Basal cell carcinoma (BCC) is the most common human malignant neoplasm, accounting for 75% of all non-melanoma skin cancer. The incidence of BCC is strongly correlated with sun exposure as well as older age. Therefore, the vast majority of BCCs is observed in elderly patients on the sun-exposed skin of the head and neck with a frequency of more than 80%. BCC is very rare on sun-protected skin such as the perianal and genital regions and other etiologic factors must be considered in these cases. Although the pathogenesis of vulvar BCC is unclear, early diagnosis is very important. Because BCC in these areas sometimes seems innocuous, it is recommended that a biopsy of all suspect lesions be performed. We report a woman with BCC of the vulva treated with wide local resection and reviews the literatures on this subject.
Accounting ; Aged ; Biopsy ; Carcinoma, Basal Cell ; Early Diagnosis ; Female ; Head ; Humans ; Incidence ; Neck ; Skin ; Skin Neoplasms ; Solar System ; Vulva

OBJECTIVE: Human cervical cancer is caused by the high-risk types of human papillomavirus (HPV) such as HPV16, which possess the E6 and E7 oncogenes, whose expressions are a prerequisite for cancer development. We performed this study to compare the efficacy of antitumor activity by HPV siRNA which silences only E6 or both E6/E7. METHODS: We transfected siRNA 377 (HPV16 E6 siRNA), siRNA 3 (HPV16 E6 siRNA), and siRNA 198 (HPV16 E7 siRNA) into SiHa cell line (siRNA 377 silences only E6, and siRNA 3 and siRNA 198 silence both E6 and E7). We experimented cell counts and morphologic changes 24 and 48 hours after transfection and expressions of HPV16 E6/E7 mRNA by RT-PCR. RESULTS: siRNA 377, siRNA 3, and siRNA 198 suppressed the cell growth. siRNA 3 and siRNA 198 were more potent than siRNA 377 in cell growth suppression. siRNA 377 knocked down the expression of E6 mRNA, and both siRNA 3 and siRNA 198 knocked down the expression of E6/E7 mRNA. CONCLUSION: Our results suggest that simultaneous suppression of E6 and E7 was more potent than E6-specific suppression in cancer cell growth.
Cell Count ; Cell Line ; Humans ; Oncogenes ; RNA, Messenger ; RNA, Small Interfering ; Transfection ; Uterine Cervical Neoplasms

OBJECTIVE: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). METHODS: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary's Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim's Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. RESULTS: There was no significant difference in patients' age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients' mean age was 46.1+/-7.0 years (SPA-LAVH) and 45.5+/-6.3 years (MPA-LAVH). The mean operating time was 87.2+/-21.0 minutes (SPA-LAVH) and 83.3+/-20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4+/-139.7 g (SPA-LAVH) and 257.8+/-132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1+/-0.7 g/dL (SPA-LAVH) and 1.2+/-0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6+/-0.6 days [SPA-LAVH] and 3.3+/-0.7 days [MPA-LAVH], P<0.05). CONCLUSION: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.
Adenomyosis ; Blood Transfusion ; Female ; Fever ; Hemoglobins ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Incidence ; Leiomyoma ; Length of Stay ; Medical Records ; Urinary Tract

Primary malignant lymphoma of the uterine cervix is very rare. Lymphomas account for 3.5% of all malignant tumors in the females. Approximately, 25% of all malignant lymphomas arise from extranodal sites, most frequently from gastrointestinal tract and skin. Although the incidence of systemic non-Hodgkin's lymphoma (NHL) and extranodal NHL has increased in recent decades, only 1 to 1.5% arises from female genital tract. Primary pelvic sites include ovary, which is the most common site, uterine corpus, cervix, vagina, and vulva. Primary cervical lymphomas account for 0.12~0.6% of all extranodal lymphomas. However, there is still no consensus on the management of cervical lymphomas due to low incidence of the disease and limited experience in the literature. We experienced two cases of primary malignant lymphoma of the uterine cervix. A 41-year-old woman, Ann Arbor stage IE, was treated with laparoscopically assisted vaginal hysterectomy and both salpingo-oophorectomy and 4 cycles chemotherapy. A second case was a 73-year-old postmenopausal woman, Ann Arbor stage III, received five courses chemotherapy without any surgery. In this article, two cases of uterine cervical lymphoma are presented with a review of the available literature.
Adult ; Aged ; Cervix Uteri ; Consensus ; Female ; Gastrointestinal Tract ; Humans ; Hysterectomy, Vaginal ; Incidence ; Lymphoma ; Lymphoma, Non-Hodgkin ; Ovary ; Skin ; Vagina ; Vulva

Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix, also called lymphoepithelioma or medullary carcinoma, is a very rare variant of squamous cell carcinoma. Histologically, the tumor is characterized by groups and nests of poorly differentiated tumor cells with abundant cytoplasm and ill-defined cell borders, surrounded by an intense chronic inflammatory infiltrate. Epstein-Barr virus (EBV) may be involved in the development of LELC but the exact role remains unclear. The relationship between human papillomavirus (HPV) and LELC of the uterine cervix has also not been reported. The prognosis of LELC of the uterine cervix seems to be better than that of cervical squamous cell carcinoma. We report a case of LELC of the uterine cervix with a brief review.
Carcinoma, Medullary ; Carcinoma, Squamous Cell ; Cervix Uteri ; Cytoplasm ; Female ; Herpesvirus 4, Human ; Humans ; Prognosis

Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix, also called lymphoepithelioma or medullary carcinoma, is a very rare variant of squamous cell carcinoma. Histologically, the tumor is characterized by groups and nests of poorly differentiated tumor cells with abundant cytoplasm and ill-defined cell borders, surrounded by an intense chronic inflammatory infiltrate. Epstein-Barr virus (EBV) may be involved in the development of LELC but the exact role remains unclear. The relationship between human papillomavirus (HPV) and LELC of the uterine cervix has also not been reported. The prognosis of LELC of the uterine cervix seems to be better than that of cervical squamous cell carcinoma. We report a case of LELC of the uterine cervix with a brief review.
Carcinoma, Medullary ; Carcinoma, Squamous Cell ; Cervix Uteri ; Cytoplasm ; Female ; Herpesvirus 4, Human ; Humans ; Prognosis

The reversible posterior leukoencephalopathy syndrome (RPLS) was first described by Hinchey et al. It is characterized by reversible posterior predominant white and gray matter lesions on brain magnetic resonance imaging (MRI) in patients with renal insufficiency or hypertension, or immunosuppression. The findings on neuroimaging are characteristic of subcortical edema without infarction. Patients with RPLS show various kinds of neurologic abnormalities characterized by headache, nausea, vomiting, visual disturbances, altered mental status, decreased alertness, seizures, and focal neurologic signs. The clinical and radiological findings usually resolve within two to three weeks when the underlying cause is removed. In this report we describe the case of RPLS with eclampsia in a 24-year-old woman, which appears to be involved in areas of the occipital, frontal, and parietal lobes. A brief review of the literature is also presented.
Brain ; Eclampsia* ; Edema ; Female ; Headache ; Humans ; Hypertension ; Immunosuppression ; Infarction ; Magnetic Resonance Imaging ; Nausea ; Neuroimaging ; Neurologic Manifestations ; Parietal Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pregnancy ; Renal Insufficiency ; Seizures ; Vomiting ; Young Adult

OBJECTIVE: This study was aimed at comparison of women with advanced ovarian cancer treated with neoadjuvant chemotherapy (NAC) followed by surgery with those treated conventionally with primary debulking surgery followed by cytotoxic chemotherapy (conventional group). METHODS: Between January 1998 and December 2005, 11 patients with advanced epithelial ovarian cancer were treated by NAC followed by debulking surgery and 20 patients were treated by primary cytoreductive surgery followed by cytotoxic chemotherapy conventionally. The files were reviewed retrospectively. RESULTS: The mean age was 54.8+/-11.6 in NAC and 53.0+/-11.9 years in conventional group. 10 cases were serous adenocarcinoma in NAC group and 16 cases were serous, 1 was mucinous and 2 cases were endometrioid type in conventional group (Table 1). Mean courses of NAC were 3 cycles (range 1-4) and carboplatin and paclitaxel regimen was most common (Table 2). After NAC, 2 complete responses (18.2%) were achieved, 4 patients (36.4%) achieved a partial response, and 5 (45.5%) had no response or progressive disease. At debulking surgery, no pathological complete response was noted, and residual ovarian cancer was present in all cases. The optimal surgery (residual tumor <2 cm) was obtained in 9 cases (81.8%) of NAC and 5 cases (25.0%) of conventional group (Table 3). The mean estimated blood loss was 604.54+/-178 ml (range 400-1,000 ml) in NAC group and 752.5+/-335 ml (range 400-2,000 ml) in conventional group , blood transfusion 2.2 pints (range 0-5 pints) in NAC and 4.6 pints (range 1-19 pints) in conventional group, the mean operative time was 244.54+/-108 minutes in NAC group and 251.5+/-94.5 minutes in conventional group, mean intensive care unit stay was 1.6 days (range 0-3 days) in NAC and 2.5 days (range 0-13 days) in conventional group, and mean hospital stay was 17.36+/-8.97 days (range 7-42 days) in NAC and 24.45+/-11.7 days (range 10-48 days) in conventional group respectively (Table 4). There were no significant statistical differences in two groups except hospital stay (p=0.04). There were no significant statistical differences of disease-free and overall survival in two groups (Fig 1&2). CONCLUSION: The rate of optimal debulking surgery, blood loss, operative time, disease-free and overall survival, excluding the length of hospital stay, showed no significant statistical differences in both groups. Even though we might have statistical shortage because we were able to get only limited cases to show meaningful results, there is enough validity of conducting prospective clinical research using NAC since the overall survival rate in both groups showed no significant difference.
Adenocarcinoma ; Blood Transfusion ; Carboplatin ; Drug Therapy* ; Female ; Humans ; Intensive Care Units ; Length of Stay ; Mucins ; Operative Time ; Ovarian Neoplasms* ; Paclitaxel ; Retrospective Studies ; Survival Rate

OBJECTIVE: To evaluate clinical-pathological aspects of uterine smooth-muscle tumors with a pathological diagnosis of uncertain malignant potential or leiomyomas with increased mitotic activity. METHODS: We reviewed the charts and pathological records of twenty seven patients with smooth muscle tumors of the uterus, with 5-9 mitotic figures per 10HPF (High power fields) and without cytological atypia or necrosis retrospectively. RESULTS: The patients were 29-60 (mean 41.8+/-6.8) years old and mean parity was 1.7+/-0.9. None of the patients had used any hormones preoperatively. The size of the myomatous tumors ranged from 2 to 23 cm (mean 7.1+/-4.6 cm). On gross examination all tumors appeared as typical leiomyomas. Twenty were intramural and 7 were submucous leiomyomas. The mitotic counts ranged 5-9/10 HPF (mean 6.0+/-1.2/10 HPF). Cytological atypia or necrosis were absent. The histological phase of the endometrium could be evaluated in 18 patients. Of these, ten had secretory-phase endometrium and proliferative endometrium was present in eight patients. Hysterectomy was performed in 20 patients with intramural leiomyoma, and myomectomy was in 7 patients under diagnosis of submucosal type. Postoperative follow-up periods ranged 5-94 months (mean 37.0+/-22.6 months). All patients were alive without evidence of recurrence or metastasis. CONCLUSION: Leiomyomas containing from five to nine mitotic figures per 10 HPF, without cellular atypia or necrosis, should be regarded as benign. Hysterectomy need not autonomically be done, as follow-up is a viable alternative. Myomectomy is an appropriate treatment, particularly in young patients interested in reproduction.
Diagnosis ; Endometrium ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Leiomyoma* ; Necrosis ; Neoplasm Metastasis ; Parity ; Recurrence ; Reproduction ; Retrospective Studies ; Smooth Muscle Tumor ; Uterus

Fibrosarcoma of the ovary is an exceedingly rare primary ovarian stromal tumor, which has a poor prognosis. Fibrosarcoma may arise de novo or as a result of malignant change in a benign fibromatous or fibrothecomatous tumor of the ovary. There are only about 30 cases in the literature reported within past three decades, showing the extreme rarity of these tumors. We report a case of primary ovarian fibrosarcoma with a review of the available literature.
Female ; Fibrosarcoma* ; Ovary ; Prognosis