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PubMed1997

Paraneoplastic syndromes of gynecologic neoplasms.

PURPOSE AND DESIGN: The purpose of this review is to define and describe the paraneoplastic syndromes associated with gynecologic neoplasms. A comprehensive search of MEDLINE from 1966 to January 1996 and Cancerlit was performed. One hundred twenty-two reports were reviewed. RESULTS: Twenty-four paraneoplastic syndromes have been associated with gynecologic malignancies. Six anatomic systems are affected by these syndromes. However, except for disseminated intravascular coagulation and hypercalcemia, these syndromes are rare. CONCLUSION: Paraneoplastic syndromes are not frequently associated with gynecologic malignancies. The diagnosis of these syndromes is essential, as they can be occasionally life-threatening. Some paraneoplastic syndromes can be used as marker of progression or regression of the underlying malignancy.

Blood Coagulation Disorders↗
PubMed1987

The ultrastructure of selected gynecologic neoplasms.

Several articles have been published recently that discuss the role of electron microscopy in the diagnosis and study of gynecologic neoplasms. It becomes apparent from those works and the review just presented that, although an ultrastructural study is not necessary for reaching a diagnosis of many of these tumors, it may be necessary or supportive in identifying the more poorly differentiated ones. Furthermore, electron microscopy is valuable in providing evidence for the histogenesis of some of these neoplasms. Unfortunately for the pathologist, a certain level of morphologic differentiation (and an absence of metaplasia) in a cell is usually necessary for these goals to be achieved. For example, an adenomatoid tumor (see the article by Dr. Srigley, Mr. Toth, and Mr. Edwards in this issue) of the fallopian tube can readily be accepted as being composed of mesothelial cells, because both the neoplastic cells and normal mesothelial cells have the same highly differentiated features of long, slender microvilli, prominent intercellular junctions, and many microfilaments. On the other hand, there is very little resemblance between the granulosa cells of a granulosa-cell tumor and mature mesothelial cells. Thus, if one of the theories of histogenesis of granulosa cells were correct--namely, that they are derived ultimately from mesothelial lining--the ultrastructural evidence would rest on recognizing a similarity between the two types of cells at an earlier stage of differentiation. The neoplastic granulosa cell has differentiated along a separate, specialized line in which the ultrastructural resemblance to the parent cell is partly, if not completely, lost. Another example of the type of information that electron microscopy can provide is in relation to the common epithelial tumors. There is good evidence that the serous tumors in this group arise from mesothelium, although ultrastructurally their differentiation has veered from a mesothelial direction to one in which the cells have a complement of organelles related to secretory activity. Paradoxically, the mucinous cystic tumors, which have been classified traditionally as tumors of surface epithelial origin, are now thought to be of germ-cell origin in some cases, as examples of monophyletic teratomas. The ultrastructural evidence for this conclusion rests on the presence of anchoring filaments in the microvilli of the neoplastic cells, similar to those of normal intestinal epithelium, and on an admixture of various types of gastrointestinal cells, including those that contain dense-core granules (argentaffin cells).(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1989

[MR imaging of gynecological neoplasms using a low-magnetic-field machine].

Magnetic resonance (MR) images were obtained from 171 patients with benign and malignant neoplasms in the uterus and ovary, by using a low magnetic-field machine with 0.22 T, and its usefulness is discussed. Small uterine neoplasms (a few mm of its diameter) can be detected as an abnormal intensity. Therefore, the detectability is helpful for determination of their staging. In addition, some adenomyosis can also detected as distinctive findings, although it is difficult to point out those diseases by other imaging modalities. From MR images of ovarian cystic tumor, the biochemical information of its fluid content can be obtained. However, it is difficult to get distinctive features from MR images of solid neoplasms. Even though the magnetic field is low such as 0.22 T, MR images are useful for diagnosis of gynecological neoplasms because of the high contrast image quality and the capability of providing tomograms with arbitrary planes.

Adult↗
PubMed1995

[Malignant gynecologic neoplasms during menopause. Authors' experience].

From January 1991 to December 1993 409 post-menopausal women were observed at the Center for the Study of Climateric Disorders of the Department of Obstetrics and Gynecology of the University of L'Aquila. The aim of the study was to evaluate the incidence of gynecologic neoplasm among this group of women. A total of 48 women at risk for malignant tumors were detected. The relationship between the climateric age and the oncologic risk is discussed.

Adult↗
PubMed2001

Immunohistochemical distribution of tumor-associated antigen CA6 in gynecological neoplasms as detected by monoclonal antibody DS6.

DS6 is a murine monoclonal antibody developed using ovarian papillary serous adenocarcinoma as the immunogen. DS6 immunohistochemically reacts with a tumor-associated antigen, CA6, which has a limited range of expression in normal human tissues and is not expressed by benign mesothelium. We have studied the spectrum of immunohistochemical reactivity of antibody DS6 in 293 formalin-fixed, paraffin-embedded human gynecological neoplasms. The CA6 antigen shows strong expression in serous adenocarcinomas of the ovary (56/58 cases) and endometrium (6/6). CA6 is also expressed by the majority of ovarian endometrioid adenocarcinomas and Brenner tumors and by the majority of endometrioid adenocarcinomas, mucinous adenocarcinomas, and clear cell adenocarcinomas of the endometrium. CA6 is detected in 14% of ovarian clear cell carcinomas and is not detected in ovarian mucinous cystadenomas (0/7), mucinous intestinal-type borderline tumors (0/8), mucinous adenocarcinomas (0/10), or in malignant mesotheliomas (0/8). In neoplasms with papillary or glandular growth patterns, CA6 is detected along luminal cell membranes. CA6 is also seen along peripheral cell membranes and focally in the cytoplasm in some epithelial neoplasms. There is heterogeneity in immunohistochemical staining for DS6 both within an individual neoplasm and between neoplasms. Reactivity is not detected in neoplasms of sex cord-stromal, mesenchymal or germ cell origin.

Adenocarcinoma↗
PubMed1993

Multiple primary gynecologic neoplasms in a young HIV-positive patient.

Immune suppression from human immunodeficiency virus (HIV) infection is frequently associated with the development of certain neoplasms, including Kaposi's sarcoma and non-Hodgkin's lymphoma. A young patient with a 5-year history of HIV infection was found simultaneously to have invasive carcinoma of the breast, microinvasive carcinoma of the cervix, and intraepithelial neoplasia of the vulva. In view of the early nature of these neoplasms, conservative therapy was utilized; lumpectomy and adjuvant radiation therapy, conservative hysterectomy, and local therapy for the breast carcinoma, cervical carcinoma and vulvar intraepithelial neoplasia, respectively. Epithelial malignancies appear to be more common in the HIV-positive population than previously appreciated. To our knowledge this is the first report of multiple primary gynecologic neoplasms in association with HIV infection.

Adult↗
PubMed1996

Diagnostic improvement in MRI of gynecological neoplasms.

The use of pelvic MRI is still limited because of motion artifacts due to respiration, blood flow and peristalsis and because of lack of contrast between bowel loops and adjacent organs. As in CT it has been suggested that the administration of an oral contrast agent might improve MR image quality. Both positive (T1) and negative (T2) agents have already been used in clinical trials. Lumirem (AMI-121) is a negative oral contrast agent consisting of a solution of superparamagnetic iron oxide particles with silicone coating. In a phase III clinical trial we have determined the safety and efficacy of Lumirem in the assessment of gynecological neoplasms. Twenty (20) patients underwent MRI at 1.5 Tesla. T1w SE and T2w fast SE images were obtained before and after the ingestion of 600-900 ml Lumirem.

Female↗
PubMed1997

Intracavitary brachytherapy in the treatment of gynecologic neoplasms.

Modern intracavitary brachytherapy carefully combined with megavoltage external beam radiotherapy is responsible for the high cure rates achieved with radiation treatment of invasive cervical cancers. Pelvic disease recurrence is rare after treatment of patients with tumors < 5 cm in diameter, and even patients with massive tumors 8-10 cm in diameter are cured in 30-50% of cases. Inoperable adenocarcinomas of the endometrium and superficial cancers of the vagina are also effectively treated with intracavitary irradiation. The relative radioresistance of the uterus and vagina, physical advantages resulting from exploitation of the inverse square law, and the radiobiological advantages of low dose rate radiation have combined to make intracavitary irradiation a critical tool in the management of many gynecologic neoplasms.

Adenocarcinoma↗
PubMed1978

[Treatment of gynecologic neoplasms in internal medicine].

In the treatment of gynecological malignancies, chemotherapy is used with increasing frequency. The palliation in advanced stages is limited, but a marked prolongation of survival is proven in patients who achieve remissions. The remission rates of the commonly used agents and their combinations are listed. The use of cytotoxic chemotherapy is recommended in advanced stages of gynecological malignancies. Hormonal therapy offers a nearly nontoxic but less effective alternative to cytotoxic therapy.

Alkylating Agents↗