Cin 3 versus carcinoma in-situ,car insurance 18 year old male,checks going clear os,online insurance news today - 2016 Feature

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DNA methylation is the addition of a methyl group to the 5-carbon on cytosine nucleotides when followed by guanine (CpG). 3) Reexpression of MSX1 resensitises platinum resistant cell line leading to greater apoptosis and decreased proliferation in the presence of platinum. Does the number of cone fragments (single versus multiple) affect the margin positivity and recurrence rate after LLETZ conisation?
Does mode of anaesthesia (GA vs LA) in LLETZ conisation for CIN pathology affect the completeness of excision and persistence of disease? Methylation status is a highly suitable biomarker due to its relatively stable nature, it’s ability to be amplified and be detected in cell-free plasma. Preliminary analysis identified the gene MSX1 as having differential methylation associated with chemotherapy response.
Overexpression of MSX1 has been shown to inhibit tumour growth by stabilising p53 and inducing apoptosis, and has been shown to upregulate inhibitors of the Wnt pathway. Results: Of the 12 cases four died of their disease, seven are still alive and disease free and one is alive with recurrent disease.
Treatment included surgical excision, occasional biopsy followed by radiotherapy with or without chemotherapy. Conclusions: Bartholin’s Gland Carcinoma is a rare condition with outcome dependent on duration of symptoms, including delay in diagnosis, cell-type, cellular differentiation and the International Federation of Gynecology and Obstetrics (FIGO) classification. A Bartholin’s gland mass in a woman aged 40 years or more should be considered malignant until a biopsy proves otherwise.The incidence of Bartholin’s Gland Carcinoma in Queensland is less than that reported elsewhere but a higher proportion of squamous cell carcinomas was found in this small series. INTRODUCTION Bartholin’s gland in the human was first described by the Danish anatomist Caspar Bartholin in 1675 [1] and the first description of a Bartholin’s Gland Carcinoma (BGC) was in 1864 [2].
The incidence of Bartholin’s Gland Carcinoma has been variously reported as between two to seven % of all vulvar carcinomas [2]. These tumours can be of long standing because they are misdiagnosed as Bartholin’s gland cysts.
When such “cysts” do not respond to conservative treatment biopsy reveals the true nature of the condition.


Bartholin’s Gland Carcinomas have a wide range of histological features because they may arise from mucinous acini or ductal transitional cell epithelium [3]. Squamous cell carcinomas and adenocarcinomas each make up between 40% - 45% of Bartholin’s Gland Carcinomas [4]. MATERIALS AND METHODS Case records, including pathology reports from the state wide QCGC data base for patients referred for registration and management of Bartholin’s Gland Carcinoma (BGC) between July 1989 and July 2012 were reviewed and abstracted relative to demographics, past surgical, medical and family history for cancer plus presenting symptoms, duration of symptoms prior to the commencement of treatment, clinical findings, International Federation of Gynecology and Obstetrics (FIGO) classification, treatment, histological findings, long term follow-up.
In addition information was sought for the changes of human papilloma virus, vulvar in-situ carcinoma, cervical carcinoma in-situ, vulvar dystrophy, past history of cancer and a family history of cancer for each case. This information was analysed using the computer software Statistical Package for the Social Sciences 11.0.
Where data was found to be incomplete attempts were made to collect this information by contacting referring doctors, reviewing patient case notes and pathology department records. RESULTS The incidence of Bartholin’s Gland Carcinoma (BGC) was 1.9% of all vulvar carcinomas recorded in the Queensland Centre for Gynaecological Cancer (QCGC) register between mid 1993 and mid 2012.
There were no cases of bilateral BGC and no cases of metastatic disease from other primary cancers. Of the 12 patients four have died of their disease, seven are still alive and disease free and one is alive with recurrent disease. Nine cases had Squamous Cell Carcinomas with a symptom to diagnosis averaged 2.9 months, one had an Adenoid Cystic Carcinoma with a symptom to diagnosis time 24 months, one had a Small Cell Carcinoma with a symptom to diagnosis time five months and one had a Transitional Cell cancer, symptom to diagnosis 12 months. The most common presenting complaints were a painless lump (in 50% of cases), painful vulvar lump (in 25% of cases) and a groin lump (in 17% of cases). Four cases underwent biopsies of the lesions and eight underwent excision of Bartholin’s gland allowing the diagnoses to be confirmed. Following diagnosis by incomplete excision, the case with the small cell carcinoma FIGO grade 2 decided to go overseas for alternative Table 1. One case underwent chemoradiation therapy (Cisplatin and 5 Flurouracil), one received radiation therapy alone and another elected to seek treatment from an alternative practitioner overseas.
The remaining eight underwent surgical procedures which included wide local excision hemi vulvectomy with or without groin node dissection, or in one case excision of groin nodes followed by radiation therapy (Table 2). The case of adenoid cystic carcinoma recurred at 36 months and the transitional cancer recurred at 36 months.


The remaining case of small cell cancer went overseas for treatment and we are unable to determine if she ever responded to treatment but she died 34 months after diagnosis.
DISCUSSION Squamous cell carcinomas and adenocarcinomas make up 90% of Bartholin’s gland cancers (BGC) with the remaining types including adenoid cystic carcinomas, melanomas, sarcomas and undifferentiated cancers [5]. Since this report other types of BGC have been described including Merkel cell carcinoma [6] and epithelialmyoepithelial carcinomas [7,8]. In the current study seven of the 12 cases have been reported previously [9] which gave us the opportunity to review their histories and up date their progress. Of the 12 cases nine (75%), had SCC and there were single cases of adenoid cystic, transitional and small cell carcinomas. A case of leiomyosarcoma was excluded because it was not a carcinoma and so did not meet the criterion for inclusion in this paper. Two of our cases of SCC type had VIN changes on their histopathology and the case of adenoid cystic carcinoma had CIN 2 and lichen sclerosus.
We did not DNA type the tissue from these three cases and so are unable to speculate as to whether HPV played any part in the genesis of these diseases. We also wondered if the presence of other cancers (lung, breast and endometrial) increased the risk for developing BGC but our numbers are too small to make any such prediction. Our case, aged 43 years had a two-year delay in diagnosis, being told that her problem was due to a Bartholin’s gland cyst. She had recurrences four and six years after her initial surgical wide excision and radiotherapy. Unfortunately she decided to seek alternative care overseas and died 34 months after leaving Queensland. ACKNOWLEDGEMENTS We gratefully acknowledge all those doctors who referred cases to the QCGC and the gynaecological oncologists who have updated QCGC records.



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