Acute Disease ; Female ; Humans ; Leukemia/therapy* ; Leukemia, Myeloid, Acute/therapy* ; Pregnancy ; Pregnancy Complications, Neoplastic/therapy*

OBJECTIVEThis study aimed to review the available literature on fertility-preserving treatment and pregnancy outcomes in patients with early-stage endometrial carcinoma who desired to preserve their fertility.

DATA SOURCESThe PubMed database (1992-2012) was searched for the words "conservative "OR" fertility sparing "OR" fertility preserving" AND "endometrial neoplasms" (MeSH). All relevant articles in English and the relevant references were collected.

STUDY SELECTIONData from published articles about fertility-preserving treatment of endometrial cancer, including the response and recurrence rate of conservative treatment, strategies of infertility treatment, pregnancy, and obstetric outcomes, were selected. Data were mainly extracted from 41 studies, which are listed in the reference section of this review.

RESULTSHormone therapy was the most common method used for early-stage endometrial carcinoma in patients who wished to preserve fertility. Sixty percent of the patients became pregnant after remission of the carcinoma. The percentage of patients who conceived in the assisted reproductive technology group was higher than that of the natural pregnancy group (80.0% vs. 43.2%, P < 0.01). A higher rate of preterm labor and multiple pregnancies was observed in the assisted reproductive technology group than that in the natural pregnancy group. The majority of pregnancies (71.4%) in the assisted reproductive technology group were achieved by in vitro fertilization-embryo transfer. The clinical pregnancy rate of transfer cycles in patients with endometrial carcinoma was 34.1%.

CONCLUSIONSAssisted reproductive technology is a good option in well-selected patients with early-stage endometrial carcinoma who have completed conservative treatment. In vitro fertilization-embryo transfer offers an opportunity to achieve an immediate pregnancy.

Endometrial Neoplasms ; therapy ; Female ; Fertility Preservation ; methods ; Humans ; Neoplasm Staging ; Pregnancy ; Pregnancy Complications, Neoplastic ; Pregnancy Outcome ; Reproductive Techniques, Assisted

OBJECTIVETo summarize the clinicopathological features and prognosis of malignant ovarian neoplasms complicating pregnancy and explore the rational treatment.

METHODSThe clinical data of 38 patients with malignant ovarian neoplasms complicating pregnancy were retrospectively analyzed,and the intra-surgical pathological sections were reviewed. International Federation of Gynecology and Obstetrics (FIGO) staging system (1988) was applied.

RESULTSOf these 38 patients,the malignancies included epithelial ovarian cancer (n=9, 23.7%), epithelial borderline ovarian tumor (n=13, 34.2%),ovarian malignant germ cell tumors (n=11, 28.9%), sex cord stromal tumors (n=3, 7.9%), and metastatic tumor from gastrointestinal tracts (n=2, 5.3%). Twenty-seven patients (71.1%) were at stage I. The pregnancy outcomes included termination in the first trimester (n=8), full-term vaginal delivery (n=6), full-term Cesarean section (n=15), and therapeutical Cesarean section for premature birth (n=9). One newborn died,and the remaining 29 survived in a healthy status. All patients underwent surgical treatment,among whom two patients received surgeries during pregnancy. Patients were followed up for (40.5±38.5) months,during which one patient was lost to follow-up, 7 died, 1 survived with tumor, and 29 (76.3%) survived free of tumors.

CONCLUSIONSThe management of ovarian malignancies complicating pregnancy should be individualized. Both surgical treatment and chemotherapy are relatively safe in the second and third trimesters. Satisfactory prognosis can be expected after appropriate treatment.

Adult ; Female ; Humans ; Ovarian Neoplasms ; pathology ; therapy ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Young Adult

To evaluate the outcomes of controlled ovarian hyperstimulation (COH)-in vitro fertilization (IVF) such as clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) for infertile patients with borderline ovarian tumor (BOT) after conservative treatment, 10 IVF cycles in five patients from January 1999 to July 2005 were analyzed. At the time of diagnosis with BOT, the mean age of patients was 30.0 yr (range, 22-40). For 8 cycles out of 10 attempted IVF cycles, except for 2 cancellation cycles, the mean number of oocytes retrieved was 5.6 (range, 2-16) with a mean fertilization rate of 74.4%. The CPR, IR, and LBR were 50.0% (4/8 cycles), 31.6% (6/19) and 50.0% (4/8 cycles) respectively. The mean follow-up period after COH-IVF initiation was 29.6 (range, 14-61) months. A gynecological oncologist followed all patients every 3 months during the first year and every 6 months thereafter. There was no recurrence during the follow-up period. Our results suggest that COH-IVF may be acceptable for infertile patients with BOT, especially in patients with early-stage BOT after conservative treatment.
Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female/*complications/*therapy ; Ovarian Neoplasms/*complications/pathology/*surgery ; Ovulation Induction/methods ; Pregnancy ; Pregnancy Complications, Neoplastic ; Prognosis ; Treatment Outcome

Adult ; Anticarcinogenic Agents ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Disease Progression ; Female ; Humans ; Interdisciplinary Communication ; Neoplasm Staging ; Pregnancy ; Pregnancy Complications, Neoplastic ; drug therapy ; pathology ; Treatment Outcome

Pheochromocytoma in pregnancy is very rare but it is associated with very high maternal and fetal mortality. Therefore, it is important to include pheochromocytoma in the differential diagnosis of hypertension associated with pregnancy. It is difficult to make a diagnosis of pheochromocytoma in pregnancy before delivery. The characteristic symptoms of pheochromocytoma could be initiated during delivery because the process of delivery, general anesthesia, fetal movement, induce acute surge of catecholamine release, which could also induce cardiomyopathy. Early diagnosis and intensive care can affect the prognosis of cardiomyopathy induced by pheochromocytoma. Proper management with alpha-blockade, beta-blockade and angiotension converting enzyme inhibitor could acutely reverse the course of cardiomyopathy.
Adrenal Gland Neoplasms/surgery ; Adrenal Gland Neoplasms/diagnosis* ; Adrenal Gland Neoplasms/complications ; Adult ; Cardiovascular Agents/therapeutic use ; Disease-Free Survival ; Echocardiography ; Electrocardiography ; Female ; Human ; Myocardial Diseases/ultrasonography ; Myocardial Diseases/etiology* ; Myocardial Diseases/drug therapy ; Pheochromocytoma/surgery ; Pheochromocytoma/diagnosis* ; Pheochromocytoma/complications ; Pregnancy ; Pregnancy Complications, Cardiovascular/etiology* ; Pregnancy Complications, Neoplastic/surgery ; Pregnancy Complications, Neoplastic/diagnosis* ; Pregnancy Outcome* ; Puerperium ; Tomography, X-Ray Computed ; Substances: Cardiovascular Agents

Abnormalities, Drug-Induced ; etiology ; Abnormalities, Radiation-Induced ; etiology ; Antineoplastic Agents ; adverse effects ; Breast Neoplasms ; diagnosis ; therapy ; Contraindications ; Female ; Humans ; Mastectomy ; Neoplasm Staging ; Pregnancy ; Pregnancy Complications, Neoplastic ; diagnosis ; therapy ; Prognosis ; Radiotherapy ; adverse effects ; Risk Assessment ; Risk Factors ; Sentinel Lymph Node Biopsy

OBJECTIVETo analyze the clinical characteristics, survival and prognosis of breast cancer patients under 30 years of age.

METHODS129 breast cancer patients under 30 years treated from Jan 1980 to May 2000 were retrospectively reviewed. Clinical features, survival and prognostic factors were analyzed by SPSS 10.0 statistic software.

RESULTSBreast cancer patients under 30 years accounted for 2.6% of all breast cancers in our hospital. The overall 5- and 10-year survival rates were 61.5% and 46.7%, respectively. For patients with tumor < or = 3 cm or > 3 cm, the 10-year survival rates were 65.5% and 27.4% (P < 0.01). For those with number of positive axillary lymph nodes 0, 1-3, or > or = 4, the 10-year survival rates were 79.5%, 40.9% or 31.4% (P < 0.01). For patients who had been treated with or without tamoxifen, the 10-year survival rates were 63.7% and 45% (P < 0.01). For those complicated with pregnancy and lactation which was found in 24.8% of such patients, the 10-year survival rate was 44.3%. In the multivariate analysis, independent prognostic factors that might improve the overall survival were tumor size, axillary metastatic status and tamoxifen treatment.

CONCLUSIONBreast cancer patients aged 30 years and younger may have good prognosis if multimodality treatment is given. Tumor size, axillary metastatic status and tamoxifen treatment are independent prognostic factors. Prognosis of patients, either complicated with pregnancy and lactation or not, is quite similar if the clinical stage is the same and if being treated by the combined therapy.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Breast Neoplasms ; mortality ; pathology ; therapy ; Carcinoma, Ductal, Breast ; mortality ; secondary ; therapy ; Carcinoma, Medullary ; mortality ; secondary ; therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lactation ; Lung Neoplasms ; secondary ; Mastectomy ; methods ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Survival Rate ; Tamoxifen ; administration & dosage

OBJECTIVETo investigate the clinicopathological characteristics, histological diagnosis, immunohistochemistry and prognosis of cervical glassy cell carcinoma (GCC).

METHODSThe clinical characteristics, cytology, histology and immunohistochemistry were analyzed in 5 cases of GCC.

RESULTSThe average age of the five patients was 34.4 years (31 - 41 years). Abnormal vaginal bleeding and/or watery discharge were clinical presentations. One case was complicated with pregnancy and another one had a seven-year history of using contraceptives. All patients had an obvious mass in the cervix. Characteristic morphological features of GCC were present in 2 cases. Morphologically, the tumors consisted of clusters of tumor cells with distinct cell bounders, a large amount of eosinophilic granules in the cytoplasm imparting ground glass appearance, and thin nuclear membrane and prominent nucleoli. Nuclear enlargement and multinucleation were frequently noted. Mitosis and apoptosis were common. Numerous eosinophils and plasma cells were present in the stroma. Immunohistochemically, GCC expressed markers for both squamous cell carcinoma (p63 and CK34βE12) and adenocarcinoma (CAM5.2, MUC1, MUC2 and CEA). Ki-67 proliferation index was high (≥ 70%). All the five patients were treated with radical hysterectomy, followed by radiation and chemotherapy. The tumor-free survival time ranged from 25 days to 33 months.

CONCLUSIONSGCC is a distinct variant of adenosquamous carcinoma of the cervix with high proliferation index and expression of markers of both squamous cell carcinoma and adenocarcinoma. The tumor has characteristic cytological and histological features.

Adult ; Biomarkers ; metabolism ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Adenosquamous ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Hysterectomy ; methods ; Immunohistochemistry ; Keratins ; metabolism ; Ki-67 Antigen ; metabolism ; Membrane Proteins ; metabolism ; Mucin-1 ; metabolism ; Pregnancy ; Pregnancy Complications, Neoplastic ; metabolism ; pathology ; therapy ; Radiotherapy, Adjuvant ; Uterine Cervical Neoplasms ; metabolism ; pathology ; therapy

Treatment-related myelodysplastic syndrome (t-MDS) and acute myelogenous leukemia (t-AML) are now well established as complications of cytotoxic chemotherapy. We experienced a 28-yr-old female patient who developed t-MDS/t-AML with characteristic chromosomal abnormalities including 11q23 chromosomal rearrangement following high-dose chemotherapy with autologous stem cell transplantation (ASCT) for non-Hodgkin's lymphoma. The patient was admitted with bulky abdominal masses of B cell lineage non-Hodgkin's lymphoma. After 2 cycles of systemic chemotherapy of the Vanderbilt regimen, the patient underwent ASCT with high dose chemotherapy of the BEAC regimen. She also received radiation of 48 Gy for the residual periportal lymphadenopathy. The initial cytogenetic analysis of the infused mononuclear cells revealed a normal karyotype. Twenty two months after the ASCT, pancytopenia was noted and her bone marrow aspirate showed dysplastic hemopoiesis with myeloblasts up to 12% of nonerythroid nucleated cells. The patient was diagnosed as t-MDS (refractory anemia with an excess of blasts). Cytogenetic analysis showed complex chromosomal abnormalities including 11q23 rearrangement, which is frequently found in topoisomerase II inhibitor-related hematologic malignancies. Four months later, it was noted that the t-MDS had evolved into an overt t-AML. Cytogenetic analysis showed an evolving pattern with more complex abnormalities. The patient was treated with combination che-motherapy, but her leukemic cells were resistant to the therapy.
Adult ; Antineoplastic Agents, Phytogenic/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/*adverse effects ; B-Lymphocytes/cytology ; Bone Marrow Cells/pathology ; Carmustine/*adverse effects ; Chromosome Aberrations ; Chromosomes, Human, Pair 11 ; Combined Modality Therapy/adverse effects ; Cyclophosphamide/*adverse effects ; Cytarabine/*adverse effects ; Etoposide/*adverse effects ; Female ; Gene Rearrangement ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Leukemia, Myeloid, Acute/*etiology/genetics ; Lymphoma, Non-Hodgkin/*therapy ; Myelodysplastic Syndromes/*etiology/genetics ; Neoplasms, Second Primary/*etiology ; Pelvis ; Pregnancy ; Pregnancy Complications, Neoplastic/*therapy ; Transplantation, Autologous