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Patel S, Anand M. Dual Gynecological Malignancies: A Case Series from Tertiary Care Center. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2019. [DOI: 10.1007/s40944-019-0306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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2
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Basolo F, Pingitore R, Gadducci A. Osteosarcoma of the Myometrium Synchronous with Bilateral Papillary Cystadenocarcinoma of the Ovary and Papillary Adenocarcinoma of the Cervix. TUMORI JOURNAL 2018; 74:227-31. [PMID: 3163444 DOI: 10.1177/030089168807400219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report an extremely rare case of a 60-year-old woman with myometrial osteosarcoma associated with bilateral papillary cystadenocarcinoma of the ovary and papillary adenocarcinoma of the cervix. The uterine osteosarcoma is the seventh case reported in the world, while it is the second case of syncronous triple primary tumors of the upper female genital tract. Clinical and pathological features of previously reported cases of uterine osteosarcoma and triple primary neoplasias of the upper female genital tract are critically reviewed.
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Affiliation(s)
- F Basolo
- Institute of Pathologic Anatomy and Histology, University of Pisa, Italy
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Demirci U, Coşkun U, Göçün PU, Gurlek B, Saka B, Oztürk B, Benekli M, Büyükberber S. Four different malignancies in one patient: a case report. CASES JOURNAL 2010; 3:53. [PMID: 20205852 PMCID: PMC2825507 DOI: 10.1186/1757-1626-3-53] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 02/08/2010] [Indexed: 02/07/2023]
Abstract
Cancer survivors have a higher risk of new primary cancer, in the same or in another organ, than the general population. We report a 78-year-old women who has metachronous quadruple adenocarcinoma, includes bilateral breast cancer, ovarian cancer and retroperitoneal neuroendocrine carcinoma. The development of second cancer in cancer survivors can be expected but third or higher order malignancies are rare.
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Affiliation(s)
- Umut Demirci
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.
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Pekin T, Yoruk P, Yildizhan R, Yildizhan B, Ramadan S. Three synchronized neoplasms of the female genital tract: an extraordinary presentation. Arch Gynecol Obstet 2007; 276:541-5. [PMID: 17522881 DOI: 10.1007/s00404-007-0379-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2006] [Accepted: 04/16/2007] [Indexed: 10/23/2022]
Abstract
INTRODUCTION We report a case of unusual co-existence of multiple primary neoplasms of female genital tract. CASE A 62-year-old gravida 2, para 2 was referred with spotting and vaginal discharge for about 6 months. Fractionate curettage was performed and documented endocervical squamous cell carcinoma in situ. Subsequently total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed. Final pathological report demonstrated cervical squamous cell carcinoma, right ovarian Brenner tumor, left ovarian granulosa tumor and endometrial polyps. DISCUSSION Multiple primary neoplasms of female genital tract is a well-recognized yet rare occurrence. Although the presented case is probably an incidental event, the pathogenesis of the neoplastic process affecting the tissues with different embryological origin needs further research and evaluation. It is important to distinguish multiple primary neoplasms from metastatic disease because of the fact that overall survival as well as treatment would vary considerably.
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Affiliation(s)
- Tanju Pekin
- Obstetrics and Gynecology Department, Marmara Univestiy, Istanbul, Turkey
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Daling JR, Madeleine MM, Schwartz SM, Shera KA, Carter JJ, McKnight B, Porter PL, Galloway DA, McDougall JK, Tamimi H. A population-based study of squamous cell vaginal cancer: HPV and cofactors. Gynecol Oncol 2002; 84:263-70. [PMID: 11812085 DOI: 10.1006/gyno.2001.6502] [Citation(s) in RCA: 186] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Little is known about the etiology of in situ or invasive squamous cell cancer of the vagina. It is thought that some vaginal cancers may have the same etiology as cervical cancer. It is also not known whether in situ and invasive vaginal cancer share the same etiologic factors. We conducted a study to evaluate risk factors for in situ and invasive vaginal cancer and their potential relationship to prior exposure to human papillomaviruses (HPV). METHODS A population-based case-control study included 156 women with squamous cell in situ or invasive vaginal cancer diagnosed between January 1981 and June 1998 and 2041 control women identified through random-digit dialing in western Washington state. Cases and controls were interviewed in person and provided blood samples; archival tumor tissue was retrieved for cases. Blood samples were tested for antibodies to HPV, and tumor tissue was tested for HPV DNA. RESULTS Women with vaginal cancer were more likely to have five or more lifetime sexual partners (OR = 3.1, 95% CI 1.9 to 4.9), to have an early age at first intercourse (<17 years OR = 2.0, 95% CI 1.2 to 3.5), and to be current smokers at diagnosis (OR = 2.1, 95% CI 1.4 to 3.1) than control women. Approximately 30% of all cases had been treated for a prior anogenital tumor, most often of the cervix. Prior hysterectomy was a risk factor only among women who had no history of prior anogenital cancer (OR = 3.9 95% CI 2.5 to 6.1). Antibodies to HPV16 L1 were strongly related to risk of vaginal cancer (OR = 4.3, 95% CI 3.0 to 6.2). We detected HPV DNA in tumor blocks from over 80% of the patients with in situ and 60% of the patients with invasive cancers. CONCLUSIONS In situ and invasive vaginal neoplasia have many of the same risk factors as cervical cancer, including a strong relationship to HPV infection. Women who have been treated for a prior anogenital cancer, particularly of the cervix, have a high relative risk, although low absolute risk, of being diagnosed with vaginal cancer.
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Affiliation(s)
- Janet R Daling
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, Washington 98109-1024, USA.
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Abu-Musa A, Khalil A, Ghaziri G, Seoud M, Abbas J. Synchronous vulvar and breast cancer. Eur J Obstet Gynecol Reprod Biol 2001; 100:92-3. [PMID: 11728665 DOI: 10.1016/s0301-2115(01)00461-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Synchronous vulvar and breast cancer is rare. A 44-year-old women presented with a lesion in the right labia majora and right upper quadrant breast lump. After work-up, she underwent radical wide local vulvar excision and modified radical mastectomy with axillary lymph node dissection. The pathology of the vulva revealed moderately-differentiated squamous cell carcinoma and that of the breast infiltrating ductal carcinoma. Only two such cases have been previously reported: one was an elderly patient and the second a young patient with HIV infection. Our patient is a young and healthy woman making her presentation a unique and rare case.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Axilla
- Biopsy, Needle
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Carcinoma, Squamous Cell/therapy
- Chemotherapy, Adjuvant
- Estrogen Antagonists/therapeutic use
- Female
- Humans
- Lymph Node Excision
- Neoplasms, Multiple Primary
- Radiotherapy
- Receptors, Progesterone/analysis
- Tamoxifen/therapeutic use
- Vulvar Neoplasms/pathology
- Vulvar Neoplasms/surgery
- Vulvar Neoplasms/therapy
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Affiliation(s)
- A Abu-Musa
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, P.O. Box 113-6044-6A, Beirut, Lebanon.
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Kamikatahira S, Jobo T, Kuramoto H. Endometrial carcinoma with synchronous ovarian malignancy-differentiation between independent and metastatic carcinomas. Int J Clin Oncol 1996. [DOI: 10.1007/bf02348275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Pilotti S, Gupta J, Stefanon B, De Palo G, Shah KV, Rilke F. Study of multiple human papillomavirus-related lesions of the lower female genital tract by in situ hybridization. Hum Pathol 1989; 20:118-23. [PMID: 2536630 DOI: 10.1016/0046-8177(89)90175-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Twenty-six women with multiple human papillomavirus (HPV)-related lesions of the lower genital tract were investigated by immunohistochemistry for the internal genus-specific capsid antigen of HPV and by DNA-DNA in situ hybridization with 35S-radiolabeled probes for sequences of HPV-6/11, HPV-16, and HPV-18. The vulva was the most frequently affected site in all of these cases; the cervix was the second most frequently affected site. The lesions displayed the features of papillomavirus infection in 14 patients, and there was also histologic evidence of early neoplasia in 12 patients. The mean age of patients with and without neoplasia was 40 and 30 years, respectively. Evidence of HPV association was found in 73% of the vulvar lesions and in 40% of the other synchronous lesions by one or both methods. Viral DNA was found in 67% of patients with neoplasia and in 71% of patients without neoplasia. Eleven of 12 HPV-positive patients with neoplasia revealed the presence of HPV-16 in their tissues by in situ hybridization. On the other hand, 50% of those without neoplasia had HPV-16 DNA, whereas the presence of HPV-6/11 was found in the other 50%. The clinical course of the disease, the distribution of HPV type, and the type of antigen in patients with and without neoplasia suggest that progression to neoplasia was associated with HPV-16. These results stress the practical value of the in situ hybridization method for the identification of those patients with HPV infection who are at risk for progression to malignancy.
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Affiliation(s)
- S Pilotti
- Division of Anatomical Pathology and Cytology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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Ulbright TM, Roth LM. Metastatic and independent cancers of the endometrium and ovary: a clinicopathologic study of 34 cases. Hum Pathol 1985; 16:28-34. [PMID: 2982713 DOI: 10.1016/s0046-8177(85)80210-0] [Citation(s) in RCA: 170] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Twenty-one of 34 simultaneous cancers involving the endometrium and ovary were classified as endometrial primary tumors with ovarian metastases. The criteria for this classification were either a multinodular ovarian pattern (major criterion) or two or more of the following minor criteria: small (less than 5 cm) ovary(ies), bilateral ovarian involvement, deep myometrial invasion, vascular invasion, and tubal lumen involvement. Twelve cancers were classified as independent neoplasms, primarily by the absence of the above criteria. Although they were classified as independent, the histologic features of the endometrial and ovarian tumors were the same in 11 of these 12 cases. Only one case represented an ovarian primary tumor with an endometrial metastasis. Both the group believed to have endometrial primaries with ovarian metastases and that with independent primaries showed high incidences of associated endometrial hyperplasia, supporting the belief that the endometrium is a primary site in both groups. The cancers classified as metastatic, with no known spread outside the endometrium-myometrium and ovary, were found to involve other sites significantly (P less than 0.01) more frequently than those classified as independent. Grade 3 endometrioid carcinoma, adenosquamous carcinoma, and malignant mixed müllerian tumors occurred only in the metastatic group, whereas the independent group had a variety of endometrioid and nonendometrioid tumors.
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Cohan L, Kaplan AL. Postmenopausal bleeding secondary to metastatic disease in the endocervix from carcinoma of the breast. Gynecol Oncol 1984; 17:133-6. [PMID: 6693049 DOI: 10.1016/0090-8258(84)90067-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A case of postmenopausal bleeding secondary to metastatic breast cancer in the endocervix is presented. This is the second reported case of cervical involvement from breast carcinoma.
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Hammond IG, Monaghan JM. Multicentric carcinoma of the female lower genital tract. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1983; 90:557-61. [PMID: 6860601 DOI: 10.1111/j.1471-0528.1983.tb08968.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The clinical history and treatment of 17 patients with multicentric primary carcinomas of the cervix and vulva is presented. There is a significant association between vulval intraepithelial neoplasia and cervical neoplasia. The concept of multicentricity in relation to invasive and intraepithelial neoplasia of the cervix and vulva is critically reviewed.
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12
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Matlock DL, Salem FA, Charles EH, Savage EW. Synchronous multiple primary neoplasms of the upper female genital tract. Gynecol Oncol 1982; 13:271-7. [PMID: 7076043 DOI: 10.1016/0090-8258(82)90040-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Kapp DS, Fischer D, Grady KJ, Schwartz PE. Subsequent malignancies associated with carcinoma of the uterine cervix: including an analysis of the effect of patient and treatment parameters on incidence and sites of metachronous malignancies. Int J Radiat Oncol Biol Phys 1982; 8:197-205. [PMID: 7085375 DOI: 10.1016/0360-3016(82)90514-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The incidence and sites of metachronous malignancies were retrospectively determined from the records of 763 patients seen at Yale University medical Center and affiliated hospitals with previously untreated, invasive carcinoma of the uterine cervix from 1953-1972. These patients were treated predominantly with radiation therapy; follow-up status was known for periods of 5-25 years or until time of death in over 96% of the patients. Forty-four patients had second malignancies noted at least 6 months after the initial cervical cancer was diagnosed. The expected incidence of second malignancies was determined from the Connecticut State Tumor Registry data controlling for year of diagnosis of the cervical cancer, patient age, sex, and time at risk (person-years exposure). To correct for any error in estimation of second malignancies introduced by the existence of a latency period for the development of a second cancer, the expected incidence of malignancies was also computed for 5-year time intervals following the cervical cancer. No significant increase in second malignancies was found (observed/expected-44/36) for the entire follow-up period nor for any individual 5-year interval. However, a statistically significant increase in lung cancer and vulva-vaginal cancer was noted and a significant decrease in breast cancer was observed. Cox regression analyses were performed to study the effect of total radium exposure and total external beam treatment, adjusting for other factors. No statistically significant increased risks were found.
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Lee JY, Perez CA, Ettinger N, Fineberg BB. The risk of second primaries subsequent to irradiation for cervix cancer. Int J Radiat Oncol Biol Phys 1982; 8:207-11. [PMID: 7085376 DOI: 10.1016/0360-3016(82)90515-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A review of 1048 patients with cancer of the cervix treated with radiation, either alone or combined with surgery, disclosed 32 cases of second primary malignancies occurring from 1 to 16 years subsequent to treatment. Using the person years approach, the incidence rate of second primaries was 5.49 per 1000 person years, which is not significantly different from population based rates. The anatomic locations of the new malignancies and the times from treatment of the cervix cancer to diagnosis of a new primary are presented; the possible carcinogenic effects of radiation are discussed. In this group of patients, it was concluded that under the period of observation irradiation administered at therapeutic doses did not increase the probability of second malignancy in the pelvis or at other sites.
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Abstract
The epidemiologic data, clinical features, associated diseases, and histologic characteristics present in 50 cases of carcinoma in situ of the vulva are analyzed. A comparison of follow-up results obtained with various treatment methods is presented. With primary surgery the recurrence rate is dependent on the presence or absence of tumor at the surgical margins. Deoxyribonucleic acid patterns, determined by microspectrophotometry, were aneuploid in 92% of the cases studied. Five patients (10%) with aneuploid lesions, observed without therapy, experienced spontaneous regression of tumor and replacement of abnormal areas by euploid epithelium.
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Milano CT, Deppe G, Deligdisch L, Cohen CJ. Multiple primary neoplasms of the upper female genital tract. Gynecol Oncol 1980; 9:120-4. [PMID: 7353799 DOI: 10.1016/0090-8258(80)90018-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Cześnin K, Wronkowski Z. Second maligancies of the irradiated area in patients treated for uterine cervix cancer. Gynecol Oncol 1978; 6:309-15. [PMID: 689482 DOI: 10.1016/0090-8258(78)90037-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Van Bogaert LJ, De Muylder E, Staquet J. Ovarian clear-cell carcinoma associated with multiple distinct Müllerian tumors. Eur J Obstet Gynecol Reprod Biol 1976. [DOI: 10.1016/0028-2243(76)90046-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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