Widespread lymph node metastases in a patient with microinvasive cervical carcinoma

Citations front the Literature adverse effects were minimal. Three patients requiring laparotomy for radiation induced smal1 bowel obstruction had confirmed complete responses but 2 died acutely of treatmentrelated complications without evidente of tumor. In the 15 patients with suboptimal disease (> 1 cm residual disease) prior to the study, only 1 had a complete response while 2 of 7 optim’al patients (< 1 cm residual disease) had a complete response. Al1 3 complete responders received cisplatin and 2 had 1 cm or less of residual disease prior to the study. In the hexamethylmelamine group 3 of 16 patients had a partial response. Concurrent single high-dose whole abdominopelvic radiation and cisplatin may be effective in patients with minimal disease (
Concomitant radiation therapy end chemotherapy in the treatment of advanced squamoos carcinoma of the lower femde gerritpItract Roberts WS; Kavanagh JJ; Greenberg H; Bryson SCP; LaPolla JP; Townsend PA; Hoffman MS; Cavanagh D; Hewitt S H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tarnpa, FL 33682; USA Gynecologic Oncology; 34/2 (183-186)/1989/ Twenty-three consecutive patients with advanced squamous carcinoma of the lower female genital tract were entered into a pilot study to determine the response rate and toxicity of a combination of intravenous cisplatin and 5-fluorouracil given concomitantly with radiation therapy. Twenty (87%) of the patients had a complete clinical response. Two patients (9070) had a partial response and one (4070)had stable disease. Nine (45%) of the complete responders have recurred with a median time to recurrence of 4 months. Seven (35%) had some component of local recurrence. The complete responders who have not recurred have been followed a median of 17 months. The acute toxicity was generally mild and there were no life-threatening acute complications. Three patients developed significant late complications. The response rate in this study was very high. The responses were usually prompt and dramatic, but often not sustained.

Relapsing Clostridium difficite toxin-associated colitis in ovarian cancer patients treated with chemotherapy Satin AJ; Harrison CR; Hancock KC; Zahn CM Department of Obstetrics and Gynecology, Wilford Hall United States Air Force Medical Center, Lackland AFB, TX 782365300; USA Obstetrics and Gynecology; 74/3 11SUPPL. (487-489)/1989/ Symptomatic relapse of Clostridium difficile toxin-associated colitis occurred in three patients with ovarian cancer. In two patients, C difficile toxin-positive diarrhea initially appeared in association with antibiotic threapy. The third patient developed diarrhea after chemotherapy, without recent antecedent antibiotic administration. Patients were initially treated with oral metronidazole and became asymptomatic and toxin-negative. A symptomatic and toxin-negative. A sympto-

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matic toxin-positive recurrence then developed after the subsequent course of systemic chemotherapy. Recurrent C difficile toxin-associated colitis or pseudomembranous colitis after chemotherapy has not been reported previously in the gynecologic oncology literature. Clostridium difficile-induced diarrhea must be considered in chemotherapy patients with diarrhea became management concepts vary from those for noninfectious diarrhea. Preoperattve assessment of myometrial invasion of endometrhd adenocarcinomr by sonography (US) nnd magnetic resonance imaging &íRI) Gordon AN; Fleischer AC; Dudley BS; Drolshagan LF; Kalemeris GC; Partain CL; Jones HW 111;Burnett LS Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 3 7232; USA Gynecologic Oncology; 34/2 (175-179)/1989/ The presence and/or depth of myometrial invasion of endometrial adenocarcinoma has important prognostic and therapeutic implications. Fifteen patients with histologically proven endometrial cancer underwent preoperative evaluation with sonography (US) and magnetic resonance imaging (MRI) to assess depth of invasion. Using criteria of greater than or equal to 50% of myometrial wal1 involvement as representing deep invasion, and less than 50% as superficial invasion, US was more accurate than MRI in five cases; in three MRI was more accurate than US; both MRI and US were equally accurate in four; neither was accurate in three. Polypoid lesions caused the greater number of false positive reports of deep invasion with both MRI and US. Preliminary results indicate that US and MRI have promise as preoperative tests to assess the extent of myometrial invasion. Significante of IympbopIasmocytIc infiltration around tumor cel1 in the prediction of regioaal lymph node metastases in patients with invasive squamous celi carcinoms of tbe vulva: A clinicopathologic study Husseinzadeh N; Wesseler T; Schellhas H; Nahhas W Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Cincinnati, Cincinnati, OH 45267; USA Gynecologic Oncology; 34/2 (200-205)/1989/ Histologie material from 42 patients treated for invasive squamous cell carcinoma of the vulva was studied to determine the prognostic significante of lymphoplasmocytic infiltration around tumor cells in the prediction of regio& lymph node metastases. NO correlation was found between lymphoplasmocytic infiltration and nodal metastases with respect to degree of tumor differentiation, stage of disease, and vascular Channel involvement. The presence or absente of lymphoplasmocytic infiltration around tumor cells appears to have no prognostic value in predicting nodal metastases. Widespread lymph node metastases in a patient witb microinvasive cervicai carcinoma Collins HS; Burke TW; Woodward JE; Spurlock JW; Heller PB Int J Gynecol Obstet 31