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Morcet-Delattre R, Espenel S, Tas P, Chargari C, Escande A. Role of radiotherapy in the management of rare gynaecological cancers. Cancer Radiother 2023; 27:778-788. [PMID: 37925347 DOI: 10.1016/j.canrad.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 11/06/2023]
Abstract
There are a large number of gynaecological cancers with rare histologies, for which the available data are limited and usually retrospective. Because of their rarity and poor prognosis, the management of these cancers must be centralized in expert centres, for both histological diagnosis and treatment. With the exception of sarcomas, most endometrial or cervical cancers with rare histologies respond to the same radiation treatment modalities than cancers with more common histologies, although there are some specificities regarding treatments such as neuroendocrine carcinomas (chemotherapy with platinum and etoposide, major role of surgery). For localized or locally advanced ovarian cancer, external beam radiotherapy has a role in the management of hypercalcaemic small cell carcinoma of the ovary. This article summarizes the current role of external beam radiotherapy and brachytherapy in the management of cancers of the uterine cervix, uterine corpus and ovaries, with rare or very rare histologies, and with localized or locally advanced stages.
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Affiliation(s)
- R Morcet-Delattre
- Radiation oncology department, centre Eugène-Marquis, Rennes, France.
| | - S Espenel
- Radiation oncology department, Gustave-Roussy Cancer Campus, Villejuif, France
| | - P Tas
- Anatomopathology department, Ouest pathologie, Rennes, France
| | - C Chargari
- Radiation oncology department, groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - A Escande
- Radiation oncology department, centre Léonard-de-Vinci, Dechy, France; Laboratoire CRIStAL UMR9189, université de Lille, CNRS, Lille, France
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2
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A Unique Glassy Cell Carcinoma (GCC) of the Cervix Diagnosed during Pregnancy—A Case Report. Healthcare (Basel) 2022; 10:healthcare10081583. [PMID: 36011240 PMCID: PMC9408539 DOI: 10.3390/healthcare10081583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/14/2022] [Accepted: 08/19/2022] [Indexed: 11/26/2022] Open
Abstract
Glassy Cell carcinoma (GCC) of the cervix is classified as a unique, aggressive neoplasm, with different sensitivity to chemotherapy and radiotherapy. It is such an extremely rare tumor that it is practically not observed during pregnancy. Information on the coexistence of cervical GCC with pregnancy is also unique, so it seems extremely important to disseminate it in order to develop the most effective treatment regimen. Additionally, making any decisions regarding therapeutic methods during pregnancy encounters great ethical problems. We present the case of a 26-year-old pregnant woman, 18 weeks gestation, diagnosed with GCC of the cervix, IB3 grade in the International Federation of Gynecology and Obstetrics (FIGO) scale. Despite the unfavorable prognosis, the use of chemotherapy in a pregnant patient brought on a favorable therapeutic effect, without any negative effects on the fetus. The article also presents a literature review on the epidemiology, pathology, immunohistochemistry, treatment and prognosis of this rare disease.
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Blake EA, Ross MS, Ross ME, Matsuo K, Silverstein ET, Torno LR, Bhargava R, Post MD, Da Silva DM, Taylor S, Walia S, Roman L, McEachron TA. Immunohistochemical analysis of glassy cell carcinoma of the cervix reveals robust lymphocyte infiltrate and the expression of targetable inhibitory immune checkpoints. Arch Gynecol Obstet 2021; 305:439-447. [PMID: 34392396 DOI: 10.1007/s00404-021-06164-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To validate our previous findings of high-level EGFR expression in GCCC using an expanded cohort of specimens and to further examine the molecular and cellular features of this aggressive malignancy to identify potentially actionable therapeutic targets. METHODS The SEER database was queried to obtain the epidemiological data regarding the current national survival trends for GCCC. Immunohistochemistry (IHC) was used to examine the expression of EGFR, PD-1, and PD-L1. CiberSort analysis was used to analyze a previously published RNA-sequencing dataset obtained from a single patient diagnosed with GCCC. RESULTS In comparison to squamous cell carcinomas and adenocarcinoma/adenosquamous carcinomas, GCCC was observed in younger patients (p < 0.001) and demonstrated inferior survival (p < 0.001). All (100%) of the specimens (8/8) exhibited immunoreactivity when stained for CD3ε (T-cell marker), EGFR, PD-1, and PD-L1 whereas CTLA4 expression was not detected. Analysis of RNA-sequencing data revealed that cetuximab and erlotinib altered the chemokine profile, lymphocyte abundance, and expression of inhibitory immune checkpoints in a single patient when combined with cytotoxic chemotherapy in a single patient. CONCLUSIONS The data from this descriptive study suggests that immune checkpoint blockade, whether single agent or in combination, may be a suitable therapeutic option for a disease for which targeted approaches do not currently exist.
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Affiliation(s)
- Erin A Blake
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
- Department of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave., Room 522, Los Angeles, CA, 90033, USA.
| | - Malcolm S Ross
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Megan E Ross
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Emily T Silverstein
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Lilibeth R Torno
- Hyundai Cancer Genomics Center, Children's Hospital of Orange County, Orange, CA, USA
- Department of Pediatrics, School of Medicine, University of California-Irvine, Orange, CA, USA
| | - Rohit Bhargava
- Division of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Miriam D Post
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Diane M Da Silva
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Sarah Taylor
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Saloni Walia
- Department of Laboratory Medicine and Pathology, Department of Gynecologic Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lynda Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Troy A McEachron
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Glassy cell carcinoma of the uterine cervix: 20-year experience from a comprehensive cancer center. Cancer Radiother 2021; 25:207-212. [PMID: 33408051 DOI: 10.1016/j.canrad.2020.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Glassy cell carcinoma (GCC) of the uterine cervix is a rare entity. This study aims at describing the clinical characteristics and outcomes of cervical GCC patients treated in a comprehensive cancer center. MATERIAL AND METHODS We retrospectively reported patients and tumors characteristics, therapeutic management, overall survival (OS), progression-free progression (PFS), relapse rates, and toxicities. RESULTS Between 1994 and 2014, 55 patients were treated with curative intent. The median age at diagnosis was 41 years (range, 20-68). Among 22 patients with early stage tumors (IA2-IB1-IIA1), 17 had preoperative brachytherapy, followed by radical hysterectomy. Among 33 patients with locally advanced disease (≥IB2), 32 underwent chemoradiation±brachytherapy boost. After a median follow-up of 5.4 years (range, 0.15-21.7 years), 18/55 (33%) patients experienced tumor relapse. Local recurrence occurred in 2/22 (9%) patients with early disease (treated with upfront surgery) and in 3/32 (9%) patients with locally advanced disease. Most frequent relapses were distant, occurring in a total of 11/55 patients (20%). PFS rates at 5-year were 86.4% (95% CI: 63.4-95.4) for early stage versus 75.9% (95% CI: 55.2-89.2) for locally advanced stages, respectively (P=0.18). CONCLUSION Large cohort data are warranted to guide the optimal management of GCC. From this retrospective analysis, a multimodal approach yielded to good disease control in early stages tumors. Given the high-risk of distant failure, consideration should be given to adjuvant chemotherapy in locally advanced disease.
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Montagner C, Bricou A, Selle F, Kafé H, Mauhin W, Fredeau L, Duval-Chopard L, Slama J, Durand P, Beal C, London J, Lidove O. [Glassy cell carcinoma of the uterine cervix: An aggressive type of cancer]. Rev Med Interne 2019; 40:754-757. [PMID: 31431320 DOI: 10.1016/j.revmed.2019.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/19/2019] [Accepted: 07/17/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cervical cancer is the twelfth most frequent cancer in women in France. Glassy cell carcinoma is a rare histological entity, rapidly aggressive, associated with a poor prognosis. CASE REPORT A 30-year-old woman was admitted in an internal medicine department for polyarthralgia with high grade fever, evolving for 3 weeks. There was an inflammatory syndrome. The 18-FDG-PET-scan showed inflammatory lymph nodes as well as disseminated osteolytic lesions, and a primitive pelvic tumor. A 3cm tumor of the cervix was found during the gynaecologic examination. Histological analysis elicited a high-index mitotic carcinoma, glassy cell carcinoma type. Despite chemotherapy, the outcome was poor, with early death occurring after three months of follow-up. CONCLUSION The glassy cell carcinoma of the cervix should be considered as an aetiology of bone metastases in young female patients.
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Affiliation(s)
- C Montagner
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France.
| | - A Bricou
- Service de chirurgie gynécologique et mammaire, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - F Selle
- Service d'oncologie, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron 75020 Paris, France
| | - H Kafé
- Centre de pathologie, 19, rue de Passy, 75016, France
| | - W Mauhin
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - L Fredeau
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - L Duval-Chopard
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - J Slama
- Paris Service de médecine nucléaire, Hôpital Beaujon, 100, boulevard du Général Leclerc, 92110 Clichy, France
| | - P Durand
- Service de radiologie, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - C Beal
- Service de rhumatologie, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - J London
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
| | - O Lidove
- Service de médecine interne, Groupe Hospitalier Diaconesses Croix Saint Simon, rue d'Avron, 75020 Paris, France
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6
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Jung YY, Nahm JH, Kim HS. Cytomorphological characteristics of glassy cell carcinoma of the uterine cervix: histopathological correlation and human papillomavirus genotyping. Oncotarget 2018; 7:74152-74161. [PMID: 27708230 PMCID: PMC5342042 DOI: 10.18632/oncotarget.12361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/17/2016] [Indexed: 11/25/2022] Open
Abstract
A retrospective analysis was performed to describe the cytomorphological and histopathological findings and human papillomavirus (HPV) genotypes for glassy cell carcinoma (GCC) of the uterine cervix. Five cases of cervical GCC, in which the glassy cell features constituted at least 95% of the specimen, were included. Four patients had stage IIB GCCs and one had stage IIIB GCC. All patients underwent concurrent chemoradiation therapy. Based on pretreatment cytology, only 1 of the 5 cases was correctly diagnosed as GCC. The remaining cases were diagnosed as carcinoma of undetermined type, adenocarcinoma, poorly differentiated carcinoma, or unsatisfactory for evaluation. Cytological specimens had moderate cellularity and contained small clusters of tumor cells admixed with amphophilic, granular tumor diathesis. The tumor cells possessed large, round to oval nuclei and abundant, granular, ground-glass cytoplasm. The nuclei exhibited prominent eosinophilic nucleoli. The cytoplasm displayed sharp margins and molding, resulting in “intercellular windows” between neighboring attached cells. HPV genotyping revealed that high-risk HPV types 18, 16, and 31 were detected in 3, 1, and 1 cases, respectively. Consistent with this finding, all cases exhibited block p16 positivity, confirming the association of HPV infection with GCC. In conclusion, a distinct cytoplasmic margin, the characteristic histopathological feature of GCC, was observed in liquid-based cytological preparations. We suggest that sharp cytoplasmic outlines with molding and intercellular windows are characteristic cytomorphological features of GCC. Detection of high-risk HPV in all cases strongly supported the notion that high-risk HPV is involved in the pathogenesis of GCC.
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Affiliation(s)
- Yoon Yang Jung
- Department of Pathology, Myongji Hospital, Seonam University College of Medicine, Goyang-si, Republic of Korea
| | - Ji Hae Nahm
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun-Soo Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yoon N, Kim JY, Kim HS. Clinical outcomes of advanced-stage glassy cell carcinoma of the uterine cervix: a need for reappraisal. Oncotarget 2018; 7:78448-78454. [PMID: 27793022 PMCID: PMC5346652 DOI: 10.18632/oncotarget.12905] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/17/2016] [Indexed: 11/25/2022] Open
Abstract
We performed a retrospective analysis of the clinical features and patient outcomes for advanced-stage glassy cell carcinoma of the uterine cervix. The study was restricted to cases in which the glassy cell features constituted at least 95% of the biopsied specimen. During the study period, 675 patients were diagnosed with primary cervical carcinoma. Five (0.7%) of the 675 patients had cervical glassy cell carcinoma; of these, three were premenopausal, and two were postmenopausal. Abnormal vaginal bleeding was the most frequent presenting symptom. Glassy cell carcinoma presented as a fungating, exophytic, or infiltrative mass. The greatest tumor dimension ranged from 3 to 9 cm. All patients had parametrial extension. Four patients had stage IIB tumors, and one had a stage IIIB tumor. All patients received concurrent chemoradiation therapy. The patient with a stage IIIB tumor died of hypovolemic shock caused by upper gastrointestinal bleeding during radiation therapy. Three patients with stage IIB tumors survived for more than 8 years without tumor recurrence or metastasis. One of these three patients died of pelvic recurrence 10 years after the initial diagnosis. Cervical glassy cell carcinoma has traditionally been considered an aggressive, highly malignant tumor with poor prognosis, but our data suggest that patient survival is not significantly decreased compared with other histological types of cervical carcinoma. It will be necessary to analyze patient outcomes using a larger number of cervical glassy cell carcinoma cases to confirm our findings.
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Affiliation(s)
- Nara Yoon
- Department of Pathology, The Catholic University of Korea Incheon St. Mary's Hospital, Incheon, Republic of Korea
| | - Ji-Ye Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Soo Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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8
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Yahiaoui Y, Gabsi A, Doghri R, Ayadi M, Mrad K, Mezlini A. [Recurrence of a glassy cell carcinoma of the vagina: An exceptional situation]. Cancer Radiother 2017; 21:301-304. [PMID: 28495482 DOI: 10.1016/j.canrad.2017.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/30/2016] [Accepted: 01/08/2017] [Indexed: 10/19/2022]
Abstract
Glassy cell carcinoma is a rare neoplasm that occurs most frequently in the uterine cervix. We describe the second reported case of glassy cell carcinoma arising in the vagina. We present a case of a 24-year-old woman with a history of post-coïtal bleeding associated with menometrorrhagia. Different explorations have concluded in a glassy cell carcinoma arising in the vagina, with clinical staging III according to the International Federation of Obstetrics and Gynecology. The patient received three cycles of neoadjuvant chemotherapy with a good response. Then she had a para-aortic lymphadenectomy and ovarian transposition. Following the surgery, she had radiotherapy. The gynecological examination showed no budding lesion and the biopsy was negative. Six months later, the patient complained of a pelvic pain. The examination revealed a locoregional recurrence. Surgical revision was not possible and the patient was a candidate for a palliative chemotherapy. Although, glassy cell carcinoma runs an aggressive clinical course, an early diagnosis may help in a more effective management and offer a better prognosis.
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Affiliation(s)
- Y Yahiaoui
- Service d'oncologie médicale, institut Salah-Azaiez, faculté de médecine de Tunis, université el-Manar, Beb Saadoun, 3099 Tunis, Tunisie
| | - A Gabsi
- Service d'oncologie médicale, institut Salah-Azaiez, faculté de médecine de Tunis, université el-Manar, Beb Saadoun, 3099 Tunis, Tunisie.
| | - R Doghri
- Service d'anatomopatholgie, institut Salah-Azaiez, faculté de médecine de Tunis, université el-Manar, Beb Saadoun, 3099 Tunis, Tunisie
| | - M Ayadi
- Service d'oncologie médicale, institut Salah-Azaiez, faculté de médecine de Tunis, université el-Manar, Beb Saadoun, 3099 Tunis, Tunisie
| | - K Mrad
- Service d'anatomopatholgie, institut Salah-Azaiez, faculté de médecine de Tunis, université el-Manar, Beb Saadoun, 3099 Tunis, Tunisie
| | - A Mezlini
- Service d'oncologie médicale, institut Salah-Azaiez, faculté de médecine de Tunis, université el-Manar, Beb Saadoun, 3099 Tunis, Tunisie
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9
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McEachron TA, Sender LS, Zabokrtsky KB, Kaltenecker B, Holmes WN, Cherni I, Manojlovic Z, Liao SY, Craig DW, Carpten JD, Torno LR. Molecular Genetic Profiling of Adolescent Glassy Cell Carcinoma of the Cervix Reveals Targetable EGFR Amplification with Potential Therapeutic Implications. J Adolesc Young Adult Oncol 2016; 5:297-302. [PMID: 26974246 DOI: 10.1089/jayao.2015.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Glassy cell carcinoma of the cervix (GCCC) is a very rare and aggressive form of cervical cancer. An adolescent female with advanced metastatic disease was enrolled in our genomic profiling research protocol. We identified high-level amplification of epidermal growth factor receptor (EGFR) and Yes-associated protein-1 (YAP1), which led to the addition of EGFR inhibitors to the chemotherapy regimen. Here, we report the first genetically profiled case of GCCC with potential therapeutic implications.
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Affiliation(s)
- Troy A McEachron
- 1 Integrated Cancer Genomics Division, Translational Genomics Research Institute , Phoenix, Arizona.,2 Hyundai Cancer Genomics Center, Children's Hospital of Orange County , Orange, California
| | - Leonard S Sender
- 2 Hyundai Cancer Genomics Center, Children's Hospital of Orange County , Orange, California.,3 Division of Hematology-Oncology, Department of Medicine, School of Medicine, University of California-Irvine , Orange, California.,4 Department of Epidemiology, School of Medicine, University of California-Irvine , Orange, California.,5 Department of Pediatrics, School of Medicine, University of California-Irvine , Orange, California
| | - Keri B Zabokrtsky
- 2 Hyundai Cancer Genomics Center, Children's Hospital of Orange County , Orange, California.,3 Division of Hematology-Oncology, Department of Medicine, School of Medicine, University of California-Irvine , Orange, California
| | - Brian Kaltenecker
- 6 Marian University Osteopathic Medical School , Indianapolis, Indiana
| | - W Nathan Holmes
- 7 Department of Radiology, Children's Hospital of Orange County , Orange, California
| | - Irene Cherni
- 1 Integrated Cancer Genomics Division, Translational Genomics Research Institute , Phoenix, Arizona
| | - Zarko Manojlovic
- 1 Integrated Cancer Genomics Division, Translational Genomics Research Institute , Phoenix, Arizona
| | - Shu-Yuan Liao
- 8 Department of Pathology, Children's Hospital of Orange County , Orange, California.,9 Department of Pathology, School of Medicine, University of California-Irvine , Orange, California
| | - David W Craig
- 10 Neurogenomics Division, Translational Genomics Research Institute , Phoenix, Arizona
| | - John D Carpten
- 1 Integrated Cancer Genomics Division, Translational Genomics Research Institute , Phoenix, Arizona
| | - Lilibeth R Torno
- 2 Hyundai Cancer Genomics Center, Children's Hospital of Orange County , Orange, California.,5 Department of Pediatrics, School of Medicine, University of California-Irvine , Orange, California
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10
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Glassy cell carcinoma of the cervix and metastasis in episiotomy scar: a case report. J Low Genit Tract Dis 2016; 19:e31-4. [PMID: 25062402 DOI: 10.1097/lgt.0000000000000054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The authors describe the 20th known case of cervical cancer with metastasis in an episiotomy scar, being the first case describing an implant of malignant cells in the episiotomy scar associated with glassy cell carcinoma. MATERIALS AND METHODS One case report. RESULTS We describe the case of a 34-year-old woman, with cervical cancer diagnosed 1 month after delivery. Four months later, a radical hysterectomy was performed. During surgery, a nodule at the site of the episiotomy scar was identified and removed. The histologic diagnosis revealed a glassy cell carcinoma of the cervix, with metastasis in the episiotomy scar. After surgery, chemotherapy and radiotherapy were performed. The disease progressed rapidly, and the patient died 9 months after surgery. CONCLUSIONS The implantation of neoplastic cells in the perineum is a potential risk of vaginal delivery, with a 40% mortality rate. It thus seems advisable to avoid vaginal delivery as much as possible when cervical cancer is diagnosed during pregnancy. Given the rarity, there are no studies on the most effective treatment in such situations.
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11
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Lépinoy A, Lescut N, Lassabe C, Bosset JF, Servagi-Vernat S. [Glassy cell carcinoma: a rare cervical neoplasm. Case report of two patients and review of the literature]. Cancer Radiother 2014; 18:211-4. [PMID: 24819246 DOI: 10.1016/j.canrad.2014.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/03/2014] [Accepted: 04/09/2014] [Indexed: 11/25/2022]
Abstract
The main histological types of cervix cancer are squamous cell carcinoma and adenocarcinoma. The glassy cell carcinoma is a rare form found in less than 2% of cases and it is an entity, aggressive and unknown, of worse prognosis, whose current treatment is not distinguished from other histological types. We report the cases of two patients with glassy cell carcinoma of the cervix with a review of the literature.
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Affiliation(s)
- A Lépinoy
- Service d'oncologie radiothérapie, centre hospitalier universitaire Jean-Minjoz, 3, boulevard Fleming, 25000 Besançon, France
| | - N Lescut
- Service d'oncologie radiothérapie, centre hospitalier universitaire Jean-Minjoz, 3, boulevard Fleming, 25000 Besançon, France
| | - C Lassabe
- Département d'anatomopathologie, centre hospitalier de Belfort-Montbéliard, 90000 Belfort, France
| | - J-F Bosset
- Service d'oncologie radiothérapie, centre hospitalier universitaire Jean-Minjoz, 3, boulevard Fleming, 25000 Besançon, France
| | - S Servagi-Vernat
- Service d'oncologie radiothérapie, centre hospitalier universitaire Jean-Minjoz, 3, boulevard Fleming, 25000 Besançon, France.
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12
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Zolciak-Siwinska A, Jonska-Gmyrek J. Glassy cell carcinoma of the cervix: a literature review. Eur J Obstet Gynecol Reprod Biol 2014; 179:232-5. [PMID: 24792540 DOI: 10.1016/j.ejogrb.2014.03.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 02/04/2014] [Accepted: 03/31/2014] [Indexed: 10/25/2022]
Abstract
Glassy cell carcinoma (GCC) is a histologically aggressive subtype of cervical cancer with rapid growth and early metastases. The prognosis for patients with GCC is poor. This article reviews the literature pertinent to the epidemiology, cytology, pathology, immunohistochemistry, treatment and prognosis of GCC. MEDLINE (PubMed) was searched for all articles or abstracts on patients diagnosed with GCC published (in English) since the original definition by Glucksmann and Cherry, Cancer 1956;9:971. Accurate diagnosis of GCC enables implementation of the correct treatment strategy. Early-stage GCC should be treated with hysterectomy and pelvic lymph node dissection, with adjuvant radiochemotherapy if at least one intermediate or high risk factor for cervical cancer is present. Advanced GCC should be treated with neoadjuvant radiochemotherapy or chemotherapy with the aim of making the disease operable. There is a need for retrospective evaluation of GCC treatment from several centres to explore knowledge about this rare entity. Future studies should explore the role of targeted therapies and the most efficient chemotherapy regimen for the management of GCC.
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Affiliation(s)
- A Zolciak-Siwinska
- Department of Brachytherapy, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
| | - J Jonska-Gmyrek
- Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
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13
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Takahashi Y, Sasaki H, Mogami H, Hamada S, Konishi I. Adjuvant combined paclitaxel and carboplatin chemotherapy for glassy cell carcinoma of the uterine cervix: Report of three cases with clinicopathological analysis. J Obstet Gynaecol Res 2011; 37:1860-3. [DOI: 10.1111/j.1447-0756.2011.01643.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Glassy Cell Carcinoma Predominantly Commits to a Squamous Lineage and is Strongly Associated With High-risk Type Human Papillomavirus Infection. Int J Gynecol Pathol 2009; 28:389-95. [DOI: 10.1097/pgp.0b013e31819343a5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Nasu K, Takai N, Narahara H. Multimodal treatment for glassy cell carcinoma of the uterine cervix. J Obstet Gynaecol Res 2009; 35:584-7. [DOI: 10.1111/j.1447-0756.2008.00968.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nagy PS, Sipos J. Glassy cell carcinoma of the endometrium: case report and review of the literature. Orv Hetil 2009; 150:1173-6. [DOI: 10.1556/oh.2009.28527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A szerzők 68 éves FIGO IB stádiumú méhnyálkahártyából kiinduló tejüvegsejtes carcinomás nőbeteg esetét ismertetik, akinél hysterectomia és kétoldali salpingo-oophorectomia, majd sugárkezelés történt. A beteg kétéves utánkövetése alatt daganatmentes volt. Az endometrium tejüvegsejtes carcinomája ritka tumorféleség, eddig 13 esetet közöltek a világon. Mint az adenosquamosus carcinoma rosszul differenciált változata valódi természetének megismerése ma is vita tárgyát képezi. A prognózisának és klinikai jelentőségének tisztázásához újabb közölt esetek és kritikai analízisük szükséges.
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Affiliation(s)
| | - József Sipos
- 2 Zala Megyei Kórház Patológiai Osztály Zalaegerszeg
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Abstract
Carcinomas of the cervix may be categorized on morphological grounds into four main groups: squamous carcinomas; adenocarcinomas; neuro-endocrine tumours; and others including adenosquamous carcinomas. Each group contains several morphological subvariants. Invasive squamous carcinomas and adenocarcinomas are preceded by cervical intra-epithelial neoplasia and cervical glandular intra-epithelial neoplasia, respectively. Each is graded into low and high grade. Micro-invasive carcinomas with stromal invasion less than 3mm in depth have a minimal chance of lymph node metastasis. When there is lymph node involvement, the obturator node may be the most common. Presence or absence of lymph node involvement, tumour size and depth of invasion are the important independent histopathological indicators of prognosis. The presence or absence of vascular space invasion is a valuable prognostic indicator. Small cell carcinomas, large cell neuro-endocrine carcinomas and possibly adenoid cystic carcinomas are aggressive. With these exceptions, it is doubtful whether tumour type is of much clinical significance. Tumour grade, as currently assessed, is of no significant value.
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Affiliation(s)
- A J Tiltman
- Whittaker & Associates, Private Bag X11, Rondebosch 7701, South Africa.
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Plante M, Renaud MC, François H, Roy M. Vaginal radical trachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literature. Gynecol Oncol 2004; 94:614-23. [PMID: 15350349 DOI: 10.1016/j.ygyno.2004.05.032] [Citation(s) in RCA: 179] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2004] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To review the oncological results and complication rate of our first consecutive 72 completed cases of vaginal radical trachelectomies (VRT). METHODS From October 1991 to October 2003, we have planned 82 VRT in patients with early-stage cervical cancer (stages IA, IB, and IIA). The VRT was preceded by a complete laparoscopic pelvic node dissection and laparoscopic parametrectomy. RESULTS The planned procedure was successfully completed in 72 cases and was abandoned in 10 cases (12%) because of either positive nodes discovered at the time of surgery (4), positive endocervical margins (5) or extensive tubal adhesions (1). The median age of the remaining 72 patients was 31 and most (75%) were nulliparous. The majority of the lesions were stage IA2 (32%) or IB1 (60%) and 54% were grade 1. In terms of histology, 58% were squamous and 42% were adenocarcinomas. Vascular space invasion was present in 20% of cases, and 90% of the lesions measured </=2 cm. An average of 32 lymph nodes has been removed laparoscopically. The mean follow-up is 60 months (6-156). The intraoperative complication rate was low (6%) and the postoperative morbidity was also low mainly involving bladder hypotonia (16%) and vulvar edema (12%). There were no bladder or ureteral injuries. The average hospital stay was 3 days. Excluding one patient with a small cell neuroendocrine tumor who rapidly recurred and died, there were two recurrences (2.8%) and one death (1.4%). The actuarial recurrence-free survival is 95%. Tumor size >2 cm was statistically significantly associated with a higher risk of recurrence (P = 0.03). The recurrence-free survival of the nine patients who did not have the planned VRT because of more advanced disease was statistically significantly less (P = 0.003). CONCLUSION VRT is an oncologically safe procedure in well-selected patients with early-stage disease. Lesion size >2 cm appears to be associated with a higher risk of recurrence. The morbidity of the procedure is low and it allows fertility preservation.
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Affiliation(s)
- Marie Plante
- Gynecologic Oncology Service, Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, Laval University, Quebec, Canada G1R-2J6.
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