1/5. Neuroendocrine small cell carcinoma of the uterine cervix: what disease? What treatment? Report of ten cases and a review of the literature.Neuroendocrine small cell carcinoma of the uterine cervix (NESCCC) is an entity with very aggressive behaviour. The optimal initial therapeutic approach to this rare disease has not yet been clearly defined. We reviewed our experience of this disease over the past 10 years with regard to chemosensitivity. Since 1988, ten patients (mean age 33 years; range 24-47) have been diagnosed with NESCCC and treated in our institutions. disease stage at presentation was IA (one), IB (five, two with lymph node involvement), IIB (one), IIIB (one), and IV (two). One patient had metastatic disease at presentation; three developed metastases during initial treatment. Eight patients underwent surgery and eight received radiation therapy. Six patients received pre- or postoperative cisplatinumvepeside (PE) combination chemotherapy, either alone or concurrently with radiation therapy. PE alone as primary chemotherapy led to disease stabilization in the two patients so treated; concurrent PE and radiation therapy resulted in a pathological complete response in one patient. Eight patients relapsed within 16 months and died of their disease within 29 months from the initial diagnosis. Two patients are alive with no evidence of disease at 13 and 53 months. Our series confirms the previously described very poor prognosis of NESCCC, despite initial aggressive multidisciplinary treatment. It may be that the introduction of chemotherapy, especially combined primary chemoradiotherapy, might allow patients to do a little better, although at the moment there is no good evidence one way or the other.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/5. Treatment policy of neuroendocrine small cell cancer of the cervix.Small cell cancers of the cervix are very rare and aggressive tumours. It is difficult to manage these tumours. They are often diagnosed in an advanced stage and their prognosis is generally poor. There are no clinical trials, due to their rarity, that would suggest optimal treatment. The present report describes a patient with a neuroendocrine small cell cancer of the cervix Stage IB2 with a positive lymph node. The treatment consisted of radical hysterectomy and node dissection, adjuvant chemotherapy, chemoradiation and brachytherapy. Currently, after 52 months, the patient is well and free of disease. Since 1996, there has been a classification for neuroendocrine tumours (NETs) of the cervix in four categories (large cell, small cell, typical carcinoid and atypical carcinoid). The aggressive behaviour of neuroendocrine small cell cancer is demonstrated by the high percentage of early lymphatic node and vessel invasion (68 and 90%). Almost half of the patients with Stage I and II will recur with an estimated 5-year survival from 14% to a maximum of 55%. Multimodal therapy for these tumours appears to give good response but often implies severe side-effects.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/5. Bizarre leiomyoblastoma of the cervix uteri. Immunohistochemical and ultrastructural study.A case of bizarre leiomyoblastoma (BL) of the cervix uteri which developed in a 44-year-old premenopausal woman was reported. The tumor was found as a cervical polyp by routine pelvic examination. Histologically, it was composed of epithelioid and bizarre, often multinucleated, giant tumor cells without elevated mitotic counts and necrosis. Electronmicroscopically, abundant myofilaments in epithelioid tumor cells were observed. Immunoreactive desmin, CPK-MM (creatinine kinase mm-isozyme), and myosin could be demonstrated in most of the epithelioid tumor cells. These immunohistochemical findings seemed to reflect on the differentiation of the tumor cells to smooth muscle and provide a reliable evidence for the smooth muscle origin. The histogenesis and relationship between the histopathological findings and clinical behaviour of uterine BL were also discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/5. Sarcomatoid squamous cell carcinoma of the uterine cervix with osteoclast-like giant cells: report of two cases.Two postmenopausal women with sarcomatoid squamous cell carcinoma (SSCC) of the uterine cervix are described. This report brings the total number of reported SSCCs in the lower female genital tract to 11. The gross and microscopic features of our SSCCs were similar to those of SSCCs in the digestive and upper respiratory tracts with the additional finding of osteoclast-like giant cells in each case. The behaviour and differential diagnosis of these tumors are briefly discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/5. Malignancy may adversely influence the quality and behaviour of oocytes.A case series of eight cycles of in-vitro fertilization (IVF) in five women diagnosed with malignant disorders is presented. These patients chose to defer definitive treatment for a chance for preservation of potential fertility. The response of these patients to ovarian stimulation, and the outcome, was compared with 17 IVF cycles in 12 age-matched patients with isolated tubal infertility. An apparent adverse influence of malignant disease on the quality and behaviour of oocytes was observed. Despite a comparable total number of oocytes per cycle in the two groups, a significantly reduced percentage of mature oocytes was retrieved per cycle from patients with malignant diseases. The oocytes from patients with malignant disorders were of a poorer quality and exhibited a significantly impaired fertilization rate compared to the controls. We propose that neoplastic processes, irrespective of the site or cell of origin, may have a detrimental impact on the biology of oocytes, an effect akin to that seen on spermatozoa in men with certain malignancies.- - - - - - - - - - ranking = 5keywords = behaviour (Clic here for more details about this article) |