Malignant lymphomas of the female genital tract are rare. When it involves the female genital tract, information in the literature regarding the classification, treatment and diagnosis of malignant lymphoma are few. Non-Hodgkin lymphomas (NHL) of the female genital tract occurs primarily in the ovary (49%), uterus (11%), vagina (7%), and vulva (4%). The vulva as the primary location is a very rare occurrence. However, autopsy studies have shown that about 40% of women who die of non-Hodgkin's lymphoma had involvement of the uterus or ovaries. There have been many cases of high-stage lymphomas presenting as secondary involvement of the female genital tract, but when the primary involvement site is the vulva, the stage of lymphoma was most commonly stage IE or IIE. Therefore, physicians should keep in mind the possibility of the presence of a malignant neoplasm when the suspected Bartholin's gland tumor does not respond to treatment. The authors propose that thorough gynecological evaluation should be conducted as a routine screening method in female patients with suspected lymphoma. We represent a case of primary non-Hodgkin's lymphoma patient who was relatively young in age and who was consequently determined to be of a high stage.
Autopsy ; Classification ; Diagnosis ; Female ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Mass Screening ; Ovary ; Uterus ; Vagina ; Vulva*

Primary peritoneal cancer is a rare tumor, which may be mesothelial or mullerian in nature. It can develop from unifocal or multifocal origin and the clinical and histologic disease entities are similar to those of primary papillary serous carcinoma of the ovary, but the main features of primary peritoneal cancer are widely disseminated malignancy along the peritoneal surfaces, the omentum, and abdominal viecera, with minimal or no ovarian involvement. Recently investigators have analyzed the morphology of these tumors and have used histochemical, eletron microscopic and immunohistologic techniques in an attempt to identify, characterize, and categorize. We have experienced a case of a primary peritoneal cancer which developed in the patient who had probably a previous total hysterectomy and both salpingooophorectomy.
Female ; Humans ; Hysterectomy ; Omentum ; Ovary ; Research Personnel

We report a rare case of epithelioid trophoblastic tumor. The patient was initially thought to have endometrial carcinoma with high possibility of clear cell carcinoma on endometrial biopsy and pelvic MRI. The Pap smear showed feature of squamous cell carcinoma and was not consistent with the physical findings. The serum beta-hCG was 33.26 mIU/ml. The initial biopsy and pelvic MRI findings lead the clinicians to misdiagnose the case as a carcinoma.
Biopsy ; Carcinoma, Squamous Cell ; Endometrial Neoplasms ; Female ; Humans ; Magnetic Resonance Imaging ; Trophoblastic Neoplasms* ; Trophoblasts*

Carcinomas of the lung, breast and lymphoma account for approximately 75% of malignant pleural effusions and the metastatic ovarian carcinoma is the fourth leading cause of malignant pleural effusions. The diagnosis of a malignant pleural effusion is established by demonstrating malignant cells in the pleural fluid or in the pleural biopsy. Chemical pleurodesis should be considered in cases of patients with malignant pleural effusion, who were not responded with systemic chemotherapy. We experienced a case of malignant pleural effusion treated by chemical pleurodesis, which was developed in a patient with ovarian carcinoma and we report it with the brief review or literatures.
Biopsy ; Breast ; Diagnosis ; Drug Therapy ; Humans ; Lung ; Lymphoma ; Pleural Effusion, Malignant* ; Pleurodesis*

OBJECTIVE: Small cell carcinoma of the cervix(SCC) is a rare aggressive tumor with a propensity for rapid distant recurrence and a high mortality rate. The purpose of this study was to review our experience in early stage disease and to perform a meta-analysis of the literature to compare neoadjuvant with adjuvant chemotherapy as prognostic factor. METHODS: Between 1990 and 1998, seven women with FIGO early stage(IB-IIA) SCC were treated with surgery and chemotherapy at our hospital. Medical records were retrospectively reviewed. And thirty-two early-stage SCC patients who similarly treated since 1990 were identified by a Medline search of the English literature and included in the analysis. The Kaplan-Meier method and log-rank test were used for survival analysis. RESULTS: Out of our patients, three patients died at 12-13 months after diagnosis due to distant metastases which were brain in two and was liver and lung in one. Other three are alive with no evidence of disease at 27, 66, and 121 months. From the meta-analysis, the overall 3-year survival rate was 49% in neoadjuvant and 33% in adjuvant chemotherapy, but there were no statistical significance.(log-rank test, 0.80) Neoadjuvant chemotherapy resulted in a high response rates(81.2%), no pelvic recurrence, and a low LN metastasis(18.8%), therefore the pelvic radiation therapy rates was low. CONCLUSIONS: Even in the early stage, SCC treatment must be combined with chemotherapy. There was no significant difference in prognosis between neoadjuvant and adjuvant chemotherapy. But this study showed neoadjuvant may extirpate the primary lesion, evaluate response, and assess more promising postoperative therapy according to pathologic features.
Brain ; Carcinoma, Small Cell* ; Cervix Uteri* ; Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Female ; Humans ; Liver ; Lung ; Medical Records ; Mortality ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

OBJECTIVE: Although a great deal of knowledge accumulated with regard to the causes and epidemiologic features of cervical cancer, primary prevention has not been particularly effective to date. Most efforts with regards of control of cervical cancer have been directed toward secondary prevention with cytologic smears in a screening program. The purpose of this study was to know the cervical smear histories in the women with neoplasia of uterine cervix at present. MATERIALS AND METHOD: Between June, 1993 and October, 1996, seventy women with invasive cervical carcinoma and eighty-seven women with cervical intraepithelial neoplasia(CIN) were interviewed about cervical smear histories to assess the frequencies of past smear at the Soonchunhyang University Hospital. RESULTS: The results were follows: 1. The mean age of the women with invasive cervical cancer and CIN were 55+/-9 and 42+/-11, respectively. 2. Of the 70 cases of cervical cancer, 61%(43/70) has not been screened, compared with 43%(37/87) in cases of CIN. 3. The mean ages at first smear in the cases of previous smear were 42+/-6 of 27 cancers, 37+/-7 of 50 CINs. The gap between the age at the first smear and the age at diagnosis were about 6 years in cases of cervical cancers, about 5 years in cases of CIN. 4. The most common symptom in cervical cancers was vaginal bleeding or postcoital bleeding(57%). Although 13%(9/70) were discovered during screening without symptom in the women with cervical cancers, 58%(52/87) were diagnosed incidently during screening in CIN. 5. Pap smear numbers before diagnosis were strongly associated with age and stage. Among women diagnosed with invasive cancer under the age of 49, 75% had at least one cervical smear. But, all women with cervical cancer over age of 65 have not been screened. Unscreened rates of stage I, II, III, and IV were 34%, 78%, 85% and 83% respectively. 6. Among 38 cases who had undergone radiation therapy, 82%(31/38) had not been screen in contrast to 38%(12/32) in the women who had undergone radical surgery. 7. Among women with previous smears in the cervical cancer, 20%(14/70) have been screened within 1year. CONCLUSION: It is likely to diagnosis cervical cancer who had normal papanicolau smear in recent. So papanicolau smear is examined carefully and other adjunctive test is help to diagnosis cervical cancer exactly, for example cervicography, HPV testing.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Diagnosis* ; Female ; Humans ; Mass Screening ; Primary Prevention ; Secondary Prevention ; Uterine Cervical Neoplasms* ; Uterine Hemorrhage ; Vaginal Smears

OBJECTIVE: To evaluate the efficacy and side effects of cispaltin and carboplatin each in combination with paclitaxel in recurrent epithelial ovarian cancer who had not taken paclitaxel-based chemotherapy. MATERIALS AND METHODS: Between January 1994 and October 1999, in department of obstetrics and gynecology, Asan medical Center, 42 recurrent ovarian cancer patients who had initial platinum-based chemotherapy except paclitaxel were treated with paclitaxel-based chemotherapy. One group was 14 patients treated with paclitaxel-cisplatin and the other group was 28 patients treated with paclitaxel-carboplatin. Disease free interval before recurrence was 6 months at least. Patients received paclitaxel 135mg/m2 followed by either cisplatin 75mg/m2 or carboplatin 300mg/m2. The schedule was repeated every 3 weeks for at least 6 cycle. Response was evaluated by physical examination, serial serum CA 125 measurement, chest PA before each cycle, and abdomino-pelvic CT scan every 3 cycles. RESULTS: As paclitaxel-cisplaitin group, with a median follow-up of 34.5 months (range, 9-60 months), 1 patient had complete response, 6 patients had partial response, 3 patients had stable disease and 4 patients had persistent disease, overall response rate was 50%, mean survival duration was 40 months. As paclitaxel-carboplatin group, with a median follow-up of 25.5 months (7-36 months), 4 patients had complete response, 11 patients had partial response, 6 patients had stable disease, and 7 patients had persistent disease, overall response rate was 53.4%, mean survival of 24 months. As grade of side effects in each group, we evaluated leukopenia, anemia, thrombocytopenia, nausea, vomiting, fever, neurological abnormality, and renal abnormality. The rate of grade 3 to 4 leukopenia was 11% in paclitaxel-cisplatin arm and 17% paclitaxel-arboplatin, in arm. CONCLUSION: These results demonstrate that the combined chemotherapy of paclitaxel followed by cisplatin or carboplatin is highly effective and safe in recurrent epithelial ovarian cancer who had taken no previous paclitaxel-based chemotherapy.
Anemia ; Appointments and Schedules ; Arm ; Carboplatin ; Chungcheongnam-do ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination* ; Fever ; Follow-Up Studies ; Gynecology ; Humans ; Leukopenia ; Nausea ; Obstetrics ; Ovarian Neoplasms* ; Paclitaxel ; Physical Examination ; Recurrence ; Thorax ; Thrombocytopenia ; Tomography, X-Ray Computed ; Vomiting

PURPOSE: The locoregional failure rate remain high in advanced cervical carcinoma. Chemotherpy(CT) was added to radiotherapy(RT) in order to improve therapeutic result. We performed this study to evaluate the response rate, toxicities and survival benefit of neoadjuvant chemotherapy and to investigate potential role of neoadjuvant chemotherapy in treatment of cervical cancer. METHODS AND MATERIALS: The patients(68 cases of cervical cancer) were divided into two groups ; The one group was neoadjuvant chemotherapy followed by radiotherapy(n=30) and the other was the radiotherapy(n=38) group. The patients were maintained by regular follow-up and evaluated with regards to treatment related toxicity and effectiveness by response using World Health Organization criteria and 5-year survival rate. RESULTS: 30 patients were assigned to receive neoadjuvant chemotherapy. After chemotherpy, the overall clinical response rate was 46.7%. The response rate of neoadjuvant chemotherapy followed radiotherapy was higher than that of the radiotherapy in cervical cancer (100% vs 84.2%). The 5-year survival rate of patients was not different between two groups(p>0.05). Toxicities of chemotherapy were generally tolerable and usually well resolved with conservative treatment. CONCLUSION: Neoadjuvant chemotherapy followed radiotherapy help to improve response rate but did not affect survival benefit in the cervical cancer in this study. However, well controlled long-term prospective study will be need to get firm conclusion.
Drug Therapy* ; Follow-Up Studies ; Humans ; Radiotherapy* ; Survival Rate ; Uterine Cervical Neoplasms* ; World Health Organization

OBJECTIVE: The aim of this study was to identify human papillomavirus (HPV) in cervical intraepithelial neoplasia (CIN) and to evaluate the persistence of HPV after loop electrosurgical excision precedure (LEEP). METHODS: Records of 138 patients with LEEP performed due to cervicitis, CIN I, CIN II and CIN III were reviewed and persistence of HPV were followed up at 3, 6, 9 and 12 month after LEEP treatment from January 1996 to December 1999. RESULTS: Among 202 patients, 138 cases (68.3%) were showed HPV positive before LEEP and histologic findings were showed as cervicitis 20 cases (14.5%), CIN I 23 cases (16.7%), CIN II 31 cases (22.5%) and CIN III 64 cases (46.3%). Persistence of HPV after LEEP treatment were 10.9% (15/138) at 3 month and 2.9% (4/138) at 6 month. However, among 15 cases of persistent HPV, only 5 cases (33.3%) were showed an abnormal Pap smear at 3 month after LEEP. CONCLUSION: Human papillomavirus (HPV) was eliminated over 90% at 3 month after LEEP treatment in CIN. Detection of HPV was helpful to estimate therapeutic effect and to predict the recurrence or persistence of CIN after LEEP treatment.
Cervical Intraepithelial Neoplasia* ; Humans ; Recurrence ; Uterine Cervicitis

OBJECTIVE: The aim of this study is to investigate the incidence of genetic instability, defined as microsatellite instability (MI) or loss of heterozygosity (LOH) in cervical carcinoma and its relationship with clinical characteristics. MATERIALS AND METHODS: Twenty-four patients with cervical carcinoma were studied. Genomic DNA was extrected from tumor tissues collected from consenting patients undergoing surgery. MI and LOH were analyzed with five microsatellite regions on chromosome 2, 3 and 6 (D2S123; 2p16-2p16 and 2p21-2p16, D3S1619; 3p24.2-3p22, D6S291; 6p21.3-6p21.2, D6S308; 6q16.3-6q27, D6S270; 6q22.3-6q23.2) by polymerase chain reaction (PCR) and automatic laser fluorescent DNA sequencer. MI was defined as tumor-associated alteration in at least of one of five dinucleotide microsatellite markers examined. The relationship between genetic instability and clinical profile was analyzed. The significance of BAT-26 sequence size as a marker of replication error (RER) phenotype was assessed. RESULTS: Total genetic instability was detected in 79%(19/24) of cervical carcinoma. MI was detected in 50% of the cervical carcinomas and LOH in 45.8%. BAT-26 size variation was observed only in one case. There was no statistically significant difference between the groups of positive and negative genetic instability in human papillomavirus (HPV) 16 or 18 positive rate, stage, 2 year-survival rate. CONCLUSION: This results suggest that MI and LOH are present in a subset of cervical carcinoma and may have a role for carcinogenesis as co-factors. BAT-26 has no value as a marker of RER in cervical cancer.
Carcinogenesis ; Chromosomes, Human, Pair 2 ; DNA ; Humans ; Incidence ; Loss of Heterozygosity ; Microsatellite Instability ; Microsatellite Repeats ; Phenotype ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms