scholarly journals A Rare Case of Choriocarcinoma following a Normal Pregnancy and Delivery

2017 ◽  
Vol 03 (01) ◽  
pp. 064-066
Author(s):  
C Hariharan ◽  
Shubhada Jajoo ◽  
Anuradha Khemka
Keyword(s):  
Postpartum Hemorrhage ◽  
Histological Study ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Normal Pregnancy ◽  
Abdominal Hysterectomy ◽  
Subsequent Treatment ◽  
Time Interval ◽  
Vaginal Deliveries ◽  
Secondary Postpartum Hemorrhage

Abstract Introduction: Choriocarcinoma is one of the rarest entities encountered in routine obstetric practice. It is usually diagnosed when patient is symptomatic, presenting with either abnormal bleeding per vaginum or symptoms of distant metastases. The presentation of choriocarcinoma as secondary postpartum hemorrhage is a least common scenario. Choriocarcinoma is mostly seen following an abnormal pregnancy, either a partial or complete mole. Case report: A 25-year-old para 3 live 3 patient presented with secondary postpartum hemorrhage on 4th week postpartum. She had two normal full-term vaginal deliveries that were uncomplicated with normal antenatal period. As she presented with secondary postpartum hemorrhage with the thought of retained products of conception, an emergency diagnostic dilatation and curettage was done. Histopathology was suggestive of gestational choriocarcinoma. Patient was given single regimen of methotrexate and subsequently decision of total abdominal hysterectomy was taken and patient was kept in close follow-up. Presently, beta-human chorionic gonadotropin (hCG) is below 2 mIU/mL. Conclusion: The concern is the time interval or delay between the onset of symptoms and diagnosis with subsequent treatment. Although there are a number of reasons of postpartum hemorrhage, simple curettage for histological study and titer serum beta-hCG may lead to early diagnosis and initiation of treatment. Obstetricians and pathologists should have increased awareness regarding the consequences of choriocarcinoma.

The Violated Neck: Cervical Node Biopsy Prior to Definitive Treatment

1986 ◽  
Vol 94 (6) ◽  
pp. 605-610 ◽  
Author(s):  
K. Thomas Robbins ◽  
Randolph Cole ◽  
Jeffrey Marvel ◽  
Robert Fields ◽  
Patricia Wolf ◽  
...  
Keyword(s):  
Distant Metastases ◽  
Subsequent Treatment ◽  
Response To Treatment ◽  
Definitive Treatment ◽  
Wound Complications ◽  
Control Group ◽  
Time Interval ◽  
Adequate Treatment ◽  
Node Biopsy ◽  
Significant Difference

The intent of this study was to determine whether open neck biopsy for patients with squamous cell carcinoma metastatic to the neck influenced the biologic course of the disease or the response to treatment. One hundred ninety-two patients, treated over a 10-year period at M.D. Anderson Hospital and Tumor Institute, were reviewed; 102 of the 139 patients, whose primary site of disease was identified prior to definitive treatment, were matched with a control group of 204 patients. The results showed no significant difference in wound complications, neck recurrence, distant metastases, and 5-year survival. Also, time interval from the biopsy to subsequent treatment and the type of node biopsy did not appear to have any significant detrimental effect. On the basis of these findings, we conclude that, although it is important to refrain from proceeding with an open biopsy until a complete head and neck evaluation has been done, violation of the neck does not signify a poorer prognosis—provided adequate treatment is subsequently given.

scholarly journals Uterine Carcinosarcoma after Prolonged Antiestrogenic Therapy-Pathohistological Characteristics, Immunohistichemical Analysis, Prognosis and Complex Treatment: A case report with literature review

2021 ◽  
Vol 2 (2) ◽  
pp. 01-11
Author(s):  
Lena Marinova ◽  
Bistra Yordanova ◽  
Nikolay Evgeniev
Keyword(s):  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Histological Study ◽  
Immunohistochemical Analysis ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Tamoxifen Treatment ◽  
Peritoneal Cytology ◽  
Uterine Carcinosarcoma ◽  
Invasive Ductal Breast Carcinoma

Uterine carcinosarcoma (UCS) is a rare aggressive neoplasm.We present a clinical case with UCS, developed during along-term five years adjuvant tamoxifen treatment and ovarian suppression with LHRH agonist on the occasion of invasive ductal breast carcinoma. Crucial for obtaining diagnosis of this rare aggressive neoplasm is the strict pathohistological and immunohistochemical analysis, carried out by an experienced pathologist. Every patient with a history of breast carcinoma is a subject for periodic monitoring. Genital bleeding is required to perform a separated endometrial abrasion with a precise histological study. For UCS / III C2 FIGO stage without distant metastases is necessary to conduct a maximal surgical tumor reduction, involving ever total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, peritoneal cytology, and omentectomy, followed by a combined simultaneous chemo-radiotherapy of tumor bed and pelvic lymph nodes, definitive radiotherapy of para-aortical lymph nodes, as well as adjuvant chemotherapy.

Retrospective analysis of 105 cases of uterine sarcoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16079-16079
Author(s):  
A. Yoney ◽  
S. Eskici ◽  
B. Eren ◽  
A. Salman ◽  
M. Unsal
Keyword(s):  
Therapeutic Option ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Sarcoma ◽  
Therapeutic Modality ◽  
Uterine Sarcomas ◽  
Pathologic Classification

16079 Background: Currently there is no randomized study based or widely accepted therapeutic modality in uterine sarcomas which are rare tumors forming a heterogeneous group in respect to their pathologic classification. Methods: In our trial, 105 pts. with uterine sarcoma who were referred to our clinic between years 1995–2003 have been retrospectively researched to evaluate the results in this tumor group. 43.8% had Leiomyosarcoma (LMS), 28.6% had Endometrial Stromal Sarcoma (ESS) and 27.6% had a Malign Mullarian Mixed Tumor (MMMT) while the distribution according to the histological subgroups were found to be 58.8% and 41.2% in low + middle grade tumors combined and in high grade tumors respectively. 76.2% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy (TAH+BSO), 18.1% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy + Lymphadenectomy (TAH+BSO+LND) and 5.7% had a suboptimal surgery as a surgical procedure. 38.1% of the pts. had Radiotherapy (RT), 18.1% had Chemotherapy (CT) and 12.4% had Chemo-radiotherapy (CT+RT) in addition to surgery. Results: The median age of the whole group is 51 (24–87). 55% of our pts. are under 50 years old and 68.5% had an “organ limited disease” ( stages I-II combined). The distant metastases rate is 30% and the local recurrence is 16.2%. All the local recurrences and 90% of the distant metastases have occurred within the first two years. The disease free survival rates at 3 and 5 years are 54.46% and 49.88% ; while the overall survival rates at 3 and 5 years are 54.63% and 51.09% all respectively. The stage is the most important factor effecting on the O.S and 5- year O.S rate is 68.43% in Stage I disease. Conclusions: The aggressive tumor progression pattern and the poor prognosis of uterine sarcomas require adjuvant therapies. The merit of current therapeutic options are still on debate since none of them has proved any specific effects. Planning further multi-center retrospective studies with high number of pts., a more clear description of the prognostic factors and thus the determination of the most appropriate therapeutic option is definitely needed. No significant financial relationships to disclose.

scholarly journals Carcinoid Syndrome Caused by an Atypical Carcinoid of the Uterine Cervix

1999 ◽  
Vol 84 (11) ◽  
pp. 4209-4213 ◽  
Author(s):  
Christian A. Koch ◽  
Norio Azumi ◽  
Mary A. Furlong ◽  
Reena C. Jha ◽  
Theresa E. Kehoe ◽  
...  
Keyword(s):  
Uterine Cervix ◽  
Acid Level ◽  
Carcinoid Syndrome ◽  
Pap Smear ◽  
Alkylating Agents ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Subsequent Treatment ◽  
Atypical Carcinoid ◽  
Biopsy Specimens

Neuroendocrine tumors of the cervix are rare and are often under- or misdiagnosed. Because these tumors are very aggressive, early diagnosis and subsequent treatment are warranted. We describe a 46-yr-old woman with carcinoid syndrome caused by an atypical carcinoid of the uterine cervix. At age 44, she had dysplasia on Pap smear and underwent total abdominal hysterectomy with the diagnosis of adenocarcinoma. Fourteen months postoperatively, she developed the carcinoid syndrome and was found to have numerous liver metastases. Histological and immunohistochemical investigations of biopsy specimens from the patient’s liver lesions and original cervical lesion (“adenocarcinoma”) suggested that this woman had a primary atypical carcinoid of the uterine cervix with metastases to the liver. Treatment with octreotide and alkylating agents decreased the episodes of flushing and diarrhea within 8 weeks. If an adenocarcinoma of the uterine cervix is diagnosed, atypical carcinoid should be in the differential diagnosis. Symptoms of the carcinoid syndrome should be pursued and, if present, a urinary 5-hydroxyindolacetic acid level should be obtained. Timely diagnosis of a neuroendocrine tumor of the cervix may improve survival.

Endometrial Stage I Carcinoma Treated with Surgery and Adjuvant Irradiation: A Retrospective Analysis

1995 ◽  
Vol 81 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Giovanni Boz ◽  
Antonino De Paoli ◽  
Roberto Innocente ◽  
Lino Del Pup ◽  
Renato Talamini ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Local Control ◽  
Combined Treatment ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Stage I ◽  
Lymph Node Sampling ◽  
Adjuvant Irradiation ◽  
Postoperative Irradiation

Aims and background Data from the literature show that the incidence of pelvic recurrences in poor prognosis endometrial carcinoma is significantly reduced by combined surgery and radiotherapy compared to surgery alone. Methods In this paper we analyze the results of the combined treatment surgery and adjuvant irradiation in patients with endometrial carcinoma with regard to survival, site of progression, and toxicity. The surgical treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy in 40 patients. Pelvic and para-aortic node dissection was performed in 19 patients and lymph node sampling in 5. Results Overall 5-year survival was 85%. One patient had local failure, and 5 patients with local control of disease had distant metastases. Toxicity was mild and transient. Conclusions Our experience confirms the data of the literature. Postoperative irradiation is a safe and well-tolerated treatment that can achieve a good local control in high risk, stage I, endometrial carcinoma. The control of distant metastases remains an open question.

The Violated Neck: Cervical Node Biopsy Prior to Definitive Treatment

1986 ◽  
Vol 94 (5) ◽  
pp. 605-610 ◽  
Author(s):  
K. Thomas Robbins ◽  
Randolph Cole ◽  
Jeffrey Marvel ◽  
Robert Fields ◽  
Patricia Wolf ◽  
...  
Keyword(s):  
Distant Metastases ◽  
Subsequent Treatment ◽  
Response To Treatment ◽  
Definitive Treatment ◽  
Wound Complications ◽  
Control Group ◽  
Time Interval ◽  
Adequate Treatment ◽  
Node Biopsy ◽  
Significant Difference

The intent of this study was to determine whether open neck biopsy for patients with squamous cell carcinoma metastatic to the neck influenced the biologic course of the disease or the response to treatment. One hundred ninety-two patients, treated over a 10-year period at M.D. Anderson Hospital and Tumor institute, were reviewed; 102 of the 139 patients, whose primary site of disease was identified prior to definitive treatment, were matched with a control group of 204 patients. The results showed no significant difference in wound complications, neck recurrence, distant metastases, and 5-year survival. Also, time interval from the biopsy to subsequent treatment and the type of node biopsy did not appear to have any significant detrimental effect. On the basis of these findings, we conclude that, although it is important to refrain from proceeding with an open biopsy until a complete head and neck evaluation has been done, violation of the neck does not signify a poorer prognosis—provided adequate treatment is subsequently given.

scholarly journals Anesthesia Management at Postpartum et causa Atonic Uteri Bleeding in P3A0H3 Post SCTP Outside Dr. Moewardi Hospital

2021 ◽  
Vol 1 (1) ◽  
pp. 34
Author(s):  
RTh Supraptomo ◽  
Muhammad Ridho Aditya
Keyword(s):  
General Anesthesia ◽  
Postpartum Hemorrhage ◽  
Hypovolemic Shock ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Emergency Laparotomy ◽  
Excessive Bleeding ◽  
Mortality And Morbidity ◽  
Anesthesia Management ◽  
Intraoperative Management

<p>Postpartum hemorrhage remains the leading cause of maternal mortality and morbidity worldwide, happens more in developing countries with an estimated mortality rate of 140,000 per year or one maternal death every four minutes</p><p>To understand anesthesia management at postpartum et causa atonic uteri bleeding outside Dr. Moewardi hospital</p><p>In this case reported 25 years old patient was admitted to the emergency room at Dr. Moewardi Hospital Surakarta, on the 28/11/2019 at 15.30 WIB, sent by Waras Hospital Wiris Boyolali. On examination found the patient in a state of weakness, apathy awareness and blood pressure 90/60, heart rate 130, respiration rate 22, conjunctival anemic and palpable contractions of soft uterine contractions. The patient's condition is in accordance with the manifestation of grade III blood loss. The anesthesiology diagnosis is a 25-year-old woman with Postpartum hemorrhage et causa Atonic Bleeding of Uterine on P3A0H3 post SCTP Outside Dr. Moewardi Hospital + Hypovolemic Shock pro Emergency Laparotomy until Total Abdominal Hysterectomy with Physical Status ASA IVE Plan with RSI general anesthesia Control.</p><p>Intraoperative Management of anesthesia uses RSI's general anesthesia technique to control hemodynamics and uses anesthesia drugs that do not worsen the patient's condition. At the time of surgery, we did the transfusion because there was a significant amount of bleeding during the procedure and was categorized as Class IV bleeding.</p><p>Anesthesia care of patients with postpartum hemorrhage extends from the antenatal period to the postpartum period. Optimal postpartum hemorrhage management occurs when nurses, obstetricians and anesthesiologists recognize early the potential for excessive bleeding and trigger a 'major obstetric hemorrhage protocol' that describes specific tasks for each team player and the algorithm that must be followed according to etiology, circumstances and time during labor.</p>

scholarly journals Surgical management of a case of recurrent carcinoma cervix: a case report

2020 ◽  
Vol 9 (4) ◽  
pp. 1721
Author(s):  
B. Kalpana ◽  
S. G. Balamurugan ◽  
Soumya Ranjan Panda
Keyword(s):  
Performance Status ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Pelvic Lymphadenectomy ◽  
Carcinoma Cervix ◽  
History Of

Worldwide cervical cancer is the fourth most common cancers among females. Pelvic recurrence, distant metastases, or a combination of both can occur in patients of carcinoma cervix. A 42-year-old P2L2 with a history of carcinoma cervix stage 3-b came to our OPD for routine follow up. Two year back she was managed with chemoradiation for her primary carcinoma which had parametrium extension. There was a 1 × 1 cm lesion on the anterior vaginal wall which was diagnosed to be cervical recurrence. Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Patient is disease free till now. Treatment decisions should be individualised based on the performance status of the patient, the site of recurrence and/or metastases, the extent of metastatic disease, and prior treatment.

scholarly journals An Unusual Presentation of Choriocarcinoma: A Case Report with a Long Latent Period

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fateme Sadat Najib ◽  
Zahra Shiravani ◽  
Mojgan Hajisafari ◽  
Shaghayegh Moradi Alamdarloo ◽  
Atefe Hashemi ◽  
...  
Keyword(s):  
Latent Period ◽  
Case Reports ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Normal Pregnancy ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Gestational Choriocarcinoma ◽  
Irregular Border

Introduction: Choriocarcinoma (CC) is a rare malignant tumor of trophoblastic tissue. This tends to invade rapidly to the vasculature and metastasis to the lung, vagina, brain, and liver. CC can present with a variety of manifestations, such as hemoptysis, gastrointestinal (GI) bleeding, and abnormal uterine bleeding. Commonly, the latent period to the development of CC is not more than 1 year after the antecedent molar or normal pregnancy. In this report, the patient developed CC about 32 months after her previous known pregnancy. We reported a rare case of gestational CC that occurred about 32 months after her antecedent pregnancy. Case Presentation: A 21-year-old admitted in shock with abnormal uterine bleeding, pain, and lower abdominal pain. The patient had one previous cesarean section 32 months prior to admission. The vaginal examination demonstrated a fused solid cervical mass with an irregular border measuring about 7 × 7 cm. In further workup, there was evidence of a 103 × 94 × 89 mm mass with the hemorrhagic area and central necrosis in the middle and lower segments of the uterus and cervix. The patient underwent a total abdominal hysterectomy and left side salpingo-oophorectomy. The diagnosis of CC was made after microscopic examination. Conclusions: There are few case reports of choriocarcinoma with more than a year latent period after antecedent pregnancy. The strongest hypothesis is having asymptomatic pregnancy during the period between the last pregnancy and the development of CC. However, the possibility of non-gestational choriocarcinoma in such cases should be considered. Treatment with a single- or multiple-agent chemotherapy regimen should be immediately initiated after diagnosis in these cases.

Postoperative Radiotherapy and Surgery in Stage I Endometrial Carcinoma: A 10-Year Experience

1998 ◽  
Vol 84 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Giovanni Boz ◽  
Antonino De Paoli ◽  
Roberto Innocente ◽  
Renato Talamini ◽  
Carlo Scarabelli ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Local Control ◽  
Postoperative Radiotherapy ◽  
Combined Treatment ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Stage I ◽  
Good Local Control ◽  
Postoperative Irradiation

Background Data from the literature show that the incidence of pelvic recurrences in poor prognosis endometrial carcinoma is significantly reduced by combined surgery and radiotherapy compared to surgery alone. Methods In this paper we analyze the results of the combined treatment surgery plus adjuvant irradiation in patients with endometrial carcinoma with regard to survival, site of progression, and toxicity. The surgical treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pelvic and para-aortic node dissection was performed. Results The overall 5-year survival was 88%. Three patients had local failure. Ten patients with local control of disease had distant metastases and 2 had local and distant recurrences. Conclusions Our experience confirms the data of the literature. Postoperative irradiation is a safe and well tolerated treatment which can achieve good local control in high-risk stage I endometrial carcinoma. The control of distant metastases remains an open issue.

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