Pembrolizumab in Vaginal and Vulvar Squamous Cell Carcinoma: a Case Series from a Phase II Basket Trial Jefrey A
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Ovarian Cancer and Cervical Cancer
What Every Woman Should Know About Gynecologic Cancer R. Kevin Reynolds, MD The George W. Morley Professor & Chief, Division of Gyn Oncology University of Michigan Ann Arbor, MI What is gynecologic cancer? Cancer is a disease where cells grow and spread without control. Gynecologic cancers begin in the female reproductive organs. The most common gynecologic cancers are endometrial cancer, ovarian cancer and cervical cancer. Less common gynecologic cancers involve vulva, Fallopian tube, uterine wall (sarcoma), vagina, and placenta (pregnancy tissue: molar pregnancy). Ovary Uterus Endometrium Cervix Vagina Vulva What causes endometrial cancer? Endometrial cancer is the most common gynecologic cancer: one out of every 40 women will develop endometrial cancer. It is caused by too much estrogen, a hormone normally present in women. The most common cause of the excess estrogen is being overweight: fat cells actually produce estrogen. Another cause of excess estrogen is medication such as tamoxifen (often prescribed for breast cancer treatment) or some forms of prescribed estrogen hormone therapy (unopposed estrogen). How is endometrial cancer detected? Almost all endometrial cancer is detected when a woman notices vaginal bleeding after her menopause or irregular bleeding before her menopause. If bleeding occurs, a woman should contact her doctor so that appropriate testing can be performed. This usually includes an endometrial biopsy, a brief, slightly crampy test, performed in the office. Fortunately, most endometrial cancers are detected before spread to other parts of the body occurs Is endometrial cancer treatable? Yes! Most women with endometrial cancer will undergo surgery including hysterectomy (removal of the uterus) in addition to removal of ovaries and lymph nodes. -
Vaginal and Vulvar Cancer 10.1136/Ijgc-2020-ESGO.178
Int J Gynecol Cancer: first published as 10.1136/ijgc-2020-ESGO.177 on 4 December 2020. Downloaded from Abstracts 520 LONG TERM FOLLOW UP AFTER DIAGNOSIS OF Introduction/Background Since the introduction of the S2K GESTATIONAL TROPHOBLASTIC DISEASE AWMF guideline-based sentinel node biopsy technique in uni- focal vulvar cancer (diameter of <4 cm) and unsuspicious Pedro Corvelo Freitas, Beatriz Mira, António Guimarães, Ana Opinião, Hugo Nunes, Ana Francisca Jorge, Fátima Vaz, António Moreira. Instituto Português de Oncologia de Lisboa groin lymph nodes, the morbidity rate of patients has signifi- Francisco Gentil cantly decreased in Germany. The groin recurrence rate after IFL is vary from 0% to 5.8%, in contrast to 2.3% (95% CI, 10.1136/ijgc-2020-ESGO.176 0.6% to 5%) in unifocal vulvar cancer vs 3% (95% CI, 1% to 6%) in multifocal vulvar cancer after SLNB only, as sug- Introduction/Background The spectrum of Gestational tropho- gested in the GRoningen INternational Study on Sentinel blastic disease (GTD) ranges from pre-malignant conditions of node in Vulvar cancer (GROINSS-V-I) in 2008. Current guide- complete (CHM) and partial (PHM) hydatidiform moles to the lines suggest that in cases of metastasis of unilateral sentinel malignant invasive mole, choriocarcinoma (CC) and very rare lymph node (SLN) biopsy (B), groin node dissection, namely placental site trophoblastic tumour/epithelioid trophoblastic inguinofemoral lymphadenectomy (IFL), should be performed tumour (PSTT/ETT). Gestational trophoblastic neoplasia (GTN) bilaterally. However, a publication by Woelber et al. in Ger- are highly responsive to chemotherapy (CT) and with appropri- many and and Nica et al. -
Primary Immature Teratoma of the Thigh Fig
CORRESPONDENCE 755 8. Gray W, Kocjan G. Diagnostic Cytopathology. 2nd ed. London: Delete all that do not apply: Elsevier Health Sciences, 2003; 677. 9. Richards A, Dalrymple C. Abnormal cervicovaginal cytology, unsatis- Cervix, colposcopic biopsy/LLETZ/cone biopsy: factory colposcopy and the use of vaginal estrogen cream: an obser- vational study of clinical outcomes for women in low estrogen states. Diagnosis: NIL (No intraepithelial lesion WHO 2014) J Obstet Gynaecol Res 2015; 41: 440e4. LSIL (CIN 1 with HPV effect WHO 2014) 10. Darragh TM, Colgan TJ, Cox T, et al. The lower anogenital squamous HSIL (CIN2/3 WHO 2014) terminology standardization project for HPV-associated lesions: back- Squamous cell carcinoma ground and consensus recommendation from the College of American Immature squamous metaplasia Pathologists and the American Society for Colposcopy and Cervical Adenocarcinoma in situ (AIS, HGGA) e Adenocarcinoma Pathology. Arch Pathol Lab Med 2012; 136: 1267 97. Atrophic change 11. McCluggage WG. Endocervical glandular lesions: controversial aspects e Extending into crypts: Not / Idenfied and ancillary techniques. J Clin Pathol 2013; 56: 164 73. Epithelial stripping: Not / Present 12. World Health Organization (WHO). Comprehensive Cervical Cancer Invasive disease: Not / Idenfied / Micro-invasive Control: A Guide to Essential Practice. 2nd ed. Geneva: WHO, 2014. Depth of invasion: mm Transformaon zone: Not / Represented Margins: DOI: https://doi.org/10.1016/j.pathol.2019.07.014 Ectocervical: Not / Clear Endocervical: Not / Clear Circumferenal: Not / Clear p16 status: Negave / Posive Primary immature teratoma of the thigh Fig. 3 A proposed synoptic reporting format for pathologists reporting colposcopic biopsies and cone biopsies or LLETZ. Sir, Teratomas are germ cell tumours composed of a variety of HSIL, AIS, micro-invasive or more advanced invasive dis- somatic tissues derived from more than one germ layer 12 ease. -
Squamous Cell Carcinoma Arising in an Ovarian Mature Cystic Teratoma
Case Report Obstet Gynecol Sci 2013;56(2):121-125 http://dx.doi.org/10.5468/OGS.2013.56.2.121 pISSN 2287-8572 · eISSN 2287-8580 Squamous cell carcinoma arising in an ovarian mature cystic teratoma complicating pregnancy Nae-Ri Yun1, Jung-Woo Park1, Min-Kyung Hyun1, Jee-Hyun Park1, Suk-Jin Choi2, Eunseop Song1 Departments of 1Obstetrics and Gynecology and 2Pathology, Inha University College of Medicine, Incheon, Korea Mature cystic teratomas of the ovary (MCT) are usually observed in women of reproductive age with the most dreadful complication being malignant transformation which occurs in approximately 1% to 3% of MCTs. In this case report, we present a patient with squamous cell carcinoma which developed from a MCT during pregnancy. The patient was treated conservatively without adjuvant chemotherapy and was followed without evidence of disease for more than 60 months using conventional tools as well as positron emission tomography-computed tomography following the initial surgery. We report this case along with the review of literature. Keywords: Dermoid cyst; Malignant transformation; Observation; Positron emission tomography-computed tomography Introduction An 18 cm solid and cystic left ovarian mass with a smooth surface and two small right ovarian cysts were detected re- The incidence of adnexal masses during pregnancy is 1% to sulting in a laparotomy at 13 weeks of gestation and left sal- 9% [1]. Mature cystic teratomas (MCT) are common during pingo-oophorectomy and right ovarian cystectomy (Fig. 1C). pregnancy with the most dreadful complication being ma- The report of the frozen section from both tissues revealed lignant transformation which occurs in approximately 1% to MCT. -
Gynecological Malignancies in Aminu Kano Teaching Hospital Kano: a 3 Year Review
Original Article Gynecological malignancies in Aminu Kano Teaching Hospital Kano: A 3 year review IA Yakasai, EA Ugwa, J Otubu Department of Obstetrics and Gynecology, Aminu Kano Teaching Hospital, Kano and Center for Reproductive Health Research, Abuja, Nigeria Abstract Objective: To study the pattern of gynecological malignancies in Aminu Kano Teaching Hospital. Materials and Methods: This was a retrospective observational study carried out in the Gynecology Department of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria between October 2008 and September 2011. Case notes of all patients seen with gynecological cancers were studied to determine the pattern, age and parity distribution. Results: A total of 2339 women were seen during the study period, while 249 were found to have gynecological malignancy. Therefore the proportion of gynecological malignancies was 10.7%. Out of the 249 patients with gynecological malignancies, most (48.6%) had cervical cancer, followed by ovarian cancer (30.5%), endometrial cancer (11.25%) and the least was choriocarcinoma (9.24%). The mean age for cervical carcinoma patients (46.25 ± 4.99 years) was higher than that of choriocarcinoma (29 ± 14.5 years) but lower than ovarian (57 ± 4.5years) and endometrial (62.4 ± 8.3 years) cancers. However, the mean parity for cervical cancer (7.0 ± 3) was higher than those of ovarian cancer (3 ± 3), choriocarcinoma (3.5 ± 4) and endometrial cancer (4 ± 3). The mean age at menarche for women with cervical cancer (14.5 ± 0.71 years) was lower than for those with choriocarcinoma (15 ± 0 years), ovarian (15.5 ± 2.1 years) and endometrial (16 ± 0 years) cancers. -
Influence of Age on Histologic Outcome of Cervical Intraepithelial Neoplasia
www.nature.com/scientificreports OPEN Infuence of age on histologic outcome of cervical intraepithelial neoplasia during observational Received: 10 May 2017 Accepted: 6 April 2018 management: results from large Published: xx xx xxxx cohort, systematic review, meta- analysis Christine Bekos1, Richard Schwameis1, Georg Heinze2, Marina Gärner1, Christoph Grimm1, Elmar Joura1,4, Reinhard Horvat3, Stephan Polterauer1,4 & Mariella Polterauer1 Aim of this study was to investigate the histologic outcome of cervical intraepithelial neoplasia (CIN) during observational management. Consecutive women with histologically verifed CIN and observational management were included. Histologic fndings of initial and follow-up visits were collected and persistence, progression and regression rates at end of observational period were assessed. Uni- and multivariate analyses were performed. A systematic review of the literature and meta-analysis was performed. In 783 women CIN I, II, and III was diagnosed by colposcopically guided biopsy in 42.5%, 26.6% and 30.9%, respectively. Younger patients had higher rates of regression (p < 0.001) and complete remission (< 0.001) and lower rates of progression (p = 0.003). Among women aged < 25, 25 < 30, 30 < 35, 35 < 40 years, and > 40 years, regression rates were 44.7%, 33.7%, 30.9%, 27.3%, and 24.9%, respectively. Pooled analysis of published data showed similar results. Multivariable analysis showed that with each fve years of age, the odds for regression reduced by 21% (p < 0.001) independently of CIN grade (p < 0.001), and presence of HPV high-risk infection (p < 0.001). Patient’s age has a considerable infuence on the natural history of CIN – independent of CIN grade and HPV high- risk infection. -
Clinical Radiation Oncology Review
Clinical Radiation Oncology Review Daniel M. Trifiletti University of Virginia Disclaimer: The following is meant to serve as a brief review of information in preparation for board examinations in Radiation Oncology and allow for an open-access, printable, updatable resource for trainees. Recommendations are briefly summarized, vary by institution, and there may be errors. NCCN guidelines are taken from 2014 and may be out-dated. This should be taken into consideration when reading. 1 Table of Contents 1) Pediatrics 6) Gastrointestinal a) Rhabdomyosarcoma a) Esophageal Cancer b) Ewings Sarcoma b) Gastric Cancer c) Wilms Tumor c) Pancreatic Cancer d) Neuroblastoma d) Hepatocellular Carcinoma e) Retinoblastoma e) Colorectal cancer f) Medulloblastoma f) Anal Cancer g) Epndymoma h) Germ cell, Non-Germ cell tumors, Pineal tumors 7) Genitourinary i) Craniopharyngioma a) Prostate Cancer j) Brainstem Glioma i) Low Risk Prostate Cancer & Brachytherapy ii) Intermediate/High Risk Prostate Cancer 2) Central Nervous System iii) Adjuvant/Salvage & Metastatic Prostate Cancer a) Low Grade Glioma b) Bladder Cancer b) High Grade Glioma c) Renal Cell Cancer c) Primary CNS lymphoma d) Urethral Cancer d) Meningioma e) Testicular Cancer e) Pituitary Tumor f) Penile Cancer 3) Head and Neck 8) Gynecologic a) Ocular Melanoma a) Cervical Cancer b) Nasopharyngeal Cancer b) Endometrial Cancer c) Paranasal Sinus Cancer c) Uterine Sarcoma d) Oral Cavity Cancer d) Vulvar Cancer e) Oropharyngeal Cancer e) Vaginal Cancer f) Salivary Gland Cancer f) Ovarian Cancer & Fallopian -
Incidence and Cost of Anal, Penile, Vaginal and Vulvar Cancer in Denmark Jens Olsen1*, Tine Rikke Jørgensen2, Kristian Kofoed3 and Helle Kiellberg Larsen3
Olsen et al. BMC Public Health 2012, 12:1082 http://www.biomedcentral.com/1471-2458/12/1082 RESEARCH ARTICLE Open Access Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark Jens Olsen1*, Tine Rikke Jørgensen2, Kristian Kofoed3 and Helle Kiellberg Larsen3 Abstract Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods: New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004–2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results: The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. -
WHO Guidelines for Treatment of Cervical Intraepithelial Neoplasia 2–3 and Adenocarcinoma in Situ
WHO guidelines WHO guidelines for treatment of cervical intraepithelial neoplasia 2–3 and adenocarcinoma in situ Cryotherapy Large loop excision of the transformation zone Cold knife conization WHO guidelines WHO guidelines for treatment of cervical intraepithelial neoplasia 2–3 and adenocarcinoma in situ: cryotherapy, large loop excision of the transformation zone, and cold knife conization Catalogage à la source : Bibliothèque de l’OMS WHO guidelines for treatment of cervical intraepithelial neoplasia 2–3 and adenocarcinoma in situ: cryotherapy, large loop excision of the transformation zone, and cold knife conization. 1.Cervical Intraepithelial Neoplasia – diagnosis. 2.Cervical Intraepithelial Neoplasia – therapy. 3.Cervical Intraepithelial Neoplasia – surgery. 4.Adenocarcinoma – diagnosis. 5.Adenocarcinoma – therapy. 6.Cryotherapy – utilization. 7.Conization – methods. 8.Uterine Cervical Neoplasms – prevention and control. 9.Guideline. I.World Health Organization. ISBN 978 92 4 150677 9 (Classification NLM : WP 480) © World Health Organization 2014 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution – should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. -
Vaginal Cancer, Risk Factors, and Prevention Risk Factors for Vaginal
cancer.org | 1.800.227.2345 Vaginal Cancer, Risk Factors, and Prevention Risk Factors A risk factor is anything that affects your chance of getting a disease such as cancer. Learn more about the risk factors for vaginal cancer. ● Risk Factors for Vaginal Cancer ● What Causes Vaginal Cancer? Prevention There's no way to completely prevent cancer. But there are things you can do that might help lower your risk. Learn more here. ● Can Vaginal Cancer Be Prevented? Risk Factors for Vaginal Cancer A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed. But having a risk factor, or even many, does not mean that you will get the disease. And 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 some people who get the disease may not have any known risk factors. Scientists have found that certain risk factors make a woman more likely to develop vaginal cancer. But many women with vaginal cancer don’t have any clear risk factors. And even if a woman with vaginal cancer has one or more risk factors, it’s impossible to know for sure how much that risk factor contributed to causing the cancer. Age Squamous cell cancer of the vagina occurs mainly in older women. It can happen at any age, but few cases are found in women younger than 40. Almost half of cases occur in women who are 70 years old or older. -
After Endometrial Cancer Treatment Living As a Cancer Survivor
cancer.org | 1.800.227.2345 After Endometrial Cancer Treatment Living as a Cancer Survivor For many people, cancer treatment leads to questions about the next steps as a survivor or about the chances of the cancer coming back. ● Living as an Endometrial Cancer Survivor Cancer Concerns After Treatment Treatment may remove or destroy the cancer, but it's very common to worry about the risk of developing another cancer. ● Second Cancers After Endometrial Cancer Living as an Endometrial Cancer Survivor For many women with endometrial cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. (When cancer comes back after treatment, it's called recurrence1.) This is a very common concern in people who have had cancer. 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 For other women, this cancer may never go away completely2. They may get regular treatments with chemotherapy, radiation, or other therapies to try to help keep the cancer in check. Learning to live with cancer that doesn't go away can be difficult and very stressful. Follow-up care When treatment ends, your doctors will still want to watch you closely. It's very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you may have and may do physical exams, blood tests, or x-rays and scans to look for signs of cancer or treatment side effects3. -
Vulvar Cancer Early Detection, Diagnosis, and Staging Detection and Diagnosis
cancer.org | 1.800.227.2345 Vulvar Cancer Early Detection, Diagnosis, and Staging Detection and Diagnosis Finding cancer early -- when it's small and before it has spread -- often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed, but that's not always the case. ● Can Vulvar Cancer Be Found Early? ● Signs and Symptoms of Vulvar Cancers and Pre-Cancers ● Tests for Vulvar Cancer Stages and Outlook (Prognosis) After a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment. ● Vulvar Cancer Stages ● Survival Rates for Vulvar Cancer Questions to Ask About Vulvar Cancer Here are some questions you can ask your cancer care team to help you better understand your cancer diagnosis and treatment options. ● Questions to Ask Your Doctor About Vulvar Cancer 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Can Vulvar Cancer Be Found Early? Having pelvic exams and knowing any signs and symptoms of vulvar cancer greatly improve the chances of early detection and successful treatment. If you have any of the problems discussed in Signs and Symptoms of Vulvar Cancers and Pre-Cancers, you should see a doctor. If the doctor finds anything abnormal during a pelvic examination, you may need more tests to figure out what is wrong. This may mean referral to a gynecologist (specialist in problems of the female genital system). Knowing what to look for can sometimes help with early detection, but it is even better not to wait until you notice symptoms.