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Abramson Cancer CenterNCI CANCERLIT® Search: Vaginal and Vulvar Cancer - September 2002
National Cancer Institute®
Last Modified: September 1, 2002
- [Aggressive angiomyxoma of the vulva]
- Primary breast carcinoma of the vulva: case report and review of literature.
- Extramammary Paget's disease found by abnormal vulvar brush sampling.
- Lymphangioma circumscriptum of the vulva.
- [Topical 5-fluorouracil for treatment of vaginal intraepithelial neoplasms]
- Vulvar malignant melanoma associated with human papillomavirus DNA: report of two cases and review of literature.
- [Treatment of vulvar cancer--updated information]
- High-grade vulval intraepithelial neoplasia (VIN 3): a retrospective analysis of patient characteristics, management, outcome and
- Sebaceous gland hyperplasia of the vulva.
- Reconstruction of an extensive vulvectomy defect using the gluteus maximus fasciocutaneous V-Y advancement flap.
- Low-dose mitomycin C, etoposide, and cisplatin for invasive vulvar Paget's disease.
- Paget's disease of the vulva.
- High dose-rate intracavitary brachytherapy for carcinoma in situ of the vagina occurring after hysterectomy: a rational prescription of
- Vulvar Paget disease. Two cases with cytokeratin 7 and 20 expression.
- Lipoblastoma-like tumour of the vulva: report of three cases of a distinctive mesenchymal neoplasm of adipocytic differentiation.
- Transcription of the E6 and E7 genes of human papillomavirus type 6 in anogenital condylomata is restricted to undifferentiated cell layers of
- The pathology and molecular biology of anal intraepithelial neoplasia: comparisons with cervical and vulvar intraepithelial carcinoma.
- Efficacy and toxicity of MDR versus HDR brachytherapy for primary vaginal cancer.
- The 1396del A mutation and a missense mutation or a rare polymorphism of the WRN gene detected in a French Werner family with a severe phenotype
- Vaginal dysplastic lesions in women with hysterectomy and receiving radiotherapy are linked to high-risk human papillomavirus.
- The evaluation of the sentinel node successfully conducted in a case of malignant melanoma of the vagina.
Table of Contents
1
UI - 11878162
AU - Jardim O; Matos R; Falcao F; Dinis M; Oliveira C
TI -
[Aggressive angiomyxoma of the vulva]
SO - Acta Med Port 2001 Sep-Dec;14(5-6):507-10
AD - Servico de Ginecologia/Obstetrica, Hospitais da Universidade de Coimbra,
Coimbra.
An unusual myxoid and vascular appearing neoplasm of the vulva, termed
an Aggressive Angiomyxoma, is described in two cases report. The
clinical presentation and recurrence pattern were typical for previously
described neoplasms of the same cellular pattern. The histopathology,
difficulties in determining the surgical margins, and the treatment of
this tumor are discussed.
2
UI - 11876386
AU - Piura B; Gemer O; Rabinovich A; Yanai-Inbar I
TI -
Primary breast carcinoma of the vulva: case report and review of
literature.
SO - Eur J Gynaecol Oncol 2002;23(1):21-4
AD - Department of Obstetrics and Gynecology, Soroka Medical Center and
Faculty of Health Sciences, Ben-Gurion University of the Negev,
Beer-Sheva, Israel.
The occurrence of ectopic breast tissue within the vulva is uncommon and
the development of breast carcinoma within vulvar ectopic breast tissue
is very rare. To date, only 12 cases of primary vulvar breast carcinoma
have previously been reported in the English literature. This paper
presents the 13th reported case of primary breast carcinoma of the
vulva. The patient presented with a vulvar ulcerated lump and the
diagnosis was based on a morphologic pattern consistent with breast
carcinoma and the presence of estrogen and progesterone receptors.
Primary surgery consisted of radical vulvectomy and bilateral groin
dissection. The groin lymph nodes were involved bilaterally. Adjuvant
therapy consisted of systemic chemotherapy (4 cycles of adriamycin and
cyclophosphamide followed by 4 cycles of paclitaxel) and pelvic
radiotherapy. Oral tamoxifen 20 mg/day was started for the next five
years. It is concluded that the management of primary breast carcinoma
of the vulva should be modeled after that for primary carcinoma of the
orthotopic breast with primary surgery followed by systemic chemotherapy
and pelvic radiotherapy. Chemotherapy should be similar to that employed
for breast carcinoma. Tamoxifen should be prescribed for patients whose
tumors contain estrogen receptors.
3
UI - 11878287
AU - Yu BK; Lai CR; Yen MS; Tou NF; Chao KC; Yuan CC
TI -
Extramammary Paget's disease found by abnormal vulvar brush sampling.
SO - Eur J Gynaecol Oncol 2002;23(1):35-6
AD - Department of Obstetrics and Gynecology, Taipei Veterans General
Hospital, National Yang-Ming University, Taiwan.
INTRODUCTION: Doctors are usually reluctant to perform a vulvar biopsy
on a patient with non-specific chronic vulvitis--especially because of
the rarity of vulvar malignancy in young women--until the lesion is
suspected of being malignant. Therefore, most cases of extramammary
Paget's disease (EMPD) were originally misdiagnosed as chronic and
recurrent vulvar lesions. Late diagnosis of invasive lesions occurring
in elderly females have resulted in cases of death. CASE: A 37-year-old
patient showed an extended lesion on the vulva and perineum. In
addition, abnormal cells were found from a vulvar scrape smear, and a
following punch biopsy was used to diagnose and determine the extension
of the disease. CONCLUSION: Diagnosis and demarcation of EMPD remain
difficult due to the multifocal lesions and subtle nature of the
disease. Brush sampling taken from suspicious areas can be a guide for
multiple biopsies to demarcate the lesion before major surgery. A brush
biopsy is presented as a first-step method to detect vulvar malignancy.
4
UI - 11876403
AU - Vlastos AT; Malpica A; Follen M
TI -
Lymphangioma circumscriptum of the vulva.
SO - Eur J Gynaecol Oncol 2002;23(1):86-7
5
UI - 12148464
AU - Gonzalez Sanchez JL; Flores Murrieta G; Chavez Brambila J; Deolarte
TI -
Manzano JM; Andrade Manzano AF
[Topical 5-fluorouracil for treatment of vaginal intraepithelial
neoplasms]
SO - Ginecol Obstet Mex 2002 May;70():244-7
AD - Clinica de Colposcopia y Patologia del Tracto Genital Inferior, Hospital
de Ginecologia y Obstetricia Luis Castelazo Ayala, Instituto Mexicano
del Seguro Social.
OBJECTIVE: Our purpose was to determine the effectiveness of
5-fluorouracil (5-FU) in the treatment of vaginal intraepithelial
neoplasia (VAIN). MATERIALS AND METHODS: The study was performed in 30
patients with a mean age of 54 years and previous diagnoses from
reviewed records and histopathology slides selected from a group of 65
patients with VAIN from 1980 to 1998. Patients received intravaginal
treatment with 5-FU, 1.5 g once weekly for 10 weeks and all patients
were followed up for at least 2-years. Papanicolaou smear and colposcopy
were performed, as was biopsy when indicated. RESULTS: Twenty eight
(93%) patients with VAIN had prior or concurrent anogenital squamous
neoplasia, including 5 with invasive cervical carcinoma and 23 with
cervical intraepithelial neoplasia. In 23 of 30 treated patients (77%),
VAIN went into remission after a single treatment; in 3, (10%), it went
into remission after two treatment; 3 (10%) had recurrent VAIN 3; and in
1 (3%) it progressed to invasive vaginal cancer. The treatment was well
tolerated. CONCLUSIONS: The 5-FU is an option choice for VAIN treatment.
It is effective, with minimal slide effects. Its use should be confined
to treating extensive or multifocal high-grade VAIN.
6
UI - 12140440
AU - Rohwedder A; Philips B; Malfetano J; Kredentser D; Carlson JA
TI -
Vulvar malignant melanoma associated with human papillomavirus DNA:
report of two cases and review of literature.
SO - Am J Dermatopathol 2002 Jun;24(3):230-40
AD - Department of Microbiology and Virology, Albany Medical College, Albany,
New York 12208, U.S.A.
Oncogenic human papillomavirus (HPV) types such as HPV 16 are known to
play a crucial role in the development of anogenital carcinomas. The
etiology of anogenital malignant melanoma is unknown. We report two case
of vulvar malignant melanoma in which multiple HPV types including HPV
16 and putative novel HPV types (alb-1, alb-2, alb-7, and alb-10) were
identified by degenerated nested polymerase chain techniques (polymerase
chain reaction) in both the malignant melanoma and surrounding skin. One
melanoma was associated with lichen sclerosus, and the other, with
melanoma in situ and pigmented vulvar squamous papillomatosis. These
melanomas harbored HPV types alb-7, and HPV 16 as well as alb-1,
respectively. HPV types 16, 20, 21, 36, alb-2, and AJ001060 were
detected in vulvar skin affected by lichen sclerosus. Vulvar squamous
papillomatosis harbored HPV types 28 and alb-10. HPV 16 was physically
integrated into the host genome in lichen sclerosus skin and possibly in
the melanoma associated with pigmented vulvar squamous papillomatosis.
Twenty-two percent (4 of 18) of normal control specimens from skin tumor
excisions were found to harbor HPV DNA (HPV types 3, 54, and alb-7);
none of these control samples harbored multiple HPV DNA. These findings
of multiple HPV DNA and integrated HPV 16 in skin associated with vulvar
malignant melanoma indicate that HPV may play a role in the development
of vulvar malignant melanoma. The role of HPV could be either direct
through infection of melanocytes or indirect as a cofactor with free
radicals in chronic fibroinflammatory vulvar disorders such as lichen
sclerosus.
7
UI - 12214465
AU - Oda T; Fujiwara K; Suzuki S; Kono I
TI -
[Treatment of vulvar cancer--updated information]
SO - Gan To Kagaku Ryoho 2002 Aug;29(8):1383-8
AD - Department of Obstetrics and Gynecology, Kawasaki Medical School, 577
Matsushima, Kurashiki, Okayama 701-0192, Japan.
Over the past 20 years, the management of vulvar cancer has changed
dramatically. The radical vulvectomy that was previously believed to be
the only effective treatment for vulvar cancer has now been replaced by
more individualized treatments. These include conservative surgery for
patients with isolated lesions, omission of groin lymph node dissection
in T1A tumors with stromal invasion < 1 mm, elimination of routine
pelvic lymphadenectomy, groin lymph node dissection with separate groin
incision, omission of contralateral groin lymph node dissection in T1
tumor with negative ipsilateral node metastasis, use of preoperative
radiotherapy to avoid pelvic exenteration in advanced cases, and
postoperative radiotherapy to decrease the incidence of groin recurrence
in patients with multiple positive groin nodes. In addition to these
changes, the identification of sentinel lymph nodes and chemoradiation
therapy are currently under investigation. In this review, we discuss
these issues along with the evidence upon which these therapies are
based.
8
UI - 11926644
AU - Sykes P; Smith N; McCormick P; Frizelle FA
TI -
High-grade vulval intraepithelial neoplasia (VIN 3): a retrospective
analysis of patient characteristics, management, outcome and
relationship to squamous cell carcinoma of the vulva 1989-1999.
SO - Aust N Z J Obstet Gynaecol 2002 Feb;42(1):69-74
AD - Department of Obstetrics and Gynaecology, Christchurch School of
Medicine, New Zealand.
OBJECTIVES: To determine patient and disease characteristics, treatment
patterns and long-term outcomes, in order to help direct management of
patients with VIN 3, to examine the risk of development of cancer
following a diagnosis of VIN 3 and the risk of recurrent disease
requiring multiple treatment episodes, and to review patients with
vulval cancer, in order to establish the relative prevalence of VIN 3
related vulval cancers. DESIGN: Retrospective chart review of 65
consecutive patients diagnosed with VIN 3 between 1989 and 1999.
POPULATION OR SAMPLE: All patients diagnosed with VIN 3 at Christchurch
Age at diagnosis, symptoms, medical history disease characteristics,
treatment, outcome and follow-up. RESULTS: The median age at diagnosis
was 38 years. Smokers were younger than non-smokers. Two-thirds had
associated dysplasia of the lower genital tract, 43% had high-grade
lesions. Seventy-nine per cent were symptomatic for a median of 9.5
months. All had macroscopically visible disease. Colposcopy and
histology diagnoses correlated in 72% of cases. Treatment by local
excision was undertaken in 84% of cases of which 65% had involved
margins. Fifty-one per cent required further treatment, risk factors
were positive margins and multifocal disease. Three developed
micro-invasive cancer. CONCLUSIONS: Treatment by local excision is both
diagnostic and therapeutic. Excision may reveal micro-invasive cancer,
patients are usually symptomatic and VIN 3 has some potential to become
invasive. Treated patients may develop microinvasive disease but frank
invasion was not seen. The true rate of malignant progression in
untreated patients remains unclear and radical surgery is rarely
indicated. All patients require long-term follow up.
9
UI - 11975959
AU - Ortiz-Rey JA; Martin-Jimenez A; Alvarez C; De La Fuente A
TI -
Sebaceous gland hyperplasia of the vulva.
SO - Obstet Gynecol 2002 May;99(5 Pt 2):919-21
AD - Department of Pathology, Policlinico Vigo S.A., Vigo, Spain.
BACKGROUND: Sebaceous gland hyperplasia is a common condition of the
face in elderly patients. We report a case of sebaceous gland
hyperplasia on the vulva. CASE: A 19-year-old woman presented with a
polypoid tumor on her left labium majus of which the greatest diameter
was 2.5 cm, covered by normal appearing skin. Histologic examination
revealed a sebaceous gland hyperplasia. Immunohistochemical techniques
showed high expression of androgen receptors on sebaceous cells.
CONCLUSION: Clinical and gross features of the two documented cases of
sebaceous gland hyperplasia on the vulva are different from those of
typical lesions on the face. Histologic study of a vulvar biopsy is
required to reach a specific diagnosis of this hamartomatous benign
condition.
10
UI - 12142595
AU - Arkoulakis NS; Angel CL; DuBeshter B; Serletti JM
TI -
Reconstruction of an extensive vulvectomy defect using the gluteus
maximus fasciocutaneous V-Y advancement flap.
SO - Ann Plast Surg 2002 Jul;49(1):50-4; discussion 54
AD - Divisions of Plastic Surgery and Gynecologic Oncology, Strong Memorial
Hospital, University of Rochester School of Medicine & Dentistry,
Rochester, NY 14642, USA.
Effective management of a vulvar wound resulting from oncological
ablative surgery poses a formidable task for the reconstructive surgeon.
During the past two decades, numerous procedures have been described in
an effort to provide stable, sensate coverage that minimizes deformity
and preserves function, often in the setting of concomitant radiation.
At the authors' institution, a fasciocutaneous V-Y advancement flap
based on the gluteus maximus has been adopted as a common approach to
this problem. They present their institutional experience with this
procedure. A 10-year chart review (1991-2001) yielded a series of 20
vulvectomy patients, all of whom were reconstructed by the same surgeon
using ischial fasciocutaneous V-Y flaps based on perforators from the
inferior border of the gluteus maximus muscle. Patients underwent
vulvectomy for recurrent or advance-stage vulvar cancer, or extensive
carcinoma in situ. Squamous cell carcinoma was the most common pathology
(N = 13). Fifteen patients had bilateral V-Y flaps; the remainder had
unilateral procedures. Six patients underwent prior radiation therapy.
Two patients had delayed reconstruction for vaginal stenosis. Flap
survival was 100%. There were no major complications, early or late.
Minor complications were limited to localized areas of delayed healing,
all of which responded to conservative measures. Functional outcome was
excellent in all patients. At an average follow-up of 44 months, there
were five episodes of recurrent disease necessitating surgical
intervention. Based on this series, the gluteus maximus V-Y advancement
flap provides a straightforward and reliable method to recruit local
tissue for stable coverage of these often difficult-to-manage wounds.
11
UI - 12060453
AU - Watanabe Y; Hoshiai H; Ueda H; Nakai H; Obata K; Noda K
TI -
Low-dose mitomycin C, etoposide, and cisplatin for invasive vulvar
Paget's disease.
SO - Int J Gynecol Cancer 2002 May-Jun;12(3):304-7
AD - Department of Obstetrics and Gynecology, Kinki University School of
Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511, Japan.
watanabe@med.kindai.ac.jp
We report the effect of low-dose mitomycin C, etoposide, and cisplatin
(low-dose MEP) therapy for three patients with invasive vulvar Paget's
disease (invasive VPD) who declined radical vulvectomy and skin
grafting. One patient achieved a complete response, while the other two
showed partial responses (PR) without grade 3 or 4 adverse effects. The
two patients with PR were undergone partial vulvectomy and inguinal
lymph node dissection. All patients have no sign of recurrence for 10
months after chemotherapy. Our present results suggest that low-dose MEP
is an effective and safe chemotherapy for invasive VPD and low-dose MEP
may significantly improve postoperative quality of life in patients with
invasive VPD by avoiding extensive vulvar resection and skin grafting.
12
UI - 12193912
AU - Tebes S; Cardosi R; Hoffman M
TI -
Paget's disease of the vulva.
SO - Am J Obstet Gynecol 2002 Aug;187(2):281-3; discussion 283-4
AD - Department of Obstetrics and Gynecology, University of South Florida,
Tampa, USA. stebes@hsc.usf.edu
OBJECTIVE: Our goal was to review our experience with Paget's disease of
the vulva relative to initial examination, treatment, and oncologic
outcome. STUDY DESIGN: Patients who were treated for extramammary
Paget's disease of the vulva at the University of South Florida were
identified in our vulvar cancer database for the period 1988 through
2000. The charts were reviewed, and the data were collected regarding
patient demographics, previous Paget's treatment, symptoms, surgical
margin status, associated malignancies, and time to recurrence. RESULTS:
Twenty-three women with extramammary Paget's disease of the vulva were
treated by the Division of Gynecologic Oncology during the 12-year
period. The average patient was postmenopausal and white and had
symptoms for 21 months before the diagnosis was made. A pruritic lesion
was the most common symptom. Treatment included wide local excision or
vulvectomy, depending on the extent of disease. Six of the 23 patients
displayed invasive disease and, consequently, underwent radical
resection. There were 8 recurrences that were found, on average, 30
months after the surgical procedure. Two of the 8 patients had invasive
disease at their primary operation, and 1 patient had underlying
invasive disease at the time of recurrence. The average follow-up time
was 39 months (median, 13.5 months; range, 1-216 months). CONCLUSION:
Delay in diagnosis did not correlate with size or extent of disease.
Margin status did not change the natural course of disease. Recurrence
is relatively common, and long-term monitoring is recommended, with
repeat excision of symptomatic lesions.
13
UI - 12193925
AU - Teruya Y; Sakumoto K; Moromizato H; Toita T; Ogawa K; Murayama S;
TI -
Kanazawa K
High dose-rate intracavitary brachytherapy for carcinoma in situ of the
vagina occurring after hysterectomy: a rational prescription of
radiation dose.
SO - Am J Obstet Gynecol 2002 Aug;187(2):360-4
AD - Department of Obstetrics and Gynecology, Faculty of Medicine, University
of the Ryukyus, Okinawa, Japan.
OBJECTIVE: Our purpose was to profile patients who were treated with
high dose-rate intracavitary brachytherapy for carcinoma in situ of the
vagina that occurred after hysterectomy, with special reference to a
rational prescription of radiation dose. STUDY DESIGN: We reviewed 13
patients who were treated for posthysterectomy carcinoma in situ of the
vagina by the brachytherapy as the sole treatment. The brachytherapy was
delivered by a remote-controlled afterloading intracavitary radiation
system. RESULTS: The mean age of the patients was 62 years. The total
dose of absorbed radiation was 36 and 30 Gy that was prescribed at
1.0-cm depth to the vaginal surface in 3 cases and at 40 and 30 Gy that
was prescribed at 0.5-cm depth in 10 cases. All patients had vaginal
mucosal radiation changes of mild to moderate grade. Three cases that
were irradiated to a total dose of 30 Gy at 1.0-cm depth had rectal
bleeding and/or macroscopic hematuria. Complaints regarding sexual
functioning were not found in this retrospective analysis. All patients
remain free of disease after a median follow-up period of 127 months.
CONCLUSION: High dose-rate brachytherapy with a dose prescription at
0.5-cm depth can yield a promising rate of tumor control, with lower
associated morbidity than that with a dose prescription at 1.0-cm depth
in the treatment of posthysterectomy carcinoma in situ of the vagina.
14
UI - 11550003
AU - Bilenchi R; Andreassi A; Santopietro R; Miracco C; Biagioli M; Cardone
TI -
C; Andreassi L
Vulvar Paget disease. Two cases with cytokeratin 7 and 20 expression.
SO - Minerva Ginecol 2001 Oct;53(5):363-6
AD - Department of Dermatology, University of Siena, Italy. bilenchi@unisi.it
Two cases of vulvar Paget's disease are described in two women aged 75
and 60 years, with onset several years earlier as eczema-like
manifestations, and evolving into erosive, slightly infiltrative
lesions. In both cases immunohistochemical examination revealed
positivity for cytokeratins CK7 and CK20. This finding suggested the
diagnosis of primitive vulvar Paget's disease, a relatively benign form,
unlike the aggressive and rapidly progressive secondary vulvar Paget's
disease.
15
UI - 12047760
AU - Lae ME; Pereira PF; Keeney GL; Nascimento AG
TI -
Lipoblastoma-like tumour of the vulva: report of three cases of a
distinctive mesenchymal neoplasm of adipocytic differentiation.
SO - Histopathology 2002 Jun;40(6):505-9
AD - Section of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA.
AIMS: We sought to delineate and describe three cases of a distinctive
mesenchymal neoplasm of the vulva showing adipocytic differentiation and
affecting young patients. METHODS AND RESULTS: In three patients between
13 and 38 years of age, the vulvar tumours had well-circumscribed
borders and ranged in size from 35 to 100 mm. Histologically, they were
well circumscribed and lobulated. The lobules were separated by thin
fibroconnective tissue septa and were composed of slender spindle cells
showing slightly eosinophilic cytoplasm with indistinct boundaries,
uniform nuclei with finely granular chromatin, and no nucleoli. The
cells were embedded in a richly myxoid stroma. The background in all
three tumours was a 'chicken-wire', capillary vascular network
resembling that seen in myxoid liposarcomas. Two tumours had scattered
signet-ring-type lipoblasts and the third a large number of such
lipoblasts. Clusters of mature adipocytes were entrapped in the tumours.
None had mitotic figures, necrosis, or pleomorphism. The neoplastic
cells stained positively for vimentin and were negative for other
immunohistochemical markers. Treatment for all three tumours was
enucleation alone. After follow-up of 10 years, 7 years, and 1 year, all
patients are well with no evidence of disease. CONCLUSIONS: The benign
behaviour of these neoplasms militates against the diagnosis of
liposarcoma. We believe these are benign lesions of adipocytic
differentiation akin to infantile lipoblastomas.
16
UI - 1321267
AU - Iftner T; Oft M; Bohm S; Wilczynski SP; Pfister H
TI -
Transcription of the E6 and E7 genes of human papillomavirus type 6 in
anogenital condylomata is restricted to undifferentiated cell layers of
the epithelium.
SO - J Virol 1992 Aug;66(8):4639-46
AD - Institut fur Klinische und Molekulare Virologie, Friedrich Alexander
Universitat Erlangen-Nurnberg, Germany.
The E6 and E7 genes of human genital papillomaviruses (HPVs) appear to
transform cells by different mechanisms. They seem to act
synergistically but are not equally important when tested under diverse
experimental conditions. We were therefore tempted to investigate the
E6- and E7-specific transcription pattern in HPV6-infected condylomas
separately, by in situ hybridization. Recent studies have identified
three promoters within the E6-E7 region of HPV6 and HPV11 by applying
S1, exonuclease VII, and cDNA analyses. On the basis of these data, we
cloned subgenomic fragments of HPV6 into plasmid pBS to obtain
riboprobes that differentiated between transcripts starting upstream of
the E6 and E7 open reading frames, respectively. These different species
of mRNAs were analyzed in serial thin sections of eight HPV6-positive
anogenital condylomas. The E6 probe (nucleotides 7862 to 241) led to
weak signals within the basal layer. In three cases, rather strong
signals were confined to a few basal cells. The E7 probe (nucleotides
242 to 534) gave rise to a more pronounced labeling of all cells within
the two to three lowest epidermal layers. In situ hybridization with a
riboprobe for human c-fos revealed an expression pattern similar to that
observed with the E7 probe. In contrast to the preferential expression
of the transforming E6 and E7 genes in the lower epithelium, the major
transcriptional activity of the virus was detected in the middle and
upper third by probes colinear with the 3' moiety of the early region.
17
UI - 12073068
AU - Zbar AP; Fenger C; Efron J; Beer-Gabel M; Wexner SD
TI -
The pathology and molecular biology of anal intraepithelial neoplasia:
comparisons with cervical and vulvar intraepithelial carcinoma.
SO - Int J Colorectal Dis 2002 Jul;17(4):203-15
AD - Department of Colorectal Surgery, Kaplan Medical Center, Rehovot,
Israel. apzbar@zahav.net.il
BACKGROUND: Anal intraepithelial neoplasia (AIN) is a well-described
pathological precursor of invasive squamous cell carcinoma which has
recently been detected with increasing frequency in immunocompromised
patients, particularly those with seropositivity for human
immunodeficiency virus (HIV). The epidemiology and natural history of
this entity is somewhat unclear, since the overall prevalence in the HIV
seronegative population is unknown. DISCUSSION: There is a clear
etiological association between AIN and high-risk human papillomavirus
(HPV) subtype infection although there is great variability in HPV DNA
detection of cytological and histological material in these patients. It
appears that there is an antigen-specific hyporesponsiveness by
cytotoxic lymphocytes against HPV peptide sequences or recombinant
proteins encoded by oncogenic HPV subtypes in these patients, which is
dependent upon the stage of their HIV-associated disease. Although the
molecular biology of AIN and cervical or vulvar intraepithelial
neoplasia are comparable, in AIN there is less significance of tumor
suppressor gene mutations, proto-oncogenic growth factor activation, and
genomic instability. CONCLUSION: Current concepts in the epidemiology
and etiology of AIN are discussed, as well as its immunological response
in the HIV-positive population, drawing parallels where possible between
other HPV-related preinvasive disorders, and concluding with a suggested
management protocol
18
UI - 12098007
AU - Rutkowski T; Bialas B; Rembielak A; Fijalkowski M; Nowakowski K
TI -
Efficacy and toxicity of MDR versus HDR brachytherapy for primary
vaginal cancer.
SO - Neoplasma 2002;49(3):197-200
AD - I. Radiotherapy Clinic; Cancer Center Maria Sklodowska-Curie Memorial
Institute, Gliwice, 44-101 Poland. tomr22@hotmail.com
The retrospective analysis includes a group of 50 patients with primary,
invasive vaginal cancer treated with brachytherapy in the period of
1982-1993. Over 80% cases were squamous cell carcinoma. There were 14
patients in stage I according to FIGO classification and 20%, 36%, and
16% of patients in stage II, III and IV, respectively. Twenty one
patients (42%) received MDR brachytherapy using Cs137 source, the
remaining 29 (58%) were treated with HDR using Co60 or Ir192 sources.
Among 50 patients 31 (62%) received also external beam irradiation. An
overall 5-year actuarial disease-free survival was 40%, and it was 78.6%
(11/14), 40% (4/10), 27.8% (5/18), 0% (0/8) for stage I, II, III and IV,
respectively. For MDR or HDR5-year disease-free survival was 38% and
41%, respectively. No influence of dose rate on survival has been found
(p=0.7). Local failure occurred in 20 patients (40%). Recurrences
appeared in 10 patients (20%). Late complications rate was 0% and 17%
for MDR and HDR, respectively. Effectiveness of brachytherapy MDR and
HDR was similar, whereas serious late complications developed more often
after HDR brachytherapy.
19
UI - 10206685
AU - Vidal V; Bay JO; Champomier F; Grancho M; Beauville L; Glowaczower C;
TI -
Lemery D; Ferrara M; Bignon YJ
The 1396del A mutation and a missense mutation or a rare polymorphism of
the WRN gene detected in a French Werner family with a severe phenotype
and a case of an unusual vulvar cancer. Mutations in brief no. 136.
Online.
SO - Hum Mutat 1998;11(5):413-4
AD - Laboratoire d'Oncologie moleculaire (INSERM CRI9402), Centre Jean
Perrin, BP 392,63011 Clemont-Ferrand, France.
The Werner's syndrome (WS) is a rare recessive disease characterized by
an early onset of geriatric disorders. The Werner's syndrome gene (WRN)
recently cloned, encodes for an helicase and therefore plays a role in
DNA metabolism and DNA repair. Here, we report the study of a French
family with two affected members and numerous cancers. Using the protein
truncation test and sequencing, we identified a homozygous mutation in
the WRN gene. This mutation generates a frame shift leading to a very
short 391 amino acids truncated protein without the helicase motif. A
particularly severe phenotype of the affected patient was associated
with an unusual vulvar cancer traditionaly observed in elderly patients
and therefore likely to be related to the Werner's syndrome. An
additional substitution of G for A at nucleotidic position 1392 was also
described. We suggest that a relation between genotype and phenotype
could exist in the studied family.
20
UI - 12116034
AU - Barzon L; Pizzighella S; Corti L; Mengoli C; Palu G
TI -
Vaginal dysplastic lesions in women with hysterectomy and receiving
radiotherapy are linked to high-risk human papillomavirus.
SO - J Med Virol 2002 Jul;67(3):401-5
AD - Department of Histology, Microbiology, and Medical Biotechnologies,
University of Padova, Padova, Italy.
Patients undergoing radiotherapy for advanced cervical and endometrial
cancer bear a considerable risk of developing vaginal preneoplastic
lesions. Radiotherapy itself has been considered to have a role in the
pathogenesis of vaginal dysplasia, although human papillomavirus (HPV)
involvement has also been suggested. A series of 88 patients who
underwent hysterectomy and were irradiated for gynecological cancer,
including 43 with postradiation vaginal dysplasia at colposcopy and 45
without vaginal lesions, were included in this study. Detection and
genotyping of HPV DNA in vaginal scraping were carried out by a
PCR-based method and compared with colposcopic and cytological findings
and with other clinical and laboratory data. Forty-two (97.7%)
colposcopy-positive subjects and 6 (13.3%) colposcopically-negative
patients were PCR-positive for high-risk HPV DNA (P < 0.000001).
Twenty-two out of the 43 patients with colposcopic lesions showed an
abnormal Papanicolau (PAP) test. Cytologic examination was negative in
all colposcopically negative women. Type 16 HPV DNA was more frequent in
patients with high-grade squamous intraepithelial lesions and in
patients treated with external radiotherapy, whereas other types of
high-risk HPV were more common in patients with low-grade lesions and in
those treated with brachytherapy. When considering colposcopy as the
standard for diagnosing vaginal dysplasia, HPV DNA testing was more
sensitive than the PAP test. However, the specificity of the PAP test
was higher with no false-positive case. In conclusion, vaginal
preneoplastic changes in women post-hysterectomy and receiving
radiotherapy for cervical, endometrial, and vaginal cancer represent an
HPV-related nosologic entity. Whereas colposcopic examination can detect
these preneoplastic lesions, HPV genotyping is a sensitive, inexpensive,
and noninvasive method that may complement colposcopy and the PAP test.
Copyright 2002 Wiley-Liss, Inc.
21
UI - 12217768
AU - Nakagawa S; Koga K; Kugu K; Tsutsumi O; Taketani Y
TI -
The evaluation of the sentinel node successfully conducted in a case of
malignant melanoma of the vagina.
SO - Gynecol Oncol 2002 Sep;86(3):387-9
AD - Department of Obstetrics and Gynecology, University of Tokyo, Hongo
7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan. nakagawas-tky@umin.ac.jp
BACKGROUND: The sentinel node biopsy has been established as a standard
procedure in many types of cancer. To date, only one case was reported
for successful detection of the sentinel node using a
radiopharmaceutical-directed mapping technique in malignant melanoma of
the vagina. CASE: An 81-year-old woman developed malignant melanoma
arising from the lower third of the vagina. She underwent local
resection of the tumor and exploration of the sentinel node using blue
dye. The sentinel node was detected successfully in the groin, and was
negative for metastasis. Intra-cavity irradiation was given as an
adjuvant therapy. CONCLUSION: In view of relative ease and minimal
trauma, sentinel node mapping could be a routine procedure in malignant
melanoma arising from the vagina or vulva.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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