1
|
Tung HJ, Wang YC, Lin CY, Liao MJ, Pan YB, Jung SM, Wang CC, Huang HJ, Chao A, Chou HH, Chang TC, Yang LY, Lai CH. Human papillomavirus prevalence, genotype distribution, and prognostic factors of vaginal cancer. Int J Cancer 2024; 155:1996-2008. [PMID: 39046705 DOI: 10.1002/ijc.35105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/22/2024] [Accepted: 05/22/2024] [Indexed: 07/25/2024]
Abstract
We aimed to investigate human papillomavirus (HPV) prevalence and genotype distribution and prognostic factors in vaginal cancer (VC). VC patients who received treatment between 1989 and 2020 were retrospectively reviewed. L1 general polymerase chain reaction (PCR) followed by HPV Blot (King Car, I-Lan, Taiwan) and E6 type-specific-PCR were performed for genotyping firstly. P16 and p53 immunohistochemistry staining was performed. Univariate and multivariate analyses identified predictors of clinical outcomes.79 VC patients were eligible for analysis. 73 patients (92.4%) were squamous cell carcinoma (SCC) and 6 (7.6%) as non-SCC. The median follow-up time was 134.3 months (range 0.9-273.4). Among nine initially HPV-negative cases, seven were identified as being positive through HPV16/18/45/52/58 whole-genome amplification followed by Sanger sequencing (WGASS). HPV DNA sequences were detected in 98.6% of SCC and 83.3% of non-SCC, respectively, with HPV16 (49.4%), HPV52 (15.2%) and HPV58 (8.9%) being predominant. Patients with paraaortic lymph node (LN) metastasis had a 5-year cancer-specific survival (CSS) rate of 0%. Multivariate analysis revealed that only p16 and stage were significantly correlated with prognosis. Variables with strong correlations (p16- and HPV-positivity, LN metastasis and stage), were included in models 2-5 alternatively. Stage III/IV (hazard ratio [HR] = 3.64-4.56) and LN metastasis (HR = 2.81-3.44) were significant negative predictors of CSS, whereas p16-positivity (HR = 0.29-0.32) and HPV-positivity (HR = 0.14) were related to better prognosis. In conclusion, 97.5% of VCs were HPV-positive with WGASS. Stage III/IV and LN metastasis were significant negative predictors, whereas p16- and HPV-positivity were significantly associated with better prognosis.
Collapse
Affiliation(s)
- Hsiu-Jung Tung
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - You-Chen Wang
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Branch and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Chiao-Yun Lin
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Min-Jie Liao
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Branch and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Yu-Bin Pan
- Clinical Trial Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Ming Jung
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Pathology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chun-Chieh Wang
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Huei-Jean Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Angel Chao
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Lan-Yan Yang
- Division of Clinical Trial, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chyong-Huey Lai
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan, Taiwan
| |
Collapse
|
2
|
Korzun T, Moses AS, Diba P, Sattler AL, Olson B, Taratula OR, Pejovic T, Marks DL, Taratula O. Development and Perspectives: Multifunctional Nucleic Acid Nanomedicines for Treatment of Gynecological Cancers. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2301776. [PMID: 37518857 PMCID: PMC10827528 DOI: 10.1002/smll.202301776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/11/2023] [Indexed: 08/01/2023]
Abstract
Gynecological malignancies are a significant cause of morbidity and mortality across the globe. Due to delayed presentation, gynecological cancer patients are often referred late in the disease's course, resulting in poor outcomes. A considerable number of patients ultimately succumb to chemotherapy-resistant disease, which reoccurs at advanced stages despite treatment interventions. Although efforts have been devoted to developing therapies that demonstrate reduced resistance to chemotherapy and enhanced toxicity profiles, current clinical outcomes remain unsatisfactory due to treatment resistance and unfavorable off-target effects. Consequently, innovative biological and nanotherapeutic approaches are imperative to strengthen and optimize the therapeutic arsenal for gynecological cancers. Advancements in nanotechnology-based therapies for gynecological malignancies offer significant advantages, including reduced toxicity, expanded drug circulation, and optimized therapeutic dosing, ultimately leading to enhanced treatment effectiveness. Recent advances in nucleic acid therapeutics using microRNA, small interfering RNA, and messenger RNA provide novel approaches for cancer therapeutics. Effective single-agent and combinatorial nucleic acid therapeutics for gynecological malignancies have the potential to transform cancer treatment by giving safer, more tailored approaches than conventional therapies. This review highlights current preclinical studies that effectively exploit these approaches for the treatment of gynecological malignant tumors and malignant ascites.
Collapse
Affiliation(s)
- Tetiana Korzun
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, 2730 S Moody Avenue, Portland, OR, 97201, USA
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 SW Bond Avenue Portland, Portland, OR, 97239, USA
- Medical Scientist Training Program, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
- Papé Family Pediatric Research Institute, Oregon Health & Science University, SW Sam Jackson Park Rd, Mail Code L481, Portland, OR, 97239, USA
| | - Abraham S Moses
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, 2730 S Moody Avenue, Portland, OR, 97201, USA
| | - Parham Diba
- Medical Scientist Training Program, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
- Papé Family Pediatric Research Institute, Oregon Health & Science University, SW Sam Jackson Park Rd, Mail Code L481, Portland, OR, 97239, USA
| | - Ariana L Sattler
- Papé Family Pediatric Research Institute, Oregon Health & Science University, SW Sam Jackson Park Rd, Mail Code L481, Portland, OR, 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, 2720 S Moody Avenue, Portland, Oregon, 97201, USA
- Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, 2730 S Moody Avenue, Portland, OR, 97201, USA
| | - Brennan Olson
- Mayo Clinic Department of Otolaryngology-Head and Neck Surgery, 200 First St. SW, Rochester, MN, 55905, USA
| | - Olena R Taratula
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, 2730 S Moody Avenue, Portland, OR, 97201, USA
| | - Tanja Pejovic
- Departments of Obstetrics and Gynecology and Pathology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Daniel L Marks
- Papé Family Pediatric Research Institute, Oregon Health & Science University, SW Sam Jackson Park Rd, Mail Code L481, Portland, OR, 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, 2720 S Moody Avenue, Portland, Oregon, 97201, USA
- Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, 2730 S Moody Avenue, Portland, OR, 97201, USA
| | - Oleh Taratula
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, 2730 S Moody Avenue, Portland, OR, 97201, USA
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 SW Bond Avenue Portland, Portland, OR, 97239, USA
| |
Collapse
|
3
|
Usman A, Bello SS, Abdurrahman A, Rasheed FA, Adam S, Dahiru A. A histopathological review of gynaecological malignancies in Katsina state North-Western Nigeria. Ecancermedicalscience 2024; 18:1750. [PMID: 39421162 PMCID: PMC11484695 DOI: 10.3332/ecancer.2024.1750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Indexed: 10/19/2024] Open
Abstract
Background Gynaecological cancers, which affect the female genital tract, constitute a significant public health problem, especially in developing countries. Some of these malignancies have known aetiology and premalignant stages making them preventable. Understanding the burden of gynaecological malignancies in our environment will provide baseline information and help form strategies for their control. Aim To describe the histological subtypes of gynaecological cancers, their frequency and age distribution trends in Katsina State over the 10-year study period. Methods This was a 10-year retrospective cross-sectional multicenter study of all histologically diagnosed gynaecological cancer cases seen from 1st January 2012 to 31st December 2021 at Federal Teaching Hospital Katsina, General Hospital Katsina and General Amadi Rimi Specialist Hospital Katsina. Data for this study were extracted from departmental record registers of the pathology laboratories of the corresponding hospitals whose laboratories provide pathology services to the State. Cancer distribution over the years was sorted based on the primary site of diagnosis, histological diagnosis and age. Data were analysed using Statistical Package for Social Science version 28 and results were presented in tables and charts. Results Two thousand three hundred and fifty-nine cancers were seen over the 10-year study period. Of these cases, 58.4% (n = 1,378) were females. Gynaecological malignancies accounted for 18.7% (441/2,359) of all cancers and 32.0% (441/1,378) of all female cancers. The highest frequency of gynaecological cancers was seen in women who were within the age groups of 40-49 and 50-59, and the lowest was seen in women who were ≥90 years old. The mean age was 48.9 ± 14.9 years. The most common site of gynaecological malignancies was the cervix uteri (n = 262, 59.4%) followed by the ovary (n = 106, 24.0%). Other sites in descending order were corpus uteri (n = 29, 6.6%), vulva (n = 9, 2.0%) and vagina (n = 2, 0.5%). The most common histo-morphologic subtypes were large-cell keratinizing squamous cell carcinoma in the cervix, large-cell non-keratinizing squamous cell carcinoma in the cervix and cystadenocarcinoma in the ovary. Choriocarcinoma was found in 33 cases (7.5%). Conclusion This study demonstrated the various histotypes of gynaecological malignancies and their trends in Katsina state. The leading cancer was found to be cervical cancer which is mainly preventable. It is hoped that data from this study will provide a basis for making and implementing policies and strategies to lessen the problems of gynaecological malignancies through regular screening programs, especially for cervical cancer and accepting human papilloma virus (HPV) vaccination take-up.
Collapse
Affiliation(s)
- Asma’u Usman
- Department of Anatomic and Molecular Pathology, Federal Teaching Hospital Katsina, Katsina 820101, Nigeria
| | | | - Aisha Abdurrahman
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Katsina, Katsina 820101, Nigeria
| | - Fatima Abubakar Rasheed
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital Katsina, Katsina 820101, Nigeria
| | - Shuaibu Adam
- Department of Anatomic and Molecular Pathology, Federal Teaching Hospital Katsina, Katsina 820101, Nigeria
| | - Abubakar Dahiru
- Department of Anatomic and Molecular Pathology, Federal Teaching Hospital Katsina, Katsina 820101, Nigeria
| |
Collapse
|
4
|
Javadi K, Ferdosi-Shahandashti E, Rajabnia M, Khaledi M. Vaginal microbiota and gynecological cancers: a complex and evolving relationship. Infect Agent Cancer 2024; 19:27. [PMID: 38877504 PMCID: PMC11179293 DOI: 10.1186/s13027-024-00590-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024] Open
Abstract
The vagina hosts a community of microorganisms known as the vaginal microbiota. This community is relatively stable and straightforward, with Lactobacillus species being the most dominant members. The vaginal microbiota has various functions that are essential for maintaining human health and balance. For example, it can metabolise dietary nutrients, produce growth factors, communicate with other bacteria, modulate the immune system, and prevent the invasion of harmful pathogens. When the vaginal microbiota is disrupted, it can lead to diseases and infections. The observed disturbance is distinguished by a reduction in the prevalence of Lactobacillus and a concurrent rise in the number of other bacterial species that exhibit a higher tolerance to low oxygen levels. Gynecologic cancers are a group of cancers that affect the female reproductive organs and tissues, such as the ovaries, uterus, cervix, vagina, vulva, and endometrium. These cancers are a major global health problem for women. Understanding the complex interactions between the host and the vaginal microorganisms may provide new insights into the prevention and treatment of gynecologic cancers. This could improve the quality of life and health outcomes for women.
Collapse
Affiliation(s)
- Kasra Javadi
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Elaheh Ferdosi-Shahandashti
- Biomedical and Microbial Advanced Technologies Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehdi Rajabnia
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Mansoor Khaledi
- Department of Microbiology and Immunology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| |
Collapse
|
5
|
Thanasa E, Thanasa A, Kontogeorgis G, Gerokostas EE, Antoniou IR, Chasiotis A, Xydias EM, Ziogas AC, Kamaretsos E, Thanasas I. Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion. Cureus 2024; 16:e55157. [PMID: 38558656 PMCID: PMC10980332 DOI: 10.7759/cureus.55157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Vaginal fibroepithelial polyps are rare benign tumors of the mucosa of the anterior vaginal wall. In extremely rare cases, they may originate from the posterior vaginal wall or be complicated by torsion. Our case concerns a 63-year-old patient who presented to the gynecology outpatient clinic of the General Hospital of Trikala with minor vaginal bleeding. On vaginal examination, a large pedunculated painless hemorrhagic polypoid mass was noticed, originating from the posterior vaginal wall. A torsion of the pedunculated vaginal tumor was suspected, leading to its surgical excision with clear resection margins. Due to extensive tissue necrosis, accurate histological identification of the vaginal neoplasm was not possible. Histological examination excluded vaginal malignancy. Based predominantly on the clinical and morphological features of the vaginal lesion, a diagnosis of vaginal fibroepithelial polyp with torsion was made, acknowledging its limitations. The patient was discharged from the clinic the same afternoon following the surgery. Three months later, no recurrence of the lesion in the vaginal wall was noted. Following the case presentation, this paper provides a brief literature review of this rare entity, focusing on the diagnostic and therapeutic approaches.
Collapse
Affiliation(s)
- Efthymia Thanasa
- Department of Histology, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Anna Thanasa
- Department of Anatomy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | | | | | - Athanasios Chasiotis
- Department of Obstetrics and Gynecology, Limassol General Hospital, Limassol, CYP
| | - Emmanouil M Xydias
- Department of Obstetrics and Gynecology, EmbryoClinic In Vitro Fertilization (IVF) Unit, Thessaloniki, GRC
| | - Apostolos C Ziogas
- Department of Obstetrics and Gynecology, University of Thessaly, Larissa, GRC
| | - Evangelos Kamaretsos
- Department of Obstetrics and Gynecology, General Hospital of Trikala, Trikala, GRC
| | - Ioannis Thanasas
- Department of Obstetrics and Gynecology, General Hospital of Trikala, Trikala, GRC
| |
Collapse
|
6
|
Khan I, Harshithkumar R, More A, Mukherjee A. Human Papilloma Virus: An Unraveled Enigma of Universal Burden of Malignancies. Pathogens 2023; 12:pathogens12040564. [PMID: 37111450 PMCID: PMC10146077 DOI: 10.3390/pathogens12040564] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
HPV, or Human Papilloma Virus, has been the primary causative agent of genital warts and cervical cancer worldwide. It is a sexually transmitted infection mainly affecting women of reproductive age group, also infecting men and high-risk group individuals globally, resulting in high mortality. In recent years, HPV has also been found to be the major culprit behind anogenital cancers in both gender and oropharyngeal and colorectal cancers. Few studies have reported the incidence of HPV in breast cancers as well. For a few decades, the burden of HPV-associated malignancies has been increasing at an alarming rate due to a lack of adequate awareness, famine vaccine coverage and hesitancy. The effectiveness of currently available vaccines has been limited to prophylactic efficacy and does not prevent malignancies associated with post-exposure persistent infection. This review focuses on the current burden of HPV-associated malignancies, their causes and strategies to combat the growing prevalence of the cancers. With the advent of new technologies associated with treatment pertaining to therapeutic interventions and employing effective vaccine coverage, the burden of this disease may be reduced in the population.
Collapse
Affiliation(s)
- Ishrat Khan
- Division of Virology, ICMR-National AIDS Research Institute, Pune 411026, India
| | - R Harshithkumar
- Division of Virology, ICMR-National AIDS Research Institute, Pune 411026, India
| | - Ashwini More
- Division of Virology, ICMR-National AIDS Research Institute, Pune 411026, India
| | - Anupam Mukherjee
- Division of Virology, ICMR-National AIDS Research Institute, Pune 411026, India
| |
Collapse
|
7
|
McGettigan M, Zulfiqar M, Shetty AS. Imaging of Vaginal and Vulvar Malignancy. Radiol Clin North Am 2023; 61:651-670. [PMID: 37169430 DOI: 10.1016/j.rcl.2023.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Vaginal and vulvar malignancies are rare gynecologic malignancies but can be associated with high morbidity and mortality if undiagnosed and untreated. Advanced imaging modalities such as MRI enable assessment of the local extent of disease and evaluation for regional or distant spread. Accurate identification and description of the primary lesion and sites of involvement as well as detection and localization of suspicious lymph nodes are critical in guiding appropriate management. Additionally, radiologists should be aware of potential mimickers on imaging and the differential diagnoses for vaginal and vulvar lesions.
Collapse
|
8
|
Shen Y, Meng X, Wang L, Wang X, Chang H. Advanced primary vaginal squamous cell carcinoma: A case report and literature review. Front Immunol 2022; 13:1007462. [PMID: 36483563 PMCID: PMC9722770 DOI: 10.3389/fimmu.2022.1007462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Vaginal carcinoma is a gynecological malignancy with low incidence, and there are few relevant and specific guidelines for vaginal cancer in our country and abroad. Here, we report the case who was diagnosed with advanced, primary vaginal squamous cell carcinoma and underwent integrated treatment successfully. Case introduction A 64-year-old Chinese woman underwent subtotal hysterectomy for uterine fibroids in 1998 and laparoscopic extensive residual cervical resection, bilateral ovarian salpingectomy, and pelvic lymph node dissection for residual cervical adenocarcinoma (stage IB1) in the First Affiliated Hospital of China Medical University in 2018. There was no postoperative review. The patient experienced vaginal discharge in March 2020, and vaginal bleeding occurred in July 2020. Our patient was diagnosed with stage IVA vaginal squamous cell carcinoma, based on a gynecological examination, colposcopy biopsy with histopathological examination, computed tomography scan, and tumor marker levels by two professors. After three phases of treatment (sequential treatment with chemotherapy plus radiotherapy, chemotherapy combined with immune checkpoint inhibitors, and immune checkpoint inhibitors combined with tyrosine kinase inhibitors therapy), her condition improved. Her current state is generally good, and she has achieved complete remission. Conclusion We report a rare case of a patient with primary advanced vaginal carcinoma combined with cervical adenocarcinoma. The patient was treated for approximately 2 years, and her personalized treatment showed promising results. We will continue to follow up with the patient and monitor her response to the current treatment process.
Collapse
|
9
|
Abstract
Vaginal cancer is a rare cancer. A lot of the data used in the treatment of this cancer are extrapolated from cervical cancer data. Radiation therapy plays a significant role in the treatment of vaginal cancer. The advances in radiation therapy in both external beam and brachytherapy have improved local control, survival, and toxicity. Brachytherapy plays an important role in treating vaginal cancer, but treatment should be individualized to each tumor. Imaging, particularly magnetic resonance imaging, plays an essential role in the management of patients with vaginal cancer, from diagnosis to staging to treatment management to surveillance.
Collapse
Affiliation(s)
- Anuja Jhingran
- Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
10
|
Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers-A State-of-the-Art Review. Nutrients 2021; 14:nu14010185. [PMID: 35011060 PMCID: PMC8746721 DOI: 10.3390/nu14010185] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/18/2022] Open
Abstract
Gynecological neoplasms pose a serious threat to women's health. It is estimated that in 2020, there were nearly 1.3 million new cases worldwide, from which almost 50% ended in death. The most commonly diagnosed are cervical and endometrial cancers; when it comes to infertility, it affects ~48.5 million couples worldwide and the number is continually rising. Ageing of the population, environmental factors such as dietary habits, environmental pollutants and increasing prevalence of risk factors may affect the reproductive potential in women. Therefore, in order to identify potential risk factors for these issues, attention has been drawn to trace elements. Trace mineral imbalances can be caused by a variety of causes, starting with hereditary diseases, finishing with an incorrect diet or exposure to polluted air or water. In this review, we aimed to summarize the current knowledge regarding trace elements imbalances in the case of gynecologic cancers as well as female fertility and during pregnancy.
Collapse
|
11
|
Abstract
Diagnosis of a primary vaginal cancer is rare, as most vaginal tumors are metastatic from another primary site. Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This is associated with persistence of high‐risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, as with cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer. A review of the different histologic subtypes of primary vaginal cancer in terms of staging and role of imaging, as well as treatment options and prognoses.
Collapse
Affiliation(s)
- Tracey S Adams
- Department of Gynecological Oncology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council University of Cape Town Gynecological Cancer Research Centre (SA MRC UCT GCRC), Cape Town, South Africa.,University of Cape Town Global Surgery, Cape Town, South Africa
| | - Linda J Rogers
- Department of Gynecological Oncology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council University of Cape Town Gynecological Cancer Research Centre (SA MRC UCT GCRC), Cape Town, South Africa
| | - Mauricio A Cuello
- Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
12
|
Sonoda K, Okadome M, Sugimoto R, Fujimoto T, Taguchi K, Saito T. Diagnostic benefit of cytological and histopathological examinations for recurrent vaginal cancer metastasizing to the duodenum: A case report. Clin Case Rep 2020; 8:2907-2913. [PMID: 33363849 PMCID: PMC7752391 DOI: 10.1002/ccr3.3288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 12/27/2022] Open
Abstract
This is the first case report of a vaginal squamous cell carcinoma that metastasized to the duodenum. Cytological and histopathological examinations are useful for the diagnosis of a duodenal metastasis.
Collapse
Affiliation(s)
- Kenzo Sonoda
- Gynecology ServiceNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Masao Okadome
- Gynecology ServiceNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Rie Sugimoto
- Department of Hepato‐Biliary‐PancreatologyNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Takahiro Fujimoto
- Department of PathologyNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Kenichi Taguchi
- Department of PathologyNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Toshiaki Saito
- Gynecology ServiceNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| |
Collapse
|
13
|
Okunowo AA, Ugwu AO, Owie E, Kolawole HF, Adebayo LA, Kusamotu OA, Kuku JO, Soibi-Harry AP, Ohazurike EO, Banjo AAF. Primary vaginal leiomyosarcoma: case report of a rare gynaecological malignancy and diagnostic challenge in a resource-constraint setting. Oxf Med Case Reports 2020; 2020:omaa081. [PMID: 32995035 PMCID: PMC7507877 DOI: 10.1093/omcr/omaa081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 11/14/2022] Open
Abstract
Primary vaginal leiomyosarcoma (VLMS) is an extremely rare variant of primary vaginal cancers with very poor prognosis irrespective of the stage at presentation and the type of treatment received. It is easily recurrent and has a high propensity for haematogenous spread especially to the lungs. We present the case of a 34-year-old Para 1 + 1 (1 alive) woman with recurrent vaginal mass of 8 years duration after two surgical excisions without histological evaluation. She had examination under anaesthesia and a wide local excision of the vaginal mass. Histological examination of the mass revealed poorly differentiated VLMS with positive surgical margins and she was commenced on adjuvant chemo-radiation. Histological evaluation remains the hallmark for diagnosing rare malignancies like VLMS, which unfortunately is not a standard practice in some resource-constraint settings.
Collapse
Affiliation(s)
- Adeyemi A Okunowo
- Department of Obstetrics & Gynaecology, College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Lagos, Nigeria
| | - Aloy O Ugwu
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Emmanuel Owie
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Habibat F Kolawole
- Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Luqman A Adebayo
- Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Olaniyi A Kusamotu
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Jubril O Kuku
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Adaiah P Soibi-Harry
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Ephraim O Ohazurike
- Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Adekunbiola A F Banjo
- Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| |
Collapse
|
14
|
Montemorano L, Vetter MH, Blumenfeld M, O'Malley DM. Positive sentinel lymph node in a patient with clinical stage I vaginal cancer. Gynecol Oncol Rep 2020; 33:100599. [PMID: 32596436 PMCID: PMC7306604 DOI: 10.1016/j.gore.2020.100599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 11/29/2022] Open
Abstract
Sentinel lymph node mapping is feasible in patients with vaginal cancer. Here we report a positive sentinel lymph node in a patient with clinically early-stage vaginal cancer. Sentinel lymph node mapping and dissection may guide primary treatment decisions.
Collapse
Affiliation(s)
- Lauren Montemorano
- Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Monica Hagan Vetter
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Michael Blumenfeld
- The Center for Women's Health, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - David M O'Malley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| |
Collapse
|
15
|
Abstract
Diagnosis of a primary vaginal cancer is rare because most of these lesions will be metastatic from another primary site. Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This will be associated with persistence of high-risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, similar to cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer.
Collapse
Affiliation(s)
- Tracey S Adams
- Department of Gynecological Oncology, Groote Schuur Hospital/University of Cape Town, Cape Town, South Africa.,South African Medical Research Council/University of Cape Town Gynaecological Cancer Research Centre (SA MRC/UCT GCRC), Cape Town, South Africa
| | - Mauricio A Cuello
- Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|