Surgical treatment of recurrent ovarian cancer: report of 21 cases and a review of the literature.

Aim: To evaluate the role of secondary cytoreductive surgery in patients with recurrent ovarian cancer.

Patients And Methods: A retrospective chart review was conducted on 21 patients submitted to secondary cytoreductive surgery for apparently isolated and resectable recurrence of ovarian cancer, after a disease-free interval of at least 12 months.

Results: Fifteen patients (71%) had complete surgical debulking with no macroscopic tumor at the completion of the surgical procedure.

Concurrent carboplatin/5-fluorouracil and radiotherapy for recurrent cervical carcinoma.

Background: Results of salvage therapy in patients with carcinoma of the uterine cervix recurrent after surgery have been dismal even when the disease was apparently confined to the pelvis. Concurrent chemoradiation is one of the several avenues being investigated to improve these results.

Patients And Methods: Thirty-five women with recurrent cervical carcinoma were enrolled in the trial.

Angiogenesis extent and expression of matrix metalloproteinase-2 and -9 correlate with upgrading and myometrial invasion in endometrial carcinoma.

Background: Changes in angiogenesis and expression of extracellular matrix-degrading enzymes have been substantiated during tumour changeover and progression.

Methods: Tissues from 64 biopsies of endometrial carcinoma (EC) and 15 biopsies of normal (control) endometrium were investigated immunohistochemically to determine their microvessel number, and by in situ hybridisation to determine the expression of mRNA of the matrix metalloproteinase-2 (MMP-2, gelatinase A) and metalloproteinase-9 (MMP-9 gelatinase B). EC were grouped according to both histological grade (G) G1 to G3 and depth of myometrial (M) invasion M1 to M3.

Surgical resection of a cerebral metastasis from cervical cancer: case report and review of the literature.

Aims And Background: Central nervous system metastasis from cervical carcinoma is uncommon.

Case Report: We report the case of a 51-year-old woman who developed a solitary cerebral metastasis 29 months after radical hysterectomy with pelvic lymphadenectomy for a stage IB, grade III cervical cancer. The patient suddenly complained of headache, confusion and dizziness; she was submitted to emergency surgical resection of a 2 x 3 cm metastasis in the right frontal lobe.

TGF-beta 1 and IGF-1 expression in atrophic post-menopausal endometrium.

Objectives: Endometrial cells may synthetize cytokines and growth factors which may modulate some of the molecular mechanisms of endometrial proliferation and differentiation.

Patients And Methods: We investigated the role of transforming growth factor beta-1 (TGF-beta 1), insulin-like growth factor-1 (IGF-1) and relative receptors in five tissue samples from atrophic post-menopausal endometria. The control group was represented by proliferative and secretory endometria from 10 healthy, normally-menstratued women.

Brachytherapy for isolated vaginal recurrences from endometrial carcinoma.

Aims And Background: Isolated vaginal recurrences of endometrial carcinoma are rare, and prognostic factors that predict treatment outcome are still not well defined. The aim of the present study was to evaluate the results of brachytherapy in isolated vaginal recurrences from endometrial carcinoma.

Methods: Thirty-five patients with isolated vaginal recurrences were treated with brachytherapy with intravaginal ovoids or cylinders that were calculated to deliver 6000 to 7000 cGy at the surface.

Phase II study of cisplatin and vinorelbine as first-line chemotherapy in patients with carcinoma of the uterine cervix.

Purpose: To evaluate the activity and toxicity of the combination of cisplatin (80 mg/m2 day 1) and vinorelbine (25 mg/m2 days 1 and 8) in patients with carcinoma of the uterine cervix that has not been previously treated with chemotherapy.

Patients And Methods: Fifty patients with cervical cancer were enrolled onto this study (27 stage IB-III, 23 stage IVB-recurrent). A two-stage optimal Simon design was applied.

[A case of Leydig cell virilizing tumor of the ovary].

A case of Leydig cell virilizing tumor of the ovary in a 68 year old woman, with clinical signs of virilization, clitoromegaly and androgenic alopecia is described. An RMN of encephalon and an abdominal ultrasound were normal. Following total abdominal hysterectomy and bilateral salpingo-oophorectomy, the patient had regression of hirsutism, and plasma testosterone dropped to normal level.

[Sarcoma of the endometrial stroma].

Background: To evaluate the most important risk factors and the efficacy of endometrial stromal sarcoma therapy.

Methods: During a period of 9 years, 5 cases of ESS have been observed at the IInd Obstetrical and Gynecological Institute of the University of Bari. The patients were staged according to the FIGO classification of endometrial carcinoma and studied from an epidemiological, histopatological and clinical point of view.

Pure lipoma of the uterus in association with endometrial carcinoma.

Pure lipoma of the uterus is a very rare entity, with few cases described in the English literature. We report the case of a 71-year-old woman, with pure lipoma of the uterus and coexistent endometrial carcinoma and discuss the possible relationship between these pathologic entities.

[Acute urinary retention in uterine myoma: description of a case].

We report the case of a 50-year-old woman admitted to our Unit with the diagnosis of acute urinary retention due to huge uterine leiomyoma. Total abdominal hysterectomy resulted in resolution of the urologic symptomatology.

Prolonged survival of stage IV malignant mixed Müllerian tumor of the ovary after carboplatin, mesna, ifosfamide, and cis-platin chemotherapy: case report.

Malignant mixed müllerian tumors (MMMT) of the ovary are rare, aggressive and rapidly progressive tumors. According to the available literature, the presence of metastatic disease rarely permits long term survival. We report on a 64-year old patient with stage IV ovarian MMMT who achieved a surgically-documented complete response (CR) after 6 cycles of carboplatin, mesna, ifosfamide, cis-platin.

Fertility-sparing surgery in uterine leiomyosarcoma.

Background: Leiomyosarcoma of the uterus is a rare malignancy with a poor prognosis. Total abdominal hysterectomy is considered the treatment of choice. Occasionally, the diagnosis is made on myomectomy specimen, and in young patients the role of conservative management is not well defined.

Non-Hodgkin lymphoma in a gynecologic service. A report of three cases.

Primary lymphoma arising in female genital tract organs is extremely rare. We report three cases of non-Hodgkin lymphoma which were encountered during a four-year period at our gynecologic department. One patient presented with an inguinal mass; another had a primary lymphoma of the vagina and the third had massive pelvic and para-aortic lymphomatous involvement.

Transforming growth factor-beta1 in hemangioma of the ovary.

Hemangioma of the ovary is extremely rare. We report the case of a 32-year-old woman who complained of pelvic pain due to a large right adnexal mass. On surgical exploration a 10 x 8 cm hemangioma of the ovary was resected.

Hemangioma of the ovary. A case report.

Background: Ovarian hemangioma is extremely rare.

Case: We report a case of a 32-year-old woman who complained of pelvic pain due to a large right adnexal mass. On color Doppler sonography the mass showed very rich and complex vascularity, with prominent blood flow.

Complete remission of brain metastases from ovarian carcinoma with carboplatin.

Central nervous system involvement by epithelial ovarian carcinoma is rare. We report the case of a 49 year old woman with stage IV serous carcinoma of the ovary who developed multiple cerebral and cerebellar metastases 7 months after achieving complete response to platin-based chemotherapy. Eight courses of carboplatin (400 mg/m2) were administered and after the second cycle complete remission of the brain deposits occured.

Concurrent carboplatin/5FU and radiotherapy compared to radiotherapy alone in locally advanced cervical carcinoma: a case-control study.

Aims And Background: Despite the introduction of innovative techniques in radiotherapy (RT) delivery, no significant improvement in survival has been achieved in the last decades. Concurrent chemoradiation therapy (CRT) is one of the several avenues being explored to improve the results.

Methods And Study Design: Twenty-eight women with locally advanced squamous cell carcinoma of the uterine cervix were treated with CRT comprising a combination of external and intracavitary RT, along with 3 cycles of 5-fluorouracil (5-FU) and carboplatin.

Platin-based chemotherapy and salvage surgery in recurrent ovarian cancer following negative second-look laparotomy.

Aim: To evaluate the role of platin-based chemotherapy followed by salvage surgery in patients with recurrent ovarian cancer after negative second-look laparotomy.

Methods: A retrospective chart review was conducted on 38 patients with recurrent ovarian cancer after a pathologic complete response to first-line chemotherapy. After diagnosis of recurrence all patients underwent retreatment with platin-based chemotherapy followed by radical salvage surgery.

Serous papillary cystadenoma of borderline malignancy of the broad ligament.

Serous papillary cystadenoma of borderline malignancy arising in the broad ligament is extremely rare. We report the case of a 28-year-old female with a cystic mass in the broad ligament, who underwent complete excision of the mass, right salpingo-oophorectomy, omentectomy and multiple peritoneal biopsies. Pathology showed a serous papillary cystadenoma of borderline malignancy of the broad ligament, without peritoneal and omental involvement.

Second-look laparotomy in the management of fallopian tube carcinoma.

Objective: To evaluate the role of second-look laparotomy following platinum-based combination chemotherapy in patients with fallopian tube carcinoma.

Methods: A retrospective chart review was conducted on 21 patients with tubal carcinoma who underwent second-look laparotomy following cytoreductive surgery and platinum-based combination chemotherapy.

Results: Thirteen patients (62%) were found to be free of disease at second-look operation.

Treatment of fallopian tube carcinoma with cyclophosphamide, adriamycin, and cisplatin.

Primary carcinoma of the fallopian tube is uncommon; optimal primary treatment is still not well defined, and little information is available about the efficacy of cisplatin-based combination chemotherapy. Thirty-eight patients with fallopian tube carcinoma were treated with cyclophosphamide (500 mg/m2), Adriamycin (50 mg/m2), and cisplatin (50 mg/m2) (CAP). Thirty-two patients received the combination chemotherapy as first-line treatment after cytoreductive surgery, whereas six subjects were treated for recurrent disease.

Transvaginal color Doppler ultrasound for monitoring the response to neoadjuvant chemotherapy in advanced cervical cancer.

Background: To evaluate the role of transvaginal color Doppler ultrasound in monitoring the response to neoadjuvant chemotherapy in patients with locally-advanced cervical cancer.

Methods: Fourteen patients with locally-advanced cervical cancer, scheduled for neoadjuvant chemotherapy, were investigated with transvaginal color Doppler ultrasonography before and at the completion of chemotherapy in order to study hemodynamic changes in cervical and intratumoral vessels. Twenty healthy women matched for age and parity served as a control group.