Malignancies of the uterine corpus are extremely rare. Diagnostic and therapeutic procedures should be performed according to oncological principles with individually adapted treatment regimes. Clinical cancer of the cervix is rare in adolescence; the treatment is radical surgery. Preclinical stages, that is, CIN III (severe dysplasia, carcinoma in situ) and microinvasive cancer (stages Ia1, Ia2), are important, also because of their frequency. Diagnosis is based on colposcopy, cytology, direct biopsy, histological examination, and conization. In addition, virology (HPV) and DNA cytometry may become prognostic factors. Treatment consists of conization with an exact histological examination in serial sections as a basis for preserving the uterus. The sarcoma botryoides is localized in the cervix in adolescence, whereas it is in the vagina in infants and children.
Observation of 18 pregnancies in 13 women who had undergone treatment for trophoblastic neoplasm with cytostatic drugs confirmed reports according to which the risk of miscarriage, premature birth, stillbirth, and severe congenital anomalies is not increased. Seven low-risk patients who had been treated with methotrexate gave birth to 10 children who were mature except for one pair of premature twins. Only one child had an anomaly, i.e. celiac disease, but this could not be linked to the prior treatment. Three high-risk patients who had been treated with methotrexate or methotrexate with actinomycin-D gave birth to four children, all of whom were mature and healthy. Intensive prenatal care, and in particular diagnosis at the beginning of pregnancy, are of great importance. At least one year must elapse between termination of chemotherapy and the beginning of a pregnancy. Effective contraception must be assured during this time.
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