Synopsis: Objective: This study compares radical hysterectomy and radiotherapy for locally resectable stage IIIC1r cervical cancer. Methods: A total of 51 patients with locally resectable stage IIIC1r cervical cancer, treated between 2003 and 2023, were included and categorized into the surgery (O) and radiotherapy (RT) groups. Results: The five-year overall survival and disease-free survival rates were comparable between the two groups (81.6%vs. 76.0%and 69.1%vs. 70.6%, respectively; p>0.05). Younger patients, those with non-squamous cell carcinoma, and those with fewer lymph node metastases on imaging were more likely to undergo surgery. However, dysuria was more frequently observed in the O group. Subgroup analyses by age, histological type, tumor diameter, and the number and size of metastatic lymph nodes on imaging indicated no significant prognostic differences between the two groups. Conclusion: The prognosis of patients with locally resectable stage IIIC1r cervical cancer in the O and RT groups was comparable. However, surgical treatment was associated with a higher complication rate. No definitive evidence was found to guide treatment selection based on patient characteristics. Further research is required to establish optimal treatment strategies for this condition.Key words: uterine cervix, cervical cancer, radical hysterectomy, radiotherapy, prognosis

Synopsis: A 23-year-old nulliparous woman was referred to our hospital with a complaint of right lower abdominal pain that had persisted for 3 weeks. Ultrasonography and MRI revealed a mass lesion exceeding 15 cm in diameter, occupying the lower abdomen, with cystic components. Contrast-enhanced CT of the entire body showed no evidence of distant metastasis. Suspecting a malignant ovarian tumor, we performed exploratory laparotomy, which revealed a retroperitoneal tumor originating from the right side of the posterior uterus, with no continuity to the uterus or ovaries. Due to the tumor's location, simultaneous removal of the retroperitoneal tumor and the right adnexa was necessary. The abdomen was closed with preservation of the uterus and left adnexa. Histopathological examination confirmed the tumor as a retroperitoneal leiomyosarcoma. After thorough discussion with the patient and her family, the decision was made to proceed with additional treatment. The patient is currently under observation following six courses of single-agent doxorubicin therapy as adjuvant chemotherapy.Key words: retroperitoneal, leiomyosarcoma

Synopsis: Vulvar intraepithelial neoplasia (VIN) is a noninvasive squamous lesion and a precursor to vulvar squamous cell carcinoma. Surgery is the primary treatment for VIN; however, depending on the lesion's size and location, surgical intervention can be highly invasive. In other countries, randomized controlled trials of topical imiquimod for VIN have been reported, and treatment efficacy comparable to surgical excision is anticipated.Key words: Vulva, Imiquimod, Intraepithelial neoplasia, non-surgical treatment

We report the case of a 59-year-old woman who developed VIN2 at the postoperative margin around the vaginal introitus eight years after undergoing vulvar cancer surgery. The lesion gradually enlarged and progressed to VIN3 by the eleventh postoperative year, necessitating intervention. Given the high invasiveness of surgical excision, off-label use of topical imiquimod was initiated after obtaining approval from the institutional ethics committee. The patient applied imiquimod two to three times per week for 16 weeks.

The treatment resulted in a partial response, with regression to VIN1. Side effects were limited to mild pain and dysuria during the initial treatment period, which subsequently resolved. At five months post-treatment, cytology revealed LSIL with no histological evidence of recurrent disease.

Topical imiquimod presents a minimally invasive and effective treatment option for VIN, particularly in cases where surgical intervention may compromise quality of life.