Vagina cancer

A diethylstilbestrol-exposed woman developed concurrent primary cancers of both the vagina and the endometrium at the age of 39 (40). 

The three principal classes of cytotoxic agents used in the treatment of cancer all contain carcinogens, for example, Melphalen, a nitrogen mustard, adriamycin, an antitumor antibiotic, and methotrexate, an antimetabolite. Diethylstilbestrol (DES), a drug formerly widely used, has been associated with cancer of the cervix and vagina in the offspring of treated women. 

Boyd J, Takahashi H, Waggoner SE, Jones LA, Hajek RA, Wharton JT et al. Molecular genetic analysis of clear cell adenocarcinomas of the vagina and cervix associated and unassociated with diethylstilbestrol exposure in utero. Cancer 1996 77 507-13. 

Employing a revised and more sensitive ELISA, Zucker et al. (Z3) reported that plasma MMP-9 levels were increased in the plasma of more than half of patients with prostate cancer (pre- and post-treatment) and bladder cancer, but not gynecologic cancers (ovary, cervix, uterus, vagina) (Fig. 3). In prostate cancer, no correlation was noted between plasma MMP-9 and PSA measurements, which suggests that MMP-9 levels do not correlate with tumor mass. 

For evaluation of the pelvic sidewall and lymph node staging, an additional proton-density or a Tl-weighted sequence in transverse orientation should be performed (see Fig. 7.11). The acquisition starts at the level of the aortic bifurcation and extends to below the pelvic floor. A slice thickness of 6 mm is used, with a 512 matrix and a phase resolution of at least 60%. Complete coverage of the inguinal lymph nodes should be attempted in patients with cervical cancers involving the lower third of the vagina (stage IIIA... 

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