RESUMO
A clinical case of placental site trophoblastic tumor, is presented in a patient of 27 years old. Diagnosis, clinical behavior and treatment are emphasized in this very infrequent pathology.
Assuntos
Tumor Trofoblástico de Localização Placentária/patologia , Neoplasias Uterinas/patologia , Adulto , Feminino , Seguimentos , Humanos , GravidezAssuntos
Adenocarcinoma/cirurgia , Laparoscopia , Neoplasias Ovarianas/cirurgia , Idoso , Feminino , Humanos , ReoperaçãoRESUMO
Between 1987 to 1992, nine patients with metastatic ovarian tumors of extragenital origin were analyzed. Seven corresponded to Krükenberg tumors, according to the traditional description of carcinoma with signet-ring cells and stroma with sarcomatoid reaction. The primary neoplasia was detected in 8 patients (89%) and corresponded to: gastric cancer (n = 4), colon cancer (n = 2), gallbladder cancer (n = 1) and breast cancer (n = 1). Mean survival in these patients was 11 months (range 4 to 20 months). Irrespective of their histology and origin, all the lesions were found to share similar macroscopic characteristics: bilateral enlarged ovaries, solid and embossed appearance.
Assuntos
Tumor de Krukenberg/secundário , Neoplasias Ovarianas/secundário , Neoplasias Gástricas/patologia , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Tumor de Krukenberg/patologia , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Estudos RetrospectivosRESUMO
Three hundred and five patients undergoing exploratory laparotomy by adnexial tumors in our institution from January 1987 to October 1992 were studied. The results of the frozen sections vs permanent sections were compared. The diagnosis was concordant in 98.7% of the cases. Sensitivity was 96.9% and specificity was 99.6%. These results consagrate frozen sections as an accuracy and efficient intraoperative diagnostic form in the ovary tumoral pathology.
Assuntos
Secções Congeladas , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
"Second look" laparotomy in ovarian cancer demonstrated negative result in 49%, microscopic positive result in 17%, and macroscopic positive result in 34%. The prediction factors were related with, clinical stage, degree of differentiation and the postsurgical residual tumors after the first operation.
Assuntos
Laparotomia , Neoplasias Ovarianas/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Valor Preditivo dos Testes , Prognóstico , Reoperação , Taxa de SobrevidaRESUMO
Twenty patients bearing lesions caused by human papillomavirus and intraepithelial neoplasia of the lower genital tract and treated with electrosurgical excision of the lesions are presented. The technique used, the benefits of the histopathologic assessment of the specimen, and the changes that this procedure produces in the specimen tissue are analyzed. In general terms, the pre and postoperative diagnosis were concordant and the early and late morbidity was found to be not significative. The efficacy of this therapy in the long term remains to be evaluated.
Assuntos
Eletrocirurgia , Displasia do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/cirurgia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/cirurgia , Infecções Tumorais por Vírus/patologia , Infecções Tumorais por Vírus/cirurgia , Neoplasias do Colo do Útero/patologia , Displasia do Colo do Útero/patologiaRESUMO
The use of long acting gonadotropin-releasing hormone (Gn-RH) agonist produces a reversible hypogonadotropic hypogonadism. This effect has been used as presurgical treatment of uterine myomata, resulting in amenorrhea and reduction in uterus and tumour sizes. We describe the case of a 43 year old patient, having a uterine myoma associated with metrorrhagia, admitted to hospital because of extensive deep phlebothrombosis requiring urgent anticoagulation. Because of the risk of exacerbating metrorrhagia and considering the high morbidity associated to emergency hysterectomy, we decided medical treatment with a depot GnRH agonist (leuprolide acetate 3.75 mg IM monthly). Bleeding ceased within 3 days, allowing the maintenance of anticoagulant treatment. A marked reduction in uterine size postponed total hysterectomy to 3 months later. The characteristics of GnRH analogues, their action mechanisms, adverse effects and other clinical indications are discussed.
Assuntos
Leiomioma/tratamento farmacológico , Leuprolida/uso terapêutico , Metrorragia/tratamento farmacológico , Neoplasias Uterinas/tratamento farmacológico , Adulto , Feminino , Humanos , Histerectomia , Leiomioma/cirurgia , Metrorragia/cirurgia , Indução de Remissão , Neoplasias Uterinas/cirurgiaRESUMO
The accuracy of frozen section biopsy was evaluated determining the deep of myometrial invasion in 30 samples of hysterectomies performed because of endometrial cancer. Results were compared with the definitive biopsy. Two sections were performed guided by the site of largest lesion seen when the uterus was sectioned in a frontal plane. The diagnosis of myometrial invasion was well determined in 29 cases with a 96.6% of accuracy. We conclude that frozen section is an exact and low cost method to determine intraoperatively, deep of myometrial invasion. This method helps the surgeon to decide the extent of surgery, specially if lymphadenectomy is necessary, during staging laparotomy.
Assuntos
Neoplasias do Endométrio/patologia , Cuidados Intraoperatórios , Miométrio/patologia , Biópsia , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Histerectomia , Laparotomia , Excisão de Linfonodo , Invasividade NeoplásicaRESUMO
Twenty seven female patients immunosuppressed after renal transplantation were studied. Cytological, colposcopic and histologic studies of biopsies were used to determine the incidence of neoplastic intraepithelial lesions and those due to infection by human papilloma virus. Intraepithelial neoplasia was found in 7.4% and papilloma virus infection in 60%. Cervix cytology was insensitive (33%) for diagnosis of intraepithelial lesions. Therefore, cytology and colposcopy are recommended for routine follow up of immunosuppressed women.
Assuntos
Carcinoma in Situ/patologia , Neoplasias dos Genitais Femininos/patologia , Hospedeiro Imunocomprometido , Transplante de Rim , Papillomaviridae , Infecções por Papillomavirus/patologia , Infecções Tumorais por Vírus/patologia , Adolescente , Adulto , Carcinoma in Situ/epidemiologia , Chile/epidemiologia , Feminino , Neoplasias dos Genitais Femininos/epidemiologia , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Infecções Tumorais por Vírus/epidemiologiaRESUMO
We present the results on the treatment of 43 patients with epithelial ovarian cancer excluding borderline tumours. Nine cases were FIGO Stage I, 4 FIGO Stage II, 24 FIGO Stage III and 6 FIGO Stage IV. The protocol consists in cytoreductive surgery followed by chemotherapy for Stages I, III, and IV, mainly using cisplatin + cyclophosphamide (PC) or cisplatin + adriamycin + cyclophosphamide (PAC). We used pelvis and whole abdomen radiotherapy for patients on Stage II. The follow up was between 26 and 76 months. The undifferentiated tumours had bad prognosis in Stage I, instead of receiving chemotherapy. Radiotherapy for patients on Stage II reached satisfactory local regional disease control but with late recurrences. On Stage III, size of residual tumour less than 2 cm on primary surgery was of good prognosis (60% 44 months survival). The addition of adriamycin to PC seems to be of no benefit in long term results. The five year actuarial survival was 44% for FIGO Stage I, 75% for FIGO Stage II, 16% for FIGO Stage III and 0% for FIGO Stage IV. These results don't differ significantly from similar protocols.