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Biomedical subjects

M A Killackey

Publications and source records attributed to M A Killackey.

11 recordsLinked to original sources
PubMed2001

Primary pelvic non-Hodgkin's lymphoma.

OBJECTIVE: To describe five cases of primary pelvic non-Hodgkin's lymphoma, a rare gynecologic malignancy. METHODS: The charts of five women with primary pelvic non-Hodgkin's lymphoma were reviewed. Histologic classification was based on the Working Formulation, and staging was based on the Ann Arbor system. Disease status was monitored with physical examination and imaging studies. RESULTS: During a 10-month period, five women were diagnosed with primary pelvic non-Hodgkin's lymphoma, including one parasacral, one uterine, one vaginal, and two ovarian tumors. Presentations included abdominal and pelvic pain, abdominal and pelvic mass, and abnormal vaginal bleeding. Treatment included combination chemotherapy, with or without radiation. Four patients were alive and disease free 20--33 months after therapy. CONCLUSION: Primary pelvic non-Hodgkin's lymphoma may present like other more common gynecologic cancers. It should be considered in the differential diagnosis of gynecologic malignancy.

Adult↗
PubMed2000

Adenocarcinoma of the endometrium after endometrial ablation.

BACKGROUND: Endometrial ablation is a relatively new technique for treating abnormal uterine bleeding not associated with malignancy. Long-term outcome data after endometrial ablation are limited, and incidence of endometrial adenocarcinoma after ablation is unknown. CASE: A 55-year-old black woman who had endometrial ablation for abnormal uterine bleeding after excluding uterine cancer presented 5 years later with similar symptoms and a histologic diagnosis of well-differentiated adenocarcinoma of the uterus. She refused surgery and had radiation treatment for probable stage I endometrial adenocarcinoma. CONCLUSION: It is unlikely in this high-risk patient that the endometrial ablation masked an undetected malignancy or delayed the diagnosis. Given the interval, the adenocarcinoma might have occurred de novo.

Adenocarcinoma↗
PubMed1993

Adjuvant chemotherapy and radiation in patients with poor prognostic stage Ib/IIa cervical cancer.

After radical hysterectomy and pelvic lymphadenectomy, 35 women with multiple negative prognostic factors (nodal metastases, stromal invasion > 65%, parametrial extension, positive surgical margins, lymphovascular involvement, lesion size > 4 cm, and adenosquamous or poorly differentiated cancers) were offered adjuvant therapy. Thirteen patients (37.1%) received radiation alone and 22 (62.9%) were treated with a platinum-based regimen of chemotherapy and radiotherapy. In the group receiving radiation, 2 (14.3%) had recurrences. In the 22 women treated with both modalities, there have been no recurrences with a mean follow-up time of 37.1 months. The results in the combined modality group were encouraging given the fact that these women had on average 3.5 poor prognostic features compared to the radiotherapy group where there was an average of 2.2 high-risk factors.

Adult↗
PubMed1993

Papillary serous carcinoma of the peritoneal surface: matched-case comparison with papillary serous ovarian carcinoma.

Between 1984 and 1991, 199 patients underwent laparotomy for epithelial "ovarian" malignancy. In 29 cases (15%) normal-sized ovaries (< 4 cm in diameter) with minimal invasion by papillary serous carcinoma were found. This entity in the setting of peritoneal carcinomatosis has been previously described and is reported here as papillary serous cancer of the peritoneal surface (PSPS). The clinical, surgical, and pathologic features of PSPS are compared with a group of age-, grade-, and stage-matched cases with papillary serous ovarian carcinomas (PSOC). PSPS was also characterized by ascites (mean = 3036 cc), malignant washings (91%), and omental involvement with bulky infiltration and/or multiple tumor nodules (96%). Mean cytoreduction in the PSPS group was 65.5% compared to 79% in the PSOC group (P = 0.049). Patients received combination chemotherapy with platinum-based regimens. In general, there was a poor response to treatment with a disease-free interval of 3.4 and median survival time of 19 months in PSPS compared to 11.7 and 31 months in the PSOC patients. Patients with PSPS have more limited cytoreduction, shorter disease-free interval, and shorter overall survival time. Such differences prompt re-evaluation of treatment modalities for PSPS and recognition that this is a condition distinct from PSOC.

Adult↗
PubMed1989

Surgical transposition of the ovary: radiologic appearance.

Therapeutic irradiation of the pelvis of a young female patient will result in loss of ovarian function. In a surgical technique termed ovarian transposition, the ovary is repositioned to the iliac fossa or paracolic gutter outside the radiation field. The computed tomographic (CT) scans and sonograms of five patients with cervical carcinoma who underwent this procedure were reviewed. The normal transposed ovary was of soft-tissue attenuation, often with one or more small cysts. Large cysts developed in the ovaries of three patients. One cyst was functional, another was due to a mesothelial inclusion cyst, and the third was most probably related to the transposition itself. Since the transposed ovary is difficult to palpate, CT or sonography can be used to demonstrate and follow up a cystic mass. Recognition of the appearance and location of the transposed ovary is important to avoid misinterpretation of a solid or cystic mass in patients who are at risk for tumor recurrence.

Adult↗
PubMed1988

Evaluation and management of the pelvic mass: a review of 540 cases.

The management of 540 patients with the diagnoses of "pelvic mass/uterine leiomyomata" was reviewed with respect to preoperative evaluation, surgical procedures, and final pathologic diagnosis. Approximately 6170 patients were admitted to the Gynecology Service at St. Luke's-Roosevelt Hospital Center from July 1984 to June 1985. During this period, 36 of 432 diagnostic laparoscopies (8.3%) and 503 of 1666 laparotomies (30.2%) were performed to evaluate or treat these women. The final diagnoses in the 249 patients admitted with the impression of leiomyomata were: leiomyomata, 235 (94.4%); benign adnexal masses, seven (2.8%); cancers, four (1.6%); and miscellaneous, three (1.2%). Of the 291 patients evaluated for pelvic mass, the findings were: benign ovarian or tubal cysts, 98 (33.7%); leiomyomata, 42 (14.4%); cancers, 40 (13.7%); benign cystic teratomas, 38 (13.1%); endometriosis, 28 (9.6%); miscellaneous, 23 (7.9%); and pelvic inflammatory disease, 22 (7.6%). Correlation between the patient's age, preoperative impression, and final diagnosis is presented with particular attention to the 44 patients (8.1%) in whom malignancy was found. All the possibilities that such masses may represent must be considered preoperatively, and the patient be informed of her risk of malignancy.

Adolescent↗
PubMed1986

Diagnostic conization of the cervix: review of 460 consecutive cases.

During a five-year period, 460 patients underwent cervical conization on the Gynecology Service at Memorial Hospital. The pertinent medical history of the 393 patients was reviewed as it related to the diagnosis of cervical intraepithelial neoplasia. All patients had repeat Papanicolaou smears and 94.4% had complete colposcopic examination using standard colposcopic procedures, endocervical curettage, and directed biopsies. For the purpose of this review, patients were separated into seven groups according to the primary and most significant indication for conization. The indications for the procedure and the histopathologic findings are discussed for each category. The usefulness of conization in the authors' institution varied according to the indication for which it was carried out. In this series of 393 patients, 18 patients (4.7%) initially diagnosed to have only intraepithelial disease, were found to have invasive carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Avoidance of female genital tract complications in relation to pelvic surgery for cancer.

As pelvic surgeons, it is essential that the colorectal surgeon and gynecologist have knowledge of and mutual respect for the areas of expertise that each specialty offers. The surgeon will encounter situations in which knowledge of the gynecologic anatomy is essential if injury is to be avoided during colorectal procedures. Gynecologic oncologists are trained not only to resect gynecologic cancers, but to also manage any complications that may result from cancer therapy or progressive disease. In many communities in which a gynecologic oncologist is not available, the surgical oncologist or colorectal surgeon will be consulted to assist in the management of gynecologic cancers. These surgeons must have the technical prerequisites and detailed knowledge about the mechanisms of spread, patterns of distant and local recurrences, the probability for cure, and the treatment methods to achieve management in the various cancers. We will discuss problems and complications of the female genital tract encountered by the colorectal surgeon during pelvic surgery for both bowel and gynecologic cancers, with an emphasis on prevention. Additionally, issues such as prophylactic oophorectomy and hysterectomy, management of gastrointestinal (GI) tract involvement in gynecologic cancer patients, the approach to peritoneal carcinomatosis, and situations where both the gynecologic and colorectal teams are required will be presented.

Colorectal Neoplasms↗