scholarly journals Endophytic-Type Endometrial Cancer with Adenomyosis Successfully Diagnosed with Hysteroscopic Endometrial Biopsy Using an 8.3-mm Operative Resectoscope: A Case Report

2018 ◽  
Vol 11 (2) ◽  
pp. 311-317
Author(s):  
Michiko Honda ◽  
Akira Tsuchiya ◽  
Wataru Isono ◽  
Mikiko Takahashi ◽  
Akihisa Fujimoto ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Final Diagnosis ◽  
Figo Stage ◽  
Abdominal Hysterectomy ◽  
Japanese Woman ◽  
Endometrial Biopsy ◽  
Pathological Diagnosis ◽  
Gynecology And Obstetrics

In order to diagnose endometrial cancer preoperatively, outpatient endometrial biopsy with a curette is frequently performed owing to its convenience. However, in some cases, gynecologists fail to diagnose endometrial cancer via outpatient endometrial biopsy because of the cancer’s distribution in the uterus and its consistency. A 57-year-old Japanese woman (gravida 4 para 4) presented with a 6-month history of light but intermittent postmenopausal vaginal bleeding. A malignant uterine tumor was strongly suspected after imaging using ultrasound examination and magnetic resonance imaging; however, a precise pathological diagnosis was not achieved despite multiple outpatient endometrial biopsies with the aid of office hysteroscopy. Based on an endometrial biopsy obtained using a cutting loop electrode on an 8.3-mm operative resectoscope, we reached a diagnosis of endophytic-type endometrial cancer, which is in accordance with the final pathological diagnosis after abdominal hysterectomy. Three months after her first visit to our hospital, total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic/para-aortic lymph node dissection were performed. Macroscopically, the endometrium was atrophic, and there was no obvious mass in the uterine cavity; however, microscopically, the cancer cells mainly existed in the deep myometrium and the final diagnosis was International Federation of Gynecology and Obstetrics (FIGO) stage IB endometrial cancer. Operative biopsy of the uterine endometrium and deep myometrium using hysteroscopy confirmed an accurate preoperative diagnosis of uterine endometrial cancer specifically of the endophytic type.

scholarly journals Isolated Humeral Metastasis in Uterine Cervical Cancer: A Rare Entity

2012 ◽  
Vol 2 ◽  
pp. 80 ◽  
Author(s):  
Mahrooz Malek ◽  
Alireza Rajabzadeh Kanafi ◽  
Ramin Pourghorban ◽  
Reza Nafisi-Moghadam
Keyword(s):  
Cervical Cancer ◽  
Uterine Cervix ◽  
Locally Advanced ◽  
Stage Iv ◽  
Total Abdominal Hysterectomy ◽  
Figo Stage ◽  
Abdominal Hysterectomy ◽  
Lytic Lesion ◽  
Gynecology And Obstetrics ◽  
First Case

Bone metastasis in cancer of uterine cervix, especially in the form of isolated bone involvement is a rare manifestation. Herein, we report the first case of isolated humeral metastasis in a known case of locally advanced cervical cancer. A fifty-six-year old female presented with International Federation of Gynecology and Obstetrics (FIGO) Stage IV A squamous cell carcinoma of uterine cervix. She was treated with a combination of radiation and chemotherapy and then total abdominal hysterectomy with bilateral salpingo-oophorectomy. Seven months later, she developed an isolated lytic lesion in the left humerus, which turned out to be a bone metastatic lesion.

scholarly journals Retrospective analysis of clinical, pathological characteristics and prognosis of the patients with endometrial stromal sarcomas

2020 ◽  
Vol 7 (1) ◽  
pp. 360-363
Author(s):  
Hacı Öztürk Şahin ◽  
Mehmet Bayrak
Keyword(s):  
Clinical Characteristics ◽  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Lymph Node Involvement ◽  
Endometrial Biopsy ◽  
Low Grade ◽  
High Grade ◽  
Gynecology And Obstetrics ◽  
Paraaortic Lymph Nodes

Objective: Endometrial stromal sarcoma (ESS) is a rare mesenchymal tumor of the uterus.Literature has limited data about the ESS. The aim of the present study was to contribute to literature by reporting the histo-pathological findings, clinical characteristics of ESS patients and the data about the accuracy of preoperative diagnosis and prognosis. Material and Methods: A total of 33 patients who were diagnosed and followed up with ESS at Department of Gynecology and Obstetrics of Bursa Uludağ University between 2007 and 2017 were retrospectively analyzed with regard to clinical and pathologic characteristics, surgical procedures they underwent and survival. Results: Mean age of the patients was 49.5 years and 60.2 years for low grade ESS (LG-ESS) and high grade ESS (HG-ESS) (p=0,01). Post-menopausal hemorrhage was the most common complaint on admission.  Correct histological diagnosis was made in only 72.7% of the patients from whom pre-operative endometrial biopsy was obtained. Twelve out of 16 cases (75%) were in Stage 1. While all patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO), 14 underwent pelvic and para-aortic lymphadenectomy for surgical staging. Lymph node involvement was detected in no patients who underwent lymphadenectomy. The patients with LG-ESS were found to have a good prognosis however the ones with HG-ESS had a high mortality rate even in the early stages (mean survival of 10 months). Conclusion: High grade ESS cases show different clinical characteristics and prognosis than LG-HSS. Diagnostic accuracy of endometrial sampling is much lower when compared to epithelial uterine malignancies. Metastasis of pelvic-paraaortic lymph nodes of which removal is reported which not to contribute to survival is rare.

Outcomes of patients with endometrial cancer and aggressive histology.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16536-e16536
Author(s):  
Samed Rahatli ◽  
Nadire Kucukoztas ◽  
Omer Dizdar ◽  
Polat Dursun ◽  
Selim Yalcin ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Total Abdominal Hysterectomy ◽  
Figo Stage ◽  
Abdominal Hysterectomy ◽  
Aggressive Histology ◽  
Patient Series ◽  
Post Menopausal

e16536 Background: To present patterns of practice and outcomes of patients with early stage poor histology endometrial cancer. Methods: Records of the patients with FIGO stage I-II serous papillary, clear cell, mixed or undifferentiated endometrial cancer were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging lymphadenectomy, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant chemotherapy was offered to all patients and given unless the patient refused. Results: 38 patients with early stage poor histology were identified Median age was 61 and 86.8 % of the patients were post menopausal. Median BMI was 31.2 kg/m2. 28 patients (73.7%) received chemotherapy (90% with paclitaxel and carboplatin for 6 cycles). 5 patients (13.2 %) received external radiotherapy 3 patients (7.9%) received brachytherapy. Median follow up was 19 mos. Totally 3 patients (7.9%) had relapse on follow up; Among those who received adjuvant chemotherapy, only one patient had recurrence on vaginal cuff and was treated with radiotherapy and currently disease free for 4 years. Among those who did not receive adjuvant chemotherapy, 2 patients had widespread abdominal and distal recurrence and died on follow up. 2 patients died without recurrence. Conclusions: Complete surgical staging and adjuvant chemotherapy results in excellent prognosis in our patient series. [Table: see text]

scholarly journals A Case of Adenosarcoma of the Uterus

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Shigeki Taga ◽  
Mari Sawada ◽  
Aya Nagai ◽  
Dan Yamamoto ◽  
Ryoji Hayase
Keyword(s):  
Histopathological Examination ◽  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Final Diagnosis ◽  
Abdominal Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
Postoperative Treatment ◽  
Case Presentation ◽  
Magnetic Resonance Imaging Mri ◽  
Gross Examination

Adenosarcoma is a rare tumor which consists of benign glandular epithelium and malignant mesenchymal component. Here we report a case of adenosarcoma of the uterine corpus.Case Presentation. A 59-year-old woman presented with vaginal bleeding and visited a local clinic. She had a uterine tumor pointed out and was referred to our hospital. Ultrasound scans revealed a large heterogeneous mass occupying the whole uterine cavity. Cytological test of endometrium was performed but the result was negative. A fractional endometrial curettage revealed no malignancy. Magnetic resonance imaging (MRI) revealed a heterogeneous solid tumor of 77 × 76 mm. Total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy was performed. On gross examination, the tumor was arising from the uterine body and occupied the whole uterine cavity. Histopathological examination revealed phyllodes-like architecture on low magnification　and　periglandular cuffing of tumor cells. The lesion was confined to the uterus. Histopathological final diagnosis was adenosarcoma. Her postoperative course was uneventful and she was discharged without postoperative treatment and remains alive without disease 6 months after the surgery.

scholarly journals A Rare Gestational Trophoblastic Disease: Placental Site Trophoblastic Tumor

2016 ◽  
Author(s):  
Senem Yaman Tunç ◽  
Elif Ağaçayak ◽  
Mehmet Sait İçen ◽  
Serdar Başaranoğlu ◽  
Mehmet Sıddık Evsen ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
Placental Site Trophoblastic Tumor ◽  
Trophoblastic Tumor ◽  
Trophoblastic Cells ◽  
Placental Site ◽  
Gestational Trophoblastic Diseases ◽  
Abnormal Vaginal Bleeding

<p>Placental site trophoblastic tumor (PSTT) is a highly rare form of gestational trophoblastic diseases that arise from intermediate trophoblastic cells. By presenting this case, we aimed to review the treatment and diagnosis, approach to PSTT.<br />A 31-year-old (G2P1A1L1) patient had abnormal vaginal bleeding. Serum ß-HCG was 5.82 mIU/ml and the transvaginal USG detected a polypoid mass in uterine cavity. Probe curettage was performed. Histopathologic specimens were confirmed as PSTT. No metastasis was detected. A total abdominal hysterectomy was performed.<br />PSTT is a rare tumor. In contrast to other trophoblastic tumors, PSTT produces a small amount of ß-HCG and it is relatively insensitive to chemotherapy. Adjuvant chemotherapy is suggested to follow surgical treatment in the cases with metastasis.</p>

Long-term quality of life outcomes of women treated for early-stage endometrial cancer

2020 ◽  
pp. ijgc-2020-002145
Author(s):  
Saira Sanjida ◽  
Andreas Obermair ◽  
Val Gebski ◽  
Nigel Armfield ◽  
Monika Janda
Keyword(s):  
Quality Of Life ◽  
Endometrial Cancer ◽  
Early Stage ◽  
Age Groups ◽  
Laparoscopic Hysterectomy ◽  
Well Being ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy

ObjectiveTo compare long-term quality of life in women treated for early-stage endometrial cancer with population norms, and to compare quality of life outcomes of patients who had total laparoscopic or total abdominal hysterectomy.MethodsOnce the last enrolled patient had completed 4.5 years of follow-up after surgery, participants in the Laparoscopic Approach to Cancer of the Endometrium (LACE) clinical trial were asked to complete a self-administered questionnaire. Two instruments—EuroQol 5 Dimension 3-level (EQ-5D-3L) and the Functional Assessment of Cancer Treatment-General Population (FACT-GP)—were used to determine quality of life. The mean computed EQ-5D-3L index scores for LACE participants at different age categories were compared with Australian normative scores; and the FACT-GP scores were compared between patients treated with surgical treatments.ResultsOf 760 women originally enrolled in the LACE trial, 259 (50.2%) of 516 women consented to provide long-term follow-up data at a median of 9 years (range 6—12) after surgery. On the EQ-5D-3L, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression than normative levels across all age groups (55–64 years, 30% vs 14.9%; 65–74 years, 30.1% vs 15.8%; ≥75 years, 25.9% vs 10.7%). For women ≥75 years of age, the prevalence of impairment in mobility (57.6% vs 43.3%) and usual activities (58.8% vs 37.9%) was also higher than for population norms. For the FACT-GP, the physical (effect size: −0.28, p<0.028) and functional (effect size: −0.30, p<0.015) well-being sub-scale favored the total laparoscopic hysterectomy compared with total abdominal hysterectomy recipients.ConclusionCompared with population-based norms, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression across all age groups, and deficits in mobility and usual activities for women aged ≥75 years. Physical and functional well-being were better among women who were treated with total laparoscopic hysterectomy than among those receiving total abdominal hysterectomy.

Accuracy of preoperative endometrial biopsy and intraoperative frozen section in predicting the final pathological diagnosis of endometrial cancer

2020 ◽  
Vol 35 ◽  
pp. 229-235
Author(s):  
Vincenzo Dario Mandato ◽  
Federica Torricelli ◽  
Valentina Mastrofilippo ◽  
Andrea Palicelli ◽  
Gino Ciarlini ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Frozen Section ◽  
Endometrial Biopsy ◽  
Pathological Diagnosis ◽  
Intraoperative Frozen Section

Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy

2016 ◽  
Vol 8 (3) ◽  
pp. 236-238
Author(s):  
Farheen Yousuf
Keyword(s):  
South Asian ◽  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Resonance Imaging ◽  
Intrauterine Adhesions ◽  
Ovarian Endometrioma ◽  
Imaging Results ◽  
Endometrial Cavity ◽  
Cut Surface

ABSTRACT Aims To report a case of iatrogenic endometrioses as a result of improper closure of endometrial cavity during myomectomy. Case Report A 30-year-old para 1 has been self-referred to our institution for medical care. A fibroid protruding the endometrial canal was removed 8 months prior to this hospital admission. In less than a month after initial myomectomy, she began experiencing severe pelvic pain more accentuated during menstruation. The pain became progressively worse. The magnetic resonance imaging results are suggestive of ovarian endometrioma. She underwent total abdominal hysterectomy and bilateral salpingo-oophrectomy. Cut surface of uterine cavity shows obliteration of endometrial canal with hourglass constriction. Conclusion Closure of endometrium during myomectomy should be carefully done; keeping an account on patency of endometrial canal is essential to prevent iatrogenic endometriosis. How to cite this article Yousuf F. Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy. J South Asian Feder Obst Gynae 2016;8(3):236-238.

Recurrence patterns in patients with stage IIIC1 versus IIIC2 endometrial adenocarcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15501-e15501
Author(s):  
Catherine Bevan ◽  
Christa Irene Nagel ◽  
Todd Patrtick Boren ◽  
David Scott Miller ◽  
Siobhan Marie Kehoe ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Adenocarcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Distant Recurrence ◽  
Exact Test ◽  
Frontline Treatment ◽  
Recurrence Patterns ◽  
The Mean ◽  
To Receive

e15501 Background: To identify differences in recurrence patterns between stage IIIC1 and IIIC2 endometrial adenocarcinomas. Methods: A retrospective review was performed with IRB approval of all patients treated for stage IIIC1 and IIIC2 endometrial adenocarcinoma at our institution from 1989-2011. Patients were required to have comprehensive surgical staging including total abdominal hysterectomy, bilateral salpingo-ophorectomy, pelvic and paraaortic lymph node dissection. Descriptive statistics were performed using Microsoft Excel 2011 and Fischer’s exact test, Kaplan-Meier analyses were used to compare disease free (DFS) and overall survival (OS). Results: Eighty-seven patients with stage IIIC endometrial adenocarcinoma were identified, of which 69 were evaluable. The mean age was 59 years and the mean follow up was 32 months. There were 31 patients with stage IIIC1 and 38 patients with stage IIIC2 disease. There was no statistical difference in histology between the two groups: 47 endometrioid, 11 papillary serous, and 11 with other types of adenocarcinoma. Patients with stage IIIC1 disease were more likely to receive pelvic radiation (p=0.0004) and patients with IIIC2 disease were more likely to receive chemotherapy (p=0.014). Median DFS was 28.9 months (range 0-112) and 15.0 months (range 0-166) (p=0.017) and median OS was 31.9 months (range 0-134) and 18.0 months (range 0-166) (p=0.061) for the IIIC1 and IIIC2 groups respectively. Seven of 31 (23%) patients with stage IIIC1 disease recurred: 1 (14%) at the vaginal cuff and 6 (86%) distant. The patient who recurred locally was initially treated with chemotherapy alone. Of the 6 patients with distant recurrences only 1 received chemotherapy. Twelve of the 38 (32%) patients with stage IIIC2 experienced a recurrence: 6 (50%) vaginal/pelvic and 6 (50%) distant. There was a difference between the rates of local versus distant recurrence in patients with IIIC1 and IIIC2 endometrial cancer. Conclusions: IIIC1 patients were less likely to receive systemic chemotherapy and more likely to recur distantly. Our findings suggest a role for adjuvant chemotherapy and radiation in the frontline treatment of both IIIC1 and IIIC2 endometrial cancer.

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