Angiomyofibroblastoma is a rare benign soft tissue neoplasm that predominantly occurs in the genital region of middle-aged women. We present a case of an angiomyofibroblastoma that involved the posterior perivesical space in a 48-year-old woman. We have documented the magnetic resonance imaging features of this case.
Angiofibroma/*diagnosis/pathology ; Angiomyoma/*diagnosis/pathology ; Female ; Humans ; *Magnetic Resonance Imaging ; Middle Aged ; Vaginal Neoplasms/*diagnosis/pathology

Primary endometrioid adenocarcinoma developed at urethrovaginal septum has not been reported. A 61-yr-old woman presented with recurrent urinary tract infection. She had received hormone replacement treatment with estrogen and progesterone for 5 yr. A pinpoint ulceration at slightly elevated anterior vaginal wall was found and biopsy revealed endometrioid adenocarcinoma. Magnetic resonance imaging showed the 4.3 cm sized mass in urethrovaginal septum. She has undergone anterior pelvic exenteration, pelvic lymph node dissection, and urostomy with ileal conduit. Microscopic finding of the pathology revealed endometrioid adenocarcinoma. Co-existence of endometriosis was not identified. Tumor at urethrovaginal septum was difficult to be detected till growing to be bulky, because of vaginal axis, misunderstanding of the tumor as symphysis pubis, no definitive symptom, and its rarity. This is the first reported case of extraovarian endometrioid adenocarcinoma developed at the urethrovaginal septum. Understanding normal functional anatomy and meticulous physical examination are essential to detect this rare tumor in the urethrovaginal septum.
Carcinoma, Endometrioid/*diagnosis/pathology/surgery ; Diagnosis, Differential ; Endometrial Neoplasms/*diagnosis/pathology/surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Urethral Neoplasms/*diagnosis/pathology/surgery ; Vaginal Neoplasms/*diagnosis/pathology/surgery

We report a case of mixed tumor arising in the lower vaginal wall. The patient was a 20-yr-old nullipararous woman. The tumor was relatively well-defined with expansile margin, and showed solid sheets or fascicles of stromal-type spindle cells and ovoid epithelial cells with sparsely scattered nests of mature squamous epithelium and glands lined by mucinous epithelium. Cellular atypia was not conspicuous, however, mitosis was counted upto 6 per 10 high power fields. We examined this tumor immunohistochemically and ultrastructurally and reviewed the articles to identify the histogenesis. Positive reaction for vimenin and cytokeratin of stromaltype spindle cells and presence of desmosome-like structures and tonofilaments on electron microscopic examination suggested the epithelial origin of the stromaltype spindle cells.
Adult ; Female ; Humans ; Immunohistochemistry ; Keratins/biosynthesis ; Microscopy, Electron ; Mitosis ; Mixed Tumor, Malignant/*diagnosis/pathology/ultrastructure ; Vagina/*pathology ; Vaginal Neoplasms/*diagnosis/pathology/ultrastructure ; Vimentin/biosynthesis

Adenoma, Villous ; metabolism ; pathology ; surgery ; Aged ; Diagnosis, Differential ; Female ; Humans ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Mullerian Ducts ; pathology ; Papilloma ; pathology ; Vaginal Neoplasms ; metabolism ; pathology ; surgery

The goal of this study was to evaluate the cytomorphologic features of histologically confirmed uterine papillary serous carcinomas (UPSC) of the endometrium. We reviewed cervicovaginal smears from 12 patients with UPSC who had done their cervical smears at six months to a year earlier before the time of diagnosis; nine smears (75%) were diagnosed as positive for malignancy and three smears (25%) were diagnosed as negative. The cervical smears of patients with UPSC revealed frequent papillary clusters that were composed of large pleomorphic tumor cells with prominent nucleoli in a background of necrosis. Other findings revealed from the tests were relatively frequent single malignant cells and bare nuclei. Although the Pap smear is not a sensitive screening test for endometrial carcinoma, we could depend on it to reveal the cytologic features of UPSC which are fairly characteristic and reliable for a preoperative diagnosis of UPSC. Preoperative identification of this poor prognostic variant of endometrial carcinoma may influence the surgical management of these cases and the choice of adjuvant therapy.
Adenocarcinoma/diagnosis/pathology ; Adult ; Aged ; Carcinoma ; Carcinoma, Squamous Cell/diagnosis/pathology ; Cystadenocarcinoma, Papillary/*diagnosis/*pathology ; Cystadenocarcinoma, Serous/*diagnosis/*pathology ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Necrosis ; Prognosis ; Uterine Neoplasms/*diagnosis/*pathology ; *Vaginal Smears

Adenocarcinoma ; diagnosis ; pathology ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; Female ; Humans ; Precancerous Conditions ; diagnosis ; pathology ; Retrospective Studies ; Uterine Cervical Neoplasms ; diagnosis ; pathology ; Vaginal Smears ; methods

Vaginal cancer is rare worldwide and represents 2% of all gynaecological cancers in Singapore. Primary vaginal malignancies are rare and vaginal metastases constitute the majority of vaginal malignancies. Most of these metastases arise from the cervix, endometrium or ovary, although they can also metastasise from distant sites such as the colon, breast and pancreas. We report a rare case of vaginal metastasis in a patient with previous gastric and rectal adenocarcinomas. An 89-year-old woman with a history of gastric and rectal malignancy presented with postmenopausal bleeding. A 2-cm vaginal tumour at the introitus was discovered upon examination. This case demonstrates the importance of performing a gynaecological examination during follow-up for patients with a history of malignancy. The prognosis for vaginal metastasis is poor, as it is often associated with disseminated disease. Depending on the extent of the lesions, radiotherapy or surgery can be considered.
Adenocarcinoma ; diagnosis ; pathology ; secondary ; Aged, 80 and over ; Biopsy ; Female ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Postmenopause ; Rectal Neoplasms ; pathology ; Stomach Neoplasms ; pathology ; Uterine Hemorrhage ; diagnosis ; Vaginal Neoplasms ; diagnosis ; pathology ; secondary

Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; surgery ; Colposcopy ; Conization ; Electrosurgery ; Female ; Humans ; Hysterectomy ; methods ; Neoplasm Regression, Spontaneous ; Uterine Cervical Neoplasms ; diagnosis ; pathology ; surgery ; Vaginal Smears

Human papillomavirus (HPV) infection is an essential cause of cervical cancer. HPV testing therefore may maximize the clinical benefits of cervical screening and abnormal cervical cytology management. A negative HPV test in combination with a normal Pap test result in women age 30 years or older allows the safe extension of the cervical screening interval to 3 years. However, because HPV infection is common in young women and is usually transient, HPV testing is not recommended as part of primary cervical screening for women younger than 30 years. HPV testing is recommended for women of any age as a triage test with atypical squamous cells of undetermined significance (ASC-US) results and as an option for follow-up of women with HPV-positive ASC-US, atypical squamous cells "cannot rule out high-grade", low-grade squamous intraepithelial lesions, or atypical granular cells not found to have CIN 2/3. HPV testing is also recommended as an alternative to colposcopy and/or cytology for follow-up of treated cases. Proper use of HPV testing improves the management of women with cytologic abnormalities.
Age Factors ; Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; virology ; Early Detection of Cancer ; Female ; Humans ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; diagnosis ; Precancerous Conditions ; diagnosis ; pathology ; virology ; Uterine Cervical Neoplasms ; diagnosis ; pathology ; virology ; Vaginal Smears ; Virology ; methods

OBJECTIVETo study the clinical value of optoelectronic cervical cancer screening system (TruScreen, TS) in the screening of cervical cancer in comparison with cervical cytology test.

METHODSA total of 392 patients were screened by TS, Pap, TCT, and HPV using the pathological and colposcopical results as the golden standard. The sensitivity, specificity, Kappa value and the area of under ROC of each method and their combinations (parallel tests) were compared.

RESULTSThe sensitivity of TS, Pap, TCT and HPV were 32.2%, 42.2%, 74.4% and 47.8%, with specificity of 96.7%, 93.7%, 78.8% and 84.8% in detecting cervical cancer, respectively. The sensitivity of the parallel tests, namely TCT/HPV, TCT/TS, Pap/TS and HPV/TS were 65.6%, 87.8%, 82.2% and 86.7%, with the specificity of 81.1%, 74.5%, 75.8% and 67.2%, respectively. In light of the areas of under ROC, significant differences were noted between the parallel tests of TS/Pap and TS/TCT (P<0.05), but not between TCT/Pap and TCT/TS (P>0.05); significant differences were found between the parallel tests with TS and those without TS (P<0.05), but not between TS alone and the parallel tests incorporating TS (P>0.05), nor between the 4 parallel tests (P>0.05).

CONCLUSIONAs a new modality for early screening of cervical carcinoma, TS offers a means for real-time cancer detection with better diagnostic efficacy than Pap and HPV and equivalent efficacy to TCT. The combination of TS and cytological tests can further enhance the diagnostic accuracy.

Adolescent ; Adult ; Aged ; Cytodiagnosis ; Early Detection of Cancer ; methods ; Female ; Humans ; Middle Aged ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; diagnosis ; pathology ; Vaginal Smears ; Young Adult