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An unusual extraperitoneal pelvic mass hemangiopericytoma: Report of a case with literature
MONDAY,
100
P1.07.06 BIOPSYCHOSOCIAL APPROACH IN THE EVALUATION OF FULL PAIN OF PATIENTS WITH GYNECOLOGICAL AND BREAST CANCER WITHOUT THERAPEUTICAL CHANCES J.J.R. L. Diniz, C. Felipe, N. Garcia, A.C. Santos, F.M.
Laginha, I.N. Alecrin, J.A. Marques, Center of Reference for Women’s Health, SBo Paula, Brasil. Objectives: The objective of this study was to make an adequate and systemized evaluation of the patients considered without perspectives of curing treatment in the unit of palliative care (UCP). Study Methods: The authors studied 600 patients attended to during the period of Jan. 1993 to Aug. 1998 at the unit of palliative care of the Center of Reference for Women’s Health. The patients with gynecological cancers and breast cancer considered by the oncological team as being without any therapeutic chances were admitted at the UCP for control of pain and correction or adaptation of the physical conditions required for the improvement of their quality of life. Results: The family monthly income of 84.8% of the patients varied from $lOOUS to $3OOUS and 25% lived in slums. Only 41% were fully aware of the disease and its evolution and 20% did not recognize its seriousness. 48.5% presented reactive depression, 14.2% of the patients showed anxiety and only 14.6% recognized and accepted the real situation of the disease. In 63% of the cases, relatives were the main care givers. Facilitation the biopsychosocial intervention for correction of family maladjustments, prejudice with disease, control of symptoms and instruction were given to the patients and family, besides the financing and legal support when required. Conclusion: The authors conclude that the multidisciplinary intervention in families and patients considered without therapeutic possibilities a significant reduction in the full pain with decrease quantity and drug toxicity for pain control.
P1.07.07 AN UNUSUAL EXTRAPERITONEAL PELVIC MASS HEMANGIOPERICYTOMA: REPORT OF A CASE WITH LITERATURE
C.H. Roan(l), W.W. Liang (2), F.M. Chen (1) (1) Dept. OBIGYN, Wang-Fan Hospital, Taipei Medical College, Taipei, Taiwan. (2) Dept. Pathology, Taipei Municipal Women’s & Children’s Hospital, Taipei, Taiwan. Hemangiopericytoma is a rare solid mass in the pelvis and is first described by Stout and Murray in 1942. We will present our experience with the clinicopathologic features for an unusual pelvic mass that had been pathologically confirmed to be hemagiopericytoma. The patient is a 45year old housewife, native of Taiwan. She suffered from a lower abdominal mass. Image studies were performed, including CT, X-ray, Radio-isotope Ga67 scan and Sonar in pre-operative condition. The clinicopathologic finding will be demonstrated in this article.
P1.07.08 LOW MOLECULAR WEIGHT HEPARIN (LMWH) IN THE THROMBOPROPHYLAXIS OF WOMEN WITH GENITAL CANCER AND THE HISTORY OF THROMBOSIS A.D. Makatsaria, A.M. Chabrov, Dept. OBIGYN, Moscow Medical
Academy,
SEPTEMBER
Results: 100% of patients had the signs of thrombophylia before the surgery. In 44 patients (lo%), we have revealed the circulation of APA. Low-molecular weight heparin (LMWH) Fraxiparin was administered subcutaneously in the prophylactic dose of 150 ICU/kg, once daily, preoperatively. The therapy was continued 8 hours after surgery for 10 days at the dosage of 150 ICU once daily. Conclusion: The drug was found to have a significant effect on the prevention of thrombosis: D-dimer left to the normal level on the 10th day of treatment. No incidence of thrombosis or hemorrhage had been revealed during treatment.
P1.07.09 HRT IN WOMEN WITH GYNECOLOGICAL MALIGNANCY M. J. Jenicek, J. Zivny, Dept. OBIGYN, Faculty of Medicine
Charles University,
Prague, Czech Republic.
Objective: In the past, hormonal replacement therapy was not recommended to patients with gynecological malignancy after ovarectomy because of the fear of a relapse of the basic disease. Gradually it was revealed that not all gynecological malignancies are hormone-dependent, and, therefore, HRT does not mean an aggravated risk to the woman’s health. HRT was then applied to selected group of women after surgical or radiation castration for the reason of gynecological malignancy. Study Methods: Our study included group A consisting of 52 women after surgical ovarectomy or consequential radiation for the reason of malignancy of their reproduction system. The women in group A started applying HRT shorter or later after ovarectomy. The second group B includes 52 women of a comparable age after surgical ovarectomy for the reason of gynecological malignancy, who did not receive hormonal therapy. Both groups received dietary calcium. The following parameters were monitored in groups during the period of 3.5 years after the beginning of HRT application: status performance, patient’s stabilized oncological status (i.e. negative palpation, tumor markers, ultrasonography, mammography), levels of gonadotropins, status of urogenital system, biochemical markers, bone density, parameters of sexual life, mental condition and subjective climacteric symptoms. Results: The group A started HRT with worse parameters as the application began later after castration than is usual in menopausal women in population without malignancy. A significant improvement was seen in nearly all parameters monitored in women in group A after treatment lasting 3.5 years on average, compared with group B, and no case of relapse of the basic oncological disease occurred. On the contrary, in one woman from group B (without HRT) occurred progression of the basic oncological disease and in two women second malignancy (Ca mammae) appeared during the study period. In another woman without HRT a fracture of right hand occurred. Conclusions: It is apparent that surgically-menopausal women with gynecological malignancy can benefit from HRT and their quality of life can be improved. No negative influence of HRT on the remission of the basic oncological disease was observed in our study throughout the entire period of application.
P1.07.10 PULMONARY BLASTOMA CASE REPORT
PRESENTING AS A PELVIC MASS: A
D. Vinevard, Dept. OBIGYN, Scott & Whitenexas Temple, Texas, USA
A&M University,
Moscow, Russia.
Objective: The aim of the study was to investigate the effect of LMWH (Fraxiparin) in women with genital cancer and the history of thrombosis. Study Methods 22 women were included in this study. All of them had genital cancer of different localization: 8 women with the I stage of endometrium cancer and 14 with the I-III stage of ovarian cancer. All had one or more thrombotic events in their history: 1 woman had an acute myocardial infarction, 1 a pulmonary thromboembolism and the others had a history of deep vein thrombosis. We used special coagulation tests to determine the signs of thrombophylia: TAT, F1+2, D-dimer and others. The circulation of antiphospholipid antibodies (APA) (anticardiolipins and/or lupus anticoagulant LA) was detected through ELISA method, mT-LA (Stage, France) and also through conformational probes with platelets lizats - PNP STAG0 France).
Background: Pulmonary blastoma is a rare primary lung malignancy, first described in 1945, composed of mixed epithelial and mesenchymal composition that recapitulates the fetal lung at 10 to 16 weeks gestation. Histologically it consists of undifferentiated embryonic connective tissue lined by vacuolated columnal epithelium, simulating fetal bronchioles. The epithelial component often forms morulae, balls of squamous cells with the appearance of squamous metaplasia. Presentation is often asymptomatic, or nonspecific symptoms such as fever, dyspnea, cough, hemoptysis, and chest pain may be the presenting complaints. Although indolent in presentation, this is an aggressive malignancy, with a fiveyear survival rate of 16 percent. Surgical resection is the therapy of choice. Case: We present the case of a 34.year old woman who presented with complaints of abdominal pain and constipation. On evaluation, she was found to have a 10 cm pelvic mass displacing her uterus to the side, and
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100
P1.07.06 BIOPSYCHOSOCIAL APPROACH IN THE EVALUATION OF FULL PAIN OF PATIENTS WITH GYNECOLOGICAL AND BREAST CANCER WITHOUT THERAPEUTICAL CHANCES J.J.R. L. Diniz, C. Felipe, N. Garcia, A.C. Santos, F.M.
Laginha, I.N. Alecrin, J.A. Marques, Center of Reference for Women’s Health, SBo Paula, Brasil. Objectives: The objective of this study was to make an adequate and systemized evaluation of the patients considered without perspectives of curing treatment in the unit of palliative care (UCP). Study Methods: The authors studied 600 patients attended to during the period of Jan. 1993 to Aug. 1998 at the unit of palliative care of the Center of Reference for Women’s Health. The patients with gynecological cancers and breast cancer considered by the oncological team as being without any therapeutic chances were admitted at the UCP for control of pain and correction or adaptation of the physical conditions required for the improvement of their quality of life. Results: The family monthly income of 84.8% of the patients varied from $lOOUS to $3OOUS and 25% lived in slums. Only 41% were fully aware of the disease and its evolution and 20% did not recognize its seriousness. 48.5% presented reactive depression, 14.2% of the patients showed anxiety and only 14.6% recognized and accepted the real situation of the disease. In 63% of the cases, relatives were the main care givers. Facilitation the biopsychosocial intervention for correction of family maladjustments, prejudice with disease, control of symptoms and instruction were given to the patients and family, besides the financing and legal support when required. Conclusion: The authors conclude that the multidisciplinary intervention in families and patients considered without therapeutic possibilities a significant reduction in the full pain with decrease quantity and drug toxicity for pain control.
P1.07.07 AN UNUSUAL EXTRAPERITONEAL PELVIC MASS HEMANGIOPERICYTOMA: REPORT OF A CASE WITH LITERATURE
C.H. Roan(l), W.W. Liang (2), F.M. Chen (1) (1) Dept. OBIGYN, Wang-Fan Hospital, Taipei Medical College, Taipei, Taiwan. (2) Dept. Pathology, Taipei Municipal Women’s & Children’s Hospital, Taipei, Taiwan. Hemangiopericytoma is a rare solid mass in the pelvis and is first described by Stout and Murray in 1942. We will present our experience with the clinicopathologic features for an unusual pelvic mass that had been pathologically confirmed to be hemagiopericytoma. The patient is a 45year old housewife, native of Taiwan. She suffered from a lower abdominal mass. Image studies were performed, including CT, X-ray, Radio-isotope Ga67 scan and Sonar in pre-operative condition. The clinicopathologic finding will be demonstrated in this article.
P1.07.08 LOW MOLECULAR WEIGHT HEPARIN (LMWH) IN THE THROMBOPROPHYLAXIS OF WOMEN WITH GENITAL CANCER AND THE HISTORY OF THROMBOSIS A.D. Makatsaria, A.M. Chabrov, Dept. OBIGYN, Moscow Medical
Academy,
SEPTEMBER
Results: 100% of patients had the signs of thrombophylia before the surgery. In 44 patients (lo%), we have revealed the circulation of APA. Low-molecular weight heparin (LMWH) Fraxiparin was administered subcutaneously in the prophylactic dose of 150 ICU/kg, once daily, preoperatively. The therapy was continued 8 hours after surgery for 10 days at the dosage of 150 ICU once daily. Conclusion: The drug was found to have a significant effect on the prevention of thrombosis: D-dimer left to the normal level on the 10th day of treatment. No incidence of thrombosis or hemorrhage had been revealed during treatment.
P1.07.09 HRT IN WOMEN WITH GYNECOLOGICAL MALIGNANCY M. J. Jenicek, J. Zivny, Dept. OBIGYN, Faculty of Medicine
Charles University,
Prague, Czech Republic.
Objective: In the past, hormonal replacement therapy was not recommended to patients with gynecological malignancy after ovarectomy because of the fear of a relapse of the basic disease. Gradually it was revealed that not all gynecological malignancies are hormone-dependent, and, therefore, HRT does not mean an aggravated risk to the woman’s health. HRT was then applied to selected group of women after surgical or radiation castration for the reason of gynecological malignancy. Study Methods: Our study included group A consisting of 52 women after surgical ovarectomy or consequential radiation for the reason of malignancy of their reproduction system. The women in group A started applying HRT shorter or later after ovarectomy. The second group B includes 52 women of a comparable age after surgical ovarectomy for the reason of gynecological malignancy, who did not receive hormonal therapy. Both groups received dietary calcium. The following parameters were monitored in groups during the period of 3.5 years after the beginning of HRT application: status performance, patient’s stabilized oncological status (i.e. negative palpation, tumor markers, ultrasonography, mammography), levels of gonadotropins, status of urogenital system, biochemical markers, bone density, parameters of sexual life, mental condition and subjective climacteric symptoms. Results: The group A started HRT with worse parameters as the application began later after castration than is usual in menopausal women in population without malignancy. A significant improvement was seen in nearly all parameters monitored in women in group A after treatment lasting 3.5 years on average, compared with group B, and no case of relapse of the basic oncological disease occurred. On the contrary, in one woman from group B (without HRT) occurred progression of the basic oncological disease and in two women second malignancy (Ca mammae) appeared during the study period. In another woman without HRT a fracture of right hand occurred. Conclusions: It is apparent that surgically-menopausal women with gynecological malignancy can benefit from HRT and their quality of life can be improved. No negative influence of HRT on the remission of the basic oncological disease was observed in our study throughout the entire period of application.
P1.07.10 PULMONARY BLASTOMA CASE REPORT
PRESENTING AS A PELVIC MASS: A
D. Vinevard, Dept. OBIGYN, Scott & Whitenexas Temple, Texas, USA
A&M University,
Moscow, Russia.
Objective: The aim of the study was to investigate the effect of LMWH (Fraxiparin) in women with genital cancer and the history of thrombosis. Study Methods 22 women were included in this study. All of them had genital cancer of different localization: 8 women with the I stage of endometrium cancer and 14 with the I-III stage of ovarian cancer. All had one or more thrombotic events in their history: 1 woman had an acute myocardial infarction, 1 a pulmonary thromboembolism and the others had a history of deep vein thrombosis. We used special coagulation tests to determine the signs of thrombophylia: TAT, F1+2, D-dimer and others. The circulation of antiphospholipid antibodies (APA) (anticardiolipins and/or lupus anticoagulant LA) was detected through ELISA method, mT-LA (Stage, France) and also through conformational probes with platelets lizats - PNP STAG0 France).
Background: Pulmonary blastoma is a rare primary lung malignancy, first described in 1945, composed of mixed epithelial and mesenchymal composition that recapitulates the fetal lung at 10 to 16 weeks gestation. Histologically it consists of undifferentiated embryonic connective tissue lined by vacuolated columnal epithelium, simulating fetal bronchioles. The epithelial component often forms morulae, balls of squamous cells with the appearance of squamous metaplasia. Presentation is often asymptomatic, or nonspecific symptoms such as fever, dyspnea, cough, hemoptysis, and chest pain may be the presenting complaints. Although indolent in presentation, this is an aggressive malignancy, with a fiveyear survival rate of 16 percent. Surgical resection is the therapy of choice. Case: We present the case of a 34.year old woman who presented with complaints of abdominal pain and constipation. On evaluation, she was found to have a 10 cm pelvic mass displacing her uterus to the side, and
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