1/23. Radical hysterectomy for IB cervical cancer in a patient with aorto-femoral transposition.We present a cervical cancer case in stage IB, according to FIGO classification, treated with radical hysterectomy and pelvic lymphadenectomy. The 48-year-old patient had 4 years previously undergone a Y aorto-bifemoral Dallon transposition as a result of Leriche's syndrome. During the routine investigation invasive cervical cancer was diagnosed. She had radical hysterectomy of Piver III type and partial pelvic lymphadectomy. Radical hysterectomy caused no technical trouble. Pelvic lymphadenectomy was only partially possible because of hard connective tissue around the artificial vessels. This scarred region made safe preparation of the total pelvic lymphatic system impossible.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/23. adenoma malignum. Report of a case with cytologic and colposcopic findings and immunohistochemical staining with antimucin monoclonal antibody HIK-1083.BACKGROUND: adenoma malignum of the uterine cervix was first described by Gusserow. We report here a case with cytologic, histologic and colposcopic findings and immunohistochemistry for HIK-1083. CASE: A 42-year-old female was noted to have a probable adenoma malignum due to the detection of atypical cells classified as V. On colposcopy, comma-shaped, atypical vessels spread over the entire cervical area. Histologic findings were characteristic of tumor invasion beyond the layer of cervical glandular ducts. Immunohistochemical detection of CEA was negative, but HIK-1083, which recognizes gastric glandular mucous cells, was positive. CONCLUSION: For a definitive diagnosis of adenoma malignum of the cervix, immunohistochemical examination for an appropriate marker, such as HIK-1083, should be added to the routine gynecologic examination, cytologic and histopathologic examination, and colposcopy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/23. Solitary metastasis to the uterine cervix from the early gastric cancer: a case report.Metastasis of gastric cancer to the uterine cervix is rare, and a case of metastasis to the uterine cervix from early gastric cancer has never before been reported. We here present a patient who underwent a gastrectomy due to asymptomatic early gastric cancer found by chance and who subsequently suffered from a solitary metastasis to the uterine cervix from the primary early gastric cancer. Similar to Krukenberg tumors of the ovary, lymphatic dissemination is regarded as the route of metastasis from the stomach to the uterine cervix. We surmise that the present metastasis occurred through the lymphatic channel because lymph vessel permeations were found in both the primary lesion of the stomach and the metastatic lesion of the uterine cervix.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/23. Surgical treatment of the radiation injured bowel.Over the last 10 years, 9 patients treated by surgical procedure for radiation injuries of the bowel were studied with the following conclusions: The damage to the small intestine caused by external irradiation leads to adhesion of the bowel, perforation and postoperative anastomotic dehiscence if the irradiated bowel is used in the anastomosis. Surgical treatment for the small intestine is resection of the damaged loop. In order to determine the extent of the resection it is important that during the operation fibrosis and obstruction of vessels in the submucosa and subserosa is examined by biopsy. On the other hand, rectal ulcer and/or rectovaginal fistula is chiefly caused by intracavitary application plus external irradiation. For these lesion Hartmann operation or colostomy is performed, and the postoperative course is uneventful.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/23. lymphangioma circumscriptum of the vulva following surgical and radiological therapy of cervical cancer.BACKGROUND: lymphangioma circumscriptum of the vulva rarely develops after postoperative pelvic irradiation. GOAL: The goal was to describe two cases of lymphangioma circumscriptum and their treatment and present a brief review of the literature. STUDY: Two female patients, aged 75 years and 46 years, presented with persistent edema, papules, and vesicles of the labia majora, which had developed 15 and 9 years after hysterectomy, lymph node dissection, and subsequent irradiation of cervical cancer. The external diagnosis was genital warts. RESULTS: In both cases histology revealed lymphangioma circumscriptum of the vulva. Whereas the older woman's condition responded well to laser treatment, keloids developed in the second patient at the site of carbon dioxide laser vaporization. CONCLUSION: CO2 laser treatment recently has been recommended for vulvar lymphangioma circumscriptum and is effective in vaporizing the communicating vessels to deeper cisterns. To our knowledge this is the first description of keloid development after laser therapy for vulvar lymphangioma circumscriptum, and such an effect should be considered before CO2 laser surgery is applied for this particular entity.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/23. Asymptomatic vasculitis of the uterine cervix in presence of cervical intraepithelial neoplasia grade III.CASE REPORT: A 34-year-old woman was diagnosed to have a high-grade cervical intraepithelial neoplasia and was treated by large loop excision of the transformation zone. histology of the excised cone confirmed the diagnosis but also showed evidence of vasculitis of medium-sized vessels of the cervix. The woman was referred to a physician to rule out underlying systemic disease. Extensive laboratory and clinical screening was negative. DISCUSSION: The clinical significance and management of asymptomatic isolated vasculitis of the uterine cervix are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/23. Delayed, massive bleeding as an unusual complication of laser conization. A case report.BACKGROUND: Although delayed bleeding following cervical conization is a common complication of this surgical procedure, the amount of blood loss is usually not life threatening. CASE: A 27-year-old woman underwent conization with a KTP laser for the treatment of microinvasive cervical adenocarcinoma. Eight days later the patient experienced sudden, massive genital bleeding at her workplace. The source of the bleeding was identified as a descending branch of the left uterine artery exposed to the wound surface. hemostasis was achieved completely with direct surgical ligature of the exposed blood vessel. The patient's blood loss during the course of the events was estimated to be 3.2 L, for which she received 1.4 L of packed red blood cells. She had an uneventful postoperative recovery. There was no bleeding or recurrence of the disease during 4 years of follow-up. CONCLUSION: Clinicians should be alert to the possibility of massive bleeding as a delayed surgical complication of cervical conization.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/23. Laparoscopic total pelvic exenteration for cervical cancer relapse.BACKGROUND: laparoscopy classically reduces morbidity and invasiveness. To decrease the operative morbidity associated with exenteration, we considered the possibility of performing a total pelvic exenteration by the laparoscopic approach. CASE: A 34-year-old woman presented with a cervical cancer relapse. The bladder, uterus, vagina, ovaries, and rectum were mobilized en bloc from the pelvic sidewall. We used vascular endoscopic staplers for the control of sigmoid vessels and anterior branches of internal iliac vessels. The specimen was removed through the vulva. A colo-anal anastomosis and an ileal-loop conduit for urinary tract diversion were made. The operative time was 9 h. The postoperative course was uneventful. Specimen margins were free of disease. CONCLUSION: With laparoscopic surgical knowledge and new endoscopic staplers, laparoscopic pelvic exenteration procedure is feasible.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
9/23. 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 = vessel (Clic here for more details about this article) |
10/23. Umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer: a true port-site metastasis?BACKGROUND: We present a case of umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer. CASE: A 59-year-old woman with stage IIIB cervical adenocarcinoma underwent laparoscopic paraaortic lymphadenectomy as well as a conventional laparoscopy to assess the presence of peritoneal carcinomatosis. The pathologic examination revealed metastasis in one paraaortic node. Peritoneal cytology proved negative for malignant cells. Seven months after completion of chemoradiotherapy, the patient presented a 2.5-cm umbilical tumor involving the trocar tract together with recurrence of the cervical mass. Histological examination of the excised umbilical mass showed recurrence of the cervical adenocarcinoma, with strong peritumoral CD31 immunocytochemical expression. CONCLUSION: The peritumoral increase in microvessel density and strong CD31 positivity suggests angiogenesis as a potential factor lead to seeding of tumor cells at the umbilical port.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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