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Objective: To assess the patterns of recurrence of vulva cancer on F-FDG PET/CT and to compare the F-FDG PET metabolic metrics in patients with and without Human Immunodeficiency Virus (HIV).
Methods: Maximum standardized uptake value (SUV), mean standardized uptake value (SUV), metabolic tumour volume (MTV and total lesion glycolysis (TLG) were obtained on Flourine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (F-FDG PET/CT) images of women referred with suspected or confirmed vulva cancer recurrence. We compared HIV-infected and HIV-uninfected patients regarding pattern disease recurrence, age at diagnosis, and the PET-derived metabolic indices.
Results: We analyzed 33 patients with a mean age 50.76 ± 15.78 including 21 HIV-infected women. The majority of patients (94 %) had squamous cell carcinoma and 84.85 % were Blacks. Of the HIV-infected individuals, the median CD4 count was 526.0 cells/mm3 (IQR: 379.0-729.0). HIV infected patients were younger than the HIV uninfected at the time of diagnosis: 40.50 ± 8.87 vs 66.54 ± 9.71 respectively, p < 0.001. We found a local (vulvar) recurrence rate of 75.8 %. Nodal pelvic recurrences were higher in the HIV-infected patients than in the HIV uninfected patients (70 % vs 30 %, p = 0.027). Three patients had distant metastasis and all three were HIV-infected. There was a higher whole-body MTV and TLG among HIV-infected women compared with HIV-uninfected women, 103.39 vs 17.58 and 852.64 vs 101.79, respectively (p < 0.05 for both).
Conclusion: HIV-infected women are diagnosed with vulva cancer at a younger age. HIV-infected patients had a higher rate of pelvic lymph node recurrence. There is a higher tumor burden at vulva cancer recurrence among women with HIV infection.
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http://dx.doi.org/10.1055/a-1221-7810 | DOI Listing |
Am J Case Rep
December 2024
Surgical Gynecology Clinic of The Gynecological and Obstetrics Clinical Hospital, Poznań University of Medical Sciences, Poznań, Poland.
BACKGROUND Human Papilloma Virus (HPV)-associated Vulvar Squamous Cell Carcinomas (VSCC) present more frequently in young women than HPV- independent tumors. Due to its association with HPV infection, the incidence of vulvar cancer is increasing in young women; however, during pregnancy, it is still extremely rare. CASE REPORT We present the case of a 36-year-old pregnant woman at 23 weeks of pregnancy, diagnosed with HPV 16-associated VSCC, Federation of Gynecology and Obstetrics (FIGO) stage IB.
View Article and Find Full Text PDFBackground: Recurrent gynecological clear cell carcinoma (rGCCC) has a low objective response rate (ORR) to chemotherapy. Previous preclinical and clinical data suggest a potential synergy between immune checkpoint inhibitors and bevacizumab in rGCCC. Dostarlimab, a humanized monoclonal antibody targeting programmed cell death protein 1 (PD-1), combined with the anti-angiogenic bevacizumab, presents a novel therapeutic approach.
View Article and Find Full Text PDFFront Med (Lausanne)
December 2024
Department of Pathology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a biphasic epithelial tumor associated with HPV infection. This rare tumor primarily affects the nasal cavity and paranasal sinuses, with only two cases reported outside these locations to date-one in the breast and one in the vulva. This report presents a case of a tumor resembling an HMSC arising in the cervix.
View Article and Find Full Text PDFMil Med
December 2024
Division of Gynecologic Oncology, Department of Gynecologic Surgery & Obstetrics, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is associated with the development of genital warts, precancerous lesions, and cancers of the oropharynx, anus, penis, vulva, vagina, and cervix. HPV-associated diseases are preventable through vaccination. An Australian nationwide vaccination program will effectively eliminate cervical cancer as a public health concern by the year 2035.
View Article and Find Full Text PDFWorld J Surg Oncol
December 2024
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Background: The objective of this study was to evaluate the clinicopathological characteristics and patterns of care among women diagnosed with vulvar malignancy at a tertiary care teaching institute. Additionally, the study aimed to analyse the implications of revised FIGO staging system on stage shift and patient outcomes.
Methods: A retrospective observational study was conducted, wherein hospital records of biopsy-proven cases of vulvar cancers managed over a period of 10 years were comprehensively reviewed.
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