CARCINOMA CERVICAL STUMP
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on Jul 30, 2012 Says :
nice and impressive presentation cervical stump carcinoma.
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Slide 1 :
DR. NIMESH DAHIMA CARCINOMA OF THE CERVICAL STUMP
Slide 2 :
CARCINOMA OF THE CERVICAL STUMP Subtotal hysterectomy, is rarely performed today. These patients are, of course, at risk for development of the uterine cervix. Carcinoma of cervical stump divide in to TRUE, when the first symptom occur 3 or more years after subtotal hysterectomy, or COINCIDENTAL when the noticed before the third postoperative year. Prognosis for carcinoma of TRUE stump is significantly better than for COINCIDENTAL lesions in which carcinoma was probably present when the hysterectomy was performed.
Slide 3 :
When surgery is performed for stage I tumors, it is somewhat more difficult because of the previous surgical procedures and the presence of adhesions in the pelvis. When irradiation is administered, the lack of uterine cavity into which to insert a tendem containing two or three sources makes intracavitary therapy more difficult. As many sources as technically feasible should be inserted in the remaining cervical canal.
Slide 4 :
Occasionally transvaginal irradiation may be used to boost the dose delivered to central disease in the stump. It is important to deliver the higher whole pelvis irradiation. In general, patients with stage I disease are treated with a combination of 20 Gy to the whole pelvis and 30 Gy to parametria with midline shielding combined with two intracavitary insertions. The dose of intracavitary therapy depends on the number of sources that can be placed in the cervical canal.
Slide 5 :
More advanced stages should be treated with 40 Gy to the whole pelvis and 20 Gy to the parametria with midline sheilding, combined with the same intracavitary doses. when there is no opportunity to insert any sources in the cervical canal, the whole pelvis must be increased to 60 Gy. Total dose EBRT AND LDR IBRT to the upper vaginal mucosa should not exceed 150 Gy and tolerance doses to small volumes of the bladder (80 Gy) or rectum (75 Gy) should be carefully monitored.
Slide 6 :
If there is bulky disease present in the cervix, parametrium or vagina, additional interstitial therpy is advisable, if technically feasible. When intravaginal cones are used, a 30 to 40 Gy air dose is delivered in 2 to 3 weeks, in three to five weekly fractions
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CARCINOMA CERVICAL STUMP IS A KIND OF THE RECURRENCE AFTER SUBTOTAL HYSTERECTOMY.
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