Müllerian and mesothelial lymph node involvement in patients with borderline ovarian tumors.

Objective: To determine the true incidence of Müllerian and mesothelial lymph node involvement in serous and mucinous borderline ovarian tumors (BLOT) with serial sectioning and immunohistochemistry.

Study Design: Formalinfixed, paraffin-embedded lymph node blocks from patients with serous (N = 21) and mucinous (N = 5) BLOT who underwent lymphadenectomy between 1995 and 2002 were serially sectioned at 5 microm levels with 3 consecutive sections taken at surface, 125 microm and 475 microm. One slide from each level was stained with hematoxylin-eosin (H-E), cytokeratin (AE1-AE3, DAKO) and calretinin (DAKO).

Smoking increases the risk of high-grade vaginal intraepithelial neoplasia in women with oncogenic human papillomavirus.

Objectives: In a large retrospective study, the association of smoking with human papillomavirus (HPV) genotype and vaginal intraepithelial neoplasia (VAIN) grade was analyzed.

Methods: A SNOMED search was performed for vaginal biopsy or resection specimens diagnosed as VAIN over an 11-year period. The diagnosis of VAIN grade was confirmed by histological review.

Laparoscopic surgery for large benign ovarian cysts.

Objective: To assess the feasibility and surgical outcome of laparoscopic surgery among women with large benign ovarian cysts.

Methods: We conducted a prospective study applying laparoscopic surgery among women with ovarian cysts whose maximum diameter was > or = 10 cm and radiologic and laboratory features suggestive of benign disease. Patients' demographics, clinical and ultrasound features, CA-125 values, surgical procedures, operative and post-operative complications, estimated amount of blood loss (EBL), operative time, conversion to laparotomy and the pathologic findings were recorded.

Broad ligament lipoma presenting as a pelvic mass: a case report.

Background: Pelvic masses can arise from gynecologic, nongynecologic, intraperitoneal and retroperitoneal structures. A retroperitoneal lipoma presenting as an adnexal mass is exceedingly rare.

Case: A 27-year-old, healthy woman had pelvic discomfort and was found to have pelvic organ displacement to the left side and a right adnexal mass.

Clinical and molecular differences between clear cell and papillary serous ovarian carcinoma.

Purpose: The aim of the current study is to compare clear cell ovarian carcinoma (CCOC) and papillary serous ovarian carcinoma (PSOC) with respect to their clinical features and expression of different regulators of cell cycle, apoptosis, and chemoresistance.

Experimental Design: Women with stage III CCOC (n = 9) and those with stage III, poorly differentiated PSOC (n = 21) seen between 1996 and 2000 and treated with cytoreductive surgery followed by paclitaxel and platinum chemotherapy were compared in their demographic features, tumor marker profile, surgical substage, results of cytoreductive surgery, thromboembolic complications, response to chemotherapy, and tumor recurrence. Tumor samples were compared in their expression of p53, Bcl(2), Bcl(x), Bax, p21, p-glycoprotein (PGP), multi-drug resistance-associated protein (MRP), lung resistance protein (LRP), and glutathione S-transferase (GST) using immunohistochemistry.

Update on the treatment of recurrent ovarian cancer.

Ovarian cancer is the leading cause of death for all gynecologic malignancies in developed countries, largely owing to the late stage of diagnosis. Despite response to initial surgery and chemotherapy, more than 65% of patients will have recurrent or persistent diseases. Approximately 50% of patients with recurrent ovarian cancer are asymptomatic.

Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma.

Objective: The purpose of our study was to find if uterine manipulation at the time of laparoscopic hysterectomy among women with endometrial carcinoma increases the incidence of malignant cells in the peritoneal washings.

Material And Methods: We conducted a prospective study including women with clinical stage I endometrioid endometrial carcinoma undergoing laparoscopic surgery between 07/01/2000 and 07/01/2004. Surgery on all patients was conducted by the same surgeon using the same technique and instruments.

Surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy shows well-differentiated tumors.

Objective: The purpose of our study was to assess the surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy showed well-differentiated (FIGO grade 1) carcinoma.

Materials And Methods: A retrospective study was conducted including all women treated at the University of Vermont between 1992 and 2004 whose preoperative endometrial biopsy was reviewed by the staff at the Pathology Department and diagnosed as FIGO grade 1 adenocarcinoma and who received peritoneal washings, total abdominal (or laparoscopic) hysterectomy, bilateral salpingo-oophorectomy, and pelvic +/- para-aortic lymphadenectomy as part of their surgery.

Results: One hundred eighty-two patients (age: 32-91, median: 60) were enrolled.

Factors associated with cytoreducibility among women with ovarian carcinoma.

Objectives: The aim of the current study is to investigate the clinical and molecular factors associated with cytoreduction among women with advanced stage epithelial ovarian carcinoma EOC.

Methods: Seventy-two women with FIGO stage III and IV EOC or primary peritoneal carcinoma (PPC) underwent similar attempt at surgical cytoreduction, mostly by the same surgeon. The histologic material of these patients was reviewed and the histologic subtype and grade were assigned.

Paclitaxel and carboplatin as second-line therapy in women with platinum-sensitive ovarian carcinoma treated with platinum and paclitaxel as first-line therapy.

The study was performed to assess response rate, progression-free interval (PFI), and side effects of the combination paclitaxel and carboplatin as second-line therapy among women with platinum-sensitive epithelial ovarian carcinoma (EOC). Thirty women who achieved partial surgical response at second-look surgery (n = 8) or who had recurrence (n = 22) more than 6 months after treatment with platinum-based chemotherapy were treated with paclitaxel (135 mg/m2 for 3 hours) and carboplatin (area under the concentration-time curve 5) every 3 weeks. Response rate, PFI, and side effects of treatment were recorded.

Positive predictive value of liquid-based and conventional cervical Papanicolaou smears reported as malignant.

Objectives: The predictive value of cervical Papanicolaou (Pap) smears reported as "positive for malignancy," especially those obtained by the liquid-based method, has not been adequately assessed. The objectives of this study are to determine the positive predictive value of Papanicolaou smears with features of malignancy, to compare the accuracy of Papanicolaou smears obtained by the liquid-based method to those obtained by the conventional technique in this setting, and to study the factors influencing a false-positive cytologic diagnosis of malignancy.

Materials And Methods: Pap smears significant for malignant cytology were identified at Fletcher Allen Health Care Hospital in Burlington, VT, from May 1, 1995, to April 30, 2001.

Lymphatic spread among women with primary peritoneal carcinoma.

Background And Objectives: Our knowledge regarding the pathologic lymphatic spread pattern of primary peritoneal carcinoma (PPC) is limited. The aim of this study was to compare the incidence and the pathologic patterns of pelvic and para-aortic lymph node metastases among women with PPC and those with papillary serous ovarian carcinoma (PSOC).

Methods: We conducted a prospective study over the last 4 years among women with FIGO stage III and IV PPC and PSOC who had optimal primary cytoreductive surgery (<1 cm residual).

Analysis of survival after laparoscopy in women with endometrial carcinoma.

Background: The effect of the laparoscopic surgical approach on the survival of women with endometrial carcinoma remains unclear. The objectives of the current study were to assess the effect of laparoscopic surgery on the survival of women with early-stage endometrial carcinoma and to analyze the factors that affect such survival.

Methods: A retrospective review of women presenting with clinical stage I endometrial carcinoma (according to the 1988 International Federation of Gynecology and Obstetrics Staging System) was performed.

Significant increase of benign endometrial cells on Papanicolaou smears in women using hormone replacement therapy.

Objective: To determine the prevalence of benign endometrial cells on Papanicolaou smears from postmenopausal women and to compare the prevalence and histologic diagnosis in women who use hormone replacement therapy (HRT) with those who do not.

Methods: Papanicolaou smear diagnoses from postmenopausal women and women over age 50 between April 1995 and December 1998 were retrieved and linked with follow-up smears and biopsies. Hormone status of women with benign endometrial cells smears was obtained from requisition forms or phone conversation with primary care providers.

Paclitaxel and platinum chemotherapy for malignant mixed müllerian tumors of the ovary.

Objective: Malignant mixed müllerian tumor (MMMT) of the ovary is a rare tumor with a dismal prognosis. The most effective therapy is unknown. The current study was undertaken to characterize a group of patients treated as if they had aggressive epithelial ovarian tumors, with cytoreductive surgery and combination paclitaxel/platinum chemotherapy.

Beta-2 microglobulin amyloidosis presenting as bilateral ovarian masses: a case report and review of the literature.

We report a case of systemic beta-2 microglobulin amyloidosis (B2M) in which the initial clinical presentation was that of bilateral ovarian masses. A 56-year-old woman who had been on renal dialysis for 12 years because of familial glomerulonephritis underwent a total hysterectomy and bilateral salpingo-oophorectomy for suspected ovarian malignancy. Pathologic findings included extensive amyloid infiltration of both ovaries, fallopian tubes, and focal perivascular deposition in the myometrium.