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Two Cases of Sclerosing Stromal Tumor of the Ovary.

Chang Nam KIM ; Seon Kyung LEE ; Seung Bo KIM ; Moon Ho YANG

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):70-76.

Sclerosing stromal tumor of the avary(SST) is a rare benign tumor first described as a distinct neoplasm by Chalvardjian and Scully(1973) and confirmed as such by Scully(1977) and Gee and Russell(1979). This tumor was separated from the thecoma fibroma group on the basis of characteristic histolog ic features. We present two caaes of postmenopausal women in seuentieth decades with SST, other reported cases of SSTs are discused.
Female ; Fibroma ; Humans ; Ovary* ; Thecoma

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Comparative Study of the Cervical Cytology, Colposcopic Impression and Directed Biopsy on the Role of the Diagnostic Approach to the Cervical Carcinoma.

Ho Suk SUH ; Joon MOON

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):56-63.

A total of 369 patients with abnoirmal cervical eytology and suspicious lesions of the cervix were colposcoped end 356 patients of whom were, taken directed biopsy to assess the lesions preeisely and compare the aeeuracy of the eaeh methods. The results of cervical cytology were elso compared with the colpoacopic impression and colposcopically directed biopsies. 252 patients with abnr;irmal colyoaeopie findings were performl conization, simple hiysterectomy or radical hysterectomy depending on their current idisease statua. The rate of one grade less or more advanced correlation between the cervical cytology and directed biopsy was 72.4% and thiat of two grade less wns 80.3% and as for the correletion between the colposcopic imprwssions and the colposcopically directed biopsies, the rate of ciompatibility was 91.5%. Bases on the hetopathologic findings of the surgical apeeimen, the eompatibility rotcs of eervical cytology, colposcopic impressions and colposcopilIy divected hiopsies were 70.2%, 90.6% and 98.0% respectively. With these results, we can reach a conclusion that the colpnscopic impression itself is almost as accurate as the colposcopicolly directed biosy and the directed biopsy can take the place of conization so far as the diagnostic accuracy is concerned.
Biopsy* ; Cervix Uteri ; Conization ; Female ; Humans ; Hysterectomy

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Adenoma Malignum(Minimal deviation adenocarcinoma) Resembling Benign Lesions of the Uterine Cervix: A Clinicopathological Analysis of six cases.

Tae Jin KIM ; Kyung Taek LIM ; Hee Soo BAEK ; Jae Uk SHIM ; Chong Taek PARK ; Hy Sook KIM

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):45-55.

Six cases of a rare variant of endocervieal adenocarcinoma (Adenoma maligum, AM) were collected for clinicopethologic analysis. The everage age of six patients was 49.3 years, and their chief com plaints were persis(ent mucid or watery discharge and intermittent vaginal spotting, The clinical im presaion was carcioma of The uterine cervix in faur out, of six cases. All except one were pathologically confirmed by initia1 biupey. two cases by colposcopic biopsies, two by cone biopsies, one by cone biopsy after suggested AM in calposcopic hiopsy. One case was incidentally found from hysterectnmised speeimen, which waas suspected as adennmyosis. On gross examination, the cervix usualty appeared either firm or indurated with thickening af the wall excepl one which was presented es a fungnting mass. The characteristic histologic feetures were ext,ensive arborizing endeervical glands with marked variation in size and shape, and the glands lined by mucin conyaining columnar epithelial cells with basal bland looking nuclei but with occasional cytologic atypia and rare mitose. The nenplasi.ic glands were characterized by deep stronml invasion be yond normal enddcervical glands, assosiated with loose edematous periglandular desmaplastic stromal reaction in moat cases. Immunohistochemical stainnings for carcinoembryonie antigen (CEA) revealed ey- toplasmic positivity in five cases. The clinical stage for all exeept one incidental case were : four Ib and one II b. In three cases, the radical hysterectomy with unilateral salpingooophorectomy plus dissection of bilateral pelvic and paraaortic lymph nodes was performed, and in one case radiotherapy was done prior to radical hysterectomy with bilateral salpingoophorectomy plus the dissection of left pelvic lymph nodes followed by chemotherapy. Total abdominal hysterectomy with bilateral salpingooophorectomy plus Burch's operation followed by radiation therapy was performed in on case. The remaining one case was treated with radiation therapy. Metastasis to the left obturator lymph node was discovered in one case with state IIb, and the patient expired 29 months after the radiotherapy. The remaining five cases are being carefully followed up. From our experience, we conclude that the early diagnosis of AM can be made based on comprehensive analysis concerning the clinical features, histopathological and immunohistochemical findings. The early diagnosis and proper therapy can lead to the better prognosis.
Adenocarcinoma ; Adenoma* ; Biopsy ; Cervix Uteri* ; Drug Therapy ; Early Diagnosis ; Epithelial Cells ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Metrorrhagia ; Mucins ; Neoplasm Metastasis ; Prognosis ; Radiotherapy

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Significance of Serum CA 125 and CA 15-3 Levels in Patients with Ovarian Tumor.

Il Soo PARK

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):36-44.

The concentration of the turnor markera CA 125 and CA 15-3 in serum of patients with ovarian tumors was quantitated to test if there is a diacrimination between benign and malignant ovariam tumors. In the study of 96 patients, 76 benign ovarian tumniors and 20 malignant ovarian tummors, the sensitivity of the preoperatiue serurn CA 125 level (>35U/ml) in cletezting malignant tumor was 75%, spicificity 78%, positive predictive value 47% engative predictive value 92%, diagnostic efficacy 77%. The sensitivit,y of the preopratiue aerum CA 15-3 level (>20U/ml) was 30%, specilicity 99%, positive prdictive value 86%, negative prodictive value 84%, deagnostic value 84%. In the elevation of CA 125 alone and both Ca 125 and 15-3 concentration, the positivity and false positivity were 70%,11% and 25%, 1% in the doagnosis of malignant ovarian tumor respectuvely. Therefore our results suggest that additional measurement of CA 15-3 is more helful than measure ment of CA 125 alone in descriminating benign from malignant ovarian tumors by increasing the specificity.
Humans ; Sensitivity and Specificity ; Weights and Measures

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Immunohistochemical Localization of Prolactin in Normal and Neoplastic Uterine Cervical Tissues.

Kyu Wan LEE ; Tak KIM ; Pyung Sahm KU

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):20-27.

Prolactin is elevated in the serum of patients with cervical carcimomas. It is suggested that such edtopically secreteted prolactin may be a potential marker for detecting early occult tumors or gauging the effectiveness of therapy for human cervicla carcinoma. We have immunohistochemical study to investigate the presence or absence of prolactin in 16 cases of nrmal cervical tissues and 26 cases of neoplastic formalin fixed cervical tissues. The results were as follows. 1. All cases of 10 normal uterine cervical tissues and all cases of 5 squamous metaplasia of the cervix revealed positive reaction to prolactin antisera. 2. One case of four moderate dyplasia of the cervix revealed positive reacion to prolactin antisera. 3. One case of five squamous cell carcinoma in situof the cervix revealed positive reaction to prolactin antisera. 4. All cases of 10 keratinizing sqyamous cell carcinoma of the cervix revealed positive reaction to prolactin antisera, but only 1 case non-keratinizing sqyamous cell carcinoma of the cervix revealed positive reaction to prolactin antisera. The results are suggested that prolactin may play a some role in the developement and growth of the cervical carcinoma. But further stydy of the biologic actions of prolactin in many cervical tissues is warranted.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Formaldehyde ; Humans ; Immune Sera ; Metaplasia ; Prolactin*

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The Clinical Effect of Granulocyte-Colony Stimulating Factor to the Leukopenia during Chemotherapy in the Patients with Gynecologic Malignancies.

Jae Sook ROH ; Sam Hyun CHO ; Kyug Tai KIM ; Soo Hyun CHO ; Youn Yeung HWANG ; Hyung MOON ; Jai Auk LEE

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):9-19.

The recent introduction of chemotherapy in the treatment of gynecological malignancies has gained wide acceptance along with prstoperative and prostperative adjuvant therapy and with preradiation and concurrent chemoradiation therapy. But, the side effects of chemotherapy including bleeding and infection due to, bone marrow suppression have reaulted in delayed treatment and a reduction in the chemotherspeutic agent used. Recent efforts overcome this bone marrow suppression have led to development of the various human colony-stimulating factor indluding recombinant granulocyte colony-stimulating factor. The author investigated the clinical benefita and toxicity of G-CSF used during chemotherapy of various gynecological malignancies at the Departent of Obstetrics & Gynecology at Hanyang University between August, 1991 and July, 1992. The results were as follows ; 1. An increase in the number of neutrophils following a single injection of G-CSF was noted in 19 out of 21 cases(600~1,000/mm3 before injection, 4,500~12,000/mm3 after injection). The remaining 2 cases showed an increase after 3~5 continuous injections. 2. To assess the increase in neutrophils according to the dosage of G-CSF given, 100 and 300microgram/m* of G-CSF were injected in each trial of chemotherapy in a single case of ovarian cancer. The results were a 1.5 time increase when injected when injected with 300microgram/m*. 3. After injecting into a patient with recurrent endometrial cancer who was managed with 15gm of ifosfamide, 50gm of cis-platinum, 50gm of adriamycin and 3gm of mesna following surgery, no evidence of neutropenia could be found after 4days of prophylactic G-CSF injections. 4. Patients with cervix cancer with metastasis to the lung were first treated with GM-CSF in one trial and G-CSF in the nest. Patients treated with Gm-CSF for a period of 7 days showed leukocytosis(3,600/mm3) but the number was reduced to 1,400/mm3 after 7 days. On the other hand, patients treated with G-CSF showed an increase of 5,700/mm3 within one day and this figure did not decrease until 20 days later. 5. The toxic effects of G-CSF included on case of severe back pain was easily managed by administration acetaminophen. Others were headache, chills, general weakness and redness of the oral mucosa and injection area. Most of these symptoms disappeared within 2 days. The G-CSF is effective in neutropenia during chemotherapy thereby decreasing the incidence of treatment delay or dose reduction. It also increases the amount of chemotherapeutic agent administered and its toxicity is more tolerable making a rigid systemic chemotherapeutic regime possible.
Acetaminophen ; Back Pain ; Bone Marrow ; Chills ; Cisplatin ; Colony-Stimulating Factors ; Doxorubicin ; Drug Therapy* ; Endometrial Neoplasms ; Female ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Gynecology ; Hand ; Headache ; Hemorrhage ; Humans ; Ifosfamide ; Incidence ; Leukopenia* ; Lung ; Mesna ; Mouth Mucosa ; Neoplasm Metastasis ; Neutropenia ; Neutrophils ; Obstetrics ; Ovarian Neoplasms ; Uterine Cervical Neoplasms

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Prognostic Significance of Human Papillomavirus Types 16 and 18 in Invasive Cervical Cancer.

Soo Nyung KIM ; Tchan Kyu PARK

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):1-8.

Thirty-nine cases of invasive cervical cancer with human papillomavirus(HPV) DNA sequences were analyzed to detennine if HPV type 16 or 18 clinical or prognostic significance. HPV type was determined by Southern blotl hybridization. HPV 16 was detected in 12 cases, and HPV 18 in 5 cases. Sixty percent of HPV 18 tumors were grade III (3 of 5), whereas 8.3% (1 of 12) of HPV 16 tumors and 5.6% (1 of 18) of HPV 16/18 negative tumors were grade III. Age, clinieal stage, histologic cell type, lesion size, and liyrriph node metestasis in relation to HPV type were not statistically significant. The mean age of HPV 1~6 group was 50 years, compared to 47 years for the HPV 18 group. Of 30 squamous carcinomas, HPV 16 was detected in 12 cases(40.0%), and HPV 18 in 4 cases (13.3%). Of 4 adenosquamous and adenocarcinomas, HPV 16 was detected in 0 case(0.0%), and HPV 18 in 1 case(25.0%). Among stge IB-IIA caners, lymph node metastasis was associated with 20% of HP-V 16 cases(2 of 10) as cotinparxl with 25% of HPV 18 cases(1 of 4) and 7.7% Of HPV 16/18 negative cases (1 of 13). It is suggested that HPV type 18 might be associated with worse prognostic factos of invasive cervical cancer than HPV type 16.
Adenocarcinoma ; Base Sequence ; Carcinoma, Squamous Cell ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Lymph Nodes ; Neoplasm Metastasis ; Uterine Cervical Neoplasms*

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Two Cases of Glassy Cell Carcionma of the Cervix, Treated by Neoadjuvant Chemotherapy and Radical Hysterectomy.

Yoon Keun HUR ; Woo Gyeong KIM ; Moon Cheol RYU ; Yoo Sun MIN ; Ki Tae KIM ; Hyun Chan KIM

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(4):29-35.

Glassy cell carcinoma is a histologic subtype of cervical cancer with distinct pathologic features and it has an aggressive biologic course. It was first described by Glucksmann and Cherry in 1956 as a poorly differentiated adenoquamous carcinoma and commented on its poor prognosis, unresponsiveness to traditional modes of therapy, and often associated with pregnancy. The characteristic histologic features are defined as follows: 1) cells with a moderate amount of cytoplasm resembling ground glass, 2) a fairly distinct cell membrane that stains with eosin or PAS, 3) large nuclei with prominent nucleoli. We present two cases of glassy cell carcinoma of the cervix successfullyl treated by neoadjuvant chemotherapy and radical hyterectorny, with a brief review of literatures.
Cell Membrane ; Cervix Uteri* ; Coloring Agents ; Cytoplasm ; Drug Therapy* ; Eosine Yellowish-(YS) ; Female ; Glass ; Hysterectomy* ; Pregnancy ; Prognosis ; Prunus ; Uterine Cervical Neoplasms

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Expression of the mutant p53 gene in the carcinoma of the cervix uteri.

Kyung Ik KWON ; Tae Sung LEE ; Jiung Ho RHEE ; Soon Do CHA ; Sang Sook LEE ; Young Wook SUH

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(4):23-28.

The nuclear accumulation of p53 protein is known to correspond with mutation of p53 tumor supressor gene. To investigate the relationsbip between clinico-pathologic features and expression of p53 mutations, 65 cases of primary cervical carcinoma were analysed by an immunohistochemieal method using monoclonal antibody of p53. Immunostaining demonstrated varioua nuclear stinings of cancer cells in 48.4% of squamous cell carcinoma(51.9% in large cell carcinoma and 25.0% in small cell carcinomas) and 23.5% of adenocarcinoma(p<0.05) No differences in clinical stage and p53 positivity were found. There was no significant correlation between p53 positive cases and status of recurrence. This data suggests that p53 protein is not correlated with the disease progression and prognosis.
Carcinoma, Large Cell ; Cervix Uteri* ; Disease Progression ; Female ; Genes, p53* ; Prognosis ; Recurrence

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Clinical Evaluation of 103 Cases of Adenocarcinoma of the Uterine Cervix.

Seung Hak YANG ; Won Gue KIM ; Un Dong PARK

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(4):15-23.

OBJECTIVE: The purpose of this study was to investigate clinical charactoristics of adenocarcinoma of the uterine cervix. STUDY METHODS: This study is a retrospective analysis of 103 patients with adenocarcinoma of cervix treated at the Kosin Medical center forom 1984 to 1993. RESULTS: The distribution by stage of disease included FIGO stage I, 51(49.6%); stage II, 32(31%); Stage III, 17(16.5%);Stage IV, 3(2.9%). The 2-year survival results for patients with stage I was 93.5%; stage II was 72.4%;stage III was 46.2% and stage IV was none survived. And 4 year survival results,'83.3/o, 591% and 33.3/o in stage I, II and III, reqxetively. The 4-year survivel rate varied significantly according to tumor size and lymph nade metastasis status-below 2cm 84.2%, 2cm~4cm 75%, above 4cm 0%: (stage I);negative node 91.3%, positive node 40% (stage I). The results of resurrent rate according to clinical stage was 11.8%, 25.8%, 84.6% and 100 % in stage I, ll, III and lV, respectively. CONCLUSION: Treatment strategies should be based on the stage of disease, tumor size, lymph node metastasis status and recurrent.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies

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