Uterine cervical cancer is the second most frequent gynecological malignancy worldwide. The assessment of the extent of disease is essential for planning optimal treatment. Imaging techniques are increasingly used in the pre-treatment work-up of cervical cancer. Currently, MRI for local extent of disease evaluation and PET-scan for distant disease assessment are considered as first-line techniques. Notwithstanding, in the last few years, ultrasound has gained attention as an imaging technique for evaluating women with cervical cancer. In this paper, current knowledge about the use of ultrasound for assessing uterine cervical cancer will be reviewed and discussed.
Vulvar cancer is a rare malignancy; most tumors are squamous cell type while adenocarcinomas are rare. Primary adenocarcinomas of the vulva predominantly include extramammary Paget's disease and sweat gland carcinomas. Greene first described a rare form of adenocarcinoma in 1936, which was called adenocarcinoma of mammary-like glands of the vulva because of its morphologic and immunohistochemical resemblance to breast adenocarcinomas. In the management of this entity, varying combinations of surgery, radiation therapy, systemic chemotherapy and/or hormonal therapy may be used, as in patients with orthotopic breast carcinoma. However, hormonal therapy leads the way in patients with positive hormonal receptors, where other therapies cannot be used due to comorbidities or advanced age. We present the first reported case of an elderly patient with metastatic vulvar adenocarcinoma arising from mammary-like glands, successfully treated with a combination of surgery and hormonal therapy.
A single 3D-PDUS assessment of tumor size and vascularization before treatment seems to be of limited value for predicting tumor response to chemoradiation therapy and for predicting tumor recurrence in women with locally advanced carcinoma of the cervix.
Results: Out of the 158 cases, the final histopathological analysis of the hysterectomy specimen revealed that 105 cases were truly low-risk cases (G1/G2 endometrioid tumors not affecting the cervix and myometrial infiltration < 50% G1/G2). 9 cases were proved to be G3 with infiltration <50% and no cervical involvement. While 44 cases were found to be at high risk because of myometrial invasion > 50% and / or cervical involvement (6 cases were G3, 4 of them were carcinosarcomas). Regardless definitive histologic gradedata that ultrasound cannot provide -, ultrasound correctly identified 81.2% (36/44) of cases of myometrial infiltration > 50% and / or cervical involvement and 85% (96/114) of cases with myometrial infiltration < 50% and / or without cervical involvement. Conclusions: Preoperative ultrasound provides a good diagnostic performance to identify high-risk cases in well or moderately differentiated endometrioid endometrial carcinomas.
OP09.06The association of changes in cervical cancerechogenicity and vascularization with treatment effect of neoadjuvant chemotherapy
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