pelvic lymph nodes
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2021 ◽  
Vol 28 (11) ◽  
pp. S5
Author(s):  
S. Varma ◽  
A.J. Palmieri ◽  
N.M. Aikman ◽  
K. ElSahwi

Brachytherapy ◽  
2021 ◽  
Author(s):  
Zahra Siavashpour ◽  
Mahdi Aghili ◽  
Shabnam Anjidani ◽  
Farid Zayeri ◽  
Mona Molekzadeh Moghani ◽  
...  

2021 ◽  
pp. ijgc-2021-002924
Author(s):  
Sarah E Gill ◽  
Simone Garzon ◽  
Francesco Multinu ◽  
Alexis N Hokenstad ◽  
Jvan Casarin ◽  
...  

ObjectiveEvidence on micrometastases and isolated tumor cells as factors associated with non-vaginal recurrence in low- and intermediate-risk endometrial cancer is limited. The goal of our study was to investigate risk factors for non-vaginal recurrence in low- and intermediate-risk endometrial cancer.MethodsRecords of all patients with endometrial cancer surgically managed at the Mayo Clinic before sentinel lymph node implementation (1999–2008) were reviewed. We identified all patients with endometrioid low-risk (International Federation of Gynecology and Obstetrics (FIGO) stage I, grade 1 or 2 with myometrial invasion <50% and negative peritoneal cytology) or intermediate-risk (FIGO stage I, grade 1 or 2 with myometrial invasion ≥50% or grade 3 with myometrial invasion <50% and negative peritoneal cytology) endometrial cancer at definitive pathology after pelvic and para-aortic lymph node assessment. All pelvic lymph nodes of patients with non-vaginal recurrence (any recurrence excluding isolated vaginal cuff recurrences) underwent ultrastaging.ResultsAmong 1303 women, we identified 321 patients with low-risk (n=236) or intermediate-risk (n=85) endometrial cancer (median age 65.4 years; 266 (82.9%) stage IA; 55 (17.1%) stage IB). Of the total of 321, 13 patients developed non-vaginal recurrence (Kaplan–Meier rate 4.7% by 60 months; 95% CI 2.1% to 7.2%): 11 hematogenous/peritoneal and two para-aortic and distant lymphatic. Myometrial invasion and lymphovascular space invasion were univariately associated with non-vaginal recurrence. In these patients, the original hematoxylin/eosin slides review confirmed all 646 pelvic and para-aortic removed lymph nodes as negative. The ultrastaging of 463 pelvic lymph nodes did not identify any occult metastases (prevalence 0%; 95% CI 0% to 22.8% considering 13 patients; 95% CI 0% to 0.8% considering 463 pelvic lymph nodes).ConclusionThere were no occult metastases in pelvic lymph nodes of patients with low- or intermediate-risk endometrial cancer with non-vaginal recurrence. Myometrial invasion and lymphovascular space invasion appear to be associated with non-vaginal recurrence.


2021 ◽  
Vol 13 (10) ◽  
pp. 1412-1424
Author(s):  
Shimpei Ogawa ◽  
Michio Itabashi ◽  
Yuji Inoue ◽  
Takeshi Ohki ◽  
Yoshiko Bamba ◽  
...  

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S74-S74
Author(s):  
H Siatecka ◽  
R Masand

Abstract Introduction/Objective Intravascular leiomyomatosis, also known as intravenous leiomyomatosis, is characterized by presence of smooth muscle within venous spaces in the myometrium, usually in conjunction with a leiomyoma. Although presence of tumor within lymphatics in addition to veins are alluded to in literature, exclusively lymphatic spread with lymph node metastases have not been previously reported. Methods/Case Report A 50-year-old woman presented with left flank pain. CT pelvis showed an enlarged uterus with multiple large leiomyomata as well as pelvic lymph node enlargement. Hysterectomy with bilateral salpingo- ophorectomy and pelvic lymph node dissection was performed. Gross examination revealed multifibroid uterus. Separately sent pelvic lymph nodes showed well-circumscribed, whorled lesions resembling leiomyoma. Microscopically, in addition to typical leiomyomata, a 11.5 cm intramural tumor with epithelioid cells, very rare mitoses and no necrosis was identified. Adjacent to this mass, several large endothelial lined spaces (positive for D240 and negative for CD31), consistent with lymphatics, showed intravascular extension of the same epithelioid tumor. All the pelvic lymph nodes were replaced by the tumor. Due to the unusual morphology and pattern of spread, immunohistochemical stains were performed to rule out an endometrial stromal sarcoma and lymphangioleiomyomatosis. The lesion was positive for desmin, caldesmon, and negative for CD10 and HMB45. Ki67 was extremely low (&lt;1%). Based on morphology and immunophenotype, the tumor was consistent with an epithelioid leiomyoma with highly unusual lymphatic spread through myometrial vessels to regional lymph nodes. Results (if a Case Study enter NA) NA Conclusion Intravascular leiomyomatosis is a rare condition with no reported progression to malignancy. Typically, benign smooth muscle is present in veins within the myometrium of a leiomyomatous uterus with progressive spread to the right heart via the inferior vena cava. We present the first report of a rare case of intravascular leiomyomatosis with spread exclusively via lymphatics to pelvic lymph nodes.


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