• The Korean Journal of Cytopathology
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• v.1 no.1
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• pp.111-120
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• 1990

Small cell neuroendocrine carcinoma of the uterine cervix is a distinct subtype of cervical cancer that appears analogous to oat cell carcinoma and carcinoid tumors of the lung. It has been assumed to be derived from the neural crest via argyrophilic cells in the normal endocervix. We have recently encountered a case of small cell neuroendocrine carcinoma of the uterine cervix coexisting with adenocarcinoma which was argyrophil negative. A 66-year-old multiparous woman was admitted because of vaginal bleeding for 2 months. Cervicovaginal smear revealed several scattered clusters and sheets of monotonous small cells with some peripheral palisading in the background of hemorrhage and necrosis. Radical hysterectomy specimen revealed an ulcerofungating tumor on endocervical canal which was composed of two components. Major component of the tumor was made up of monomorphic population of small oval-shaped tumor cells arranged in sheets and partly in acinar structures or trabecular fashion. Other component was adenocarcinoma, endocervical well-differentiated type. Argyrophilia was present on the Grimelius stain and immunohistochemical studies revealed diffuse positivity to neuron-specific enolase and carcinoembryonic antigen. Electron microscopic examination showed clusters of small round to oval cells, which had a few well-formed desmosomes and several membrane-bound, dense-core neurosectetory granules.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.143-148
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• 1993

From September 1985 through September 1989,56 patients with stage IIIB carcinoma of the cervix were treated with radiation therapy with curative aim. The overall survival at 5 year was $38{\%}$. The survival rate was better for patients treated with combined external radiotherapy and high dose rate intracavitary radiotherapy than with external radiotherapy alone. No significant survival difference was observed between the unilateral and bilateral parametrial extension of the tumor Seventeen patients experienced recurrence within the irradiated field with a loco-regional recurrence rate of $30{\%}$. Ten patients had complications ($18{\%}$). The complications were mild in three, moderate in four, and severe in three patients. A study was made on the relationship between the fraction numbers of intracavitary radiotherapy, vaginal packing and the complication rate, respectively. In this analysis author observed that the significant treatment factor influencing the survival of cervical cancer was the use of intracavitary radiation, and meticulous vaginal packing could decrease the late complication rate of radiotherapy of cervical cancer.

• The Korean Journal of Cytopathology
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• v.4 no.1
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• pp.41-44
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• 1993

A case of primary amelanotic melanoma of the vagina diagnosed in scraping smear is described. A 64-year-old woman complained of vaginal bleeding with a $2.5\times2cm$ sized, fungating mass on the right lateral vaginal wall near the introitus for 2 months. Scraping smears from the mass showed scattered individual tumor cells with single, bi- or multi-nucleated eccentric nuclei having prominent macrouucleoli and occasional intranuclear inclusions. The cytoplasm was plump and cyanophilic with a indistinct rim. No melanin pigment was identified. Characteristic cytologic features of this case were very helpful to exclude more common squamous cell carcinoma in the vagina, which was strongly suggested in biopsy specimen.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9395-9404
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• 2014

Background: Primary vaginal yolk sac tumor is a rare malignancy in the pediatric population, and a diagnostic challenge and appropriate initial treatment remains unsolved. The aim of this study was to investigate the clinicopathologic features, treatment and prognosis of this tumor. Materials and Methods: Eight cases of primary vaginal yolk sac tumor were reported with a literature review. Results: There were 4 pure yolk sac tumor cases and four mixed germ cell tumors containing yolk sac tumor element, including two cases with embryonal carcinoma and two cases with embryonal carcinoma and dysgerminoma. Partial vaginectomy was performed in four cases and all patients received chemotherapy. 85 cases in literatures were reviewed and 9 cases were misdiagnosed. Follow-up data was available in 77 cases and 5-year overall survival rate was 87.6%. 5-year survival rate of biopsy with chemotherapy, conservative surgery with chemotherapy and radical surgery with chemotherapy was 91.1%, 100% and 28.6%, respectively (p<0.001). Compared to cases without relapse or metastasis after initial treatment, patients with relapse or metastasis had a shorter overall survival (35.6% vs 96.6%, p<0.001). Conclusions: Mixed germ cell tumor containing yolk sac tumor element was not uncommon and partial vaginectomy may be a good choice for primary vaginal mixed yolk sac tumor type to eradicate local tumor cells and provide complete information for pathological diagnosis and postoperative adjuvant therapy.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.143-148
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• 2003

Purpose: The purpose of this study was to evaluate treatment results in terms of the survival and failure patterns subsequent to radiation therapy in recurrent cervical cancer, fellowing primary surgery. Material and Methods: Between January 1990 and December 1999, 27 patients, with recurrent cervical cancer following primary surgery, were subsequently treated with radiation in the Department of Radiation Oncology, at the Keimyung University Dongsan Medical Center. Their median age was 48, ranging from 31 to 70 years old. With regard to the Initial FIGO stage on presentation, 20 and 7 patients were stages I and II, respectively. Twenty three patients had squamous cell carcinomas and 4 had adenocarcinomas. The time interval from the primary surgery to the recurrence ranged from 2 to 90 months with a median of 29 months. The recurrent sites were the vaginal cuff alone, the pelvic cavity and combined recurrence in 14, 9 and 4 patients, respectively. Radiation was peformed, with external and vaginal intracavitary radiation in 13 patients, external radiation alone in 13 and vaginal intracavitary radiation alone in another one. The median follow-up period was 55 months, ranging from 6 to 128 months. Results: The five year disease free survival (5y DFS) and five year overall survival (5y OS) rates were 68.2 and 71.9$\%$, respectively. There was a marginal statistically significant difference in the 5y DFS in relation to the recurrent site (5y DFS, 85.7$\%$ in vaginal cuff recurrence alone, 53.3$\%$ in pelvic cavity recurrence, p=0.09). There was no difference in the survival according to the time interval between the primary surgery and a recurrence. There was only a 7$\%$ local failure rate in the patients with a vaginal cuff recurrence. The major failure patterns were local failure in the patients with pelvic cavity recurrence, and distant failure in the patients with a combined recurrence. There were no complications above grade 3 after the radiation therapy. Conclusion: Radiation therapy was safe and effective treatment for a recurrent carcinoma of the uterine cervix following primary surgery, especially the external beam radiation and vaginal intracavitary irradiation achieved the best results in the patients with a vaginal cuff recurrence following primary surgery.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.40-45
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• 2000

Purpose : To evaluate the histopathological prognostic factors, relapse pattern and survival in patients with endometrial carcinoma who were treated with surgery and postoperative adjuvant radiotherapy (RT). Methods and Materials : From September 1991 to December 1997, 27 patients with endometrial carcinoma treated with surgery and postoperative adjuvant RT at Asan Medical Center were entered in this study. Surgery was peformed with total abdominal hysterectomy in six, total abdominal hysterectomy with pelvic lymph node dissection in eight and radical hysterectomy in 13 patients. External RT of 50.4 Gy was done to all patients and among these, additional high dose rate vaginal vault irradiation of 20$\~$25 Gy with fractional dose of 4$\~$5 Gy was boosted In 16 patients. The patients were followed for 6$\~$95 months(median 30). Results : The number of patients according to FIGO stage were I 18 (67$\%$), II 1 ($4\%$) and III 7 ($26\%$). Patients with poor histologic grade, deep myometrial invasion, adnexal involvement, lymphovascular invasion showed more pelvic lymph node involvement, but no statistical significance was indicated. The 5 year overall and disease free survival were 100$\%$ and 76.8$\%$, respectively. Relapse sites were pelvic, para-aortic lymph node, and multiple metastases including lung, and no vaginal relapse was developed. Factors that were associated with disease free survival were FIGO stage (p=0.01), lymphovascular invasion (p=0.03), pelvic lymph node involvement (p=0.0001). There was only one Grade 1 rectal bleeding without moderate to severe complications. Conclusion : Postoperative adjuvant RT is considered to reduce the loco-regional failure, resulting the improvement of survival. The group of patients with the risk of vaginal failure without vaginal vault irradiation should be investigated according to stage and grade.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.317-322
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• 1996

Purpose : Patients with cervical cancer who have positive resection margins after radical hysterectomy are at increased risk for local recurrence. The result of postoperative pelvic radiotherapy for cervix cancer with positive resection margins were analyzed to evaluate the role of radiotherapy. Materials and Methods : Between n 1979 and 1992, 60 patients of cervix carcinoma were treated with postoperative radiotherapy after radical hysterectomy and pelvic lymphadenectomy because of positive vaginal (48 patients) or parametrial resection margins (12 patients). Patients were treated with external beam radiation therapy (EBRT) alone (12 Patients) or EBRT plus vaginal ovoid irradiation (VOI) (48 patients). The median followup period was 55 months. Results : The 5-year actuarial disease free and overall survival rates for all patients were $75.2\%$, $84.1\%$, respectively. The overall recurrence rate was $23\%$ (14/60). In 48 patients with Positive vaginal resection margins, the pelvic recurrence was $8\%$ (4/48). Distant metastasis was $15\%$(7/48). Of the 43 patients with positive vaginal resection margins treated with EBRT and VOI, recurrence rate was $21\%$(9/43) , while recurrence rate was $40\%$(2/5) in the EBRT only treated group. In 12 patients with positive parametrial margins, three patients ($25\%$) had distant metastases. The most significant prognostic factor was lymph node metastasis. Complications resulting from radiotherapy occurred at a rate of $32\%$(19/60) and grade III complications occurred in three patients ($5\%$). Conclusion : Postoperative radiotherapy can produce excellent pelvic control rates in patients with positive resection margins. In patients with positive vaginal margins, whole pelvic EBRT and VOI is recommended.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.121-128
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• 1988

Clinical and histopathological studies were made on 202 cases of malignancy of cervix, that were visited to the Department of Obstertrics and Gynecology, Yeungnam University Hospital, during 5 years from 1983 to 1987. The results were summarised as follows. 1. Malignancies of the uterine cervix were 10% of total female malignancies. 2. Among 202 cases, 195 cases(96.5%) were squamous cell carcinoma, in which 60 cases(30.0%) of carcinoma in situ, 9 cases(4%) of microinvasive, and 126 cases(62.5%) of invasive carcinoma were included. 3. The average age of the patients with squamous cell carcinoma was 49.4 years old. ; In cases of carcinoma in situ, it was 43.8, microinvasive, 40.0, invasive 52.1 years old. 4. Clinical symptoms of the patient with squamous cell carcinoma in order of frequency were as follows. ; vaginal bleeding(47.5%), abnormal cytology(15.4%), and abnormal vaginal discharge(9.4%). 5. Duration of the chief complaints was most commanly less than 6 months(73.2%), and the average duration was 3.8 months. 6. The most common age of marriage was between 19 to 22 years 0Id(46.5%). The average was 21.5 years old. 7. The gravity was 51.5% in 5~8 times, and average 6.2 times. The parity was 61.9% in 1~4 times, and average 3.9 times. 8. The subdivision of 126 cases of invasive carcinoma was made according to FIGO stage classification, stage I, 40 cases(31.8%), stage II, 54 cases(42.9%), stage III, 11 cases(8.7%), and stage IV, 8 cases(6.3%). 9. The histologic subtypes of invasive squamous cell carcinoma were distributed as follows. ; large cell keratinizing type, 25 cases(19.8%), large cell nonkeratinizing type, 101 cases(80.2%). 10. In the cytologic diagnosis, class I was 2 cases(l.9%), class II was 16 cases(15.1%), class III was 33 cases(31.1%), class IV was 31 cases(29.3%), class V was 24 cases(24.6%). 11. The frequency of lymph node metastasis was 7.5% in stage I, and 11.1% in stage II.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.3
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• pp.507-515
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• 2008

To make a bibliographical review on the most frequently used prescriptions and herbs in treating the uterine carcinoma. 43 texts in China and 6 texts in Korea published since 1980 were reviewed for this objective. 590 Oriental Herbal Medicine formulas composed of 457 herbs were investigated. The frequency and efficacy of each herb used were statistically analyzed. The most frequently used herbal medicine formulas were Danchisoyosan in hepatic Qi stasis, Sihosogan-tang mixed with Lungeumdaebo-tang in damage of conception and thoroughfare vessel, Danchisoyosangagam in blood heat, Hoangyunhaedok-tang in pattern of retained dampness-heat, Jibapjihang-tang in iver-kidney yin deficiency pattern, Naebohyunhapsamyoungbaekchulsan in spleen-kidney yang deficiency pattern. The herbal medicines most frequently used were; Angelicae gigantis radix(126 times), Phellodendri cortex(91 times), Borneolum(87 times), Glycyrrhizae radix and Paeoniae radix alba(82 times), Realgar and Alumen(80times), Poria(77 times), Astragali radix(75 times), Moschus and Myrrha(74 times), Coicis semen and Olibanum(73 times), Codonopsis pilosulae radix and Scutellaria bardata Don(70 times) etc. The effect of the most frequently used herbs were : heat-clearing medicine(12), blood-circulation and stasis-dispelling medicine(9), tonifying and replenishing medicine(5), ointments(5), heat-clearing and blood-cooling medicine(3) and etc. The most frequently used herbs may be applied in future animal studies and clinical trials. Also this data can be used as a reference in formulating new Oriental Herbal Medicine formulas for uterine carcinoma.

• The Korean Journal of Cytopathology
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• v.4 no.2
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• pp.87-92
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• 1993

The effect of Roentgen rays on carcinoma of the cervix has long been of great interest to both radiologists and gynecologists. Since most cervical carcinomas are treated by irradiation, any additional knowledge either concerning the radiosensitivity of cervical tumors or their ultimate prognosis would be of value. The vaginal smear is considered to be one of convenient and rapid methods to study the effects of radiation on cervical malignancy. We observed morphologic changes in 297 cytologic preparations obtained from 60 patients who had underwent irradiation for cancer of the cervix. With the morphologic parameters such as cytoplasmic vacuolization, cytoplasmic basophilia, multinucleated giant cell formation, polymorphonuclear leucocytes (PMNL) sticking and postradiation dysplasia, we analyzed the findings in relation to the follow up time interval. The most common effect was the cytoplasmic vacuolization with basophilia of basaloid cells, which were noted in more than 90% of followed patients. The multinucleated giant ceil formation and PMNL stickering were noted in 38 cases(63%) and 48 cases(80% ) respectively. The differential diagnosis of postradiation dysplasia from recurrent or persistent carcinoma, reparative atypical cells, and regressing tumor cells was difficult and further study seems to be needed to clarify the more accurate morphologic features and biologic behavior.