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  • 1
    Electronic Resource
    Electronic Resource
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Science Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of this study was to analyze the occurrence of ipsilateral, bilateral and contralateral inguinofemoral node metastases in unilateral vulvar carcinoma. One hundred and eighty-five women with a T1 or T2 squamous cell carcinoma who underwent radical vulvectomy with bilateral inguinofemoral lymphadenectomy were surveyed. Inguinofemoral lymph node metastases were found in 23 (22.1%) out of the 104 patients with a unilateral primary tumor. These lymph node metastases were found solely on the ipsilateral side in 21 (91.3%) out of the 23 patients. One patient presented with bilateral extranodal growth in the groins. Another patient with a history of endometrial carcinoma had a right-sided vulvar tumor with contralateral groin node metastases. Half a year later, she was diagnosed with recurrent endometrial cancer on the right pelvic side-wall. Our study endorses clinical evidence that the preferential lymph flow is to the ipsilateral groin. Established lymph node metastases may disturb the normal lymph flow with contralateral metastases as a possible consequence.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Between 1982 and 1992, 32 patients with squamous cell vaginal cancer were treated. Fourteen patients had stage I, 11 stage II, two stage III and five stage IV disease. The mean age of stage I and II patients was 64, of stage III and IV patients 73. Six patients were pessary-bearing, two had a total procidentia, eight had been treated for cervical intraepithelial neoplasia (CIN), one for cervical cancer and one for vulvar cancer 5–21 years before diagnosis. One patient had had external irradiation for endometrial cancer 15 years before. Nine patients had no follow-up examinations after treatment for CIN, for vulvar cancer or after insertion of a pessary. In 14 patients doctors’ or patients’ delays were considerable. Most patients presented with vaginal discharge or bleeding, and urinary symptoms. Various treatment modalities were used. The selected patients who could be treated by surgery did best. Only patients with a stage I tumor or a stage II tumor with a diameter of at most 30 mm survived. Tumor stage and tumor diameter were the important prognostic factors. No patient died of disease after 33 months. Failure in obtaining local control was the usual cause of death. Recommendations for prevention or early diagnosis are formulated.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    238 Main Street, Cambridge, MA 02142, USA : Blackwell Scientific Publications
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    Signatur Availability
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  • 4
    Electronic Resource
    Electronic Resource
    238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A total of 121 patients with cervical intraepithelial neoplasia (CIN) in their punch biopsies were treated by LETZ. In all cases, the transformation zone was fully visible and there were no signs of abnormal cylindrical epithelium. The final diagnosis was classified in accordance with the histologic report showing the most severe lesion. The biopsy diagnosis underestimated the final diagnosis in 27 out of the 121 cases. Invasion was present in five out of these 27 cases. The discrepancies between the biopsy diagnosis and the final diagnosis were not related to the number of colposcopically directed biopsies. It is concluded that an important advantage of LETZ, as compared with tissue-destructive techniques, is the detection of previously unrecognized invasive disease.
    Type of Medium: Electronic Resource
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