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NCI CANCERLIT® Search: Vaginal and Vulvar Cancer - July 2002
National Cancer Institute®
Ultima Vez Modificado: 1 de julio del 2002
- [Single erythroplastic vulvar lesion in a 70-year-old woman: Bowen disease]
- Recurrent cellular angiofibroma of the vulva.
- Non-small cell carcinoma of the lung metastatic to the lower female genital tract and mimicking glassy cell carcinoma.
- Case report: plexiform schwannoma of the vulva.
- HIV-1 infection and intraepithelial neoplasia of lower genital tract.
- Vulvar Paget disease. Two cases with cytokeratin 7 and 20 expression.
- Squamous cell carcinoma of the vulva: study of ploidy, HPV, p53, and pRb.
- Vulvar cancer. A potentially deadly skin cancer.
- Vulvar basal cell carcinoma: two unusual presentations and review of the literature.
- Uterine/female genital sarcomas.
- Vulvar carcinoma.
- Uroplakin-III to distinguish primary vulvar Paget disease from Paget disease secondary to urothelial carcinoma.
- Vulvar Paget disease of urothelial origin: a report of three cases and a proposed classification of vulvar Paget disease.
- What doctors and patients think about false-negative sentinel lymph nodes in vulvar cancer.
- Groin recurrence after micrometastasis in a sentinel lymph node in a patient with vulvar cancer.
- Spontaneous expulsion of submucous fibroid after preterm labour.
Table of Contents
1
UI - 11908149
AU - Renaud-Vilmer C; Dehen L
TI -
[Single erythroplastic vulvar lesion in a 70-year-old woman: Bowen
disease]
SO - Ann Dermatol Venereol 2001 Dec;128(12):1361-2
AD - Institut de Recherche sur la Peau, Service de Dermatologie du Professeur
L. Dubertret, Hopital Saint-Louis, 1, avenue Claude Vellefaux, 75475
Paris, France.
2
UI - 12037036
AU - McCluggage WG; Perenyei M; Irwin ST
TI -
Recurrent cellular angiofibroma of the vulva.
SO - J Clin Pathol 2002 Jun;55(6):477-9
3
UI - 11917602
AU - Ng WK
TI -
Non-small cell carcinoma of the lung metastatic to the lower female
genital tract and mimicking glassy cell carcinoma.
SO - Acta Cytol 2002 Mar-Apr;46(2):438-40
4
UI - 11827426
AU - Santos LD; Currie BG; Killingsworth MC
TI -
Case report: plexiform schwannoma of the vulva.
SO - Pathology 2001 Nov;33(4):526-31
AD - Department of Anatomical Pathology, Liverpool Hospital, NSW, Australia.
We describe a case of plexiform schwannoma, a benign tumour of the
peripheral nerve sheath, arising in the labia of a 5-year-old girl who
presented with a mass in the vulva. Light and electron microscopy,
special stains and immunohistochemistry studies were done on the excised
specimen. A Medline search revealed a single case of vulvar plexiform
schwannoma which was reported in 1983.
5
UI - 12076583
AU - Baldwin P; Sterling J
TI -
HIV-1 infection and intraepithelial neoplasia of lower genital tract.
SO - Lancet 2002 Jun 8;359(9322):2040
6
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.
7
UI - 12090585
AU - Lerma E; Matias-Guiu X; Lee SJ; Prat J
TI -
Squamous cell carcinoma of the vulva: study of ploidy, HPV, p53, and
pRb.
SO - Int J Gynecol Pathol 1999 Jul;18(3):191-7
AD - Department of Pathology, Hospital de la Santa Creu i Sant Pau,
Autonomous University of Barcelona, Spain.
Seventy-one cases of invasive squamous cell carcinoma (ISCC) of the
vulva were compared with 18 cases of vulvar intraepithelial neoplasia
(VIN) and 21 cases of lichen sclerosus. Ploidy was studied by image
analysis, HPV-DNA by PCR, and p53 and pRb by immunohistochemistry.
Univariate and multivariate statistical analyses were performed. The
mean age of the patients with ISCC was 70.6 years; only 8.5% were < 60
(range, 43-89) years. For the 43 patients with follow-up, FIGO surgical
stages were I in 16.2%, II in 48.8%, III in 27.9%, and IV in 6.9%. The
5-year survival was 90% for the patients with curative surgery
(vulvectomy and lymphadenectomy) and 32% for those with tumors in stages
III to IV. Previous history of nonneoplastic epithelial alterations was
recorded in 54%. Vascular invasion was detected in 4.3% and perineural
invasion in 21.4%. Inguinal lymph node metastases were present in 34.9%
of the cases. Fifty-one (72%) ISCCs were aneuploid, HPV-DNA-16 was
detected in 7 (12.3%) cases, overexpression of p53 was found in 40
(56%), and pRb expression was negative in 15 (21.4%). Fifteen cases
(80%) of VIN were aneuploid, 5 (27.7%) contained HPV-DNA, 11 (61%) were
positive for p53, and all immunoreacted for pRb. All lichen sclerosus
cases were diploid, did not contain HPV-DNA, failed to stain for p53,
and were positive for pRb. Our study confirmed the prognostic value of
conventional pathological features: stage, lymph node metastasis,
histological grade, and vascular and perineural invasion; all were
statistically significant for survival in the univariate analysis. Also,
ploidy was significant in patients with stages I and II tumors. The only
significant variable in the multivariate analysis was stage. p53
overexpression appears as a late event in vulvar carcinogenesis, but it
may occur before tumor invasion. Lack of pRb expression can occur in
vulvar neoplasia, but it does not seem to play any role in the
initiation or prognosis of vulvar ISCC.
8
UI - 12132474
AU - Anonymous
TI -
Vulvar cancer. A potentially deadly skin cancer.
SO - Mayo Clin Health Lett 2002 Jul;20(7):6
9
UI - 12051887
AU - Mulayim N; Foster Silver D; Tolgay Ocal I; Babalola E
TI -
Vulvar basal cell carcinoma: two unusual presentations and review of the
literature.
SO - Gynecol Oncol 2002 Jun;85(3):532-7
AD - Department of Obstetrics and Gynecology, Yale University School of
Medicine, New Haven, Connecticut 06520, USA. mulayin2@hotmail.com
BACKGROUND: Basal cell carcinoma (BCC) of the vulva comprises 2-4% of
all vulvar cancers. In general, vulvar BCCs tend to grow at slow rates.
Nonetheless, they may be locally invasive and destructive if they are
neglected. Eight cases of vulvar BCC metastatic to regional lymph nodes
have been documented in the literature. CASES: Two unusual cases of
vulvar BCC are presented. Case 1 is an 86-year-old white woman who
presented with vulvar BCC metastatic to the femoral head. This is the
first report of hematogeneous metastasis of vulvar BCC. The patient was
treated with palliative vulvar resection and radiation to the femoral
metastasis. At 6 months, she progressed with multiple bony and
intraperitoneal metastases and died with disease. Case 2 is vulvar BCC
in a 90-year-old African-American woman. She was managed by wide local
excision and remains disease free to date. CONCLUSION: Vulvar BCCs are
rare tumors with an unclear etiology. They can be aggressive and are
capable of causing significant morbidity and occasional mortality if
they are neglected or improperly treated. Hematogeneous metastasis at
presentation appears to result in rapidly progressive disease. The
literature regarding the pathogenesis, biologic behavior, and treatment
of vulvar BCC is reviewed.
10
UI - 12057054
AU - Hensley ML
TI -
Uterine/female genital sarcomas.
SO - Curr Treat Options Oncol 2000 Jun;1(2):161-8
AD - Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY
10021, USA.
Choosing the best management of uterine and vulvo-vaginal sarcomas
depends on careful histologic review of the pathologic specimen.
Prognosis and treatment vary greatly depending on specific histology,
grade, and tumor stage. The initial approach to sarcomas of the female
genital tract, with the occasional exception of vulvo-vaginal
rhabdomyosarcoma, is surgery. Adjuvant radiation decreases local
recurrence rates for uterine sarcomas, but has not been clearly shown to
improve overall survival. It is frequently used as adjuvant therapy for
resected high-grade or margin-positive vulvo-vaginal sarcomas, and for
endometrial stromal sarcomas. Adjuvant chemotherapy has not been
demonstrated to improve survival in vulvo-vaginal sarcomas, with the
exception of vulvo-vaginal rhabdomyosarcomas, nor has it been
demonstrated to improve survival in uterine sarcomas. Chemotherapy may
be used for recurrent or persistent disease. The choice of agent depends
on the histologic type of sarcoma.
11
UI - 12057056
AU - Coleman RL; Santoso JT
TI -
Vulvar carcinoma.
SO - Curr Treat Options Oncol 2000 Jun;1(2):177-90
AD - University of Texas, Southwestern Medical Center, Division of
Gynecologic Oncology, 5323 Harry Hines Blvd., J7.124, Dallas, TX
75235-9032, USA.
Carcinoma of the vulva is an uncommon gynecologic malignancy primarily
affecting postmenopausal women. The lesion is most commonly associated
with HPV DNA, although, for many, a defined preinvasive to invasive
connection is not readily apparent. Most patients experience symptoms of
pruritus, irritation, and even pain for weeks or months before the
diagnostic biopsy is performed. Patient embarrassment and unfamiliarity
and reluctance on the part of the physician to fully evaluate these
symptoms add to the delay. Vulvar carcinoma is staged surgically
following resection. A concerted effort to conserve as much normal
tissue as possible has been the focus of recent investigation. Separate
incision resection of the vulvar mass and groin has improved wound
healing and quality of life for many patients. The effect these
conservative procedures have on long-term survival is currently being
evaluated. Increased use of radiation therapy or chemoradiation has
allowed organ preservation in many otherwise exenterative cases. In some
instances, this neoadjuvant therapy has provided an opportunity to
surgically clear otherwise unresectable lesions. Current radiotherapy
techniques might also be as effective as groin dissection in certain
low-risk patients. Adjuvant radiation and chemoradiation improve local
control and reduce groin recurrence risk. In addition, patients with
histologically positive groins enjoy longer survival when the pelvis is
also treated. Selected use of multimodality therapy will likely extend
the lives of women with vulvar cancer.
12
UI - 12094381
AU - Brown HM; Wilkinson EJ
TI -
Uroplakin-III to distinguish primary vulvar Paget disease from Paget
disease secondary to urothelial carcinoma.
SO - Hum Pathol 2002 May;33(5):545-8
AD - Department of Pathology, Immunology and Laboratory Medicine, University
of Florida College of Medicine, Gainesville 32610, USA.
Paget disease of the vulva can be mimicked by several disease entities
histopathologically, but most of these entities can be clinically
distinguished from vulvar Paget disease. However, vulvar Paget disease
is in itself a heterogeneous group of epithelial neoplasms that can be
similar both clinically and histopathologically. The subtypes of vulvar
Paget disease include primary Paget disease arising from a pluripotent
stem cell within the epithelium of the vulva, and secondary Paget
disease of the vulva. Secondary vulvar Paget disease results from spread
of an internal malignancy, most commonly from an anorectal
adenocarcinoma or urothelial carcinoma of the bladder or urethra, to the
vulvar epithelium. We have recently proposed that these lesions be
classified as primary (of cutaneous origin) or secondary (of
extracutaneous origin). These subtypes can present similarly as
eczematoid skin lesions and may appear similar on routine hematoxylin
and eosin-stained slides. Immunohistochemical studies can help
differentiate between them. Our current study includes 17 patients with
a pathologic diagnosis of vulvar Paget disease. We performed a panel of
immunohistochemical stains, including cytokeratin (CK) 7 and 20,
carcinoembryonic antigen (CEA), gross cystic disease fluid protein-15
(GCDFP-15), and uroplakin-III (UP-III). Of these 17 patients, 14 (80%)
had primary intraepithelial cutaneous Paget disease, 13 without invasion
and 1 with associated invasion. Three patients had urothelial carcinoma
with spread to the vulva, manifesting as secondary vulvar Paget disease.
Immunohistochemically, primary vulvar Paget disease is immunoreactive
for CK 7 and GCDFP-15, but uncommonly for CK 20. Vulvar Paget disease
secondary to anorectal carcinoma demonstrates CK 20 immunoreactivity but
is usually nonreactive for CK 7 and consistently nonimmunoreactive for
GCDFP-15. Vulvar Paget disease secondary to urothelial carcinoma is
immunoreactive for CK 7 and CK 20 but nonimmunoreactive for GCDFP-15. In
addition, we propose the use of a new, commercially available antibody,
UP-III, which is specific for urothelium and, in our experience, is
immunoreactive in secondary vulvar Paget disease of urothelial origin.
The distinction between these 3 types of Paget and Paget-like lesions is
essential in that the specific diagnosis has a significant influence on
current treatment. The difference in surgical approach to the subtypes
of vulvar Paget disease justifies classifying them into distinct
lesions, which may be aided by the use of immunohistochemistry,
including UP-III. Copyright 2002, Elsevier Science (USA). All rights
reserved.
13
UI - 12094382
AU - Wilkinson EJ; Brown HM
TI -
Vulvar Paget disease of urothelial origin: a report of three cases and a
proposed classification of vulvar Paget disease.
SO - Hum Pathol 2002 May;33(5):549-54
AD - Department of Pathology, Immunology and Laboratory Medicine, University
of Florida College of Medicine, Gainesville, FL 32610, USA.
Extramammary Paget disease is generally considered a distinct entity
that can involve the genital tract skin and may be associated with
underlying adenocarcinoma. Evidence is presented that vulvar Paget
disease represents a heterogeneous group of epithelial neoplasms that
can be similar both clinically and histopathologically. Three cases of
vulvar Paget-like disease that were manifestations of urothelial
carcinoma are investigated. Vulvar Paget disease can be classified based
on the origin of the neoplastic Paget cells as either primary (of
cutaneous origin) or secondary (of noncutaneous origin). Each
classification has 3 subtypes: primary, intraepithelial cutaneous Paget
disease of the usual type; intraepithelial cutaneous Paget disease with
invasion, and intraepithelial cutaneous Paget disease as a manifestation
of underlying skin appendage adenocarcinoma; secondary, Paget disease of
anorectal origin, Paget disease of urothelial origin, and Paget disease
of other origin. This subclassification is based on a review of the
literature and the current study of 3 patients with Paget-like disease
of urothelial neoplastic origin. The 3 subtypes of vulvar Paget disease
studied here can present similarly as eczematoid skin or vulvar mucosal
lesions and may appear similar on routine hematoxylin and eosin-stained
slides. Immunohistochemical studies can be used to help differentiate
them. The distinction between these 3 types of Paget-like lesions is
essential in that the specific diagnosis has a significant influence on
current treatment. The difference in surgical approach to the subtypes
of vulvar Paget disease justifies classifying them into distinct lesions
to avoid potential confusion and unnecessary surgery. Copyright 2002,
Elsevier Science (USA). All rights reserved.
14
UI - 11840573
AU - de Hullu JA; Ansink AC; Tymstra T; van der Zee AG
TI -
What doctors and patients think about false-negative sentinel lymph
nodes in vulvar cancer.
SO - J Psychosom Obstet Gynaecol 2001 Dec;22(4):199-203
AD - Department of Gynecologic Oncology, Groningen University Hospital,
Groningen, Hanzeplein 1, PO Box 30001, 9700RB Groningen, The
Netherlands. j.a.de.hull@og.azg.nl
The sentinel lymph node procedure is a relatively new,
minimally-invasive method for the assessment of nodal status in
malignancies such as breast cancer, cutaneous melanoma and vulvar
cancer. Although highly accurate, this new method is inevitably
associated with a certain false-negative rate, possibly leading to worse
survival in a small subset of patients. The clinical implementation of
the sentinel lymph node procedure is therefore a matter of ongoing
debate, especially among doctors. The aim of this study was to assess
opinions on the acceptable false-negative rate of the sentinel lymph
node procedure in patients with vulvar cancer, who in the past had
undergone standard routine radical vulvectomy and complete
inguinofemoral lymphadenectomy (and frequently experienced
complications), and in gynecologists treating patients with vulvar
cancer. Structured questionnaires were sent to both patients and
gynecologists. The patients had been treated for vulvar cancer between
1985 and 1993, and were all in complete remission with a median
follow-up of 118 months (range: 76-185). Questions to the patients dealt
with experienced side-effects of the standard treatment and opinion on
the acceptable false-negative rate of the sentinel lymph node procedure.
The response rate among patients was 91% (106/117). Forty per cent of
the patients experienced one or more infections in the legs (cellulitis)
and 49% of the patients still experience either severe pain and/or
severe lymphedema in the legs. Sixty-six per cent of the patients
preferred complete inguinofemoral lymphadenectomy in preference to a 5%
false-negative rate of the sentinel lymph node procedure of 5%. Their
preference was not related to age or the side-effects they had
experienced. The response rate among gynecologists was 80% (80/100), of
whom 60% were willing to accept a 5-20% false-negative rate of the
sentinel lymph node procedure. While gynecologists may consider the
sentinel lymph node procedure to be a promising diagnostic tool, the
majority of vulvar cancer patients, who have undergone complete
inguinofemoral lymphadenectomy in the past and have frequently
experienced complications, would not advise introduction of this
technique because they do not want to take any risk of missing a lymph
node metastasis.
15
UI - 12079308
AU - Tamussino KF; Bader AA; Lax SF; Aigner RM; Winter R
TI -
Groin recurrence after micrometastasis in a sentinel lymph node in a
patient with vulvar cancer.
SO - Gynecol Oncol 2002 Jul;86(1):99-101
AD - Department of Obstetrics and Gynecology, University of Graz, Austria.
karl.tamussino@kfunigraz.ac.at
BACKGROUND: The sentinel lymph node concept is attractive in vulvar
cancer because of the potential to avoid the morbidity associated with
formal groin dissection. CASE: An 84-year-old patient with a T2
carcinoma of the anterior vulva underwent surgery including bilateral
sentinel node excision after identification with technetium-labeled
nanocolloid. Frozen section histology showed a tumor deposit <1 mm in
diameter in a left groin node whereas four nodes in the right groin were
apparently negative. Completion lymphadenectomy was performed only for
the left groin. Final histology including serial sectioning showed a
micrometastasis in one of seven nodes from the right groin; no further
treatment was given. Sixteen months postoperatively the patient
developed a recurrence in the right groin; the left groin was free of
tumor. CONCLUSION: This case indicates that groins with a
micrometastasis detected by sentinel lymph node excision require further
treatment. (c) 2002 Elsevier Science (USA).
16
UI - 12118657
AU - Thorpe-Beeston JG; Sebire NJ
TI -
Spontaneous expulsion of submucous fibroid after preterm labour.
SO - BJOG 2002 Jun;109(6):726-7
AD - Department of Obstetrics and Gynaecology, Chelsea and Westminster
Hospital, London, UK.
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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