Endometrial stromal sarcoma (ESS) is a rare malignant tumour of the endometrium, accounts for less than 1% of all uterine malignancies. Routinely, it is diagnosed morphologically, supported by immunomarkers of CD10 and vimentin. CD56 is used widely in neuroendocrine tumour. In our current practice, CD56 is not used to support the diagnosis of ESS. We present a case of a postmenopausal lady with advanced ESS who had expression of CD56 upon immunohistochemical study
CD56 ; endometrial stromal sarcoma ; immunohistochemistry ; uterine leiomyoma ; vaginal neoplasm

Variable clinical manifestations and the unpredictable biological behavior of renal cell carcinomas are well known. About a third of patients have metastasis by the time they are first seen by a physician, most commonly to the lung, frequently to the bone and/or liver and less commonly to a virtually unlimited range of tissues and organs. Vaginal cancer represents approximately 1-3% of all genital tract malignancies, and most cases present as metastasis from the cervix, endometrium or colon. Vaginal metastasis from a renal cell carcinoma can be confused with a primary vaginal clear cell carcinoma, and metastasis of a renal cell carcinoma to the vagina is extremely rare. Here, we report a case of a renal cell carcinoma, detected by a metastatic vaginal mass.
Carcinoma, Renal Cell* ; Cervix Uteri ; Colon ; Endometrium ; Female ; Humans ; Liver ; Lung ; Neoplasm Metastasis* ; Vagina ; Vaginal Neoplasms

Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.
Brain ; Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Ovary ; Urinary Bladder ; Vaginal Discharge

BACKGROUND: The study evaluated the histologic correlation and clinical significance of atypical glandular cells (AGC) detected either on conventional smears (CS) or liquid-based cytology (LBC). METHODS: Two hundred and seventy-seven (0.11%) of 261,925 cervical smears were interpreted as AGC by the Bethesda system 2001 from January 2006 to December 2008. Cytohistological correlation was performed on 192 cases. RESULTS: The prevalence of AGC was 0.07% and 0.13% for CS and LBC smears, respectively. Distribution of AGC subcategories were as follows: atypical endometrial cells 53.8%, atypical endocervical cells 22.7%, atypical glandular cells 19.5%, atypical endocervical cells favoring neoplasia 2.2%, and atypical glandular cells favoring neoplasia 1.8%. Fifty-nine (27.4%) of 192 patients were confirmed as having clinically significant lesions comprising endometrial adenocarcinoma (12.5%), endometrial hyperplasia (6.0%), cervical adenocarcinoma (2.3%), high-grade squamous intraepithelial lesion (HSIL) (1.9%), low-grade SIL (1.9%), adenocarcinoma in situ (1.4%), or ovarian metastasis (1.4%). Conclusion: Compared with CS, LBC was presently associated with a higher prevalence of AGC. Histologic follow-up showed a very low HSIL rate compared to other studies. Endometrial adenocarcinoma was the most common malignant lesion detected because of increasing prevalence of endometrial adenocarcinoma, concentration on endometrial cytology, and introduction of LBC.
Adenocarcinoma ; Endometrial Hyperplasia ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Prevalence ; Vaginal Smears

A retrospective study was carried out of 20 patients with histologically proven invasive carcinoma of the vagina from 1979 to 1993; 17 cases with curative primary radiotherapy and three cases with postoperative radiotherapy. The five and ten year overall survival rates were 79% and 53%, respectively. Survival was strongly correlated with stage. Five year survival rates of stage I, stage II, and stage III, IV were 100%, 78%, and 0%, respectively. Eight patients experienced recurrences; five within the irradiated volume, two distant metastasis, and one combined both local and distant metastasis. There was no significant late complication. From these data, radiation is effective in the mangement of the vaginal cancer patients and optimum treatment modality and total dose recommendation are made.
Humans ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Vagina* ; Vaginal Neoplasms

Accurate staging as well as diagnosis of cervix carcinoma is of paramount importance in planning treatment. Cervical smear cytologic studies have increased the detection rate of cervix carcinoma, but current radiologictechniques are limited in staging cervix carcinoma and precise visualization of lymphnodal metastasis. The CT scancan display the precise transaxial anatomical structures, permitting us not only to know the tumor size, shape andits extent but also lymphnodal enlargement in the pelvic cavity and around the abdominal aorta and secondarychanges of the kidney. The authors have tested the usefulness of CT in staging cervix carcinoma and detectinglymphatic involvement by analysis of 24 cases diagnosed by CT and confirmed histologically at St. Mary's hospitalduring the period from Oct. 1982 to May 1984. The conclusions are as follows; 1. The accuracy of CT instaging ofcervix carcinoma was 79%. 2. The accuracy of CT diagnosis of lymphatic involvement was 87.5%, sesitivity was85.7%, and speicificity was 88.2%.
Aorta, Abdominal ; Cervix Uteri ; Diagnosis ; Female ; Kidney ; Neoplasm Metastasis ; Vaginal Smears

OBJECTIVE: Sentinel lymph node (SLN) mapping is being adapted to gynecologic cancer. Higher SLN mapping rates were reported with indocyanine green (ICG) compared to other dyes. The aim of this film is to share our experience of SLN mapping with ICG in vaginal cancer. METHODS: A 40 year-old woman was diagnosed with squamous cell vaginal cancer. About 1.5 cm-sized tumor was located on the posterior vaginal fornix. Preoperatively she was assumed to be stage I vaginal cancer. Beginning of surgery, we performed SLN mapping by ICG injection into 3- and 9-o'clock positions of the vaginal tumor. Concentrated in 1.25 mg/mL, 1 mL of ICG solution was injected into deep stroma and another 1 mL submucosally in both sides. Bilateral SLN identification and lymphadenectomy were done. Afterward, laparoscopic Type C1 Querleu-Morrow radical hysterectomy with vaginectomy was done. A fluorescence endoscope produced by KARL STORZ (Tuttlingen, Germany) was used for ICG detection. RESULTS: To our knowledge, this is the first film report performing SLN mapping with ICG in vaginal cancer. The mapping was successful and we were able to recognize SLN of vaginal cancer. SLNs were located in the bilateral obturator fossa. According to the pathologic diagnosis, the mass size was 15 mm and invasion depth was 1 mm. Subvaginal tissue involvement and pelvic wall extension were absent. Resection margin of the vagina was free from carcinoma. No lymph node metastasis was reported including the bilateral SLNs. CONCLUSION: For vaginal cancer, SLN mapping can be applied by injecting ICG into the bilateral sides of the vaginal tumor.
Coloring Agents ; Diagnosis ; Endoscopes ; Epithelial Cells ; Female ; Fluorescence ; Humans ; Hysterectomy ; Indocyanine Green* ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis ; Vagina ; Vaginal Diseases ; Vaginal Neoplasms*

Although there have been a few reports of cases in which cancer cells of extrauterine origin were observed in vaginal smears, such findings are relatively uncommon. We recently experienced a case of ovarian serous cystadenocarcinoma diagnosed by cervicovaginal smear in a 56-year-old woman in routine work-up of carcinoma peritonei. The cellular features were several scattered cellular clusters of adenocarcinoma cells in clear background without tumor diathesis. Psammoma body was not present. Exploratory laparotomy confirmed the diagnosis of bilateral ovarian serous cystadenocarcinoma with multiple metastases.
Adenocarcinoma ; Cystadenocarcinoma, Serous ; Diagnosis ; Disease Susceptibility ; Female ; Humans ; Kidney Failure, Chronic* ; Laparotomy ; Middle Aged ; Neoplasm Metastasis ; Thyroid Gland ; Vaginal Smears

This paper reports our experiences in laparoscopically assisted surgical staging (LASS) to manage the patients with early-stage endometrial cancer. From March 1996 to March 1999, we performed LASS in 6 patients with clincal stage I adenocarcinoma of the endometrium. We performed laparoscopic-assisted vaginal hysterectomy (LAVH) with bilateral salpingo-oophorectomy (BSO) and intraoperative frozen-section (IFS) diagnosis. The depth of myometrial invasion, tumor differentiation, histologic types, cervical invasion, and adnexal involvement were determined by IFS diagnosis. Laparoscopic pelvic and/or para-aortic lymphadenectomies were performed based on the grade of the tumor and depth of myometrial invasion. One patient was discovered to have tumor metastases in pelvic peritoneum and uterosacral ligaments, and underwent only para-aortic lymphadenectomy for determining field of radiation therapy. 2 out of 5 patients only underwent LAVH with BSO and peroitoneal washing cytology. Three other patients underwent LAVH with BSO, peritoneal washing cytology and pelvic lymphadenectomy because they were identified by IFS diagnosis as intermediate risk group for nodal metastasis. The mean age of the patients was 46.4 years. Total length of the operation time ranged from 100 minutes to 305 minutes and the mean was 187.5 minutes. The mean hemoglobin decrement after the surgery was 0.9 gm/dl. No one recieved blood transfusion. The average number of pelvic and para-aortic lymph nodes removed were 16.7 and 18, respectively. After the surgery, the patients passed gas after an average of 2.0 days and urinated urine after an average of 3.8 days. No one had complication after LASS. Based on our experiences, LASS might be an alternative to the traditional surgical approach in patients with early-stage endometrial carcinoma.
Adenocarcinoma ; Blood Transfusion ; Diagnosis ; Endometrial Neoplasms* ; Endometrium ; Female ; Humans ; Hysterectomy, Vaginal ; Ligaments ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Peritoneum

Primary ovarian carcinoid tumors usually arise in association with gastrointestinal or respiratory epithelium, which is present in mature cystic teratoma. One case of carcinoid tumor arising from ovarian mature cystic teratoma is presented with a brief review of the literatures. Right ovarian solid tumor was detected incidentally in a 28 year-old woman complaining foul odor vaginal discharge. Explorative laparotomy was done on 20th Feb. 2004. There was no ascites or adhesions, but fetal head sized and dermoid natured tumor was found on right ovary, and follicular cyst, on left ovary. Bilateral ovarian cystectomy was done, and she was discharged 7 days later without any problem. One third of the reported cases have been associated with the typical carcinoid syndrome, despite the absence of metastasis. The prognosis after excision of the primary tumor is favorable, and in most cases a cure results.
Adult ; Ascites ; Carcinoid Tumor* ; Cystectomy ; Dermoid Cyst ; Female ; Follicular Cyst ; Head ; Humans ; Laparotomy ; Neoplasm Metastasis ; Odors ; Ovary ; Prognosis ; Respiratory Mucosa ; Teratoma* ; Vaginal Discharge