Effects of transdermal and oral hormone replacement therapies on monocyte chemoattractant protein-1 levels: a randomized clinical trial.

OBJECTIVES: To assess the effects of oral and transdermal hormone replacement therapies (HRT) on levels of important cardiovascular disease (CVD) markers, MCP-1 and homocyteine, in the early postmenopausal period. STUDY DESIGN: Seventy-six healthy, early postmenopausal women were enrolled in the study. Patients were randomly assigned to receive oral or transdermal HRT for 6 months. The first group received continuous combined oral HRT containing 1mg 17ß-estradiol and 0.5mg norethisterone acetate (n=39), and the second group received sequential transdermal HRT releasing 50µg/day estradiol alone given twice a week on days 1-14 and 50µg/day estradiol plus 0.25mg/day norethisterone acetate given twice a week on days 15-28 (n=37). Circulating levels of MCP-1 and homocysteine, along with other CVD markers, were assessed before and after treatment in all patients. RESULTS: There were no significant differences between the baseline characteristics of the two groups. Baseline serum MCP-1 levels were similar between the oral and transdermal HRT groups (150.1±12.8 vs. 145.2±11.6pg/ml; P=.219). The mean MCP-1 levels did not change after 6 months of HRT in both oral (150.1±12.8 vs. 153.6±12.5pg/ml; P=.192) and transdermal HRT groups (145.2±11.6 vs. 146.1±15.1pg/ml; P=.419). Moreover, there was no significant difference between the groups in MCP-1 serum levels after 6 months of HRT. Similarly, no difference was found in serum homocyteine levels following 6 months of HRT. CONCLUSIONS: Both oral continuous and sequential transdermal HRTs do not have significant effects on serum MCP-1 and homocyteine levels in women during the early postmenopausal period.

Late recurrence of sigmoid carcinoma mimicking primary vulvar cancer: case report and review of the literature.

OBJECTIVE: To demonstrate a unique case report about late and isolated vulvar metastasis of sigmoid adeno-carcinoma with review of the literature. MATERIAL-METHOD: 57 year old postmenopausal patient with prior sigmoid colon cancer history was admitted with isolated vulvar mass. Immunohistochemistry (IHC) and KRAS gen mutation analysis following surgery were performed to discriminate the metastasis from a vulvar primary malignancy. Further imaging techniques were also performed to exclude additional tumours. RESULTS: Immunohistochemistry (IHC) and KRAS gene mutation analysis revealed isolated metastasis of the colonic adeno-carcinoma in the vulva. CONCLUSION: Isolated and late occurring vulvar metastasis of colonic origin is very unusual. Careful evaluation and IHC is useful for such cases.