). Fourteen patients without gross residual disease after cytoreductive surgery had no measurable lesions and were not evaluable for response. Seven of them had negative SLO and remain disease free. Three patients (two stage III and one stage II) who refused SLO relapsed 14, 16, and 26 months after completion of chemotherapy. The median survival for the entire group was 38 months, and the 5-year survival rate was 35%. The toxicity of the regimen was moderate. The CAP regimen appears to be active in primary fallopian tube carcinoma and yields response rates comparable to those reported for epithelial ovarian cancer.

Adult↗
PubMed1997

Second-look laparotomy in the management of fallopian tube carcinoma.

OBJECTIVE: To evaluate the role of second-look laparotomy following platinum-based combination chemotherapy in patients with fallopian tube carcinoma. METHODS: A retrospective chart review was conducted on 21 patients with tubal carcinoma who underwent second-look laparotomy following cytoreductive surgery and platinum-based combination chemotherapy. RESULTS: Thirteen patients (62%) were found to be free of disease at second-look operation. Neither stage nor grade were predictive of findings at second-look procedure. The absence of gross residual disease following primary surgery was the only predictor of disease-free status at second-look laparotomy (p < 0.01). With a mean follow-up of 49 months among the survivors, four (31%) of the patients with negative second-look laparotomy have had a recurrence. The median survival following a positive second-look laparotomy was 18 months (range 5-42 months). CONCLUSION: Second-look laparotomy provides useful prognostic information in patients with tubal carcinoma. The high rate of recurrent disease after negative second-look laparotomy, and the lack of an effective second-line treatment in patients with persistent disease, represent major criticisms of this procedure.

Adult↗
PubMed1997

Central nervous system involvement secondary to metastatic mixed müllerian tumor of the uterus.

The central nervous system is traditionally considered an uncommon site for metastatic disease from female genital tract tumors. We report the case of a 48-year-old woman with malignant mixed müllerian tumor of the uterus, who developed spinal cord compression by epidural metastasis a few days after the diagnosis of the uterine malignancy. Emergency decompressive laminectomy was performed and a good recovery of the neurological function was achieved. In the following days, while submitted to extensive staging for the uterine malignancy, the patient complained of headache, confusion and visual disturbance. CT scan revealed multiple brain metastases. No other site of metastatic disease could be detected. The patient refused any further treatment and died 1 month later from progressive cerebral disease. Attention should be paid to the possibility of unusual distant metastases associated to uterine sarcoma in order to treat these patients promptly.

Brain Neoplasms↗
PubMed1997

Squamous carcinoma in situ of the ovary.

We report a case of a squamous cell carcinoma in situ of the ovary in a patient previously submitted to radical hysterectomy and pelvic lymphadenectomy for an epidermoid carcinoma of the uterine cervix. The histogenesis of epidermoid tumors of the ovary and their association with squamous malignancies of the uterine cervix are discussed.

Adult↗
PubMed1997

Transvaginal color Doppler ultrasound for monitoring the response to neoadjuvant chemotherapy in advanced cervical cancer.

BACKGROUND: To evaluate the role of transvaginal color Doppler ultrasound in monitoring the response to neoadjuvant chemotherapy in patients with locally-advanced cervical cancer. METHODS: Fourteen patients with locally-advanced cervical cancer, scheduled for neoadjuvant chemotherapy, were investigated with transvaginal color Doppler ultrasonography before and at the completion of chemotherapy in order to study hemodynamic changes in cervical and intratumoral vessels. Twenty healthy women matched for age and parity served as a control group. Statistical analysis was performed with Student's t test for paired data. RESULTS: Statistically different blood flow recording between patients with cervical cancer and healthy controls could be observed only in intratumoral vessels. A significant increase of RI and PI values, recorded in both cervical artery and intratumoral vessels, have been observed in the group of patients responding to neoadjuvant chemotherapy. In patients with stable disease at the completion of chemotherapy, flow characteristics did not change significantly. CONCLUSION: Preliminary results of our study suggest that transvaginal color Doppler ultrasound evaluation of flow characteristics in the cervical and intratumoral vessels might be useful in monitoring the response to neoadjuvant chemotherapy in patients with invasive cervical cancer.

Aged↗
PubMed1997

Fibromatosis of the female pelvis.

BACKGROUND AND AIMS: Desmoid tumour is a rare entity characterized by benign proliferation of fibroblasts. Although non malignant, this tumour can be life-threatening due to its invasive property and high recurrence rate. MATERIAL AND METHODS: We report a case of pelvic fibromatosis whereby the tumour was completely resected without sacrificing organs or major vessels. RESULTS: Thirty months after surgery the patient is asymptomatic, without any sign of recurrent disease. CONCLUSIONS: Radical surgery represents the main primary treatment for pelvic fibromatosis. The other available therapeutic options are discussed.

Adult↗
PubMed1997

Giant malignant fibrous histiocytoma of the uterus.

A case of giant (32 Kg) malignant fibrous histiocytoma (MFH) arising from the uterus and occupying the entire abdomen and the pelvis is reported. The patient had debulking surgery, followed by combination chemotherapy, but died 7 months after diagnosis.

Fatal Outcome↗
PubMed1996

Lipoperoxidation and antioxidant enzymes activity in pregnancy complicated with hypertension.

OBJECTIVE: To assess maternal circulating levels of lipid peroxidation breakdown products and antioxidant enzymes activity in pregnancies complicated with hypertension. STUDY DESIGN: Ten women with uncomplicated pregnancies and nine women with hypertension antedating pregnancy were prospectively sampled. Eight women, who had developed preeclampsia, were also cross-sectionally included. Twenty healthy non pregnant volunteers were the control group. Thiobarbituric acid reactive substances (TBA-RS), as lipid peroxidation products, and the activity of catalase (CAT), glutathione peroxidase (GPX) and superoxide dismutase (SOD), as antioxidant enzymes, were assayed in red blood cell hemolysates. A prooxidant/antioxidant (P/A) ratio (TBA-RS/CAT + GPX + SOD) was determined from the mean value of the volunteers. RESULTS: In women with chronic hypertension, TBA-RS levels were higher than those in normal pregnant women, whereas antioxidant enzymes activities were either stable or decreased. Therefore the P/A ratio was progressively lower in the second and third trimester. Similar result were found in patients with preeclampsia. CONCLUSIONS: Normal gestation induces an increase of lipid peroxidation products, whereas antioxidant activity seems stable. In pregnancies complicated by chronic hypertension, a deficiency of the oxidative system balance is detectable, which consistently progresses in the second and third trimester, strongly suggesting a failure of the protective mechanisms.

Adult↗
PubMed1996

Brain metastases from endometrial carcinoma.

Central nervous system (CNS) involvement by endometrial carcinoma is uncommon. Among 1069 patients registered for endometrial carcinoma at our institution between 1982 and 1994, 10 (0,9%) developed brain metastases. Median age at the time of CNS metastasis diagnosis was 59 years. Median interval between diagnosis of endometrial cancer and documentation of brain involvement was 26 months. Clinical manifestation of brain metastasis included headache (80%), motor weakness (50%), seizures (20%), confusion (10%), balance (10%), and visual disturbances (10%). All lesions (4 multiple, 6 single) were contrast enhancing on computed tomography (CT) scans, and were located in the cerebrum in seven cases, in the cerebellum in one case, and in both in two cases. The CNS was the only site of detectable disease in six patients with recurrent disease. Nine patients died and one is alive with disease 3 months after surgical resection of a single cerebral deposit. Median survival from diagnosis of brain metastases for the entire series was 1 month (range 1-83). Six patients receiving only steroids died within 1 month from the diagnosis. One patient received radiotherapy (survival, 3 months) and two underwent surgical resection of solitary metastasis followed by radiotherapy (survival = 28 and 83 months). Prognosis of patients with CNS metastases from endometrial carcinoma appears poor; however, in a selected group of patients early diagnosis followed by multimodal treatment may result in a palliation of the disease.

Aged↗
PubMed1996

Diagnostic accuracy of hysteroscopy in endometrial hyperplasia.

OBJECTIVES: To determine the diagnostic accuracy of hysteroscopy in the diagnosis of endometrial hyperplasia in women with abnormal uterine bleeding. METHODS: From 1993 through 1995, 980 women referred to our institution for abnormal uterine bleeding underwent diagnostic hysteroscopy with eye direct biopsy of the endometrium in case of macroscopic abnormalities. Hysteroscopic features were compared with pathologic findings in order to detect the reliability of the endoscopic procedure. Statistical analysis was performed with the McNemar test. RESULTS: Positive predictive value of hysteroscopy in the diagnosis of endometrial hyperplasia accounted for 63%. In fact hysteroscopic diagnosis of endometrial hyperplasia was confirmed at pathologic examination in 81 out of 128 patients. Sensitivity and specificity of the endoscopic procedure accounted for 98% and 95%, respectively. Negative predictive value accounted for 99%, as only two cases of atypical hyperplasia were missed at hysteroscopy. Positive predictive value was higher in postmenopausal patients compared to women in the fertile age (72 vs. 58%). CONCLUSIONS: Overall, results appear encouraging, since no case of endometrial hyperplasia was missed by hysteroscopy. The high diagnostic accuracy, associated with a minimal trauma, renders hysteroscopy the ideal procedure for both diagnosis and follow-up of conservative management of endometrial hyperplasia.

Adult↗
PubMed1996

Primary carcinoma of the fallopian tube. A retrospective analysis of 47 patients.

BACKGROUND: Fallopian tube carcinoma is a rare disease, and few data about prognostic factors are available in the literature. PATIENTS AND METHODS: The medical charts of 47 patients with primary carcinoma of the fallopian tube treated at our institution between 1982 and 1994 were reviewed. Age, stage, histologic grade, residual disease after surgery, peritoneal cytology and lymph-node involvement were evaluated for their prognostic impact in a univariate analysis. RESULTS: The mean age of the patients was 57.5 years and 19 of them (40%) had early-stage disease. Poorly differentiated tumors were diagnosed in 64% of the patients. Eleven of 20 patients (55%) submitted to surgical evaluation of lymph nodes had retroperitoneal involvement. Thirty-three patients received CAP chemotherapy following surgery, and the overall clinical response rate was 80%. Sixteen patients (34%) had recurrences within 8 to 50 months from diagnosis. Twenty patients (42.6%) are alive without disease, one patient is alive with tumor, and 26 patients (55.3%) died of the disease. The median survival for the group as a whole was 44 months, and the actuarial 5-year survival was 29%. In univariate analysis stage (I + II vs. III + IV), grade (G1 + G2 vs. G3) residual disease after surgery (less than 2 cm vs. greater than 2 cm). peritoneal cytology (negative vs. positive) and lymph-node metastases were all factors significantly affecting survival. CONCLUSIONS: Aggressive cytoreductive surgery followed by platin-based chemotherapy offer the possibility of long-term control of primary tubal carcinoma.

Adult↗