Vol. XXV, n. 4, 2004 ISSN: 0392-2936



european journal
of
gynaecological oncology

an International Journal


Editor-in-Chief
A. Onnis P. Bösze
Montréal (CND) Budapest (Hungary)

Associate Editor
M. Marchetti
Montréal (CND)

Assistant Editor
J. Wilson
San Diego - CA (USA)
Editorial Board

H.H. Allen, London, Ontario (Canada)
S.O. Anteby, Jerusalem (Israel)
P. Audet-Lapointe, Montreal (Canada)
L. Aurelian, Baltimore, MD (USA)
A. Ayhan, Ankara (Turkey)
O. Balat, Graziantep (Turkey)
H.K. Barber, New York, NY (USA)
A. Basta, Krakow (Poland)
H.C. Bender, Dusseldorf (Germany)
P.L. Benedetti Panici, Rome (Italy)
T. Charkviani, Tbilisi (Georgia)
D. Dargent, Lyon (France)
C.F. De Oliveira, Coimbra (Portugal)
S. Dexeus Jr., Barcelona (Spain)
G. De Palo, Milan (Italy)
G. De Palo, Milan (Italy), Buenos Aires (Argentina)
F. Di Re, Milan (Italy)
P. Di Saia, Orange, CA (USA)
M. Friedrich, Luebeck (Germany)

S.K. Fotiou, Athens (Greece)
A.F. Fuller Jr., Boston, MA (USA)
H.E. Geisler, Indianapolis, IN (USA)
A. Gerbaulet, Villejuif (France)
A. Gorins, Paris (France)
A.P.M. Heintz, Utrecht (The Netherlands)
L. Ioannidou-Mouzaka, Athens (Greece)
J.A. Jordan, Birmingham, England (UK)
A.I. Karseladze, Moscow (Russia)
J. Klastersky, Bruxelles (Belgium)
V. Kozachenko, Moscow (Russia)
B. Kralj, Ljubljana (Slovenia)
E. Kubista, Vienna (Austria)
A.P. Kudelka, Houston, TX (USA)
T. Maggino, Padua (Italy)
J. Markowska, Poznan (Poland)
C. Marth, Innsbruck (Austria)
Leon F. A. G. Massuger,
Nijmegen (The Netherlands)
J. Menczer, Savyon (Israel)
J. Monsonego, Paris (France)
A. Pinotti, São Paulo (Brasil)
S.M. Piver, Buffalo, NY (USA)
S. Rakar, Ljubljana (Slovenia)
K.S. Raju, London, England (UK)
J.H. Shepherd, London, England (UK)
P. Sismondi, Turin (Italy)
J. Stelmachów, Warsaw (Poland)
L. Ungár, Budapest (Hungary)
I. Vergote, Leuven (Belgium)
J.B. Vermorken, Edegem (Belgium)
P. Vîrtej, Bucharest (Romania)
P.-H. Wang, Taipei (Taiwan)
R. Winter, Graz (Austria)
Y. Yokoyama, Hirosaki (Japan)
J. Zielinski, Warsaw (Poland)

Publisher Organization:
I.R.O.G. CANADA, Inc. - 4900 Côte St-Luc - Apt # 212
Montréal, Qué. H3W 2H3 (Canada)
Tel. +514-4893242-4854513 - Fax +514-4854513
E-mail: canlux@qc.aira.com - www.irog.net

EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY (ISSN 0392-2936) publishes original peer reviewed works in the fields of female genital cancers and related subjects and also proceedings of gynecologic oncology society meetings all over the world. The Journal is covered by CURRENT CONTENTS, SCISEARCH, RESEARCH ALERT, INDEX MEDICUS, MEDLINE, EMBASE/ Excerpta Medica, CURRENT ADVANCES IN CANCER RESEARCH, BIOSIS.
European Journal of Gynaecological Oncology - Vol. XXV, n. 4, 2004
 
CONTENTS  
DISTINGUISHED EXPERT SERIES  
Diagnostic and therapeutic dilemmas in vulvar cancer 405
J. Baltzer - Krefeld, GERMANY
The etiology of vulvar cancer is incompletely understood. The human papilloma virus is the major causal factor. Special attention must be paid to the size, surface, site of the tumor, unifocal or multifocal growth and lymph node status. Surgery is the cornerstone of management in order to reduce radicality without jeopardizing the chances of cure.
 
 
REVIEW ARTICLES  
Pseudomyxoma peritonei usually originates from the appendix: a review of the evidence 411
A. Mukherjee, A. Parvaiz, T.D. Cecil, B.J. Moran - Hampshire, UNITED KINGDOM
Controversy prevails regarding the origin of pseudomyxoma peritonei. Clinical and scientific evidence point towards an appendicular origin predominantly.
 
 
ORIGINAL ARTICLES  
Carcinoma in situ and early breast carcinoma. Survey of the Portuguese Senology Society on the diagnostic tools used in Portugal and their evolution between 1985 and 2000 415
C.F. de Oliveira, V. Rodrigues, H. Gervásio, J. Moura Pereira, J. Albano, N. Amaral - Coimbra, PORTUGAL
The treatment of carcinoma in situ and early breast cancer as well as the evolution between 1985 and 2000 in the Portuguese hsopi-tals was evaluated. There was an increase in conservative surgery and in the average of excised axillary lymph nodes. Postoperative radiotherapy in patients submitted to conservative surgery and adjuvant chemotherapy have improved the survival rate.
 
Establishment and characterization of two cell (HEC-155, HEC-180) derived from uterine papillary serous adenocarcinoma 423
T. Iida, M. Hamano, N. Yoshida, K. Yonamine, K. Hayashi, K. Kiguchi, B. Ishizuka, Y. Nishimura, T. Arai,
M. Kawaguchi, H. Hata, J. Watanabe, H. Kuramoto - Kawasaki, JAPAN Two novel cell lines of UPSC have been established which should be useful for investigating the characteristics of UPSC.
 
Flow cytometric analysis of DNA ploidy and S-phase fraction of Stage IIIB cervical carcinoma 428
S. Wilailak, M. Rochanawutanon, S. Srisupundit, A. Aumkhyan, K. Pattanapanyasat - Bangkok, THAILAND
Aneuploidy and S-phase fraction > 12 were found to be correlated with poor survival in a homogeneous study of 66 women with FIGO Stage IIIB cervical carcinoma.
 
Clinical review of 63 cases of sex cord stromal tumors 431
V. Zanagnolo, B. Pasinetti, E. Sartori - Brescia, ITALY
The primary treatment of sex cord stromal tumors is surgery and the role of adjuvant treatment is uncertain. Tumor stage is the most important prognostic factor.
 
Laparoscopic treatment of endometrial cancer: five-year recurrence and survival rates 439
J.F. Magrina, A.L. Weaver - Rochester, MN (USA)
Laparoscopy and laparotomy for endometrial cancer provide similar 5-year survival and recurrence rates.
 
Clinical value of the ultrasound Doppler index in determination of ovarian tumor malignancy 442
D. Szpurek, R. Moszyn´ski, S. Sajdak - Poznan, POLAND
A new Doppler index was created to improve the clinical preoperative differentiating diagnosis of ovarian tumor malignancy.
 
Does improving communication and information for women increase attendance at colposcopy in an inner city clinic? A randomised controlled trial 445
A. Tomlinson, M. Kyrgiou, E. Paraskevaidis, H. Kitchener, P. Martin-Hirsch - Ioannina, GREECE
Improved communication and information for women with a recent abnormal smear result increased attendance for initial colposcopy assessment.
 
Gemcitabine in heavily pretreated patients with recurrent ovarian, peritoneal and fallopian tube carcinoma 449
B. Piura, A. Rabinovich - Beer-Sheva, ISRAEL
Gemcitabine demonstrated some activity and low toxicity in 21 heavily pretreated patients with platinum-resistant recurrent ovarian, peritoneal and fallopian tube carcinoma.
 
Laparoscopic coagulation of the uterine blood supply in laparoscopic-assisted vaginal hysterectomy is associated with less blood loss 453
C. Köhler, K. Hasenbein, P. Klemm, R. Tozzi, W. Michels, A. Schneider - Jena, GERMANY
Laparoscopic coagulation of the uterine blood supply at the origin of the uterine vessels is a safe technique which minimizes blood loss in LAVH. In patients with a low preoperative hemoglobin value this technique is indicated.
 
Estrogen receptor beta (ERb) expression in breast carcinomas is not correlated with estrogen receptor alpha (ERa) and prognosis: The Greek experience 457
D. Stefanou, A. Batistatou, E. Briasoulis, E. Arkoumani, N.J. Agnantis - Ioannina, GREECE
The expression of ERb in breast carcinomas was examined and no correlation with ERa expression and known prognostic indicators was found.
 
Reporting of “LSIL with ASC-H” on cervicovaginal smears: Is it a valid category to predict cases with HSIL follow-up? 462
G. Kir, H. Cetiner, A. Gurbuz, A. Karateke - Istanbul, TURKEY
Diagnosis of LASC-H may be valid to distinguish patients with LSIL that would have HSIL in follow-up.
 
Expression of beta-human chorionic gonadotropin in ovarian cancer tissue 465
E. Nowak-Markwitz, A. Jankowska, M. Andrusiewicz, A. Szczerba - Poznan, POLAND
The study shows the expression of hCG bmRNA and distribution of the hormone in ovarian carcinoma tissue.
 
The presence of hereditary BRCA1 gene mutations in women with familial breast or ovarian cancer and the frequency of occurrence of these tumours in their relatives 470
E. Skasko, Z. Paszko, A. Niwin´ska, E. Kwiatkowska, A. Kruczek, T. Pien´kowski - Warsaw, POLAND
The presence of the 5382insC mutation in the BRCA1 gene is not always associated with ovarian cancer. It is very likely that the development of ovarian cancer requires some additional factors. The diagnosis of ovarian cancer at a later age than breast cancer in probands suggests that some factors exist which slow down the development of ovarian cancer or which accelerate the development of breast cancer.
 
A second Pap smear during colposcopy: is it really worth it? 475
G.S. Kourounis, G.D. Michail, P. Ravazoula - Patras, GREECE
Repeating the Pap smear during colposcopy shows limited clinical benefit, especially in patients where the initial Pap smear indicating LGSIL was obtained shortly before ovulation.
 
The effect of recombinant GM-CSF on IL-6 and TNF-a levels in epithelial ovarian cancer patients who received paclitaxel and cisplatinum: preliminary results 478
M. Oktem, T.U.K. Dilek, H. Guner, M.B. Tiras - Ankara, TURKEY
Twenty-three patients with Stage III-IV epithelial ovarian cancer received paclitaxel-cisplatinum after cytoreductive surgery. RhuGM-CSF was administered before the chemotherapy cycles for three days. TNF-a and IL-6 levels were measured before and after the RhuGM-CSF. This difference was statistically significant for TNF-a.
 
Immunohistochemical profile of intravenous leiomyomatosis 481
G. Kir, H. Cetiner, A. Gurbuz, S. Eren - Istanbul, TURKEY
The immunohistochemical profile of intravenous leiomyomatosis was analysed and its value in the differential diagnosis of ordinary leiomyoma, endometrial stromal sarcoma and leiomyosarcoma is discussed.
 
K-ras gene point mutations and p21 ras immunostaining in human ovarian tumors 484
A. Semczuk, K. Postawski, D. Przadka, K. Rozynska, A. Wrobel, E. Korobowicz - Lublin, POLAND
K-ras gene point mutations and p21 ras immunostaining were assessed in a group of benign and malignant human ovarian tumors.
 
Stromomyomas of the uterus - importance of total circumferential evaluation of the margin 489
G. Kir, A. Gurbuz, A. Karateke, V. Dayicioglu - Istanbul, TURKEY
Stromomyomas must be extensively dissected in the entire circumference for sequential histologic sections. This is a promising procedure which allows the distinction of stromomyomas with focal angioinvasion.
 
Mammographic changes during postmenopausal hormonal replacement therapy with tibolone 493
A. Pantidou, K. Kaplanis, I. Chrissogonidis, C. Destouni - Thessaloniki, GREECE
The evaluation of mammographic changes in postmenopausal women receiving tibolone as hormonal replacement therapy is presented.
 
Fibroadenomas of the breast: is there any association with breast cancer? 495
C. Markopoulos, E. Kouskos, D. Mantas, K. Kontzoglou, Z. Antonopoulou, K. Revenas, V. Kyriakou -Lesvos Island, GREECE
Fibroadenomas harboring breast cancer are uncommon but this entity should not be ignored by breast specialists, and patients should be well informed.
 
Postoperative patient-controlled analgesia with intravenous tramadol, intravenous fentanyl, epidural tramadol and epidural ropivacaine+ fentanyl combination 498
S. Aygun, H. Kocoglu, S. Goksu, M. Karaca, U. Oner - Gaziantep, TURKEY
Intravenous tramadol, intravenous fentanyl, epidural tramadol, and an epidural ropivacaine + fentanyl combination were used and compared in patient-controlled analgesia for postoperative pain control after lower abdominal surgery.
 
The value of epithelial membrane antigen overexpression in hyperplastic and malignant endometrium and its relationship with steroid hormone receptor expression 502
G. Kir, H. Centiner, A. Gurbuz, A. Karateke - Istanbul, TURKEY
EMA-OE shows increased expression as the lesion progresses to malignancy and can also aid discrimination between hyper-plastic and neoplastic states. The correlation of immunohistochemical findings with tumor grade and myometrial invasion could help in predicting behavior of the tumor and planning treatment in patients with endometrial carcinoma.
 
 
CASE REPORTS  
Adenosarcoma of the ovary. A case report 507
P. Litta, C. Pozzan, G. Sacco, F. Merlin, C. Saccardi, A. Ambrosini - Padova, ITALY
A case of an ovarian adenosarcoma (low stage and low grade) in a young woman treated by conservative laparoscopy is reported.
 
A case of rhabdomyosarcoma of the vagina in an elderly woman 509
Y. Suzuki, H. Sakurai, M. Hasegawa, T. Kanuma, A. Segawa, T. Nakano - Gunma, JAPAN
A rare case of a 70-year-old woman who presented with vaginal rhabdomyosarcoma resulting in rapid systemic progression is reported.
 
Massive ovarian edema: A case report 512
K. Bildirici, S. Kabukcuoglu, S.S. Ozalp, Ö.T. Yalçin, H. Ozden - Eskisehir, TURKEY
A case of massive ovarian edema in a 15-year-old female thought to be a solid neoplasm preoperatively is described.
 
Primary ovarian leiomyosarcoma. Proliferation rate and survival 515
P.A. Nicòtina, F. Antico, C. Caruso, O. Triolo - Messina, ITALY
A variant of primary ovarian leiomyosarcoma was investigated to assess cell density and proliferation indices as prognosticators together with the tumor stage and clinical course.
 
Pelvic lipomatosis complicating ovarian cyst removal: a case report 517
L. Quirino, A. Izzo, E. Niglio, R. Quirino, G. Ciavolino, M. Rotondi, G. Mainini, M. Ardovino, E.M. Mes-salli
- Naples, ITALY
A case of pelvic lipomatosis accidentally found during surgery for an ovarian cyst without symptoms or signs is reported.
 
Aggressive angiomyxoma of the vagina: a case report and review of the literature 519
D.J. Papachristou, A. Batistatou, E. Paraskevaidis, N.J. Agnantis - Ioannina, GREECE
A case of vaginal aggressive angiomyxoma is presented. The histological and immunohistochemical phenotype and the behavior of this neoplasm are reported.
 
Primary fallopian tube cancer - a ten year review. Clinicopathological study of 12 cases 522
A. Liapis, E. Michailidis, E. Deligeoroglou, A. Kondi-Pafiti, S. Konidaris, G. Creatsas - Athens, GREECE
Primary fallopian tube cancer is the rarest of all gynecologic cancers. A retrospective study involving 12 patients with primary fallopian tube cancer treated in our Department is presented. The clinicopathologic characteristics and treatment are revised.
 
Total laparoscopic radical hysterectomy (type III) and pelvic lymphadenectomy 525
M. Malzoni, C. Malzoni, C. Perone, M. Rotondi, H. Reich - New York, USA
The first case in Italy of a total laparoscopic radical hysterectomy and pelvic lymphadenectomy to treat a Stage IIA G2 carcinoma of the cervix is presented.
 
Sclerosing stromal tumor of the ovary associated with Meigs’ syndrome: A case report 528
K. Bildirici, Ö.T. Yalçin, S.S. Ozalp, B. Peker, H. Ozden - Eskisehir, TURKEY
Benign ovarian tumors associated with Meigs’ syndrome are rare. A case of ovarian sclerosing stromal tumor associated with Meigs’ syndrome in a 17-year-old women is described and the differential diagnosis is also discussed.
 
Expression of estrogen receptors a and b in two uterine mesenchymal tumors after prolonged tamoxifen therapy. Report of two cases 530
M. Zafrakas, E. Kostopoulou, K. Dragoumis, T. Mikos, J. Papadimas, J. Bontis - Thessaloniki, Greece
Expression of estrogen receptor alpha and beta in a malignant mixed mullerian tumor and in a smooth muscle tumor of unknown malignant potential of the uterus after prolonged tamoxifen therapy is reported.
 
Sclerosing stromal cell tumor of the ovary in pregnancy: A case report 534
A. Gurbuz, A. Karateke, C. Kabaca, G. Ozturk Gaziyiz, G. Kir - Istanbul, TURKEY
A case of sclerosing stromal tumor of the ovary presenting in early pregnancy, with the only sign being a rapidly growing adnexal mass, is reported.
 
Acute renal failure after anterior pelvic exenteration: a case report and review of the literature 536
D. Wydra, J. Emerich, K. Ciach, A. Marciniak - Gdan´ski, POLAND
A case of massive gynecological hemorrhage after anterior pelvic exenteration in a patient with cervical cancer is reported.
 
   
   
   
   
EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY
Vol. XXV, Number 3, 2004
ISSN: 0392-2936
I.R.O.G. CANADA, Inc.
Publisher office: 4900 Côte St. Luc - Apt. 212 - Montréal, Québec H3W 2H3 (Canada) - Tél.: (514) 4893640-4893242 - Fax: (514) 4854513
E-mail: canlux@qc.aira.com - www.irog.net

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