PSEUDOSARCOMATOUS CHANGES IN THE CERVIX FOLLOWING IRRADIATION FOR CERVICAL CARCINOMA
S>A case is presented in which pseudosarcomatous changes of the cervix occurred after internal and external radiotherapy was completed for a stage I epidermoid carcinoma of the cervix. Changes were noted approximates 9 months after completion of therapy. The patient was treated with a Ra applicator which deiivered 7000 r to point A and 1750 r to point B, as well as external radiotherapy. By utilizing large anterior and posterior pelvic ports, an additional dose to point A was 9300 r and approximately 5050 r to point B. The patient responded well to external therapy, having only mild nausea, diarrhea and moderate dermatitis. A follow-up study with biopsies showed pseudosarcomatous change. Histopathologic study of sections of the cervix showed marked fibrosis and sclerosis of the connective tissue stroma. The exocervix was epithelialized and there was no evidence of neoplastic changes. However, the connective tissue stroma of the cervix showed microscopic masses formed from elongated, spindle- shape, relatively large cells. The nuclei of the connective tissue cells showed considerable degree of hyperchromatism. No mitotic divisions were encountered. Between the proliferated and elongated cells there was a considerable degree of collagen tissue. The lesion was interpreted as being pseudosarcoma of the cervix following internal and external radiation. No evidence of residual carcinoma was observed. Pseudosarcoma of the cervix, as the end-result of extenal, internal or combined radiotherapy for preexisting cervical neoplasms may be clinically misinterpreted, as in the case presented, as a residual neoplasia. The postirradiation alterations in connective tissue lead it to assume microscopic features of neoplasia. Postirradiation pseudosarcoma of the cervix should be considered in evaluating tumor response to radiotherapy for cervical carcinoma. A review of the literature shows two earlier analogous reports. The term pseudosarcoma was applied here to indicate a presumably non-neoplastic connective tissue mass with a histological appearance which is deceivingly suggestive of a fully malignant form of true sarcoma capable of metastasis. (BBB)
- Research Organization:
- Columbia-Presbyterian Medical Center, New York
- NSA Number:
- NSA-18-011679
- OSTI ID:
- 4094561
- Journal Information:
- Bull. Sloane Hosp. Women, Vol. Vol: 9; Other Information: Orig. Receipt Date: 31-DEC-64
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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