We report a patient with stage II primary vaginal cancer whose tumor disappeared on magnetic resonance imaging after a single course of neoajuvant chemotherapy using irinotecan and cisplatin. The regimen was 60 mg/m2 of cisplatin (day 1) and 60 mg/m2 of irinotecan (days 1, 8, 15). After addition of 1 course of cisplatin alone, radical surgery was performed. Histological examination of the excised tissue revealed no cancer cells. This is the first report on the good efficacy of chemotherapy with irinotecan and cisplatin for advanced vaginal cancer.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Remarkable suppressive effect of consecutive low-dose cisplatin therapy on advanced ovarian clear cell adenocarcinoma.

Ovarian clear cell adenocarcinoma (OCCA) is known to be less responsive to cisplatin and most other anti-cancer drugs and to have a poorer prognosis than other ovarian cancers. We report a rare case of stage IIIc OCCA in a patient who has been treated postoperatively with cisplatin alone and continues to survive after 7.5 years. In this case, 25 mg/m2/day of cisplatin was administered for 5 consecutive days every 4 weeks. After remission, intermittent administration of cisplatin every 3 to 4 months was performed 8 times. This case suggests that induction and intermittent chemotherapy using consecutive low-dose cisplatin administration may be a useful treatment for OCCA.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Transient rapid growth of uterine leiomyoma in a postmenopausal woman.

We report a case of transient rapid growth of uterine leiomyoma in a postmenopausal woman. A 58-year old woman presented with a rapidly enlarging pelvic tumor, from a 14-week to a 20-week gestational size in the one month. Transcervical needle biopsy revealed a smooth muscle tumor with 5 mitotic figures per 10 high power fields. However, surgical specimen obtained 1 month later revealed less than 1 mitotic figure per 100 high power fields. This variation may influence the final histopathological diagnosis because mitotic index is believed to be one of the most reliable histopathological parameters for differentiating between uterine leiomyoma and leiomyosarcoma.

Cell Division↗

PubMedDate not supplied

Diagnostic accuracy of needle biopsy of uterine leiomyosarcoma.

We previously reported on the efficacy of transcervical needle biopsy of a uterine muscle tumor. In this study, to examine diagnostic accuracy of our needle biopsy with small specimen size, previous slide preparations were used from 8 cases diagnosed with leiomyosarcoma and from 24 post-operative leiomyoma cases. Each tissue specimen was examined through needle biopsy-sized slit that had been randomly positioned over the slide. Three predictors: mitotic index, cytologic atypism, and tumor cell necrosis were evaluated on a 3-point scale (0, 1, or 2 points). When the diagnostic cut-off value was set to two, the sensitivity was 92.5% and the specificity was 100%.

Biopsy, Needle↗

PubMedDate not supplied

The usefulness and limits of magnetic resonance imaging in the differential diagnosis of pelvic tumors.

Three cases of benign pelvic tumors are presented (2 leiomyomas and 1 fibroma). All three tumors were suspected of being malignant neoplasms because they were visualized as heterogeneous high signal intensity on T2-weighted images, and thus they were difficult to diagnose preoperatively. One of the leiomyomas was located in the retroperitoneum and had been misdiagnosed as an ovarian tumor. All three tumors exhibited secondary myxoid changes, these changes may have been responsible for the high signal intensity on the T2-weighted MR images. Since benign tumors sometimes mimic malignant tumors on MR images, exploratory laparotomy is essential to make a definitive diagnosis.

Female↗

PubMedDate not supplied

Primary peritoneal clear cell carcinoma: excellent results from paclitaxel and carboplatin combination chemotherapy.

While papillary serous adenocarcinomas are histocytologically common in primary peritoneal carcinomas, clear cell carcinomas are rare. We report a new regimen for the treatment of recurrent clear cell carcinomas of the peritoneum. A 45-year-old woman was referred to our hospital and underwent optimal debulking surgery. Thirty-two months after the operation, lymph node swelling and elevation of serum CA19-9 were detected and recurrence was diagnosed. Paclitaxel (175 mg/m(2)) in a 3-hour and carboplatin (300 mg/m(2)) in a 1-hour infusion were repeated at three-week intervals. After completion of four courses, abdominal CT and serum CA19-9 were undertaken and results compared. Lymph node swelling was significantly decreased and the serum CA19-9 level was decreased to within a normal range. Paclitaxel and carboplatin combination chemotherapy may be effective in preventing the recurrence of peritoneal carcinomas.

Adenocarcinoma, Clear Cell↗