Extramammary Paget's disease of the vulva is a rare intraepithelial neoplasm which is most commonly seen in postmenopausal Caucasian females. The most common presenting complaint is pruritis, vulvar pain, red eczematoid skin change. Treatment of Paget`s disease of the vulva requires wide local excision and if there is an underlying adenocarcinoma, radical vulvectomy with ipsilateral inguinal femoral lymphadenectomy is required. We experienced a case of extramammary Paget`s disease of the vulva, underwent radical vulvectomy with gluteal thigh flap and present with a brief review of literature.
Adenocarcinoma ; Carcinoma in Situ ; Female ; Humans ; Lymph Node Excision ; Paget Disease, Extramammary* ; Pruritus ; Skin ; Thigh* ; Vulva* ; Vulvar Neoplasms

Ovarian serous tumors of low malignant potential (borderline serous tumors) are intermediate in their clinical behavior between benign serous cystadenoma and malignant neoplasm, and are associated with 10 year survival rates in excess of 90%. Borderline ovarian serous tumors are characterized by absence of stromal invasion but presence of some characteristics of malignancy. Borderline ovarian tumors occur predominantly in premenopausal women, and associated with a very good prognosis. The principal treatment of borderline malignancy is surgical resection of the primary tumor. But approximatley 20% of patients with ovarian tumors of low malignant potential present with Stage III or IV disease at the time of diagnosis. The benefit of postsurgical therapy in this group of patients has not been well established. We report two cases of advanced ovarian serous borderline tumor, one of which was treated with 3 cycles of cisplatin-taxol chemotherpy.
Cystadenoma, Serous ; Diagnosis ; Female ; Humans ; Prognosis ; Survival Rate

Primary transitional cell carcinoma of the ovary is recently recognized, as one of the main types of ovarian carcinoma. Histologically, it is distinguished from malignant Brenner tumor only in the abscence of benign or proliferative Brenner tumor component. primary transitional cell carcinomas are more aggressive than malignant Brenner tumors. However, Primary transitional cell carcinomas have a better response to chemotherapy than other types of ovarian carcinomas. We report a case of primary transitional cell carcinoma presenting as both ovarian masses that developed in a 60-year-old woman with a brief review of literature.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Humans ; Middle Aged ; Ovary*

Neoplasm of the fallopian tube, which account for only a small minority of female genital tract tumors, may have diagnostic difficulties both clinically and pathologically. In most cases, the diagnosis of tubal carcinoma is not suspected preoperatively, and an abnormality of the tube is first appreciated by the gynecologist at the time of operation or by the pathologist on gross or microscopic examination. The predominant cell type of the fallopian tubal carcinoma is known for adenomatous cell type of carcinoma. A case of pure primary squamous cell carcinoma of the Fallopian tube presenting is reported first in Korea.
Carcinoma, Squamous Cell* ; Diagnosis ; Fallopian Tubes ; Female ; Humans ; Korea

Primary ovarian squamous cell carcinoma is the one of the rarest of all ovarian malignancies. Most of them arise in mature cystic teratoma and a minority of them associated with endometriosis, arising in a Brenner tumor, or appearing in pure form. Due to its rarity, there is no agreement concerning the efficacy of postoperative treatment of primary squamous cell carcinoma of the ovary, although the prognosis of this type of tumor is much worse than that of other epithelial ovarian cancers. We describe a patient with squamous cell carcinoma of the ovary in association with ovarian endometriosis, who has undergone postoperative systemic chemotherapy.
Brenner Tumor ; Carcinoma, Squamous Cell* ; Drug Therapy ; Endometriosis* ; Female ; Humans ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Teratoma

OBJECTIVE: The aim of this study was to describe the unique transvaginal sonographic(TVS) findings and clinical manifestations attributes of adult ovarian granulosa cell tumor(GCT) in postmenopausal women. METHODS: Data for 7 postmenopausal women with pathological proven adult ovarian GCT were respectively reviewed in Samsung Cheil Women's Hospital, between 1996 and 1999. Characteristics of transvaginal sonographic findings, pathological findings and clinical manifestations were analyzed. RESULT: On the basis of TVS findings, 7 cases of adult ovarian GCT were varied, but grossly categorized into 2 morphologic patterns: semisolid mass with scattered cystic components (n=3), muliticystic mass resembling typical hemorrhagic cyst (n=4). There are characteristics of TVS imaging of GCT that various size and stage of hemorrhage presents in the tumor. Endometrial transvaginal sonographic findings were normal atrophic EM (n=1), less than 5 mm with fluid collection (n=1), more than 5 mm with or without abnormal echogenicity (n=5). Clinical manifestations were, combination or alone, abnormal uterine bleeding (n=all), abdominal pain (n=1), mass palpation(n=3). Histopathologically most tumors were mixed, such as microfollicular, marcofollicular, trabecular pattern and also varied histologic appearance and tumor cell arrangement. CONCLUSION: TVS findings and combined presenting symptoms in postmenopausal women that raise suspicion of adult ovarian GCT include a relatively large ovarian mass (especially with hemorrhage) with a complex consistency, thickened endometrium and abnormal uterine bleeding without horomone replacement therapy. So it is possible to differentiate on basis of TVS imaging and symptoms between GCT and epithelial tumors of the ovary in postmenopausal women.
Abdominal Pain ; Adult ; Endometrium ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Hemorrhage ; Humans ; Ovary* ; Ultrasonography ; Uterine Hemorrhage

OBJECTIVE: To evaluate a clinical outcome of 7 patients diagnosed as ovarian dysgerminoma at the Department of Obstetrics and Gynecology, Kyunpookpook National University Hospital between 1994 and 1998 for 5 years. METHODS: After review of charts in seven patients, datas including clinical findings, treatment and outcome were analysed. RESULTS: The mean age of the patients with the ovarian dysgerminoma was 22 years and the highest incidence was shown in 10-19 years group. Among 7 patients, 5 cases(71.4%) were nulligravida, 2 cases of multigravida. According to FIGO classification, there were 5 cases of stage I(71.4%), 1 case(14.3%) of stage II and 1 case( 14.3%) of stage III. The clinical symptoms were abdominal distension(4 cases; 57.1%), palpable mass(4 cases; 57.1%), abdominal discomfort or pain(2 cases; 28.6%), amenorrhea(2 cases; 28.6%) and dysuria(1 case; 14.3%). Metastasis to other organ was found in 2 cases including pelvic cavity and paraaortic lymph node. Radiation therapy was performed on 1 case and chemotherapy on 4 cases after surgery. CONCLUSION: Dysgerminoma is the most common & radiosensitive malignant germ cell tumor of the ovary tumor. Dysgerminoma occurs usually between the ages of 10 and 30 years and has a relative better prognosis with postoperative chemotherapy than other malignant germ cell tumors.
Classification ; Drug Therapy ; Dysgerminoma* ; Female ; Gynecology ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal ; Obstetrics ; Ovary ; Prognosis

OBJECTIVE: This study was performed to evaluate the radiosensitizing effect of combined administration of 13-cis-retinoic acid (cRA) and interferon-alpha-2a (INF) in normal cervical keratinocyte and cervical cancer cell lines. METHODS: cRA, INF and radiotherapy was applied to cervical cancer cell lines (HT-3 and HeLa cells) to obtain optimum dose 20% cytotoxicity in MTT assay from each treatment. The dose was determined as 1.8 Gy for radiation, 10uM for cRA, and 1,000 U/ml for INF. Primary cultured cervical keratinocyte (PCCK), HT-3 and HeLa cells were treated with cRA and INF alone or in combination and compared with untreated control cells. Finally, radiotherapy was added to the cRA and INF treatment. RESULTS: The treatment of cRA and INF-alpha reduced significantly the mean number of colony of HT-3 cells from 250 (SD, 19) to 143 (SD, 32). In contrast, PCCK and HeLa cells exhibited less than 15% reduction of colony formation with the treatment of cRA and INF-alpha. Irradiation of HT-3 cells reduced the colony formation significantly (from 63.6% to 18.4%, p=0.002) after treatment of cRA and INF-alpha. However, PCCK and HeLa cells showed 13.2% (from 70.0 to 56.8%, p=0.807) and 8.4% (from 60.8% to 52.4%, p=0.816) reduction of their colonies respectively. CONCLUSION: These results suggested that the treatment of cRA and INF-alpha showed significant radiosensitizing effect in HPV-negative HT-3 cells but not in the normal cervical cells or HPV-positive HeLa cervical cancer cells.
Cell Line* ; HeLa Cells ; Humans ; Isotretinoin* ; Keratinocytes* ; Radiation-Sensitizing Agents* ; Radiotherapy ; Uterine Cervical Neoplasms*

OBJECTIVE: Tumor angiogenesis is essential for the progression and metastases of solid tumors. Microvessel density(MVD), a measure of tumor angiogenesis, has a prognostic significance in many types of tumors for predicting metastasis and survival. This study had two primary goals: 1. To determine how MVD correlates with tumor invasion in early squamous cell carcinoma(SCC) of the uterine cervix, and 2. To compare p53 protein expression in normal tissue with squamous cell lesions of the uterine cervix. METHODS: Quantification of MVD was performed on 59 specimens of cervical squamous cell lesions by immunohistochemical staining for factor VIII-related antigen. MVD was counted in a x200 field in the most active area of neovascularization. The same tumor sections were also immunohistochemically stains for p53 protein. RESULTS: 1. Compared with nonneoplastic areas, the degree of MVD was significantly increased in low- grade squamous intraepithelial lesion, high-grade squamous intraepithelial lesion, and squamous cell carcinomas(p=0.045). Microinvasive squamous cell carcinoma showed the highest MVD value. 2. p53 protein expression was increased in greater severity cases compared with mild cases(p=0.000). CONCLUSION: In the uterine cervix, MVD was significantly increased in microinvasive squamous cell carcinoma. p53 protein expression was well correlated with progression of squamous cell lesions.
Carcinoma, Squamous Cell ; Cervix Uteri* ; Coloring Agents ; Factor VIII ; Female ; Microvessels ; Neoplasm Metastasis ; von Willebrand Factor

OBJECTIVE: This study was undertaken to evaluate the clinical significance of ASCUS and AGUS in routine Papanicolaou smears. METHOD: A review of retrospective medical records was conducted on 267 women whose Papanicolaou smears yielded diagnoses of either ASCUS or AGUS from March, 1998 to December, 2000 at Youngdong Severance Hospital. RESULT: The incidences of ASCUS and AGUS on PAP smears are 1.3%(258 cases) and 0.1%(23 cases). Of these, 89 cases with ASCUS and 9 cases with AGUS had subsequent cervical biopsies. The biopsy cases with ASCUS showed 68(74.4%) cervicitis, 2(2.2%) hyperkeratosis, 1(1.1%) condyloma, 9(9.9%) CIN 1, 5(5.5%) CIN 2, 1(1.1%) CIN 3, 2(2.2%) microinvasive squamous cell carcinoma and 1(1.1%) adenocarcinoma. Those with AGUS showed 6(6.6%) cervicitis, 1(1.1%) CIN 2, 1(1.1%) CIN 3, 1(1.1%) endometrial cancer. Women under 35 year-old(P=0.012) or who had coital history in younger periods(before 20 years old, P=0.014) had much higher frequency of high grade lesion. The overall incidence of HSIL was higher in the group with ASCUS favoring SIL than in the group with unqualified ASCUS. (P=0.042) The group with AGUS also had much higher frequency of high grade lesion than the group with ASCUS. (P=0.043) CONCLUSION: Immediate colposopic evaluation should be performed for AGUS and ASCUS favoring SIL. Regarding ASCUS, high risk patients who are under 35 years old or who have early coital history(< 20 yrears old) also should undergo colposcopic examination. With the exception of the aboves, we propose HPV screening and HPV DNA testing for intermediate screening test.
Adenocarcinoma ; Adult ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Endometrial Neoplasms ; Female ; Human Papillomavirus DNA Tests ; Humans ; Incidence ; Mass Screening ; Medical Records ; Papanicolaou Test ; Retrospective Studies ; Uterine Cervicitis ; Young Adult