[MOSODERMAL MIXED TUMORS OF THE UTERUS AND VAGINA].
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The Authors retrospectively considered colpocytological and colposcopic findings in a series of 400 women, aged 16 to 83 years, presenting for the first time at the Oncological Gynaecology Unit of the Institute of Gynaecology and Obstetrics of Padua University between 1991 and 1992. In addition to oncological evaluation, the bacteriological profile and hormone status of cytological samples were formulated in all cases. The most common oncological finding was a cell morphology within normal limits (67%), followed by reactive and reparative changes (19%) and low-grade squamous intraepithelial lesions (SIL, 12%). Histological findings correlated well with the cytological diagnosis, though low-grade SIL was over-estimated. As for the bacteriological profile, a mixed flora was most frequent (56.7%) followed, especially in fertile age, by Döderlein's bacillus (20%) and vaginosis (15.5%). Colposcopy most frequently revealed ectopia and/or a normal transformation zone (50.7%) and dystrophic mucosa (21%). An abnormal transformation zone was more common among women with a moderate-to-abundant flora. Fifteen male partners were also checked: cellular changes typical of human papilloma virus infection were found in 40% and colposcopic findings compatible with said virus were observed in 26.6% of cases. These results confirm that colpocytology provides a complete and simultaneous evaluation not only of cell morphology, but also of the bacterial population and hormones in the vaginal ecosystem. It is therefore the method of choice in screening for cervical and vaginal neoplasms and an effective means for simultaneously evaluating vaginal flora and hormone status.
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Castrate female rats given weekly applications of DMBA to the genital tract and treated additionally with growth hormone, insulin or alloxan (to induce diabetes) are heavier and have more sarcomatous and epithelial cervico-vaginal neoplasms than intact animals under the same experimental conditions. Promotion of carcinogenesis and gain in body weight are independent phenomena caused by castration in the medicated rats. Growth hormone is most effective in enhancing body weight in all animals, but least as regards tumour formation. It reduces the incidence of sarcomas in intacts, but raises that of epithelial neoplasms, and promotes both types of neoplasms in castrates. The highest incidence of cervico-vaginal epithelial and sarcomatous tumours occurs in spayed diabetics.Squamous celled epitheliomas of the vulva are not affected by castration or additional medication, while basal celled neoplasms tend to be more frequent in intacts than in castrates and particularly numerous in intact failed diabetics. Vulval sarcomas are usually rare but are increased in numbers in diabetic and in insulin treated intacts.Granular myoblastomas of the cervico-vaginal tract occur in intacts only and particularly in diabetics and those medicated with growth hormone or insulin.
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During follow-up examinations; 1,338 cervicovaginal cytologic smears were obtained from 254 women who had irradiation therapy for cervical cancer. These specimens were meticulously searched for the various cellular phenomena that may characterize such preparations, and some of the findings were subjectively quantitated. Correlations were made with histopathologic diagnoses, clinical findings, and results of treatment. Patients with malignant postradiation cells who were promptly treated for latent new or recurrent tumors generally responded well to treatment of the secondary tumor. The presence of malignant cells at any time after completion of therapy is an ominous sign, irrespective of the clinical status, and should lead to intensive effort to identify the site of a new or persisting lesion. The significance of dysplasia in postradiation smears is not entirely clear, and in certain instances it is difficult to distinguish severely dysplastic cells from either repair cells or malignant cells.