Malignant disease of vulvaPrepared by- Mrs Raheegeh Awni.pptVIP

Stage IV: Growth involving one or both ovaries with distant metastasis. If pleural effusion is present, Parenchymal liver metastasis equals stage IV. Pure immature teratomas do not produce hCG or AFP. Neural elements are most frequently seen, but cartilage and epithelial tissues are also common. * Treatment The primary tumor should be removed. In young patients, the uterus and contralateral ovary should be preserved to maintain fertility. postoperative chemotherapy using bleomycin, etoposide, and cisplatin. Prognosis Survival correlates with grade and stage of disease. The 5-year survival rate for patients with grade 1 immature teratomas is about 95%, * FALLOPIAN TUBE MALIGNANCIES Fallopian tube malignancies account for less than 0.3 per cent of gynaecological malignancies. The mean age of patients is 57 years. The most common presenting symptoms are abnormal vaginal bleeding and abdominal pain. ’Hydrops tubae profluens’ is a symptom complex occurring in about 10 per cent. It is characterised by intermittent colicky pain, relieved by a sudden vaginal discharge of watery fluid. CA125 levels are often elevated. * * The carcinomas affecting the tube are similar to those of the ovary. Serous carcinoma is the most common (70 per cent), followed by endometrioid and transitional These tumours are surgically staged These tumours spread to the peritoneum, adjacent organs and para-aortic and pelvic lymph nodes. Distant metastases are present Treatment is as for ovarian cancers. * ENDOMETRIAL CARCINOMAS Primary malignancies of the endometrium are the most common gynaecological malignancies, and account for 13 per cent of cancers Almost one third of cases occur in premenopausal women, but most patients are over 40 years old. * Clinical presentation and symptoms abnormal or postmenopausal vaginal bleeding The risk of malignancy associated with bleeding increases with age (asymptomatic women may present with abnormal endometri