1/595. Failure of high-dose chemotherapy with peripheral blood stem cell support for refractory placental site trophoblastic tumor.Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease. The metastatic and refractory cases have a very poor prognosis. To our knowledge, this is the first report of the application of high-dose chemotherapy with autologous peripheral blood stem cell transplantation (PBSCT) for the treatment of refractory metastatic PSTT. A 36-year-old woman had a metastatic PSTT refractory to several lines of chemotherapy. She was treated with high dose of carboplatin and etoposide with autologous PBSCT. She showed only a temporary response to high-dose chemotherapy with PBSCT support and died of disease.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
2/595. Complete clinical responses to neoadjuvant chemotherapy for uterine serous carcinoma.Three cases of serous carcinoma of the uterus with radiographically documented widespread metastases are presented. Following confirmation of histopathology, all were treated with a standard regimen of carboplatin and paclitaxel for eight courses with complete resolution of distant metastases on CT scan prior to postchemotherapy surgical exploration. Two patients had gross disease at laparotomy, and one had only microscopic tumor found in the uterine specimen. This experience offers rationale for treatment of patients with widely metastatic uterine serous carcinoma or other relative contraindications to surgery with primary carboplatin and paclitaxel. In addition, we believe this experience supports the hypothesis that this regimen may result in prolonged disease-free survival when employed as postsurgical adjuvant therapy.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
3/595. Malignant mixed Mullerian tumor with rhabdoid features: a report of two cases and a review of the literature.Rhabdoid tumors were originally described as a type of pediatric renal neoplasm that contains cells resembling rhabdomyoblasts but lacking muscle differentiation. Extrarenal rhabdoid tumors have since been reported in multiple anatomic sites in the pediatric and adult population. These tumors are characterized by an aggressive clinical course, resistance to treatment, and a rapidly fatal outcome. Eight cases of uterine neoplasms with rhabdoid differentiation have been previously reported. In the three cases where clinical follow-up was available, the patients died of disease within 3 to 17 months after the diagnosis was established. We report two cases of uterine malignant mixed Mullerian tumor (carcinosarcoma) with rhabdoid differentiation. The findings and clinical outcome confirm the aggressive nature of uterine tumors with rhabdoid differentiation. One of the patients died of disease 3 months after initial operative treatment while the other patient's tumor recurred in 1 month and she died within 10 weeks. The poor prognosis of these neoplasms makes their histopathologic recognition important.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
4/595. Pelvic lipomatosis.A case report of pelvic lipomatosis in a woman is presented. This condition is a benign, apparently self-limited disease in which mature adipose tissue is deposited in the pelvis. The clinical presentation is discussed.- - - - - - - - - - ranking = 0.5keywords = disease (Clic here for more details about this article) |
5/595. Prognostic factors and treatment for placental site trophoblastic tumor-report of 3 cases and analysis of 88 cases.OBJECTIVE: In order to understand the prognostic factors of placental site trophoblastic tumors (PSTT), we performed a medline search for cases from 1976 through 1998 and report three cases. MATERIALS AND methods: The patients' age at presentation, antecedent pregnancies, and responses to treatment were analyzed according to the extent of disease, disease status after treatment, and survival in 88 cases. RESULTS: patients with disease extending outside the uterus at presentation had a median latency of 24 months between the antecedent pregnancy and presentation of PSTT, which was significantly longer than that of 12 months in those with disease confined to the uterus. patients with metastatic diseases were 3 years older than patients with diseases confined to the uterus and had a higher incidence of term delivery as their antecedent pregnancy. The outcomes of patients with FIGO stage I-II disease after hysterectomy were excellent, while those with FIGO stage III-IV diseases had a 30% survival. Although initial partial responses to chemotherapy were observed in some patients, only 5 patients achieved a complete remission and 3 of these 5 received a combination of etoposide, methotrexate, and actinomycin-D, alternating with cyclophosphamide and vincristine. CONCLUSION: FIGO stage is the most important prognostic factor, and complete removal of all lesions provided good outcomes in PSTT patients. For those with unresectable tumors, combination chemotherapy showed a high response rate, but only a few achieved a complete response.- - - - - - - - - - ranking = 4keywords = disease (Clic here for more details about this article) |
6/595. pregnancy with primary tubal placental site trophoblastic tumor--A case report and literature review.Placental site trophoblastic tumor (PSTT) is a rare trophoblastic neoplasm with malignant potential. The diagnosis and prognosis of this rare disease remain difficult. A case of tubal PSTT with the primary manifestation of internal bleeding at 30 weeks' gestation is presented. Emergency exploratory laparotomy and right partial salpingectomy were performed initially. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were done immediately after cesarean section at 34 weeks' gestation. No further adjuvant therapy was given after surgery. No evidence of tumor recurrence or signs of metastasis were noted during 12 months of follow-up. Heterotopic pregnancy, one with intrauterine normal pregnancy and the other with implanting in the right fallopian tube and placental site trophoblastic tumor transformation, was proposed. To our knowledge, this is the first such case in the English literature.- - - - - - - - - - ranking = 9.3101920805612keywords = fallopian tube, disease, tube (Clic here for more details about this article) |
7/595. Spinal manifestation of metastasizing leiomyosarcoma.STUDY DESIGN: Case report. OBJECTIVE: To provide additional information on possible relations between uterine and spinal manifestations of leiomyosarcoma. SUMMARY OF BACKGROUND DATA: Spinal metastases and primary spinal manifestation of leiomyosarcoma and other malignant smooth muscle tumors are rarely observed. methods: Clinical and radiologic follow-up of a patient with a spinal tumor. RESULTS: A 46-year-old women had rapidly progressive paraplegia caused by an extramedullary lesion in the extradural space at T2-T3, with spinal cord compression. After surgical decompression, the resected tumor was histologically classified as a leiomyosarcoma. Diagnostic work-up failed to detect the primary tumor site. Previous medical history had been uneventful except for hysterectomy 3 years earlier for a leiomyoma. Extended necroses and focal metaplasia were already described in the hysterectomy specimen indicating malignant disease; however, it was not definitely diagnosed. Multiple leiomyosarcoma metastases developed 22 months later. CONCLUSIONS: In retrospect, the origin of the leiomyosarcoma that manifested in the thoracic spine of the patient must be reconsidered. Rather than a primary dural leiomyosarcoma, this tumor represented the first evidence of recurrence of a missed diagnosis of early-stage uterine leiomyosarcoma.- - - - - - - - - - ranking = 0.5keywords = disease (Clic here for more details about this article) |
8/595. Malignant trophoblastic disease following a twin pregnancy consisting of a complete hydatiform mole and a normal fetus and placenta. A case report.We report an unusual pregnancy with a complete hydatiform mole coexisting with a normal fetus and placenta. This report stresses the importance of a correct diagnosis and the dilemmas the clinician is faced with when managing such a case. Malignant trophoblastic disease occurs in 55% of complete hydatiform mole and fetus. Two-thirds require combination chemotherapy.- - - - - - - - - - ranking = 2.5keywords = disease (Clic here for more details about this article) |
9/595. Exaggerated placental site erroneously diagnosed as non-metastatic trophoblastic disease. A case report.BACKGROUND: Exaggerated placental site (EPS) is classified as a non-neoplastic trophoblastic lesion, and histologically it consists of endometrial and myometrial invasion of intermediate trophoblasts and syncytiotrophoblasts and it differs morphologically from placental site trophoblastic tumors and placental nodules. The purpose of this report is to increase physicians' awareness of this lesion. CASE: A 48-year-old woman with post-molar rising betahCG titers and a clinical diagnosis of non-metastatic trophoblastic disease underwent hysterectomy. Final histopathology showed exaggerated placental site--a lesion often unfamiliar to clinicians. CONCLUSION: It is suggested that operative hysteroscopy may be useful in the diagnosis and management of EPS.- - - - - - - - - - ranking = 2.5keywords = disease (Clic here for more details about this article) |
10/595. Following metastatic placental site trophoblastic tumor with urine beta-core fragment.OBJECTIVE: We document a case with metastatic placental site trophoblastic tumor in a 47-year-old postmenopausal women. methods: beta-core fragment was measured in urine using the Triton UGP kit. hCG was also measured using the Bayer Immuno-1hCG assay (at Memorial Sloan-Kettering Cancer Center). RESULTS: Over 2 years the patient underwent two courses of chemotherapy and two debulking operations. During this time, hCG levels decreased from 227 to 4.1 mIU/ml. hCG levels were close to the limit of detection (<3 mIU/ml), indicating complete or near-complete regression of disease. At this point urine beta-core fragment levels were determined. High levels were detected 7.9 fmol/ml, consistent with the continued existence of tumor (>1.9 fmol/ml). High-dose chemotherapy (CEM) was started with stem cell harvesting. In the following weeks hCG levels failed to identify the tumor (4.1 to <3 mIU/ml). In the first week (during therapy) beta-core fragment levels increased (12 fmol/ml), and in the following weeks (after therapy) levels regressed to 1.2 fmol/ml. CONCLUSION: urine beta-core fragment may be a useful tumor maker when serum hCG levels are near to or below the limit of detection.- - - - - - - - - - ranking = 0.5keywords = disease (Clic here for more details about this article) |
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