Publications (76) View all
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Article: Vulvar paget disease: a large single-centre experience on clinical presentation, surgical treatment, and long-term outcomes.
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ABSTRACT: Our aim was to add information to the current literature on vulvar Paget disease by reviewing a consistent number of patients who have been all diagnosed, treated, and followed up by the same group of physicians at a single medical institution. Clinical, surgical, histological, and follow-up data of 34 patients (mean [SD] age at diagnosis = 68.7 [10.1] years) with vulvar Paget disease were reviewed during a 27-year period. Primary symptoms were itching (76.5%) and burning (58.8%). Clinical manifestations were present for a mean (SD) of 17.8 (7.2) months before the diagnosis was made. Multifocal lesions were observed in 17 patients (50%) and were associated with a delay in diagnosis exceeding 12 months (p = .03). Of the patients, 10 (29.4%) presented a history of malignancy in other sites. Surgery with various extent of resection was performed as primary treatment in all patients. Definitive histological examination revealed positive surgical margins in 15 cases (44.1%), stromal invasion in 4 (11.7%), and associated adenocarcinoma in 2 (5.9%). Of the patients, 6 (17.6%) underwent reconstructive technique at their primary surgery or radicalization. During a mean (SD) follow-up of 76.9 (51.3) months, 15 patients (44.1%) experienced local recurrence (1 recurrence in 29.4%, 2 recurrences in 5.9%, and 3 recurrences in 8.8%). First recurrence appeared after a mean (SD) time of 45.7 (25.1) months and was associated with multifocal lesions (p = 0.005) and surgical margins involvement (p = 0.03). One patient (2.6%) died of the disease. Vulvar Paget disease is a chronic disease with high recurrence rate and low mortality. Early diagnosis, minimal surgery with free margins, and long-term follow-up are the cornerstones of treatment.Journal of Lower Genital Tract Disease 04/2013; 17(2):104-10. · 1.07 Impact Factor -
Article: CO(2) Laser Total Superficial Vulvectomy: An Outpatient Treatment for Wide Multifocal Vulvar Intraepithelial Neoplasia Grade 3.
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ABSTRACT: The ideal treatment of large multifocal vulvar intraepithelial neoplasia grade 3 (VIN 3) in young patients is still debated. The goal is to prevent development of invasive vulvar cancer while preserving normal vulvar anatomy and function. The authors describe the case of a 37-year-old woman affected by a biopsy-proven VIN 3 involving the entire external genitalia. A total superficial vulvectomy was carried out in 2 closer sessions by CO(2) laser used in an excisional way. Both procedures were performed in an outpatient setting with the patient under local anesthesia and without suturing stitches or skin flaps. Definitive pathologic analysis confirmed VIN 3 with free margins. No intraoperative and postoperative complications were documented. Functional and anatomic outcomes were optimal, and no relapse occurred after 12 months of follow-up. Use of CO(2) laser total superficial vulvectomy shows promise of a safe and adequate treatment in selected young patients with VIN 3 involving the entire external genitalia.Journal of Minimally Invasive Gynecology 11/2012; 19(6):758-61. · 1.74 Impact Factor -
Article: Reply of the authors.
Fertility and sterility 11/2012; 98(5):e28. · 3.97 Impact Factor -
Article: Spontaneous unilateral twin tubal pregnancy: the result of bilateral ovulation?
Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC 10/2012; 34(10):895. -
Article: A case of metachronous double primary neuroendocrine cancer in pancreas/ileum and uterine cervix.
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ABSTRACT: Abstract We describe an unusual case of a 50-year-old female patient developing two primary cancers with neuroendocrine features. Initially the patient underwent surgery for an entero-pancreatic neuroendocrine carcinoma. During the subsequent follow-up she experienced some episodes of vaginal bleeding with negative PET scanning with the tracer fluorine-18 (F-18) fluorodeoxyglucose (FDG). A Papanicolaou (pap) smear and an endometrial biopsy revealed a primary neuroendocrine cancer of the uterine cervix. The present case underlines the importance of clinical follow-up after a diagnosis of intestinal neuroendocrine tumor, investigating any new symptom. Female patients, after the diagnosis of entero-pancreatic neuroendocrine carcinoma, must be recommended to continue screening pap test examinations for the likelihood of classical squamous and glandular cervical cancers and also for neuroendocrine cervical cancer.Upsala journal of medical sciences 09/2012; · 0.73 Impact Factor
