Tumors of Female Reproductive Organs

  • Kathi D. Clement
  • Pamela D. Connor
  • Kristina J. Hartman


This chapter focuses on the common tumors of the female reproductive system: leiomyomas and cervical, endometrial, and ovarian carcinomas. At the outset, physicians should know that emphasizing prevention and early detection (Table 107.1) in the office setting is the best means to decrease mortality. Patients must be taught to recognize early warning signs. Physicians should continue to read the medical literature for developments in screening and treatment techniques.


Ovarian Cancer Cervical Cancer Endometrial Cancer Endometrial Carcinoma Cervical Intraepithelial Neoplasia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Fedele L, Bianchi S, Dorta M, et al. Transvaginal ultrasonography versus hysteroscopy in the diagnosis of uterine submucous myoma. Obstet Gynecol 1991;77:745–8.PubMedGoogle Scholar
  2. 2.
    Weinreb JC, Barkoff ND, Megibow A, et al. The value of MR imaging in distinguishing leiomyomas from other solid pelvic masses when sonography is indeterminate. AJR 1990;154:295–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Derman SG, Rehnstrom J, Neuwirth RS. The long-term effectiveness of hysteroscopic treatment of menorrhagia and leiomyomas. Obstet Gynecol 1991;77:591–4.PubMedGoogle Scholar
  4. 4.
    Candiani GB, Fedele L, Parazzini F, et al. Risk of recurrence after myomectomy. Br J Obstet Gynaecol 1991;98:385–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Friedman AJ, Hoffman DI, Comite F, et al. Treatment of leiomyomata uteri with leuprolide acetate depot: a double blind, placebo-controlled, multicenter study: the leuprolide study group. Obstet Gynecol 1991;77:720–5.PubMedGoogle Scholar
  6. 6.
    Stovall TG, Ling FW, Henry LC, et al. A randomized trial evaluation: leuprolide acetate before hysterectomy as treatment for leiomyomas. Am J Obstet Gynecol 1991;164:1420–3.PubMedCrossRefGoogle Scholar
  7. 7.
    Pace JN, Miller JL, Rose LI. GnRH agonists: gonadorelin, leuprolide, and nafarelin. Am Fam Physician 1991;44:1777–82.PubMedGoogle Scholar
  8. 8.
    Physicians’ Desk Reference. 46th ed. Montvale, NJ: Medical Economics Data, 1992:2310.Google Scholar
  9. 9.
    Friedman AJ, Lobel SM, Rein MS, et al. Efficacy and safety considerations in women with uterine leiomyomas treated with gonadotrophin-releasing hormone agonists: the estrogen threshold hypothesis. Am J Obstet Gynecol 1990;163:1114–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Barbieri RL. Gonadotrophin-releasing hormone agonists and estrogen-progesterone replacement therapy. Am J Obstet Gynecol 1990;162:593–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Moghissi KS. Hormonal therapy before surgical treatment for uterine leiomyomas. Surg Gynecol Obstet 1991;172:497–502.PubMedGoogle Scholar
  12. 12.
    Devesa SS, Young JL, Brinton LA, et al. Recent trends in cervix uteri cancer. CA Cancer J Clin 1989;64:2184–90.Google Scholar
  13. 13.
    Boring CC, Squires TS, Tong T. Cancer statistics: 1993. CA Cancer J Clin 1993;43:18–19.CrossRefGoogle Scholar
  14. 14.
    Moscicki A, Palefsky JM, Gonzales J, et al. The association between human papillomavirus, deoxyribonucleic acid status, and the results of cytologic rescreening tests in young, sexually active women. Am J Obstet Gynecol 1991;165:67–71.PubMedCrossRefGoogle Scholar
  15. 15.
    Carmichael JA, Maskens PD. Cervical dysplasia and human papillomavirus. Am J Obstet Gynecol 1989;160:916–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Brinton LA, Frammeni JF. Epidemiology of uterine cervical cancer. J Chronic Dis 1986;39:1051–68.PubMedCrossRefGoogle Scholar
  17. 17.
    Centers for Disease Control. Black-white differences in cervical cancer mortality: United States, 1980–1987. MMWR 1990;39;245–8.Google Scholar
  18. 18.
    Slattery ML, Robison LM, Schuman KL, et al. Cigarette smoking and exposure to passive smoke are risk factors for cervical cancer. JAMA 1989;261:1593–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Brinton LA, Schairer C, Haenszel W, et al. Cigarette smoking and invasive cervical cancer. JAMA 1986;255:3265–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Brinton LA, Juggin GR, Lehman HF, et al. Long-term use of oral contraceptives and risk of invasive cervical cancer. Int J Cancer 1986;38;339–44.PubMedCrossRefGoogle Scholar
  21. 21.
    Boring CC, Squires TS, Tong T. Cancer statistics: 1992. CA Cancer J Clin 1992;42:19–38.PubMedCrossRefGoogle Scholar
  22. 22.
    Nelson JH, Averette HE, Richart RM. Cervical intraepithelial neoplasia (dysplasia and carcinoma in situ) and early invasive cervical carcinoma. CA Cancer J Clin 1989;39:157–78.PubMedCrossRefGoogle Scholar
  23. 23.
    Baker RM. Improving the adequacy of Pap smears. Am Fam Physician 1989;39:109–14.PubMedGoogle Scholar
  24. 24.
    Hamblin JE, Brock CD, Litchfield L, et al. Papanicolaou smear adequacy: effect of different techniques in specific fertility states. J Fam Pract 1985;20:257–60.PubMedGoogle Scholar
  25. 25.
    Davey-Sullivan BS, Gearhart J, Evers CG, et al. The cytobrush effect on Pap smear adequacy. Fam Pract Res J 1991;1:57–64.Google Scholar
  26. 26.
    Benedet JL, Selke PA, Nickerson KG. Colposcopic evaluation of abnormal Papanicolaou smears in pregnancy. Am J Obstet Gynecol 1987;157:932–7.PubMedGoogle Scholar
  27. 27.
    Stafl A, Mattingly RF. Angiogenesis of cervical neoplasia. Am J Obstet Gynecol 1975;121:845–51.PubMedGoogle Scholar
  28. 28.
    Stringer CA. When the Pap is positive: confirming the diagnosis, verifying extent of disease. Prim Care Cancer 1989;9:15–8.Google Scholar
  29. 29.
    Abayomi O, Dritschilo A, Emami B, et al. The value of “routine tests” in the staging evaluation of gynecologic malignancies: a cost effectiveness analysis. Int J Radiat Oncol Biol Phys 1982;8:241–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Kim SH, Choi BI, Lee HP, et al. Uterine cervical carcinoma: comparison of CT and MR findings. Radiology 1990;175:45–51.PubMedGoogle Scholar
  31. 31.
    Perez CA, Zivnuska F, Askin F, Kumar B, Camel HM, Powers WE. Prognostic significance of endometrial extension from primary carcinoma of the uterine cervix. CA Cancer J Clin 1975;35:1493–1504.Google Scholar
  32. 32.
    Lifshitz S, Buchsbaum HJ. The spread of cervical carcinoma. In: Sciarra J, editor. Gynecology and obstetrics. Philadelphia: Lippin-cott, 1991;4:1–9.Google Scholar
  33. 33.
    Petterson F, editor. Annual report on the results of treatment in gynecologic cancer. Stockholm: International Federation of Gynecology and Obstetrics, 1989;20:75–109.Google Scholar
  34. 34.
    Van Nagell JR, Parker JC, Maruyama Y, Utley J, Luckett P. Bladder or rectal injury following radiation therapy for cervical cancer. Am J Obstet Gynecol 1974;119:727–32.PubMedGoogle Scholar
  35. 35.
    Devesa SS, Silverman DT, Young JL, et al. Cancer incidence and mortality trends among whites in the United States: 1947–1984. J Natl Cancer Inst 1987;79:701–70.PubMedGoogle Scholar
  36. 36.
    Fu YS, Gambone JC, Berek JS. Pathophysiology and management of endometrial hyperplasia and carcinoma. West J Med 1990; 153: 50–61.PubMedGoogle Scholar
  37. 37.
    Whitehead M, Fraser D. Controversies concerning the safety of estrogen replacement therapy. Am J Obstet Gynecol 1987; 156: 1313–22.PubMedGoogle Scholar
  38. 38.
    Gal D. Endometrial hyperplasia: diagnosis and management. In: Sciarra J, editor. Gynecology and obstetrics. Vol. 4. Philadelphia: Lippincott, 1992:1–11.Google Scholar
  39. 39.
    Gusberg SB, Chen SY, Cohen CJ. Endometrial cancer: factors influencing the choice of treatment. Gynecol Oncol 1974;2:308–13.PubMedCrossRefGoogle Scholar
  40. 40.
    Ferenczy A. Methods for detecting endometrial carcinoma and its precursors. In: Buchsbaum HJ, Sciarra JJ, editors. Gynecology and obstetrics. Vol. 4. New York: Harper & Row, 1982:1–8.Google Scholar
  41. 41.
    Gilman CJ. Management of early-stage endometrial carcinoma. Am Fam Physician 1987;35:103–12.PubMedGoogle Scholar
  42. 42.
    Gallup DG, Stock RJ. Adenocarcinoma of the endometrium in women 40 years of age or younger. Obstet Gynecol 1984;64:417–20.PubMedGoogle Scholar
  43. 43.
    Damon A. Host factors in cancer of the breast and uterine cervix. J Natl Cancer Inst 1960;24:483–516.PubMedGoogle Scholar
  44. 44.
    Wynder EL, Escher GC, Mantel N. An epidemiologic investigation of cancer of the endometrium. Cancer 1966;19:489–520.PubMedCrossRefGoogle Scholar
  45. 45.
    Dunn LJ, Bradbury JT. Endocrine factors in endometrial carcinoma: a preliminary report. Am J Obstet Gynecol 1967;97:465–71.PubMedGoogle Scholar
  46. 46.
    Hershcopf RJ, Bradlow HL. Obesity, diet, endogenous estrogens, and the risk of hormone-sensitive cancer. Am J Clin Nutr 1987;45:283–9.PubMedGoogle Scholar
  47. 47.
    Schapira DV, Jumar NB, Lyman GH, Cavanagh D, Roberts WS, LaPolla J. Upper-body fat distribution and endometrial cancer risk. JAMA 1991;226:1808–11.CrossRefGoogle Scholar
  48. 48.
    Lucas WE. The epidemiology of endometrial cancer. In Sciarra J, editor. Gynecology and obstetrics. Philadelphia: Lippincott; 1990: 7–10.Google Scholar
  49. 49.
    Staszewski J. Breast cancer and body build. Prev Med 1977;6: 410–5.PubMedCrossRefGoogle Scholar
  50. 50.
    Parazzini F, La Vecchia C, Negri E, Fedele L, Balotta F. Reproductive factors and risk of endometrial cancer. Am J Obstet Gynecol 1991;164:522–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Elwood JM, Cole P, Rothman KJ, Kaplan SD. Epidemiology of endometrial cancer. J Natl Cancer Inst 1977;59:1055–60.PubMedGoogle Scholar
  52. 52.
    Koonings PP, Grimes DA. Endometrial sampling techniques for the office. Am Fam Physician 1989;40:207–10.PubMedGoogle Scholar
  53. 53.
    Lacey CG. Premalignant and malignant disorders of the uterine corpus. In: Pernoll MI, editor. Current obstetrics and gynecologic diagnosis and treatment. Norwalk, CT: Appleton & Lange, 1991: 955–73.Google Scholar
  54. 54.
    Sonnendecker EWW, Simon GB, Sevitz H, Hofmeyer GJ. Diagnostic accuracy of the Accurette endometrial sampler. S Afr Med J 1982;61:109–13.PubMedGoogle Scholar
  55. 55.
    Boone MI, Calvert JC, Gates HS. Uterine cancer screening by the family physician. Am Fam Physician 1984;30:157–66.PubMedGoogle Scholar
  56. 56.
    Nasri MN, Shepherd JH, Setchell ME, Lowe DG, Chard T. The role of vaginal scan in measurement of endometrial thickness in postmenopausal women. Br J Obstet Gynaecol 1991;98:470–5.PubMedCrossRefGoogle Scholar
  57. 57.
    Ascher SM, Frost AR, Garra BS, Potkul R, Zeman RK. Endometrial ultrasound of the uterus: correlation with histopathology. J Ultrasound Med 1992;11 Suppl 3:1159.Google Scholar
  58. 58.
    Volksen M, Dietrich M, Osmers R, Kuhn W. Early diagnosis of carcinomas of the endometrium via transvaginal sonography. J Ultrasound Med 1992;11 Suppl 3:1155–8.Google Scholar
  59. 59.
    Boronow RC. Advances in diagnosis, staging, and management of cervical and endometrial cancer, stages I and II. Cancer 1990;65: 648–59.PubMedCrossRefGoogle Scholar
  60. 60.
    Oram DH, Jacobs IJ, Brady JL, Prys-Davies A. Early diagnosis of ovarian cancer. Br J Hosp Med 1990;44:320–4.PubMedGoogle Scholar
  61. 61.
    Piver MS, Baker TR, Piedmonte M, Sandecki AM. Epidemiology and etiology of ovarian cancer. Semin Oncol 1991;18:177–85.PubMedGoogle Scholar
  62. 62.
    Pike MC. Age-related factors in cancers of the breast, ovary, and endometrium. J Chronic Dis 1987;40 Suppl 2:59S-69S.Google Scholar
  63. 63.
    Bourne T, Reynolds K, Campbell S. Ovarian cancer screening. Eur J Cancer 1991;27:655–9.PubMedCrossRefGoogle Scholar
  64. 64.
    Young RC, Walton LA, Ellenberg SS, et al. Adjuvant therapy in stage I and stage II epithelial ovarian cancer: results of two prospective randomised trials. N Engl J Med 1990;322:1021–7.PubMedCrossRefGoogle Scholar
  65. 65.
    Friedlander ML, Dembo AJ. Prognostic factors in ovarian cancer. Semin Oncol 1991;18:205–12.PubMedGoogle Scholar
  66. 66.
    Campbell S, Goessens L, Goswamy R, Whitehead MI. Real-time ultrasonography for determination of ovarian morphology and volume: a possible new screening test for ovarian cancer? Lancet 1982;1:425–6.PubMedCrossRefGoogle Scholar
  67. 67.
    Averette HE, Donato DM. Ovarian carcinoma. CA Cancer J Clin 1990;65 Suppl 3:703–8.Google Scholar
  68. 68.
    Omura GA, Brady MF, Homesley HD, et al. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the gynecologic oncology group experience. J Clin Oncol 1991;9: 1138–50.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Kathi D. Clement
  • Pamela D. Connor
  • Kristina J. Hartman

There are no affiliations available

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