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At least 19 recordsLinked to original sources
PubMed2002

Is vascular and lymphatic space invasion a main prognostic factor in uterine neoplasms with a sarcomatous component? A retrospective study of prognostic factors of 60 patients stratified by stages.

BACKGROUND: Sarcomatous neoplasms of the uterine corpus are still a challenge in terms of obtaining prognostic factors and the most optimum complementary treatment to surgery. The most important prognostic factor is stage; relapses usually appear during the first 2 years, and most patients die within the first 3 years. We have performed a multivariate study of prognostic factors, stratifying patients by stage, to determine their impact on overall survival, disease-free survival, local relapse-free survival, and distant metastasis-free survival. Special emphasis has been given to vascular and lymphatic space invasion (VLSI). METHODS: Sixty patients diagnosed with uterine neoplasms with a main sarcomatous component were treated at Hospital Clínic i Universitari of Barcelona between January 1975 and June 1999. Pathologic type: 32 carcinosarcomas, 14 leiomyosarcomas, 9 adenosarcomas, and 5 endometrial stromal sarcomas. TREATMENT: 58/60 surgery, 35/60 postoperative radiotherapy, 2/60 exclusive chemotherapy, and 3/60 complementary chemotherapy. FIGO stages: 43 Stage I, 4 Stage II, 11 Stage III, and 2 Stage IV. Variables analyzed: age, stage, vascular and lymphatic space invasion, myometrial invasion, mitotic index, tumor size, unicentricity/multicentricity, necrosis, and radiotherapy. STATISTICS: the S and Cox proportional risk models. The partial effect of each risk factor was calculated by hazard ratio (HR) with a confidence interval of 95%. RESULTS: Early stages: Multivariate analysis showed that tumor size larger than 8 cm and VLSI had an impact on overall survival (HR = 4.01 and HR = 24.45, respectively). VLSI was present in 23% of the cases. Myometrial invasion greater than 50% had an impact on disease-free survival and local relapse-free survival (HR was 9.75 and 3.20, respectively). VLSI had an impact on distant metastasis-free survival (HR = 2.92). Advanced stages: VLSI was present in 89% of the cases. Only leiomyosarcoma type made the overall survival worse (HR = 10.54). CONCLUSIONS: Vascular and lymphatic space invasion was a relevant prognostic factor in our series, with an impact on overall survival and distant metastasis-free survival in early stages. In advanced stages, VLSI had no impact on survival, but was present in 89% of cases. Myometrial invasion >50% had an impact on local relapse. Advanced stages had a more aggressive behavior, and there was a higher incidence of poor prognostic factors in these stages. Nevertheless, prospective studies are still needed on prognostic factors and on the best treatment option.

Adenosarcoma↗
PubMed2003

Uterine neoplasm resembling an ovarian sex cord tumor.

Uterine neoplasm resembling an ovarian sex cord tumor is a rare neoplasm. Patients are generally of reproductive age, although a few may be perimenopausal or post menopausal. This neoplasm produces abnormal vaginal bleeding and uterine enlargement, suggesting leiomyoma or polyps. Based on the histology and clinical outcome, this tumor can be classified into 2 groups, namely one with focal areas resembling sex cord elements with a tendency to recur or metastasize and another with exclusive sex cord elements which runs a benign course. Immunohistochemical stains of the sex cord elements may show positively for vimentin, cytokeratin, actin and desmin in variable proportions. Inhibin is a more specific marker for these cells. Our case was a 50-year- old Omani lady with menorrhagia. Histology revealed features consistent with uterine neoplasm resembling an ovarian sex cord tumor.

Female↗
PubMed1992

Preliminary experience with gadolinium-enhanced dynamic MR imaging for uterine neoplasms.

Usefulness of gadopentetate dimeglumine in magnetic resonance (MR) imaging of uterine neoplasms was evaluated in 53 patients with endometrial carcinoma and 15 patients with cervical carcinoma. T1- and T2-weighted MR images were obtained before the contrast material was administered. After a bolus injection of gadopentetate dimeglumine, dynamic MR images were acquired, followed by static T1-weighted images. Gadolinium-enhanced MR images revealed relatively small endometrial carcinomas in the uterine cavity as high signal intensity in four cases and invasion of the myometrium as low signal intensity in 20 cases. In eight cases, endometrial tumors showed irregular, early enhancement compared with that of the myometrium on dynamic images; these cases were associated with poor prognosis. Tumor extension into the lower part of the uterus, parametrium, and paracervical fat was well seen on enhanced images in cases of cervical carcinoma. The authors believe that gadolinium-enhanced MR imaging will prove helpful in the staging of uterine neoplasms.

Adenocarcinoma↗
PubMed1986

Uterine neoplasms: MR imaging.

Magnetic resonance (MR) studies were performed on 20 healthy volunteers and 41 patients with proved cervical and uterine neoplasms. MR imaging demonstrated normal uterine landmarks in all patients. On T2-weighted images, the normal uterine wall could be differentiated into three distinct layers: a central high-intensity zone, a junctional low-intensity band, and a peripheral medium-intensity area. While most of the normal cervices had only two distinct zones (central high-intensity zone and peripheral low-intensity zone), a small percentage had three layers of signal intensity, similar to the uterine body. Primary cervical and uterine neoplasms could be identified on MR images. In 18 of 22 patients with proved carcinoma, a mass with a signal intensity higher than that of normal cervical lips was seen on T2-weighted images. Endometrial carcinoma was most often identified as expansion of the central high-intensity area; discrete tumor nodules were visible in nine of 15 patients. Mixed müllerian sarcoma appeared as a large pelvic mass with complete obliteration of normal uterine landmarks. MR imaging delineates primary cervical and endometrial carcinoma better than computed tomography does.

Adenocarcinoma↗
PubMed1997

Uterine neoplasms: magnetization transfer analysis of MR images.

PURPOSE: To determine whether the magnetization transfer effects seen at fast spin-echo (SE) magnetic resonance (MR) imaging provide additional information in the diagnosis of uterine neoplasms. MATERIALS AND METHODS: MR images were obtained in 58 subjects with a normal uterus, 27 patients with cervical carcinoma (17 before therapy; 10 after irradiation), 10 with endometrial carcinoma, and five with endometrial hyperplasia. The magnetization transfer ratios (MTRs) were calculated by measuring the signal intensity on the central section of multisection fast SE images (15 sections) and that on a single-section fast SE image (5,000/136 [repetition time msec/echo time msec]). The additional imaging time required for MTR measurement was 4 minutes. RESULTS: Conspicuity of lesions and normal zonal anatomy was improved with single-section fast SE. The mean MTR in untreated cervical carcinoma (37.6% +/- 4.2 [standard deviation]) showed a statistically significant increase relative to that in irradiated cervical carcinoma (24.5% +/- 5.1, P < .01), normal cervical stroma (23.8% +/- 6.7, P < .01), or normal endocervix (24.2% +/- 7.3, P < .01). The mean MTR in endometrial carcinoma (34.5% +/- 3.6) was significantly higher than that in endometrial hyperplasia (25.5% +/- 1.5, P < .01) or normal endometrium (24.3% +/- 3.6, P < .01). CONCLUSION: Single-section fast SE imaging provides better lesion contrast than multisection fast SE imaging and enables quantification of the MTRs in uterine neoplasms.

Adolescent↗
PubMed2003

Bromoethane, chloroethane and ethylene oxide induced uterine neoplasms in B6C3F1 mice from 2-year NTP inhalation bioassays: pathology and incidence data revisited.

Chloroethane, bromoethane and ethylene oxide represent a unique set of chemicals that induce endometrial neoplasms in the uterus of B6C3F1 mice following an inhalation route of exposure. The results of the NTP's chronic bioassays with these three compounds resulted in an unusually high incidence of uterine epithelial neoplasms in B6C3F1 mice (chloroethane 86%, bromoethane 56%) and a lower incidence for ethylene oxide (10%). The uterine neoplasms were classified as adenomas, adenocarcinomas, and squamous cell carcinomas for bromoethane, and as adenocarcinomas for both chloroethane and ethylene oxide. The adenocarcinomas and squamous cell carcinomas were invasive into the myometrium and the serosa, and metastasized to a wide variety of organs. Metastatic sites included most commonly the lung, lymph nodes, and ovary at unusually high rates of metastases (79% for chloroethane and 38% for bromoethane). Because of the dramatically high rates of uterine neoplasms (induced by chemicals given by the inhalation route) and metastases, a re-evaluation of the pathology and incidence data was undertaken. The earlier results were confirmed. The mechanism of uterine carcinogenesis by chloroethane, bromoethane and ethylene oxide is unclear.

Adenocarcinoma↗