Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441214
C. Albrecht
The war on cancer started in earnest in 1971 when Richard Nixon empowered the National Cancer Institute to eradicate cancer. Forty years later, after spending close on a trillion dollars and involving approximately 100 000 cancer researchers, roughly 50% of the cancer problem remains to be solved. Achieving this could take another 40 years.
{"title":"The prevention of cancer in South Africa","authors":"C. Albrecht","doi":"10.1080/20742835.2013.11441214","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441214","url":null,"abstract":"The war on cancer started in earnest in 1971 when Richard Nixon empowered the National Cancer Institute to eradicate cancer. Forty years later, after spending close on a trillion dollars and involving approximately 100 000 cancer researchers, roughly 50% of the cancer problem remains to be solved. Achieving this could take another 40 years.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"S3 - S4"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441208
G. du Toit, M. Kidd
Abstract Objective: In South Africa, the majority of cervical carcinoma cases present when they are in the advanced stage. Concomitant HIV/AIDS further compromise patient health. Data on the impact of HIV/AIDS on the quality of life of cases with advanced cervical carcinoma are lacking. Contextual factors, e.g. patient’s educational level and income, influence their experience of quality of life. Design: A cross-sectional study was carried out on the quality of life of newly diagnosed cases of cervical carcinoma. Self-administered questionnaires were completed by patients and other contextual factors (e.g. age, educational level, socio-economic status and clinical information), were obtained from patient folders. Setting and subjects: Newly diagnosed cases of invasive cervical carcinoma who presented at the Gynaecological Oncology Unit, Tyberberg Hospital, were included in the study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (QLQ)-C30 version 3 and QLQ-CX24 were used. Results: The total study cohort of 73 patients (HIV-negative and HIV-positive) had a median age of 49 (28.3- 85.2 years). Of the patients, 7.1% had no formal education. The cohort had an unemployment rate of 41.5%, and 14.2% were pensioners. The marital state was predominantly single persons (31.4%), with a mean monthly income of R 1 373 (R0-14 000). Advanced stage of the disease was present in more than 50% of cases, and 32.2% were stage IIIb. Sixteen patients were HIV positive with an HIV-positive incidence of 22%.The comparative quality-of-life domains of HIV-negative and HIV-positive cases were statistically equal. Advanced stage, as a contextual factor, impacted significantly on a number of quality-of-life domains. These domains are amenable to medication. Conclusion: HIV/AIDS did not adversely influence the quality of life of the newly diagnosed cervical carcinoma cases. In this regard, stage of disease had a significant impact on the domains of pain, insomnia, nausea and vomiting, appetite loss and constipation. These aspects are amenable to treatment. Cognitive function was adversely influenced by increasing age, poor education and a low monthly income. When giving support to patients with regard to enhancing their quality of life, this should be recognised and communicated to them.
{"title":"Contextual quality of life of HIV-positive patients with cervical carcinoma at Tygerberg Hospital","authors":"G. du Toit, M. Kidd","doi":"10.1080/20742835.2013.11441208","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441208","url":null,"abstract":"Abstract Objective: In South Africa, the majority of cervical carcinoma cases present when they are in the advanced stage. Concomitant HIV/AIDS further compromise patient health. Data on the impact of HIV/AIDS on the quality of life of cases with advanced cervical carcinoma are lacking. Contextual factors, e.g. patient’s educational level and income, influence their experience of quality of life. Design: A cross-sectional study was carried out on the quality of life of newly diagnosed cases of cervical carcinoma. Self-administered questionnaires were completed by patients and other contextual factors (e.g. age, educational level, socio-economic status and clinical information), were obtained from patient folders. Setting and subjects: Newly diagnosed cases of invasive cervical carcinoma who presented at the Gynaecological Oncology Unit, Tyberberg Hospital, were included in the study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (QLQ)-C30 version 3 and QLQ-CX24 were used. Results: The total study cohort of 73 patients (HIV-negative and HIV-positive) had a median age of 49 (28.3- 85.2 years). Of the patients, 7.1% had no formal education. The cohort had an unemployment rate of 41.5%, and 14.2% were pensioners. The marital state was predominantly single persons (31.4%), with a mean monthly income of R 1 373 (R0-14 000). Advanced stage of the disease was present in more than 50% of cases, and 32.2% were stage IIIb. Sixteen patients were HIV positive with an HIV-positive incidence of 22%.The comparative quality-of-life domains of HIV-negative and HIV-positive cases were statistically equal. Advanced stage, as a contextual factor, impacted significantly on a number of quality-of-life domains. These domains are amenable to medication. Conclusion: HIV/AIDS did not adversely influence the quality of life of the newly diagnosed cervical carcinoma cases. In this regard, stage of disease had a significant impact on the domains of pain, insomnia, nausea and vomiting, appetite loss and constipation. These aspects are amenable to treatment. Cognitive function was adversely influenced by increasing age, poor education and a low monthly income. When giving support to patients with regard to enhancing their quality of life, this should be recognised and communicated to them.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"41 - 46"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441212
P. M. Zaheeruddin, C. Prameela, M. A. Antony, K. Pavithran, M. Dinesh
Endometrial cancer is the seventh most common gynecological malignancy. The standard of care is surgery, followed by further treatment based on the surgical and histological findings. 1 Usually, recurrences (80%) from endometrial cancer are seen within three years of hysterectomy and late recurrences are rare. The incidence of isolated lung recurrences is approximately 2.3-7%. 2,3 This is a case report of endometrial cancer with locoregional and distant recurrence.
{"title":"Metastatic endometrial carcinoma in the lung: unusual timing and site","authors":"P. M. Zaheeruddin, C. Prameela, M. A. Antony, K. Pavithran, M. Dinesh","doi":"10.1080/20742835.2013.11441212","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441212","url":null,"abstract":"Endometrial cancer is the seventh most common gynecological malignancy. The standard of care is surgery, followed by further treatment based on the surgical and histological findings. 1 Usually, recurrences (80%) from endometrial cancer are seen within three years of hysterectomy and late recurrences are rare. The incidence of isolated lung recurrences is approximately 2.3-7%. 2,3 This is a case report of endometrial cancer with locoregional and distant recurrence.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"64 - 67"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441204
K. Mohammed, A. V. van Wijk
Abstract Objective: This retrospective observational study aims to review patients with malignant ovarian germ cell tumours (MOGCTs) treated at Groote Schuur Hospital over a 15-year period. Method: A medical chart review of adult patients with MOGCTs treated between 1994 and 2008 was conducted. Gathered data were transferred to an electronic spreadsheet. The Kaplan-Meier method was used to obtain fiveyear survival data. Results: Forty patients were treated for MOGCTs. Median age at the time of diagnosis was 30.2 years (a range of 13–63 years). Ten patients (25%) had dysgerminoma and 30 (75%) had non-dysgerminomatous types. The latter group comprised immature teratoma (10 patients), yolk sac tumour (8), mixed germ cell tumour (3), and mature teratoma with malignant transformation (MTMT) (9). Standard staging surgery was performed with fertility-sparing procedures wherever possible. Chemotherapy entailed a three-day modified bleomycin/etoposide/cisplatinum (BEP) regimen during the study period. Excluding the group of nine with monodermal malignant transformation in mature teratoma, complete response to primary treatment was achieved in 24 of 31 patients (77.4%). After a median follow-up of 42.5 months (a range of 2–60), the overall five-year survival rate was 69.1%. The overall five-year survival rate was only 40% in five human immunodeficiency virus (HIV)-positive patients. Four of the nine patients with MTMT were alive after five years. Conclusion: The prognosis of MOGCTs is excellent if managed with standard treatment initially. Treatment of MTMT is less well defined. Patients with advanced HIV infection did poorly and should be considered for initiation of antiretroviral therapy prior to chemotherapy.
{"title":"The types and treatment outcomes of germ cell tumours of the ovary seen at Groote Schuur Hospital, Cape Town, between 1994 and 2008: a retrospective survey","authors":"K. Mohammed, A. V. van Wijk","doi":"10.1080/20742835.2013.11441204","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441204","url":null,"abstract":"Abstract Objective: This retrospective observational study aims to review patients with malignant ovarian germ cell tumours (MOGCTs) treated at Groote Schuur Hospital over a 15-year period. Method: A medical chart review of adult patients with MOGCTs treated between 1994 and 2008 was conducted. Gathered data were transferred to an electronic spreadsheet. The Kaplan-Meier method was used to obtain fiveyear survival data. Results: Forty patients were treated for MOGCTs. Median age at the time of diagnosis was 30.2 years (a range of 13–63 years). Ten patients (25%) had dysgerminoma and 30 (75%) had non-dysgerminomatous types. The latter group comprised immature teratoma (10 patients), yolk sac tumour (8), mixed germ cell tumour (3), and mature teratoma with malignant transformation (MTMT) (9). Standard staging surgery was performed with fertility-sparing procedures wherever possible. Chemotherapy entailed a three-day modified bleomycin/etoposide/cisplatinum (BEP) regimen during the study period. Excluding the group of nine with monodermal malignant transformation in mature teratoma, complete response to primary treatment was achieved in 24 of 31 patients (77.4%). After a median follow-up of 42.5 months (a range of 2–60), the overall five-year survival rate was 69.1%. The overall five-year survival rate was only 40% in five human immunodeficiency virus (HIV)-positive patients. Four of the nine patients with MTMT were alive after five years. Conclusion: The prognosis of MOGCTs is excellent if managed with standard treatment initially. Treatment of MTMT is less well defined. Patients with advanced HIV infection did poorly and should be considered for initiation of antiretroviral therapy prior to chemotherapy.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"21 - 28"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441210
F. Marriqoun-Harris, Y. J. Rhou, D. Storey, S. Pather
Isolated splenic recurrent ovarian cancer is uncommon and may present remotely from initial surgery and chemotherapy. Surgical excision remains the treatment of choice for this condition. While widely used, the role of adjuvant therapy in this situation is unclear. We present a case of isolated recurrent splenic ovarian cancer treated with surgery and no adjuvant therapy, and review the literature on management of this condition.
{"title":"Prolonged survival after laparoscopic splenectomy for recurrent ovarian cancer and no adjuvant therapy: a report and review of the literature","authors":"F. Marriqoun-Harris, Y. J. Rhou, D. Storey, S. Pather","doi":"10.1080/20742835.2013.11441210","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441210","url":null,"abstract":"Isolated splenic recurrent ovarian cancer is uncommon and may present remotely from initial surgery and chemotherapy. Surgical excision remains the treatment of choice for this condition. While widely used, the role of adjuvant therapy in this situation is unclear. We present a case of isolated recurrent splenic ovarian cancer treated with surgery and no adjuvant therapy, and review the literature on management of this condition.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"58 - 61"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441215
K. Richter
Abstract The coverage of cervical cancer screening in South Africa is inadequate, with an estimated 8.8-million unscreened women who are mainly serviced by the public health sector in lower-resourced areas. Alternative screening options need to be considered. Every step in the screening process needs to be critically evaluated to design a practical programme without a bottleneck, to deliver maximum benefit with limited available resources. Patient self-sampling has been identified as an acceptable method of specimen collection for many women. Patient selfsampling, combined with high-risk human papillomavirus-based testing, has the potential to increase cervical cancer screening coverage, especially in areas where screening is inadequate.
{"title":"Alternative sampling methods for cervical cancer screening: practical perspectives from the laboratory","authors":"K. Richter","doi":"10.1080/20742835.2013.11441215","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441215","url":null,"abstract":"Abstract The coverage of cervical cancer screening in South Africa is inadequate, with an estimated 8.8-million unscreened women who are mainly serviced by the public health sector in lower-resourced areas. Alternative screening options need to be considered. Every step in the screening process needs to be critically evaluated to design a practical programme without a bottleneck, to deliver maximum benefit with limited available resources. Patient self-sampling has been identified as an acceptable method of specimen collection for many women. Patient selfsampling, combined with high-risk human papillomavirus-based testing, has the potential to increase cervical cancer screening coverage, especially in areas where screening is inadequate.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"S5 - S9"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441202
J. Sauer, H. Simonds, H. van der Merwe, S. Hattingh
Abstract This single-institution retrospective study compares the accuracy of clinical and magnetic resonance imaging (MRI) staging of cervical cancer. For patients who underwent surgery, MRI and clinical staging were compared to final pathological stage. Pathological stage was utilised as the reference standard. One hundred and twenty-eight patients underwent MRI and 45 proceeded to surgery. There was concurrence between MRI staging and pathological stage in only 29.3% of patients. MRI overestimated staging in 53.6% of the patients, and underestimated staging in 17.1%. The comparison between clinical staging and pathological stage indicated concurrences in 43.9% of the patients. Stage was overestimated in 19.5% and was underestimated in 36.6%. There was no statistically significant difference between the two staging options.
{"title":"A retrospective analysis comparing clinical staging with magnetic resonance imaging staging in patients with cervical cancer","authors":"J. Sauer, H. Simonds, H. van der Merwe, S. Hattingh","doi":"10.1080/20742835.2013.11441202","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441202","url":null,"abstract":"Abstract This single-institution retrospective study compares the accuracy of clinical and magnetic resonance imaging (MRI) staging of cervical cancer. For patients who underwent surgery, MRI and clinical staging were compared to final pathological stage. Pathological stage was utilised as the reference standard. One hundred and twenty-eight patients underwent MRI and 45 proceeded to surgery. There was concurrence between MRI staging and pathological stage in only 29.3% of patients. MRI overestimated staging in 53.6% of the patients, and underestimated staging in 17.1%. The comparison between clinical staging and pathological stage indicated concurrences in 43.9% of the patients. Stage was overestimated in 19.5% and was underestimated in 36.6%. There was no statistically significant difference between the two staging options.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"11 - 15"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441203
L. Snyman, U. Herbst
Abstract Objective: Cervical cancer is the most common gynaecological cancer in South Africa, and the vast majority of women present with an advanced stage of the disease. This can be attributed to the absence of an implemented screening programme, resulting in patients becoming symptomatic prior to diagnosis. There are little data on the health-seeking behaviour of these women. The objective was to investigate the circumstances of patients who present with cervical cancer, as well as examine their presenting symptoms and behaviour following the onset of symptoms. Design: Descriptive study. Data were collected from patients who were diagnosed with cervical cancer by means interviews and a questionnaire. Setting and subjects: Women diagnosed and managed with cervical cancer at the Gynaecological Oncology Unit, Kalafong Hospital, Pretoria. Outcomes measured: Included demographic data, tumour characteristics, presenting symptoms, number of visits to and interventions performed at the primary healthcare contact. Results: Eighty-five patients were recruited. Of these, 74% lived in rural areas, 81% had access to primary healthcare facilities and 83% lived close to a healthcare provider. Eight had early-stage disease. The most common presenting symptoms were vaginal bleeding, pain and vaginal discharge. After the onset of symptoms, 55% of patients visited their healthcare provider within four weeks. At the first visit, only 41% of patients had a gynaecological examination and only 15% were appropriately referred, compared to 23% at their second visit. Late presentation was significantly associated with no gynaecological examination (p-value < 0.01). Conclusion: The lack of a cervical cancer screening programme, suboptimal management of symptomatic patients and low levels of literacy and knowledge about cervical cancer and screening are compounding the plight of these patients.
{"title":"Reasons why unscreened patients with cervical cancer present with advanced stage disease","authors":"L. Snyman, U. Herbst","doi":"10.1080/20742835.2013.11441203","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441203","url":null,"abstract":"Abstract Objective: Cervical cancer is the most common gynaecological cancer in South Africa, and the vast majority of women present with an advanced stage of the disease. This can be attributed to the absence of an implemented screening programme, resulting in patients becoming symptomatic prior to diagnosis. There are little data on the health-seeking behaviour of these women. The objective was to investigate the circumstances of patients who present with cervical cancer, as well as examine their presenting symptoms and behaviour following the onset of symptoms. Design: Descriptive study. Data were collected from patients who were diagnosed with cervical cancer by means interviews and a questionnaire. Setting and subjects: Women diagnosed and managed with cervical cancer at the Gynaecological Oncology Unit, Kalafong Hospital, Pretoria. Outcomes measured: Included demographic data, tumour characteristics, presenting symptoms, number of visits to and interventions performed at the primary healthcare contact. Results: Eighty-five patients were recruited. Of these, 74% lived in rural areas, 81% had access to primary healthcare facilities and 83% lived close to a healthcare provider. Eight had early-stage disease. The most common presenting symptoms were vaginal bleeding, pain and vaginal discharge. After the onset of symptoms, 55% of patients visited their healthcare provider within four weeks. At the first visit, only 41% of patients had a gynaecological examination and only 15% were appropriately referred, compared to 23% at their second visit. Late presentation was significantly associated with no gynaecological examination (p-value < 0.01). Conclusion: The lack of a cervical cancer screening programme, suboptimal management of symptomatic patients and low levels of literacy and knowledge about cervical cancer and screening are compounding the plight of these patients.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"5 1","pages":"16 - 20"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60047043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1080/20742835.2013.11441205
B. Chakrabarti, S. Roy, C. Mallik, K. Bhattacharya, S. Mukherjee
Abstract Paraneoplastic syndrome frequently presents before cancer is diagnosed and can be associated with neoplastic disease that is not yet radiographically detectable. We report on the case of a 35-year-old woman who presented at the neurology department with complaints of insidious onset and gradually progressive weakness in all four limbs, which had lasted for the past six months. The weakness originally commenced in both lower limbs and was progressive, ascending in nature from distal to proximal. Both upper limbs were affected seven days later. Magnetic resonance imaging of the dorsal spine revealed long-segment T2 and short T1 inversion recovery (STIR) hyperintensity, suggestive of myelitis. Nerve conduction studies and an electromyogram suggested sensory motor polyneuropathy which affected all four limbs. On gynaecological check-up, a diagnosis of International Federation of Gynaecology and Obstetrics (FIGO) stage IIB carcinoma cervix was made. Histology diagnosed it as a case of small cell neuroendocrine carcinoma. Thus, a diagnosis of chronic inflammatory demyelinating polyneuropathy, arising as a paraneoplastic syndrome in the carcinoma cervix, was made. The patient was treated with chemotherapy, steroids and radical radiotherapy. She recovered partially from her motor deficiencies and completely from her sensory derangement, and was devoid of gynaecological complaints. The cancer growth regressed completely.
{"title":"Chronic inflammatory demyelinating polyneuropathy, diagnosed as a paraneoplastic manifestation of small cell neuroendocrine carcinoma of the cervix","authors":"B. Chakrabarti, S. Roy, C. Mallik, K. Bhattacharya, S. Mukherjee","doi":"10.1080/20742835.2013.11441205","DOIUrl":"https://doi.org/10.1080/20742835.2013.11441205","url":null,"abstract":"Abstract Paraneoplastic syndrome frequently presents before cancer is diagnosed and can be associated with neoplastic disease that is not yet radiographically detectable. We report on the case of a 35-year-old woman who presented at the neurology department with complaints of insidious onset and gradually progressive weakness in all four limbs, which had lasted for the past six months. The weakness originally commenced in both lower limbs and was progressive, ascending in nature from distal to proximal. Both upper limbs were affected seven days later. Magnetic resonance imaging of the dorsal spine revealed long-segment T2 and short T1 inversion recovery (STIR) hyperintensity, suggestive of myelitis. Nerve conduction studies and an electromyogram suggested sensory motor polyneuropathy which affected all four limbs. On gynaecological check-up, a diagnosis of International Federation of Gynaecology and Obstetrics (FIGO) stage IIB carcinoma cervix was made. Histology diagnosed it as a case of small cell neuroendocrine carcinoma. Thus, a diagnosis of chronic inflammatory demyelinating polyneuropathy, arising as a paraneoplastic syndrome in the carcinoma cervix, was made. The patient was treated with chemotherapy, steroids and radical radiotherapy. She recovered partially from her motor deficiencies and completely from her sensory derangement, and was devoid of gynaecological complaints. The cancer growth regressed completely.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"34 1","pages":"29 - 32"},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2013.11441205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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