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Boret S, Lambert E, Charles VP, Philippe T, Ponette D, Darras J, Mattelaer P, Verbeke S, Lumen N, Decaestecker K. Vulvar pagetoid urothelial intraepithelial neoplasia: a case report. Acta Chir Belg 2023; 123:174-177. [PMID: 34134597 DOI: 10.1080/00015458.2021.1940442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pagetoid urothelial intraepithelial neoplasia (PUIN) is a form of secondary Extramammary Paget Disease (EMPD). It is a rare malignant condition seen on the female genitalia synchronous or metachronous with bladder cancer (BC). CASE PRESENTATION A 66-year-old female presented with PUIN at the labia minora 2 years after an open anterior pelvic exenteration with ileal conduit urinary diversion for carcinoma in situ (CIS) of the bladder. PUIN of the vulva and vagina was confirmed by a punch biopsy and the patient underwent a radical vaginectomy with urethrectomy and inguinal sentinel node procedure. Immunohistochemically EMPD was identified by the expression tumor protein 63 (p63), cytokeratin 7, and cytokeratin 20 (CK20). CONCLUSIONS PUIN is a rare but distinct clinical entity as a form of secondary EMPD which can be differentiated from primary EMPD based on medical history, histology, and immunohistochemistry.
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Donat SM, Sonoda Y, Al-Ahmadie H, Murali R, Ng DL, Funt SA, Park KJ. Evaluation of Women With a Positive Urine Cytology and no Demonstrable Disease in the Urinary Tract. Urology 2023; 173:10-16. [PMID: 36621649 PMCID: PMC10406391 DOI: 10.1016/j.urology.2022.12.032] [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: 11/09/2022] [Revised: 12/08/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
Urinary cytology is indispensable both for the evaluation of gross hematuria and surveillance of patients with urothelial neoplasms. A positive urine cytology usually indicates the presence of urothelial carcinoma somewhere in the urinary tract. However, in women, it may also signal urothelial carcinoma involvement of the lower gynecologic tract or be the presenting sign for a primary cancer of the lower gynecologic tract or rectum. Guidelines for the evaluation of women with a positive cytology and normal urinary tract are lacking. We present a review of the current literature with case scenarios to bring clinicians attention to this diagnostic dilemma.
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Affiliation(s)
- Sherri M Donat
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY.
| | - Yukio Sonoda
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY
| | - Hikmat Al-Ahmadie
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rajmohan Murali
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Dianna L Ng
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samuel A Funt
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY
| | - Kay J Park
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Law ZW, Anbudurai M, Lee CSN, Lee LS. Vulvar urothelial carcinoma recurrence in an intact bladder free of disease. ANZ J Surg 2021; 92:1952-1954. [PMID: 34874090 DOI: 10.1111/ans.17415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/13/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Zhi Wei Law
- Department of Urology, Sengkang General Hospital, Singapore
| | - Manisha Anbudurai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Lui Shiong Lee
- Department of Urology, Sengkang General Hospital, Singapore
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Bi Y, Yi M, Yu Z, Han X, Ren J. Clinical outcomes of transarterial chemotherapy and embolization for vaginal cancer. J Obstet Gynaecol Res 2020; 46:924-930. [PMID: 32144875 DOI: 10.1111/jog.14234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/30/2020] [Accepted: 02/24/2020] [Indexed: 11/29/2022]
Abstract
AIM We report clinical outcomes of transarterial embolization in 19 cases of vaginal cancer. METHODS From August 2011 to October 2019, 19 patients with histologically diagnosed vaginal cancer were identified in our department. Transarterial chemotherapy and embolization was performed for all patients. Patient characteristics, treatment plans and the clinical outcomes, were recorded. RESULTS Among 19 identified cases, nine of them are squamous cell carcinoma, five of adenocarcinoma, one of adenosquamous carcinoma, two of vaginal malignant melanoma, one leiomyosarcoma and one of stromal sarcoma. Transarterial chemotherapy and embolization was successfully performed in all patients. No related complication was found after intervention treatment. Besides, eight patients received adjuvant chemotherapy, four received both adjuvant chemotherapy and radiotherapy and seven received no therapies. Four patients were cured and seven were stable during follow-up. CONCLUSION Transarterial embolization appears safe and effective for vaginal cancer, with a currently acceptable prognosis.
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Affiliation(s)
- Yonghua Bi
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengfei Yi
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zepeng Yu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinwei Han
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianzhuang Ren
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Fedus T, Raś R, Książek M, Filipowska J, Kaznowska E, Skręt A, Skręt-Magierło J, Barnaś E. Primary vaginal squamous cell carcinoma with bladder involvement in uterine prolapsed patient: Case report. Medicine (Baltimore) 2017; 96:e8993. [PMID: 29390294 PMCID: PMC5815706 DOI: 10.1097/md.0000000000008993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Primary vaginal squamous cell carcinoma (SCC) is a rare disease. Primary SCC in prolapsed vagina is extremely rare. In the presented case additional bladder involvement was found. PATIENTS CONCERNS Primary vaginal SCC may be misinterpreted as decubitus in prolapsed vagina and it may delay proper diagnosis and treatment. DIAGNOSES Diagnosis was confirmed by the vaginal ulceration biopsy and cystoscopic biopsy of the involved bladder. INTERVENTIONS In the case presented percutaneous nephrostomy was the only possible treatment of hydronephrosis. OUTCOMES In advanced primary SCC (Figo IVA) with nodal involvement palliative treatment is only option. LESSONS Primary SCC mimicking decubitus which appeared in prolapsed vagina, may be accompanied by bladder involvement.
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Affiliation(s)
| | - Renata Raś
- Obstetrics and Gynecology Clinic, Frederick Chopin Clinical Provincial Hospital No 1
| | - Mariusz Książek
- Department of Patomorphology, Chair of Morphological Sciences, Faculty of Medicine
| | | | - Ewa Kaznowska
- Department of Patomorphology, Chair of Morphological Sciences, Faculty of Medicine
| | - Andrzej Skręt
- Obstetrics and Gynecology Clinic, Frederick Chopin Clinical Provincial Hospital No 1
| | - Joanna Skręt-Magierło
- Institute of Obstetrics and Emergency Medicine, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Edyta Barnaś
- Institute of Obstetrics and Emergency Medicine, Medical Faculty, University of Rzeszow, Rzeszow, Poland
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Warzecha HN, Fend F, Steinhilber J, Abele H, Henes M, Harland N, Staebler A. Non-invasive papillary urothelial carcinoma of the vagina: molecular analysis of a rare case identifies clonal relationship to non-invasive urothelial carcinoma of the bladder. Virchows Arch 2017; 471:347-353. [PMID: 28589387 DOI: 10.1007/s00428-017-2165-4] [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: 02/13/2017] [Revised: 05/04/2017] [Accepted: 05/30/2017] [Indexed: 11/25/2022]
Abstract
We present a rare case of non-invasive papillary urothelial carcinoma of the vagina as the initial presentation of a multicentric urothelial carcinoma also involving bladder and renal pelvis and report for the first time in the literature the molecular alterations observed in the vaginal urothelial lesion and the synchronous lesions of the urinary tract. In this case, the non-invasive papillary urothelial carcinoma in the vagina displayed the same genetic alterations in the FGFR3 and PIK3CA genes as those seen in the non-invasive papillary urothelial carcinoma of the bladder contrasting with the wild phenotype observed in the invasive urothelial carcinoma of the renal pelvis. This observation could reinforce the theory of "seeding" of carcinoma cells as a valid and most likely explanation of this multifocality. In addition, we emphasize in this report the importance of recognizing this rare lesion in the female genital tract and its differential diagnosis.
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Affiliation(s)
- Hind N Warzecha
- Department of Pathology, University Hospital Tuebingen, Tuebingen, Germany.
| | - Falko Fend
- Department of Pathology, University Hospital Tuebingen, Tuebingen, Germany
| | - Julia Steinhilber
- Department of Pathology, University Hospital Tuebingen, Tuebingen, Germany
| | - Harald Abele
- Department of Gynecology, University Hospital Tuebingen, Tuebingen, Germany
| | - Melanie Henes
- Department of Gynecology, University Hospital Tuebingen, Tuebingen, Germany
| | - Niklas Harland
- Department of Urology, University Hospital Tuebingen, Tuebingen, Germany
| | - Annette Staebler
- Department of Pathology, University Hospital Tuebingen, Tuebingen, Germany
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