- Email: [email protected]
P1098 Reproductive risk factors of breast cancers among Yemeni women
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
a third localization of respective disease (synchrone or metachrone) accounts for the importance of rigorous evidence of cases, continuous surveillance especially of those preoperatory irradiated or postoperatory treated with tamoxiphene. P1094 Primary abdominal compartment syndrome associated with Meig’s syndrome S. Schwarz, M. Fernandez. ´ University of Puerto Rico Medical School Objectives: To present an unusual case of Primary Abdominal Compartment Syndrome thought to be of malignant cause and resulting in a benign condition that completely resolved after surgical intervention. Materials and Methods: This is a case of a 25 y/o G-2 P-2, weight 91 kg (200 lbs.) and a height of 162 cm. (64") presenting with persistant intra-abdominal pressure of 20 mmHg associated with a pelvic mass. The patient had upper respiratory difficulty and gastrointestinal symptoms one week before admission. Three days before admission she began to exhibit food intolerance and abdominal distention. When brought to the ER she was found with bilateral complex ovarian masses, ascites and hydrothorax. An assesment of ovarian neoplasia was made and she was referred to our tertiary University center. Due to respiratory failure she was intubated shortly after admission. Renal failure was diagnosed and she was transferred to MICU. The patient’s condition continued to deteriorate due to increasing pressure that compromised organ perfusion. Surgical intervention to relieve the immense intraabdominal pressure was undertaken. At surgery, over 3 liters of ascitic liquid was removed resulting in immediate improvement of respiratory parameters. Organ perfusion was restored and renal filtration improved. The removal of two large 20 cm. ovarian masses that were necrotic as well as a hysterectomy were required. Results: Soon after surgery ascitis and hydrothorax disappeared. The patient was discharged home. The hystologic diagnosis: hemorrhagic infarction of ovarian tumors, 410 gms and 400 gms, consistent with fibrothecoma. Conclusion: Abdominal compartment syndrome secondary to a very large benign ovarian tumor has been rarely reported in gynecology. With the increase in intra-abdominal pressure there is multi organ system failure that can be fatal. Meig’s syndrome is the presentation of a rare benign ovarian tumor, a Thecoma, accompanied by ascities and hydrothorax. Thecomas represent less than 1% of all ovarian tumors. When associated with Meig’s syndrome the clinical picture is similar to that of ovarian carcinoma. This is an excellent example of complete improvement of abdominal compartment syndrome by surgical removal of what was thought to be a malignant stage four disease and resulted to be a benign reversible condition: Meig’s syndrome. P1095 Human papilloma Virus (HPV): Burden of the disease in the general population in the Extended Middle East and North Africa (EMENA): A comprehensive review M. Seoud1 , S. Lindley2 , K. Seoud, S. Anis. 1 American University of Beirut Medical Center, 2 WellsCare, 3 Introduction: The EMENA countries have traditionally been viewed as societies that are more conservative with a rather low prevalence of STIs. The purpose of this paper is to review the prevalence of HPV infections and HPV related diseases in the general population in EMENA. Materials and Methods: We performed an extensive literature in PubMed, Medline, Embase, national data bases, references in the abstracted papers, and unpublished data from local experts. Data extracted included information on the method of HPV detection and HPV type-specific data. Other data included age and whether
S719
it is a low or high risk population and the number of subjects in each study. Results: In North Africa: The prevalence of HPV varied between from 5–12% in the low risk population and from 20–49% in the high population such as prostitutes. In the Middle East: The prevalence of HPV varied between from 1.8–13% in the low risk population and 31.6% in a family planning clinic in Saudi Arabia. In the gulf countries: The prevalence of HPV varied between from 4–11% in the low risk population and from 20–30% in the high population such as cervicitis. In Turkey, Iran and Pakistan: Tthe prevalence of HPV varied between from 1.5–13% in the low risk population and up to 42.9% in patients with abnormal smears. The studies were varied with small number of patients and varied detection methods that difficult to compare with few standard tests such as Hybrid capture I or II. Few were ISH and most were PCR. The average age (30–50 years), in general, was higher than that noted in other parts of the world where the peak prevalence occur around 24–25 years. Conclusions: Although the studies on the prevalence of HPV in the EMENA region are not abundant, but there enough data to suggest that the prevalence of HPV in the low risk population of the countries is around 5–12% which is close to the world wide prevalence of 10%. P1096 Is p16INK4A expression useful to determine the outcome of atypical squamous cells of undetermined significance S. Douvier, S. Thouvenot, L. Filipuzzi, P. Sagot. Gynecologic Department, Dijon France Objective: The aim of this study was to determine the interest of p16INK4A marker in the triage of Atypical Squamous Cells of Undetermined Significance (ASCUS) in pap smear. Methods: We studied 137 ASCUS categorized pap smears with susequent follow-up biopsies or long term cytologies. All smears were immunostained with a primary anti-p16 antibody, clone E6H4. Immunoreactivity for p16 was correlated with histological lesions. Results: In 137 ASCUS, 8 cases failed in p16 staining. 25 histological lesions were found: 11 (9%) CIN1 and 14 (10.4%) CIN2+. 104 histologic samples or follow-up cytologies were normal (80.6%). the Sensitivity, Specificity, PPV and NPV of p16 to found a CIN2+ were respectively 78.6%, 88.7%, 45.8% and 97.2%. Conclusions: There is an association between strong p16 immunostaining of ASCUS and the presence of high grade lesions in the cervix, except 3 cases. Similarly there is an association between the lack of p16 expression and the absence of cervical lesion (NPV = 97.2%). The p16 immunocytochimical stain may serve as a useful biomarker in ASCUS containing smear diagnoses. P1098 Reproductive risk factors of breast cancers among Yemeni women K. Shamsuddin1 , A. Alyamani2 , M. Kamaluddin3 , S. Bin Bisher2 , A. Batarfi4 . 1 Dept of Community Health, Medical Faculty, Universiti Kebangsaan Malaysia, 2 Dept of Surgery, Hadramout University Medical College, Yemen, 3 Institute for Medical Research, Ministry of Health Malaysia, 4 Hadramout University Medical College, Yemen Introduction: Breast cancer is one of the main cancers experienced by women worldwide. Although many studies on the risk factors of breast cancers had been done, fewer such studies had been done in less developed countries such as Yemen, a country known to have a high rate of early marriage and a very high fertility. This paper focuses on identifying the reproductive risk factors of breast cancers among Yemeni women, particularly their menstrual, birth and breastfeeding history, as well as hormonal use. Materials and Methods: A case–control study comparing cases with histologically diagnosed breast cancers with patients not known to have breast cancers from 5 major hospitals in Yemen
S720
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
was carried out in 2006. The risk factors of breast cancers were analyzed using 202 cases and 384 controls. Results showed more than 90% of these women were married, 56.8% were grand multiparous and 20.3% had 8 or more children. Data adjusted for age, education, family income, medical, surgical and family history of breast diseases, nutrition and anthropometric factors and lifestyles related to smoking, physical exercise and chewing of qat leaves, a popular habit in Yemen, showed that early age at menarche less than 12 years (OR = 13.2; 95% CI 5.2–33.8), irregular menses (OR = 5.4; 95% CI 1.1–27.7), age at first fullterm pregnancy >20 years (OR = 4.2; 95% CI 1.8–9.7), menopause status (OR = 3.9; 95% CI 1.8–8.5), and use of hormone replacement therapy (OR = 11.7; 95% CI 1.8–74.0) were significant risk factors of breast cancers in Yemeni women. The study also showed the protective effects of breastfeeding on breast cancers (OR = 0.14; 95% CI 0.1–0.6). Being never married, and having positive history of abortion were not significant risk factors of breast cancer in these women. Adjusted for age, the risk of breast cancer among women with 1–4, 5–8 and more than 8 children were significantly lower than nulliparous women. However when adjusted for all the other risk factors in this study, nulliparity was no longer a significant risk factor of breast cancer. Conclusion: The study among Yemeni women offers opportunity to explore reproductive risk factors of breast cancers in a population with high fertility. This study also showed the continued protective effects of breastfeeding but not high parity in this population with high fertility. P1099 Differential diagnosis of malignant ovarian tumors – use of advanced data mining systems for classification making processes A. Smolen1 , A. Czekierdowski2 , N. Stachowicz2 , M. Kotarska2 , J. Kotarski2 . 1 Department of Mathematics and Biostatistics, Medical University in Lublin, 2 Department of Gynecology and Gynecological Oncology, Medical University in Lublin Objective: Study applies methods of data exploration and decisionmaking processes support in early differential diagnosis of adnexal masses in women. Methods: 637 women with adnexal masses treated in the Department of Gynecology and Gynecological Oncology at the Medical University of Lublin were analyzed. Combination of clinical, ultrasonographic parameters and CA-125 serum levels was apllied to construct prognostic models using discriminant function analysis, logistic regression, multivariate adaptive regression splines (MARS), standard and boosted classification trees, artificial neural networks, support vector machines, naive Bayes, K-nearest neighbors, which allows for a comprehensive analysis of possibilities of decision-making processes support in early adnexal masses differential diagnosis. Results: Among 637 women with adnexal masses 202 (31.7%) had malignant tumors and 435 (68.3%) had non-malignant adnexal tumors. Optimal combination of parameters to consider in early differential diagnosis of adnexal masses are: half-quantitative assessment of “color” feature and vessels location in twodimensional color Doppler sonography; tumor ultrasonographic morphology assessment allowing endophytic endostoses >3 mm; tumor’s volume and location assessment; vascular flow assessment in three-dimensional sonography with sonoangiography allowing vascularization index (VI) and vascular flow index (VFI); age, menopausal status of a patient; preoperative CA-125 serum level. MLP artificial neural network proved as the best individual classification model, while networks’ cluster and the best models’ contamination method (“K-judge voting” algorithm), i.e. logistic regression model, boosted classification trees model and MLP neural network, support choosing optimal discrimination prognosis.
Conclusion: Integration into a multimodal project results in obtaining the highest predictive values and enables support of preoperative differential diagnosis of adnexal masses in women. P1100 CA 125 level as a predictive value of second look operation finding and prognostic marker in epithelial ovarian cancer J. Song, K. Ahn, H. Park, S. Hong, T. Kim, Y. Kim, S. Kim, K. Lee. Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Objectives: CA 125 levels are regarded as a marker of epithelial ovarian cancer and recently suggested as a predictor of survivals. The objectives of this study are to determine the correlation between CA 125 level and second look operation pathologic results, and whether CA 125 is a predictor of prognosis. Materials and Methods: The medical records of 49 patients diagnosed and treated with ovarian cancer in Korea University Anam Hospital from 1994 and 2007 were retrospectively reviewed. CA 125 level at the time of second look operation was compared with second look operation results, disease free survival and overall survival. Chi-square and log-rank test was used with SPSS 13.0. Results: The patients with positive second look operation were 27/49 (55.1%). The positive rate in second look operation with CA 125 level of <10 U/ml was 26.3% (5/19) and ≥10 U/ml was 73.3% (22/30) (p = 0.003). The overall survival was increased in the patients with CA 125 level <10 U/ml (mean 142.4 months) compared with ≥10 (mean 35.2 months) (p = 0.046). The disease free survival was also increased in the patients with CA 125 level <10 U/ml (mean 71.8 months) compared with ≥10 (mean 5.0 months) (p = 0.007). Conclusions: CA 125 level at the time of second look operation with cut-off level <10 U/ml is a useful predictive marker of second look operation pathologic result and also is a good prognostic marker of epithelial ovarian cancer. P1101 Primary squamous cell carcinoma arising from the pelvic retroperitoneum: A case report J. Song1 , J. Lee1 , N. Lee1 , C. Kim2 , K. Lee1 . 1 Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea, 2 Department of Pathology, Korea University College of Medicine, Seoul, Korea Background: Primary retroperitoneal squamous cell carcinoma (SCC) is very rare. Case: A 66-year-old woman presented with right leg edema and pain that had developed one month prior. Pelvis magnetic resonance imaging (MRI) showed the presence of a mass around the iliac vessels. The patient underwent an exploratory laparotomy but the mass was not completely removed. The histopathological diagnosis was a SCC and there was no primary site based on systemic evaluation with the use of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scanning. The patient was treated with concurrent chemoradiatiotherapy (CCRT) with paclitaxel-carboplatin and Tomotherapy three weeks after surgery. Conclusion: This is the first case of a primary SCC arising from the retroperitoneum that was treated with surgery and adjuvant CCRT with paclitaxel-carboplatin and Tomotherapy. P1102 Clinical analysis of patients with CIN 2/3 diagnosed by cervical punch biopsy E. Song, J. Park, S. Hwang, M. Im, B. Lee, W. Lee. Inha University Hospital, Incheon, South Korea Introduction: Cervical cancer is a major health problem for Korean women, accounting for 9.8% of new female cancer cases, even though incidence rates have been decreasing. Cervical intraepithelial neoplasia (CIN) is a precancerous lesion and takes 5 to 15 years to progress to invasive cancer. Therefore, the appropriate
a third localization of respective disease (synchrone or metachrone) accounts for the importance of rigorous evidence of cases, continuous surveillance especially of those preoperatory irradiated or postoperatory treated with tamoxiphene. P1094 Primary abdominal compartment syndrome associated with Meig’s syndrome S. Schwarz, M. Fernandez. ´ University of Puerto Rico Medical School Objectives: To present an unusual case of Primary Abdominal Compartment Syndrome thought to be of malignant cause and resulting in a benign condition that completely resolved after surgical intervention. Materials and Methods: This is a case of a 25 y/o G-2 P-2, weight 91 kg (200 lbs.) and a height of 162 cm. (64") presenting with persistant intra-abdominal pressure of 20 mmHg associated with a pelvic mass. The patient had upper respiratory difficulty and gastrointestinal symptoms one week before admission. Three days before admission she began to exhibit food intolerance and abdominal distention. When brought to the ER she was found with bilateral complex ovarian masses, ascites and hydrothorax. An assesment of ovarian neoplasia was made and she was referred to our tertiary University center. Due to respiratory failure she was intubated shortly after admission. Renal failure was diagnosed and she was transferred to MICU. The patient’s condition continued to deteriorate due to increasing pressure that compromised organ perfusion. Surgical intervention to relieve the immense intraabdominal pressure was undertaken. At surgery, over 3 liters of ascitic liquid was removed resulting in immediate improvement of respiratory parameters. Organ perfusion was restored and renal filtration improved. The removal of two large 20 cm. ovarian masses that were necrotic as well as a hysterectomy were required. Results: Soon after surgery ascitis and hydrothorax disappeared. The patient was discharged home. The hystologic diagnosis: hemorrhagic infarction of ovarian tumors, 410 gms and 400 gms, consistent with fibrothecoma. Conclusion: Abdominal compartment syndrome secondary to a very large benign ovarian tumor has been rarely reported in gynecology. With the increase in intra-abdominal pressure there is multi organ system failure that can be fatal. Meig’s syndrome is the presentation of a rare benign ovarian tumor, a Thecoma, accompanied by ascities and hydrothorax. Thecomas represent less than 1% of all ovarian tumors. When associated with Meig’s syndrome the clinical picture is similar to that of ovarian carcinoma. This is an excellent example of complete improvement of abdominal compartment syndrome by surgical removal of what was thought to be a malignant stage four disease and resulted to be a benign reversible condition: Meig’s syndrome. P1095 Human papilloma Virus (HPV): Burden of the disease in the general population in the Extended Middle East and North Africa (EMENA): A comprehensive review M. Seoud1 , S. Lindley2 , K. Seoud, S. Anis. 1 American University of Beirut Medical Center, 2 WellsCare, 3 Introduction: The EMENA countries have traditionally been viewed as societies that are more conservative with a rather low prevalence of STIs. The purpose of this paper is to review the prevalence of HPV infections and HPV related diseases in the general population in EMENA. Materials and Methods: We performed an extensive literature in PubMed, Medline, Embase, national data bases, references in the abstracted papers, and unpublished data from local experts. Data extracted included information on the method of HPV detection and HPV type-specific data. Other data included age and whether
S719
it is a low or high risk population and the number of subjects in each study. Results: In North Africa: The prevalence of HPV varied between from 5–12% in the low risk population and from 20–49% in the high population such as prostitutes. In the Middle East: The prevalence of HPV varied between from 1.8–13% in the low risk population and 31.6% in a family planning clinic in Saudi Arabia. In the gulf countries: The prevalence of HPV varied between from 4–11% in the low risk population and from 20–30% in the high population such as cervicitis. In Turkey, Iran and Pakistan: Tthe prevalence of HPV varied between from 1.5–13% in the low risk population and up to 42.9% in patients with abnormal smears. The studies were varied with small number of patients and varied detection methods that difficult to compare with few standard tests such as Hybrid capture I or II. Few were ISH and most were PCR. The average age (30–50 years), in general, was higher than that noted in other parts of the world where the peak prevalence occur around 24–25 years. Conclusions: Although the studies on the prevalence of HPV in the EMENA region are not abundant, but there enough data to suggest that the prevalence of HPV in the low risk population of the countries is around 5–12% which is close to the world wide prevalence of 10%. P1096 Is p16INK4A expression useful to determine the outcome of atypical squamous cells of undetermined significance S. Douvier, S. Thouvenot, L. Filipuzzi, P. Sagot. Gynecologic Department, Dijon France Objective: The aim of this study was to determine the interest of p16INK4A marker in the triage of Atypical Squamous Cells of Undetermined Significance (ASCUS) in pap smear. Methods: We studied 137 ASCUS categorized pap smears with susequent follow-up biopsies or long term cytologies. All smears were immunostained with a primary anti-p16 antibody, clone E6H4. Immunoreactivity for p16 was correlated with histological lesions. Results: In 137 ASCUS, 8 cases failed in p16 staining. 25 histological lesions were found: 11 (9%) CIN1 and 14 (10.4%) CIN2+. 104 histologic samples or follow-up cytologies were normal (80.6%). the Sensitivity, Specificity, PPV and NPV of p16 to found a CIN2+ were respectively 78.6%, 88.7%, 45.8% and 97.2%. Conclusions: There is an association between strong p16 immunostaining of ASCUS and the presence of high grade lesions in the cervix, except 3 cases. Similarly there is an association between the lack of p16 expression and the absence of cervical lesion (NPV = 97.2%). The p16 immunocytochimical stain may serve as a useful biomarker in ASCUS containing smear diagnoses. P1098 Reproductive risk factors of breast cancers among Yemeni women K. Shamsuddin1 , A. Alyamani2 , M. Kamaluddin3 , S. Bin Bisher2 , A. Batarfi4 . 1 Dept of Community Health, Medical Faculty, Universiti Kebangsaan Malaysia, 2 Dept of Surgery, Hadramout University Medical College, Yemen, 3 Institute for Medical Research, Ministry of Health Malaysia, 4 Hadramout University Medical College, Yemen Introduction: Breast cancer is one of the main cancers experienced by women worldwide. Although many studies on the risk factors of breast cancers had been done, fewer such studies had been done in less developed countries such as Yemen, a country known to have a high rate of early marriage and a very high fertility. This paper focuses on identifying the reproductive risk factors of breast cancers among Yemeni women, particularly their menstrual, birth and breastfeeding history, as well as hormonal use. Materials and Methods: A case–control study comparing cases with histologically diagnosed breast cancers with patients not known to have breast cancers from 5 major hospitals in Yemen
S720
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
was carried out in 2006. The risk factors of breast cancers were analyzed using 202 cases and 384 controls. Results showed more than 90% of these women were married, 56.8% were grand multiparous and 20.3% had 8 or more children. Data adjusted for age, education, family income, medical, surgical and family history of breast diseases, nutrition and anthropometric factors and lifestyles related to smoking, physical exercise and chewing of qat leaves, a popular habit in Yemen, showed that early age at menarche less than 12 years (OR = 13.2; 95% CI 5.2–33.8), irregular menses (OR = 5.4; 95% CI 1.1–27.7), age at first fullterm pregnancy >20 years (OR = 4.2; 95% CI 1.8–9.7), menopause status (OR = 3.9; 95% CI 1.8–8.5), and use of hormone replacement therapy (OR = 11.7; 95% CI 1.8–74.0) were significant risk factors of breast cancers in Yemeni women. The study also showed the protective effects of breastfeeding on breast cancers (OR = 0.14; 95% CI 0.1–0.6). Being never married, and having positive history of abortion were not significant risk factors of breast cancer in these women. Adjusted for age, the risk of breast cancer among women with 1–4, 5–8 and more than 8 children were significantly lower than nulliparous women. However when adjusted for all the other risk factors in this study, nulliparity was no longer a significant risk factor of breast cancer. Conclusion: The study among Yemeni women offers opportunity to explore reproductive risk factors of breast cancers in a population with high fertility. This study also showed the continued protective effects of breastfeeding but not high parity in this population with high fertility. P1099 Differential diagnosis of malignant ovarian tumors – use of advanced data mining systems for classification making processes A. Smolen1 , A. Czekierdowski2 , N. Stachowicz2 , M. Kotarska2 , J. Kotarski2 . 1 Department of Mathematics and Biostatistics, Medical University in Lublin, 2 Department of Gynecology and Gynecological Oncology, Medical University in Lublin Objective: Study applies methods of data exploration and decisionmaking processes support in early differential diagnosis of adnexal masses in women. Methods: 637 women with adnexal masses treated in the Department of Gynecology and Gynecological Oncology at the Medical University of Lublin were analyzed. Combination of clinical, ultrasonographic parameters and CA-125 serum levels was apllied to construct prognostic models using discriminant function analysis, logistic regression, multivariate adaptive regression splines (MARS), standard and boosted classification trees, artificial neural networks, support vector machines, naive Bayes, K-nearest neighbors, which allows for a comprehensive analysis of possibilities of decision-making processes support in early adnexal masses differential diagnosis. Results: Among 637 women with adnexal masses 202 (31.7%) had malignant tumors and 435 (68.3%) had non-malignant adnexal tumors. Optimal combination of parameters to consider in early differential diagnosis of adnexal masses are: half-quantitative assessment of “color” feature and vessels location in twodimensional color Doppler sonography; tumor ultrasonographic morphology assessment allowing endophytic endostoses >3 mm; tumor’s volume and location assessment; vascular flow assessment in three-dimensional sonography with sonoangiography allowing vascularization index (VI) and vascular flow index (VFI); age, menopausal status of a patient; preoperative CA-125 serum level. MLP artificial neural network proved as the best individual classification model, while networks’ cluster and the best models’ contamination method (“K-judge voting” algorithm), i.e. logistic regression model, boosted classification trees model and MLP neural network, support choosing optimal discrimination prognosis.
Conclusion: Integration into a multimodal project results in obtaining the highest predictive values and enables support of preoperative differential diagnosis of adnexal masses in women. P1100 CA 125 level as a predictive value of second look operation finding and prognostic marker in epithelial ovarian cancer J. Song, K. Ahn, H. Park, S. Hong, T. Kim, Y. Kim, S. Kim, K. Lee. Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Objectives: CA 125 levels are regarded as a marker of epithelial ovarian cancer and recently suggested as a predictor of survivals. The objectives of this study are to determine the correlation between CA 125 level and second look operation pathologic results, and whether CA 125 is a predictor of prognosis. Materials and Methods: The medical records of 49 patients diagnosed and treated with ovarian cancer in Korea University Anam Hospital from 1994 and 2007 were retrospectively reviewed. CA 125 level at the time of second look operation was compared with second look operation results, disease free survival and overall survival. Chi-square and log-rank test was used with SPSS 13.0. Results: The patients with positive second look operation were 27/49 (55.1%). The positive rate in second look operation with CA 125 level of <10 U/ml was 26.3% (5/19) and ≥10 U/ml was 73.3% (22/30) (p = 0.003). The overall survival was increased in the patients with CA 125 level <10 U/ml (mean 142.4 months) compared with ≥10 (mean 35.2 months) (p = 0.046). The disease free survival was also increased in the patients with CA 125 level <10 U/ml (mean 71.8 months) compared with ≥10 (mean 5.0 months) (p = 0.007). Conclusions: CA 125 level at the time of second look operation with cut-off level <10 U/ml is a useful predictive marker of second look operation pathologic result and also is a good prognostic marker of epithelial ovarian cancer. P1101 Primary squamous cell carcinoma arising from the pelvic retroperitoneum: A case report J. Song1 , J. Lee1 , N. Lee1 , C. Kim2 , K. Lee1 . 1 Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea, 2 Department of Pathology, Korea University College of Medicine, Seoul, Korea Background: Primary retroperitoneal squamous cell carcinoma (SCC) is very rare. Case: A 66-year-old woman presented with right leg edema and pain that had developed one month prior. Pelvis magnetic resonance imaging (MRI) showed the presence of a mass around the iliac vessels. The patient underwent an exploratory laparotomy but the mass was not completely removed. The histopathological diagnosis was a SCC and there was no primary site based on systemic evaluation with the use of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scanning. The patient was treated with concurrent chemoradiatiotherapy (CCRT) with paclitaxel-carboplatin and Tomotherapy three weeks after surgery. Conclusion: This is the first case of a primary SCC arising from the retroperitoneum that was treated with surgery and adjuvant CCRT with paclitaxel-carboplatin and Tomotherapy. P1102 Clinical analysis of patients with CIN 2/3 diagnosed by cervical punch biopsy E. Song, J. Park, S. Hwang, M. Im, B. Lee, W. Lee. Inha University Hospital, Incheon, South Korea Introduction: Cervical cancer is a major health problem for Korean women, accounting for 9.8% of new female cancer cases, even though incidence rates have been decreasing. Cervical intraepithelial neoplasia (CIN) is a precancerous lesion and takes 5 to 15 years to progress to invasive cancer. Therefore, the appropriate