scholarly journals Small Cell Neuroendocrine Cervical Carcinoma: A Case Report

2021 ◽  
Author(s):  
Malihe Hasanzadeh ◽  
Nooshin Babapour ◽  
Marjaneh Farazestanian ◽  
Farzaneh Hashem Niay Torshizi
Keyword(s):  
Cervical Cancer ◽  
Case Report ◽  
Neuroendocrine Tumor ◽  
Cervical Carcinoma ◽  
Radical Hysterectomy ◽  
Survival Rates ◽  
Small Cell ◽  
Therapeutic Approaches ◽  
Vaginal Cuff ◽  
Cervical Tumors

Objective: Small cell neuroendocrine cervical carcinoma is a neuroendocrine tumor with the great aggravation that comprises 0.5 to 3 percent of cervical tumors and progresses rapidly with early lymphogenous and hematogenous metastases. Case report: We reported a 40 years old woman with cervical cancer in stage IB2 that had radical hysterectomy with mistaken diagnosis of squamous cervical cancer. The disease has progressed after 50 days of surgery with a 6 cm tumor in vaginal cuff; review of pathology demonstrated small cell neuroendocrine cervical carcinoma. Conclusion: Recognition of this separate histopathological entity with IHC analysis is important. Chemoradiotherapy and multimodality therapeutic approaches could improve the survival rates.  

scholarly journals The value of sentinel lymphadenectomy in radical operative treatment of cervical cancer

2009 ◽  
Vol 66 (7) ◽  
pp. 539-543 ◽  
Author(s):  
Vladimir Pazin ◽  
Svetlana Dragojevic ◽  
Zeljko Mikovic ◽  
Milan Djukic ◽  
Snezana Rakic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Sentinel Node ◽  
Cervical Carcinoma ◽  
Radical Hysterectomy ◽  
Predictive Value ◽  
Sentinel Nodes ◽  
Sentinel Lymphadenectomy ◽  
Stage Ib ◽  
The Mean

Background/Aim. Therapy of the early stages of cervical carcinoma is surgical or radiation therapy, and for advanced stages chemoradiotherapy. Pelvic and paraaortic lymphadenectomy in early stages offers the most important prognostic factor for survival. To evaluate the method and possible influence on surgical staging and therapy of the disease, we performed sentinel node (SN) identification and excision during open radical hysterectomy and lymphadenectomy in stage Ib-IIa cervical carcinoma. Methods. Fifty patients initially diagnosed with invasive squamous-cell cervical cancer stage Ib-IIa were included in the study. Only blue dye was used for sentinel node mapping. During the surgery sentinel nodes were identified and sent to histopathology separately from the other lymph nodes. After lymphadenectomy, radical hysterectomy was performed. Results. The mean age of our fifty patients was 49.10 years (SD = 5.92), and the mean number of extracted lymph nodes per patient was 25.78 (SD = 5.58). The number of sentinel nodes identified per patient was between 0 and 5, mean 2.60 (SD = 1.54). There were no inframesenteric paraaortic sentinel nodes found among the patients. The dominant tumor grades were 1 and 2, 40% and 50% respectively, and 37 out of 50 patients (74%) had tumor diameter less than 2 cm. In four patients (8%) SN were not identified. In the rest of 46 patients the presence of SN was bilateral (19 patients, 38%) or unilateral (27 patients, 54%). Positive SN were found in 17 patients (34%), and negative in 29 patients (58%). Out of the whole group of patients (50), 21 of them (42%) had positive lymph nodes (LN). In the crosstab statistics, no differences were noticed in the group without SN found, in comparison with tumor grade and diameter. Finally, our test showed sensitivity of 85% (SE = 8%), specificity 100%, positive predictive value of 100%, negative predictive value of 89.6% (SE = 5.6%), and effectiveness of 93% (SE = 3.6%) regarding sentinel lymphadenectomy. Conclusion. This method of sentinel lymph node identification is simple, but not reliable enough to support further laparoscopic SN excision in order to make the final decision about the treatment of cervical cancer.

scholarly journals Internal hernia beneath superior vesical artery after pelvic lymphadenectomy for cervical cancer: a case report and literature review

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Ai ◽  
Zhihua Liang ◽  
Feng Li ◽  
Haihua Yu
Keyword(s):  
Cervical Cancer ◽  
Case Report ◽  
Literature Review ◽  
Internal Hernia ◽  
Radical Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
Case Presentation ◽  
The Common ◽  
Laparoscopic Pelvic Lymphadenectomy ◽  
The Right

Abstract Background The common complications of radical hysterectomy and pelvic lymphadenectomy usually include wound infection, hemorrhage or hematomas, lymphocele, uretheral injury, ileus and incisional hernias. However, internal hernia secondary to the orifice associated with the uncovered vessels after pelvic lymphadenectomy is very rare. Case presentation We report a case of internal hernia with intestinal perforation beneath the superior vesical artery that occurred one month after laparoscopic pelvic lymphadenectomy for cervical cancer. A partial ileum resection was performed and the right superior vesical artery was transected to prevent recurrence of the internal hernia. Conclusions Retroperitonealization after the pelvic lymphadenectomy should be considered in patients with tortuous, elongated arteries which could be causal lesions of an internal hernia.

The prognostic factors responsible for survival of women with neuroendocrine small-cell cervical carcinoma—A study of 188 women

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5539-5539
Author(s):  
D. S. Kapp ◽  
J. Cohen ◽  
J. Y. Shin ◽  
A. Husain ◽  
N. N. Teng ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Cervical Carcinoma ◽  
Radical Hysterectomy ◽  
Small Cell ◽  
Stage I ◽  
Poor Prognostic Factor ◽  
Cox Regression Analysis ◽  
Stage Of Disease ◽  
Initial Surgery

5539 Background: To determine the clinical and pathological factors associated with survival in women with neuroendocrine small-cell cervical carcinoma. Methods: A review of the literature identified 136 patients with neuroendocrine small-cell carcinoma and an additional 52 patients identified from tumor registry databases at four hospitals. Survival analyses and predictors of outcome were analyzed using Kaplan-Meier method and Cox regression analysis. Results: Of 188 patients, the median age was 41.5 years (range: 20–87 years); 135 had stages I-IIA, 45 IIB-IVA, and 8 had stage IVB disease. Of all patients, 55.3% underwent primary surgery, 16.0% had chemoradiation therapy, 12.8% primary radiation therapy, 3.2% chemotherapy alone, and 12.8% had unknown or no primary treatment. Of the women who had initial surgery, 46.8% patients underwent a radical hysterectomy, and 6.4% had a simple hysterectomy. 49.5% of patients with nodal information had lymph node metastases. After initial surgery, 15.4% of all patients had adjuvant radiation therapy, 13.8% chemoradiation, 6.9% chemotherapy, and 2.1% had neoadjuvant chemoradiation. Of the 81 patients who received chemotherapy, 51.9% had etoposide and cisplatin combinations, 25.9% other cisplatin combinations, and 7.4% had cisplatin alone. The 5-year disease-specific survivals for those stage I-IIA, IIB-IVA, and IVB were 36.8%, 9.8%, and 0.0%, respectively (p<0.001). Those with tumors <2 cm showed a trend toward better survival (67.4% vs. 34.4%) compared to those with larger tumors (p=0.057). Women with stage I-IIA disease who underwent a radical hysterectomy had a survival of 42.5% vs. 38.4% without radical surgery. Chemotherapy (adjuvant or radiation sensitizer) was associated with improved survival in patients with stages IIB-IVA disease compared to those who did not receive chemotherapy (17.8% vs. 6.0%; p=0.043). On multivariable analysis, early stage of disease and chemotherapy were independent prognostic factors for improved survival. Conclusions: Advanced stage of disease is a poor prognostic factor for survival in neuroendocrine small-cell cancer of the cervix. Chemotherapy appears to offer a survival advantage, particularly in patients with stage IIB-IVA disease. No significant financial relationships to disclose.

Surgical treatment for early cervical cancer: Experience at a cancer hospital in Nepal

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16575-e16575
Author(s):  
G. Dangal
Keyword(s):  
Cervical Cancer ◽  
Postoperative Complications ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Cervical Carcinoma ◽  
Radical Hysterectomy ◽  
Chief Complaint ◽  
Duration Of Hospital Stay ◽  
Cancer Hospital ◽  
Early Cervical Cancer

e16575 Background: The purpose of this study was to find out the clinocopathologic characteristics, post-operative findings and complications of patients with early (up to stage IIA) cervical carcinoma who underwent radical hysterectomy. This study concentrates on the evaluation of our early experience in radical hysterectomy for cervical cancer in Nepal. Methods: This was a retrospective analysis of 48 patients who had radical hysterectomy with bilateral pelvic lymphadenectomy for early cervical cancer at the BP Koirala Memorial Cancer Hospital (BPKMCH) from September 2002 through September 2005. Characteristics such as chief complaint, disease staging and duration, intraoperative and postoperative complications, histopathological findings, need for blood transfusion, and duration of hospital stay were considered for analysis. Results: Patients’ age ranged from 28–67 years. Age group of 40–49 had highest number of patients (58.3%). Majority (62.5%) were premenopausal women who presented with abnormal vaginal bleeding (73%) as the chief complaint. More than half of them (56%) had FIGO stage IIA disease. Thirty-three percent had intraoperative and postoperative complications such as urinary problems, wound infection and vessel injury/ureteric injury. All needed blood transfusion, 42% needing four pints. The average duration of hospital stay was 11 days. Forty-four had squamous cell carcinoma and four had adenocarcinoma. Pelvic lymph node metastasis was found in 10 patients. Resected margins were adequate in 42 patients. Majority (62.5%) of the women were premenopausal and 56% of them had stage IIA disease. Conclusions: Although the primary treatment of early-stage cervical carcinoma involves either surgery or radiation therapy with or without chemotherapy, surgery (radical hysterectomy) was used for lower-stage disease and smaller lesions in fit and young patients in our resource-poor set-up. The complication rate seems to be higher in Nepal; however, it will decrease as more experience is gained. No significant financial relationships to disclose.

scholarly journals Treatment of cervical cancer in the Republic of Srpska

2011 ◽  
Vol 64 (11-12) ◽  
pp. 588-591 ◽  
Author(s):  
Nenad Lucic ◽  
Zora Antonic ◽  
Vesna Ecim ◽  
Dragica Draganovic ◽  
Ljiljana Latinovic
Keyword(s):  
Cervical Cancer ◽  
Postoperative Complications ◽  
Radical Hysterectomy ◽  
Invasive Cervical Cancer ◽  
Figo Stage ◽  
International Federation ◽  
Gynecology And Obstetrics ◽  
The Republic ◽  
Banja Luka ◽  
Cervical Tumors

Introduction. Since 1897, when the first radical hysterectomy with lymphadenectomy was done by Wertheim in Vienna, this operation has had the central role in the surgical treatment of invasive cervical tumors. Material and methods. In the period from 1997 to 2010, 177 patients diagnosed with invasive cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 - II were operated at the Department of Obstetrics and Gynecology in Banja Luka. All patients underwent radical hysterectomy by Wertheim - Meigs. The aim of this study is to present the technique of this operation, as well as its effectiveness in the treatment of cervical cancer. Results. The distribution of the patients having invasive cervical cancer according to the International Federation of Gynecology and Obstetrics classification was as follows: I B1 - 35.67%, I B2 - 23.17%, II A - 15.48%, II B - 25.68% on average is 21.3 removed lymph glands. The rate of intraoperative and postoperative complications was 8 (4.51%) and 17 (9.60%), respectively. Of the 26 patients who were operated in the period from 2005 - 2010, 13 had stage II B according to the International Federation of Gynecology and Obstetrics; there were 6 lethal outcomes (23.08) and the five-year survival rate was 76.92%. Discussion and conclusion. By applying the proper surgical technique and early prevention of immediate complications, we achieved satisfactory results in operative morbity and mortality, intraoperative and postoperative complications of the lesion for radical surgery by the Wertheim- Meigs-in the treatment of cancer of the uterus in the I B - II B stage according to the International Federation of Gynecology and Obstetrics classification.

scholarly journals Outcomes of Patients Undergoing Radical Hysterectomy for Cervical Cancer of High-Risk Histological Subtypes

2011 ◽  
Vol 21 (1) ◽  
pp. 123-127 ◽  
Author(s):  
Sonika Agarwal ◽  
Kathleen M. Schmeler ◽  
Pedro T. Ramirez ◽  
Charlotte C. Sun ◽  
Alpa Nick ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Radical Hysterectomy ◽  
Clear Cell ◽  
Early Stage ◽  
Small Cell ◽  
Adjuvant Radiation ◽  
Grade 3 ◽  
Worse Prognosis

Background:The most common types of cervical cancer are squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma, referred to here collectively as SA cervical cancer. Other types of cervical cancer, referred to here collectively as nonsquamous/nonadenocarcinoma (NSNA) cervical cancer, include neuroendocrine, small cell, clear cell, sarcomatoid, and serous tumors. Anecdotally, NSNA tumors seem to have a worse prognosis than their SA counterparts. We sought to determine whether patients with early-stage NSNA have a worse prognosis than those with early-stage SA cervical cancer.Methods:We retrospectively reviewed charts of women with stage IA1-IB2 NSNA cervical cancer treated by radical hysterectomy and lymph node staging at M. D. Anderson Cancer Center from 1990 to 2006. The NSNA patients were matched 1:2 to patients with grade 3 SA lesions on the basis of stage, age at diagnosis, tumor size, and date of diagnosis.Results:Eighteen patients with NSNA primary cervical cancer subtypes (neuroendocrine [n = 7], small cell [n = 5], clear cell [n = 4], papillary serous [n = 1], and sarcomatoid [n = 1]) were matched to 36 patients with grade 3 SA lesions. There were no differences between the 2 groups in age, body mass index, clinical stage, or lesion size. The 2 groups also did not differ with respect to number of nodes resected, lymphovascular space invasion, margin status, lymph node metastasis, or adjuvant radiation therapy or chemotherapy. At a median follow-up of 44 months, median progression-free and overall survivals had not been reached; however, both progression-free survival (P= 0.018) and overall survival (P= 0.028) were worse for the NSNA group. The 5-year progression-free and overall survival rates were 61.2% and 67.6%, respectively, for the NSNA group, compared with 90.1% and 88.3%, respectively, for the SA group.Conclusions:Patients with early-stage NSNA cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy have a worse prognosis than patients with grade 3 SA lesions. Patients with NSNA tumors may require a multimodality approach to their cancer care.

scholarly journals An Alternative Treatment for Vaginal Cuff Wart: a Case Report

2020 ◽  
Vol 63 (1) ◽  
pp. 49-51
Author(s):  
Victoria Psomiadou ◽  
Christos Iavazzo ◽  
Athanasios Douligeris ◽  
Alexandros Fotiou ◽  
Anastasia Prodromidou ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Case Report ◽  
Aloe Vera ◽  
Immunological Response ◽  
Hpv Infection ◽  
Vaginal Cuff ◽  
Significant Treatment ◽  
Postmenopausal Patient ◽  
History Of ◽  
Methods Of Treatment

Human papillomavirus (HPV) has been directly related to acuminate warts and cervical cancer, the second most common neoplasia among women. Given the lack of treatment against the virus itself, many medications have been utilised, mainly aiming in modifying the host’s immunological response. We present the case of a 54 years old postmenopausal patient with a history of vaginal cuff wart and HPV persistence that we managed in our clinic for 6 months with a mix of curcumin, aloe vera, amla and other natural ingredients. As the patient was found to be intolerant to imiquimod (one of the most common conservative methods of treatment) we attempted the use of curcumin, which was applied to the area of the wart three times per week for 6 months. Both clinical and colposcopical improvement was noted in regular clinic visits with regression of the lesion. The outcome of this case encourages our view that curcumin should be considered as a significant treatment modality against HPV infection and acuminate warts.

scholarly journals Retrospective Analysis of Cervical Cancer Treatment Outcomes: Ten Years of Experience with the Vaginal Assisted Radical Laparoscopic Hysterectomy VARLH

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
R. Wojdat ◽  
E. Malanowska
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Invasive Cervical Cancer ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Laparoscopic Approach ◽  
Laparoscopic Hysterectomy ◽  
Study Results ◽  
Early Stage Cervical Cancer

Background. LACC trial demonstrated inferiority of laparoscopic approach for the treatment of early-stage cervical cancer. There are still limited data from retrospective trials regarding whether survival outcomes after laparoscopic radical hysterectomy are equivalent to those after open abdominal radical hysterectomy. In this study, we present results of combined vaginal radical laparoscopic hysterectomy in the treatment of early-stage cervical cancer. Methods. This retrospective study was carried out at the Department of Gynecology in Mathilden Hospital (Herford, Germany). Between January 2008 and April 2018, all the patients with invasive cervical cancer who underwent combined vaginal assisted radical laparoscopic hysterectomy (VARLH) without the use of any uterine manipulator were enrolled to the study. Results. A total number of 124 patients with diagnosis of invasive cervical cancer were enrolled in the study. All of the patients underwent minimally invasive surgery and were divided according to FIGO 2019: stage IA (25.9%), IB1 (25.0%), IB2-IIB (28.4%), and III/IV (20.7%). Overall, the mean age of the patients was 51.84 years. After a study collection, a median follow-up was 45.6 (range 23.7-76.5) months. The 3- and 5-year disease-free survival rates for early-stage cervical cancer were both 98%, and the 3- and 5-year overall survival rates were 100% and 97%, respectively. We have not observed any recurrence in our study group of patients with early-stage cervical cancer. Conclusions. Combined VARLH can be considered a safe and effective procedure for the treatment of early-stage cervical cancer. Surgical strategy with oncological principles determines the quality and long-term success of the operation in early cervical cancer regardless of laparoscopic approach.

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