Table of Contents
1
UI - 11912541
AU - Bava GL; Dalmonte P; Oddone M; Rossi U
TI -
Life-threatening hemorrhage from a vulvar hemangioma.
SO - J Pediatr Surg 2002 Apr;37(4):E6
AD - Multidisciplinary Group for Hemangiomas and Vascular Malformations,
"Giannina Gaslini" Children's Hospital, Genoa, Italy.
Capillary hemangioma, the most common tumor of infancy, usually does not
require any treatment, but in a minority of cases it may cause
morphologic, functional, or life-threatening complications. The authors
report a case of a vulvar emangioma complicated by life-threatening
hemorrhage not responsive to corticosteroids therapy, which showed no
signs of spontaneous involution. The therapeutic approach consisted of 3
steps of selective arterial embolizations followed 5 months later by
surgical excision and reconstruction of the vulva. Selective
embolization rarely is used in the treatment of hemangiomas but may be
required in cases of intractable bleeding, severe heart failure, large
and poorly involuting hemangiomas, and as preparation for surgery. The
results of the combined approach in this case are reported, and the
indications discussed. Copyright 2002, Elsevier Science (USA). All
rights reserved.
2
UI - 11883304
AU - Panek G; Bidzinski M; Nasierowska-Guttmeier A
TI -
[Primary vaginal and uterine melanoma--a case of long term survival
after local excision and vaginal brachytherapy]
SO - Ginekol Pol 2001 Dec;72(12A):1501-6
AD - Kliniki Nowotworow Narzadow Plciowych Kobiecych Centrum
Onkologii-Instytutu w Warszawie.
This report presents the case of long term survival of primary vaginal
melanoma treated by local excision and vaginal brachytherapy. A unique
histopathological pattern of preinvasive vaginal melanoma is also
described. A review of the literature revealed 22 long term survivals
after treatment of malignant melanoma of the vagina, and only 4
surviving more than 10 years. In general the prognosis in women with
these malignancy is poor regardless of type of surgery. Depth of
infiltration seems to be the only important prognostic factor
influencing the survival.
3
UI - 11925129
AU - Miller BE
TI -
Vulvar intraepithelial neoplasia treated with cavitational ultrasonic
surgical aspiration.
SO - Gynecol Oncol 2002 Apr;85(1):114-8
AD - Section on Gynecologic Oncology, Department of Obstetrics and
Gynecology, Wake Forest University School of Medicine, Medical Center
Boulevard, Winston-Salem, North Carolina 27157-1065, USA.
bemiller@wfubmc.edu
OBJECTIVE: The aim of the study was to investigate the use of the
cavitron ultrasonic surgical aspirator (CUSA) for the treatment of
vulvar intraepithelial neoplasia (VIN) as it combines the advantage of
laser removal of the superficial dermal layers without scars and the
advantage of resection with collection of a pathological specimen.
METHODS: Between 1992 and 1998, 37 patients with VIN were treated using
the CUSA. Charts were reviewed retrospectively. RESULTS: The median age
at diagnosis was 40 years. Eleven patients (30%) had been previously
treated for VIN. Diagnosis was made by inspection before and after
ascitic acid application, colposcopy, and multiple biopsies revealing
VIN II in 8 patients (22%) and VIN III in 29 patients (78%). At least
two quadrants of the vulva were involved in 16 cases (43%) and three or
four quadrants in 12 cases (33%). Under anesthesia the CUSA was used to
remove all lesions with a 1-cm margin. There were no complications
except 1 admission for pain control. Healing was complete in 4 to 6
weeks and no patient developed scarring. Final pathology confirmed the
preoperative diagnostic grade in 24 cases (65%), while upgrading to a
higher dysplasia occurred in 4 patients (11%). A second treatment was
necessary in 3 patients with widespread disease. Patients were followed
for an average of 33 months. Thirteen recurrences (35%) developed after
a median interval of 16 months. Recurrences were significantly (P =
0.004) more frequent if VIN involved hair-bearing tissue, 6 of 7 (86%)
cases, in contrast to patients with disease confined to the labia minora
and introitus, 7 of 30 (23%) cases. CONCLUSION: CUSA is an acceptable
treatment alternative for VIN confined to non-hair-bearing vulvar skin.
4
UI - 11925141
AU - Cohn DE; Dehdashti F; Gibb RK; Mutch DG; Rader JS; Siegel BA; Herzog TJ
TI -
Prospective evaluation of positron emission tomography for the detection
of groin node metastases from vulvar cancer.
SO - Gynecol Oncol 2002 Apr;85(1):179-84
AD - Division of Gynecologic Oncology, Washington University School of
Medicine, St. Louis, Missouri, USA. cohn-1@medctr.osu.edu
OBJECTIVE: We set out to determine the ability of positron emission
tomography with fluorodeoxyglucose to detect groin lymph node metastases
with squamous cell cancer of the vulva undergoing radical excision and
lymphadenectomy were offered preoperative positron emission tomography.
The imaging and pathologic status of each patient and groin were
compared, and the sensitivity, specificity, and predictive value of
positron emission tomography in predicting nodal metastasis were
determined. RESULTS: Fifteen patients underwent positron emission
tomography prior to exploration of 29 groins. Six patients had positive
scans, suggesting metastases in 8 groins. Pathologically, 5 patients had
metastases in 9 groins, with positron emission tomography demonstrating
metastases in 4 of 5 patients and 6 of 9 groins with disease. On a
patient-by-patients basis, positron emission tomography had a
sensitivity of 80%, specificity of 90%, positive predictive value of
80%, and negative predictive value of 90% in demonstrating metastases.
On a groin-by-groin basis, positron emission tomography had a
sensitivity of 67%, specificity of 95%, positive predictive value of
86%, and negative predictive value of 86%. Positron emission tomography
was more accurate in detecting extranodal metastases than disease
confined within the groin nodes (P = 0.048). CONCLUSIONS: Positron
emission tomography is relatively insensitive in predicting lymph node
metastasis, and a negative study is not a reliable surrogate for a
pathologically negative groin. However, the high specificity suggests
that positron emission tomography is useful in planning radiation
therapy and as an adjunct to lymphatic mapping and sentinel lymph node
dissection.
5
UI - 11925143
AU - Cardosi RJ; Hoffman MS; Greenwald D
TI -
Rectus femoris myocutaneous flap for vulvoperineal reconstruction.
SO - Gynecol Oncol 2002 Apr;85(1):188-91
AD - Division of Gynecologic Oncology, University of South Florida College of
Medicine, Tampa, Florida 33606, USA. rcardosi@tampabay.rr.com
BACKGROUND: Many reconstructive procedures for large vulvoperineal
defects have been described. The present report describes the use of the
rectus femoris myocutaneous flap, which has not previously been
described for this purpose. CASE: A 52-year-old woman suffered a local
recurrence of a Bartholin's gland carcinoma after anterior exenteration
and pubectomy. A palliative resection was performed which resulted in a
large vulvoperineal defect with transpelvic herniation of the peritoneal
contents. This was immediately reconstructed with a rectus femoris
myocutaneous flap. Her postoperative course and healing were uneventful.
CONCLUSION: This technique is an alternative method for vulvar
reconstruction. It is especially useful for large defects when a
gracilis or rectus abdominis flap is not available.
6
UI - 11925150
AU - Moore RG; Steinhoff MM; Granai CO; DeMars LR
TI -
Vulvar epithelioid sarcoma in pregnancy.
SO - Gynecol Oncol 2002 Apr;85(1):218-22
AD - Department of Obstetrics and Gynecology, Program in Women's Oncology,
Brown University, Providence, Rhode Island 02905, USA. rmoore@wihri.org
BACKGROUND: Epithelioid sarcoma is a soft tissue tumor rarely found
centrally and even less commonly on the vulva. Vulvar sarcoma in
pregnancy is also exceedingly rare with only five cases reported to
date, none of which have been an epithelioid sarcoma. CASE: We report a
case of a 29-year-old woman presenting with a vulvar epithelioid sarcoma
at 36 weeks of gestation. The patient underwent a radical resection 6
weeks postpartum followed by chemotherapy. Despite a radical
hemivulvectomy and doxorubicin and ifosfamide chemotherapy, she
developed pulmonary metastasis and died of tumor-related pulmonary
failure secondary to her disease 612 months after diagnosis. To our
knowledge this is the first case of a vulvar epithelioid sarcoma
presenting during pregnancy. The English literature is reviewed and a
total of 18 previous cases of vulvar epithelioid sarcoma have been
reported outside of pregnancy. Insight into the biological behavior and
therapeutic management of this disease is discussed. CONCLUSION: The
optimal management of vulvar epithelioid sarcoma remains to be
determined. However, it would seem that early and aggressive surgical
resection provides the best possibility for cure. The role of radiation
and/or chemotherapy remains to be determined.
7
UI - 11925122
AU - Todd RW; Etherington IJ; Luesley DM
TI -
The effects of 5% imiquimod cream on high-grade vulval intraepithelial
neoplasia.
SO - Gynecol Oncol 2002 Apr;85(1):67-70
AD - Birmingham Women's NHS Trust, Edgbaston, Birmingham, B15 2TG, United
Kingdom. r.w.todd@bham.ac.uk
OBJECTIVES: The aim of this study was to investigate the effects of
topical 5% Imiquimod (3M Pharmaceuticals, St. Paul, Minnessota) on
high-grade vulval intraepithelial neoplasia (VIN). METHODS: A
prospective uncontrolled observational study was performed. Fifteen
patients with histologically confirmed VIN 3 were asked to
self-administer 5% Imiquimod cream to their vulval lesions up to three
times weekly for 16 weeks. Review was conducted at 1, 2, 3, 4, 6, and 9
months postrecruitment. Lesions were photodocumented and at 4 months any
areas demonstrating a clinical response were biopsied. RESULTS: Of 15
patients recruited, 4 demonstrated a clinical improvement in their
disease, 3 of whom had negative biopsies posttreatment. Local side
effects limited the frequency of application such that 7 patients
applied the cream once weekly, 6 twice weekly, and 2 three times weekly.
CONCLUSIONS: 5% Imiquimod cream appears to have an effect when used on
high-grade VIN. The frequency of application was limited by local side
effects which may have reduced the clinical responses seen. Measures to
alleviate local side effects may allow more aggressive use of Imiquimod
and lead to improved responses.
8
UI - 11979073
AU - Santos-Briz A; Antunez P; Lopez-Rios F; Rodriguez-Peralto JL; Garzon A
TI -
Human papillomavirus-negative spindle cell carcinoma of the vulva
associated with lichen sclerosus: case report and literature review.
SO - Am J Dermatopathol 2002 Apr;24(2):135-8
AD - Departaments of Pathology, Hospital Universitario 12 de Octubre, Madrid,
Spain.
Although spindle cell carcinoma (SC) is a common neoplasm in the oral
cavity, upper respiratory tract, and other head and neck areas, its
occurrence in the vulva is rare. We report a case of this rare condition
with immunohistochemical, ultrastructural, and human papillomavirus
(HPV) testing. The neoplastic cells were positive for vimentin, keratins
(AE1-AE3, keratin 902, and keratin 903), and epithelial membrane
antigen. Ultrastructurally, they showed primitive junctions and
tonofilaments. HPV testing by polymerase chain reaction was negative. In
addition, we review the clinicopathologic findings of the four
well-documented cases of vulvar SC that have been reported previously in
the English language literature.
9
UI - 11982258
AU - Anonymous
TI -
Vulvar pain may signal cancer.
SO - AWHONN Lifelines 2001 Jun-Jul;5(3):19
10
UI - 11904476
AU - Girardi F; Pickel H; Joura EA; Breitenecker G; Gitsch G; Graf AH;
TI -
Neunteufel W
[Guidelines for diagnosis and therapy of intraepithelial neoplasia and
early invasive carcinoma of the female lower genital system (cervix
uteri, vagina, vulva) established by the AGK (Colposcopy Work Group in
the OGGG [Austrian Society of Gynecology and Obstetrics])]
SO - Gynakol Geburtshilfliche Rundsch 2001;41(3):197-200
AD - Abteilung fur Gynakologie und Geburtshilfe, A. o. KH Baden, Osterreich.
11
UI - 11912413
AU - O'Connor RC; Hollowell CM; Laven BA; Yang XJ; Steinberg GD; Zagaja GP
TI -
Recurrent giant cell carcinoma of the bladder.
SO - J Urol 2002 Apr;167(4):1784
AD - Section of Urology, Department of Surgery, University of Chicago
Hospitals, Chicago, Illinois, USA.
12
UI - 11953073
AU - Kong W; Sun J
TI -
[Outcome with intracavitary high-dose-rate brachytherapy for primary
vaginal cancer]
SO - Zhonghua Fu Chan Ke Za Zhi 2002 Feb;37(2):94-6
AD - Department of Gynecology, Beijing Obstetric and Gynecology Hospital,
Affiliated to Medical Science of Capital University, Beijing 100021,
China.
OBJECTIVE: To evaluate the efficacy of radiation therapy on primary
vaginal cancer with high-dose-rate brachytherapy alone or in combination
with external radiation. METHODS: Fifty one cases with primary vaginal
cancer who were treated with high-dose-rate brachytherapy alone or in
combination with the external radiation in Cancer Hospital, Chinese
Academy of Medical Sciences from 1989 to 1999 were retrospectively
studied, including stage I 10 cases, stage II 13 cases, stage III 23
cases and stage IV 5 cases. WD-HDR18 after-loading equipment was used in
the brachytherapy and 6 or 8 MV linear accelerator was used in the
external radiation. RESULTS: The overall 5-year survival rate with
WD-HDR18 was 58.8%, with 80.0% for stage I, 76.9% for stage II, 65.2%
for stage III, and 0.0% for stage IV. The comparison of treatments with
WD-HDR18 and radium therapy showed the 5-year survival rates of the
cases of each stage treated with WD-HDR18 were higher. CONCLUSION:
Treatment results obtained with high-dose-rate brachytherapy are at
least similar to traditional radium therapy for primary vaginal cancer.
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