Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery
Vaginoscopy has been mainly used diagnostically due to the lack of adequate equipment for performing complicated surgeries (Johary et al., 2015). However, herein, we report therapeutic vaginal endoscopic surgery (pneumovaginoscopy) for secondary malignant vaginal tumors using the vNOTES technique an...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578923000048 |
| _version_ | 1811166411205115904 |
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| author | Masato Kita Yuki Yasuhara Genichiro Sumi Takuya Yokoe Yusuke Butsuhara Yoji Hisamatsu Hidetaka Okada |
| author_facet | Masato Kita Yuki Yasuhara Genichiro Sumi Takuya Yokoe Yusuke Butsuhara Yoji Hisamatsu Hidetaka Okada |
| author_sort | Masato Kita |
| collection | DOAJ |
| description | Vaginoscopy has been mainly used diagnostically due to the lack of adequate equipment for performing complicated surgeries (Johary et al., 2015). However, herein, we report therapeutic vaginal endoscopic surgery (pneumovaginoscopy) for secondary malignant vaginal tumors using the vNOTES technique and devices (Kita et al., 2021; Yokoe et al., 2022).To our knowledge, this report and surgical video demonstrate the first case of successful fertility-sparing R0 tumor resection of a rare primary cervical clear cell adenocarcinoma using pneumovaginoscopy.A 12-year-old girl was referred to our outpatient clinic with a chief complaint of a genital tumor and possible clear cell carcinoma on biopsy. There was no history of diethylstilbestrol exposure. MRI and CT images suggested a polypoid cervical tumor without metastatic lesions. Therefore, we performed therapeutic pneumovaginoscopic surgery with diagnostic laparoscopy and hysteroscopy.The cervical tumor was resected completely, and hysteroscopy and laparoscopy revealed no abnormalities. The total surgical time was 123 min, and the blood loss volume was minimal. R0 resection was achieved microscopically.Postoperatively, we performed a partial cervical resection around the first surgical scar to confirm no residual tumor.There were no postoperative complications, and a 2-year follow-up revealed no recurrence.The standard treatment for early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. However, fertility-sparing minimally invasive surgery has recently been introduced for clear cell adenocarcinoma of the cervix (Su et al., 2020). Our report supports the possibility of this minimally invasive surgery under exceptional conditions. This study was approved by the ethics committee of Kansai Medical University. Written and signed informed consent was obtained from the patient’s legal guardian. |
| first_indexed | 2024-04-10T15:51:52Z |
| format | Article |
| id | doaj.art-8bfe616df4614efb9070fdf714924ac0 |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-04-10T15:51:52Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-8bfe616df4614efb9070fdf714924ac02023-02-11T04:15:49ZengElsevierGynecologic Oncology Reports2352-57892023-02-0145101135Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgeryMasato Kita0Yuki Yasuhara1Genichiro Sumi2Takuya Yokoe3Yusuke Butsuhara4Yoji Hisamatsu5Hidetaka Okada6Corresponding author at: Department of Obstetrics and Gynecology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata City, Osaka 573-1010, Japan.; Department of Obstetrics and Gynecology, Kansai Medical University, Osaka, JapanDepartment of Obstetrics and Gynecology, Kansai Medical University, Osaka, JapanDepartment of Obstetrics and Gynecology, Kansai Medical University, Osaka, JapanDepartment of Obstetrics and Gynecology, Kansai Medical University, Osaka, JapanDepartment of Obstetrics and Gynecology, Kansai Medical University, Osaka, JapanDepartment of Obstetrics and Gynecology, Kansai Medical University, Osaka, JapanDepartment of Obstetrics and Gynecology, Kansai Medical University, Osaka, JapanVaginoscopy has been mainly used diagnostically due to the lack of adequate equipment for performing complicated surgeries (Johary et al., 2015). However, herein, we report therapeutic vaginal endoscopic surgery (pneumovaginoscopy) for secondary malignant vaginal tumors using the vNOTES technique and devices (Kita et al., 2021; Yokoe et al., 2022).To our knowledge, this report and surgical video demonstrate the first case of successful fertility-sparing R0 tumor resection of a rare primary cervical clear cell adenocarcinoma using pneumovaginoscopy.A 12-year-old girl was referred to our outpatient clinic with a chief complaint of a genital tumor and possible clear cell carcinoma on biopsy. There was no history of diethylstilbestrol exposure. MRI and CT images suggested a polypoid cervical tumor without metastatic lesions. Therefore, we performed therapeutic pneumovaginoscopic surgery with diagnostic laparoscopy and hysteroscopy.The cervical tumor was resected completely, and hysteroscopy and laparoscopy revealed no abnormalities. The total surgical time was 123 min, and the blood loss volume was minimal. R0 resection was achieved microscopically.Postoperatively, we performed a partial cervical resection around the first surgical scar to confirm no residual tumor.There were no postoperative complications, and a 2-year follow-up revealed no recurrence.The standard treatment for early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. However, fertility-sparing minimally invasive surgery has recently been introduced for clear cell adenocarcinoma of the cervix (Su et al., 2020). Our report supports the possibility of this minimally invasive surgery under exceptional conditions. This study was approved by the ethics committee of Kansai Medical University. Written and signed informed consent was obtained from the patient’s legal guardian.http://www.sciencedirect.com/science/article/pii/S2352578923000048PneumovaginoscopyCervical clear cell adenocarcinomaFertility-sparing surgeryvNOTES |
| spellingShingle | Masato Kita Yuki Yasuhara Genichiro Sumi Takuya Yokoe Yusuke Butsuhara Yoji Hisamatsu Hidetaka Okada Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery Gynecologic Oncology Reports Pneumovaginoscopy Cervical clear cell adenocarcinoma Fertility-sparing surgery vNOTES |
| title | Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery |
| title_full | Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery |
| title_fullStr | Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery |
| title_full_unstemmed | Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery |
| title_short | Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery |
| title_sort | fertility sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery |
| topic | Pneumovaginoscopy Cervical clear cell adenocarcinoma Fertility-sparing surgery vNOTES |
| url | http://www.sciencedirect.com/science/article/pii/S2352578923000048 |
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