levoleucovorin and Vaginal-Neoplasms

Non-Hodgkin's Lymphomas (NHL) frequently affect the uterine corpus, cervix, and vagina in cases of advanced disease. However, these organs are rarely the site of origin of this type of neoplasia. Because of the rarity of primary genital tract lymphomas, a standard treatment has not been defined.. Three patients with large B-cell primary Non-Hodgkin's lymphoma of the lower genital tract (vaginal, cervical and cervico-vaginal) presented with bulky lesions and underwent diagnostic evaluation, staging, and chemotherapy with adriamycin-containing regimens. All three patients, including two with stage IIE and one with stage IE disease demonstrated complete remission and are alive and well without evidence of disease at 10, 7, and 6 years of follow-up, respectively.. Our observations suggest that young patients with large B-cell lymphomas of lower genital tract stages I-IIE, even with bulky lesions, may benefit from chemotherapy alone as initial treatment.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Female; Humans; Leucovorin; Lymphoma, B-Cell; Lymphoma, Non-Hodgkin; Methotrexate; Neoplasm Staging; Prednisone; Uterine Cervical Neoplasms; Uterine Neoplasms; Vaginal Neoplasms; Vincristine

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Choriocarcinoma; Cyclophosphamide; Doxorubicin; Female; Humans; Leucovorin; Lung Neoplasms; Methotrexate; Neoplasm Regression, Spontaneous; Vaginal Neoplasms

Five patients with gestational trophoblastic disease whose presenting symptom was hemorrhage from vaginal metastases have been added to our previous report. The clinical features, management, and responses to treatment are outlined. All the patients required suturing of the bleeding lesions under general anesthetic to arrest the hemorrhage. In addition one patient needed selective arterial embolization. This did not compromise the response to chemotherapy. We confirm our previous view that the presence of vaginal metastases should be classified as a high-risk factor and that these patients be treated with multiple agent chemotherapy from the outset.

Topics: Adult; Age Factors; Antineoplastic Combined Chemotherapy Protocols; Curettage; Cyclophosphamide; Dactinomycin; Embolization, Therapeutic; Female; Hemostasis, Surgical; Humans; Leucovorin; Methotrexate; Middle Aged; Parity; Pregnancy; Trophoblastic Neoplasms; Uterine Hemorrhage; Uterine Neoplasms; Vaginal Neoplasms