Carcinoma of the vulva in Jamaican women.

Clinical and pathological analysis of vulvar carcinoma in 119 Jamaican women, treated at the University Hospital of the West Indies, over the past 18 years stresses that the tumor was more frequently seen in women under the age of 50 - contrary to the experience of authors from the Western metropolitan countries. The natural history of the tumor showed that in 51% of cases, vulvar carcinoma co-existed or followed previous chronic vulvar granulomatous diseases and showed a rapid tumor progression in these post-granulomatous cases. Features of other epidemiological and clinical important are discussed. Special reference has been made concerning the problem of applying FIGO staging of vulvar carcinoma.

Vulvar carcinoma in premenopausal Jamaican women.

Between the years 1958 and 1973, 119 patients with primary invasive cancer of the vulva were treated at the University Hospital of the West Indies, Kingston, Jamaica. Seventy-seven (64.7%) were premenopausal women. Because the pattern of the disease differed from that in late middle and older aged Jamaican women, the results of the disease are presented. The analysis stresses that vulvar carcinoma before menopause in our community is rare in the absence of various sexually transmitted granulomatous diseases of the vulva.

Myomectomy in infertile Jamaican women.

One hundred nineteen Jamaican women who underwent myomectomy from 1964 to 1969 were followed up for 5 to 9 years. Infertility was the most common presenting complaint. Preoperative hysterosalpingograms were performed on 61 patients and were abnormal for the majority of these patients. Surgery revealed submucous fibroids in 41 patients and pelvic inflammatory disease in 51 patients. The pregnancy rate following myomectomy was 18.5%, but successful outcomes occurred in only 9.2% of the cases. Pregnancy was unsuccessful for all patients who underwent both myomectomy and tuboplasty. Twenty-three patients had a recurrence of myoma, and 13 of these underwent subsequent hysterectomy.

Choriocarcinoma in Jamaica.

Fifty-two cases of choriocarcinoma were recorded in the Jamaica Cancer Registry for the parishes of Kingston and St. Andrew, giving an incidence of 1:7,384 live births. This is intermediate between figures reported for Western metropolitan populations and for Far Eastern countries. Clinicopathological studies on 26 cases treated at the University Hospital in Jamaica revealed that 65% followed either normal pregnancy or abortion. Choriocarcinoma following a normal pregnancy or occurring without a previous history of pregnancy carried a poorer prognosis than those with a preceding hydatidiform mole. Many patients had primary neurological manifestations. The overall prognosis was poor due to late presentation with disseminated metastases. Of the 26 patients, 15 died of the disease within two years and only six appeared for a six-year follow-up.

Defective luteal phase--measurement and evaluation of the ovarian hormone before and during cyclofenil (bis-P-acetoxphenyl) cyclo-hexylidenemethane (Compound 6066) treatment.

PIP: The nature of defective luteal phase (DLP) was investigated by the measurement and evaluation of the ovarian hormone before and during Cyclofenil (bis-p-acetoxphenyl) cyclo-hexylidenemethane treatment. Total urinary estrogens and plasma progesterone were measured in 50 infertile patients with DLP. Prior to treatment these patients revealed wide variations in their urinary estrogen pattern while plasma progesterone was uniformly low. Treatment results were dependent on the dose of Cyclofenil and on the baseline estrogen configuration of the patient. The pregnancy rate was 28%. The results indicated that follicular dysmaturity precedes luteal insufficiency in the majority of cases. Therefore, treatment should be aimed at correcting the hormonal imbalance both at hypothalamico pituitary axis level and at the ovarian level rather than simple substitution therapy. Both of these qualities are present in Cyclofenil.^ieng