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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ftdoajarticles:oai:doaj.org/article:8bfe616df4614efb9070fdf714924ac0 2023-05-15T18:15:19+02:00 Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery Masato Kita Yuki Yasuhara Genichiro Sumi Takuya Yokoe Yusuke Butsuhara Yoji Hisamatsu Hidetaka Okada 2023-02-01T00:00:00Z https://doi.org/10.1016/j.gore.2023.101135 https://doaj.org/article/8bfe616df4614efb9070fdf714924ac0 EN eng Elsevier http://www.sciencedirect.com/science/article/pii/S2352578923000048 https://doaj.org/toc/2352-5789 2352-5789 doi:10.1016/j.gore.2023.101135 https://doaj.org/article/8bfe616df4614efb9070fdf714924ac0 Gynecologic Oncology Reports, Vol 45, Iss , Pp 101135- (2023) Pneumovaginoscopy Cervical clear cell adenocarcinoma Fertility-sparing surgery vNOTES Gynecology and obstetrics RG1-991 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 article 2023 ftdoajarticles https://doi.org/10.1016/j.gore.2023.101135 2023-02-12T01:25:21Z 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. Article in Journal/Newspaper SCAR Directory of Open Access Journals: DOAJ Articles Gynecologic Oncology Reports 45 101135 |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Pneumovaginoscopy Cervical clear cell adenocarcinoma Fertility-sparing surgery vNOTES Gynecology and obstetrics RG1-991 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
spellingShingle |
Pneumovaginoscopy Cervical clear cell adenocarcinoma Fertility-sparing surgery vNOTES Gynecology and obstetrics RG1-991 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 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 |
topic_facet |
Pneumovaginoscopy Cervical clear cell adenocarcinoma Fertility-sparing surgery vNOTES Gynecology and obstetrics RG1-991 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
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. |
format |
Article in Journal/Newspaper |
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 |
title |
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_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_sort |
fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery |
publisher |
Elsevier |
publishDate |
2023 |
url |
https://doi.org/10.1016/j.gore.2023.101135 https://doaj.org/article/8bfe616df4614efb9070fdf714924ac0 |
genre |
SCAR |
genre_facet |
SCAR |
op_source |
Gynecologic Oncology Reports, Vol 45, Iss , Pp 101135- (2023) |
op_relation |
http://www.sciencedirect.com/science/article/pii/S2352578923000048 https://doaj.org/toc/2352-5789 2352-5789 doi:10.1016/j.gore.2023.101135 https://doaj.org/article/8bfe616df4614efb9070fdf714924ac0 |
op_doi |
https://doi.org/10.1016/j.gore.2023.101135 |
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Gynecologic Oncology Reports |
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45 |
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101135 |
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