Re: Surgical Pathology Report
From: Debbie (anonymous@obgyn.net)
Wed Nov 28 19:07:06 2007
I really hate to do this on a message board but I feel like you really
need some advice. Having a carcinoma anywhere, particularly one that is
defined as invasive, must be excised as soon as possible for the best
outcome to be achieved. "Poorly differentiated" means that the tumor
cells do not look like the associated cells in the organ close by, which
means it is a more aggressive form of cancer. When the words
"extensive" and "invasive" are used together to describe cancer, it
means you MUST get treatment as soon as possible. I don't know you or
your case, but from reading this pathology report it would seem to be
that, yes, you will probably have to have a hysterectomy. I am so sorry
that you have this diagnosis. Please, please go back to your doctor and
ask him or her to explain this in detail, and offer you treatment
options. Then get a second opinion, but do it soon. If you can,
approach the Cancer Treatment Centers of America (
http://www.cancercenter.com/ ) as they offer the absolute best advice
and treatment.
Again, I am so sorry you have had to go through this. I hope you have
someone close to you who can support you and help you. Sending big hugs
your way.
--
Debbie
=+=+=+http://www.angryuterus.com
At Wed, 28 Nov 2007, anonymous@obgyn.net wrote:
>
>At Wed, 28 Nov 2007, anonymous wrote:
>>
>>At Wed, 28 Nov 2007, Sarah wrote:
>>> I am the original poster of this message, but am unclear on what this response means. I just want to understand if my pathology means I must have a hysterectomy. I am 29 and not yet married and am devastated at the thought of not being able to have children.
>>>Abstract
>>>The clinico-pathologic details of 200 patients with micro-invasive
>>>squamous-cell carcinoma of the cervix have been analyzed. All tumors
>>>invaded 5 mm or less below the basement membrane. One hundred and nine
>>>were categorized as FIGO stage 1a1 (early stromal invasion) and 91 as
>>>FIGO stage 1a2 (micro-carcinoma). The horizontal spread (length) of 12
>>>micro-carcinomas exceeded 7 mm. Twenty-three had stromal invasion 3 mm
>>>or more, and 22 had capillary-like space involvement. Fifty-eight
>>>patients underwent pelvic lymphadenectomy in addition to hysterectomy
>>>and none had positive nodes. Univariate and multivariate analyses of
>>>possible prognostic factors including depth, horizontal spread, width,
>>>area, volume, grade, growth pattern, capillary-like space involvement,
>>>and stromal reaction failed to show any to be significantly associated
>>>with recurrence. The median duration of follow-up is now 8 years (0–22
>>>years). Despite complete resection, seven (3.5%) patients developed
>>>recurrence of in situ or invasive carcinoma (three after early stromal
>>>invasion and four after micro-carcinoma), all of which were located at
>>>the vaginal vault. There were two deaths, one due to pulmonary
>>>squamous-cell carcinomatosis 21 years after early stromal invasion, the
>>>connection being tenuous, and the other due to local recurrence. There
>>>have been no recurrences to date in 23 patients treated by conization
>>>alone. The uniformly good prognosis of patients in this study is
>>>attributed to meticulous sampling of operative specimens resulting in
>>>accurate diagnosis and appropriate treatment, which may be conization
>>>alone provided the margins are free, there is no capillary-like space
>>>involvement, and the depth of penetration is less than 3 mm.
>>>
>>>This article is cited by:
>>>
>>>At Wed, 28 Nov 2007, anonymous wrote:
>>>>
>>>>My doctor recently called me to alert me of my pathology report from a
>>>>recent LEEP procedure and I have been referred to a specialist. I have
>>>>a copy of the pathology report and am trying to understand what it
>>>>means. I have done a ton of research and think I understand the
>>>>important questions I need to make sure to ask the specialist, but am
>>>>looking for any additional insight into the findings because they sound
>>>>alarming. Here are my results:
>>>>
>>>>"Endocervix, Leep Excisiion: INVASIVE MODERATE TO POORLY DIFFERENTIATED
>>>>SQUAMOUS CELL CARCINOMA ARISING IN EXTENSIVE SQUAMOUS CELL CARCINOMA IN
>>>>SITU. INVASIVE CARCINOMA AND CARCINOMA IN SITU EXTENSIVELY EXTEND TO
>>>>CAUTERY.
>>>>
>>>>ENDOCERVIX, CURETTAGE: EXTENSIVE SQUAMOUS CELL CARCINOMA IN SITU WITH
>>>>FOCI SUSPICIOUS FOR INVASIVE CARCINOMA.
>>>>
>>>>THE INVASIVE COMPONENT IS PRESENT ON MULTIPLE FRAGMENTS, MULTIFOCALLY
>>>>EXTENDS TO CAUTERIZED MARGINS AND IS PROBABLY MACROINVASIVE (GREATER
>>>>THAN pT1a)."
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