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1

Selective uterine arterial embolization of uterine myoma  

International Nuclear Information System (INIS)

Objective: Study the value of clinical application of Baiji and absorbable Gelatin in embolizing uterine myoma together with its effect, side effect and complication. Methods: 21 women with uterine myoma undergoing selective uterine arterial embolization by Seldinger's technique were studied. After retrograde trans-femoral introduction of a 5 french catheter, the uterine arteries were successively catheterized. Baiji and absorbable Gelatin sponge particles were injected through free flow until devasculariztion. Results: Uterine myomas blood supply came from bilateral uterine arteries demonstrated by angiography. All the supplying artery images disappeared after the embolization. 3-6 months follow-up study showed: a marked reduction in the size of myomata by 38%-90%. Clinical symptoms were improved. There was one failure cas and then underwent uterotomy due to infection. Conclusions: The short-term effect of using Baiji and absorbable Gelatin for embolizing uterine myoma is clinically significant, while long-term effects is still waiting for research

2001-12-01

2

Ultrasonographic findings of uterine myoma  

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Uterine myoma is one of the most commonly encountered gynecologic problem in daily ultrasonographic practice, and is one of the few conditions with which specific histologic diagnosis is possible by ultrasonography in selected patients as well. We recently analysed ultrasonograms of 132 cases of uterine myoma and 31 cases that showed similar ultrasonographic findings of myoma, histopathologically verified in both cases. The results were as follows. 1. The diagnostic accuracy by ultrasonography was 93%. 2. The most common ultrasonographic findings of uterine myoma were nodular enlargement of uterus and irregular internal echo texture changes. 3. It was not possible to differentiate the various kinds of secondary degeneration by ultrasonography, except for calcification and cystic change. 4. It was usually unable to differentiate solitary from multiple myoma, and subserosal, interstitial and submucosal types from each other by ultrasonographic findings alone, except for the usual cases of exophytically growing subserosal mass. 5. The most frequent disease that is hard to differentiate from small uterine myoma was adenomyosis, and therefore it is considered necessary to include the adenomyosis in differential diagnosis in the diagnosis of myoma causing moderately enlarged uterus.

Lee, Jong Beum; Kim, Kie Hwan; Chin, Soo Yil [Cancer Research Hospital, Korea Advanced Energy Research Institute, Seoul (Korea, Republic of)

1984-06-15

3

Ultrasonographic findings of uterine myoma  

International Nuclear Information System (INIS)

Uterine myoma is one of the most commonly encountered gynecologic problem in daily ultrasonographic practice, and is one of the few conditions with which specific histologic diagnosis is possible by ultrasonography in selected patients as well. We recently analysed ultrasonograms of 132 cases of uterine myoma and 31 cases that showed similar ultrasonographic findings of myoma, histopathologically verified in both cases. The results were as follows. 1. The diagnostic accuracy by ultrasonography was 93%. 2. The most common ultrasonographic findings of uterine myoma were nodular enlargement of uterus and irregular internal echo texture changes. 3. It was not possible to differentiate the various kinds of secondary degeneration by ultrasonography, except for calcification and cystic change. 4. It was usually unable to differentiate solitary from multiple myoma, and subserosal, interstitial and submucosal types from each other by ultrasonographic findings alone, except for the usual cases of exophytically growing subserosal mass. 5. The most frequent disease that is hard to differentiate from small uterine myoma was adenomyosis, and therefore it is considered necessary to include the adenomyosis in differential diagnosis in the diagnosis of myoma causing moderately enlarged uterus

1984-06-01

4

Uterine myoma and adenomyosis: sonographic findings and differentiation  

International Nuclear Information System (INIS)

Uterine myoma and adenomyosis are the two most likely diagnoses in women with hypermenorrhea, dysmenorrhea, and an enlarged uterus, but it is often not possible to make a distinction between them preoperatively. But their treatments can differ : myoma can be treated through myomectomy whereas adenomyosis require hysterectomy. In order to establish the characteristic and differential findings of myoma and adenomyosis sonographically, sonographic findings of 125 cases of pathologically proven myoma and adenomyosis were reviewed retrospectively. Histologic diagnosis were myoma in 94 patients and adenomyosis in 31 patients. The results were as follows : 1. The common sonographic findings of uterine myoma were globular enlargement or bulging contour of uterus 77.8%, loss of central endometrial echoes 66.0%, and homogeneous decreased internal echoes 35.1% or heterogeneous internal echoes 44.7%. 2. The common sonographic findings of adenomyosis were diffuse enlargement without contour change 80.6%, homogeneous hypoechoic or isoechoic internal textures 96.8%, preserved central endometrial echoes 80.6%, and thickening of posterior uterine wall 64.5%. 3. Adenomyosis was highly suggested if the uterus showed diffuse enlargement without contour change or visible nodule, homogeneous hypoechoic textures, and especially thickened posterior wall with anteriorly displaced central endometrial echoes. 4. Adenomyosis could be excluded if the patient was under 30 or above 50 years old, and especially had no previous obstetric history

1990-07-01

5

Uterine myoma and adenomyosis: sonographic findings and differentiation  

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Uterine myoma and adenomyosis are the two most likely diagnoses in women with hypermenorrhea, dysmenorrhea, and an enlarged uterus, but it is often not possible to make a distinction between them preoperatively. But their treatments can differ : myoma can be treated through myomectomy whereas adenomyosis require hysterectomy. In order to establish the characteristic and differential findings of myoma and adenomyosis sonographically, sonographic findings of 125 cases of pathologically proven myoma and adenomyosis were reviewed retrospectively. Histologic diagnosis were myoma in 94 patients and adenomyosis in 31 patients. The results were as follows : 1. The common sonographic findings of uterine myoma were globular enlargement or bulging contour of uterus 77.8%, loss of central endometrial echoes 66.0%, and homogeneous decreased internal echoes 35.1% or heterogeneous internal echoes 44.7%. 2. The common sonographic findings of adenomyosis were diffuse enlargement without contour change 80.6%, homogeneous hypoechoic or isoechoic internal textures 96.8%, preserved central endometrial echoes 80.6%, and thickening of posterior uterine wall 64.5%. 3. Adenomyosis was highly suggested if the uterus showed diffuse enlargement without contour change or visible nodule, homogeneous hypoechoic textures, and especially thickened posterior wall with anteriorly displaced central endometrial echoes. 4. Adenomyosis could be excluded if the patient was under 30 or above 50 years old, and especially had no previous obstetric history.

Lee, Yeong Hwan; Yun, Kwang Myeong; Kim, Ok Dong; Chung, Duck Soo [College of Medicine, Taegu Catholic Hospital, Taegu (Korea, Republic of)

1990-07-15

6

Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in english Oxidative stress is considered to be involved in pathogenesis of many disorders of the female genital tract. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of uterine diseases in order to evaluate the extent of oxida [...] tive stress in blood of such patients. Blood samples of healthy subjects and gynecological patients were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and lipid hydroperoxides. The results show that alterations of measured parameters vary with the enzyme type and diagnosis. However, both reduction in antioxidants and elevation of lipid peroxidation were observed in general. Lipid hydroperoxides level was negatively correlated to superoxide dismutase and glutathione peroxidase activities, as well as positively correlated to catalase activity. In addition, the lipid hydroperoxides/ glutathione peroxidase ratio was found to be increased, according to the type of uterine disease. The obtained results show that perturbation of antioxidant status is more pronounced in blood of patients with premalignant (hyperplastic) and malignant (adenocarcinoma) lesions, compared to those with benign uterine changes such as polypus and myoma

SNEZANA, PEJIC; JELENA, KASAPOVIC; ANA, TODOROVIC; VESNA, STOJILJKOVIC; SNEZANA B, PAJOVIC.

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Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium  

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Full Text Available Oxidative stress is considered to be involved in pathogenesis of many disorders of the female genital tract. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of uterine diseases in order to evaluate the extent of oxidative stress in blood of such patients. Blood samples of healthy subjects and gynecological patients were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and lipid hydroperoxides. The results show that alterations of measured parameters vary with the enzyme type and diagnosis. However, both reduction in antioxidants and elevation of lipid peroxidation were observed in general. Lipid hydroperoxides level was negatively correlated to superoxide dismutase and glutathione peroxidase activities, as well as positively correlated to catalase activity. In addition, the lipid hydroperoxides/ glutathione peroxidase ratio was found to be increased, according to the type of uterine disease. The obtained results show that perturbation of antioxidant status is more pronounced in blood of patients with premalignant (hyperplastic and malignant (adenocarcinoma lesions, compared to those with benign uterine changes such as polypus and myoma

SNEZANA PEJIC

2006-01-01

8

Imaging for uterine myomas and adenomyosis.  

Science.gov (United States)

Uterine myomas and adenomyosis are common findings, in particular in patients with symptoms of abdominal enlargement, pelvic pressure, abnormal uterine bleeding, dysmenorrhea, and dyspareunia. Diagnosis and differentiation between the 2 entities are critical in establishing treatment options and the operative approach for surgical management. Herein are reviewed diagnostic options, their relative accuracy, and the effect of accurate diagnosis on treatment. A review was performed using PubMed, MdConsult, OVID, and reviews including cross-referenced articles and prospective and retrospective studies published from 1980 to 2013. Also reviewed are use of ultrasound with its various methods, magnetic resonance imaging, computed tomography, and positron emission tomography in the diagnosis, pretreatment evaluation, and differentiation of myomas and adenomyosis. PMID:24316138

Shwayder, James; Sakhel, Khaled

2014-01-01

9

Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium  

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Oxidative stress is considered to be involved in pathogenesis of many disorders of the female genital tract. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of uterine diseases in order to evaluate the extent of oxidative stress in blood of such patients. Blood samples of healthy subjects and gynecological patients were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase...

SNEZANA PEJIC; JELENA KASAPOVIC; ANA TODOROVIC; VESNA STOJILJKOVIC; Pajovic, Snezana B.

2006-01-01

10

Differentiation of Sumucosal Myoma from Endometrial Polyp by Sonohysterography  

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To describe the characteristic sonohystero-graphic features of submucosal myoma and to determine the diagnostic usefulness of sonohysterography (SH) in the differentiation of submucosal myoma from endometrial polyp. We evaluated the SH findings of 15 (16 cases) patients with histologically confirmed submucosal myoma and compared these findings with 15 endometrial polyp patients (18 cases). The characteristics of echo patterns, angle between the mass and endometrium, and the presence of hyperechoic line overlying mass lesion and its thickness were compared between submucosal myoma and endometrial polyp. SH findings of submucosal myoma are iso (n = 14) or hypoechoic (n = 2) than myometrium, and show heterogenous echotexture (n =15) and posterior shadowings (n = 13). Angles between mass and endometrium are obtuse (n = 12). In all patients with submucosal myoma, hyperechoic line consistent with the layer of endometrium was detected as overlying the submucosal myoma in SH. Histologic findings of the endometrium were correlated. Visualization of endometrium overlying the submucosal myoma with SH allowed differentiation of submucosal myoma from endometrial polyp and SH is useful in the diagnosis and the proper management of submucosal myoma

1996-12-01

11

MRI evaluation for conservative treatment in endometriosis and uterine myoma  

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Eighteen patients with endometriosis or uterine myoma underwent MRI before and after conservative treatment with Danazol (400 mg/day) or Buserelin (900 {mu}g/day) to examine pathological changes. Of 8 patients with endometrial chocolate cyst, 7 patients were given Dazazol for 3 to 7 months, in whom high signal intensity indicative of mass tended to decrease after chemotherapy especially on T2-weighted images. In addition, the area of cyst was reduced by 31% to 100%. In the remaining one patient receiving Buserelin for 8 months, the reduction rate of cyst was 31%. Ten patients with adenomyosis were classified into the group given Danazol for 5 to 15 months (n=4) and the group given Buserelin for 3 to 8 months (n=6). Low intensity area was decreased by 9% to 25% in the Danazol group and by 20% to 69% in the Buserelin group. Uterine area was reduced by 10% to 32% in the Danazol group and by 4.5% to 51% in the Buserelin group. MRI was helpful in the management of these diseases during conservative treatment. (N.K.).

Kasai, Mayumi; Karibe, Akihiko; Sato, Ken; Suzuki, Hirosi; Iida, Hajime (Iwate Prefectural Central Hospital, Morioka (Japan)); Yamaya, Rie

1991-07-01

12

Current and emerging treatments for uterine myoma – an update  

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Full Text Available Nirmala DuhanPt Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaAbstract: Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as a first line of treatment for symptomatic myomas, while surgical treatment should be reserved only for appropriate indications. Hysterectomy has its place in myoma management in its definitiveness. However, myomectomy, rather than hysterectomy, should be performed when subsequent childbearing is a consideration. Preoperative gonadotropin-releasing hormone analog treatment before myomectomy decreases the size and vascularity of the myoma but may render the capsule more fibrous and difficult to resect. Uterine artery embolization is an effective standard alternative for women with large symptomatic myomas who are poor surgical risks or wish to avoid major surgery. Its effects on future fertility need further evaluation in larger studies. Serial follow-up without surgery for growth and/or development of symptoms is advisable for asymptomatic women, particularly those approaching menopause. The present article is incorporated with multiple clear clinical photographs and simplified elaboration of the available management options for these tumors of uterine smooth muscle to facilitate clear understanding.Keywords: myomectomy, uterine artery embolization, pelvic tumor, hysterectomy, GnRH, leiomyoma

Duhan N

2011-08-01

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Submucosal uterine leiomyomas have a global effect on molecular determinants of endometrial receptivity  

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Study objective To evaluate the effect of uterine leiomyomas on the endometrium using molecular markers of endometrial receptivity: HOXA10, HOXA11, LIF, and BTEB1. Design Case-control study Setting University medical center Patients Thirty reproductive-age women with submucosal, intramural, or no uterine myomas who underwent hysteroscopy or hysterectomy. Interventions Proliferative phase endometrial sampling was performed at the time of surgery. In uteri with a submucosal myoma, directed endometrial biopsies were obtained over the myoma and over normal myometrium. Main outcome measures Endometrial HOXA10 expression was evaluated as a primary end point using quantitative real time RT-PCR and immunohistochemistry. HOXA11, BTEB1, and LIF were evaluated using real time RT-PCR. Results Endometrial HOXA10 and HOXA11 mRNA expression were significantly decreased in uteri with submucosal myomas compared to controls and to uteri with intramural myomas. A similar trend was seen in BTEB1 mRNA expression, however no difference was found in LIF mRNA expression. Immunohistochemistry localized the decrease in endometrial HOXA10 protein expression to stroma. In the presence of a submucosal myoma, there were no regional differences in gene expression. Conclusions The molecular mechanism by which submucosal myomas adversely affect reproduction includes a global decrease in endometrial HOX gene expression, not simply a focal change over the myoma. This may explain the reproductive dysfunction observed with submucosal myomas.

Rackow, Beth W.; Taylor, Hugh S.

2011-01-01

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Prevalence of urinary incontinence and other lower tract urinary symptoms in patients with uterine myomas  

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Full Text Available To study the prevalence and risk factors of the overactive bladder, urinary incontinence and other lower tract urinary symptoms in patients with uterine myomas, female patients with established diagnosis of the uterine myomas presenting to gynecology clinic were invited to answer a self-administered questionnaire, which included questions on evidence of lower urinary tract symptoms [modified Overactive Bladder-Validated 8-question Screener (OAB-V8]. Demographic data, relevant medical and surgical history, and pelvic ultrasound findings were reviewed from the patients charts. Statistical significance of relationship between OAB, stress incontinence and urge incontinence in relation to body mass index (BMI, uterine volume and size of dominant myoma were analyzed using 2-taild exact Fisher test and Wilcoxon test. Ninty-eight patients (28 to 81 years completed the questionnaire over a period of 3 months. The majority were premenopausal and had detectable myomas on ultrasound. OAB was present in 47.9% women. No significant statistical relation between size and volume of the uterus and overactive bladder, urge incontinence, stress incontinence and mixed incontinence was noted. Observation of OAB subtypes with urge and stress incontinence in premenopausal patients with uterine myomas was statistically significant in comparison with premenopausal women studied (60.8% vs 15.3 and 63% vs 6.8, respectively; P<0.001. Overall prevalence of OAB was similar in both groups. Our study showed the higher prevalence of overactive bladder than in the general population, however overall OAB prevalence related to fibroids did not show statistical significance. OAB-stress incontinence and OABurge incontinence subtypes were associated with uterine myomas.

Wellman W. Cheung

2011-07-01

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Symptomatic improvement in uterine myomas after MRgFUS: 4 year follow up  

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Objective: To assess the long-term improvement in symptoms after magnetic resonance-guided focused ultrasound surgery (MRgFUS) for uterine myomas. Methods: Japanese women with symptomatic myomas underwent MRgFUS using the ExAblate 2000 system. The symptom severity score (SSS) was examined before and after the treatment at 3, 6, 12, 24, and 48 months. Simultaneously, we asked the patients' satisfaction level regarding the overall change of subjective symptoms: symptom free, improved a great deal, improved to some extent, no change, or worsened. The myoma volumes were measured at 6, 12, 24, 36 and 48 months after MRgFUS. Results: No severe adverse event occurred with any of the patients. The mean SSS value before treatment was 38.3+/-21.5 (n = 106), which diminished significantly during follow-up for 3-48 months after treatment. Patients' satisfaction level was favorable, although the response rate was low. Over 80% of the patients replied that their symptoms were improved to at least some extent, and over 50% of the patients replied that their symptoms were improved a great deal. This trend continued throughout this follow up period. The mean myoma volume was also decreased from the pretreatment volume in this follow up period. Conclusion: MRgFUS is an effective and safe method for treating symptomatic uterine myomas. Long-term symptomatic improvement is promising.

Funaki, Kaoru

2011-09-01

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Uterine artery embolization for the treatment of symptomatic myomas in Brazilian women Embolização da artéria uterina para o tratamento de miomas sintomáticos em mulheres brasileiras  

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CONTEXT: Uterine myomas are benign tumors that mostly occur in women of reproductive age at a frequency ranging from 20 to 25%. The symptoms are increased menstrual flow, pain and compressive signs. New treatments have been proposed and uterine artery embolization is one of them. OBJECTIVE: To evaluate the effects of treatment by embolization of the uterine artery, in women with symptomatic myomas. Uterine and dominant myoma volumes and the major symptoms were evaluated before treatment and 1...

Maurício Sena-Martins; Cecilia Maria Roteli-Martins; Valdir Tadini; Gustavo Antonio de Souza; Nestor Kisilevzky; Felipe Lazar Junior

2003-01-01

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Changes of serum levels of prolactin (PRL), testosterone (T) and estriol (E2) in patients with uterine myoma and endometriocarcinoma  

International Nuclear Information System (INIS)

Objective: To study the relationship between the serum levels of PRL, T, E2 and development of uterine myoma/endometriocarcinoma. Methods: Serum PRL, T and E2 levels were determined with CLIA in 30 patients with uterine myoma, 28 patients with endometriocarcinoma and 38 controls. Results: (1) Serum levels of PRL and T in both the patient groups were significantly higher than those in controls (P2 levels in both patient groups were not significantly different from those in controls (P>0.01), (3) The serum PRL levels were lowest in the controls and highest in patients with endometriocarcinoma while levels in patients with uterine myoma were intermediate. Conclusion: With the development of uterine myoma/endometriocarcinoma the serum PRL and T levels increased significantly. (authors)

2005-08-01

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Polymorphisms of the GSTT1 and GSTM1 genes in women of central Serbia: Absence of association with uterine myoma  

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Since glutathione S-transferase (GST) enzymes are involved in cellular protection, we aimed to determine the distribution of GSTT1 and GSTM1 null genotypes in women in central Serbia in order to assess the risk of development of uterine myoma. The study consisted of 34 clinically diagnosed uterine myoma patients and 35 healthy control women. Analyses of GST polymorphism were carried out by multiplex PCR. Our results showed no significant differences in the GSTT1 and GSTM1 null genotypes...

Arsenijevi? S.; Ljuji? Biljana; Stoši? Ivana; Gruji?i? D.; Marinkovi? D.; Miloševi?-?or?evi? Olivera

2013-01-01

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ENDOMETRIAL POLYPS AFFECT UTERINE RECEPTIVITY  

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This case-control study evaluated the effect of hysteroscopically identified endometrial polyps on endometrium using HOXA10 and HOX11, known molecular markers of endometrial receptivity. Uteri with endometrial polyps demonstrated a marked decrease in HOXA10 and HOXA11mRNA levels that may impair implantation; these findings suggest a molecular mechanism to support clinical findings of diminished pregnancy rates in women with endometrial polyps.

Rackow, Beth W.; Jorgensen, Elisa; Taylor, Hugh S.

2011-01-01

20

ENDOMETRIAL POLYPS AFFECT UTERINE RECEPTIVITY  

Science.gov (United States)

Narrative abstract This case-control study evaluated the effect of hysteroscopically identified endometrial polyps on endometrium using HOXA10 and HOX11, known molecular markers of endometrial receptivity. Uteri with endometrial polyps demonstrated a marked decrease in HOXA10 and HOXA11mRNA levels that may impair implantation; these findings suggest a molecular mechanism to support clinical findings of diminished pregnancy rates in women with endometrial polyps.

Rackow, Beth W.; Jorgensen, Elisa; Taylor, Hugh S.

2011-01-01

 
 
 
 
21

Diagnostic value of saline contrast sonohysterography comparing with hysteroscopy for detecting endometrial abnormalities in women with abnormal uterine bleeding  

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Full Text Available Background: Abnormal uterine bleeding is a common presentation of uterine abnormalities among premenopausal and postmenopausal women.Objective: To evaluate and compare the diagnostic accuracy of saline contrast sonohysterography and hysteroscopy for detecting the cause of abnormal uterine bleeding.Materials and Methods: A total of 65 women with abnormal uterine bleeding were enrolled in this study. A prior saline contrast sonohysetrography followed by a hysteroscopy was performed in all cases. Sensitivity, specificity, positive and negative predictive value and test accuracy were calculated.Results: As the most common abnormality, SCSH showed hyperplasia in 19 patients while hysteroscopy diagnosed polyp in 15 cases. A sensitivity of 73.3%, 71.4% and 90.9% were reported for polyp, hyperplasia and submucous myoma respectively whereas the specificity was calculated 96% for polyps, 82.3% for hyperplasia and 90.7% for submucous myoma.Conclusion: Comparing with hysteroscopy, sonohysterography showed a high sensitivity and specificity for detecting submucous myoma but not for endometrial polyp and endometrial hyperplasia

Farzaneh Goharzad

2011-01-01

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Polypoid uterine lesions mimicking endometrial stromal sarcoma.  

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Two polypoid submucosal uterine lesions were examined histologically and immunohistochemically with monoclonal antibodies to desmin and alpha smooth muscle actin. One case comprised a leiomyoma and the other a polypoid form of adenomyosis. Both polyps had prolapsed through the external cervical os. The lesions had an ulcerated surface with focal areas of marked increased cellularity and pronounced vascularity throughout, such that they mimicked a low grade endometrial stromal sarcoma infiltra...

Mccluggage, W. G.; Alderdice, J. M.; Walsh, M. Y.

1999-01-01

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Polymorphisms of the GSTT1 and GSTM1 genes in women of central Serbia: Absence of association with uterine myoma  

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Full Text Available Since glutathione S-transferase (GST enzymes are involved in cellular protection, we aimed to determine the distribution of GSTT1 and GSTM1 null genotypes in women in central Serbia in order to assess the risk of development of uterine myoma. The study consisted of 34 clinically diagnosed uterine myoma patients and 35 healthy control women. Analyses of GST polymorphism were carried out by multiplex PCR. Our results showed no significant differences in the GSTT1 and GSTM1 null genotypes between the patients and controls. Using the GSTT1 positive/GSTM1 positive combination as reference, there was no statistically significant risk of uterine myoma with the combination of GSTT1 null and GSTM1 null genotypes. We conclude that polymorphism of both GSTT1 and GSTM1 genes, alone or in combination, did not present the main risk for uterine myoma in women from central Serbia.[Projekat Ministarstva nauke Republike Srbije, br. III41010 i br. ON 175103

Arsenijevi? S.

2013-01-01

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An Unusual Extremely Distant Noncommunicating Uterine Horn with Myoma and Adenomyosis Treated with Laparoscopic Hemihysterectomy  

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A 41-year-old woman referred to us with dysmenorrhea and severe pelvic pain although she was previously submitted to right laparotomic adnexectomy for ovarian endometrioma and to a subsequent operative laparoscopy for pelvic adhesions. After ultrasound examination, the patient underwent diagnostic hysteroscopy and operative laparoscopy which confirmed the clinic suspect of an unicornuate uterus. However, it was very unusual to see an extremely distanced right horn, without communication with uterus, without adnexa, and with a small myoma belonging to it. Moreover, omentum and bowel were attached to fundus of right horn and thick adhesions fixed it to rectum and right pelvic wall. Therefore, identification of anatomical structures was difficult, as it was extremely arduous to isolate the ureter, which was involved inside the adhesions surrounding the right uterine horn. Nevertheless, laparoscopic right hemihysterectomy was successfully performed and right horn was sent to our pathologist who recognized hypotrophic endometrium and adenomyosis.

Morelli, Michele; Mocciaro, Rita; Lico, Daniela; Zullo, Fulvio

2013-01-01

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Diagnóstico ecográfico de mioma uterino en mujeres con síntomas ginecológicos / Ultrasound diagnosis of uterine myoma in women with gynecological symptoms  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se realizó un estudio descriptivo y transversal de 76 pacientes atendidas en el Departamento de Ultrasonido del Hospital "Carlos Manuel de Céspedes" de Bayamo, Granma, desde junio de 2011 hasta enero de 2012, con vistas a describir las características ecográficas del mioma uterino en mujeres con sín [...] tomas ginecológicos. Entre las variables analizadas figuraron: edad, color de la piel, hallazgos ecográficos y correspondencia entre el diagnostico presuntivo y el ecográfico. En la serie prevalecieron las diagnosticadas con mioma uterino, el grupo etario de 15-45 años y las féminas de piel negra. Asimismo, predominaron los miomas múltiples y de localización intramural. Las complicaciones que primaron fueron la degeneración quística y las calcificaciones. No hubo total correspondencia entre las indicaciones médicas presuntivas de miomas y el diagnóstico ecográfico definitivo. Abstract in english A descriptive and cross-sectional study was conducted in 76 patients attended in the Ultrasound Department of "Carlos Manuel de Céspedes" Hospital in Bayamo, Granma, from June 2011 to January 2012, in order to describe the sonographic characteristics of the uterine myoma in women with gynecological [...] symptoms. Among the analyzed variables were age, race, sonographic findings and correspondence between the presumptive and sonographic diagnosis. Those diagnosed with uterine myoma, age group of 15-45 years and black women prevailed in the series. Also, multiple myomas and those of intramural location prevailed. Cystic degeneration and calcifications were the prevailing complications. There was not total correspondence between the presumptive medical indications of myomas and the final ultrasound diagnosis.

Katia, Ramírez Fajardo; Grisell, Torres Alfes; Yuleydis K, Frutos Ramírez.

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Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.  

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Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy. PMID:24592801

Vaidya, S; Lakhey, M; Vaidya, S; Sharma, P K; Hirachand, S; Lama, S; KC, S

2013-03-01

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Interleukin 11 is upregulated in uterine lavage and endometrial cancer cells in women with endometrial carcinoma  

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Full Text Available Abstract Background Interleukin (IL 11 is produced by human endometrium and endometrial cancer tissue. It has roles in endometrial epithelial cell adhesion and trophoblast cell invasion, two important processes in cancer progression. This study aimed to determine the levels of IL11 in uterine lavage fluid in women with endometrial cancer and postmenopausal women. It further aimed to determine the levels of IL11 protein and its signaling molecules in human endometrial cancer of varying grades, and endometrium from postmenopausal women and IL11 signalling mechanisms in endometrial cancer cell lines. Methods IL11 levels in uterine lavage were measured by ELISA. IL11, IL11 receptor(R ?, phosphorylated (p STAT3 and SOCS3 were examined by immunohistochemistry in endometrial carcinomas and in control endometrium from postmenopausal women and normal cycling women. The effect of IL11 on pSTAT3/STAT3 and SOCS3 protein abundance in endometrial cancer cell lines and non-cancer endometrial epithelial cells was determined by Western blot. Results IL11 was present in uterine flushings and was significantly higher in women with Grade 1 carcinomas compared to postmenopausal women (p Conclusions The present study suggests that IL11 in uterine washings may be useful as a diagnostic marker for early stage endometrial cancer. It indicates that IL11, along with its specific receptor, IL11R?, and downstream signalling molecules, STAT3 and SOCS3, are likely to play a role in the progression of endometrial carcinoma. The precise role of IL11 in endometrial cancer remains to be elucidated.

Nicholls Peter K

2010-06-01

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Study of endometrial pathology in abnormal uterine bleeding  

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Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology outpatient department. Endometrial sampling could be effectively used as a first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing obstetrician. This study was done to evaluate histopathology of endometrium for identifying endometrial causes of AUB. We observed the incidence of various pathology in different age groups presenting with abnormal...

Jignasha Parmar; Deepak Desai

2013-01-01

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Endometrial morphology after treatment of uterine fibroids with the selective progesterone receptor modulator, ulipristal acetate.  

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Selective progesterone receptor modulators (SPRMs) have beneficial effects in reducing the size of uterine fibroids and the amount of bleeding, but their endometrial effects have not been seen with other agents. This report describes the morphology of the endometrium after 3 mo of treatment with the SPRM, ulipristal acetate (UPA). In 2 Phase III randomized double-blind controlled clinical trials, 546 patients with uterine myomas were treated with 5 or 10 mg of UPA daily for 13 wk or placebo or gonadotropin-releasing hormone agonist. Endometrial biopsies were taken at screening, end of treatment (13 wk), and after treatment-free follow-up (38 wk). Biopsies were assessed independently by 3 pathologists according to a preset morphologic scheme. After 13 wk, the UPA-treated endometrium showed altered architectural glandular features including extensive cystic dilatation. The glandular epithelium appeared inactive or contained abortive subnuclear vacuolization, occasional mitoses, and apoptosis. Abnormal stromal vessels were commonly seen. There was a high level of agreement between pathologists on the presence or the absence of nonphysiological changes. One case of hyperplasia without atypia and 4 polyps were seen at 13 wk of UPA treatment. Six months after treatment, the endometrium returned to normal histology in the majority of the patients, with 1 polyp and no cases of hyperplasia in the UPA-treated groups, and 2 hyperplasias (1 with and 1 without atypia) in the placebo or the gonadotropin-releasing hormone-agonist groups. Mild reversible thickening of the endometrium occurs in a minority of cases. It is important that pathologists are aware of the spectrum of changes induced by SPRMs to avoid misdiagnoses of endometrial hyperplasia or polyps. PMID:23018219

Williams, Alistair R W; Bergeron, Christine; Barlow, David H; Ferenczy, Alex

2012-11-01

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Endometrial polyps in postmenopausal women  

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The malignancy risk of endometrial polyps in postmenopausal women was correlated with the presence or absence of abnormal uterine bleeding. Of 481 postmenopausal women who presented with endometrial polyps at diagnostic hysteroscopy between 2004 and 2007, 48.9% were asymptomatic and 51.1% had postmenopausal uterine bleeding. Transvaginal ultrasound revealed abnormal endometrial thickness in 60.0% vs. 57.7%, polyps in 37.9% vs. 32.9%, endometrial tumors in 1.3% vs. 0.8%, and submucosal myomas ...

Domingues, Ap; Lopes, H.; Dias, I.; Oliveira, Cf

2009-01-01

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Study of endometrial pathology in abnormal uterine bleeding  

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Full Text Available Background: Abnormal uterine bleeding (AUB is the commonest presenting symptom in gynaecology outpatient department. Endometrial sampling could be effectively used as a first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing obstetrician. This study was done to evaluate histopathology of endometrium for identifying endometrial causes of AUB. We observed the incidence of various pathology in different age groups presenting with abnormal uterine bleeding & with respect to it were offered pharmacological management. Methods: This was a study done at S B K S Medical Institute & Research Centre, Vadodara, India on 155 patients who presented with AUB from February 2010-2012, these were the cases of isolated endometrial pathology diagnosed on histopathology were selected for analyses. A statistical analysis between age of presentation and specific endometrial causes was done using chi - square test. Results: The most common age group presenting with AUB was 30- 40 yrs. The commonest pattern in these patients was normal cycling endometrium (32.65%.The commonest pathology irrespective of the age group was disordered proliferative endometrium (33.33%. Other causes identified were pregnancy associated conditions (0.08%, benign endometrial polyp (10.78%, endometrial hyperplasia without atypia (0.05%, chronic endometritis (0.03%, endometrial hyperplasia with atypia (0.04%. Endometrial causes of AUB and age pattern was statistically significant with p value < 0.05. Conclusions: There is an age specific association of endometrial lesions. In perimenopausal women AUB is most commonly dysfunctional in origin and in reproductive age group, one should rule out pregnancy associated conditions. The incidence of disordered proliferative pattern was significantly high in this study, suggesting an early presentation of these patients & procuring success with pharmacological management. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 182-185

Jignasha Parmar

2013-04-01

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Management of dysfunctional uterine bleeding based on endometrial thickness  

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Full Text Available Ozgul Muneyyirci-Delale1,2, Anuja Gupta1,2, Cynthia Abraham1, Ashadeep Chandrareddy1, Charles H Bowers Jr2, Jed B Cutler2Departments of Obstetrics and Gynecology, 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, New York, USAObjective: To manage patients with dysfunctional uterine bleeding (DUB according to endometrial thickness.Methods: A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three groups based on endometrial thickness (mm: less than 6, 6–11, and greater than 11. These three groups were treated with combined oral contraceptive pills (OCP, conjugated estrogen plus progesterone and megestrol respectively. Patients given megestrol also underwent endometrial biopsy before treatment. Patients recorded the degree of bleeding each day for one month after starting treatment.Results: Mean endometrial thickness in the combined OCPs, conjugated estrogen plus progesterone and megestrol groups were 4, 8 and 14 mm, respectively. Combined OCPs decreased bleeding from 46 to 8 days (P < 0.05, n = 8. Conjugated estrogen plus progesterone decreased the number of days of bleeding from a mean of 41 to 9 (P < 0.01, n = 16. Megestrol decreased bleeding from 54 to 3 days (P < 0.001, n = 25. 52% of patients given megestrol had endometrial hyperplasia.Conclusion: These results support the effectiveness of treating patients with DUB according to endometrial thickness.Keywords: DUB, abnormal uterine bleeding, endometrium, hyperplasia, megestrol acetate

Ozgul Muneyyirci-Delale

2010-09-01

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Management of dysfunctional uterine bleeding based on endometrial thickness  

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Ozgul Muneyyirci-Delale1,2, Anuja Gupta1,2, Cynthia Abraham1, Ashadeep Chandrareddy1, Charles H Bowers Jr2, Jed B Cutler2Departments of Obstetrics and Gynecology, 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, New York, USAObjective: To manage patients with dysfunctional uterine bleeding (DUB) according to endometrial thickness.Methods: A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three...

Ozgul Muneyyirci-Delale; Anuja Gupta; Cynthia Abraham; et al., .

2010-01-01

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Molecular markers of endometrial carcinoma detected in uterine aspirates.  

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Endometrial cancer (EC) is the most frequent of the invasive tumors of the female genital tract. Although usually detected in its initial stages, a 20% of the patients present with advanced disease. To date, no characterized molecular marker has been validated for the diagnosis of EC. In addition, new methods for prognosis and classification of EC are needed to combat this deadly disease. We thus aimed to identify new molecular markers of EC and to evaluate their validity on endometrial aspirates. Gene expression screening on 52 carcinoma samples and series of real-time quantitative PCR validation on 19 paired carcinomas and normal tissue samples and on 50 carcinoma and noncarcinoma uterine aspirates were performed to identify and validate potential biomarkers of EC. Candidate markers were further confirmed at the protein level by immunohistochemistry and Western blot. We identified ACAA1, AP1M2, CGN, DDR1, EPS8L2, FASTKD1, GMIP, IKBKE, P2RX4, P4HB, PHKG2, PPFIBP2, PPP1R16A, RASSF7, RNF183, SIRT6, TJP3, EFEMP2, SOCS2 and DCN as differentially expressed in ECs. Furthermore, the differential expression of these biomarkers in primary endometrial tumors is correlated to their expression level in corresponding uterine fluid samples. Finally, these biomarkers significantly identified EC with area under the receiver-operating-characteristic values ranging from 0.74 to 0.95 in uterine aspirates. Interestingly, analogous values were found among initial stages. We present the discovery of molecular biomarkers of EC and describe their utility in uterine aspirates. These findings represent the basis for the development of a highly sensitive and specific minimally invasive method for screening ECs. PMID:21207424

Colas, Eva; Perez, Cristina; Cabrera, Silvia; Pedrola, Nuria; Monge, Marta; Castellvi, Josep; Eyzaguirre, Fernando; Gregorio, Jesus; Ruiz, Anna; Llaurado, Marta; Rigau, Marina; Garcia, Marta; Ertekin, Tugçe; Montes, Melania; Lopez-Lopez, Rafael; Carreras, Ramon; Xercavins, Jordi; Ortega, Alicia; Maes, Tamara; Rosell, Elisabet; Doll, Andreas; Abal, Miguel; Reventos, Jaume; Gil-Moreno, Antonio

2011-11-15

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Quiste gigante de ovario y mioma uterino. Presentación de un caso / Giant ovarian cyst and uterine myoma. A case report  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta un caso de quiste gigante del ovario, en una paciente de 30 años de edad, que fue atendida por el Servicio de Ginecología del Hospital Provincial de Inhambane, en el año 2010, por un aumento de tamaño en el abdomen. Se realizaron los estudios clínicos y ultrasonográficos. Se confirmó a t [...] ravés de una laparotomía exploradora una tumoración quística gigante del ovario con dimensiones extraordinarias y un mioma uterino, lo que es poco frecuente en la actualidad. En el estudio anatomopatológico se comprobó el diagnóstico de cistoadenoma seroso del ovario. Abstract in english A 30-year old patient presenting a giant ovarian cyst was attended at Gynecology service in the Provincial Hospital of Inhambane in 2010, the patient complained of abdominal distension. Clinical and ultrasonographic studies were completed. An exploratory laparotomy confirmed a giant ovarian cyst hav [...] ing odd dimensions and uterine myoma, not frequently found in present times. Pathological studies proved a serous cystadenoma of the ovary.

Carlos Antonio, Sánchez Portela; Adonis, García Valladares; Carmen Juana, Sánchez Portela.

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Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging  

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The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial-myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis. (orig.)

2005-11-01

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Molecular diagnosis of endometrial cancer from uterine aspirates.  

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Rapid and reliable diagnosis of endometrial cancer (EC) in uterine aspirates is highly desirable. Current sensitivity and failure rate of histological diagnosis limit the success of this method and subsequent hysteroscopy is often necessary. Using quantitative reverse transcriptase-polymerase chain reaction on RNA from uterine aspirates samples, we measured the expression level of 20 previously identified genes involved in EC pathology, created five algorithms based on combinations of five genes and evaluated their ability to diagnose EC. The algorithms were tested in a prospective, double-blind, multicenter study. We enlisted 514 patients who presented with abnormal uterine bleeding. EC was diagnosed in 60 of the 514 patients (12%). Molecular analysis was performed on the remnants of aspirates and results were compared to the final histological diagnoses obtained through biopsies acquired by aspiration or guided by hysteroscopy, or from the specimens resected by hysterectomy. Algorithm 5 was the best performing molecular diagnostic classifier in the case-control and validation study. The molecular test had a sensitivity of 81%, specificity of 96%, positive predictive value (PPV) of 75% and negative predictive value (NPV) of 97%. A combination of the molecular and histological diagnosis had a sensitivity of 91%, specificity of 97%, PPV of 79% and NPV of 99% and the cases that could be diagnosed on uterine aspirate rose from 76 to 93% when combined with the molecular test. Incorporation of the molecular diagnosis increases the reliability of a negative diagnosis, reduces the need for hysteroscopies and helps to identify additional cases. PMID:23649867

Perez-Sanchez, Cristina; Colas, Eva; Cabrera, Silvia; Falcon, Orlando; Sanchez-del-Río, Angel; García, Enrique; Fernández-de-Castillo, Luis; Muruzabal, Juan Carlos; Alvarez, Elena; Fiol, Gabriel; González, Carmen; Torrejón, Rafael; Moral, Eloy; Campos, Miriam; Repollés, Manuel; Carreras, Ramon; Jiménez-López, Jesus; Xercavins, Jordi; Aibar, Elena; Perdones-Montero, Alvaro; Lalanne, Eric; Palicio, Marta; Maes, Tamara; Rosell-Vives, Elisabet; Nieto, Carlos; Ortega, Alicia; Pedrola, Nuria; Llauradó, Marta; Rigau, Marina; Doll, Andreas; Abal, Miguel; Ponce, Jordi; Gil-Moreno, Antonio; Reventós, Jaume

2013-11-15

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Presentación de una paciente con mioma gigante del útero / Report of a Patient with Giant Uterine Myoma  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presentó una paciente de 32 años de edad, de la raza negra, con historia obstétrica de dos abortos espontáneos en el primer trimestre del embarazo, nulípara, que acudió a la Consulta de Ginecología en enero de 2010 en el Hospital de Kabgayi, Rwanda, África, y refirió aumento de volumen del abdome [...] n y además, constipación, tenesmo vesical y sangrados abundantes, que le causaban anemia severa. Después del interrogatorio y examen físico se encontró una tumoración gigante de la cavidad abdominal que ocupaba todo el hemiabdomen inferior y sobrepasaba la cicatriz umbilical que parecía ser un mioma uterino, diagnóstico que se corroboró posteriormente con la ultrasonografía abdominal. Se decidió tratamiento quirúrgico con histerectomía total, y se obtuvo una pieza correspondiente a un mioma uterino con un peso de 4,7 kg. Abstract in english A 32- year- old patient of black race, with obstetrical history of two spontaneous abortions in the first trimester of pregnancy, nullipara, who was attended at Gynecology Service in January 2010, Kabgayi Hospital in Rwanda, Africa. The patient´s abdomen increased and the clinical manifestations wer [...] e constipation, vesiacal tenesmus and profuse bleeding that caused severe anemia. After the patient’s interview application and the physical examination was done a giant tumor of the abdominal cavity was found that filled the lower abdomen and surpassed the umbilicus that clinically impressed: a uterine myoma that was later confirmed by abdominal ultrasonography. Surgical treatment was performed with total hysterectomy, and showed a giant tumor of 4.7 kg

Jorge Luís, Hiralda Martínez.

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Frequent CCNE1 amplification in endometrial intraepithelial carcinoma and uterine serous carcinoma.  

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Uterine serous carcinoma accounts for only 10% of all uterine epithelial cancers, but is the leading cause of death among them. The pathogenesis of this aggressive neoplasm has been largely elusive until recently, when comprehensive genome-wide analyses of uterine serous carcinoma have been performed. Among amplified cancer-related genes, CCNE1, encoding for cyclin E1, is frequently amplified in uterine serous carcinoma. In the current study we applied fluorescence in situ hybridization (FISH) to determine CCNE1 copy number in uterine serous carcinoma and concurrent endometrial intraepithelial carcinoma, the noninvasive component of uterine serous carcinoma, and the results were correlated with clinicopathological and molecular features. We found that 20 (45%) of 44 uterine serous carcinomas and 11 (41%) of 27 endometrial intraepithelial carcinomas showed CCNE1 amplification. Overall, we found high concordance in CCNE1 copy number in concurrent uterine serous carcinoma and endometrial intraepithelial carcinoma pairs (P-value=0.0003). No correlation was observed between CCNE1 copy number and clinicopathological features, as well as common mutations previously reported in uterine serous carcinoma. In summary, we confirm that amplification of CCNE1 is a frequent molecular genetic change in uterine serous carcinoma. Moreover, the identification of CCNE1 amplification in many endometrial intraepithelial carcinomas suggests that this genetic event occurs early during tumor progression. PMID:24309323

Kuhn, Elisabetta; Bahadirli-Talbott, Asli; Shih, Ie-Ming

2014-07-01

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Uterine vascular degeneration is present throughout the uterine wall of multiparous mares. Colinearity between elastosis, endometrial grade, age and parity.  

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Vascular degeneration is present in endometrial vessels of multiparous aged mares. The lesions associated with vascular degeneration consist of enlargement, duplication and splitting of the membrana elastica interna and perivascular deposits of elastin. However, there are no similar data available for deep myometrial vessels and the vascular layer. The objectives of the present study were to characterize the status of vasculature in full-thickness uterine necropsy samples and to correlate these findings to endometrial grade, age, and parity. Elastosis was present in myometrial vessels, as well as in large arteries and veins located between the circular and longitudinal myometrial layers. Vascular degeneration was associated with number of foals (P 0.05). Endometrial grade was associated with age (P 0.05). The presence of elastosis in the myometrial vessels was related to problems associated with chronic uterine infection (CUI) and delayed uterine clearance (DUC) of infertile mares. Uterine contractility was impaired in mares affected by CUI and/or DUC and could be related to a lack of myometrial blood flow. Additionally, degeneration of large vessels in the vascular layer may indicate a general compromise in uterine blood flow and fertility. The main conclusions were the presence of vascular elastosis in large deep myometrial vessels as well as in endometrial vessels, and that the factor with the strongest association with vascular degeneration was number of foals (P < 0.001), followed by endometrial grade (P < 0.05), but no association with mare age. PMID:22763073

Esteller-Vico, A; Liu, I K; Couto, S

2012-09-15

 
 
 
 
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Endometrial Exosomes/Microvesicles in the Uterine Microenvironment: A New Paradigm for Embryo-Endometrial Cross Talk at Implantation  

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Exosomes are nanoparticles (?100 nm diameter) released from cells, which can transfer small RNAs and mRNA via the extracellular environment to cells at distant sites. We hypothesised that exosomes or the slightly larger microvesicles (100–300 nm) are released from the endometrial epithelium into the uterine cavity, and that these contain specific micro (mi)RNA that could be transferred to either the trophectodermal cells of the blastocyst or to endometrial epithelial cells, to promote imp...

Ng, York Hunt; Rome, Sophie; Jalabert, Audrey; Forterre, Alexis; Singh, Harmeet; Hincks, Cassandra L.; Salamonsen, Lois A.

2013-01-01

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Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding  

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Background and Objectives: We compared endometrial sampling by pipelle endometrial curette with Conventional dilatation and curettage (D&C) in patients with abnormal uterine bleeding. Methods: Endometrial sampling with pipelle curette was performed on 100 patients followed by formal D&C. Samples were labeled as A and B, respectively, and sent to a histopathologist who was blinded as to the method of sampling. The histopathology reports of both samples were compared, taking D&...

Fakhar Shazia; Saeed Gulshan; Khan Amir; Alam Ali

2008-01-01

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Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding  

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Background/Aim. The prevalence of endometrial polyps (EPs) in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regar...

?or?evi? Biljana; Miloševi? Jelena; Stanojevi? Zorica

2008-01-01

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The aromatase expression in myomas and myometriums of women in reproduction and perimenopausal age.  

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Full Text Available Uterine myomas represent one of the most common female pathologies. Uterine smooth muscle myomas or fibromas are benign tumours which respond to hormones and their etiology induces wide interest. The myomas were found to contain aromatase and, in addition, cells of the myomas were found to synthesize estrogen. This study was conducted on patients with the myomas, in either generative age or in the perimenopausal period. Expression of aromatase was detected in patients of various age, with large or small uterine myomas, using an immunohistochemical technique. In addition expression of the enzyme was examined at the periphery of every myoma.

Edyta Bogunia

2010-02-01

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Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis  

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To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 ± 0.7, which was significantly lower than that of group A, 8.2 ± 0.7 (p0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

2011-05-01

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Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis  

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To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 {+-} 0.7, which was significantly lower than that of group A, 8.2 {+-} 0.7 (p<0.05). The mean dose of intravenous pethidine was 114.3 {+-} 59.5 mg in group A and 90.5 {+-} 49.0 mg in group B, while the incidence of nausea was 67% in group A and 77% in group B. In both cases, the differences were not significantly different (p>0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

Song, Suk Yun; Kang, Byung Chul; Rho, Kyung Min [Dept. of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

2011-05-15

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Uterine volume and endometrial thickness in the early follicular phase in patients with polycystic ovary syndrome.  

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Objective: We aimed to evaluate uterine volume and endometrial thickness during the early follicular phase in patients with polycystic ovary syndrome (PCOS) and healthy controls.Methods: We studied 1,016 PCOS patients and 182 healthy controls. The anthropometric, endocrine, and metabolic characteristics of PCOS were determined. Uterine volume and endometrial thickness were also recorded.Results: Uterine volume progressively increased with age both in PCOS patients and controls. Patients with PCOS and body mass index (BMI) ?25 kg/m2 had greater uterine volumes than PCOS patients with BMI PCOS phenotypes (i.e., with oligo-ovulation and/or anovulation [ANOV] and hyperandrogenemia [HA] with or without polycystic ovaries [PCO]) had smaller uterine volume than PCOS patients with the additional phenotypes introduced by the Rotterdam criteria (i.e., with PCO and either ANOV or HA; P = .033) and controls (P = .045).Conclusion: Uterine volume increases progressively with age and obesity in PCOS patients. The smaller uterine volumes and endometrial thicknesses in the classic PCOS phenotypes might be attributed to the more severe HA of these patients. PMID:24325993

Panidis, Dimitrios; Tziomalos, Konstantinos; Papadakis, Efstathios; Vosnakis, Christos; Betsas, Georgios; Tsourdi, Ekaterini; Katsikis, Ilias

2014-06-01

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Decidualized Human Endometrial Stromal Cells Mediate Hemostasis, Angiogenesis, and Abnormal Uterine Bleeding  

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Factor VII binds trans-membrane tissue factor to initiate hemostasis by forming thrombin. Tissue factor expression is enhanced in decidualized human endometrial stromal cells during the luteal phase. Long-term progestin only contraceptives elicit: 1) abnormal uterine bleeding from fragile vessels at focal bleeding sites, 2) paradoxically high tissue factor expression at bleeding sites; 3) reduced endometrial blood flow promoting local hypoxia and enhancing reactive oxygen species levels; and ...

Lockwood, Charles J.; Krikun, Graciela; Hickey, Martha; Huang, S. Joseph; Schatz, Frederick

2009-01-01

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Endometrial carcinoma in a 15-year-old obese patient with persistent uterine bleeding.  

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Endometrial carcinoma is the most common malignancy of the upper female genital tract but is rare in teenagers. Here, we report the case of a 15-year-old, nulliparous, morbidly obese female with complaints of asthenia and menometrorrhagia lasting for six months. On examination, the patient had an enlarged uterus approximately 14 gestational weeks in size, and ultrasound revealed an intrauterine mass and polycystic ovaries. An endometrial biopsy performed during hysteroscopy revealed endometrioid adenocarcinoma, and magnetic resonance imaging showed myometrial invasion. The patient underwent a laparotomy involving total abdominal hysterectomy, right salpingo-oophorectomy, wedge-shape dissection of the left ovary, and pelvic and para-aortic lymphadenectomy. We analyze the pathogenesis of endometrial carcinoma in this case and discuss the risk factors for endometrial carcinoma, especially in young women. Gynecologists should be vigilant for persistent abnormal uterine bleeding and other signs of endometrial carcinoma in young women, especially those who have risk factors for the disease. PMID:24456540

Liu, Guoyan; Wang, Yingmei; Zhang, Xuhong; Yuan, Bibo; Han, Cha; Xue, Fengxia

2014-04-01

50

Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding  

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Full Text Available Background/Aim. The prevalence of endometrial polyps (EPs in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma, patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204 and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7. Results. In 211 (21.94% patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94% EPs, 29 (13.74% EPs with hyperplasia without atypia, 5 (2.37% EPs with atypical hyperplasia, and 2 (0.95% EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A, patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B were older (p < 0.05, and more commonly postmenopausal (p < 0.05 and with hypertension (p < 0.05, all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

?or?evi? Biljana

2008-01-01

51

A study of differential diagnosis of uterine endometrial pathologies with MR imaging in postmenopausal women  

International Nuclear Information System (INIS)

In postmenopausal women, the usefulness of the thickness and the organic changes of the endometrium obtained in MRI were investigated in the diagnosis of uterine cancer. A total of 129 study subjects were selected from the postmenopausal women, consisting of 72 cases of control group (C-group) having no endometrial hyperplasia or uterine cancer, 12 cases of endometrial hyperplasia group (EH-group) and 45 cases of uterine body cancer group (Ca-group), which were confirmed by histological diagnosis during the period from 1996 to 2001. Women with submucous myomata or endometrial polyp were excluded form the subjects. With the T2-weighted MRI, the thickness and heterogeneity of the endometrium (evaluated by comparisons with heterogeneity in the signal of bladder content), and the intensity of endometrial signal (classified by rating ''high'', ''intermediate'' or ''low'' in comparison with intracystic signal intensity) were comparatively examined. To determine cut-off values for differentiation of disease-free from EH, and for that of EH from cancer, analyses with receiver-operating characteristic (ROC) curve were performed. The endometrial thickness (mm, M±SD) in the Ca-group (24.6±17.2) was significantly greater than that in the C-group (3.0±1.2) or EH-group (6.9±5.3). ROC curve analyses revealed cut-off value for differentiating EH from disease-free was 4 mm, and that for EH from cancer was 10 mm. The, endometrial thickness in the EH-group tended to increase compared to that in the C-group, while there were no significant differences in endometrial heterogeneity and signal intensity between these groups. In the Ca-group, there were significantly more cases (77.8%) showing endometrial heterogeneity compared to those in the C-group (0%) or EH-group (9.3%). The percentage of the cases showing a ''low'' endometrial signal intensity was found to be significantly higher in the Ca-group (48.9%) compared to those in the C-group (0%) or EH-group (0%), and the same was observed in any clinical stage in the Ca-group. The endometrial thickness in the Ca-group was examined at different clinical stages, showing an increasing trend with the progress of clinical stage, while significant differences in the endometrial heterogeneity and signal intensity between the Ca-group and C- or EH-group were observed from an early period of clinical stage. The present study revealed that there are qualitative and quantitative differences in MRI findings of endometrium and/or myometrium between in patients with uterine cancer and in those with endometrial hyperplasia or with uterine pathologies other than endometrial cancer. This suggests the usefulness of MRI for the differential diagnosis of endometrial disorders. Endometrium thickness over 10 mm, heterogeneity in endometrial signal intensity, and ''low'' signal intensity of endometrial tissue in T2 weighted MRI would be useful criteria for screening diagnosis of endometrial cancer in postmenopausal women. (authors)

2005-02-01

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Comparison of Office Hysteroscopy, Transvaginal Ultrasonography and Endometrial Biopsy in Evaluation of Abnormal Uterine Bleeding  

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This is a prospective, observational study that utilizes hysteroscopy as the “gold standard” for evaluation of transvaginal ultrasound and endometrial biopsy in the detection of intrauterine pathology. The sensitivity and specificity for detecting focal intrauterine lesions are examined in order to suggest the most cost-effective approach in patients with abnormal uterine bleeding.

Pal, Lubna; Lapensee, L.; Toth, T. L.; Isaacson, K. B.

1997-01-01

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Endometrial Exosomes/Microvesicles in the Uterine Microenvironment: A New Paradigm for Embryo-Endometrial Cross Talk at Implantation  

Science.gov (United States)

Exosomes are nanoparticles (?100 nm diameter) released from cells, which can transfer small RNAs and mRNA via the extracellular environment to cells at distant sites. We hypothesised that exosomes or the slightly larger microvesicles (100–300 nm) are released from the endometrial epithelium into the uterine cavity, and that these contain specific micro (mi)RNA that could be transferred to either the trophectodermal cells of the blastocyst or to endometrial epithelial cells, to promote implantation. The aim of this study was to specifically identify and characterise exosomes/microvesicles (mv) released from endometrial epithelial cells and to determine whether exosomes/mv are present in uterine fluid. Immunostaining demonstrated that the tetraspanins, CD9 and CD63 used as cell surface markers of exosomes are present on the apical surfaces of endometrial epithelial cells in tissue sections taken across the menstrual cycle: CD63 showed cyclical regulation. Exosome/mv pellets were prepared from culture medium of endometrial epithelial cell (ECC1 cells) and from uterine fluid and its associated mucus by sequential ultracentifugation. Exosomes/mv were positively identified in all preparations by FACS and immunofluorescence staining following exosome binding to beads. Size particle analysis confirmed the predominance of particles of 50–150 nm in each of these fluids. MiRNA analysis of the ECC1 cells and their exosomes/mv demonstrated sorting of miRNA into exosomes/mv: 13 of the 227 miRNA were specific to exosomes/mv, while a further 5 were not present in these. The most abundant miRNA in exosomes/mv were hsa-miR-200c, hsa-miR-17 and hsa-miR-106a. Bioinformatic analysis showed that the exosome/mv-specific miRNAs have potential targets in biological pathways highly relevant for embryo implantation. Thus exosomes/mv containing specific miRNA are present in the microenvironment in which embryo implantation occurs and may contribute to the endometrial-embryo cross talk essential for this process.

Ng, York Hunt; Rome, Sophie; Jalabert, Audrey; Forterre, Alexis; Singh, Harmeet; Hincks, Cassandra L.; Salamonsen, Lois A.

2013-01-01

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ASSESSMENT OF ENDOMETRIAL-SUBENDOMETRIAL BLOOD FLOW DETECTED BY COLOR DOPPLER SONOGRAPHY AND UTERINE RECEPTIVITY IN INFERTILE WOMEN  

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"nndometrial vasculature has been shown to play an important role in the early endometrial response to the implanting blastocyst, and vascular changes may contribute to uterine receptivity. The aim of this study was to investigate the role of endometrial and subendometrial vascularity and thickness in uterine receptivity in infertile women treated with assisted reproductive technologies (ART). A total of 175 women were recruited from our ART program from June 2005 to May 2006. In the fir...

Aghahoseini, M.; Tuba, K.; Marsousi, V.; Aleyasin, A.

2008-01-01

55

Simultaneous uterine leiomyoma and endometrial hiperplasia in a white-nosed monkey (cercopithecus nictitans). First case report  

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This paper describes histopathological and immunocytochemical features of a combined uterine leyomioma and a non atypical complex endometrial hyperplasia in a white-nosed monkey (Cercopithecus nictitans). Immunocytochemically, uterine leiomyoma was a-actin positive, and negative for desmin. By the other hand, endometrial hyperplasia showed strong immunoreaction against ciclin D1, cyclooxygenase-2 (COX-2), oestrogen receptor, isoform A of progesterone receptor and slight p53 immunoreaction. Th...

Marti?nez, Carlos M.; Iba?n?ez, Carla; Corpa, Juan M.

2010-01-01

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Endometrial oxytocin receptor and uterine prostaglandin secretion in mares during the oestrous cycle and early pregnancy.  

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Circulating concentrations of 13,14-dihydro-15-ketoprostaglandin F2 alpha (PGFM) were measured before and after administration of oxytocin and after endometrial biopsy, with or without uterine flushing performed per vaginam, on days 10, 14 and 18 after ovulation in nine pregnant and nine cyclic mares. Concentrations of oxytocin receptor were measured in endometrial biopsy samples. Neither pregnancy status nor time after ovulation affected basal PGFM concentrations. PGFM concentrations were increased after oxytocin administration on each of the days studied in cyclic mares; on day 14 the mean response was 4.5 times higher than the mean response on days 10 and 18. In contrast, during pregnancy, responses to oxytocin administration occurred only on days 10 and 18. Marked increases in PGFM concentrations in response to endometrial biopsy occurred only on day 14 in cyclic mares and on day 18 in pregnant mares. Mean concentrations of oxytocin receptor were between 200 and 300 fmol mg-1 protein on day 10 in both pregnant and cyclic mares; in cyclic mares oxytocin receptor concentrations were increased approximately threefold on day 14 compared with days 10 and 18, but no such increase was evident during pregnancy. Total amounts of PGFM secreted after oxytocin treatment correlated with endometrial oxytocin receptor concentrations in cyclic (P 0.5) mares, and the same was true for PGFM release induced by endometrial biopsy (cyclic: P = 0.0025; pregnant: P > 0.5). The data support the hypothesis that endometrial concentrations of oxytocin receptor determine uterine prostaglandin F2 alpha secretion in cyclic mares and that endometrial oxytocin receptor concentrations are reduced in early pregnancy by a product of the conceptus. The increase in response of the pregnant uterus to oxytocin treatment or biopsy-flushing between days 14 and 18 was not due to an increase in the concentration of oxytocin receptors but presumably reflected increased receptor sensitivity. PMID:9861156

Starbuck, G R; Stout, T A; Lamming, G E; Allen, W R; Flint, A P

1998-07-01

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Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium  

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Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD) and lipid hydroperoxides (LOOH) in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. T...

Snežana Peji?; Ana Todorovi?; Vesna Stojiljkovi?; Dragana Cvetkovi?; Nenad Lu?i?; Ratko M. Radoji?i?; Zorica S. Sai?i?; Pajovic, Snez?ana B.

2008-01-01

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Analysis of 258 cases of uterine endometrial carcinoma in 18 years  

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We investigated 258 cases of uterine endometrial cancer diagnosed and treated from 1980 through 1997 at our institution. Disease outcome, adjuvant therapies, and histologic features were analyzed. Patients' ages ranged from 20 to 90 years (mean, 57.0{+-}10.8 years). The 5-year survival rates were 97.5% for stage I disease, 81.7% for stage II disease, 69.8% for stage III disease, and 0% for stage IV disease. Patients with stage III disease who received both chemotherapy and radiation therapy as adjuvant therapies survive slightly, but not significantly, longer than did patients who received chemotherapy alone or radiation alone or no adjuvant therapy. The 136 patients (59.9%) with well-differentiated (G1) endometrioid carcinomas were significantly younger (mean age, 55.9{+-}10.3 years) than the 58 (25.6%) patients with moderately differentiated carcinomas (G2, 59.9{+-}10.4 years, p=0.01) and the 33 patients (14.5%) with poorly differentiated (G3, 59.9{+-}8.2 years, p=0.04) endometrioid carcinomas. The 60 cases of endometrial carcinoma from 1994 through 1997 were examined to determine whether endometrial hyperplasia and adenocarcinoma coexist. Endometrial hyperplasia was present in 23 (38%) of the 60 cases. The patients with both endometrial hyperplasia and adenocarcinoma were significantly younger (mean age, 47.7{+-}10.9 years) than the patients with endometrial adenocarcinoma alone (mean age, 59.5{+-}9.5 years, p<0.001). (author)

Akutagawa, Noriyuki; Nishikawa, Akira; Saito, Tsuyoshi; Sagae, Satoru; Kudo, Ryuichi [Sapporo Medical Coll. (Japan)

1999-12-01

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Chromohysteroscopy—A new technique for endometrial biopsy in Abnormal Uterine Bleeding (AUB  

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Full Text Available Objective: To evaluate the role of chromohysteroscopy in improving diagnostic accuracy of endometrial biopsy in cases of AUB. Design: Cross sectional interventional study. Materials and Methods: This study was conducted on 60 women with AUB in Dept. of Obst. & Gyne at King George Medical University, Lucknow over a period of one year. All cases underwent diagnostic hysteroscopy followed by chromohysteroscopy using 2% methylene blue dye. Hysteroscopic guided biopsy was taken from stained and unstained areas followed by an endometrial aspiration biopsy from whole uterine cavity. The histopathology results of three samples were compared and analyzed in relation with staining pattern and type of AUB. Data analysis was done on SPSS version 15 of windows 2007. Results: Out of 60 cases, 11cases were found to have non hormonal pathology after chromohysterosopic biopsy. Eight (72.72% cases were diagnosed by stained endometrial tissue, one (9.09% by unstained tissue and three (27.27% by endometrial aspiration. The diagnostic ability of stained tissue biopsy was significantly higher (p = 0.006 than unstained biopsy and endometrial aspiration. Conclusion: Chromohysteroscopy is a simple and effective technique for diagnosing endometrial pathology in cases of AUB.

Bharti Singh

2013-07-01

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Assisted reproductive technologies and uterine factors influencing their success.  

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Congenital and acquired uterine factors are known to influence the success of assisted reproductive technologies (ARTs). Several studies analyzed the role of uterine septa, adenomyosis, myomas, endometrial polyps and intrauterine adhesions in female infertility. All of them might cause defective endometrial receptivity and consequently decreased embryo implantation and pregnancy rate. In particular, septate uterus represents the most frequent Müllerian anomaly leading to an increased risk of abortion. Many studies evaluated the role of hysteroscopic metroplasty on fertility outcomes, but this topic remains controversial. The role of adenomyosis in infertility is still debated and, even if different mechanisms have been described to explain implantation failure, there are still conflicting findings on the impact of adenomyosis on ART. The effects of myomas on fertility mainly depend on their type, so that submucous have a detrimental impact on fertility, subserous seem to have no effect, while there is no clear consensus regarding the effect of intramural. Consequently, the potential influence of myomectomy on fertility outcomes depends on the type, being mandatory only the hysteroscopic treatment of submucous myomas. The effect of endometrial polyps on endometrial receptivity and fertility is not clear, even if some studies identified improvement in pregnancy rates after hysteroscopic polipectomy. In presence of intrauterine adhesions, infertility represents the most common manifestation and the restoring of normal uterine cavity should be always pursued when possible. PMID:24096288

Savasi, V; Leone, F P G; Fusè, F; Parisi, F; Cetin, I

2013-10-01

 
 
 
 
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Diagnostic Value of Endometrial Sampling with Pipelle Suction Curettage for Identifying Endometrial Lesions in Patients with Abnormal Uterine Bleeding  

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Full Text Available Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. Results: The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. Conclusions: The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C. Keywords: Pipelle Suction Curette, Dilatation and Curettage, Premenopause, Postmenopause.

F Behnamfar

2004-06-01

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Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding  

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Full Text Available Background and Objectives: We compared endometrial sampling by pipelle endometrial curette with Conventional dilatation and curettage (D&C in patients with abnormal uterine bleeding. Methods: Endometrial sampling with pipelle curette was performed on 100 patients followed by formal D&C. Samples were labeled as A and B, respectively, and sent to a histopathologist who was blinded as to the method of sampling. The histopathology reports of both samples were compared, taking D&C as the gold standard. Results: An adequate sample was obtained in 98% of cases by pipelle and in 100% of cases by D&C. Pipelle had a sensitivity, specificity, positive predictive value and negative predictive value of 100% for diagnosing endometrial carcinoma, hyperplasia and secretory endometrium. Pipelle also had high diagnostic sensitivity, specificity and negative predictive value (100%, 98% and 100%, respectively for hyperplasia with atypia, and low sensitivity (57% and positive predictive value (57%, but high specificity (97% and negative predictive value (97% for endometritis. Similarly, for proliferative endometrium, the pipelle technique had values of 94% and 93% for sensitivity and specificity, respectively. Both samples labeled as inadequate for histology by pipelle were polyps on the D&C report. Difficult endotracheal intubation was encountered in two cases of D&C. No other complications of the procedure were observed. Conclusion: The pipelle is a safe device for getting an adequate endometrial sample for histology, with a high sensitivity and specificity for detection of hyperplasia and malignancy.

Fakhar Shazia

2008-01-01

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Study of the Impact of Uterine Artery Embolization (UAE) on Endometrial Microvessel Density (MVD) and Angiogenesis  

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PurposeTo investigate the influence of uterine artery embolization (UAE) on endometrial microvessel density (MVD) and angiogenesis.MethodsSixty female guinea pigs were divided into two groups, the control group (n = 15) and the UAE treatment group (n = 45). In the UAE group, tris-acryl gelatin microspheres were used to generate embolization. Animals were further divided into three subgroups, A1, A2, and A3 (n = 15 for each subgroup), with uterine specimens collected at 7-15, 16-30, and 31-45 days after UAE, respectively. Immunostaining for factor VIII and CD105 was performed to identify total endometrial MVD (MVD{sub FVIII}) and CD105-positive angiogenesis (MVD{sub CD105}) at the indicated time points after UAE.ResultsQuantitative analysis revealed that MVD{sub FVIII} significantly decreased in the A1 (11.40 {+-} 2.76, p < 0.05) and A2 (15.37 {+-} 3.06, p < 0.05) groups compared to the control group (19.40 {+-} 2.50), and was restored to normal in the A3 group (18.77 {+-} 2.69). UAE caused a temporal up-regulation of MVD{sub CD105}-positive angiogenesis in the A1 group (9.33 {+-} 2.37, p < 0.05) and the A2 group (11.63 {+-} 1.56, p < 0.05) compared to the control group (7.12 {+-} 1.67), and the MVD{sub CD105} value returned to normal in the A3 group (8.07 {+-} 1.97).ConclusionUAE caused a temporal decrease in endometrial MVD that reversed over time as a result of the increase of CD105-positive angiogenesis. Although the UAE-induced reduction of endometrial MVD was reversible, its long-term effect on endometrial receptivity still needs further study.

Tan Guosheng; Xiang Xianhong; Guo Wenbo; Zhang Bing; Chen Wei; Yang Jianyong, E-mail: kerisgz@126.com [The First Affiliated Hospital of Sun Yat-sen University, Department of Interventional Radiology (China)

2013-08-01

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Atypical Polypoid Adenomyoma (APAM of the Uterine: Relationship with Endometrial Cancer  

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Full Text Available Atypical polypoid adenomyoma (APAM is a rare polypoid tumor that generally occurs in women of reproductive age who have abnormal genital bleeding. The tumor was reported as a new disease concept by Mazur in 1981. Pathologically, APAM consist of irregularly proliferated endometrial gland cells and interlacing bundles of smooth muscle cells within the stroma, and have a similar form to adenocarcinoma, adenofibroma, adenosarcoma, and carcinosarcoma. Therefore, differential diagnosis is required in many cases. APAM is pathologically classified as a benign lesion and clinically has a comparatively favorable outcome. However, treatment and follow-up observation should be performed carefully because recurrence and residual lesions occur in many patients after conservative treatment. Concomitant development of endometrial adenocarcinoma also occurs in many cases and it is difficult to differentiate this disease from APAM. Thus, diagnosis of APAM should be made carefully, particularly since the number of cases of endometrial adenocarcinoma has increased in recent years. Furthermore, APAM tends to develop during a woman’s reproductive years, and fertility sparing treatment should be considered. Here, we review the clinicopathological characteristics of APAM, including the difficulty of diagnosis as a benign or malignant uterine tumor, and we examine the relationship between APAM and endometrial cancer.

Iori Kisu

2011-10-01

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Endometrial curettage in abnormal uterine bleeding and efficacy of progestins for control in cases of hyperplasia.  

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Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasia and endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patients who underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia. Materials and Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 for AUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasia were treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetate continuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles by repeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conducted using the chi-square test. Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186 had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%), 6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma (1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonal therapy. Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significant regression even in females with atypical hyperplasia. PMID:24870785

Mesci-Haftaci, Simender; Ankarali, Handan; Yavuzcan, Ali; Caglar, Mete

2014-01-01

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Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study.  

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Background: Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology. Aim: To study the clinicopathological spectrum of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. Material and Methods: The study included prospective analysis of 119 cases of endometrial samples in patients of abnormal uterine bleeding above 40 years of age. The specimens were routinely processed and H&E stained slides were studied. Patients were categorized into peri-menopausal (40-49 years) and post-menopausal (> 50 years) age group. Results: A total of 119 specimens of endometrium were analyzed. Maximum number (73.94%) of cases were from peri-menopausal age group. The most common presenting complaint was menorrhagia (48.86%) followed by post-menopausal bleeding (26.05%). In peri-menopausal age group proliferative endometrium (35.22%) was the predominant histopathological pattern followed by endometrial hyperplasia (23.86%). Atrophic endometrium (25.80%) was the most frequent finding followed by endometrial hyperplasia (19.35%) in post-menopausal age group. Three cases of endometrial carcinoma were reported in post-menopausal age group only. Conclusion: A thorough histopathological work up and clinical correlation is mandatory in cases of abnormal uterine bleeding above the age of 40 years to find out organic lesions. Careful screening can detect early cancer of endometrium which has excellent prognosis and it will help in further management. PMID:24551634

Damle, Rajshri P; Dravid, N V; Suryawanshi, Kishor H; Gadre, Arundhati S; Bagale, Priya S; Ahire, Neelam

2013-12-01

67

How should painful cystic degeneration of myomas be managed during pregnancy? a case report and review of the literature  

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Full Text Available Background: Uterine myomas are common pelvic masses during pregnancy. The pain and rapid growth of myomas are among the most common complications during pregnancy. We evaluate management of painful cystic degeneration of myomas during pregnancy.Case: A 27-year-old primigravida had a pelvic mass. We have managed a case in which the diagnosis of cystic degeneration of uterine myomas could not be easily differentiated from an ovarian torsion or carcinoma. Differentiation between degenerative pain of the myoma and an ovarian malignancy or torsion was necessary. A complete aspiration of the cystic changes of the uterine myoma was performed without performing a myomectomy.Conclusion: We report a good result of aspiration of a cystic uterine myoma during pregnancy with a review of the literature published for twenty years since 1 January 1988

Hae-Hyeog Lee

2011-01-01

68

Factors associated with uterine endometrial hyperplasia and pyometra in wild canids: implications for fertility.  

Science.gov (United States)

The ability to safely and effectively manage reproduction is central to the success of AZA captive-breeding programs. Although the AZA Wildlife Contraception Center routinely monitors contraceptive safety, there have been no studies that compare the effects of contraceptive use to separation of males from females, the other option for preventing reproduction. We used retrospective medical records and pathology reports submitted by AZA and related facilities for the seven AZA-managed canid species to assess rates of uterine pathology relative to female reproductive life histories. Our results showed that the prevalence of both pyometra and endometrial hyperplasia (EH) was associated not only with treatment with the two most common contraceptives (Suprelorin® and MGA implants) but also with the number of years barren (i.e., not producing a litter and not contracepted). Rates of pyometra and EH were especially high in African painted dogs and red wolves, but lowest in swift and fennec foxes. The number of years producing a litter had a low association, suggesting it could be protective against uterine pathology. A more recently developed Suprelorin® protocol using Ovaban® to prevent the initial stimulation phase, followed by implant removal when reversal is desired, may be a safer contraceptive option. These results concerning the relationship between reproductive management and uterine health have important implications for AZA-managed programs, since the unsustainability of many captive populations may be due at least in part to infertility. Managing a female's reproductive lifespan to optimize or maintain fertility will require a reconsideration of how breeding recommendations are formulated. PMID:23553688

Asa, Cheryl S; Bauman, Karen L; Devery, Sarah; Zordan, Martín; Camilo, Gerardo R; Boutelle, Sally; Moresco, Anneke

2014-01-01

69

Uterine-sparing surgery for adenomyosis and/or adenomyoma.  

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Adenomyosis of the uterus is defined as the presence of endometrial tissue, including glands and stroma, situated at least 2.5 mm below the endometrial-myometrial junction and widely distributed within the myometrium layer of the uterus. There is no consensus on the appropriate treatment for symptomatic uterine adenomyosis in women who want to preserve their uterus, partly because adenomyosis is somewhat enigmatic in diagnosis and owing to its clinical significance. Hysterectomy, through either exploratory laparotomy or minimally invasive procedures, is a definite treatment for uterine adenomyosis, once the women have completed childbirth or do not require future fertility. However, many women with a uterine pathology still have a strong desire to preserve the uterus, for which conservative and uterine-sparing procedures are increasingly used, and with which fertility preservation or quality-of-life improvement can be achieved. Although medical management can be effective, similar to the management of uterine fibroids (myoma), its effect is often transient and rapid regrowth of adenomyosis and relapse of symptoms and signs always occur once the treatment is stopped. Therefore, other strategies should be selected. Conservative and uterine-sparing surgery might be one of the most familiar procedures of these uterine-sparing procedures. In this article, the latest knowledge and research evidence on uterine-sparing surgery for uterine adenomyosis are reviewed. PMID:24767637

Horng, Huann-Cheng; Chen, Ching-Hui; Chen, Chih-Yao; Tsui, Kuan-Hao; Liu, Wei-Min; Wang, Peng-Hui; Chang, Wen-Hsun; Huang, Ben-Shian; Sun, Hsu-Dong; Chang, Ting-Chang; Chang, Wei-Chun; Yen, Ming-Shyen

2014-03-01

70

Hysteroscopic endometrial resection: efficacy and factors for failure  

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Full Text Available Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation in women with abnormal benign uterine bleeding resistant to clinical treatment, and to identify factors potentially related to its failure. Methods: Ninety patients with abnormal benign uterine bleeding were retrospectively evaluated. They were submitted to endometrial ablation between January 2000 and August 2003. Their mean age was 44.3 years and their average parity was 2.3 childbirths. All patients had been given gonadotrophin-releasing hormone analogues prior to surgery, to make the procedure easier. Rresults: After surgery, amenorrhea occurred in 20% of cases, hypomenorrhea in 30%, and eumenorrhea in 32.2%. In 17.8% of patients, the procedure failed. No intra or postoperative complications occurred. There was no statistically significant difference between the patients in which the ablation failed and those in which it was successful regarding mean age (p = 0.557, parity (p = 0.891, presence of intramural myoma (p= 0.29, submucosal myoma (p = 0.68 or endometrial polyps (p = 0.76. A significant difference between the two groups was observed with regard to the uterine size median (7  cm in the successful group and 9 cm in the failure group, p  = 0.008. A statistically significant difference was also found in follow-up time: 13 months in the first group and nine months in the second group (p = 0.001. Cconclusions: Endometrial ablation is a good treatment method for abnormal uterine bleeding of benign etiology. Special attention must be paid to patients with increased uterine size, since failure is more frequent in these cases.

Geraldo Rodrigues de Lima

2008-09-01

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A Comparison of Endometrial Biopsy, Transvaginal Ultrasonography and Dilation and Curettage in Diagnosis of Abnormal Uterine Bleeding  

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Background: Abnormal uterine bleeding (AUB) is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C) which is the current gold standard procedure. Methods: A prospective-descriptive study was con...

Ghanbari, Z.; Hajibaratali, B.; Fazaeli, M.; Mehdizadeh, P.; Dadyar, M.

2006-01-01

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A Comparison of Endometrial Biopsy, Transvaginal Ultrasonography and Dilation and Curettage in Diagnosis of Abnormal Uterine Bleeding  

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Full Text Available Background: Abnormal uterine bleeding (AUB is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C which is the current gold standard procedure. Methods: A prospective-descriptive study was conducted on fifty patients referred to our center for refractory abnormal uterine bleeding who were candidates for hysterectomy. All patients underwent endometrial biopsy and transvaginal ultrasonography , followed by D&C as a Gold standard procedure in operating room just before surgery. Results: Mean age of patients was 46.62 years. Transvaginal utrasonography offered a sensitivity of 70% and specificity of 68% demonstrating the lowest numbers compared to D&C. Endometrial biopsy had a sensitivity of 70% and specificity of 75% that was better than sonography alone. Conclusion: D&C was the most useful and valuable procedure and addition of endometrial biopsy with transvaginal ultrasonography will not be of high value in diagnosis.

M. Dadyar

2006-07-01

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ASSESSMENT OF ENDOMETRIAL-SUBENDOMETRIAL BLOOD FLOW DETECTED BY COLOR DOPPLER SONOGRAPHY AND UTERINE RECEPTIVITY IN INFERTILE WOMEN  

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Full Text Available "nndometrial vasculature has been shown to play an important role in the early endometrial response to the implanting blastocyst, and vascular changes may contribute to uterine receptivity. The aim of this study was to investigate the role of endometrial and subendometrial vascularity and thickness in uterine receptivity in infertile women treated with assisted reproductive technologies (ART. A total of 175 women were recruited from our ART program from June 2005 to May 2006. In the first stage, down regulation was done using GnRH-a and then ovarian hyperstimulation was initiated with human menopausal gonadotrophin and in vitro fertilization (IVF procedures were performed. Then, the endometrial-subendometrial blood flow distribution pattern was determined by color Doppler ultrasonography and its characteristics were compared between pregnant (n = 56 and non-pregnant (n = 119 women.  Zones 1, 2 and 3 of vascular penetration were found in 15.4%, 22.3%, and 62.3% of patients, respectively. The number of implanted embryos was 62 and implantation rate was 11.61%. There was no significant association between implantation rate and endometrial thickness or zone of vascular penetration. Among all women, fertility occurred in 56 (32.2% women. Zone 1 of vascular penetration was found in 10.71% and 10.08% (P = 0.898, zone 2 in 16.07% and 13.44% (P = 0.643, and zone 3 in 41.07% and 41.17% (P = 0.989 of pregnant and non-pregnant groups, respectively. Endometrial-subendometrial blood flow (according the findings of Doppler ultrasonography in women undergoing ART could not predict endometrial receptivity and IVF outcome.

M Aghahoseini

2008-12-01

74

Antioxidant enzymes and lipid peroxidation in endometrium of patients with polyps, myoma, hyperplasia and adenocarcinoma  

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Full Text Available Abstract Background Oxidative stress and impaired antioxidant system have been proposed as a potential factors involved in the pathophysiology of diverse disease states, including carcinogenesis. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of gynecological diseases in order to evaluate the antioxidant status in endometrium of such patients. Methods Endometrial tissues of gynecological patients with different diagnoses were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and lipid hydroperoxides. Results Superoxide dismutase activity was significantly decreased (50% in average in hyperplastic and adenocarcinoma patients. Activities of both glutathione peroxidase and glutathione reductase were increased 60% and 100% on average, in hyperplastic patients, while in adenocarcinoma patients only glutathione reductase activity was elevated 100%. Catalase activity was significantly decreased in adenocarcinoma patients (47%. Lipid hydroperoxides level was negatively correlated to superoxide dismutase and catalase activities, and positively correlated to glutathione peroxidase and glutathione reductase activities. Conclusions This study provided the first comparison of antioxidant status and lipid peroxidation in endometrial tissues of patients with polyps, myoma, hyperplasia and adenocarcinoma. The results showed that patients with premalignant (hyperplastic and malignant (adenocarcinoma lesions had enhanced lipid peroxidation and altered uterine antioxidant enzyme activities than patients with benign uterine diseases, polyps and myoma, although the extent of disturbance varied with the diagnosis. Further investigation is needed to clarify the mechanisms responsible for the observed alterations and whether lipid hydroperoxide levels and antioxidant enzyme activities in uterus of gynecological patients might be used as additional parameter in clinical evaluation of gynecological disorders.

Pajovi? Snežana B

2009-12-01

75

Decreased expression of survivin, estrogen and progesterone receptors in endometrial tissues after radiofrequency treatment of dysfunctional uterine bleeding  

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Full Text Available Abstract Background The purpose of the research is to study the histopathology and expression of survivin, estrogen and progesterone receptors (ER/PR in the endometrium of patients with dysfunctional uterine bleeding (DUB treated with radiofrequency endometrial ablation (REA. Methods A total of 98 DUB patients were enrolled in this case–control study. Among them, 66 underwent REA treatment and 32 optioned for hormone therapy as the control group. Immunohistochemical analysis for survivin, ER and PR expression was carried out on endometrial tissue samples collected before and 6 to 7?months after treatment for both groups. Results Both hormone and REA treatment ameliorated menstrual bleeding of DUB patients, with the latter showing a significantly higher effective rate. Endometrial surface tissue was replaced by fibrosis tissue in the REA treatment group. REA treatment also significantly reduced the expression of survivin, ER, and PR. Endometrial surface tissues collected from the hormone-treated control group neither showed any apparent morphological alteration nor in the expression of those receptors. Conclusions REA treatment changed endometrial surface tissue type from gland rich to gland poor, and significantly decreased the expression of survivin, ER, and PR. This may be an important contributing mechanism for the long-term curative effect and prevention of DUB recurrence.

Yin Geping

2012-06-01

76

Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI  

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A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from endometrial cancer clinically presenting as cervical myoma is rare. This case suggests that poorly differentiated endometrial cancer may extend into the cervix, presenting as cervical myoma, and the possibility of a metastatic mass should be considered in the differential diagnosis when dealing with cervical myoma

2012-09-01

77

Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI  

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A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from endometrial cancer clinically presenting as cervical myoma is rare. This case suggests that poorly differentiated endometrial cancer may extend into the cervix, presenting as cervical myoma, and the possibility of a metastatic mass should be considered in the differential diagnosis when dealing with cervical myoma.

Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

2012-09-15

78

Laser-induced interstitial thermotherapy (LITT) for treatment of uterine leiomyomas: 750 myomas were treated by LITT and the results over a five-year period are analyzed  

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Approximately 750 leiomyomas of 250 symptomatic patients were treated by LITT over a five-year period. Only 12% were lost to follow-up. Most were treated by a combination of the KTP/YAG laser, rarely by one or the other alone, and a few with the diode laser. The fiber optic was inserted 2 cm apart and, depending on the size of the tumor, 480 - 20,000 Joules were required. Most were treated laparoscopically but very large myomas were treated percutaneously under ultrasound control. Symptoms were nearly always relieved and the six failures were found to be due to unrecognized adenomyosis and other associated pathology. Half the patients complaining of infertility became pregnant and, in those whose only pathology had been leiomyomas it approached 90%. Vaginal delivery was not found to be contraindicated. Finally, oestrogen receptors and epidermal growth factor were found to be destroyed. It is concluded that LITT enables leiomyomas of all sizes and locations to be treated by a minimally invasive method with preservation of the uterus.

Chapman, Roxana

1997-05-01

79

Sequential MR images of uterus after Gd-DTPA injection; Studies of normal volunteers and uterine endometrial malignant tumors  

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To investigate the sequential changes in signal intensity (SI) of normal and abnormal uteri, T1-weighted images were taken repeatedly after the injection of Gd-diethylenetriaminepentaacetic acid (DTPA). Six volunteers and 19 patients with known uterine body malignancy (18 carcinomas, one carcinosarcoma) were examined. The results in volunteers were as follows. In the secretory phase, SI of the endometrium was stronger in the late images than in the early ones, whereas in the proliferative phase, SI was stronger in the early images. SI of the myometrium decreased rapidly and there were no differences in SI between menstrual phases. In 17 of 18 endometrial carcinomas, the tumors showed hypointensity relative to the myometrium, and the contrast between the tumor and the myometrium was better in the early images. In the remaining two cases, the tumor showed hyperintensity and the contrast was better in the late images. After the injection of Gd-DTPA, the endometrium appeared differently according to the menstrual cycle in normal volunteers, and the appearance of uterine structures and endometrial malignant tumors changed sequentially. These findings must be kept in mind when evaluating uterine diseases by Gd-DTPA enhanced MRI. (author).

Okada, Susumu; Kato, Tomoyasu; Yamada, Keiko; Sawano, Seishi; Yamashita, Takashi; Hirai, Yasuo; Hasumi, Katsuhiko (Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital)

1993-03-01

80

Differential endometrial cell sensitivity to a cholesterol-dependent cytolysin links Trueperella pyogenes to uterine disease in cattle.  

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Purulent disease of the uterus develops in 40% of dairy cows after parturition, when the epithelium of the endometrium is disrupted to expose the underlying stroma to bacteria. The severity of endometrial pathology is associated with isolation of Trueperella pyogenes. In the present study, T. pyogenes alone caused uterine disease when infused into the uterus of cattle where the endometrial epithelium was disrupted. The bacterium secretes a cholesterol-dependent cytolysin, pyolysin (PLO), and the plo gene was identical and the plo gene promoter was highly similar amongst 12 clinical isolates of T. pyogenes. Bacteria-free filtrates of the T. pyogenes cultures caused hemolysis and endometrial cytolysis, and PLO was the main cytolytic agent, because addition of anti-PLO antibody prevented cytolysis. Similarly, a plo-deletion T. pyogenes mutant did not cause hemolysis or endometrial cytolysis. Endometrial stromal cells were notably more sensitive to PLO-mediated cytolysis than epithelial or immune cells. Stromal cells also contained more cholesterol than epithelial cells, and reducing stromal cell cholesterol content using cyclodextrins protected against PLO. Although T. pyogenes or plo-deletion T. pyogenes stimulated accumulation of inflammatory mediators, such as IL-1beta, IL-6, and IL-8, from endometrium, PLO did not stimulate inflammatory responses by endometrial or hematopoietic cells, or in vitro organ cultures of endometrium. The marked sensitivity of stromal cells to PLO-mediated cytolysis provides an explanation for how T. pyogenes acts as an opportunistic pathogen to cause pathology of the endometrium once the protective epithelium is lost after parturition. PMID:24478394

Amos, Matthew R; Healey, Gareth D; Goldstone, Robert J; Mahan, Suman M; Düvel, Anna; Schuberth, Hans-Joachim; Sandra, Olivier; Zieger, Peter; Dieuzy-Labaye, Isabelle; Smith, David G E; Sheldon, Iain Martin

2014-03-01

 
 
 
 
81

Microscopic endometrial perivascular epithelioid cell nodules: a case report with the earliest presentation of a uterine perivascular epithelioid cell tumor  

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Full Text Available Abstract Perivascular epithelioid cell (PEC tumors (PEComas are a family of related mesenchymal tumors composed of PECs which co-express melanocytic and smooth muscle markers. Although their distinctive histologic, immunohistochemical, ultrastructural, and genetic features have been clearly demonstrated, their histogenesis and normal counterpart remain largely unknown. Precursor lesions of PEComas have rarely been reported. We herein describe a tuberous sclerosis patient with microscopic PEC nodules in the endometrium of adenomyosis, pelvic endometriosis, an ovarian endometriotic cyst, and the endometrium of the uterine cavity. The nodules showed a mixture of spindle-shaped and epithelioid cells concentrically arranged around small arteries. The cells exhibited uniform nuclei, light eosinophilic cytoplasm, and immunoreactivity with HMB-45 and CD10. Some nodules revealed continuity with a PEComa in the myometrium. These findings support microscopic endometrial PEC nodules possibly being precursor lesions of uterine PEComas. The wide distribution of the nodules in the pelvis may be related to the multicentricity of PEComas in tuberous sclerosis patients. Owing to the immunoreactivity with CD10, microscopic endometrial PEC nodules may be misinterpreted as endothelial stromal cells unless melanocytic markers are stained. To the best of our knowledge, this is a case with the earliest manifestation of PEC lesions occurring in the endometrium. Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9658280017862643

Fang Chia-Lang

2012-09-01

82

INFLUENCE OF THE MENOPAUSAL STATUS TO THE FREQUENCY AND PATHOHISTOLOGICAL FEATURES OF ENDOMETRIAL HYPERPLASIA AND CARCINOMA IN PATIENTS WITH ABNORMAL UTERINE BLEEDING  

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Full Text Available The aim of the study was to determine the frequency and pathohistological features of endometrial hyperplasia and carcinoma in premenopausal and postmenopausal patients with abnormal uterine bleeding (AUB.The frequency and pathohistological features of endometrial hyperplasia and carcinoma were investigated in 961 patients with AUB who underwent dilatation and curettage (D&C between January and December 2006. Regarding the menopausal status, patients were divided into two groups: group of premenopausal patients (n=808 and group of postmenopausal patients (n=153.Endometrial hyperplasia was significantly (p<0,05 more frequent cause of AUB in premenopausal patients (23,4% than in postmenopausal patients (13,7%. AUB caused by endometrial carcinoma was significantly (p<0,001 more common in postmenopausal patients (18,9% than in premenopausal patients (1,4%. Compared to the postmenopausal patients, endometrial hyperplasia without atypia was significantly (p<0,01 more frequent, while atypical hyperplasia was significantly (p<0,05 less frequent in premenopausal patients. In contrast to the premenopausal patients, endometrioid type and non-endometrioid type of endometrial carcinoma and carcinoma localized in endometrial polyp were significantly more common in postmenopausal patients (p<0,001, p<0,001, p<0,05, respectively.Endometrial hyperplasia (diffuse or localized to the polyp is more frequent cause of AUB in premenopausal patients than in postmenopausal patents. Compared to the premenopausal patients, atypical hyperplasia and endometrial carcinoma are more frequent causes of AUB in postmenopausal patients. In contrast to the premenopause, there were higher risks for developing endometrioid type and non-endometrioid type of endometrial carcinoma and carcinoma localized in endometrial polyp in postmenopause.

Biljana Djordjevic

2008-04-01

83

The occurrence of fetal microchimeric cells in endometrial tissues is a very common phenomenon in benign uterine disorders, and the lower prevalence of fetal microchimerism is associated with better uterine cancer prognoses.  

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This is the first study carried out to describe the role of fetal microchimerism (FM) in the pathogenesis of uterine cancer. The prevalence and concentration of male fetal microchimeric cells (FMCs) were examined in endometrial tissues in relation to subtypes of uterine cancer, and the histological grade and stage of the tumor. FM occurrence was analyzed in relation to risk factors, including hypertension, obesity, type 2 diabetes, dyslipidemia, age at cancer diagnosis, and patient pregnancy history. The prevalence and concentration of FMCs were examined in endometrial tissues using real-time polymerase chain reaction, SRY and ?-globin sequences as markers for male fetal FMCs and total DNA. The studied group involved 47 type 1 endometrial cancers, 28 type 2 endometrial cancers, and 41 benign uterine diseases. While the prevalence of FM was decreased only in type 1 endometrial cancer, compared with benign uterine disorders (38.3% vs.70.7%; odds ratio [OR]=0.257, 95% confidence interval [CI]: 0.105 to 0.628, p=0.003), FMC concentrations did not differ within examined groups. The lower FM prevalence was detected in low-grade (grade 1 and grade 2) endometrioid cancer (38.3% vs. 70.7%, OR=0.256, 95% CI: 0.105 to 0.627, p=0.003) and in FIGO 1 tumors (40.7% vs. 70.7%, OR=0.285, 95% CI: 0.120 to 0.675, p=0.004). No correlation between FM prevalence or FMC concentrations and risk factors was demonstrated. A lower prevalence of male FM seemed to be associated with better prognoses in uterine cancer based on tumor subtype, histological grade, and stage of the tumor. PMID:24283364

Hromadnikova, Ilona; Kotlabova, Katerina; Pirkova, Petra; Libalova, Pavla; Vernerova, Zdenka; Svoboda, Bohuslav; Kucera, Eduard

2014-01-01

84

Laparoscopic Management of Large Myomas  

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The objective of this article is to review the different techniques that have been adopted for removal of large myomas laparoscopically. We have also quoted literature about the impact of myomas on Pregnancy and obstetrical outcome and the effect of laparoscopic myomectomy on the same. Technical modifications to remove large myomas have been described along with methods to reduce intraoperative bleeding. This comprehensive review describes all possibilities of laparoscopic myomectomy irrespec...

Sinha Rakesh; Sundaram Meenakshi

2009-01-01

85

Endometrial expression of the insulin-like growth factor system during uterine involution in the postpartum dairy cow.  

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Rapid uterine involution in the postpartum period of dairy cows is important to achieve a short interval to conception. Expression patterns for members of the insulin-like growth factor (IGF) family were determined by in situ hybridisation at day 14+/-0.4 postpartum (n=12 cows) to investigate a potential role for IGFs in modulating uterine involution. Expression in each uterine tissue region was measured as optical density units and data were analysed according to region and horn. IGF-I mRNA was localized to the sub-epithelial stroma (SES) of inter-caruncular and caruncular endometrium. Both IGF-II and IGF-1R expression was detected in the deep endometrial stroma (DES), the caruncular stroma and myometrium. IGFBP-2, IGFBP-4 and IGFBP-6 mRNAs were all localised to the SES of inter-caruncular and caruncular uterine tissue, and in the DES and caruncular stroma, with IGFBP-4 mRNA additionally expressed in myometrium. IGFBP-3 mRNA was only detectable in luminal epithelium. IGFBP-5 mRNA was found in myometrium, inter-caruncular and caruncular SES and caruncular stroma. These data support a role for IGF-I and IGF-II in the extensive tissue remodelling and repair which the postpartum uterus undergoes to return to its non-pregnant state. The differential expression of binding proteins between tissues (IGFBP-3 in epithelium, IGFBP-2, -4, -5 and -6 in stroma and IGFBP-4 and -5 in myometrium) suggest tight control of IGF activity within each compartment. Differential expression of many members of the IGF family between the significantly larger previously gravid horn and the previously non-gravid horn may relate to differences in their rate of tissue remodelling. PMID:18258405

Llewellyn, S; Fitzpatrick, R; Kenny, D A; Patton, J; Wathes, D C

2008-05-01

86

Endometrial expression of the insulin-like growth factor system during uterine involution in the postpartum dairy cow?  

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Rapid uterine involution in the postpartum period of dairy cows is important to achieve a short interval to conception. Expression patterns for members of the insulin-like growth factor (IGF) family were determined by in situ hybridisation at day 14 ± 0.4 postpartum (n = 12 cows) to investigate a potential role for IGFs in modulating uterine involution. Expression in each uterine tissue region was measured as optical density units and data were analysed according to region and horn. IGF-I mRNA was localized to the sub-epithelial stroma (SES) of inter-caruncular and caruncular endometrium. Both IGF-II and IGF-1R expression was detected in the deep endometrial stroma (DES), the caruncular stroma and myometrium. IGFBP-2, IGFBP-4 and IGFBP-6 mRNAs were all localised to the SES of inter-caruncular and caruncular uterine tissue, and in the DES and caruncular stroma, with IGFBP-4 mRNA additionally expressed in myometrium. IGFBP-3 mRNA was only detectable in luminal epithelium. IGFBP-5 mRNA was found in myometrium, inter-caruncular and caruncular SES and caruncular stroma. These data support a role for IGF-I and IGF-II in the extensive tissue remodelling and repair which the postpartum uterus undergoes to return to its non-pregnant state. The differential expression of binding proteins between tissues (IGFBP-3 in epithelium, IGFBP-2, -4, -5 and -6 in stroma and IGFBP-4 and -5 in myometrium) suggest tight control of IGF activity within each compartment. Differential expression of many members of the IGF family between the significantly larger previously gravid horn and the previously non-gravid horn may relate to differences in their rate of tissue remodelling.

Llewellyn, S.; Fitzpatrick, R.; Kenny, D.A.; Patton, J.; Wathes, D.C.

2008-01-01

87

Absence of CD9 reduces endometrial VEGF secretion and impairs uterine repair after parturition  

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In mammals, uterine epithelium is remodeled cyclically throughout adult life for pregnancy. Despite the expression of CD9 in the uterine epithelium, its role in maternal reproduction is unclear. Here, we addressed this issue by examining uterine secretions collected from patients undergoing fertility treatment and fertilization-competent Cd9?/? mice expressing CD9-GFP in their eggs (Cd9?/?TG). CD9 in uterine secretions was observed as extracellular matrix-like feature, and its amount of the secretions associated with repeated pregnancy failures. We also found that the litter size of Cd9?/?TG female mice was significantly reduced after their first birth. Severely delayed re-epithelialization of the endometrium was then occurred. Concomitantly, vascular endothelial growth factor (VEGF) was remarkably reduced in the uterine secretions of Cd9?/?TG female mice. These results provide the first evidence that CD9-mediated VEGF secretion plays a role in re-epithelialization of the uterus.

Kawano, Natsuko; Miyado, Kenji; Yoshii, Noriko; Kanai, Seiya; Saito, Hidekazu; Miyado, Mami; Inagaki, Noboru; Odawara, Yasushi; Hamatani, Toshio; Umezawa, Akihiro

2014-01-01

88

Hysteroscopic findings in postmenopausal patients with ultrasonographic diagnosis of endometrial thickening  

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Full Text Available Objective: To evaluate the results of hysteroscopy for investigating the uterine cavity of postmenopausal women presenting endometrial thickening on ultrasound. Methods: A cross-sectional study was conducted on hysteroscopic evaluations of 329 postmenopausal women presenting with endometrial thickening on transvaginal ultrasonography. Hysteroscopies were performed in an outpatient setting, using a 4 mm optic Hamou II microhysteroscope and gas (CO2 to distend the uterine cavity. A guided biopsy for histology was performed in all patients with suspected endometrial malignancies and in most patients with benign abnormalities. Rresults: Endometrial thickness ranged from 6 to 38 mm (mean of 10.03 ± 4.49 mm. The hysteroscopic findings were polyps in 183 patients (55.62%; atrophic endometrium in 55 patients (16.72%; synechia in 26 patients (7.90%; a “cerebroid” appearance lesion in 13 patients (3.95%; myoma in 12 patients (3.65%; endometrial hyperplasia in 11 patients (3.34%; focal thickening in ten patients (3.04%; proliferative endometrium in eight patients (2.43%; mucus in seven patients (2.13%; and cystic atrophy in four patients (1.22%. Endometrial carcinoma was confirmed by histology in 11 of 13 suspected cases, in which hysteroscopy showed the cerebroid appearance. Hyperplasias were confirmed in seven of 11 cases. The respective accuracy was 99.26 and 96.67%. Nine out of 11 endometrial cancer cases and six out of 12 hyperplasia cases presented uterine bleeding. Cconclusions: The most frequent findings were benign lesions (92.71%. Hysteroscopy with biopsy is an accurate method to detect intracavitary uterine disease.

Hosana Karinne de Marathaoan Souza Martins e Castello Branco

2008-09-01

89

Exploring the effects of Chinese medicine in improving uterine endometrial blood flow for increasing the successful rate of in vitro fertilization and embryo transfer  

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Full Text Available Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a variety of vessel growth factors, and regulating nitric oxide level for inhibition of vascular smooth muscle contraction of the uterus. Treatments based on differentiation of syndromes are key to the theory of TCM. Differentiation of syndromes should be combined with biomedical disease diagnosis. It is also necessary to further clarify other endometrial blood flow disorders using TCM diagnostic methods. In these cases, drugs for reinforcing kidney and activating blood are relevant, but other medicines for smoothing liver qi and nourishing blood, as well as tonifying the spleen and generating blood may also be effective. Future clinical studies should focus on the observation of different types of TCM syndromes and the research on compatibility ratio and dose-dependent relationship of Chinese medicines. Acupuncture has been used during IVF-ET for more than 10 years. Electro-acupuncture can control the expansion of the uterine arteries by inhibiting the sympathetic nerves. However, acupuncture has not been proved to regulate endometrial arteries. To sum up, TCM can be applied to improve endometrial blood flow so as to increase birth rates in IVF-ET. The combination of Chinese and Western medicines and acupuncture application will increase their combined effect, thereby obtaining greater clinical benefits.

Jia Guo

2011-12-01

90

Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies  

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Full Text Available ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI and resistive index (RI of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2% endometrial polyp, 9 cases (9.3% endometrial hyperplasia, 10 cases (10.3 submucous myoma, 7 cases (7.2% endometrium cancer, and 32 cases (33% nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01. The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05. Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometrium

Suna Kabil Kucur

2013-01-01

91

Chromohysteroscopy—A new technique for endometrial biopsy in Abnormal Uterine Bleeding (AUB)  

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Objective: To evaluate the role of chromohysteroscopy in improving diagnostic accuracy of endometrial biopsy in cases of AUB. Design: Cross sectional interventional study. Materials and Methods: This study was conducted on 60 women with AUB in Dept. of Obst. & Gyne at King George Medical University, Lucknow over a period of one year. All cases underwent diagnostic hysteroscopy followed by chromohysteroscopy using 2% methyl...

Nisha Singh; Bharti Singh

2013-01-01

92

Calcified pure uterine lipoma mimicking myoma  

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Full Text Available Pure lipoma of the uterus is a rare entity and only a few cases have been reported in the literature. Clinical symptoms and signs are similar to those found in leiomyoma and create preoperative diagnostic confusion. The histogenesis is still unclear. We report the case of a 70 year-old woman with pure lipoma of the uterus with calcification.

Arghya Bandopadhyay

2010-06-01

93

Body diffusion-weighted MR imaging of uterine endometrial cancer: Is it helpful in the detection of cancer in nonenhanced MR imaging?  

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Objective: In this study, the authors discussed the feasibility and value of diffusion-weighted (DW) MR imaging in the detection of uterine endometrial cancer in addition to conventional nonenhanced MR images. Methods and materials: DW images of endometrial cancer in 23 patients were examined by using a 1.5-T MR scanner. This study investigated whether or not DW images offer additional incremental value to conventional nonenhanced MR imaging in comparison with histopathological results. Moreover, the apparent diffusion coefficient (ADC) values were measured in the regions of interest within the endometrial cancer and compared with those of normal endometrium and myometrium in 31 volunteers, leiomyoma in 14 patients and adenomyosis in 10 patients. The Wilcoxon rank sum test was used, with a p -3 mm2/s, which was significantly lower than those of the normal endometrium, myometrium, leiomyoma and adenomyosis (p < 0.05). Conclusion: DW imaging can be helpful in the detection of uterine endometrial cancer in nonenhanced MR imaging.

2009-04-01

94

Body diffusion-weighted MR imaging of uterine endometrial cancer: Is it helpful in the detection of cancer in nonenhanced MR imaging?  

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Objective: In this study, the authors discussed the feasibility and value of diffusion-weighted (DW) MR imaging in the detection of uterine endometrial cancer in addition to conventional nonenhanced MR images. Methods and materials: DW images of endometrial cancer in 23 patients were examined by using a 1.5-T MR scanner. This study investigated whether or not DW images offer additional incremental value to conventional nonenhanced MR imaging in comparison with histopathological results. Moreover, the apparent diffusion coefficient (ADC) values were measured in the regions of interest within the endometrial cancer and compared with those of normal endometrium and myometrium in 31 volunteers, leiomyoma in 14 patients and adenomyosis in 10 patients. The Wilcoxon rank sum test was used, with a p < 0.05 considered statistically significant. Results: In 19 of 23 patients, endometrial cancers were detected only on T2-weighted images. In the remaining 4 patients, of whom two had coexisting leiomyoma, no cancer was detected on T2-weighted images. This corresponds to an 83% detection sensitivity for the carcinomas. When DW images and fused DW images/T2-weighted images were used in addition to the T2-weighted images, cancers were identified in 3 of the remaining 4 patients in addition to the 19 patients (overall detection sensitivity of 96%). The mean ADC value of endometrial cancer (n = 22) was (0.97 {+-} 0.19) x 10{sup -3} mm{sup 2}/s, which was significantly lower than those of the normal endometrium, myometrium, leiomyoma and adenomyosis (p < 0.05). Conclusion: DW imaging can be helpful in the detection of uterine endometrial cancer in nonenhanced MR imaging.

Inada, Yuki [Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686 (Japan)], E-mail: rad068@poh.osaka-med.ac.jp; Matsuki, Mitsuru; Nakai, Go; Tatsugami, Fuminari; Tanikake, Masato; Narabayashi, Isamu [Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686 (Japan); Yamada, Takashi; Tsuji, Motomu [Department of Pathology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686 (Japan)

2009-04-15

95

Atypical Polypoid Adenomyoma (APAM) of the Uterine: Relationship with Endometrial Cancer  

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Atypical polypoid adenomyoma (APAM) is a rare polypoid tumor that generally occurs in women of reproductive age who have abnormal genital bleeding. The tumor was reported as a new disease concept by Mazur in 1981. Pathologically, APAM consist of irregularly proliferated endometrial gland cells and interlacing bundles of smooth muscle cells within the stroma, and have a similar form to adenocarcinoma, adenofibroma, adenosarcoma, and carcinosarcoma. Therefore, differential diagnosis is required...

Iori Kisu; Kouji Banno; Megumi Yanokura; Yusuke Kobayashi; Arisa Ueki; Asuka Ono; Kennta Masuda; Wataru Yamagami; Hiroyuki Nomura; Akira Hirasawa; Nobuyuki Susumu; Daisuke Aoki

2011-01-01

96

Vascular endothelial growth factor-D over-expressing tumor cells induce differential effects on uterine vasculature in a mouse model of endometrial cancer  

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Full Text Available Abstract Background It has been hypothesised that increased VEGF-D expression may be an independent prognostic factor for endometrial cancer progression and lymph node metastasis; however, the mechanism by which VEGF-D may promote disease progression in women with endometrial cancer has not been investigated. Our aim was to describe the distribution of lymphatic vessels in mouse uterus and to examine the effect of VEGF-D over-expression on these vessels in a model of endometrial cancer. We hypothesised that VEGF-D over-expression would stimulate growth of new lymphatic vessels into the endometrium, thereby contributing to cancer progression. Methods We initially described the distribution of lymphatic vessels (Lyve-1, podoplanin, VEGFR-3 and VEGF-D expression in the mouse uterus during the estrous cycle, early pregnancy and in response to estradiol-17beta and progesterone using immunohistochemistry. We also examined the effects of VEGF-D over-expression on uterine vasculature by inoculating uterine horns in NOD SCID mice with control or VEGF-D-expressing 293EBNA tumor cells. Results Lymphatic vessels positive for the lymphatic endothelial cell markers Lyve-1, podoplanin and VEGFR-3 profiles were largely restricted to the connective tissue between the myometrial circular and longitudinal muscle layers; very few lymphatic vessel profiles were observed in the endometrium. VEGF-D immunostaining was present in all uterine compartments (epithelium, stroma, myometrium, although expression was generally low. VEGF-D immunoexpression was slightly but significantly higher in estrus relative to diestrus; and in estradiol-17beta treated mice relative to vehicle or progesterone treated mice. The presence of VEGF-D over-expressing tumor cells did not induce endometrial lymphangiogenesis, although changes were observed in existing vessel profiles. For myometrial lymphatic and endometrial blood vessels, the percentage of profiles containing proliferating endothelial cells, and the cross sectional area of vessel profiles were significantly increased in response to VEGF-D in comparison to control tumor cells. In contrast, no significant changes were noted in myometrial blood vessels. In addition, examples of invading cells or tumor emboli were observed in mice receiving VEGF-D expressing 293EBNA cells. Conclusions These results illustrate that VEGF-D over-expression has differential effects on the uterine vasculature. These effects may facilitate VEGF-D's ability to promote endometrial cancer metastasis and disease progression.

Stacker Steven A

2010-07-01

97

Overcoming paclitaxel resistance in uterine endometrial cancer using a COX-2 inhibitor.  

Science.gov (United States)

Cyclooxygenase (COX)-2 inhibitors have been reported to potentially modulate the resistance of cancer cells to chemotherapeutic drugs by affecting multidrug resistance 1 (MDR1) expression. In the present study, we investigated the association between COX-2 and MDR1 expression in endometrial cancers and evaluated the effects of the COX-2 inhibitor, etodolac, in combination with paclitaxel on paclitaxel-resistant endometrial cancer cells. The relationship between COX-2 and MDR1 mRNA expression was examined by quantitative PCR in 36 endometrial cancer specimens. The paclitaxel-resistant cell line OMC-2P was established from OMC-2 cells. Paclitaxel (1 µg/ml) with or without etodolac (10 µg/ml) was added to OMC-2 and OMC-2P cells, and COX-2 and MDR1 mRNA expression levels were examined. The concentration of prostaglandin E2 (PGE2) in the supernatant of each cell line was examined by enzyme-linked immunosorbent assay. The function of MDR1 was determined by intracellular accumulation of rhodamine 123 using flow cytometry, and the concentration of intracellular paclitaxel was determined by high-performance liquid chromatography. We found a positive relationship between COX-2 and MDR1 mRNA expression in endometrial cancer. Both COX-2 mRNA expression and PGE2 production were elevated in resistant OMC-2P cells when compared to non-resistant OMC-2 cells. Additionally, MDR1 mRNA expression was markedly upregulated in OMC-2P cells. In OMC-2 cells, COX-2 and MDR1 mRNA levels were significantly upregulated by paclitaxel treatment and downregulated by co-administration with etodolac. In OMC-2P cells, COX-2 mRNA expression was also significantly upregulated by paclitaxel treatment and tended to be downregulated by co-administration with etodolac. Moreover, co-administration of paclitaxel and etodolac suppressed the induction of MDR1 mRNA. Rhodamine 123 efflux was increased in OMC-2P cells when compared to the efflux in the OMC-2 cells and was increased in response to paclitaxel treatment. Co-administration of paclitaxel and etodolac in both cell lines resulted in decreased rhodamine 123 efflux. The actual concentration of intracellular paclitaxel in OMC-2P cells was significantly lower than that in OMC-2 cells treated with paclitaxel alone and was significantly increased after co-administration of paclitaxel and etodolac. These findings suggest that paclitaxel resistance may be associated with COX-2 and MDR1 expression in cancer cells. Co-administration of COX-2 inhibitors and paclitaxel may have a key role in modulating or overcoming paclitaxel resistance in endometrial cancers. PMID:24100466

Hasegawa, Kiyoshi; Ishikawa, Kunimi; Kawai, Satoshi; Torii, Yutaka; Kawamura, Kyoko; Kato, Rina; Tsukada, Kazuhiko; Udagawa, Yasuhiro

2013-12-01

98

Endometrial Imaging  

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  "nAbnormal uterine bleeding, whether in peri menopausal or postmenopausal patients, is an important clinical concern and results in much medical intervention. When bleeding occurs in women over 40 years of age as well as any postmenopausal women, endometrial assessment is mandatory. In the past and present, many clinicians prefer to begin such assessment with blind endometrial sampling. However, when an ultrasound-based approach to such patients is present, a thin distinct endomet...

Khadijeh Bakhtavar

2009-01-01

99

Abnormal uterine bleeding: an evaluation endometrial biopsy, vaginal ultrasound and outpatient hysteroscopy.  

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Abnormal uterine bleeding is a common gynaecological symptom. Whilst most patients have benign disease, thorough investigation is necessary, particularly in the peri- and post-menopausal woman. Hysteroscopy with directed biopsy of suspicious lesions is the gold standard investigation but it is invasive and is not offered in all units as an outpatient procedure. Ultrasound and outpatient biopsy techniques may allow patients to be triaged to select those who require formal evaluation by hystero...

Hunter, D. C.; Mcclure, N.

2001-01-01

100

A clinical and pathologic comparison between stage-matched endometrial intraepithelial carcinoma and uterine serous carcinoma: is there a difference?  

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Endometrial intraepithelial carcinoma (EIC) is a rare pathologic variant of uterine serous carcinoma (USC). Our aim is to distinguish patterns of clinic-pathologic outcomes in patients with EIC and USC for disease limited to the endometrium (stage 1A) as well as with distant metastasis (stage 4B). Surgically staged patients were retrospectively identified and relevant variables were extracted and compared. Kaplan-Meier was used to generate the survival data. More USC (n = 29) exhibited lymphovascular invasion (stage 4, P = .01) and expressed higher levels of estrogen receptor-? than EIC (P = .0009 and .063 for stages 1 and 4, respectively). The survival is comparable, with 1 recurrence in each group for stage 1A disease. For stage 4 EIC and USC, the progression-free survival (14 vs10 months) and overall survival (19 vs 20 months) are similar to what is previously published. In conclusion, EIC, whether limited to the endometrium, or widely metastatic, imparts similar outcomes and should be treated comparably with stage-matched USC. PMID:24023030

Hou, June Y; McAndrew, Thomas C; Goldberg, Gary L; Whitney, Kathleen; Shahabi, Shohreh

2014-04-01

 
 
 
 
101

CT differentiation of solid ovarian tumor and uterine subserosal leiomyoma  

International Nuclear Information System (INIS)

On the basis of CT findings, to differentiate between solid ovarian tumor and uterine subserosal myoma. In eight surgically proven cases of solid ovarian tumor and in ten uterine subserosal myoma patients, contrast-enhanced CT images were obtained. Two genitourinary radiologists reviewed the findings with regard to degree of enhancement of the mass as compared with enhancement of uterine myometrium, thickening of round ligaments, visualization of normal ovaries, contour of the mass, and the presence of ascites in the pelvic cavity. Six of eight ovarian tumors but only two of ten uterine myomas were less enhanced than normal uterine myometrium (p0.05). The contour of the mass was lobulated in two of eight ovarian tumor patients, but in five of ten uterine myoma patients (p>0.05). CT findings suggestive of solid ovarian tumor were less contrast enhancement of the mass than of normal uterine myometrium, pelvic ascites, and nonvisualization of normal ovary

1999-06-01

102

Diffuse uterine adenomyosis: Transvaginal US with histopathologic correlation  

International Nuclear Information System (INIS)

To correlate transvaginal sonographic findings with histopathology in diffuse uterine adenomyosis. We prospectively analyzed the transvaginal sonographic findings of 15 patients undergoing hysterectomy for adenomyosis. Diffuse adenomyosis was diagnosed when an abnormal echotexture (heterogenous echogenicity, decreased echogenicity, increased echogenicity, cystic lesion) was present in myometrium of enlarged uterus. We evaluate the size of the uterus, abnormal echotexture in myometrium and anterior and posterior myometrial wall thickness'. Transvaginal sonographic findings of diffuse adenomyosis are enlarged uterus (n=15), heterogenous and increased echogenicity in myometrium (n=10), heterogenous echogenicity in myometrium (n=4), heterogenous and increased echogenicity with cystic lesion lesion in myometrium (n=1). The posterior myometrial wall is equal to anterior wall (n=7), thicker than anterior wall (n=4), thinner than anterior wall (n=4). The histopathologic findings including ectopic endometrial gland (n=14), muscular hypertrophy (n=15), myoma (n=4). Diffuse adenomyosis was confirmed except one case that proved myoma. Transvaginal sonographic findings of enlarged uterus with heterogenous and increased echotexture in myometrium of adenomyosis is correlated with ectopic endometrial gland with secondary muscular hypertrophy.

1999-06-01

103

Diffuse uterine adenomyosis: Transvaginal US with histopathologic correlation  

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To correlate transvaginal sonographic findings with histopathology in diffuse uterine adenomyosis. We prospectively analyzed the transvaginal sonographic findings of 15 patients undergoing hysterectomy for adenomyosis. Diffuse adenomyosis was diagnosed when an abnormal echotexture (heterogenous echogenicity, decreased echogenicity, increased echogenicity, cystic lesion) was present in myometrium of enlarged uterus. We evaluate the size of the uterus, abnormal echotexture in myometrium and anterior and posterior myometrial wall thickness'. Transvaginal sonographic findings of diffuse adenomyosis are enlarged uterus (n=15), heterogenous and increased echogenicity in myometrium (n=10), heterogenous echogenicity in myometrium (n=4), heterogenous and increased echogenicity with cystic lesion lesion in myometrium (n=1). The posterior myometrial wall is equal to anterior wall (n=7), thicker than anterior wall (n=4), thinner than anterior wall (n=4). The histopathologic findings including ectopic endometrial gland (n=14), muscular hypertrophy (n=15), myoma (n=4). Diffuse adenomyosis was confirmed except one case that proved myoma. Transvaginal sonographic findings of enlarged uterus with heterogenous and increased echotexture in myometrium of adenomyosis is correlated with ectopic endometrial gland with secondary muscular hypertrophy.

Song, Mi Jin; Kim, Hye Sun; Lee, Myung Sook; Cho, Hyeun Cha; Lee, Young Ho [Samsung Cheil Hospital, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

1999-06-15

104

Endometrial ablation: postoperative complications.  

Science.gov (United States)

Endometrial ablation as a treatment for abnormal uterine bleeding has evolved considerably over the past several decades. Postoperative complications include the following: (1) pregnancy after endometrial ablation; (2) pain-related obstructed menses (hematometra, postablation tubal sterilization syndrome); (3) failure to control menses (repeat ablation, hysterectomy); (4) risk from preexisting conditions (endometrial neoplasia, cesarean section); and (5) infection. Physicians performing endometrial ablation should be aware of postoperative complications and be able to diagnose and provide treatment for these conditions. PMID:22541856

Sharp, Howard T

2012-10-01

105

Laparoscopic Myomectomy for Large Myomas  

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The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9±5.6 yr, mean parity was 0.6±0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, ...

Yoon, Hyo Jin; Kyung, Min Sun; Jung, Un Suk; Choi, Joong Sub

2007-01-01

106

Papel da Histerossonografia no Estudo da Cavidade Uterina em Pacientes com Sangramento Uterino Anormal / Role of Sonohysterography in the Evaluation of the Uterine Cavity in Patients with Abnormal Uterine Bleeding  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Objetivo: determinar o papel da histerossonografia na avaliação das anormalidades da cavidade uterina, em pacientes com sangramento uterino anormal, selecionadas previamente pela ultra-sonografia transvaginal. Métodos: foram selecionadas 48 pacientes na menacme e pós-menopausa, portadoras de sangram [...] ento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonografia e, posteriormente, aos métodos "padrão ouro", a histeroscopia e/ou histerectomia. As histerossonografias foram avaliadas por dois diferentes médicos e os diagnósticos confrontados. Resultados: a histerossonografia mostrou ter alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina. Na presença de pólipo a sensibilidade e a especificidade do método foram, respectivamente, de 100 e 97%, seguido do mioma submucoso cuja sensibilidade e especificidade foram, respectivamente, de 83 e 100%. Já na hiperplasia endometrial e no endométrio normal a sensibilidade e especificidade foram de 100%. Diagnosticamos 33 casos de pólipos, 13 casos de miomas submucosos, quatro casos de hiperplasia endometrial e três casos normais na análise dos métodos "padrão ouro". Houve alta correlação entre os diagnósticos dados pelos dois examinadores. Conclusões: a histerossonografia mostrou ser um exame reprodutível, com alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina em pacientes com sangramento uterino anormal. Abstract in english Purpose: to determine the role of sonohysterography in the evaluation of abnormalities in the uterine cavity in patients presenting abnormal uterine bleeding, who had previously been selected by transvaginal ultrasonography. Methods: forty-eight patients presenting abnormal uterine bleeding and chan [...] ges in the uterine cavity seen by transvaginal ultrasonography were selected, and they were in the menacme or postmenopause period. All patients underwent a sonohysterography, and later a hysteroscopy and/or a hysterectomy. The sonohysterographies were evaluated by two different physicians, and the diagnoses were compared. Results: the sonohysterography method showed high sensitivity and specificity for the diagnosis of benign pathologies in the uterine cavity. First, in the presence of polyps the sensitivity and specificity rates were 100 and 97%, respectively, second, in the presence of submucous myoma, they were 83 and 100%, and finally, concerning endometrial hyperplasia and normal endometrium, they were 100%. We diagnosed thirty-three cases of polyps, thirteen cases of submucous myoma, four cases of endometrial hyperplasia and three normal cases. The correlation between the diagnoses provided by the two physicians was high. Conclusions: sonohysterography is a safe and fast method which is very well tolerated by the patient, and has low levels of complications. Its high sensitivity and specificity allow this method to be used for routine diagnosis concerning benign pathologies in the uterine cavity of patients presenting abnormal uterine bleeding.

Angélica Lemos Debs, Diniz; Elmar Gonzaga, Gonçalves.

107

Papel da Histerossonografia no Estudo da Cavidade Uterina em Pacientes com Sangramento Uterino Anormal Role of Sonohysterography in the Evaluation of the Uterine Cavity in Patients with Abnormal Uterine Bleeding  

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Full Text Available Objetivo: determinar o papel da histerossonografia na avaliação das anormalidades da cavidade uterina, em pacientes com sangramento uterino anormal, selecionadas previamente pela ultra-sonografia transvaginal. Métodos: foram selecionadas 48 pacientes na menacme e pós-menopausa, portadoras de sangramento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonografia e, posteriormente, aos métodos "padrão ouro", a histeroscopia e/ou histerectomia. As histerossonografias foram avaliadas por dois diferentes médicos e os diagnósticos confrontados. Resultados: a histerossonografia mostrou ter alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina. Na presença de pólipo a sensibilidade e a especificidade do método foram, respectivamente, de 100 e 97%, seguido do mioma submucoso cuja sensibilidade e especificidade foram, respectivamente, de 83 e 100%. Já na hiperplasia endometrial e no endométrio normal a sensibilidade e especificidade foram de 100%. Diagnosticamos 33 casos de pólipos, 13 casos de miomas submucosos, quatro casos de hiperplasia endometrial e três casos normais na análise dos métodos "padrão ouro". Houve alta correlação entre os diagnósticos dados pelos dois examinadores. Conclusões: a histerossonografia mostrou ser um exame reprodutível, com alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina em pacientes com sangramento uterino anormal.Purpose: to determine the role of sonohysterography in the evaluation of abnormalities in the uterine cavity in patients presenting abnormal uterine bleeding, who had previously been selected by transvaginal ultrasonography. Methods: forty-eight patients presenting abnormal uterine bleeding and changes in the uterine cavity seen by transvaginal ultrasonography were selected, and they were in the menacme or postmenopause period. All patients underwent a sonohysterography, and later a hysteroscopy and/or a hysterectomy. The sonohysterographies were evaluated by two different physicians, and the diagnoses were compared. Results: the sonohysterography method showed high sensitivity and specificity for the diagnosis of benign pathologies in the uterine cavity. First, in the presence of polyps the sensitivity and specificity rates were 100 and 97%, respectively, second, in the presence of submucous myoma, they were 83 and 100%, and finally, concerning endometrial hyperplasia and normal endometrium, they were 100%. We diagnosed thirty-three cases of polyps, thirteen cases of submucous myoma, four cases of endometrial hyperplasia and three normal cases. The correlation between the diagnoses provided by the two physicians was high. Conclusions: sonohysterography is a safe and fast method which is very well tolerated by the patient, and has low levels of complications. Its high sensitivity and specificity allow this method to be used for routine diagnosis concerning benign pathologies in the uterine cavity of patients presenting abnormal uterine bleeding.

Angélica Lemos Debs Diniz

2000-06-01

108

Is there a role for a brachytherapy vaginal cuff boost in the adjuvant management of patients with uterine-confined endometrial cancer?  

International Nuclear Information System (INIS)

Purpose/Objective: Many patients who have uterine-confined endometrial cancer with prognostic factors predictive of recurrence are treated with adjuvant pelvic radiation. The addition of a brachytherapy vaginal cuff boost is controversial. Materials and Methods: Between 1983 and 1993, 270 patients received adjuvant postoperative pelvic irradiation following hysterectomy for Stage I or II endometrial cancer. Group A includes 173 patients who received external beam irradiation alone (EBRT), while group B includes 97 patients who received EBRT with a vaginal brachytherapy application. The median dose of EBRT was 45 Gy. Vaginal brachytherapy consisted of a low dose rate ovoid or cylinder in 41 patients, a high dose rate cylinder in 54 patients, and a radioactive gold seed implant in two patients. The median follow-up time was 64 months. The two groups were compared in terms of age, histologic grade, favorable versus unfavorable histology, capillary space invasion, depth of myometrial invasion, and pathologic stage. Results: Chi-square analysis revealed that the only difference between the two groups was the presence of more Stage II patients in group B (38% versus 14%). No difference was detected for 5 year pelvic control and disease-free survival rates between groups A and B. Conclusion: There is no suggestion that the addition of a vaginal cuff brachytherapy boost to pelvic radiation is beneficial for pelvic control or disease-free survival for patients with Stage I or II endometrial cancer. Prospective randomized trials designed to study external irradiation alone versus external beam treatment plus vaginal brachytherapy are unlikely to show a positive result. Because EBRT provides excellent pelvic control, protocol development for uterine-confined corpus cancer should focus on identifying patients at risk for recurrence as well as other means of augmenting EBRT (e.g. addition of chemotherapy) in order to improve disease free survival in those subgroups

1998-08-01

109

Endometrial Imaging  

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Full Text Available   "nAbnormal uterine bleeding, whether in peri menopausal or postmenopausal patients, is an important clinical concern and results in much medical intervention. When bleeding occurs in women over 40 years of age as well as any postmenopausal women, endometrial assessment is mandatory. In the past and present, many clinicians prefer to begin such assessment with blind endometrial sampling. However, when an ultrasound-based approach to such patients is present, a thin distinct endometrial echo excludes significant pathology, assuming it is performed at an appropriate time if the patient is, in fact, cycling. When a thin distinct endometrial echo is not visualized (inadequate visualization or presence of thickened echo then saline infusion sonohysterography can help to triage patients to no anatomic pathology, globally thickened anatomic pathology that may then be evaluated with blind endometrial sampling, and focal abnormalities that must be evaluated under direct vision. Such an ultrasound-based approach will not only help to exclude endometrial carcinoma, but also to identify the source of any bleeding for better clinical management. MRI has no role as a screening technique for endometrial carcinoma however the accuracy of MRI in differentiating non invasive from invasive carcinoma is high.   

Khadijeh Bakhtavar

2009-01-01

110

Screening for uterine tumours.  

Science.gov (United States)

The most prevalent uterine tumours are leiomyomas, which are benign and have a prevalence of about 50% at menopause. The incidence of endometrial cancer and uterine sarcomas is about 25 per 100,000 and 0.7 per 100,000, respectively. Reported risk factors for endometrial cancer are advanced age, unopposed oestrogen stimulation, late menopause, obesity, diabetes mellitus, nulliparity, feminising ovarian tumours, polycystic ovarian syndrome, tamoxifen and belonging to a hereditary non-polyposis colorectal cancer family. Unopposed oestrogen stimulation and tamoxifen have also been confirmed to induce uterine sarcomas. Cervical cytology, endometrial sampling and ultrasound have been proposed in the early diagnosis of endometrial cancer. No pathognomonic ultrasound, magnetic resonance imaging or computed tomography features are able to differentiate between a leiomyoma and a uterine sarcoma, and reliable serum markers for sarcomas are lacking. To date, mass screening for uterine malignancies is not feasible or effective. PMID:22078749

Van den Bosch, Thierry; Coosemans, An; Morina, Memli; Timmerman, Dirk; Amant, Frederic

2012-04-01

111

Endometrial expression of the insulin-like growth factor system during uterine involution in the postpartum dairy cow?  

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Rapid uterine involution in the postpartum period of dairy cows is important to achieve a short interval to conception. Expression patterns for members of the insulin-like growth factor (IGF) family were determined by in situ hybridisation at day 14 ± 0.4 postpartum (n = 12 cows) to investigate a potential role for IGFs in modulating uterine involution. Expression in each uterine tissue region was measured as optical density units and data were analysed according to region and horn. IGF-...

Llewellyn, S.; Fitzpatrick, R.; Kenny, D. A.; Patton, J.; Wathes, D. C.

2008-01-01

112

Ulipristal Acetate for Symptomatic Uterine Fibroids and Myoma-Related Hypermenorrhea Joint Statement by the German Society for Gynecological Endocrinology and Reproductive Medicine (DGGEF and the German Professional Association of Gynecologists (BVF  

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Full Text Available Approximately 24 million European and more than 20 million North American women between the ages of 35 and 55 are suffering from uterine fibroids, i.e. 40% of all women in this age group are affected. The symptoms are excessive uterine bleeding, anaemia, pain and infertility. Many women find their quality of life severely compromised, and this leads to hysterectomy in many cases. So far there has been no effective and well-tolerated drug. The only approved drugs for the treatment of symptomatic uterine fibroids are GnRH agonists, but their use is relatively limited because of severe side effects due to the resulting low levels of estrogen causing hot flushes, depression, mood swings, loss of libido, vaginitis and loss of bone mineral density. As fibroid growth is dependent on progesterone, progesterone receptor modulators have proven effective in pilot studies. Two randomised double-blind studies have shown the effectiveness of the progesterone receptor modulator ulipristal acetate in the preoperative treatment of leiomyomas and the control of concomitant menorrhagia. No significant side effects have occurred under a dosage of 5 and 10 mg UPA over 3 months. A cessation of menorrhagia was observed after only 7 days, and a volume reduction of the uterine fibroids by 40% was achieved within 3 months and seemed to persist even 6 months after discontinuing the drug. A preparation with a dosage of 5 mg ulipristal acetate is available as Esmya® from the spring of 2012 for the preoperative treatment of leiomyomas.

Rabe T

2013-01-01

113

Transcriptional profile of endometrial TLR4 and 5 genes during the estrous cycle and uterine infection in the buffalo (Bubalus bubalis).  

Science.gov (United States)

Endometritis is one of the leading causes of infertility in the cattle and buffalo and innate immune mechanism plays an important role in clearing the infection. In this regard, endometrial expression and function of Toll Like Receptors (TLR) are focus of investigation in the recent years. In this study, we report the transcriptional profiles of TLR4 and 5 in the buffalo endometrium during the follicular, early, mid and late luteal phases of estrous cycle and 'subclinical and clinical endometritis' and also at true anestrus (n?=?10 for each stage) using RT-PCR and qRT-PCR as they are the ligands for the lipopolysaccharide and flagellin components of E.coli, the most common cause of postpartum endometritis. We found a significant positive correlation between TLR4 and 5 in all the groups (r?=?0.696-0.803; P??0.05). Chi-square analysis showed that the qualitative expression of endometrial TLR4 and 5 transcripts was significantly associated with the phase of estrous cycle and also with uterine infection (P?24.6-83.3 folds) during endometritis conditions and moderately upregulated during mid-luteal phase (6.8-16.2) of the estrous cycle (P?

Ajevar, Ganesan; Muthu, Sankar; Sarkar, Mihir; Kumar, Harendra; Das, Goutam Kumar; Krishnaswamy, Narayanan

2014-06-01

114

A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas Sonohysterography in the evaluation of the uterine cavity in postmenopausal women  

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Full Text Available Objetivos: avaliar a acuidade diagnóstica da histerossonografia como método de avaliação da cavidade uterina em pacientes menopausadas com cavidade uterina alterada à ultra-sonografia endovaginal convencional. Métodos: este estudo consistiu na avaliação de 99 pacientes menopausadas com cavidade uterina anormal à ultra-sonografia endovaginal convencional, caracterizada por espessura endometrial maior ou igual a 5 mm em pacientes sem terapia de reposição hormonal, ou espessura endometrial maior ou igual a 8 mm em pacientes em terapia de reposição hormonal, com sangramento irregular. Estas pacientes foram submetidas à histerossonografia e após, foram obtidas amostras para avaliação histopatológica por biópsia dirigida por histeroscopia em 92 pacientes, biópsia endometrial em quatro pacientes e histerectomia em três pacientes. Os resultados da histerossonografia foram comparados com os resultados do exame histopatológico, considerado como "padrão-ouro". Resultados: houve oito casos de cavidade uterina normal e 20 casos de atrofia endometrial e a histerossonografia teve altos níveis de especificidade (97,8 e 97,5% e baixa sensibilidade (35 e 25%. Houve altos níveis de sensibilidade (92,3 e 75,0% e especificidade (94,1 e 97,9% em pólipos (65 casos e miomas submucosos (quatro casos. Houve três casos de câncer de endométrio e a histerossonografia teve sensibilidade e especificidade de 100%. Conclusões: a histerossonografia mostrou boa acuidade no diagnóstico de doenças focais (pólipos endometriais e miomas submucosos, com altos níveis de sensibilidade e especificidade. Houve três casos de câncer endometrial, e a histerossonografia diagnosticou corretamente todos eles. Mostrou também ser método acurado para excluir anormalidades endometriais. Entretanto, nos casos de espessamento endometrial difuso, a acuidade é baixa, porque endométrios atróficos ou normais freqüentemente aparecem como tendo espessamento difuso à ultra-sonografia endovaginal e à histerossonografia. A histerossonografia não teve complicações durante e após o procedimento.Purpose: to evaluate the diagnostic accuracy of sonohysterography as a diagnostic method for the evaluation of the uterine cavity in postmenopausal women with abnormal uterine cavity at conventional endovaginal sonography. Methods: this study consisted of the evaluation of 99 postmenopausal patients with abnormal uterine cavity on conventional endovaginal sonography, that was defined as endometrial thickness equal to or larger than 5 mm in a postmenopausal patient not on hormone replacement therapy, or endometrial thickness equal to or larger than 8 mm in patients on hormone replacement therapy, with irregular bleeding. These patients were subjected to sonohysterography, and specimens were obtained for pathologic examination by biopsy guided by histeroscopy in 92 patients, endometrial biopsy in four patientes and hysterectomy in three patients. The results of sonohysterography were compared with the pathologic findings, considered "gold standard". Results: there were eight cases of normal uterine cavity and 20 cases of atrophic endometrium and sonohysterography had high levels of specificity (97.8 and 97.5% and low sensitivity (35 and 25%. There were high levels of sensitivity (92.3 and 75.0% and specificity (94.1 and 97.9% for polyps (65 cases and submucous myomas (four cases. There were three cases of endometrial carcinoma and the sonohysterography had a sensitivity and specificity of 100%. Conclusions: sonohysterography showed to be accurate in the diagnostic of focal diseases (endometrial polyps and submucous myomas. There were three cases of endometrial cancer, and sonohysterography correctly diagnosed all of them. This method was also accurate to exclude endometrial abnormality. However, in the cases of diffusely thickened endometrium, the accuracy was low, because atrophic and normal endometrium on histopathology frequently appears as diffusely thickened endometrium at endovaginal sonography and sonohysterography. Sonohyst

Benito Pio Vitório Ceccato Júnior

2002-09-01

115

Therapeutic management of uterine fibroid tumors: updated French guidelines.  

Science.gov (United States)

The medical management of symptomatic non-submucosal uterine fibroid tumors (leiomyomas or myomas) is based on the treatment of abnormal uterine bleeding by any of the following: progestogens, a levonorgestrel-releasing intrauterine device, tranexamic acid, nonsteroidal anti-inflammatory drugs, or GnRH analogs. Selective progesterone receptor modulators are currently being evaluated and have recently been approved for fibroid treatment. Neither combined estrogen-progestogen contraception nor hormone treatment of the menopause is contraindicated in women with fibroids. When pregnancy is desired, whether or not infertility is being treated by assisted reproductive technology, hysteroscopic resection in one or two separate procedures of submucosal fibroids less than 4 cm in length is recommended, regardless of whether they are symptomatic. Interstitial, also known as intramural, fibroids have a negative effect on fertility but treating them does not improve fertility. Myomectomy is therefore indicated only for symptomatic fibroids; depending on their size and number, and may be performed by laparoscopy or laparotomy. Physicians must explain to women the potential consequences of myomas and myomectomy on future pregnancy. For perimenopausal women who have been informed of the alternatives and the risks, hysterectomy is the most effective treatment for symptomatic fibroids and is associated with a high rate of patient satisfaction. When possible, the vaginal or laparoscopic routes should be preferred to laparotomy for hysterectomies for fibroids considered typical on imaging. Because uterine artery embolization is an effective treatment with low long-term morbidity, it is an option for symptomatic fibroids in women who do not want to become pregnant, and a validated alternative to myomectomy and hysterectomy that must be offered to patients. Myolysis is under assessment, and research on its use is recommended. Isolated laparoscopic ligation of the uterine arteries is a potential alternative to uterine artery embolization; it also complements myomectomy by reducing intraoperative bleeding. It is possible to use second-generation techniques of endometrial ablation to treat submucosal fibroids in women whose families are complete. Subtotal hysterectomy is a possible alternative to total hysterectomy for fibroid treatment, given that by laparotomy the former has a lower complication rate than the latter, while by laparoscopy, these rates are the same. In each case, the patient is informed about the benefit and risk associated with each therapeutic option. PMID:22939241

Marret, Henri; Fritel, Xavier; Ouldamer, Lobna; Bendifallah, Sofiane; Brun, Jean-Luc; De Jesus, Isabelle; Derrien, Jean; Giraudet, Géraldine; Kahn, Vanessa; Koskas, Martin; Legendre, Guillaume; Lucot, Jean Philippe; Niro, Julien; Panel, Pierre; Pelage, Jean-Pierre; Fernandez, Hervé

2012-12-01

116

A case of acute on chronic uterine inversion with fibroid polyp.  

Science.gov (United States)

Chronic nonpuerperal inversion of the uterus is uncommon and is usually associated with a fundal submucous myoma extrusion. We report herewith the case of a young lady with hitherto asymptomatic long standing mass per vagina presenting acutely with vaginal bleeding and shock. The mass was a uterine myoma. She underwent hysterectomy in view of extensive necrosis. PMID:24392411

Shivanagappa, Mamatha; Bhandiwad, Ambarisha; Mahesh, M

2013-11-01

117

[Uterine fibroids].  

Science.gov (United States)

The uterine fibroid is a benign tumour. The prevalence, in all the population, is 50% for european women and 80% for black women. 30% of fibroids are symptomatic. The new FIGO classification gives 7 positions (0 to 7), submuccus (0, 1, 2), interstitial (3, 4, 5), subserous (6, 7). Diagnosis is performed by 2D and 3D ultrasound which could be associated by hysterosonography. Hysteroscopy and MRI could be proposed. Hysterectomy is the main treatment, if possible by vaginal or laparoscopic way. Conservative treatment (myomectomy) could be realized by hysteroscopic, laparoscopic way or laparotomy for patients who desire to preserve fertility. Arteries embolisation is an alternative to hysterectomy or myomectomy for patients without desire of pregnancy. Preoperative treatments by GnRH agonist or SPRM like ulipristal acetate treat anaemia, decrease the myoma volume and could modify the therapeutic strategy. PMID:24855792

Fernandez, Hervé

2014-04-01

118

A case of parasitic myoma diagnosed by immunohistochemistry  

Directory of Open Access Journals (Sweden)

Full Text Available A case of parasitic myoma diagnosed by immunohistochemistry is presented . The importance of histopathological and immumohistochemical procedures in the differential diagnosis of parasitic myoma from stromal tumors was discussed.

Kamac?, M.

2004-01-01

119

Treatment of uterine leiomyoma with magnetic resonance-guided focused ultrasound surgery (MRgFUS)  

International Nuclear Information System (INIS)

Uterine leiomyoma is the most common pelvic tumor in women. Although hysterectomy has long been the standard treatment for uterine myoma, some uterus-preserving alternatives are available today. Among these, magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a minimally-invasive procedure that uses high intensity ultrasound waves to ablate tissue. The present study investigates the efficacy of MRgFUS in the treatment of uterine myoma and the histopathological features on extirpated myoma tissue, when alternative surgical treatment is requisite. The Ethics Committee of Shinsuma Hospital approved the treatment of uterine myoma by MRgFUS, and written informed consent was obtained from all of the patients in compliance with the principles of good clinical practice. Between June 2004 and March 2007, 81 premenopausal patients with 125 myomas confirmed by T2-weighted MRI were treated by MRgFUS. The myomas were classified into 3 types based on signal intensity of T2-weighted images type I, low intensity; type II, intermediate intensity and type III, high intensity. The ablation (the non-perfused ratio of gadolinium injection) was about 55% in type I and type II, and 38% in type III. There was no correlation between the ablation ratio and the location or the size of the myoma. The uterine muscle was spared ablation when 2 combined myomas were treated as one tumor, suggesting that the vascularity was richer in the uterine muscle layer than in the myoma Sufficient ablation of the myoma near the Os sacrum is not able to attain immediately after the treatment; however, in several cases a complete non-perfusion margin was observed 3 or 6 months after the treatment. These cases yield very satisfactory results and it is meaningful to search for the reason why such good results were induced. Alternative treatment such as hysterectomy, myomectomy, trans cervical resection (TCR) or uterine artery embolization (UAE) was indicated for 13.6% of the patients. Here, we demonstrate a case of leiomyosarcoma disclosed after MRgFUS and display T2-weighted schemas of myoma and leiomyosarcoma before and 6 months after treatment, attesting to the essentiality of follow-up after the procedure. MRgFUS was of little effect in cases of cellular leiomyoma in which regrowth of leiomyoma cells was observed at the periphery of the myoma. Necl-2 and COX-2 were positive in cellular leiomyoma tissue, as are myogenic stem cells in skeletal muscle. Moreover, numerous mast cells and abundant vascularity was found in cellular leiomyomas. These results suggest that cellular leiomyoma and myoma with hypervascularity or degenerative changes are resistant to MRgFUS treatment. (author)

2007-09-01

120

Uterine fibroid embolization  

International Nuclear Information System (INIS)

Full text: Introduction: Today, after numerous lengthy randomized trials embolization of uterine fibroids has become a standard treatment. Percutaneous embolization of myomas is a micro - invasive surgery, which can be regarded as an alternative to traditional surgery. Although these data 2/3 of the patients were not informed about this treatment option. What you will learn: The uterine embolization is minimal invasive non-surgical procedure. It is an alternative treatment to surgery. Under local anesthesia in the femoral artery puncture reaches the internal iliac artery and uterine arteries. Reached selectively by the catheter and chemicals, which causes clogging, are injected into them. In the vessels that feed fibroids occur a process like an attack, the feeding stops, it starts to shrink and it is replaced by fibrous tissue. The blood vessels of the healthy tissue are different in size and have a plurality of collateral connections as opposed to those of the myoma and thus the blood supply to the normal tissue of the uterus is not distorted. Discussion: Nowadays there are more well- calibrated materials for embolization and those with a particle size of about 700µ are proven as the most successful. The procedure is well tolerated, but after a pain occurs, which has to be covered with anesthetics. Usually pain and metrorrhagia disappear immediately. The fibroids themselves shrink to varying degrees. Hospital stay was significantly shorter than that after surgery, and remained fertile power. Complications are few and rare require further treatment. Multiple nodes are problematic and it is difficult to detect the primary one. A three and six months tracking by MRI is desirable. Conclusion: Embolization of uterine myoma is an established method of treatment primarily on clinical symptoms resulting therefrom. In all patients rapidly disappear metrorrhagia symptoms and morbidity, the volume of the assembly decrease, which together with shorter hospital stays and fertility preservation is well accepted by patients and therefore it is a good alternative to surgery

2013-09-26

 
 
 
 
121

Water Intoxication during Transcervical Electrosurgical Resection of Uterine Myoma  

Directory of Open Access Journals (Sweden)

Full Text Available Submucous leiomyomas, the most common benign tumors of the female genital tract, affect 20%to 30% of all women of reproductive age. Transcervical electrosurgical resection (TCR is usuallyperformed for patients with chronic menorrhagia caused by submucous leiomyomas. We report a caseof severe intraoperative hyponatremia resulting from water intoxication during TCR. Although waterintoxication during TCR is not common due to its short surgical duration, anesthesiologists shouldstill be alert to the manifestation of intraoperative water intoxication and surgeons should also keep inmind the possibility of water intoxication during extended surgical procedures. With appropriate proceduresin place, more complications will be avoided.

Chih-Chung Tsai

2006-08-01

122

[Uterine myoma: modalities and indications for coelioscopic treatment].  

Science.gov (United States)

Only complicated fibromas refractory to medical treatment should be treated surgically. Two types of operations can be proposed for interstitial and subserosal fibromas: myomectomy and hysterectomy. The indication, based on a through preoperative assessment, depends on the patient's age and the size, number and sites of the fibromas and associated lesions. Preliminary series confirm the feasibility of these two operations performed by laparoscopy, as a result of the progress in this modality over recent years. In the future, larger series will determine the respective place of each of these surgical procedures in relation to others surgical possibilities. PMID:7847925

Chapron, C; Dubuisson, J B; Chavet, X; Aubert, V; Morice, P; Aubriot, F X; Foulot, H

1994-01-01

123

Comparison of DNA hypermethylation patterns in different types of uterine cancer: cervical squamous cell carcinoma, cervical adenocarcinoma and endometrial adenocarcinoma.  

Science.gov (United States)

The incidence of cervical adenocarcinoma (CA) is rising, whereas the incidence of cervical squamous cell carcinoma (CSCC) continues to decrease. However, it is still unclear whether different molecular characteristics underlie these 2 types of cervical carcinoma. To better understand the epigenetic characteristics of cervical carcinoma, we investigated the DNA promoter hypermethylation profiles in CA and CSCC. In addition, we investigated whether DNA hypermethylation patterns might be used for the molecular diagnosis of CA and endometrial adenocarcinoma (EA). Using the bisulfite-modification technique and methylation-specific PCR, we examined the aberrant promoter hypermethylation patterns of 9 tumor suppressor genes (APC, DAPK, CDH1, HLTF, hMLH1, p16, RASSF1A, THBS1 and TIMP3) in 62 CSCCs, 30 CAs and 21 EAs. After Bonferroni correction adjustment (statistically significant at p HLTF and TIMP3 were more frequently methylated in CAs (3.2% vs. 43.3%, p < 0.001; 8.1% vs. 53.3%, p = 0.001). The hypermethylations of RASSF1A and APC were more frequent in CAs than in CSCCs, but this was not significant (9.7% vs. 33.3%, p = 0.008; and 14.5% vs. 40.0%, respectively, p = 0.009). In addition, RASSF1A hypermethylation was significantly more frequent in EAs than in CAs (81.0% vs. 33.3%, p = 0.001). In conclusion, the existence of these unique methylation patterns in these cancers suggests that their tumorigenesis may involve different epigenetic mechanisms. PMID:16331610

Kang, Sokbom; Kim, Jae Weon; Kang, Gyeong Hoon; Lee, Sun; Park, Noh Hyun; Song, Yong Sang; Park, Sang Yoon; Kang, Soon Beom; Lee, Hyo Pyo

2006-05-01

124

Epidemiological factors associated with uterine fibroids  

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Introduction: The uterine fibroids are the most common benign neoplasm in the female genital tract. However, the prevalence of this disease in the general population is unknown, which justifies this investigation. Objective: To evaluate epidemiological factors associated with uterine myomas, in a setting of a private medical clinic. Methodology: It is presented as a cross-sectional research, drafted with a descriptive and an analytical component. To collect data a routine...

Barbosa, Li?gia Fla?via Da Silva

2012-01-01

125

Cesarean Section followed by myomectomy in a pregnancy complicated by left intraligamentous myoma  

Directory of Open Access Journals (Sweden)

Full Text Available A 20-year-old primigravida with 38th weeks of gestation complicated with a left large solid intraligamentous uterine tumor. The operation started with lower segment cesarean section to delivere the fetus. Intramural uterotonica was given and the uterus contracted well; intra- and up to 24 hours post-operatively oxytocin infusion was administered. Double circle stitching technique was performed on lateral side of the mioma before starting myomectomy. No blood transfusion was given. The histopatological report was leiomyoma. She was discharged in healthy condition 4 days post-operatively. (Med J Indones 2004; 13: 66-8 Keywords: Myomectomy, cesarean section, intraligamentous myoma

Arifuddin Djuanna

2004-03-01

126

Curative effects of two new endometrial ablation procedures using radiofrequency thermocoagulation for the treatment of severe abnormal uterine bleeding.  

Science.gov (United States)

Severe Abnormal Uterine Bleeding (SAUB) is a common gynecological disorder. The clinical characteristics include disordered menstrual cycle and massive bleeding that can cause anemia or secondary infection. Current treatment mainly relies on drug therapy or surgical removal of the uterus, each having its significant disadvantages. How to preserve the uterus, reduce the pain from surgery, and achieve better treatment effects have been well known but remaining as unresolved issues. This study aims at evaluating two types of radiofrequency (RF) thermocoagulation procedures for the treatment of SAUB: the RF-A procedure group included 25 SAUB patients ?45 years of age treated for amenorrhea; the RF-B procedure group included 51 patients at <45 years of age treated for the control of excessive bleeding. Post-treatment ratings of menstrual satisfaction and pre-/post-treatment menstrual scores-pictorial blood loss assessment chart (PBAC)-and hemoglobin levels were collected; and the mean length of follow-up was 72 months. Also, 38 SAUB patients treated with standard drug regimens served as a control group. The results of the study showed that following RF treatment, the average long-term patient menstrual satisfaction was greater than 92 %. In both the RF groups, PBAC scores and hemoglobin levels were significantly improved from baseline (p < .05). Compared with the control group, PBAC scores and hemoglobin levels were also significantly better for the RF groups at 6-24-month post-operation. Patients experienced no hysterectomy in association with the RF procedures. In conclusion, this pilot study suggests that the novel RF procedures are both safe and effective in treating patients with SAUB. Further investigation is necessary to evaluate their application in broader clinical indication. PMID:23325308

Yin, Geping; Li, Juan; Zhu, Tongyu; Chen, Ming

2013-07-01

127

Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding  

DEFF Research Database (Denmark)

To evaluate whether saline contrast sonohysterography (SCSH) adds additional information to that obtained by transvaginal sonography (TVS) for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding.

Dueholm, M; Forman, Axel

2001-01-01

128

Dysfunctional Uterine Bleeding  

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Dysfunctional uterine bleeding (DUB) is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. It may be associated with ovulatory and anovulatory cycles. The diagnosis of DUB depends on a thorough history and physical examination to exclude organic disorders. In older women, endometrial biopsy should be done before starting therapy. The treatment depends on an understanding of the menstrual cycle. In less urgent cases, anovulatory cycles are managed using progester...

Livingstone, Verity H.

1987-01-01

129

Uterine neoplasms, version 1.2014.  

Science.gov (United States)

Adenocarcinoma of the endometrium (also known as endometrial cancer or more broadly as uterine cancer or carcinoma of the uterine corpus) is the most common malignancy of the female genital tract in the United States. An estimated 49,560 new uterine cancer cases will occur in 2013, with 8190 deaths resulting from the disease. Uterine sarcomas (stromal/mesenchymal tumors) are uncommon malignancies, accounting for approximately 3% of all uterine cancers. The NCCN Guidelines for Uterine Neoplasms describe malignant epithelial carcinomas and uterine sarcomas; each of these major categories contains specific histologic groups that require different management. This excerpt of these guidelines focuses on early-stage disease. PMID:24586086

Koh, Wui-Jin; Greer, Benjamin E; Abu-Rustum, Nadeem R; Apte, Sachin M; Campos, Susana M; Chan, John; Cho, Kathleen R; Cohn, David; Crispens, Marta Ann; Dupont, Nefertiti; Eifel, Patricia J; Fader, Amanda Nickles; Fisher, Christine M; Gaffney, David K; George, Suzanne; Han, Ernest; Huh, Warner K; Lurain, John R; Martin, Lainie; Mutch, David; Remmenga, Steven W; Reynolds, R Kevin; Small, William; Teng, Nelson; Tillmanns, Todd; Valea, Fidel A; McMillian, Nicole; Hughes, Miranda

2014-02-01

130

Role of emmprin in endometrial cancer  

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Abstract Background Extracellular matrix metalloproteinase inducer (Emmprin/CD147) is a transmembrane glycoprotein that belongs to the immunoglobulin superfamily. Enriched on the surface of many tumor cells, emmprin promotes tumor growth, invasion, metastasis and angiogenesis. We evaluated the clinical importance of emmprin and investigated its role in endometrial cancer. Methods Emmprin expression was examined in uterine normal endometrium, endometrial hyperpla...

Nakamura Keiichiro; Kodama Junichi; Hongo Atsushi; Hiramatsu Yuji

2012-01-01

131

[Endometrial stromal nodule: a case report].  

Science.gov (United States)

The endometrial stromal nodule is the rarest of the endometrial stromal tumours. It is a benign tumour composed of well-differentiated endometrial stromal cells arranged as a well-circumscribed nodule with smooth, non invasive margins. We describe a case of uterine stromal nodule occurring in a 45-year-old woman with history of menometrorrhagia in which case ultrasonography conclude to a leiomyoma. Epidemiology, pathologic aspects, differential diagnosis, treatment and prognosis are reviewed. PMID:15453037

Mekni, Amina; Bouraoui, Saadia; Kchir, Nidhameddine; Bellil, Khadija; Zouari, Faouzia; Zitouna, Moncef; Haouet, Slim

2004-04-01

132

Endometrial Metastasis from Breast Cancer during Adjuvant Endocrine Therapy  

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It is well-known that tamoxifen increases the risk of endometrial cancer. Although metastasis to the uterus from breast cancer is uncommon, there have been some case reports on uterine metastasis. If an endometrial abnormality is detected, the differential diagnosis of whether the uterine tumor is metastatic or primary is very important to determine the course of treatment. We herein report a case in which we detected a uterine tumor during follow-up after treatment with tamoxifen, and demons...

Hara, Fumikata; Kiyoto, Sachiko; Takabatake, Daisuke; Takashima, Seiki; Aogi, Kenjiro; Ohsumi, Shozo; Teramoto, Norihiro; Nishimura, Rieko; Takashima, Shigemitsu

2010-01-01

133

Imaging of endometrial adenocarcinoma  

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Endometrial cancer is the most common gynaecological malignancy and the incidence rising. Prognosis depends on age of patient, histological grade, depth of myometrial invasion and cervical invasion and lymph node metastases. Myometrial invasion and accurate cervical involvement cannot be predicted clinically. Pre-treatment knowledge of these criteria is advantageous in order to plan treatment. The clinical challenge is to effectively select patients at risk of relapse for more radical treatment whilst avoiding over treating low risk cases. This is important as endometrial cancer predominately occurs in postmenopausal women with co-morbidities. Modern imaging provides important tools in the accurate pre-treatment assessment of endometrial cancer and may optimize treatment planning. However, there is little consensus to date on imaging in the routine preoperative assessment of endometrial carcinoma and practice varies amongst many gynaecologists. Transvaginal ultrasound is often the initial imaging examination for women with uterine bleeding. However, once the diagnosis of endometrial cancer has been made, contrast-enhanced magnetic resonance imaging (MRI) provides the best assessment of the disease. The results of contrast-enhanced MRI may identify patients who need more aggressive therapy and referral to a cancer centre. In this article we review the role of imaging in the diagnosis and staging/preoperative assessment of endometrial carcinoma.

Barwick, T.D. [Department of Radiology, St Bartholomew' s Hospital, West Smithfield, London (United Kingdom); Rockall, A.G. [Department of Radiology, St Bartholomew' s Hospital, West Smithfield, London (United Kingdom); Barton, D.P. [Department of Gynaecological Oncology, Royal Marsden Hospital, London (United Kingdom); Sohaib, S.A. [Department of Radiology, Royal Marsden Hospital, London (United Kingdom)

2006-07-15

134

Imaging of endometrial adenocarcinoma  

International Nuclear Information System (INIS)

Endometrial cancer is the most common gynaecological malignancy and the incidence rising. Prognosis depends on age of patient, histological grade, depth of myometrial invasion and cervical invasion and lymph node metastases. Myometrial invasion and accurate cervical involvement cannot be predicted clinically. Pre-treatment knowledge of these criteria is advantageous in order to plan treatment. The clinical challenge is to effectively select patients at risk of relapse for more radical treatment whilst avoiding over treating low risk cases. This is important as endometrial cancer predominately occurs in postmenopausal women with co-morbidities. Modern imaging provides important tools in the accurate pre-treatment assessment of endometrial cancer and may optimize treatment planning. However, there is little consensus to date on imaging in the routine preoperative assessment of endometrial carcinoma and practice varies amongst many gynaecologists. Transvaginal ultrasound is often the initial imaging examination for women with uterine bleeding. However, once the diagnosis of endometrial cancer has been made, contrast-enhanced magnetic resonance imaging (MRI) provides the best assessment of the disease. The results of contrast-enhanced MRI may identify patients who need more aggressive therapy and referral to a cancer centre. In this article we review the role of imaging in the diagnosis and staging/preoperative assessment of endometrial carcinoma

2006-07-01

135

Diagnostic use of immunohistochemistry in uterine mesenchymal tumors.  

Science.gov (United States)

Immunohistochemistry may be helpful in the diagnosis of mesenchymal uterine tumors. This article reviews the immunoreactions used most frequently in the diagnosis of uterine smooth muscle tumors, endometrial stromal tumors, undifferentiated endometrial sarcomas, UTROSCTs, PEComas, adenomyomas, adenosarcomas and carcinosarcomas. PMID:24863031

D'Angelo, Emanuela; Prat, Jaime

2014-05-01

136

Role of emmprin in endometrial cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Extracellular matrix metalloproteinase inducer (Emmprin/CD147 is a transmembrane glycoprotein that belongs to the immunoglobulin superfamily. Enriched on the surface of many tumor cells, emmprin promotes tumor growth, invasion, metastasis and angiogenesis. We evaluated the clinical importance of emmprin and investigated its role in endometrial cancer. Methods Emmprin expression was examined in uterine normal endometrium, endometrial hyperplasia and cancer specimens by immunohistochemistry. In addition, the biological functions and inhibitory effects of an emmprin knockdown were investigated in HEC-50B and KLE endometrial cancer cell lines. Results The levels of emmprin expression were significantly increased in the endometrial cancer specimens compared with the normal endometrium and endometrial hyperplasia specimens (p?p?p? Conclusions The present findings suggest that low emmprin expression might be a predictor of favorable prognosis in endometrial cancer patients, and that emmprin may represent a potential therapeutic target for endometrial cancer.

Nakamura Keiichiro

2012-05-01

137

Usefulness of Sonohysterography in the Differentiation of Endometrial and EndometriaI Cavity Abnormalities :Comparison with TransvaginaI Sonography  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the diagnostic accuracy and usefulness odsonohysterography(SH) in the diagnosis of endometrial and endometrial cavity abnormalities. 51 patients with suspected endometrial abnormalities were examined with both transvaginal sonography(TVS) and SH. The results of both techniques were correlated with pathologic findings obtained by surgical procedures and the accuracies of the techniques were compared. Of 55 histologically proven lesions, there were endometrialhyperplasia(n=4), endometrial polyp(n=30), endometrial polyp with hyperplasia(n=2), placental polyp(n=3), submucosal myoma(n=10) and synechia(n=6). The diagnostic accuracy in differentiation of endometrial and endometrial cavity abnormalities was increased from 79% in conventional TVS to 95% in SH(p<0.001). SH was a simple and well-tolerated technique to perform, favorably depicting the endometrial and endometrial cavity abnormalities that were equivocal on TVS

1995-12-01

138

Uterine sarcoma.  

Science.gov (United States)

Thirty-four cases of uterine sarcoma were studied with regard to their pathologic characteristics and response to treatment. Pathologic features did not always correlate with subsequent course. Combined therapy seems to enhance two-year survival in endometrial stromal sarcoma (ESS), although some patients may have low-grade tumors and hence represent a more favorable group. Adjuvant irradiation may improve local control rates in some mixed mesodermal sarcomas (MMS), but does not add appreciably to survival. It is of doubtful benefit in the leiomyosarcoma (LMS) group. When irradiation is employed, preoperative therapy is preferred except in the highly malignant mixed mesodermal sarcomas where prompt surgery seems indicated first. Supplemental brachytherapy may also be employed. PMID:1208858

Belgrad, R; Elbadawi, N; Rubin, P

1975-01-01

139

A murine uterine transcriptome, responsive to steroid receptor coactivator-2, reveals transcription factor 23 as essential for decidualization of human endometrial stromal cells.  

Science.gov (United States)

Recent data from human and mouse studies strongly support an indispensable role for steroid receptor coactivator-2 (SRC-2)-a member of the p160/SRC family of coregulators-in progesterone-dependent endometrial stromal cell decidualization, an essential cellular transformation process that regulates invasion of the developing embryo into the maternal compartment. To identify the key progesterone-induced transcriptional changes that are dependent on SRC-2 and required for endometrial decidualization, we performed comparative genome-wide transcriptional profiling of endometrial tissue RNA from ovariectomized SRC-2(flox/flox) (SRC-2(f/f) [control]) and PR(cre/+)/SRC-2(flox/flox) (SRC-2(d/d) [SRC-2-depleted]) mice, acutely treated with vehicle or progesterone. Although data mining revealed that only a small subset of the total progesterone-dependent transcriptional changes is dependent on SRC-2 (?13%), key genes previously reported to mediate progesterone-driven endometrial stromal cell decidualization are present within this subset. Along with providing a more detailed molecular portrait of the decidual transcriptional program governed by SRC-2, the degree of functional diversity of these progesterone mediators underscores the pleiotropic regulatory role of SRC-2 in this tissue. To showcase the utility of this powerful informational resource to uncover novel signaling paradigms, we stratified the total SRC-2-dependent subset of progesterone-induced transcriptional changes in terms of novel gene expression and identified transcription factor 23 (Tcf23), a basic-helix-loop-helix transcription factor, as a new progesterone-induced target gene that requires SRC-2 for full induction. Importantly, using primary human endometrial stromal cells in culture, we demonstrate that TCF23 function is essential for progesterone-dependent decidualization, providing crucial translational support for this transcription factor as a new decidual mediator of progesterone action. PMID:24571987

Kommagani, Ramakrishna; Szwarc, Maria M; Kovanci, Ertug; Creighton, Chad J; O'Malley, Bert W; Demayo, Francesco J; Lydon, John P

2014-04-01

140

Treatment of myomas by laparoscopic and laparotomic myomectomy and laparoscopic hysterectomy.  

Science.gov (United States)

The objective of this study was to evaluate the benefits, feasibility and limitations of laparoscopic myomectomy. It was a retrospective review (Canadian Task Force Classification II-2) at a university-based primary treatment centre for endoscopic surgery. The 216 evaluated patients were treated at the Department of Obstetrics and Gynaecology, University of Kiel, between January 1998 and November 2000. Of 216 patients with myomas, 178 (83%) underwent laparoscopic myomectomy, 27 (12%) laparoscopic hysterectomy and 11 (5%) laparotomic myomectomy. The study reviewed the indications and surgical techniques and evaluated the benefits and limitations of laparoscopic myomectomy. Nine patients were selected for Classic Intrafascial Supracervical Hysterectomy (CISH) and 18 for Laparoscopic Assisted Vaginal Hysterectomy (LAVH), i.e. 12% of the patients were selected for laparoscopic hysterectomy. In an additional 11 (5%) patients the laparoscopic approach was difficult because of the location of the myoma and the procedure converted to a laparotomic myomectomy. A total of 178 patients (83%) was treated by laparoscopic myomectomy. The mean hospital stay was three days. No serious complications occurred. Two patients suffered a uterine wound bleeding which was corrected and one patient an abdominal hematoma. Since this study mainly focuses on laparoscopic myomectomies (83%), hysteroscopic myomectomies were evaluated in a separate study. At our institution laparoscopic myomectomy is the first-step treatment for patients with myomatous uteri. Only a small percentage of patients had to undergo a laparotomy (5%) and for 27 patients (12%) hysterectomy proved to be the treatment of choice. PMID:16754126

Mettler; Schollmeyer; Lehmann-Willenbrock; Dowaji; Zavala

2004-02-01

 
 
 
 
141

Endometrial haemostasis and menstruation.  

Science.gov (United States)

Under normal physiological circumstances menstruation is a highly regulated, complex process that is under strict hormonal control. During normal menstruation, progesterone withdrawal initiates menstruation. The cessation of menstrual bleeding is achieved by endometrial haemostasis via platelet aggregation, fibrin deposition and thrombus formation. Local endocrine, immunological and haemostatic factors interact at a molecular level to control endometrial haemostasis. Tissue factor and thrombin play a key role locally in the cessation of menstrual bleeding through instigation of the coagulation factors. On the other hand, fibrinolysis prevents clot organisation within the uterine cavity while plasminogen activator inhibitors (PAI) and thrombin-activatable fibrinolysis inhibitors control plasminogen activators and plasmin activity. Abnormalities of uterine bleeding can result from imbalance of the haemostatic factors. The most common abnormality of uterine bleeding is heavy menstrual bleeding (HMB). Modern research has shown that an undiagnosed bleeding disorder, in particular von Willebrand disease (VWD) and platelet function disorders, can be an underlying cause of HMB. This has led to a change in the approach to the management of HMB. While full haemostatic assessment is not required for all women presenting with HMB, menstrual score and bleeding score can help to discriminate women who are more likely to have a bleeding disorder and benefit from laboratory haemostatic evaluation. Haemostatic agents (tranexamic acid and DDAVP) enhance systemic and endometrial haemostasis and are effective in reducing menstrual blood loss in women with or without bleeding disorders. Further research is required to enhance our understanding of the complex interactions of haemostatic factors in general, and specifically within the endometrium. This will lead to the development of more targeted interventions for the management of abnormal uterine bleeding in the future. PMID:23180227

Davies, Joanna; Kadir, Rezan A

2012-12-01

142

Evaluation of uterine adenomyosis by magnetic resonance imaging  

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To assess the capability of magnetic resonance imaging (MR imaging) to enable the detection of the characteristic findings of uterine adenomyosis, 50 pathologically proved adenomyosis lesions (27 cases accompanied with uterine myoma) were chosen and their MRI findings were reviewed. MR imaging was performed with a superconducting magnet, Magnex 150/HP ( 1.5 Tesla), 100 ( 1.0 Tesla) and {alpha} (0.5 Tesla). When both T1-weighted images and T2-weighted images were analyzed, the detection rate of adenomyosis was 82%. In 9 cases (18%), adenomyosis was not detected, due to motion artifact in 2 cases, diffuse hypointensity of the myometrium in 3 cases and distortion of the endometrium by myoma node in 4 cases. On the T1-weighted image, adenomyosis was detected as an enlarged uterus with a smooth external configuration in 20%, within half of which high signal intensity spots representing islands of menstrual hemorrhagic areas were seen. A specific diagnosis of adenomyosis could be made in those cases. On the T2-weighted image, high signal intensity spots (thought to represent heterotopic endometrium) were seen in 46%. On the T2-weighted image, adenomyosis was demonstrated as thickening of the junctional zone (JZ) extending through the myometrium in 80%. Dynamic enhanced MR imaging was performed in 5 cases, 4 of which were accompanied with uterine myoma. Adenomyosis showed sparse contrast enhancement in the early phase, while uterine myoma had no morked enhancement in the early phase but became gradually enhanced in the late phase. In conclusion, MR imaging is useful for detection of adenomyosis. However, when it is difficult to detect adenomyosis or to distinguish it from uterine myoma, dynamic enhanced MR imagings may provide more useful information. (author)

Kakiuchi, Hideo [Tokyo Medical Coll. (Japan)

1997-03-01

143

Evaluation of uterine adenomyosis by magnetic resonance imaging  

International Nuclear Information System (INIS)

To assess the capability of magnetic resonance imaging (MR imaging) to enable the detection of the characteristic findings of uterine adenomyosis, 50 pathologically proved adenomyosis lesions (27 cases accompanied with uterine myoma) were chosen and their MRI findings were reviewed. MR imaging was performed with a superconducting magnet, Magnex 150/HP ( 1.5 Tesla), 100 ( 1.0 Tesla) and ? (0.5 Tesla). When both T1-weighted images and T2-weighted images were analyzed, the detection rate of adenomyosis was 82%. In 9 cases (18%), adenomyosis was not detected, due to motion artifact in 2 cases, diffuse hypointensity of the myometrium in 3 cases and distortion of the endometrium by myoma node in 4 cases. On the T1-weighted image, adenomyosis was detected as an enlarged uterus with a smooth external configuration in 20%, within half of which high signal intensity spots representing islands of menstrual hemorrhagic areas were seen. A specific diagnosis of adenomyosis could be made in those cases. On the T2-weighted image, high signal intensity spots (thought to represent heterotopic endometrium) were seen in 46%. On the T2-weighted image, adenomyosis was demonstrated as thickening of the junctional zone (JZ) extending through the myometrium in 80%. Dynamic enhanced MR imaging was performed in 5 cases, 4 of which were accompanied with uterine myoma. Adenomyosis showed sparse contrast enhancement in the early phase, while uterine myoma had no morked enhancement in the early phase but became gradually enhanced in the late phase. In conclusion, MR imaging is useful for detection of adenomyosis. However, when it is difficult to detect adenomyosis or to distinguish it from uterine myoma, dynamic enhanced MR imagings may provide more useful information. (author)

1997-03-01

144

Benign and malignant tumor of the uterine body with broccoli sign: MR imaging features for differential diagnosis.  

Science.gov (United States)

The characteristic morphology called broccoli sign combines a stalk and prolapsed tumor and is a useful diagnostic indicator of prolapsed tumor of the uterine body. Magnetic resonance (MR) imaging findings of broccoli sign are common for uterine submucosal leiomyomata but not well described for other tumors of the endometrial cavity, such as endometrial polyp, atypical polypoid adenomyoma, endometrial carcinoma, carcinosarcoma, and adenosarcoma. Both benign and malignant masses of the uterine body can show broccoli sign. The MR imaging features of prolapsed uterine tumor with broccoli sign resemble those of usual uterine body tumors, but the location is different. We describe the MR imaging features of prolapsed uterine tumors with broccoli sign. PMID:23719762

Kozawa, Eito; Takahashi, Masahiro; Meguro, Shiori; Yasuda, Masanori; Iwasa, Norihiro; Fujiwara, Keiichi; Kimura, Fumiko

2013-07-01

145

Uterine diseases in cattle after parturition  

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Bacterial contamination of the uterine lumen is common in cattle after parturition, often leading to infection and uterine disease. Clinical disease can be diagnosed and scored by examination of the vaginal mucus, which reflects the presence of pathogenic bacteria such as Escherichia coli and Arcanobacterium pyogenes. Viruses may also cause uterine disease and bovine herpesvirus 4 (BoHV-4) is tropic for endometrial cells, causing a rapid cytopathic effect. The elimination of pathogens by the ...

2008-01-01

146

Endometrial Hyperplasia  

Science.gov (United States)

... be done with an endometrial biopsy , dilation and curettage , or hysteroscopy . What treatments are available for endometrial ... in the blood are too high. Dilation and Curettage: A procedure in which the cervix is opened ...

147

Uterine leiomyoma and its association with menstrual pattern and history of depo-medroxyprogesterone acetate injections  

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Full Text Available L Amanti2, H Sadeghi-Bazargani1, H Abdollahi2, F Ehdaeivand31Statistics and Epidemiology Department, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran; 2Tabriz University of Medical Sciences, Tabriz, Iran; 3Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, IranBackground and aim: Despite the high prevalence of uterine leiomyoma, according to recent review studies there is uncertainty and a paucity of information regarding its predisposing or protective factors. The aim of this study was to assess the possible association between menstrual cycle pattern and occurrence of surgically treated myomas and also to check if depo-medroxyprogesterone acetate (DMPA injection earlier in reproductive life can affect the later occurrence of myomas needing surgical treatment.Methods: In a case–control study in Ardabil, 85 women with definite diagnosis of surgically treated uterine leiomyoma and 154 community controls were enrolled. Possible predictors of myoma including menstrual cycle and menstrual bleeding patterns were assessed. Data were analyzed using SPSS software (SPSS, IBM, Somers, NY. Odds ratios were used as the main statistic in assessing the strength of observed associations.Results: Mean age of the participants was 41.8 ± 8.5 years. Length of menstrual cycle was associated with myoma and a higher likelihood of myoma was observed among those having shorter menstrual cycles (P < 0.05. Number of menstrual bleeding days was also associated with surgically treated myoma and longer bleeding periods increased the likelihood of myoma (P < 0.05. Only one of the eight women who had a history of depo-medroxyprogesterone acetate injections had developed surgically treated uterine leiomyoma and the others belonged to the control group without a history of surgical treatment for uterine leiomyoma.Conclusion: Menstrual cycle pattern is associated with developing leiomyomas requiring surgical treatment. DMPA, other than its role in myoma treatment, is also assumed to have a role in preventing myomas, but due to the small sample size in this study, larger scale prospective trials are needed in the future.Keywords: myoma, uterine leiomyoma, DMPA, medroxyprogesterone, menstrual cycle, menstrual, depo-provera

Amanati L

2011-07-01

148

[Comparative socioeconomic, anamnestic and psychological studies of patients with uterine myoma and uterine prolapse].  

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30 female patients with the diagnosis of "uterus myomatosus" and a control group of also 30 women with the diagnosis "descensus uteri et vaginae" were examined by a standardized questionnaire containing socio-economic, anamnestic and psychological data. To get information about their personality the "Freiburger Persönlichkeitsinventar" (Freiburg Personality Inventory), half-form A, was administered at the end of the interview. The age limits were 35 and 55 years. The main socio-economic results are the following: during childhood and adolescence the myom-patients lived mainly near towns (p less than 0,01). The women of this group have better relationships to their husbands than the descensus-patients (p less than 0,01) and the husbands of the myom-patients are more often (p less than 0,01) of the same age or younger than their women. 18 out of the 30 women of the myom-group (i.e. more than 50%) said that their wish to become a mother has not been fulfilled while this answer was given by none of the 30 descensus-patients (p less than 0,01). The question is discussed in how far the uterus-myom can be understood as a somatic expression of the frustrated wish to get a child, as a "compensatory growth". Beside this, the authors are aware of the fact that other aspects, f.e. hormonal factors, may be important. PMID:6857159

Fellmann, M; Battegay, R; Rauchfleisch, U; Mall-Haefeli, M

1983-01-01

149

Giant intraabdominal endometrial cyst.  

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Endometriosis is the condition where endometrium gets implanted and flourishes outside the uterine cavity, most commonly in ovary and on the peritoneum which lines the abdominal cavity and viscera. Endometrial cells in areas outside the uterus are influenced by hormonal changes and respond in a way similar to the endometrium inside the uterus. Symptoms often worsen with the menstrual cycle. We present a case of 50 years old female who presented with gross abdominal distension and abdominal pain over years. CT scan showed a huge intraabdominal cyst of unknown origin which was compressing adjacent structures. Patient underwent a high risk operation and whole cyst weighing 214 kg (471 lbs) was removed along with both ovaries and uterus. Histopathologically, it was reported as endometrial cyst. PMID:24953922

Shah, Azhar Ali; Soomro, Niaz Ahmed; Talib, Rabender Kumar; Sadhayo, Asif Nabi; Soomro, Suhail Ahmed

2014-06-01

150

Ultrasonographic findings of Myoma, H-mole and Missed abortion  

International Nuclear Information System (INIS)

Ultrasonography is very important in the diagnosis of various kinds of diseases in Obsterics and Gynecology. It has high diagnostic accuracy in the diagnosis of pelvic masses and widely used for the detection of normal orpathologic pregnancy. But still it is difficult to differentiate degenerated myoma, H-mole and missed abortion by ultrasonography. So the authors analyzed the ultrasonographic findings of 81 patients with myoma(29 cases), H-mole(23 cases), and missed abortion(29 cases) and the results are as follows; 1. Diagnostic accuracy was 8.6% in myoma, 87% in H-mole and 89% in missed abortion. 2. The most typical ultrasonographic finding of myoma was obulated mass contour with nonhomogenous internal echo. 3. The most characteristic finding of H-mole was fine vesicular pattern internal echo with globular enlargement of uterus. 4. The most frequent finding of missed abortion was deformed gestational sac with or without remained fetal echo. 5. Clinical correlation was very important for accurate diagnosis, especially when differential diagnosis was very difficult between myoma with marked cystic degeneration, missed abortion with large distorted gestational sac and H-mole with severe degeneration

1982-12-01

151

Endometrial adenofibroma: a rare entity.  

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Endometrial adenofibroma is an uncommon mullerian mixed tumor composed of benign epithelial and mesenchymal components. This tumor must be distinguished from other malignant lesions of the uterus, particularly adenosarcoma. The authors report three cases of endometrial adenofibroma and discuss their clinical and histopathologic features. The tumors were diagnosed in patients 31, 55 and 63 years of age. In all three cases polypoid lesions of 13, 2 and 5 cm, respectively, were found in the uterine cavity. A polypectomy was performed in two cases; one patient underwent hysterectomy. Follow-up was available for two patients who are today alive and well. PMID:16858575

Bettaieb, Ilhem; Mekni, Amina; Bellil, Khadija; Haouet, Slim; Bellil, Selma; Kchir, Nidhameddine; Chelly, Hela; Zitouna, Moncef

2007-03-01

152

Morphometric evaluation of endometrial blood vessels  

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Five hundred endometrial specimens were studied to document the changes in blood vessels in various phases of menstrual cycle, menstrual disturbances and in unexplained infertility. Sixty-three cases were taken as control and 437 cases as study group which included cases of dysfunctional uterine bleeding (DUB), endometrial polyps, fibroids, adenomyosis, infertility and atrophic endometrium. Using light microscopy, the vascular morphology was studied. The blood vessels were concentrated more i...

Makhija Divya; Mathai Alka; Naik Ramadas; Kumar Suneet; Rai Sharada; Pai Muktha; Baliga Poornima

2008-01-01

153

PET in uterine malignancies  

Directory of Open Access Journals (Sweden)

Full Text Available Positron Emission Tomography (PET or integrated PET/Computed Tomography (PET/CT with 18F-Fluoro-Deoxy-Glucose (18F-FDG is a functional imaging modality, useful in the characterization of undetermined morphological findings, and in the staging/re-staging of a large number of malignancies. Although its use in uterine malignancies has been poorly investigated, in recent years the employment of this technique has constantly increased. In this review, we evaluate the role of PET (/CT with 18FFDG in uterine malignancies (cervical and endometrial cancers as well as uterine sarcomas, underlying its advantages and discussing its limitations. Metabolic and anatomic information given by PET/CT with 18F-FDG could be useful in the evaluation of local and distant disease involvement at the staging, in the detection of disease recurrence, and in the evaluation of the response after chemotherapy and/or radio-therapy.

Valeria Pirro

2010-07-01

154

Dysfunctional uterine bleeding.  

Science.gov (United States)

Abnormal uterine bleeding is a common, debilitating condition. Dysfunctional uterine bleeding (DUB) is the diagnosis given to women with abnormal uterine bleeding in whom no clear etiology can be identified. DUB has been observed in both ovulatory and anovulatory cycles. Medical treatments include nonsteroidal anti-inflammatory drugs, oral contraceptive pills, progestins, danazol (a synthetic androgen), GnRH agonists, and antifibrinolytic drugs. The drawback to medical therapy, in addition to side effects, is that the benefit lasts only while the patient takes the medication. Surgical options have concentrated mainly on endometrial ablation and hysterectomy, and it is unclear whether one is superior to the other in terms of long-term outcome and patient satisfaction. Newer and less invasive ablation techniques, such as thermal balloon ablation, offer more treatment alternatives. PMID:9830356

Chen, B H; Giudice, L C

1998-11-01

155

A single horn endometrial carcinoma of a uterus bicornis unicollis  

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In this report, we describe a case of endometrial carcinoma arising in one horn of a bicornuate uterus. The diagnosis of this rare combination can be missed unless an unrecognized postmenopausal bleeding alerts the gynecologist to make a careful search for both endometrial cavities that may be curetted. Physicians should remember the possible existence of a separate uterine cavity when endometrial cancer is clinically suspected but histology fails to confirm the diagnosis.

Dane, Cem; Tatar, Zeynep; Dane, Banu; Erqinbas, Murat; Cetin, Ahmet

2009-01-01

156

Controlled analysis of factors associated with insufficient sample on outpatient endometrial biopsy.  

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We examined the relative significance of hysteroscopic and ultrasonographic evidence of endometrial atrophy in relation to insufficient sample on outpatient endometrial biopsy in women with abnormal uterine bleeding. Multivariate logistic regression modelling was used to evaluate the independent effects of age, menopausal status, hysteroscopic findings and sonographic endometrial thickness on outpatient endometrial sampling (sufficient or insufficient) used as the binary dependent variable. Insufficient sample on endometrial biopsy was associated with hysteroscopic finding of endometrial atrophy (OR 4.79, 95% CI 1.05-21.91, P = 0.04) and sonographic endometrial thickness below 5 mm (OR 0- 19. 95% CI 0.07-0.53, P = 0.001). There was no association with patient's age and menopausal status. In conclusion, when reassuring women with insufficient sample on outpatient endometrial biopsy, one can be confident about absence of pathology provided the hysteroscopic and sonographic endometrial assessment is consistent with endometrial atrophy. PMID:11028588

Bakour, S H; Khan, K S; Gupta, J K

2000-10-01

157

Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions  

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Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB) or intrauterine lesions causing uterine bleeding. Methods: This study prospectively enrolled 100 patients who underwent operative hysteroscopy in tertiary referral university center because of uterine bleeding due to endometrial polyps or uterine submucosal leiomyomas diagnosed by t...

2013-01-01

158

Can ABCF2 protein expression predict the prognosis of uterine cancer?  

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Uterine cervical and endometrial cancers are common malignant solid neoplasms for which there are no useful prognostic markers. In this study, we evaluate the relationship between ATP-binding cassette superfamily F2 (ABCF2) expression and clinical factors including clinical stage, histologic type, grade and prognosis in uterine cervical and endometrial cancer. Two hundred and sixty seven cervical and 103 endometrial cancers were studied. ATP-binding cassette superfamily F2 cytoplasmic express...

2008-01-01

159

Low grade endometrial stromal sarcoma in a premenopausal woman.  

Science.gov (United States)

Endometrial stromal sarcoma are rare malignant tumors of the uterus and has been described as the second most common malignant uterine mesenchymal tumor. The diagnosis is confirmed on hysterectomy for a presumed benign disease. In the latest World Health Organization (WHO) classification (2003), the term endometrial stromal tumor is applied to neoplasms typically composed of cells that morphologically resemble endometrial stromal cells of the nonneoplastic proliferative phase endometrium. The WHO recognizes three categories of endometrial stromal tumors: Endometrial stromal nodule, low-grade endometrial stromal sarcomas (LGESS), and undifferentiated endometrial sarcoma. We report here an interesting case of a 39-year-old female who presented with irregular bleeding per vaginum and urinary retention with a clinical impression of a leiomyomatous polyp, which on histological examination showed a LGESS. PMID:24678233

Jetley, Sujata; Rana, Safia; Jairajpuri, Zeeba S

2014-01-01

160

UTERINE ARTERY EMBOLIZATION FOR THE TREATMENT OF UTERINE FIBROIDS  

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Full Text Available AIM: To determine the outcome of uterine artery embolization in patients with symptomatic uterine fibroids, in order to assess the response of symptoms and fibroid size. METHODS: We analyzed the results of a population study of 112 patients with uterine fibroids made in the period between 2006 and 2010. Main parameters were assessed improvement or disappearance of symptoms and downsizing the adverse effects of the procedure. RESULTS: The predominant age of the patients are in the group of 41-45 years with 80.35%, being the most common symptom of menorrhagia 66.07%, myoma volume ranged between 35cm3 and 523cm3, and procedure duration ranged from 1 hour to 2.5 hours. The most common symptoms after embolization was mild pain 44.64%, not having symptoms in 43.75%. Also it was associated nausea in 8.03% and vomiting in 3.57% as other adverse effects. After three months of treatment 47.32% had oligomenorrhea and amenorrhea was 17.85%. Fibroid size at 6 months was reduced significantly dominate the volume between 36 and 113cm3. CONCLUSION: Uterine artery embolization is an effective treatment for symptomatic fibroids, considered an alternative to surgical treatment

González- Perez Santiago

2013-01-01

 
 
 
 
161

False contouring effect of the uterine wall during hysteroscopy a lesson from immediate hydrosonography  

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A 42 years old woman suffering from repeated events of intensive vaginal bleeding during the week off birth control pills was referred for diagnostic hysteroscopy. The patient underwent hysterohy drosonoscopy, a 3-step procedure, including a transvaginal ultrasound scan, a diagnostic hysteroscopy and immediate hydrosonography. A3 cmintramural myoma was detected by the ultrasound scan without impinging onto the uterine ...

Yaron Hamani; Ernst Voss; Asher Shushan; Ronit Haimov-Kochman

2013-01-01

162

CA 125 and other tumor markers in uterine leiomyomas and their association with lesion characteristics.  

Science.gov (United States)

The aim of this study was to investigate the factors associated with serum levels of several tumor markers in a group of patients operated for uterine myoma. One hundred thirty-seven female patients operated for uterine myoma were included. Serum samples were examined for CA 125, CA 19-9, CA 15-3, carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels as part of routine workup. Pathological and morphological characteristics of the patients were retrieved from medical records. The mean age was 46.7 ± 8.8 years (range, 22-85 y). Abnormally high levels of CA 125, CA 19-9, CA 15-3, CEA, and AFP were found in 19.7%, 6.6%, 5.1%, 3.7%, and 1.5% of the patients, respectively. Patients with additional adenomyosis and patients with at least one large myoma (? 5 cm diameter) had significantly higher levels of CA 125. Multivariate analysis identified coexistence of adenomyosis (OR 7.7 [95% CI, 2.6-23.0], p adenomyosis in uterine leiomyomas. Indirect mechanisms caused by large myoma size such as peritoneal irritation may be responsible for CA 125 elevations. PMID:24955185

Babacan, Ali; Kizilaslan, Cem; Gun, Ismet; Muhcu, Murat; Mungen, Ercument; Atay, Vedat

2014-01-01

163

Uterine Fibroids  

Medline Plus

Full Text Available ... focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The procedure ... the bowel or bladder and those outside the image area cannot be treated with FUA. Summary Uterine ...

164

Endometrial Assessment: When is it Necessary?  

Science.gov (United States)

Background Endometrial cancer is the fourth most common cancer among women and the most common malignant neoplasm of the female genital tract in the USA. The onset is usually after the age of 50 and prognosis depends on the stage of disease at diagnosis. We aimed at determining the prevalence of high-risk endometrial lesions in women of different ages to establish a protocol for the indication of invasive diagnostic procedures. Methods A retrospective study was conducted based on the descriptive and statistical analysis of histopathological records of 2,931 patients who underwent uterine curettage between January 2001 and December 2011 at our institution. Results The risk of endometrial malignancy was about 10 times higher in patients aged 50 years or older than that in younger women. However, women with abnormal uterine bleeding had a higher prevalence of high-risk conditions, regardless of age. Conclusion Atypical and complex endometrial hyperplasia and carcinoma can affect women of all ages, but are more common in patients 50 years of age or older. Thus, endometrial sampling is recommended as a routine procedure for all women 50 years of age or older with clinical indications of the disease and as a screening procedure for those undergoing hysterectomy.

Pessoa, Juliana Nicoletti; Freitas, Ana Carolina Lopes; Guimaraes, Ronney Antonio; Lima, Jonnymar; dos Reis, Helena Lucia Barroso; Filho, Antonio Chambo

2014-01-01

165

Radiation therapy of the uterine cancer  

Energy Technology Data Exchange (ETDEWEB)

Cervical and endometrial cancer of the uterus, and ovarian cancer are three major malignant diseases in gynecology in Japan. These diagnosis and therapy are almost established. In uterine cervical cancer, radiation therapy and surgery of these diseases are two main treatment methods, and both treatment results are almost the same. And radiation therapy is also used as postoperative treatment to patients with high risk factors. In endometrial cancer, surgery is main therapy. Radiation therapy is undergone only to medically inoperable cases preoperative radiation is widely carried out in Europe and America, but almost none in Japan. Postoperative irradiation is adapted to the cases with high risk factors. But recent advance of chemotherapy changes the importance of radiation therapy in such patients. I review the literatures of radiation therapy of uterine cervical cancer and of endometrial cancer. (author)

Noguchi, Hiroshi [Matsumoto National Hospital, Nagano (Japan)

1999-02-01

166

Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium  

Directory of Open Access Journals (Sweden)

Full Text Available Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD and lipid hydroperoxides (LOOH in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasiaor adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS. An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications.Resultados epidemiológicos e experimentais apontam para o envolvimento dos radicais derivados do oxigênio na patogênese das moléstias ginecológicas, assim como no desenvolvimento do câncer. O objetivo do presente estudo foi o de examinar as alterações nas atividades e níveis de Cu/Zn superóxido dismutase (CuZnSOD e hidroperóxidos lipídicos (LOOHno sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simplex, hiperplasia complex e adenocarcinoma do endométrio. Os resultados de nosso estudo mostraram atividades de SOD diminuídas e nível de SOD proteína inalterado no sangue de todos os pacientes examinados em comparação a indivíduos saudáveis. Diminuição de ambos, atividade de SOD e nível protéico, foram encontrados no endométrio de pacientes com hiperplasia simplex, hiperplasia complex e adenocarcinoma em comparação às mulheres com pólipos e/ou mioma. O nível de LOOH estava elevado em ambos os tecidos de pacientes com hyperplasia e adenocarcinoma em comparação a indivíduos saudáveis ou pacientes com diagnóstico benigno. Nossos resultados sugerem que um decréscimo na atividade e nível protéico de SOD, assim como um incremento no nível de LOOH, em pacientes com desordens ginecológicas, tornam esses pacientes mais susceptíveis ao dano oxidativo causado pelas espécies reativas de oxigênio (ROS. Um desequilíbrio na formação de ROS e no nível de SOD pode ser importante na patogênese e/ou perpetuação do dano tecidual em pacientes ginecológicos. Desde que existe evidência de que SOD pode ser um alvo para terapia de câncer, nossos resultados fornecem uma base para futura pesquisa e opções para aplicações clínicas.

Snežana Peji?

2008-09-01

167

Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Resultados epidemiológicos e experimentais apontam para o envolvimento dos radicais derivados do oxigênio na patogênese das moléstias ginecológicas, assim como no desenvolvimento do câncer. O objetivo do presente estudo foi o de examinar as alterações nas atividades e níveis de Cu/Zn superóxido dism [...] utase (CuZnSOD) e hidroperóxidos lipídicos (LOOH)no sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simplex, hiperplasia complex e adenocarcinoma do endométrio. Os resultados de nosso estudo mostraram atividades de SOD diminuídas e nível de SOD proteína inalterado no sangue de todos os pacientes examinados em comparação a indivíduos saudáveis. Diminuição de ambos, atividade de SOD e nível protéico, foram encontrados no endométrio de pacientes com hiperplasia simplex, hiperplasia complex e adenocarcinoma em comparação às mulheres com pólipos e/ou mioma. O nível de LOOH estava elevado em ambos os tecidos de pacientes com hyperplasia e adenocarcinoma em comparação a indivíduos saudáveis ou pacientes com diagnóstico benigno. Nossos resultados sugerem que um decréscimo na atividade e nível protéico de SOD, assim como um incremento no nível de LOOH, em pacientes com desordens ginecológicas, tornam esses pacientes mais susceptíveis ao dano oxidativo causado pelas espécies reativas de oxigênio (ROS). Um desequilíbrio na formação de ROS e no nível de SOD pode ser importante na patogênese e/ou perpetuação do dano tecidual em pacientes ginecológicos. Desde que existe evidência de que SOD pode ser um alvo para terapia de câncer, nossos resultados fornecem uma base para futura pesquisa e opções para aplicações clínicas. Abstract in english Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD) and [...] lipid hydroperoxides (LOOH) in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasiaor adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS). An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications.

Peji& #263; , Sne?ana; Todorovi& #263; , Ana; Stojiljkovi& #263; , Vesna; Cvetkovi& #263; , Dragana; Lu& #269; i& #263; , Nenad; Radoji& #269; i& #263; , Ratko M.; Sai& #269; i& #263; , Zorica S.; Pajovic, Sne?ana B..

168

Uterine factors.  

Science.gov (United States)

Uterine anomalies are one of the most common parental causes of recurrent pregnancy loss, occurring in about 19% of patients. Congenital uterine anomalies are most likely caused by HOX gene mutations, although the mechanism is probably polygenic. There are no known environmental causes other than estrogenic endocrine disruptors such as diethylstilbestrol. Acquired uterine anomalies may result from uterine trauma (adhesions) or benign growths of the myometrium (fibroids) or endometrium (polyps). Although randomized controlled trials are lacking, surgical treatment is recommended for repair of uterine septa, and for removal of severe adhesions and submucosal fibroids, especially if no other causes are identified. PMID:24491984

Jaslow, Carolyn R

2014-03-01

169

Biomarkers of endometrial cancer and related gynaecological malignancies  

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In the Western World, endometrial cancer is the most common malignancy of the female genital tract. Endometrioid endometrial carcinoma (EEC or Type I tumour), accounts for approximately 75% of cases. Type II tumours, of which uterine papillary serous carcinoma (UPSC) is the most common subtype, are less common. Since classification as EEC or UPSC has therapeutic and prognostic implications, it is important to make the proper diagnosis. UPSC share their aggressive clinical behaviour and their ...

2010-01-01

170

Use of Outpatient Endometrial Biopsy in a Population with Intellectual Disability  

Science.gov (United States)

Background: To demonstrate the feasibility of outpatient endometrial sampling to evaluate abnormal uterine bleeding in a population of women with intellectual disability. Method: Retrospective chart review was completed of all endometrial biopsies performed on women attending a dedicated gynaecology clinic for women with intellectual disability…

Jaffe, Joshua S.

2008-01-01

171

Gestação de termo após ablação endometrial Full-term pregnancy after endometrial ablation  

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Full Text Available A ablação endometrial por via histeroscópica é uma técnica utilizada em casos de sangramento uterino anormal com resposta desfavorável ao tratamento clínico. Mesmo com destruição ou ressecção das camadas funcional e basal do endométrio é possível ocorrer uma gravidez posterior à intervenção. No entanto essas gestações freqüentemente terminam em abortamento ou se apresentam com complicações. Relata-se o caso de uma paciente que desenvolveu gravidez a termo sem intercorrências após ter realizado ablação endometrial por sangramento uterino anormal resistente ao tratamento clínico.Endometrial ablation is a useful technique in patientes with abnormal uterine bleeding without response to clinical measures. Pregnancy is possible even after the destruction or resection of the endometrium. The case reported is a normal term pregnancy after endometrial ablation because ot menorrhagia without successful prior clinical treatment.

Rievane S. Damião

1999-06-01

172

Gestação de termo após ablação endometrial / Full-term pregnancy after endometrial ablation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A ablação endometrial por via histeroscópica é uma técnica utilizada em casos de sangramento uterino anormal com resposta desfavorável ao tratamento clínico. Mesmo com destruição ou ressecção das camadas funcional e basal do endométrio é possível ocorrer uma gravidez posterior à intervenção. No enta [...] nto essas gestações freqüentemente terminam em abortamento ou se apresentam com complicações. Relata-se o caso de uma paciente que desenvolveu gravidez a termo sem intercorrências após ter realizado ablação endometrial por sangramento uterino anormal resistente ao tratamento clínico. Abstract in english Endometrial ablation is a useful technique in patientes with abnormal uterine bleeding without response to clinical measures. Pregnancy is possible even after the destruction or resection of the endometrium. The case reported is a normal term pregnancy after endometrial ablation because ot menorrhag [...] ia without successful prior clinical treatment.

Rievane S., Damião; Frederico F., Rodrigues; Salete Yatabe José Francisco D., Ramos; Reginaldo G. C., Lopes; Umberto G, Lippi.

173

Endometrial coccidiosis  

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This report describes a case of granulomatous endometritis caused by coccidiosis in an immunologically uncompromised 63 year old patient. The glandular epithelium of the endometrium contained numerous intracytoplasmic cysts, corresponding to periodic acid Schiff positive and methenamine silver negative sporoblasts. The endometrial glands revealed reactive phenomena, such as eosinophilic and squamous glandular metaplasia and intraluminal desquamation. Non-necrotising epithelioid granulomata, l...

2004-01-01

174

Ultrasound detection of endometrial fluid in postmenopausal women  

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Full Text Available Introduction. The aim of this prospective study was to estimate whether the presence of endometrial fluid detected by transvaginal ultrasound investigation was a marker for the pathological changes of the endometrium in postmenopausal women. Material and methods. 128 postmenopausal women with uterine bleeding and 29 asymptomatic postmenopausal women underwent transvaginal ultrasound investigation, curettage and histopathological investigation of the curettage specimens. Results. There were significantly more asymptomatic women with endometrial fluid collection was found (41,4% than those with uterine bleeding (7,8% (p<0,001. We found 4 cases of carcinoma of the endometrium, 4 with hyperplasia and 1 with polyp of the endometrium in women with uterine bleeding and endometrial fluid collection. In the asymptomatic group of women we found 1 case with polyp and 1 with carcinoma of the endometrium. In the presence of endometrial fluid collection the least thickness of the endometrium measured by transvaginal ultrasound was 12 mm in postmenopausal women with carcinoma of the endometrium, 7 mm in women with hyperplasia and 5 mm with polyp. No pathological changes were found below the above values. Conclusion. The presence of endometrial fluid detected by transvaginal ultrasonography is a good marker for pathological changes of the endometrium in postmenopausal women if the endometrial thickness is greater than 4 mm. If the endometrial thickness is 4 mm or less, the presence of endometrial fluid is not an indication for further invasive investigation of endometrial cavity, but we must eliminate possible presence of ednexal or cervical malignant disease in some patients.

?ur?i? Aleksandar

2009-01-01

175

Endometrial intraepithelial carcinoma: A case report and brief review  

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Full Text Available This case report describes the precursor lesion of uterine papillary serous carcinoma (UPSC. A 65-year-old post-menopausal female presented with prolapse and vaginal discharge and underwent a hysterectomy revealing an atrophic endometrium, highly atypical endometrial glands, the lining cells of which showed pseudostratification, hobnailing, a high nuclear to cytoplasmic ratio, and prominent nucleoli. A p53 immunoreactivity score of 8 and a MIB-1 index of 80% was obtained leading to a diagnosis of endometrial intraepithelial carcinoma (EIC. Since serous EIC is commonly associated with extra-uterine serous carcinoma, it is a uniquely aggressive precursor lesion. Molecular studies support the hypothesis that EIC is a precursor of both uterine and extra-uterine invasive serous carcinomas. This is why the treatment protocol for EIC cases is total abdominal hysterectomy (TAH, accompanied by a staging procedure. In our patient, EIC was limited to the endometrium; associated with an excellent clinical outcome.

Ram Manisha

2008-10-01

176

Studies on the diagnosis of uterine tumor by 201-thallium-chloride  

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Cases of gynecological tumor mainly uterine benign and malignant tumors were evaluated using /sup 201/Thallium-Chloride (/sup 201/Tl-Cl) after intravenous injection. The positive scans of 100% in 42 cases of uterine myoma including 29 cases of leiomyoma, 8 cases of adenomyosis and 5 cases of combined type myoma, also 100% in 8 cases of body cancer indicating adenocarcinoma and 25% in 12 cases of cervical cancer indicating squamous cell carcinoma were observed. The smallest focal lesion for the positive scans was needed approximately more 5 cm in diameter in the cases of leiomyoma. The most accumulation of activities was shown in adenomyosis or adenocarcinoma with much adenoid structure in the pathological study. Accumulation of /sup 201/Tl in uterine benign and malignant tumors was suggested the analog of potassium. The mechanism of tumor affinity was correlated to perfusion volume and the acceleration of the potassium metabolism in a tumor. On the other hand, we suggested the diagnosis of the malignant uterine tumor should be attended due to /sup 201/Tl accumulation also in the benign uterine tumor. The uterine scanning using /sup 201/Tl-Cl was acknowledged to be very useful and safe indicating early detection at 20 minutes after the injection, (non-traumatic procedure and non-visualized bone tissues). In conclusion, this radioisotopical procedure was indicated to be a high value screening examination in the diagnosis of uterine tumor.

Tobari, C.; Muroi, K.; Watanabe, H.; Noguchi, S.; Kurosawa, H. (Toho Univ., Tokyo (Japan). School of Medicine)

1981-10-01

177

Studies on the diagnosis of uterine tumor by 201-thallium-chloride  

International Nuclear Information System (INIS)

Cases of gynecological tumor mainly uterine benign and malignant tumors were evaluated using _2_0_1Thallium-Chloride (_2_0_1Tl-Cl) after intravenous injection. The positive scans of 100% in 42 cases of uterine myoma including 29 cases of leiomyoma, 8 cases of adenomyosis and 5 cases of combined type myoma, also 100% in 8 cases of body cancer indicating adenocarcinoma and 25% in 12 cases of cervical cancer indicating squamous cell carcinoma were observed. The smallest focal lesion for the positive scans was needed approximately more 5 cm in diameter in the cases of leimyoma. The most accumulation of activities was showed in adenomyosis or adenocarcinoma with much adenoid structure in the pathological study. Accumulation of _2_0_1Tl in uterine benign and malignant tumors was suggested the analog of potassium. The mechanism of tumor affinity was correlated to perfusion volume and the acceleration of the potassium metabolism in a tumor. On the other hand, we suggested the diagnosis of the malignant uterine tumor should be attended due to _2_0_1Tl was accumulation also in the benign uterine tumor. The uterine scanning using _2_0_1Tl-Cl was acknowledged to be very useful and safe indicating early detection at 20 minutes after the injection, (non-traumatic procedure and non-visualized bone tissues). In conclusion, this radioisotopical procedure was indicated high value of screening examination in the diagnosis of uterine tumor. (author)

1981-01-01

178

Achados histeroscópicos na cavidade endometrial após ablação endometrial / Hysteroscopic appearance of the endometrial cavity after endometrial ablation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Verificar o aspecto da cavidade uterina após a ablação endometrial histeroscópica, a prevalência de sinéquias após o procedimento e, com isso, avaliar a importância da histeroscopia realizada no pós-operatório dessas pacientes. MÉTODOS: Foram avaliados, retrospectivamente, os laudos [...] dos exames de 153 pacientes que haviam sido submetidas à histeroscopia ambulatorial após ablação do endométrio devido a sangramento uterino anormal de causa benigna, no período entre janeiro de 2006 e julho de 2011. As pacientes foram divididas em dois grupos: HIST?60 (n=90), com pacientes submetidas ao exame no período de 40 a 60 dias após o procedimento, e grupo HIST>60 (n=63), das que foram examinadas entre 61 dias e 12 meses. RESULTADOS: No grupo HIST?60, 30% das pacientes apresentavam algum grau de sinéquia; aderências grau I foram descritas em 4,4%; grau II em 6,7%; grau IIa em 4,4%; grau III em 7,8%; e 2,2% apresentavam grau IV. No HIST>60, sinéquias foram descritas em 53,9% dos casos, 3,2% tinham sinéquias grau I; 11,1%, grau II; 7,9%, grau IIa; 15,9%, grau III; e 4,8%, grau IV. Hematometra foi descrito em 2,2% dos casos do HIST?60 e em 6,3% no HIST>60. CONCLUSÕES: A cavidade uterina de pacientes submetidas à histeroscopia ambulatorial até 60 dias após a ablação endometrial mostrou menor número de sinéquias quando comparada com as cavidades uterinas de pacientes que foram submetidas ao exame após 60 dias. Acompanhamento em longo prazo é necessário para avaliar plenamente o impacto da histeroscopia ambulatorial após a ablação endometrial. Abstract in english PURPOSE: To examine the aspect of the uterine cavity after hysteroscopic endometrial ablation, to determine the prevalence of synechiae after the procedure, and to analyze the importance of hysteroscopy during the postoperative period. METHODS: The results of the hysteroscopic exams of 153 pat [...] ients who underwent outpatient hysteroscopy after endometrial ablation due to abnormal uterine bleeding of benign etiology during the period from January 2006 to July 2011 were retrospectively reviewed. The patients were divided into two groups: HIST?60 (n=90) consisting of patients undergoing the exam 40-60 days after the ablation procedure, and the group HIST>60 (n=63) consisting of patients undergoing the exam between 61 days and 12 months after the procedure. RESULTS: In the HIST?60 group, 30% of the patients presented some degree of synechiae: synechiae grade I in 4.4% of patients, grade II in 6.7% , grade IIa in 4.4%, grade III in 7.8%, and grade IV in 2.2%. In the HIST>60 group, 53.9% of all cases had synechiae, 3.2% were grade I, 11.1% grade II, 7.9% grade IIa, 15.9% grade III, and 4.8% grade IV. Hematometra was detected in 2.2 % of all cases in group HIST?60 and in 6.3% of all cases in group HIST>60. CONCLUSIONS: The uterine cavity of the patients submitted to diagnostic hysteroscopy up to 60 days after endometrial ablation showed significantly fewer synechiae compared to the uterine cavity of patients who underwent the exam after 60 days. Long-term follow-up is necessary to fully evaluate the importance of outpatient hysteroscopy after endometrial ablation regarding menstrual patterns, risk of cancer and prevalence of treatment failure.

Aline Rocha, Guerin; Reginaldo Guedes Coelho, Lopes; Daniella de Batista, Depes; João Alfredo, Martins.

2014-05-20

179

Investigation of amyloid deposition in uterine leiomyoma patients  

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Full Text Available Objects: To investigate the pathogenesis of amyloid presented in uterine leiomyoma. Methods: 36 uterine leiomyoma patients were recruited and divided into two groups according to Congo red staining results. 6 cases are Congo red staining-positive, and 30 cases Congo red staining-negative which represented amyloid positive and amyloid negative respectively. All patients’ serum total protein (TP, albumin (Alb and prealbumin (PA levels were measured as well as blood hemoglobin (Hb, cell counts of white blood cell (WBC, neutrophils (NEU and lymphocyte (LYM. Glycogen in tissue was compared between amyloid accumulated and amyloid negative sections with periodic acid schiff staining (PAS in leiomyoma patients. Results: All of blood Hb concentration, WBC, NEU and LYM have not been found significant differences between two groups. Also no obvious infiltration of inflammatory cells was observed in tissue with amyloid deposition in uterine leiomyoma patients. And levels of TP, Alb and prealbumin have not been found significant differences between two groups. The amyloid was negative in leiomyoma entity cells range by Congo red staining, while small blood vessels in myoma tissues were positively detected with high rate. Amyloid was found in normal tissue around myoma as well as in blood vessel of pseudo-capsule. Increased PAS-positive material induced by leiomyoma was not correlated with amyloid deposition. Conclusions: Metabolic changes in the setting of functional alterations of cell in local microenvironment with uterine leiomyoma, may be related to the amyloid deposition.

Jinping Liu

2012-08-01

180

Serous endometrial intraepithelial carcinoma: a case series and literature review  

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P Pathiraja, S Dhar, K HaldarOxford University Hospital, Oxford, UKBackground: Minimal uterine serous cancer (MUSC) or serous endometrial intraepithelial carcinoma (EIC) has been described by many different names since 1998. There have been very few cases reported in literature since EIC/MUSC was recognized as a separate entity. The World health Organization (WHO) Classification favors the term serous EIC. Although serous EIC is confined to the uterine endometrium at initial histology diagnos...

Pathiraja P; Dhar S; Haldar K

2013-01-01

 
 
 
 
181

Endometrial cancer. Prevention, detection, management, and follow up.  

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OBJECTIVE: To review risk factors for uterine cancer; to discuss strategies for detecting uterine cancer; to outline prognostic factors and treatment; and to review the role of follow up for patients who have completed primary therapy. QUALITY OF EVIDENCE: MEDLINE was searched from January 1996 to June 1998 using the terms endometrial neoplasms, estrogen replacement therapy, hormone replacement therapy, tamoxifen, and screening. Only English language articles were reviewed. Study types includ...

Elit, L.

2000-01-01

182

[Endometrial adenofibroma].  

Science.gov (United States)

We report a case of papillary adenofibroma of the uterine corpus in a 31 year-old woman who was initially examined for vaginal bleeding. Pelvic examination showed a large polypoid mass protruding through the cervix canal. A pelvic ultrasound revealed a polypoid cystic mass apparently arising from the uterus. A polypectomy was performed. The tumor was composed histologically by begin epithelial and mesenchymal components. Uterine adenofibroma is a extremely rare tumor which considered to be a mixed tumor of Müllerian origin. This lesion appears to be clinically and histologically benign but must be differentiated from other malignant lesions of the uterus, particularly from the adenosarcoma. PMID:11462961

Bellil, K; Haouet, S; Ben Fadhel, C; Kchir, N; Chelli, H; Zitouna, M

2001-06-01

183

Controversies in the Management of Endometrial Cancer  

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Endometrial cancer (EC) remains the most common malignancy of the female genital tract. The median age at diagnosis is the sixth decade, with abnormal uterine bleeding at the presentation in 90% of the patients. Surgical treatment, including complete hysterectomy, removal of remaining adnexal structures, and an appropriate surgical staging, represents the milestone of curative therapy for patients with EC. Adjuvant therapy is necessary in patients at high risk of recurrence. Conservative trea...

Masciullo, V.; Amadio, G.; Lo Russo, D.; Raimondo, I.; Giordano, A.; Scambia, G.

2010-01-01

184

Diffusion-Weighted Magnetic Resonance Imaging of Endometrial Cancer: Differentiation from Benign Endometrial Lesions and Preoperative Assessment of Myometrial Invasion  

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Background: Uterine endometrial cancer is the most common gynecologic malignancy, and benign endometrial hyperplasia or polyps should be differentiated from endometrial cancer. In evaluating endometrial cancer on magnetic resonance imaging (MRI), the assessment of the depth of myometrial invasion is important because it closely correlates with the patient's prognosis. Purpose: To verify the feasibility of diffusion-weighted magnetic resonance imaging (DWI) to distinguish benign and malignant endometrial lesions, and to evaluate myometrial invasion of endometrial cancer. Material and Methods: Sixty-seven endometrial lesions including 45 cancers and 22 benign lesions (hyperplasia and polyps) were evaluated by DWI with apparent diffusion coefficient (ADC) measurement. The staging accuracies of DWI and gadolinium-enhanced T1-weighted images in the assessment of myometrial invasion were evaluated in 33 patients with endometrial cancer. Results: The ADC values (x10-3 mm2/s) in cancer and benign lesions were 0.84+-0.19 and 1.58+-0.36, respectively (P<0.01). The staging accuracy (superficial or deep myometrial invasion) was 94% for DWI and 88% for gadolinium-enhanced T1-weighted images. Coexisting adenomyosis and infiltrative myometrial invasion caused staging errors on gadolinium-enhanced T1-weighted images, whereas DWI could demonstrate the tumor extent correctly. Conclusion: DWI provides helpful information in evaluating benign and malignant endometrial lesions.

Takeuchi, M.; Matsuzaki, K.; Nishitani, H. (Dept. of Radiology, Univ. of Tokushima, Tokushima (Japan))

2009-10-15

185

Diffusion-Weighted Magnetic Resonance Imaging of Endometrial Cancer: Differentiation from Benign Endometrial Lesions and Preoperative Assessment of Myometrial Invasion  

International Nuclear Information System (INIS)

Background: Uterine endometrial cancer is the most common gynecologic malignancy, and benign endometrial hyperplasia or polyps should be differentiated from endometrial cancer. In evaluating endometrial cancer on magnetic resonance imaging (MRI), the assessment of the depth of myometrial invasion is important because it closely correlates with the patient's prognosis. Purpose: To verify the feasibility of diffusion-weighted magnetic resonance imaging (DWI) to distinguish benign and malignant endometrial lesions, and to evaluate myometrial invasion of endometrial cancer. Material and Methods: Sixty-seven endometrial lesions including 45 cancers and 22 benign lesions (hyperplasia and polyps) were evaluated by DWI with apparent diffusion coefficient (ADC) measurement. The staging accuracies of DWI and gadolinium-enhanced T1-weighted images in the assessment of myometrial invasion were evaluated in 33 patients with endometrial cancer. Results: The ADC values (x10-3 mm2/s) in cancer and benign lesions were 0.84±0.19 and 1.58±0.36, respectively (P<0.01). The staging accuracy (superficial or deep myometrial invasion) was 94% for DWI and 88% for gadolinium-enhanced T1-weighted images. Coexisting adenomyosis and infiltrative myometrial invasion caused staging errors on gadolinium-enhanced T1-weighted images, whereas DWI could demonstrate the tumor extent correctly. Conclusion: DWI provides helpful information in evaluating benign and malignant endometrial lesions

2009-10-01

186

Morphometric evaluation of endometrial blood vessels  

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Full Text Available Five hundred endometrial specimens were studied to document the changes in blood vessels in various phases of menstrual cycle, menstrual disturbances and in unexplained infertility. Sixty-three cases were taken as control and 437 cases as study group which included cases of dysfunctional uterine bleeding (DUB, endometrial polyps, fibroids, adenomyosis, infertility and atrophic endometrium. Using light microscopy, the vascular morphology was studied. The blood vessels were concentrated more in basal layer in the proliferative phase and in functional layer in the secretory phase. Cases of complex hyperplasia and pill endometrium had significantly higher vessel concentration. Congestion and dilatation of blood vessels were significantly higher in cases of DUB. The present study showed a positive correlation between endometrial angiogenesis and menstrual disorders. The alteration in blood vessel morphology has significant role in prognosis and in various anti-angiogenic therapies.

Makhija Divya

2008-07-01

187

Endometrial carcinoma  

International Nuclear Information System (INIS)

From June 1974 to June 1984, 347 women with endometrial carcinoma were referred to the radiotherapy department of the Catharina Hospital, Eindhoven, The Netherlands. Of this total number, 327 patients were considered eligible for analysis; 36 being referred for recurrences of previous surgically treated endometrial carcinoma, and 291 bein referred for radiotherapy as part of the initial treatment. The 28% 5-year relapse-free survival (RFS) of the group of 36 patients demonstrated that endometrial carcinoma may behave as a radiosensitive tumour. The remaining 291 had all undergone surgery, except 10. Radiotherapy consisted of high dose-rate brachytherapy applied to the vaginal vault for pathological stage I tumours, well differentiated, and with superficial myometrial invasion. All other patients received external beam irradiation to a pelvic dose of 40 Gy in 4 weeks, followed by brachytherapy (4 fractions of 5 Gy each). The 5-year RFS for pathologically staged patients was: stage I (232 patients) 88%, stage II (27 patients) 68%, stage III and IV (22 patients) 50%. Treatment-related complications were minimal. In-field recurrences were rare: 5% locoregional, 2.2 both loco-regional and distant, versus 9.3% distant failures. Multivariate RFS analysis demonstrated age, stage and tumour differentiation as independent prognostic factors, tumour differentiation being the most important factor. (author). 16 refs.; 3 figs.; 4 tabs

1989-01-01

188

Endometrial Cancer  

Science.gov (United States)

... uterine wall. This tissue is tested in a lab for cancerous or precancerous cells. The procedure usually takes just a few minutes. Dilatation and ... collect tissue. D & C is also an outpatient procedure. It takes about an ... pressure, obesity, diabetes, or other types of cancer. These patients may ...

189

Evaluation of endometrium in peri-menopausal abnormal uterine bleeding  

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Abnormal Uterine Bleeding (AUB) is one of the most common health problems encountered by women. It affects about 20% women of reproductive age, and accounts for almost two thirds of all hysterectomies. Gynaecologists are often unable to identify the cause of abnormal bleeding even after a thorough history and physical examination. Diagnostic evaluations and treatment modalities have been evolving over time. The onus in AUB management is to exclude complex endometrial hyperplasia and endometri...

Kotdawala, Parul; Kotdawala, Sonal; Nagar, Nidhi

2013-01-01

190

Pólipos endometriais / Endometrial polyps  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os pólipos endometriais são lesões benignas, com baixo potencial de malignização. No período reprodutivo seu diagnóstico é obtido nas pacientes sintomáticas, com sangramento uterino anormal ou infertilidade. Na pós-menopausa em sua maioria são assintomáticos, podendo estar associados a sangramento a [...] normal em torno de um terço dos casos. São mais freqüentes na pós-menopausa e os fatores de risco para câncer de endométrio não têm sido associados da mesma maneira, como de risco para pólipos endometriais, embora sejam hormônio-dependentes, como nas pacientes usuárias do tamoxifeno, por exemplo. Seu diagnóstico definitivo é realizado pelo exame histológico com amostra obtida de maneira mais eficiente por biópsia dirigida por meio da histeroscopia, assim como seu tratamento mais efetivo é a ressecção histeroscópica. Pólipos podem apresentar recorrência após tratamento. A polipectomia é altamente satisfatória na pós-menopausa, tem menor taxa de sucesso em mulheres sintomáticas no período reprodutivo e melhora as taxas de fertilidade em mulheres inférteis. Abstract in english Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there i [...] s an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive period and improves fertility rates in infertile women.

Antonio Alberto, Nogueira.

191

Pólipos endometriais Endometrial polyps  

Directory of Open Access Journals (Sweden)

Full Text Available Os pólipos endometriais são lesões benignas, com baixo potencial de malignização. No período reprodutivo seu diagnóstico é obtido nas pacientes sintomáticas, com sangramento uterino anormal ou infertilidade. Na pós-menopausa em sua maioria são assintomáticos, podendo estar associados a sangramento anormal em torno de um terço dos casos. São mais freqüentes na pós-menopausa e os fatores de risco para câncer de endométrio não têm sido associados da mesma maneira, como de risco para pólipos endometriais, embora sejam hormônio-dependentes, como nas pacientes usuárias do tamoxifeno, por exemplo. Seu diagnóstico definitivo é realizado pelo exame histológico com amostra obtida de maneira mais eficiente por biópsia dirigida por meio da histeroscopia, assim como seu tratamento mais efetivo é a ressecção histeroscópica. Pólipos podem apresentar recorrência após tratamento. A polipectomia é altamente satisfatória na pós-menopausa, tem menor taxa de sucesso em mulheres sintomáticas no período reprodutivo e melhora as taxas de fertilidade em mulheres inférteis.Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there is an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive period and improves fertility rates in infertile women.

Antonio Alberto Nogueira

2005-05-01

192

Uterine morphology and peristalsis in women with polycystic ovary syndrome  

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Background. Polycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS. Purpose. To assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis. Material and Methods. In this prospective case-control study 55 women with PCOS (mean age, 29.5 years {+-} 4.5 SD) and 28 controls (27.6 {+-} 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS). Results. The endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014). Conclusion. There were no differences in myometrial morphology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls.

Leonhardt, Henrik; Hellstroem, Mikael [Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden)], E-mail: henrik.leonhardt@vgregion.se; Gull, Berit; Nilsson, Lars; Janson, Per O. [Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Kishimoto, Keiko [Department of Radiology, St Marianna University School of Medicine, Kanagawa (Japan); Kataoka, Masako [Department of Radiology, Kyoto University Hospital, Kyoto (Japan); Stener-Victorin, Elisabet [Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden)

2012-12-15

193

Ultrasound detection of endometrial fluid in postmenopausal women  

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Introduction. The aim of this prospective study was to estimate whether the presence of endometrial fluid detected by transvaginal ultrasound investigation was a marker for the pathological changes of the endometrium in postmenopausal women. Material and methods. 128 postmenopausal women with uterine bleeding and 29 asymptomatic postmenopausal women underwent transvaginal ultrasound investigation, curettage and histopathological investigation of the curettage specimens. Results. There were si...

?ur?i? Aleksandar; ?ur?evi? Sr?an; Mihaldži?-Tubi? Slobodana; Mladenovi?-Segedi Ljiljana; Maksimovi? Marko

2009-01-01

194

Endometrial aspiration biopsy: a non-invasive method of obtaining functional lymphoid progenitor cells and mature natural killer cells.  

LENUS (Irish Health Repository)

The aim of this study was to compare the efficacy of endometrial aspiration biopsy (EAB) with the more traditional dilatation and curettage (D&C) for the procurement of lymphoid progenitor cells and uterine natural killer (NK) populations in endometrial tissue. This prospective observational study conducted in a tertiary referral university hospital examined endometrium obtained from 32 women admitted for laparoscopic gynaecological procedures. Each participant had endometrium sampled using both EAB and D&C. Both methods were assessed as a source of uterine NK and lymphoid progenitor cells. Similar proportions of mature CD45+CD56+ NK cells (range 25.4-36.2%) and CD45+CD34+ lymphoid progenitors (range 1.2-2.0%) were found in tissue obtained using both EAB and D&C. These cells were adequate for flow cytometric analysis, magnetic bead separation and culture. Colony formation by the CD34+ population demonstrated maturational potential. Tissues obtained via endometrial biopsy and D&C are equivalent, by analysis of uterine NK and lymphoid progenitor cells. The aim of this study was to compare two methods of endometrial sampling - endometrial aspiration biopsy and traditional dilatation and curettage - for the procurement of haematopoietic stem cells and uterine natural killer (NK) populations in endometrial tissue. Thirty-two women who had gynaecological procedures in a tertiary referral hospital participated in this study and had endometrial tissue collected via both methods. Similar populations of mature NK cells and haematopoietic stem cells were found in tissue obtained using both endometrial aspiration biopsy and dilatation and curettage. Tissue obtained via endometrial aspiration biopsy was adequate for the culture and growth of haematopoietic stem cells. We conclude that tissue obtained via endometrial biopsy and dilatation and curettage is equivalent, by analysis of uterine NK and haematopoietic stem cells using flow cytometry. This has implications for further more extensive study of endometrial haematopoietic stem cell populations, as these samples can be collected in a clinical setting without a requirement for general anaesthesia.

McMenamin, Moya

2012-09-01

195

Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation  

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Background and Objectives: The most frequent procedures performed on women with abnormal uterine bleeding are 2D and 3D ultrasound. The most common accepted approach for the management of abnormal uterine bleeding is 2D TV scan followed by therapeutic hysteroscopy. The purpose of this prospective study was to assess whether 3D saline infusion sonohysterography (3D SIS) could replace diagnostic hysteroscopy (DH) for the diagnosis of endometrial pathology, in patients with abnormal uteri...

2011-01-01

196

Adenovirus Mediated Homozyogous Endometrial Epithelial Pten Deletion Results in Aggressive Endometrial Carcinoma  

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PTEN is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, PTEN mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten+/? mouse model has demonstrated somatic inactivaton of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into...

Joshi, Ayesha; Ellenson, Lora Hedrick

2011-01-01

197

Uterine Fibroids  

Science.gov (United States)

... evidence indicating how natural processes of scarring and wound healing go awry. A preliminary NIH study tested ... is possible to shrink uterine fibroids by directing ultrasound waves at them, superheating the fibroids and destroying ...

198

Uterine Fibroids  

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Full Text Available ... fullness in the lower abdomen Other symptoms of uterine fibroids include: ... and migration of the egg, which can result in infertility. After surgical removal of the fibroid, fertility is ...

199

Uterine Fibroids  

Medline Plus

Full Text Available Uterine Fibroids Introduction Fibroids are common, benign tumors of the uterus. They can cause significant pain, as well as abnormal bleeding. About 30% of all women may have fibroids. Most ...

200

Uterine Fibroids  

Medline Plus

Full Text Available ... such as: • Excessive or painful bleeding during menstruation • Bleeding between periods • A feeling of fullness in the lower abdomen Other symptoms of uterine fibroids include: • Frequent urination ...

 
 
 
 
201

Uterine Fibroids  

Medline Plus

Full Text Available ... Uterine fibroid embolization (UFE) is a treatment that cuts off the blood supply to the uterus and the ... particles that are put into the fibroids to cut off their blood supply travel to the ovaries. In ...

202

Uterine Fibroids  

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Full Text Available ... uses focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The ... a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize patient anatomy, map ...

203

Uterine Fibroids  

Medline Plus

Full Text Available ... uterine fibroids and their causes, symptoms, diagnosis, and treatment options. Anatomy Vagina Uterus Fallopian Tubes Ovaries The female ... in shrinking the uterus and the fibroids. New treatment options have been developed to deal with fibroids. These ...

204

Uterine prolapse  

Science.gov (United States)

... how to insert, clean, and remove a pessary. Side effects of pessaries include: Foul smelling discharge from the ... Other procedures are also available. Often, a vaginal hysterectomy is used to correct uterine prolapse. Any sagging ...

205

Uterine Fibroids  

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Full Text Available ... Ablation uses focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The ... uses a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize patient anatomy, map ...

206

Uterine Fibroids  

Medline Plus

Full Text Available ... well as abnormal bleeding. About 30% of all women may have fibroids. Most of them do not ... may be discovered during a routine examination. Some women who have uterine fibroids may experience symptoms such ...

207

Targeted development of specific biomarkers of endometrial stromal cell differentiation using bioinformatics: the IFITM1 model.  

Science.gov (United States)

When classifying cellular uterine mesenchymal neoplasms, histological distinction of endometrial stromal from smooth muscle neoplasms can be difficult. The only widely established marker of endometrial stromal differentiation, CD10, has marginal specificity. We took a bioinformatics approach to identify more specific markers of endometrial stromal differentiation by searching the Human Protein Atlas, a public database of protein expression profiles. After screening the database using different methods, interferon-induced transmembrane protein 1 (IFITM1) was selected for further analysis. Immunohistochemistry for IFITM1 was performed using tissue sections from the selected cases of proliferative endometrium (22), secretory endometrium (6), inactive endometrium (19), adenomyosis (10), conventional leiomyoma (11), cellular leiomyoma (16), endometrial stromal nodule (2), low-grade endometrial stromal sarcoma (16), high-grade endometrial stromal sarcoma (2) and undifferentiated uterine sarcoma (2). Stained slides were scored in terms of intensity and distribution. Normal endometrial samples uniformly showed diffuse and strong IFITM1 staining. Endometrial stromal neoplasms, particularly low-grade endometrial stromal sarcoma, showed higher IFITM1 expression compared with smooth muscle neoplasms (P<0.0001). IFITM1 immunohistochemistry has high sensitivity and specificity, particularly in the distinction between low-grade endometrial stromal sarcoma and leiomyoma (81.2 and 86.7%, respectively). Our results indicate that IFITM1 is a sensitive and specific marker of endometrial stromal differentiation across the spectrum from proliferative endometrium to metastatic stromal sarcoma. IFITM1 is a potential valuable addition to immunohistochemical panels used in the diagnosis of cellular mesenchymal uterine tumors. Further studies with larger number of cases are necessary to corroborate this impression and determine the utility of IFITM1 in routine practice. This study is a clear example of how bioinformatics, particularly tools for mining genomic and proteomic databases, can enhance and accelerate biomarker development in diagnostic pathology. PMID:24072182

Parra-Herran, Carlos E; Yuan, Liping; Nucci, Marisa R; Quade, Bradley J

2014-04-01

208

Carcinoma of the Lower Uterine Segment (LUS): Clinicopathological Characteristics and Association with Lynch Syndrome  

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Endometrial cancer arises from the uterine body and fundus in many cases, but can also originate from the lower region of the uterine body through the upper region of the cervix. Such tumors are referred to as carcinoma of the lower uterine segment (LUS) or isthmus, and account for 3-6.3% of all cases of endometrial cancer. This relatively low incidence has permitted performance of only small-scale studies, but the clinical and pathological characteristics of carcinoma of the LUS in all these...

Masuda, Kenta; Banno, Kouji; Yanokura, Megumi; Kobayashi, Yusuke; Kisu, Iori; Ueki, Arisa; Ono, Asuka; Nomura, Hiroyuki; Hirasawa, Akira; Susumu, Nobuyuki; Aoki, Daisuke

2011-01-01

209

Ultrastaging of lymph node in uterine cancers  

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Full Text Available Abstract Background Lymph node status is an important prognostic factor and a criterion for adjuvant therapy in uterine cancers. While detection of micrometastases by ultrastaging techniques is correlated to prognosis in several other cancers, this remains a matter of debate for uterine cancers. The objective of this review on sentinel nodes (SN in uterine cancers was to determine the contribution of ultrastaging to detect micrometastases. Methods Review of the English literature on SN procedure in cervical and endometrial cancers and histological techniques including hematoxylin and eosin (H&E staining, serial sectioning, immunohistochemistry (IHC and molecular techniques to detect micrometastases. Results In both cervical and endometrial cancers, H&E and IHC appeared insufficient to detect micrometastases. In cervical cancer, using H&E, serial sectioning and IHC, the rate of macrometastases varied between 7.1% and 36.3% with a mean value of 25.8%. The percentage of women with micrometastases ranged from 0% and 47.4% with a mean value of 28.3%. In endometrial cancer, the rate of macrometastases varied from 0% to 22%. Using H&E, serial sectioning and IHC, the rate of micrometastases varied from 0% to 15% with a mean value of 5.8%. In both cervical and endometrial cancers, data on the contribution of molecular techniques to detect micrometastases are insufficient to clarify their role in SN ultrastaging. Conclusion In uterine cancers, H&E, serial sectioning and IHC appears the best histological combined technique to detect micrometastases. Although accumulating data have proved the relation between the risk of recurrence and the presence of micrometastases, their clinical implications on indications for adjuvant therapy has to be clarified.

Uzan Serge

2010-01-01

210

Miomatosis uterina gigante / Giant uterine myomatosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish El gran tamaño de algunos tumores ha sido descrito con asombro a través del tiempo. Entre ellos se incluyen los ginecológicos, sobre los cuales se describen casos de crecimiento descomunal, e incluyen los uterinos u ováricos. El caso de mayor tamaño fue descrito por Hunt en 1888 como hallazgo en una [...] necropsia, con el "asombroso" peso de 63,5 kg. La terminología de estos tumores de gran tamaño contiene calificativos muy variados y confusos, entre los cuales se incluyen "inmensos", "enormes" "extensos", "voluminosos", "masivos", "grandes", "muy grandes", "gigantes", "gigantescos". Beacham y otros, en 1971 definieron como "gigantes" a los tumores uterinos u ováricos con peso superior a 25 lbs (11,3 kg). Briceño-Pérez y otros en el año 2001 propusieron utilizar el término de "grandes miomas uterinos" (GMU) para aquellos con peso entre 0,8 Kg (peso límite aproximado para decidir la vía quirúrgica abdominal o vaginal) y 11,3 Kg (peso límite establecido por Beacham y colaboradores para los miomas uterinos gigantes). El caso que se presenta fue operado el día 20 de enero de 2009 en el Centro de Investigaciones Médico Quirúrgicas, al cual se le realizó histerectomía total con el diagnóstico de miomatosis gigante del útero cuyo peso fue de 11,31 kg. Se hacen recomendaciones para el manejo quirúrgico de las pacientes con tumores ginecológicos gigantes. Abstract in english The large size of some tumors has been described with surprise over the time. Among them are included the gynecologic ones, on which are presented cases of an enormous growth and the uterine and ovarian types are also included. The largest size of a tumor was described by Hunt in 1888 as a necropsy [...] finding, which weighing 63,5 kg. Terminology of these large size tumors include very varied and confused epithets: "inmenses", "huges", "extensive", "bulkies", "mass", "larges", "very larges", "giants" , and "gigantics". Beachman et al, in 1971 defined as "giants" the uterine or ovarian tumors weighing more than 25 pounds (11,3 kg). Briceño-Pérez et al in 2001 proposed the use of the term "large uterine myomas" (LUM) for those weighing between 0,8 kg (limit weight established by Beacham et al for the giant uterine myomas). Present case was operated on in January 20, 2009 in Medical and Surgical Researches Center, performing a total hysterectomy diagnosed with uterine giant myomatosis weighing 11,31 kg. Authors made recommendations on surgical management of patients presenting giant gynecological tumors.

Miguel, Sarduy Nápoles; Raúl, Vasallo Prieto; Simeón, Collera; Ysis M., Martínez Chang; Jorge Miguel, Correa Padilla; Javier, Rivero Ojeda; Joel, Frigola Cartaya; Carlos, Alfonso Sabatier.

211

Global endometrial ablation in the presence of essure® microinserts.  

Science.gov (United States)

Abnormal uterine bleeding (AUB) affects 30% of women at some time during their reproductive years and is one of the most common reasons a woman sees a gynecologist. Many women are turning to endometrial ablation to manage their AUB. This article reviews the data relating to the available endometrial ablation techniques performed with hysteroscopic sterilization, and focuses on data from patients who had Essure® (Conceptus, San Carlos, CA) coils placed prior to performance of endometrial ablation. Reviewed specifically are data regarding safety and efficacy of these two procedures when combined. Data submitted to the US Food and Drug Administration for the three devices currently approved are reviewed, as well as all published case series. Articles included were selected based on a PubMed search for endometrial ablation (also using the brand names of the different techniques currently available), hysteroscopic sterilization, and Essure. PMID:24358407

Aldape, Diana; Chudnoff, Scott G; Levie, Mark D

2013-01-01

212

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas  

International Nuclear Information System (INIS)

Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss

2005-01-01

213

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas  

Energy Technology Data Exchange (ETDEWEB)

Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

Nishino, Mizuki E-mail: mizuki@mbox.kyoto-inet.or.jpnishinomizuki@hotmail.com; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo

2005-01-01

214

Diagnosis and surgical therapy of uterine sarkoma  

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Full Text Available Introduction: Uterine sarcomas are rare gynecological neoplasms and their classification is complicated. Uterine sarcoma is usually diagnosed in postmenopausal women and the diagnosis is often accidental and postoperative. Aim of this study was to present clinical and pathological characteristics of uterine sarcomas, diagnostic procedures, treatment and two-, three- and five-years cumulative survival rates. Materials and methods: The retrospective study of 61 cases of uterine sarcomas was conducted. Cases were distributed into groups based on definitive diagnosis of uterine sarcoma: group of leiomyosarcomas (LMS, carcinosarcoma (CS, endometrial stromal sarcomas (ESS, adenosarcomas (AS and other rare uterine sarcomas. We investigated patients with clinical and pathological characteristics of uterine sarcomas, diagnostic procedures and treatment. Survival rate was calculated by Kaplan-Meier method. Results: From 61 patients 43 patients (70.49% were postmenopausal. Mean period from menopause until appearance of symptoms was 14,63 years. One or more risk factors were present in 46 (75.4% patients. Diagnosis of uterine sarcoma were established averagely 7.38 months after appearance of symptoms. 50 patients (82.0% underwent one or more diagnostic procedures. Preoperative diagnosis of uterine sarcoma was established in 42.5% of patients. 53 (86.9% of patients were treated operatively. The most used operative procedure (60,7% was total hysterectomy with bilateral salpingooophorectomy. Postoperative pathohistologic analysis showed that low grade (LG leiomyosarcoma were present in 19 (35.9% cases, high grade (HG leiomyosarcoma in 1 (1.9% case, carcinosarcoma in 14 (26.4% cases, low grade (LG endometrial stromal sarcoma in 5 (9.4% cases, high grade (HG endometrial stromal sarcoma in 9 (17.0% cases, adenosarcoma in 2 (3.8% cases, and 2 cases of rare uterine sarcomas: 1 (1.9% MALT HG lymphoma and 1(1.9% malignant hemangiopericytoma. In one case of ESS (1.9% only adenomyosis was found postoperatively suggesting that the whole tumour was removed during diagnostic procedure. Eight patients were not treated operatively. Two-years cumulative survival rate was 74.3%, three-years cumulative survival rate was 71.1%, and five years survival rate was 64.3%. Discussion: Average age, percent of postmenopausal patients and the mean age at the time of menopause in our studied correlate with current data. Clinical presentation of uterine sarcoma is associated with obesity and hypertension in more than 30% of cases, which is approved in our study. For early diagnostics it is important to notice that risk factors are similar to those connected with far more frequent endometrial carcinoma. Postmenopausal abnormal bleeding was the main reason for medical examination, explaining relatively short period for establishing the diagnosis in this group of patients. The variety of clinical findings in our studied group showed that the diagnosis must be based on preoperative pathohistology. Conclusion: Adequate diagnosis and treatment of uterine sarcoma is possible with regular yearly or more frequent follow-up, especially in postmenopausal women with known risk factors present. We need special attention for unclear symptoms and postmenopausal bleeding and we need to use all diagnostic procedures soon as possible including preoperative histology because early metastases are characteristic for uterine sarcomas. Factor of the most important predictive value is histologic grade. .

La?evi? N.N.

2006-01-01

215

Late leiomyoma expulsion after uterine artery embolization.  

Science.gov (United States)

A case of late expulsion of a leiomyoma after uterine artery embolization (UAE) is reported in a 49-year-old woman who underwent UAE for a huge (13 cm x 12 cm; 1,061 cm(3)) bleeding- and bulk-related intramural leiomyoma diagnosed with ultrasonography. Free-flow embolization was performed with 150-400-microm polyvinyl alcohol particles and absorbable particle sponge. Symptoms and myoma size were successfully controlled until 44 months, at which time the patient reported vaginal discharge. A 7-cm necrotic, partly submucosal leiomyoma was detected. The patient refused hysterectomy and spontaneously expelled the leiomyoma through the cervix 6 months later. In conclusion, UAE necessitates long-term follow-up and women should be warned of late complications. PMID:15590809

Marret, Henri; Keris, Yann Le Brun; Acker, Olivier; Cottier, Jean Philippe; Herbreteau, Denis

2004-12-01

216

Ressecção Histeroscópica do Endométrio: Resultados e Fatores de Risco para insucesso Hysteroscopic Endometrial Resection: Results and Risk Factors for Failures  

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Full Text Available Objetivo: estudar o resultado da ablação endometrial histeroscópica, com o uso de ressectoscópio, em pacientes com sangramento uterino anormal de etiologia benigna e refratária ao tratamento clínico, e relatar os fatores associados aos insucessos. Métodos: foram avaliados retrospectivamente informações sobre 64 pacientes com sangramento uterino anormal de causa benigna, submetidas à intervenção entre abril de 1994 e fevereiro de 2000. A média de idade foi de 42,9 anos e a paridade média, de 2,6 partos. Foi realizada histeroscopia diagnóstica com biópsia endometrial pré-operatoriamente. Duas pacientes receberam previamente gestrinona, seis danazol e 44 análogo do GnRH. No ato cirúrgico realizou-se a cauterização elétrica do fundo uterino e das regiões cornuais. Depois, com o ressectoscópio, foi removido o endométrio até 1 cm cranialmente ao orifício interno e na profundidade de 2 a 3 mm na musculatura. A distensão uterina se fazia com glicina a 1,5% até há dois anos, quando se passou a usar o manitol a 3%. O seguimento foi de 11,5 meses em média. Resultados: estabeleceu-se amenorréia em 31,2% das pacientes e hipomenorréia em 45,3%. Houve persistência do sangramento anormal em 23,5%. Houve uma perfuração uterina na cérvico-dilatação (1,5%. Os resultados foram melhores nas pacientes com mais de 40 anos de idade, nas multíparas e nas que usaram análogos do GnRH. Nos casos de falhas houve freqüência estatisticamente significante (p=0,04 de miomas submucosos de 46,6% contra 20,6% no grupo com hipomenorréia e 20% no grupo com amenorréia. O uso de análogo do GnRH fez decrescer de modo significante (p=0,03 os insucessos. No grupo de pacientes nos quais se considerou haver falha da cirurgia, 46% tiveram, ao exame anatomopatológico, endométrio secretor; no grupo com hipomenorréia, 10,3% tiveram este resultado histológico e no grupo com amenorréia, 10%, o que não apresentou significância estatística (p=0,12. Conclusão: o método mostrou-se útil para tratar o sangramento uterino anormal de etiologia benigna. Recomenda-se o uso de análogos do GnRH previamente à intervenção. Sugere-se que as pacientes mais jovens, com menor paridade e com diagnóstico pré-operatório de mioma submucoso recebam atenção especial, pois entre elas ocorrem falhas com maior freqüência.Purpose: to evaluate the results of 64 hysteroscopic endometrial ablations using a resectoscope in women with abnormal uterine bleeding of benign etiology and nonresponsive to clinical measures and to describe the failures and their associated conditions. Methods: sixty-four patients with abnormal uterine bleeding were submitted to the intervention between April 1994 and February 2000. The mean age was 42.9 years and the mean parity, 2.6 deliveries. Diagnostic hysteroscopy and endometrial biopsy were performed preoperatively. Before surgery, two women received gestrinone, six danazol and 44 GnRH analogue. During the surgery electric cauterization of the fundus uteri and cornual regions was made. Afterwards, with a resectoscope, the endometrium was removed as far as 1 cm above the internal ostium, and as deep as 2 to 3 mm into the myometrium. The uterine distension was obtained with 1.5% glycine and since two years ago with 3% manitol. The average follow-up was 11.5 months. After six months of endometrial ablation, the patients with persistence of symptoms were submitted to hysterectomy. Results: amenorrhea occurred in 31.2% of the patients and hypomenorrhea in 45.3%. The abnormal bleeding was maintained in 23.5%. There was one uterine perforation during the dilatation of the cervix. Results were better in the higher age and parity ranges and in the women who received GnRH analogues (p=0.03. Where the method was not successful there was a statistically significant frequency of submucous myoma (p=0.04 and a nonsignificant increase of secretory endometrium (p=0.12. Conclusions: the method is useful for the management of abnormal uterine bleeding of benign etiology. Previous administration of GnRH

Frederico Faria Rodrigues

2001-08-01

217

Application of saline infusion sonography in the diagnosis of endometrial polyps  

Directory of Open Access Journals (Sweden)

Full Text Available Endometrial polyps represent benign focused growths of endometrium with the prevalnece of 5-10 in 100 patients older than 30 years of age. The most frequent symptom is irregular uterine bleeding. Saline Infusion Sonography (SIS is the least invasive and the simplest method for detection of an abnormality of the uterine cavity. In this paper we have presented a case of a65- year old patient with endometrial polypus, irregular uterine bleeding referred to hyperplasia endometria as a working diagnosis. Using the Saline Infusion Sonography check-up the diagnosis of endometrial polypus was established including its localization, diameter and other diagnostic parameters. The results of this study have shown that the Saline Infusion Sonography provides more information about the state of uterocervical cavity as compared to the standard transvaginal sonography.

K. Drljevi?

2006-08-01

218

[The clinical characteristics of women with uterine hemorrhages in premenopause].  

Science.gov (United States)

The clinical characteristics was studied on 431 women with uterine bleedings during the premenopaussal phase of the climacterium. The author established that menarche, duration of menstrual interval and the menstruation itself before the bleeding did not differ from those of female population in the country. The same was referred to the reproductive characteristics. Premenopausal bleeding reached its peak between 46 and 48 years of age as its duration was relatively great. It was connected with frequent neuro-endocrine and metabolic pathology. The most frequent manifestations were obesity and hypertension. The number of the former hepatitis patients was comparatively large. Diseases of the uterine body were frequent in the structure of genital pathology. The frequency of benign, precancerous and malignant neoplastic processes (without myoma) was high-12.7%. PMID:2802100

Rachev, E

1989-01-01

219

Endometrial brush cytology of advanced postmenopausal endometrium: does endometrial intraepithelial neoplasia exist in the absence of hyperplasia?  

Science.gov (United States)

Postmenopausal uterine bleeding is an indication to sample the endometrium for diagnostic purposes. The endometrial brush cytologies of 20 advanced postmenopausal women collected at the time of hysterectomy in order to benchmark the expected morphology of postmenopausal endometrial brushings were reviewed. No women had symptoms or gross findings of primary endomyometrial disease. Endometrium was collected at the surgical pathology laboratory using the Tao Brush and CytoRich Fixative System. After formalin fixation of the uterus, the entire endometrium was embedded for routine histology. Sixteen endometrial brushings and matched endometrial sections showed endometrial atrophy, one brushing showed many ciliated epithelial cells, and three brushings showed focal (less than 10%) epithelial-cell atypia. In two atypias, abnormal endometrial epithelial-cell sheets contained enlarged, clear nuclei with nuclear notches and grooves resembling papillary thyroid cancer. One case showed no histological counterpart to this finding. The other case showed thickening of the pericornual fundic endometrium with cystic glands. The third case with epithelial atypia showed abnormal endometrial-cell sheets with nuclei resembling atypical hyperplasia or type I endometrial adenocarcinoma; corresponding endometrial tissue sections showed rare, irregular glands and back-to-back gland clusters with equivalent nuclear features. Atypical epithelium may be found in atrophic uteri in the absence of gross endometrial thickening. This may be a common event related either to de novo intraepithelial dysplasia in a noncycling endometrium or to hyperplasia that has partly regressed with estradiol withdrawal. This study shows that, in addition to endometrial intraepithelial carcinoma (EIC), isolated atypical glands with morphological and immunohistochemical features of atypical hyperplasia or type I endometrial adenocarcinoma may be found in grossly normal advanced postmenopausal endometrium of asymptomatic patients. This atypical epithelium is readily apparent in endometrial brush preparations, but requires serial sectioning of the endometrium to be demonstrated histologically. We have not established the natural history of this lesion, and in the absence of EIC or gross endometrial thickening indicative of atypical hyperplasia, we do not know whether this degree of epithelial atypia should be an indication for hysterectomy. PMID:9812226

Maksem, J A

1998-11-01

220

Uterine arterial embolization for hysteromyomas: report of 45 cases  

International Nuclear Information System (INIS)

Objective: To assess the effectiveness of uterine arterial embolization for the treatment of hysteromyomas and to discuss the factors related to the clinical results. Methods: Super-selective uterine arterial embolization was performed in forty-five patients with hysteromyomas. Of 45 patients, multiple hysteromyomas were seen in 36 and solitary lesion in 9. The lesion was located at the myometrium in 41 cases, among them coexisted endometrioma was found in 5 cases and coexisted submucosal myoma in 2. The lesion was located submucous layer in the remaining 4 cases. The diagnosis was confirmed by imaging study and gynecological examination. After the operation, ultrasonography and laboratory tests were carried out in all patients to observe the tumor size, hormone levels and hemoglobin concentration. Results: A total of 91 uterine arteries were found in 45 patients, including double left uterine arteries in one case. Successful catheterization was obtained in 87 arteries (95.6%). All forty-five patients were followed up for 6-36 months. Six months after the procedure the mean reduction of the tumor size was 69.3%, and the lesion completely disappeared in two cases. In the anemic patients the hemoglobin concentration returned to normal level. The main side-effects included low fever and pain at lower abdomen. Conclusion: Uterine arterial embolization is a safe and effective treatment for hysteromyomas. (authors)

2010-04-01

 
 
 
 
221

Uterine Fibroids  

Medline Plus

Full Text Available ... and who are not candidates for surgery, hormone therapy may be used. Hormone therapy medications reduce estrogen levels and seem to be ... an alternative to leiomyomectomy, hysterectomy, watchful waiting, hormone therapy, or uterine fibroid embolization. FUA uses a device ...

222

Parasitic myomas after laparoscopic-assisted myomectomy in multiple endocrine neoplasia type 1.  

Science.gov (United States)

Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant hereditary disorder that develops multiple tumors arising from various endocrine organs, including the parathyroid gland, endocrine pancreas and pituitary gland. Although mesenchymal tumors can be an integral part of the syndrome, parasitic peritoneal myomas have never been described in an MEN1 patient. Seven years after laparoscopic-assisted myomectomy, parasitic peritoneal myomas were diagnosed in a 31-year-old woman with situs inversus totalis and previous history of parathyroid adenoma. Subsequently, MEN1 was clinically diagnosed by identification of endocrine pancreatic, adrenal and pituitary tumors. Genetic analysis revealed a heterozygous germline mutation in the splice donor sequence of intron 6 of the MEN1 gene. Although rare, parasitic peritoneal myomas could potentially be associated with MEN1 syndrome. PMID:23496674

Takeda, Akihiro; Sakurai, Akihiro; Imoto, Sanae; Nakamura, Hiromi

2013-05-01

223

Angiogenesis Following Three-Dimensional Culture of Isolated Human Endometrial Stromal Cells  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Endometriosis is the presence of endometrial tissue outside of the uterine cavity andis the most common gynecologic disorder in women of reproductive age. We have preliminaryevidence that in the presence of a 3-dimensional (3-D) fibrin matrix, human endometrial glands,stroma, and neovascularization can develop in vitro, mimicking the earliest stages of endometriosis.The aim of the present study was to determine if angiogenesis can be developed in a 3-D culture ofhuman stromal cell...

2008-01-01

224

Utility of immunohistochemistry method in expression of thyroid transcription factor-1 in endometrial and endocervical adenocarcinoma  

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"nBackground: Thyroid transcription factor-1 (TTF-1) is widely used in the diagnosis of lung and thyroid carcinomas. Although there have been reports of TTF-1 immunoreactivity in tumors other than those originating from the lung or thyroid, endocervical and endometrial adenocarcinomas have not been studied in large numbers in this regard."n "nMethods: Thirteen endocervical adenocarcinomas, 39 endometrioid endometrial adenocarcinomas and four uterine serous carcinomas which had ...

Janbazvatan A; Foruhesh Tehrani Z; Izadi Mood N; Malayeri A

2011-01-01

225

Fluid Within the Endometrial Cavity in an IVF Cycle—A Novel Approach to Its Management  

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Fluid within the endometrial cavity before embryo transfer in IVF cycles is associated with failure of implantation. The etiology of endometrial fluid is surrounded in controversy but it is associated with hydrosalpinges, polycystic ovarian disease, and subclinical uterine infections. The current treatment consists of postponing embryo transfer. This of course has biological and psychological disadvantages; a decreased implantation rate from frozen embryo transfer, and frustration and disappo...

Griffiths, Anthony N.; Watermeyer, Sean R.; Klentzeris, Lucas D.

2002-01-01

226

WNT pathways in the neonatal ovine uterus: potential specification of endometrial gland morphogenesis by SFRP2.  

Science.gov (United States)

Endometrial glands are critical for uterine function and develop between birth (Postnatal Day [P] 0) and P56 in the neonatal ewe. Endometrial gland morphogenesis or adenogenesis involves the site-specific budding differentiation of the glandular epithelium from the luminal epithelium followed by their coiling/branching development within the stroma of the intercaruncular areas of the endometrium. To determine whether WNT signaling regulates endometrial adenogenesis, the WNT signaling system was studied in the neonatal ovine uterus. WNT5A, WNT7A, and WNT11 were expressed in the uterine epithelia, whereas WNT2B was in the stroma. The WNT receptors FZD2 and FZD6 and coreceptor LRP6 were detected in all uterine cells, and FZD6 was particularly abundant in the endometrial epithelia. Secreted FZD-related protein-2 (SFRP2), a WNT antagonist, was not detected in the P0 uterus, but was abundant in the aglandular caruncular areas of the endometrium between P7 and P56. Exposure of ewes to estrogens during critical developmental periods inhibits or retards endometrial adenogenesis. Estrogen-induced disruption of endometrial adenogenesis was associated with reduction or ablation of WNT2B, WNT7A, and WNT11, and with an increase in WNT2 and SFRP2 mRNA, depending on exposure period. Collectively, results implicate the canonical and noncanonical WNT pathways in regulation of postnatal ovine uterine development and endometrial adenogenesis. Expression of SFRP2 in aglandular caruncular areas may inhibit the WNT signaling pathway, thereby concentrating WNT signaling and restricting endometrial adenogenesis in the intercaruncular areas of the uterus. Further, estrogen-induced inhibition of adenogenesis may be mediated by a reduction in WNT signaling caused by aberrant induction of SFRP2 and loss of several critical WNTs. PMID:16407498

Hayashi, Kanako; Spencer, Thomas E

2006-04-01

227

Surveillance for endometrial cancer with transvaginal ultrasonography of breast cancer patients under tamoxifen treatment  

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The association of endometrial thickness with the risk of developing endometrial cancer (EC) within 2 years was investigated in a consecutive cohort of 1205 breast cancer patients under tamoxifen treatment, undergoing transvaginal ultrasonography (TVUS) for follow-up purpose (asymptomatic, 1068) or for abnormal uterine bleeding (AUB, 137). Linkage with tumour registry allowed for the follow-up of 3184.3 person-years. According to underlying incidence, 1.85 EC cases were expected in the study ...

Ciatto, S.; Cecchini, S.; Gervasi, G.; Landini, A.; Zappa, M.; Crocetti, E.

2003-01-01

228

Endometrial carcinoma; Endometriumkarzinom  

Energy Technology Data Exchange (ETDEWEB)

Magnetic resonance imaging (MRI) is the method of choice in staging endometrial cancer. Using MRI early tumor invasion (stage IA) can be differentiated from a deep tumor growth (stage IB) of the myometrium with reported sensitivities of 85-95%.Tumor invasion of the uterine cervix can be depicted with a sensitivity of 80% and specificity of 96%. In demonstrating lymph node metastases MRI shows a sensitivity of 50%, a specificity of 95% and and accuracy of 90%. These diagnostic criteria are decisive for the choice of therapy procedures. So a simple hysterectomy will be performed in early stage IA disease while an extended surgical procedure with pelvic lymphadenectomy and radiotherapy will be considered in advanced stages IB and II disease. Vaginal ultrasound shows lower values in tumor staging with accuracies of 73-95%. Staging accuracies of computed tomography also show lower results with 61-76%. For planning radiotherapy and detection of cancer recurrence MRI is the most valuable tool. (orig.) [German] Fuer die Stadieneinteilung des Endometriumkarzinoms ist die Magnetresonanztomographie Methode der Wahl. Die Sensitivitaeten zur Differenzierung einer oberflaechlichen (Stadium IA) von einer tiefen myometrialen Invasion des Tumors (Stadium IB) liegen bei 85-95%, bei Spezifitaeten von 80-85%. Eine Infiltration der Zervix (Stadium II) kann mit Sensitivitaeten von 80% und Spezifitaeten von 96% nachgewiesen werden. Bei der Detektion von Lymphknotenmetastasen liegen die Sensitivitaeten der MRT bei 50%, bei Spezifitaeten von 95% und Treffsicherheiten von 90%. Die genannten diagnostischen Kriterien bestimmen das therapeutische Vorgehen. Werden fruehe Stadien mit einfacher Hysterektomie behandelt, erfordern die Stadien IB und II kombinierte erweiterte chirurgische Techniken und eine Radiotherapie. Die Treffsicherheiten des vaginalen Ultraschalls (73-93%) und der Computertomographie (61-76%) fuer die Stadieneinteilung des Tumors liegen deutlich niedriger als die Werte fuer die MRT. Die Planung einer Radiotherapie und die Rezidiverkennung sind Domaenen der MRT. (orig.)

Engelhard, K. [Krankenhaus Martha-Maria, Nuernberg (Germany)

2011-07-15

229

CA 125 and other tumor markers in uterine leiomyomas and their association with lesion characteristics  

Science.gov (United States)

The aim of this study was to investigate the factors associated with serum levels of several tumor markers in a group of patients operated for uterine myoma. One hundred thirty-seven female patients operated for uterine myoma were included. Serum samples were examined for CA 125, CA 19-9, CA 15-3, carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels as part of routine workup. Pathological and morphological characteristics of the patients were retrieved from medical records. The mean age was 46.7 ± 8.8 years (range, 22-85 y). Abnormally high levels of CA 125, CA 19-9, CA 15-3, CEA, and AFP were found in 19.7%, 6.6%, 5.1%, 3.7%, and 1.5% of the patients, respectively. Patients with additional adenomyosis and patients with at least one large myoma (? 5 cm diameter) had significantly higher levels of CA 125. Multivariate analysis identified coexistence of adenomyosis (OR 7.7 [95% CI, 2.6-23.0], p elevations.

Babacan, Ali; Kizilaslan, Cem; Gun, Ismet; Muhcu, Murat; Mungen, Ercument; Atay, Vedat

2014-01-01

230

The Krüppel-like factor 9 (KLF9) network in HEC-1-A endometrial carcinoma cells suggests the carcinogenic potential of dys-regulated KLF9 expression  

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Abstract Background Krüppel-like factor 9 (KLF9) is a transcriptional regulator of uterine endometrial cell proliferation, adhesion and differentiation; processes essential for pregnancy success and which are subverted during tumorigenesis. The network of endometrial genes controlled by KLF9 is largely unknown. Over-expression of KLF9 in the human endometrial cancer cell line HEC-1-A alters cell morphology, proliferative indices, and differentiation, when compared to KLF9 un...

2008-01-01

231

[Management of myoma: what is the place for hysterectomy and how to perform it?].  

Science.gov (United States)

Hysterectomy is the most effective treatment for symptomatic myoma with no possible recurrence. Hysterectomy for myoma is associated with a high rate of patient satisfaction (95%). Quality of life is globally improved by hysterectomy, as is sexuality with less pelvic pain, asthenia, urinary symptoms and impaired mental health. Vaginal and laparoscopic routes should be preferred to diminish blood loss, hospital stay and postoperative pain. Patients with hysterectomy are at twice as much risk of requiring surgical treatment for incontinence later on. Stress urinary incontinence must be looked for during the preoperative history-taking. PMID:23582149

Giraudet, Géraldine; Niro, Julien; Lucot, Jean-Philippe; Panel, Pierre

2013-01-01

232

Dosimetry for photodynamic therapy of endometrial tissue  

Science.gov (United States)

Hysterectomy is the most common major operation performed in the United States with dysfunctional uterine bleeding as one of the major indications. The clinical needs for simple and safe endometrial destruction are essential. Photodynamic therapy (PDT) may offer a simple and cost effective solution for the treatment of dysfunctional uterine bleeding. The dosimetry is discussed for the case of topical application of photosensitizer. This technique might be the method of preference because undesired side effects such as skin photosensitization that is typical for systemically injected photosensitizers, can be avoided. Effective PDT requires a sufficient amount of light delivered to the targeted tissue in a reasonable period of time. A trifurcated optical applicator consisting of three cylindrical diffusing fibers has been constructed, and this applicator can deliver a typical required optical dose of about 50-100 J/cm2 to the full depth of the endometrium for an exposure time of 10-20 minutes.

Svaasand, Lars O.; Fehr, Mathias K.; Madsen, Sten; Tadir, Yona; Tromberg, Bruce J.

1995-05-01

233

Interdisciplinary stratification of patients with myoma-related symptoms  

International Nuclear Information System (INIS)

With the establishment of uterine artery embolization (UAE), the individualization of treatment of the symptomatic myomatous uterus showed a general progression. The concrete therapy decision is made in an interactive process between doctor and patient. A series of factors influence the choice of a suitable, operative or non-operative, therapeutic procedure. In the weighting of therapeutic options between surgery or UAE, in addition to current results of studies which compare both techniques,recommendations made by expert committees and guidelines are helpful for a competent counseling of patients and additionally supportive in decision processes such as interdisciplinary stratification. (orig.)

2008-07-01

234

Long-term follow up after uterine artery embolization for symptomatic uterine leiomyomas  

DEFF Research Database (Denmark)

Uterine artery embolization is one of the established treatment options for symptomatic uterine leiomyomas, with a proven effect on the size of leiomyomas and providing short-term relief of symptoms. Only few studies have addressed long-term satisfaction with the treatment. We conducted a historical cohort study of 96 patients. The patients were treated at a median age of 43years (range 23-59years). The median size of the largest myoma was 69mm (range 20-170mm). By use of a postal questionnaire (response rate 86%) and audit of patient files, we found that 53% reported full recovery of symptoms and 36% some effect on symptoms after a median of 8.9years (range 8-9.4years). Overall, 25% of the women reported a need for further treatment. The rate of eventual hysterectomy was 22%. We confirm that uterine artery embolization is a safe and well-tolerated procedure with a high long-term satisfaction rate.

Poulsen, Bente; Munk, Torben

2011-01-01

235

Persistence of endometrial activity after radiation therapy for cervical carcinoma  

International Nuclear Information System (INIS)

Radiation therapy is a proved treatment for cervical carcinoma; however, it destroys ovarian function and has been thought to ablate the endometrium. Estrogen replacement therapy is often prescribed for patients with cervical carcinoma after radiation therapy. A review of records of six teaching hospitals revealed 16 patients who had endometrial sampling for uterine bleeding after standard radiation therapy for cervical carcinoma. Fifteen patients underwent dilatation and curettage, and one patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy when a dilatation and curettage was unsuccessful. Six patients had fibrosis and inflammation of the endometrial cavity, seven had proliferative endometrium, one had cystic hyperplasia, one had atypical adenomatous hyperplasia, and one had adenocarcinoma. Although the number of patients who have an active endometrium after radiation therapy for cervical carcinoma is not known, this report demonstrates that proliferative endometrium may persist, and these patients may develop endometrial hyperplasia or adenocarcinoma. Studies have indicated that patients with normal endometrial glands have an increased risk of developing endometrial adenocarcinoma if they are treated with unopposed estrogen. Patients who have had radiation therapy for cervical carcinoma should be treated with estrogen and a progestational agent to avoid endometrial stimulation from unopposed estrogen therapy

1985-01-01

236

Persistence of endometrial activity after radiation therapy for cervical carcinoma  

Energy Technology Data Exchange (ETDEWEB)

Radiation therapy is a proved treatment for cervical carcinoma; however, it destroys ovarian function and has been thought to ablate the endometrium. Estrogen replacement therapy is often prescribed for patients with cervical carcinoma after radiation therapy. A review of records of six teaching hospitals revealed 16 patients who had endometrial sampling for uterine bleeding after standard radiation therapy for cervical carcinoma. Fifteen patients underwent dilatation and curettage, and one patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy when a dilatation and curettage was unsuccessful. Six patients had fibrosis and inflammation of the endometrial cavity, seven had proliferative endometrium, one had cystic hyperplasia, one had atypical adenomatous hyperplasia, and one had adenocarcinoma. Although the number of patients who have an active endometrium after radiation therapy for cervical carcinoma is not known, this report demonstrates that proliferative endometrium may persist, and these patients may develop endometrial hyperplasia or adenocarcinoma. Studies have indicated that patients with normal endometrial glands have an increased risk of developing endometrial adenocarcinoma if they are treated with unopposed estrogen. Patients who have had radiation therapy for cervical carcinoma should be treated with estrogen and a progestational agent to avoid endometrial stimulation from unopposed estrogen therapy.

Barnhill, D.; Heller, P.; Dames, J.; Hoskins, W.; Gallup, D.; Park, R.

1985-12-01

237

Primary Endometrial Squamous Cell Carcinoma: A Case Report and Review of Relevant Literature on Korean Women  

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Primary endometrial squamous cell carcinoma (PESCC) is an extremely rare tumor with unclear pathogenesis. A 54-year-old postmenopausal woman presented with a 6-month history of vaginal bleeding. The patient was provisionally diagnosed with uterine submucosal leiomyoma. This was followed by total hysterectomy with a bilateral salpingo-oophorectomy under the laparoscopic guidance. Histopathologically, the tumor was PESCC which was accompanied by a lack of the tumor in the uterine cervix. The tu...

Lee, Sung Jong; Choi, Hyun Joo

2012-01-01

238

Recidual carcinoma after intracavitary irradiation of endometrial carcinoma, stage I  

International Nuclear Information System (INIS)

Surgical specimens from 87 patients with endometrial carcinoma, stage I, preoperatively treated by intracavitary irradiation were investigated by a whole-organ sectioning technique. Re-examination of the curettage material showed cancer stage 0 in 8 (9 percent) and carcinoma stage I in 79 cases (91 percent). In the stage I cases 57 percent showed residual carcinoma localized mainly to the myometrium of the uterine body and cornuae. Histological changes in the carcinoma were unevenly distributed, but tumors growing close to the external uterine surface were well preserved. In 40.5 percent, no carcinoma was present, and in 2.5 percent the changes found could not be classified. Correlated to disparity in irradiation technique, no significant difference could be demonstrated in the incidence or localization of residual carcinoma. The findings indicate that it is unlikely that endometrial carcinoma stage I with myometrial invasion will be eradicated by intracavitary irradiation. (Authors)

1982-01-01

239

The Value of Tumor Markers in Endometrial Carcinoma: Review of Literature  

Directory of Open Access Journals (Sweden)

Full Text Available Endometrial cancer is the most common gynecologic malignancy in more developed countries. Most endometrial carcinomas cases are diagnosed at an early stage with a tumor confined to the uterine corpus. Although most patients are cured by surgery alone, about 15% - 20% with no signs of locally advanced or metastatic disease at primary treatment recurs, with limited responsiveness to systemic therapy. Although it has a comparatively low mortality rate compared with other gynaecological cancers, it is capable of aggressive behaviour. Diagnosis at an early stage is the most important determinant of survival. Discovery of new diagnostic biomarkers/panels for early diagnosis of endometrial cancer is one of the main challenges of modern medicine. For endometrial cancers, there are no established serum markers. We will review the present knowledge regarding tumor markers, assessing how such markers could be applied to address in screening, diagnosis and monitoring of endometrial carcinoma.

Cenk Yasa

2013-06-01

240

Redução Endometrial por Vídeo-Histeroscopia: experiência em um Hospital de Ensino Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivo: demonstrar a efetividade da redução endometrial vídeo-histeroscópica no tratamento do sangramento uterino anormal. Métodos: foram analisados os prontuários de 60 pacientes com sangramento uterino anormal não-controlado clinicamente. Resultados: oitenta e oito por cento das pacientes tiveram resposta adequada ao tratamento (53,3% oligomenorréia e 35% amenorréia. Foi encontrado um índice de 8,3% de complicações (5 perfurações uterinas. Conclusão: a redução endometrial vídeo-histeroscópica é uma técnica eficaz no tratamento do sangramento uterino anormal não-controlado clinicamente, com baixos índices de complicações intra e pós-operatórias.Objective: to demonstrate the effectiveness of video-hysteroscopic endometrial resection in the treatment of abnormal uterine bleeding. Patients and method: The authors studied 60 records of patients with abnormal uterine bleeding who did not respond to clinical treatment. Results: eighty-eight percent of the patients had adequate response to the treatment (53% oligomenorrhea and 35% amenorrhea. The complication rate was 8.3% (5 uterine perforations. Conclusion: video-hysteroscopic endometrial resection is an effective technique to treat abnormal uterine bleeding which failed to respond to clinical management. The intra and postoperative complication rates are low.

Caio Parente Barbosa

1998-08-01

 
 
 
 
241

Redução Endometrial por Vídeo-Histeroscopia: experiência em um Hospital de Ensino / Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Objetivo: demonstrar a efetividade da redução endometrial vídeo-histeroscópica no tratamento do sangramento uterino anormal. Métodos: foram analisados os prontuários de 60 pacientes com sangramento uterino anormal não-controlado clinicamente. Resultados: oitenta e oito por cento das pacientes tivera [...] m resposta adequada ao tratamento (53,3% oligomenorréia e 35% amenorréia). Foi encontrado um índice de 8,3% de complicações (5 perfurações uterinas). Conclusão: a redução endometrial vídeo-histeroscópica é uma técnica eficaz no tratamento do sangramento uterino anormal não-controlado clinicamente, com baixos índices de complicações intra e pós-operatórias. Abstract in english Objective: to demonstrate the effectiveness of video-hysteroscopic endometrial resection in the treatment of abnormal uterine bleeding. Patients and method: The authors studied 60 records of patients with abnormal uterine bleeding who did not respond to clinical treatment. Results: eighty-eight perc [...] ent of the patients had adequate response to the treatment (53% oligomenorrhea and 35% amenorrhea). The complication rate was 8.3% (5 uterine perforations). Conclusion: video-hysteroscopic endometrial resection is an effective technique to treat abnormal uterine bleeding which failed to respond to clinical management. The intra and postoperative complication rates are low.

Caio Parente, Barbosa; Marcelo Ettruri, Santos; Ana Cristina, Napolitano; Paula Harue, Tamanaka; Emerson Barchi, Cordts.

242

p53 gene mutations are common in uterine serous carcinoma and occur early in their pathogenesis.  

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Uterine serous carcinoma (USC) is an uncommon but aggressive type of endometrial cancer associated with rapid progression of disease and a poor prognosis. Both USC and its recently described putative precursor, endometrial intraepithelial carcinoma (EIC), demonstrate strong p53 overexpression by immunohistochemistry, suggesting alteration of the p53 gene in their pathogenesis. In the present study, we evaluated 21 USCs and 9 EICs for mutations in the p53 gene using direct sequence analysis an...

Tashiro, H.; Isacson, C.; Levine, R.; Kurman, R. J.; Cho, K. R.; Hedrick, L.

1997-01-01

243

Usefulness of sonohysterography in differentiating endometrial cancer from endometrial hyperplasia  

Energy Technology Data Exchange (ETDEWEB)

To characterize the sonohysterographic (SH) findings of endometrial hyperplasia and cancer and to determine the role of SH in differentiating endometrial cancer from hyperplasia. The clinical, pathologic and SH findings of 38 patients with histologically confirmed endometrial hyperplasia (n=21), atypical hyperplasia 9n=6), and cancer (n=11) were reviewed retrospectively. We evaluate the presence and morphologic characteristics 9 surface contour ehcogenicity, echotexture) of endometrial thickening and mass, obliteration of endometrial cavity, and disruption of endometrial-myometrial interface on SH. SH findings of endometrial hyperplasia were endometrial thickening in 17 cases (81%), mass in 8 cases (38%), and regular surface of endometrium and mass in 16 (76%) and 6 cases (75%) respectively. Obliteration of endometrial cavity was seen only in 3 cases (14%) of endometrial hyperplasia and 1 case (17%) of atypical hyperplasia and disruption of endometrial-myometrial interface was not seen. Endometrial cancer showed endometrial thickening in 6 cases (55%), mass in 7 cases (64%), irregular surface of endometrium and mass in 10 (91%) and 7 cases (100%) respectively, obliteration of endometrial cavity in 10 cases(91%), and disruption of endometrial-myometrial interface in 4 of 8 cases with myometrial invasion. Using endometrial thickening or mass with irregular surface and obliteration of endometrial cavity as the positive findings for SH diagnosis of endometrial cancer, we observed sensitivity of 90.9%, specificity of 85.2%, and accuracy of 86.8%. The demonstration of the irregular surface with endometrial thickening or mass and obliteration of endometrial cavity through SH were suggestive of endometrial cancer.

Lee, Eun Ju; Kim, Min Jung; Ryu, Hee Sug [Aju University School of Medicine, Suwon (Korea, Republic of)

1999-06-15

244

BAJA INCIDENCIA DE PATOLOGIA ENDOMETRIAL EN MUJERES POSTMENOPAUSICAS CON SANGRADO ANORMAL QUE RECIBEN TERAPIA DE REEMPLAZO HORMONAL  

Directory of Open Access Journals (Sweden)

Full Text Available Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de reemplazo hormonal (TRH. Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo durante TRH con estrógenos y progesterona en diferentes esquemas (57% secuencial continuo; 31% combinado continuo; 12% secuencial discontinuo. A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38,5%; endometrio proliferativo 25%; endometrio atrófico 11,5%; hierplasia endometrial sin atipias 4,8%; pólipo endometrial benigno 2,9%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,5%; adenocarcinoma de endometrio 1% y ausencia de tejido endometrial 4,8%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hromonalObjetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during hormone replacement therapy (HRT. Material and method: 104 postmenopausal women presenting abnormal uterine bleeding (irregular or excessive while using HRT with estrogen and progestin in different schemes. All the patients underwent endometrial aspiration biopsies. Results: Endometrial biopsy was well tolerated and no infectious or hemorrhagic complications related to the procedure were observed. Results of endometrial sampling were as followed: secretor endometrium 38.5%; proliferative endometrium 25%; atrophic endometrium 11.5%; hyperplastic endometrium without atypia 4.8%; benign endometrial polyps 2.9%; benign endometrial tissue, inactive or fragment of epithelium 11.5%: endometrial adenocarcinoma 1%; and absence of endometrial tissue 4.8%. No samples with diagnosis of endometrial hyperplasia with atypia were found. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in about 95% of patients. Histologic sample for diagnosis was not obtained in 5% of cases, thus suggesting endometrial atrophy or focal pathology misdiagnosed by the method used. The abscense of premalignant and the low incidence of malignant pathology in our study confirms their low incidence in patients receiving adquate regime of HRT

Marcelo Bianchi P.

2002-01-01

245

BAJA INCIDENCIA DE PATOLOGIA ENDOMETRIAL EN MUJERES POSTMENOPAUSICAS CON SANGRADO ANORMAL QUE RECIBEN TERAPIA DE REEMPLAZO HORMONAL  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de reemplazo hormonal (TRH). Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo) durante TRH con [...] estrógenos y progesterona en diferentes esquemas (57% secuencial continuo; 31% combinado continuo; 12% secuencial discontinuo. A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38,5%; endometrio proliferativo 25%; endometrio atrófico 11,5%; hierplasia endometrial sin atipias 4,8%; pólipo endometrial benigno 2,9%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,5%; adenocarcinoma de endometrio 1% y ausencia de tejido endometrial 4,8%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hromonal Abstract in english Objetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during hormone replacement therapy (HRT). Material and method: 104 postmenopausal women presenting abnormal uterine bleeding (irregular or excessive) while using HRT wi [...] th estrogen and progestin in different schemes. All the patients underwent endometrial aspiration biopsies. Results: Endometrial biopsy was well tolerated and no infectious or hemorrhagic complications related to the procedure were observed. Results of endometrial sampling were as followed: secretor endometrium 38.5%; proliferative endometrium 25%; atrophic endometrium 11.5%; hyperplastic endometrium without atypia 4.8%; benign endometrial polyps 2.9%; benign endometrial tissue, inactive or fragment of epithelium 11.5%: endometrial adenocarcinoma 1%; and absence of endometrial tissue 4.8%. No samples with diagnosis of endometrial hyperplasia with atypia were found. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in about 95% of patients. Histologic sample for diagnosis was not obtained in 5% of cases, thus suggesting endometrial atrophy or focal pathology misdiagnosed by the method used. The abscense of premalignant and the low incidence of malignant pathology in our study confirms their low incidence in patients receiving adquate regime of HRT

Marcelo, Bianchi P.; Eugenio, Arteaga U.; Paulina, Villaseca D..

246

Surgical management of neurovascular bundle in uterine fibroid pseudocapsule.  

Science.gov (United States)

The uterine fibroid pseudocapsule is a fibro-neurovascular structure surrounding a leiomyoma, separating it from normal peripheral myometrium. The fibroid pseudocapsule is composed of a neurovascular network rich in neurofibers similar to the neurovascular bundle surrounding a prostate. The nerve-sparing radical prostatectomy has several intriguing parallels to myomectomy. It may serve either as a useful model in modern fibroid surgical removal, or it may accelerate our understanding of the role of the fibrovascular bundle and neurotransmitters in the healing and restoration of reproductive potential after intracapsular myomectomy. Surgical innovations, such as laparoscopic or robotic myomectomy applied to the intracapsular technique with magnification of the fibroid pseudocapsule surrounding a leiomyoma, originated from the radical prostatectomy method that highlighted a careful dissection of the neurovascular bundle to preserve sexual functioning after prostatectomy. Gentle uterine leiomyoma detachment from the pseudocapsule neurovascular bundle has allowed a reduction in uterine bleeding and uterine musculature trauma with sparing of the pseudocapsule neuropeptide fibers. This technique has had a favorable impact on functionality in reproduction and has improved fertility outcomes. Further research should determine the role of the myoma pseudocapsule neurovascular bundle in the formation, growth, and pathophysiological consequences of fibroids, including pain, infertility, and reproductive outcomes. PMID:22906340

Tinelli, Andrea; Malvasi, Antonio; Hurst, Brad S; Tsin, Daniel A; Davila, Fausto; Dominguez, Guillermo; Dell'edera, Domenico; Cavallotti, Carlo; Negro, Roberto; Gustapane, Sarah; Teigland, Chris M; Mettler, Liselotte

2012-01-01

247

Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma  

International Nuclear Information System (INIS)

Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten+/- mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten+/- mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER? as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

2011-07-01

248

Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma  

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Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten{sup +/-} mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten{sup +/-} mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER{alpha} as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

Joshi, Ayesha; Ellenson, Lora Hedrick, E-mail: lora.ellenson@med.cornell.edu

2011-07-01

249

GnRH agonists and uterine leiomyomas.  

Science.gov (United States)

Gonadotrophin-releasing hormone (GnRH) agonists are widely used in the treatment of women with symptomatic leiomyomas. The effectiveness of this treatment, as far as symptoms are concerned, is well established, and in recent years many studies have contributed to defining the optimal role for GnRH agonists. Side-effects and health risks prohibit the long-term use of these compounds. The combined use of high-dose agonists and steroids in the so-called 'add back' schedules reduces many of the disadvantages of the monotherapy. However, it is still an expensive alternative when compared with definitive surgery, and therefore should only be used in women who insist on preservation of the uterus. Low-dose agonist therapy ('draw back') has not yet been proven to be suitable for clinical application. The use of GnRH agonists and steroids in sequential schedules seems to result in a loss of both the volume reduction as well as the reduction in clinical symptoms. The use of GnRH agonists prior to myoma surgery should not become a routine measure and should be limited to cases where the size of the uterus is > 600 ml. Hysterectomy should only be preceded by GnRH agonist treatment if uterine volume decrease is expected to facilitate either the abdominal or vaginal procedure. For both operative procedures the presence of myoma-related anaemia is an indication for pretreatment. The use of GnRH agonists before endoscopic surgery is widely accepted on the basis of assumptional advantages; however, definite proof of these advantages is not yet available. PMID:9147098

Broekmans, F J

1996-11-01

250

Uterine horn aplasia with complications in two mixed-breed bitches : case report  

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Full Text Available Unilateral segmental uterine horn aplasia was found in 2 mixed-breed bitches. The 1st bitch was presented with clinical signs of acute abdominal pain, and pyometra was suspected. Pyometra was confirmed surgically with rupture of a blind-ending cranial portion of the anomalous right uterine horn, which had resulted in peritonitis. The 2nd bitch was presented for routine ovariohysterectomy. The right uterine horn was affected by segmental aplasia, with mucometra of the cranial portion of the affected horn. Histopathology demonstrated both uteri to have diffuse cystic endometrial hyperplasia. It is postulated that cystic endometrial hyperplasia, together with the congenital anomaly, resulted in pyometra in one case and in mucometra in the other case. This is believed to be the 1st report of uterine horn aplasia in the bitch in association with clinical signs and lesions other than infertility.

M.L. Schulman

2012-07-01

251

Treatment of endometrial cancer  

International Nuclear Information System (INIS)

The current status of radiotherapy of endometrial cancer was discussed based on the literature, and the radiotherapeutic technique performed at the authors' institution and its results were presented. The treatment of endometrial cancer is predicted to become increasingly important, since this cancer tends to gradually increase in number, particularly among the aged. (Chiba, N.)

1981-01-01

252

Ressecção Histeroscópica do Endométrio: Resultados e Fatores de Risco para insucesso / Hysteroscopic Endometrial Resection: Results and Risk Factors for Failures  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Objetivo: estudar o resultado da ablação endometrial histeroscópica, com o uso de ressectoscópio, em pacientes com sangramento uterino anormal de etiologia benigna e refratária ao tratamento clínico, e relatar os fatores associados aos insucessos. Métodos: foram avaliados retrospectivamente informaç [...] ões sobre 64 pacientes com sangramento uterino anormal de causa benigna, submetidas à intervenção entre abril de 1994 e fevereiro de 2000. A média de idade foi de 42,9 anos e a paridade média, de 2,6 partos. Foi realizada histeroscopia diagnóstica com biópsia endometrial pré-operatoriamente. Duas pacientes receberam previamente gestrinona, seis danazol e 44 análogo do GnRH. No ato cirúrgico realizou-se a cauterização elétrica do fundo uterino e das regiões cornuais. Depois, com o ressectoscópio, foi removido o endométrio até 1 cm cranialmente ao orifício interno e na profundidade de 2 a 3 mm na musculatura. A distensão uterina se fazia com glicina a 1,5% até há dois anos, quando se passou a usar o manitol a 3%. O seguimento foi de 11,5 meses em média. Resultados: estabeleceu-se amenorréia em 31,2% das pacientes e hipomenorréia em 45,3%. Houve persistência do sangramento anormal em 23,5%. Houve uma perfuração uterina na cérvico-dilatação (1,5%). Os resultados foram melhores nas pacientes com mais de 40 anos de idade, nas multíparas e nas que usaram análogos do GnRH. Nos casos de falhas houve freqüência estatisticamente significante (p=0,04) de miomas submucosos de 46,6% contra 20,6% no grupo com hipomenorréia e 20% no grupo com amenorréia. O uso de análogo do GnRH fez decrescer de modo significante (p=0,03) os insucessos. No grupo de pacientes nos quais se considerou haver falha da cirurgia, 46% tiveram, ao exame anatomopatológico, endométrio secretor; no grupo com hipomenorréia, 10,3% tiveram este resultado histológico e no grupo com amenorréia, 10%, o que não apresentou significância estatística (p=0,12). Conclusão: o método mostrou-se útil para tratar o sangramento uterino anormal de etiologia benigna. Recomenda-se o uso de análogos do GnRH previamente à intervenção. Sugere-se que as pacientes mais jovens, com menor paridade e com diagnóstico pré-operatório de mioma submucoso recebam atenção especial, pois entre elas ocorrem falhas com maior freqüência. Abstract in english Purpose: to evaluate the results of 64 hysteroscopic endometrial ablations using a resectoscope in women with abnormal uterine bleeding of benign etiology and nonresponsive to clinical measures and to describe the failures and their associated conditions. Methods: sixty-four patients with abnormal u [...] terine bleeding were submitted to the intervention between April 1994 and February 2000. The mean age was 42.9 years and the mean parity, 2.6 deliveries. Diagnostic hysteroscopy and endometrial biopsy were performed preoperatively. Before surgery, two women received gestrinone, six danazol and 44 GnRH analogue. During the surgery electric cauterization of the fundus uteri and cornual regions was made. Afterwards, with a resectoscope, the endometrium was removed as far as 1 cm above the internal ostium, and as deep as 2 to 3 mm into the myometrium. The uterine distension was obtained with 1.5% glycine and since two years ago with 3% manitol. The average follow-up was 11.5 months. After six months of endometrial ablation, the patients with persistence of symptoms were submitted to hysterectomy. Results: amenorrhea occurred in 31.2% of the patients and hypomenorrhea in 45.3%. The abnormal bleeding was maintained in 23.5%. There was one uterine perforation during the dilatation of the cervix. Results were better in the higher age and parity ranges and in the women who received GnRH analogues (p=0.03). Where the method was not successful there was a statistically significant frequency of submucous myoma (p=0.04) and a nonsignificant increase of secretory endometrium (p=0.12). Conclusions: the method is usefu

Frederico Faria, Rodrigues; Michelle Soares de, Moura; Eduardo Camargo, Millen; José Francisco Dória, Ramos; Salete, Yatabe; Reginaldo Guedes Coelho, Lopes; Umberto Gazi, Lippi.

253

HIPERPLASIA ENDOMETRIAL: ANÁLISIS DE SERIE DE CASOS DIAGNOSTICADOS EN BIOPSIA ENDOMETRIAL  

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Full Text Available Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15% de legrados/biopsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en legrado/biopsia endometrial en pacientes de un hospital público de tercer nivel. Métodos: Se revisaron 22.048 procedimientos realizados en el Hospital Universitario de Santander, procesados en el Departamento de Patología de la Universidad Industrial de Santander, en el periodo comprendido entre 1 de enero de 2005 y 31 de diciembre 2008, de los cuales 1.750 correspondieron a legrados/biopsias de endometrio y en 168 de estos se realizó el diagnóstico histopatológico de hiperplasia endometrial. Resultados: Se encontró que el promedio de edad de presentación de está entidad fue de 44,8 años y que el mayor porcentaje de pacientes (68,5% estuvieron en el grupo de la hiperplasia simple sin atipia. En el 19,7% de los casos hubo evidencia de atipia. Conclusiones: El promedio de edad encontrado y los porcentajes por subgrupos de hiperplasia estuvieron en relación a otros estudios. Se destaca una menor proporción de casos con atipia.Background: Endometrial hyperplasia is an entity in which there is a proliferation of endometrial glands of irregular size and shape, with the highest proportion of glands on the stroma, resulting from excessive exposure to estrogen. Approximately 15% of curettages/endometrial biopsies of postmenopausal women with clinical symptoms of abnormal uterine bleeding is diagnosed this entity. Objective: To describe the incidence and pathological findings in curettage/endometrial biopsy in patients of a tertiary public hospital. Methods: A retrospective review of 22,048 surgical procedures performed in the University Hospital of Santander, processed in the Pathology Department of Industrial University of Santander in the period from 1 January 2005 and 31 December 2008, of which 1,750 corresponded to curettage/biopsy of the endometrium and in 168 of these histopathological diagnosis was made of endometrial hyperplasia. Results: We found that the average age of presentation in this institution was 44.8 years and that the greater percentage of patients (68.5% were in the group of simple hyperplasia without atypia. In 19.7% of the cases had evidence of atypia. Conclusions: The mean age and percentages found by hyperplasia subgroups were relatively within limits with regard to other studies, although broadly outlined in a lower proportion of cases with atypia.

Ernesto García Ayala

2010-01-01

254

The effects of estradiol and catecholestrogens on uterine glycogen metabolism in mink (Neovison vison)  

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Glycogen is a uterine histotroph nutrient synthesized by endometrial glands in response to estradiol. The effects of estradiol may be mediated, in part, through the catecholestrogens, 2-hydroxycatecholestradiol (2-OHE2) and 4-hydroxycatecholestradiol (4-OHE2), produced by hydroxylation of estradiol within the endometrium. Using ovariectomized mink, our objectives were to determine the effects of estradiol, 4-OHE2, and 2-OHE2 on uterine: 1) glycogen concentrations and tissue localization; 2) g...

2011-01-01

255

Primary cervical and uterine corpus lymphoma; a case report and literature review  

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Primary lymphoma of the uterine corpus and cervix is rare. We present a case of primary non-Hodgkin follicular lymphoma isolated to uterine corpus and parametria with focal spread to ovaries and fallopian tubes, incidentally found on the background of endometrial malignancy. A summary of the published cases focusing on the presentation and prognosis as well as a review of current management are discussed. The rising incidence of extra-nodal lymphoma and recent changes in classification and th...

Anagnostopoulos, Antonios; Mouzakiti, Niki; Ruthven, Stuart; Herod, Jonathan; Kotsyfakis, Michail

2013-01-01

256

Serous endometrial intraepithelial carcinoma: a case series and literature review  

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Full Text Available P Pathiraja, S Dhar, K HaldarOxford University Hospital, Oxford, UKBackground: Minimal uterine serous cancer (MUSC or serous endometrial intraepithelial carcinoma (EIC has been described by many different names since 1998. There have been very few cases reported in literature since EIC/MUSC was recognized as a separate entity. The World health Organization (WHO Classification favors the term serous EIC. Although serous EIC is confined to the uterine endometrium at initial histology diagnosis, a significant number of patients could have distal metastasis at diagnosis, without symptoms. Serous EIC is considered as being the precursor of uterine serous cancer (USC, but pure serous EIC also has an aggressive behavior similar to USC. It is therefore prudent to have an accurate diagnosis and appropriate surgical staging. There are very few published articles in literature that discuss the pure form of serous EIC. The aim of this series is to share our experience and review evidence for optimum management of serous EIC.Patients and methods: We report a series of five women treated in our institute in the last 3 years. We reviewed the relevant literature on serous EIC and various management strategies, to recommend best clinical practice.Conclusion: Pure serous EIC is a difficult histopathological diagnosis, which requires ancillary immunohistochemical staining. It can have an aggressive clinical behavior with early recurrence and poor survival. Optimum surgical staging, with appropriate adjuvant treatment, should be discussed when treating these patients.Keywords: serous EIC, minimal uterine serous cancer, papillary serous endometrial cancer

Pathiraja P

2013-06-01

257

Uterine Fibroid Embolization  

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Uterine fibroids are commonly asymptomatic. They often cause pelvic pain, abnormal and increased vaginal bleeding, etc. Traditional treatment of symptomatic uterine fibroids was trans-abdominal hysterectomy. Nowadays, uterine artery embolization (UAE), also called uterine fibroid embolization, is considered as a safe and highly-effective nonsurgical treatment for women with symptomatic uterine fibroid tumors. Advantages of UAE over conventional hormonal suppression and surgical procedures inc...

Malek, R.; Padidar, A.

2003-01-01

258

PATOLOGIA ENDOMETRIAL EN MUJERES CON SANGRADO ANORMAL DURANTE TERAPIA DE REEMPLAZO HORMONAL  

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Full Text Available Se presenta un estudio para analizar la incidencia de patología endometrial en mujeres sanas posmenopáusicas que reciben terapia de reemplazo hormonal (TRH y que presentan sangrado uterino anormal. Se estudiaron 188 mujeres posmenopáusicas que presentaron flujo rojo uterino anormal (irregular o excesivo durante TRH con estrógenos y progesterona en diferentes esquemas (49% secuencial continuo; 39% combinado continuo; 12% secuencial discontinuo. Al 100% de las pacientes se les realizó en forma ambulatoria un estudio biópsico aspirativo de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 28,8%; endometrio proliferativo 31,3%; endometrio atrófico 18,0%; hiperplasia endometrial sin atipías 4,3%; pólipo endometrial benigno 2,7%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,7%; adenocarcinoma de endometrio 0,5% y ausencia de tejido endometrial 2,7%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en 97,3% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 2,7% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. Se concluye que la baja incidencia de patología maligna de endometrio en nuestro estudio confirma su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hormonalObjetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during HRT. Subject and Methods: The case of 188 postmenopausal women (54,8 + 6.6 years of age and 38,1 months of therapy presenting abnormal uterine bleeding (irregular or excessive while using HRT with estrogen and progestin in different schemes (49% sequential continuous; 39% combined continuous; 12% sequential discontinuous. All the patients underwent endometrial aspiration biopsies between January 1996 and October 2002 using a 2 mm (Z sampler aspiration curette. The samples were preserved in formaline, processed with standard methods and stained by hematoxylin and eosin. Results: We found secretor endometrium 28,8%; proliferative endometrium 31,3%; atrophic endometrium 18,0%; hyperplastic endometrium without atypia 4,3%; benign endometrial polyps 2,7%; benign endometrial tissue, inactive or fragment of epithelium 11,7%: endometrial adenocarcinoma 0,5%; and absence of endometrial tissue 2,7%. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in 97.3% of patients; the remaining 2.7% could correspond to atrophic endometrium of misdiagnosed focal pathology. We conclude that on standard HRT regimens the prevalence of malignant pathology in patients with irregular bleeding is very low

Marcelo Bianchi P.

2003-01-01

259

PATOLOGIA ENDOMETRIAL EN MUJERES CON SANGRADO ANORMAL DURANTE TERAPIA DE REEMPLAZO HORMONAL  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Se presenta un estudio para analizar la incidencia de patología endometrial en mujeres sanas posmenopáusicas que reciben terapia de reemplazo hormonal (TRH) y que presentan sangrado uterino anormal. Se estudiaron 188 mujeres posmenopáusicas que presentaron flujo rojo uterino anormal (irregular o exc [...] esivo) durante TRH con estrógenos y progesterona en diferentes esquemas (49% secuencial continuo; 39% combinado continuo; 12% secuencial discontinuo. Al 100% de las pacientes se les realizó en forma ambulatoria un estudio biópsico aspirativo de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 28,8%; endometrio proliferativo 31,3%; endometrio atrófico 18,0%; hiperplasia endometrial sin atipías 4,3%; pólipo endometrial benigno 2,7%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,7%; adenocarcinoma de endometrio 0,5% y ausencia de tejido endometrial 2,7%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en 97,3% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 2,7% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. Se concluye que la baja incidencia de patología maligna de endometrio en nuestro estudio confirma su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hormonal Abstract in english Objetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during HRT. Subject and Methods: The case of 188 postmenopausal women (54,8 + 6.6 years of age and 38,1 months of therapy) presenting abnormal uterine bleeding (irregul [...] ar or excessive) while using HRT with estrogen and progestin in different schemes (49% sequential continuous; 39% combined continuous; 12% sequential discontinuous). All the patients underwent endometrial aspiration biopsies between January 1996 and October 2002 using a 2 mm (Z sampler) aspiration curette. The samples were preserved in formaline, processed with standard methods and stained by hematoxylin and eosin. Results: We found secretor endometrium 28,8%; proliferative endometrium 31,3%; atrophic endometrium 18,0%; hyperplastic endometrium without atypia 4,3%; benign endometrial polyps 2,7%; benign endometrial tissue, inactive or fragment of epithelium 11,7%: endometrial adenocarcinoma 0,5%; and absence of endometrial tissue 2,7%. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in 97.3% of patients; the remaining 2.7% could correspond to atrophic endometrium of misdiagnosed focal pathology. We conclude that on standard HRT regimens the prevalence of malignant pathology in patients with irregular bleeding is very low

Marcelo, Bianchi P.; Cecilia, Berrios C.; Paulina, Villaseca D.; Eugenio, Arteaga U..

260

Comparison of endometrial biopsy by PIPELLE with diagnostic curretage in patients with abnormal utrine bleeding, Imam Khomeini Hospital  

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It this prospective cross sectional study out-patient endometrial biopsy by PIPELLE was compared with diagnostic curretage (D&C) in patients suffering of Abnormal Uterine bleeding (AUB). Diagnostic accuracy, sufficient tissue sampling, intensity of pain and effective factors in biopsy results were the evaluated parameters in this study. In 70 patients with complaint of AUB (20 of them were post-menoupsal age admitted in hospital for D&C) endometrial biopsy was conducted by PIPELLE bef...

Ghaemmaghami F; Ensani F; Bigdely H

1999-01-01

 
 
 
 
261

An orthotopic endometrial cancer mouse model demonstrates a role for RUNX1 in distant metastasis.  

Science.gov (United States)

Endometrial carcinoma is the most common malignancy of the female genital tract in industrialized countries. Metastasis is the major cause of endometrial cancer deaths. Therefore, there is a vital need for clinically relevant in vivo models allowing the elucidation of the molecular and cellular mechanisms underlying metastatic behavior. In this study, we describe an innovative experimental orthotopic model of human endometrial carcinoma. Implantation in the bifurcation of the uterine horns resulted in tumors integrated into the myometrial compartment, which can be used and further exploited for the study of in vivo angiogenesis, myometrial invasion, and the metastatic capacity of endometrial cancer cells. This orthotopic model also represents a suitable tool to analyze how tumorigenesis and distant metastasis of endometrial cancer might be influenced by gene alteration, by modulating its expression in the original cancer cell line. One of the candidate genes implicated in endometrial cancer is the transcription factor RUNX1. The over-expression of RUNX1 in the endometrial cancer cell line HEC1A and the transplantation of these cells to the uterus of nude mice were associated specifically with distant metastasis in the lung. RUNX1 plays a role in the establishment of metastases in endometrial cancer. Translated to the clinics, these models would be equivalent to an advanced undifferentiated carcinoma with node affectation (stage IIIC) and distant metastasis (stage IVB). These patients would be candidates for adjuvant therapy, not efficient until today, and therefore, our models are actually suitable for the design and evaluation of experimental therapies. PMID:19384951

Doll, Andreas; Gonzalez, Marta; Abal, Miguel; Llaurado, Marta; Rigau, Marina; Colas, Eva; Monge, Marta; Xercavins, Jordi; Capella, Gabriel; Diaz, Berta; Gil-Moreno, Antonio; Alameda, Francesc; Reventos, Jaume

2009-07-15

262

Imaging of endometrial lesion  

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Full Text Available Introduction & Background: The main role of imaging of endometrium is to differentiate between normal and abnormal endometrium and triage patients to those patients requiring guided biopsy vs. those patients that can be managed by blind biopsy. Endometrial thickness of 5mm has been proven to be a reliable threshold to ex-clude endometrial cancer. Transvaginal sonography (TVS can detect focal pathology in most cases. Endo-metrial polyp and submucosal fibroid (SMF have distinguishing features on TVS. Endometrial polyp is recog-nized by the presence of a complete endometrial stripe sign. SMF presenting as endometrial mass shows stretched overlying endometrium and continuity with myometrium as specific features. Sonohysterography (SHG is indicated when TVS is suboptimal or inconclusive as well as for staging of SMF prior to surgery. Hys-teroscopic removal of SMF requires that more than 50% of the mass is intracavitary. Some technical points re-lated to SHG and the mechanism and sonographic changes of endometrium due to tamoxifen are also dis-cussed. An algorithm is presented for sonographic-based assessment of endometrial thickening.

M. Atri

2005-08-01

263

[Uterine leiomyoma].  

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Uterine fibroids, benign tumors of the human uterus, are the most common indication for hysterectomy. They are clinically apparent in 20-25% of women and cause significant complaints, like prolonged and heavy menstruation, pelvic pressure or pain, sometimes reproductive dysfunction. Though surgery has been the mainstay of fibroid treatment, various minimally invasive procedures have been developed in addition to hysterectomy and abdominal myomectomy. Formation of new leiomyomas after these conservative therapies remains a substantial problem. Also drug-therapy methods are available, but the possible side-effects limit their long-term use. Authors attempt to give an overview of this common gynecological disease, yielding a new insight into the basic biology and genetics of fibroids, with the hope of new and effective methods of therapy in the future. PMID:20889441

Csatlós, Eva; Rigó, János; Szabó, István; Nagy, Zsolt; Joó, József Gábor

2010-10-17

264

Surgical options for recurrent uterine sarcomas.  

Science.gov (United States)

Leiomyosarcoma, the most frequent pure uterine sarcoma, is an aggressive tumor with a tendency toward early relapse. Survival for patients with recurrent disease is poor. In contrast, endometrial stromal sarcoma, the second most common uterine sarcoma, is a more indolent malignancy with a tendency toward recurrence after a long latency period. The relative infrequency of both diseases makes the study and standardization of treatment for recurrent disease challenging. Treatment of recurrence with cytotoxic chemotherapy, radiation therapy, or hormone therapy produces modest to poor response rates. Surgical resection is one treatment modality offering the potential for cure and perhaps a more durable response than is seen with medical management. Although initial studies focused on pulmonary metastasectomy in recurrent soft tissue sarcoma, an increasingly large body of data specifically evaluating outcomes after both thoracic and extrathoracic metastasectomy in patients with recurrent uterine sarcoma is now available. Though no prospective trials have been conducted, retrospective comparisons of chemotherapy or radiation therapy with surgery for recurrent uterine sarcoma suggest improvement in disease-specific survival for the surgery group. Clearly defined factors are associated with better prognosis after surgical resection of recurrence, including a prolonged disease-free interval and complete resection of disease. In properly selected women, surgery and even repeated metastasectomy for recurrent disease may improve survival and should be considered. PMID:24451764

Korets, Sharmilee B; Curtin, John P

2012-01-01

265

The value of diagnostic hysteroscopy with biopsy in the preoperative of endometrial ablation  

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Full Text Available Objective: To assess the value of diagnostic hysteroscopy with biopsy in the preoperative preparation for endometrial ablation. Methods: It was a prospective non-randomized study conducted at the division of Gynecologic Endoscopy of Hospital do Servidor Público Estadual “Francisco Morato de Oliveira” from March 2007 to May 2009. A total of 45 patients with abnormal uterine bleeding, and referred to endometrial ablation were included. All women underwent a diagnostic hysteroscopy, and were treated with a GnRH analogous – goserelin – 10.8 mg before surgery. The endometrial ablation was performed with a surgical resectoscope. Patients were submitted to one directed endometrial biopsy, one guided endometrial biopsy with Novak curette, and to endometrial ablation, which was considered as reference for pathological examination with samples from the biopsies. Data were analyze using the SPSS-v16 software, and considered significance at p = 0.05. Results: The mean age of women was 44.20 years (33-56, parity of 2.67 (0-9, uterus size of 139.99 calculated in cc (42-278, and the mean duration of symptoms was 3.68 years (0.5-15. The guided endometrial biopsy showed sensitivity of 80% for endometrium without atypia, and the directed endometrial biopsy had sensitivity of 60%. For proliferative endometrium the directed endometrial biopsy showed sensitivity of 76 and 100% for secretory endometrium, which was higher than the guided endometrial biopsy with 53 and 50%, respectively. Conclusion: The directed biopsy before endometrial ablation had lower sensitivity than guided biopsy for endometrium without atypia, however it was higher for proliferative and secretory endometrium.

Salete Yatabe

2011-12-01

266

RESECCIÓN ENDOMETRIAL HISTEROSCÓPICA MÁS INSERCIÓN DE DIU-LNG EN EL SANGRADO UTERINO ANORMAL REFRACTARIO A TRATAMIENTO MÉDICO  

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Full Text Available Objetivo: Evaluar los resultados del tratamiento del sangrado uterino anormal (SUA refractario a tratamiento médico, con resección endometrial histeroscópica asociado a la inserción de un sistema intrauterino de liberación de levonorgestrel. Método: Estudio prospectivo de 24 pacientes con SUA tratadas con resección endometrial histeroscópica seguida de inserción de un dispositivo intrauterino que libera 20 microgramos diarios de levonorgestrel. Resultados: En 23 de las 24 pacientes tratadas se obtuvo un resultado favorable en término de control del SUA, con un período de seguimiento promedio de 18,3 meses. Una paciente requirió histerectomía por persistencia de dolor pélvico. Conclusión: Asociar a la resección endometrial histeroscópica la inserción de un sistema intrauterino de liberación de levonorgestrel mejora los resultados de la cirugía conservadora pudiendo evitar la histerectomía en el 95,9% de las mujeres con SUA de causa benignaObjective: To evaluate hysteroscopic endometrial resection associated to levonorgestrel intrauterine device insertion as a treatment of abnormal uterine bleeding of benign cause. Method: 24 patients with abnormal uterine bleeding, were treated with hysteroscopic endometrial resection followed by the insertion of a intrauterine levonorgestrel device. Results: 23 of 24 patients no report symptoms after 18.3 months follow up. One hysterectomy was performed for persistent chronic pelvic pain. Conclusions: Endometrial ablations with diathermic loop followed by the insertion of intrauterine levonorgestrel device improve the results of the conservative surgeries, avoiding 95.9% of hysterectomies in patients with abnormal uterine bleeding

Juan Carlos Carvajal V

2007-01-01

267

Avaliação de morfologia e histologia endometrial de mulheres após a menopausa Assessment of endometrial morphology and histology in postmenopausal women  

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Full Text Available OBJETIVO: Avaliar ambulatorialmente a morfologia e histologia endometrial de mulheres sem sangramento genital após a menopausa. MÉTODOS: Em estudo descritivo foram selecionadas 52 mulheres, após a menopausa, entre 50 e 60 anos, sem terapia hormonal nos últimos seis meses. Todas foram submetidas a exame ultrassonográfico, histeroscópico e biópsias endometriais. RESULTADOS: Das 52 mulheres selecionadas 32 (61,5% apresentaram ultrassonografia normal, cavidade uterina normal com endométrio atrófico à histeroscopia, confirmada pela biópsia endometrial. Vinte (38,4% apresentaram achados histeroscópicos ou histológicos anormais, sendo que apenas cinco destas mostraram endométrio com espessura superior a cinco milímetros ao ultrassom. CONCLUSÃO: A histeroscopia diagnóstica associada à biópsia aspirativa (Pipelle pode evidenciar alterações não observadas ao ultrassom transvaginal.OBJECTIVE: Evaluate in outpatients , the endometrial morphology and histology of non- bleeding postmenopausal women. METHODS: We conducted a descriptive study where 52 menopausal women were selected, between 50 and 60 years of age, who had not used hormone replacement therapy in the last six months and did not present any kind of vaginal bleeding after menopause. These women underwent ultrasound examination, hysteroscopy and biopsy, and then endometrial findings were analyzed. RESULTS: Of the 52 women selected, thirty two (61,5% had normal ultrasound, normal uterine cavity with atrophic endometrium, hysteroscopy, confirmed by endometrial biopsy. Twenty (38,4% had hysteroscopuc and histologic alterations and only five women showed by ultrasound an endometrial thickness of more than five millimeters. CONCLUSION: Diagnostic Hysteroscopy associated with aspiration biopsy (Pipelle performed in the day care facility can reveal endometrial alterations that cannot be diagnosed by transvaginal ultrasound.

Luis Paulo Galvao Wolff

2010-01-01

268

Citología endometrial en pacientes posmenopáusicas con terapia hormonal  

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Full Text Available Objetivo: Demostrar la utilidad de la toma de muestra con Uterobrush® y compararlo con la biopsia endometrial, en pacientes posmenopáusicas con terapia hormonal. Método: Estudio prospectivo durante un lapso de seis meses, en el cual se incluyeron 30 pacientes, de las cuales 15 referían sangrado genital anormal y 15 no referían sintomatología. A cada paciente se le realizó citología endometrial con Uterobrush® y posteriormente se le realizó biopsia de endometrio con cureta de Novak. El diagnóstico citológico se comparó con el diagnóstico biópsico, para obtener la sensibilidad y especificidad de la técnica con Uterobrush®. Ambiente: Consulta externa del Servicio de Ginecología del Instituto Autónomo Hospital Universitario de Los Andes (IAHULA Mérida. Resultados: El procedimiento fue fácil en un 73,3 % de las pacientes, no refiriendo dolor. No se presentó sangrado posterior a la introducción del Uterobrush® en un 53,3 %. Las muestras fueron adecuadas en el 70 % de los casos. La principal causa de limitación fue la mala preservación de las células. Al comparar los diagnósticos citológicos con la biopsia encontramos una sensibilidad del 71 % y una especificidad del 75 %. Conclusión: La citología endometrial con Uterobrush® es un procedimiento aceptable, fácil de usar, económico, y bien tolerado por las pacientes; siendo útil para la valoración endometrial en mujeres posmenopáusicas y en aquellas que así lo ameriten, pero no se pretende desplazar a la biopsia endometrial sino sugerir estudios más extensos.Objective: To demonstrate the efficacy of endometrial cytology with the Uterobrush® sampler and compare it with endometrial biopsy, in postmenopausal women under hormonal replacement therapy. Method: Prospective study with 30 patients during a lapse of six months, fifteen of them refered abnormal uterine bleeding and the other fifteen did not. Endometrial cytology sampling was done with Uterobrush® and biopsy with Novak´s currette to all patients. Difficulty, pain, bleeding, cervical characteristics, celularity and adequacy of the sampling where assessed, cytology was compared with biopsy diagnosis. Setting: Gynecology service of the University Hospital of Los Andes, Results: 73.3 % of the patients did not refer pain. No bleeding was present after the introduction of Uterobrush ® in 53.3 %. The samples were adequate in 70 % of cases. Principal cause of limitation was poor fixation of cells. When comparing cytologic diagnosis with biopsy we found a sensitivity of 71 % and 75 % specificity. Conclusions: The endometrial cytology with Uterobrush® is a procedure easy to use, economic, and well tolerated by the patients; being useful to evaluate the endometrium in post menopausal women, but not pretending to overtake endometrial biopsy.

Belkys Chacín Peña

2008-06-01

269

Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation  

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Full Text Available Background and Objectives: The most frequent procedures performed on women with abnormal uterine bleeding are 2D and 3D ultrasound. The most common accepted approach for the management of abnormal uterine bleeding is 2D TV scan followed by therapeutic hysteroscopy. The purpose of this prospective study was to assess whether 3D saline infusion sonohysterography (3D SIS could replace diagnostic hysteroscopy (DH for the diagnosis of endometrial pathology, in patients with abnormal uterine bleeding. Design and Setting: A prospective study in the ultrasound department of the Women?s Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia from January 2008 to February 2010. Patients and Methods: 0One hundred and one patients with abnormal uterine bleeding, suspected to have endometrial abnormality by 2D and 3D transvaginal scan, were prospectively studied. Of these, 55 patients had undergone both 3D SIS and DH, followed by verification of results with histopathology. Results: Upon comparison of 3D SIS and DH individually with histopathology, specificity and sensitivity for 3D SIS were 67% and 100%, respectively, and for hysteroscopy 67% and 98%, respectively. In addition, the positive predictive value and negative predictive value were 98% and 100%, respectively, for 3D SIS, while for DH they were 98% and 67%, respectively. Conclusion: 3D SIS is a safe alternative to hysteroscopy. However, larger randomized controlled trials should be conducted to ascertain the validity and reliability of this advantageous, less-invasive procedure, for women with abnormal uterine bleeding, who require evaluation of the endometrial cavity.

Khan Faryal

2011-01-01

270

Genetics of Endometrial Cancers  

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Endometrial cancers exhibit a different mechanism of tumorigenesis and progression depending on histopathological and clinical types. The most frequently altered gene in estrogen-dependent endometrioid endometrial carcinoma tumors is PTEN. Microsatellite instability is another important genetic event in this type of tumor. In contrast, p53 mutations or Her2/neu overexpression are more frequent in non-endometrioid tumors. On the other hand, it is possible that the clear cell type may arise fro...

Tsuyoshi Okuda; Akihiko Sekizawa; Yuditiya Purwosunu; Masaaki Nagatsuka; Miki Morioka; Masaki Hayashi; Takashi Okai

2010-01-01

271

Does gestrinone antagonize the effects of estrogen on endometrial implants upon the peritoneum of rats?  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To evaluate the effects of estrogen treatment in combination with gestrinone on an experimental rat model of endometriosis. METHODS: Uterine transplants were attached to the peritoneum of female Wistar rats via a surgical autotransplantation technique. The implanted area was measured duri [...] ng the proestrus phase and after hormonal treatment. We performed morphometric analysis and examined the macroscopic and morphometric alterations of endometrial implants after hormonal treatment in ovariectomized rats. RESULTS: The high dose of estrogen caused macroscopic increases in the endometrial implant group compared with other groups, which were similar to increases in the proestrus phase. The low dose showed morphometric development of implants, such as an increase in number of endometrial glands, leukocyte infiltration and mitosis. Gestrinone antagonized both doses of estrogen. CONCLUSION: Our findings suggest that gestrinone antagonizes estrogen's effects on rat peritoneal endometrial implants.

Lobo, Vera Lúcia Rodrigues; Soares Júnior, José Maria; Simões, Manuel de Jesus; Simões, Ricardo dos Santos; Lima, Geraldo Rodrigues de; Baracat, Edmund C.

272

Global Endometrial Ablation in the Presence of Essure(R) Microinserts  

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Abnormal uterine bleeding (AUB) affects 30% of women at some time during their reproductive years and is one of the most common reasons a woman sees a gynecologist. Many women are turning to endometrial ablation to manage their AUB. This article reviews the data relating to the available endometrial ablation techniques performed with hysteroscopic sterilization, and focuses on data from patients who had Essure® (Conceptus, San Carlos, CA) coils placed prior to performance of endometrial ablation. Reviewed specifically are data regarding safety and efficacy of these two procedures when combined. Data submitted to the US Food and Drug Administration for the three devices currently approved are reviewed, as well as all published case series. Articles included were selected based on a PubMed search for endometrial ablation (also using the brand names of the different techniques currently available), hysteroscopic sterilization, and Essure.

Aldape, Diana; Chudnoff, Scott G; Levie, Mark D

2013-01-01

273

Uterine Fibroid Embolization  

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Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the ... today is going to be an embolization of uterine fibroids. So we're going to show you the ...

274

Uterine Cancer Statistics  

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... Use Social Media Poster Presentation Buttons and Badges Statistics for Other Types of Cancer Breast Cervical Colorectal ( ... Lung Ovarian Prostate Skin Cancer Home Uterine Cancer Statistics Uterine cancer is the fourth most common cancer ...

275

Total laparoscopic hysterectomy with earlier uterine artery ligation.  

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We compared the feasibility, blood loss, duration of surgery, and complications between patients in whom both uterine arteries were sutured at the beginning of total laparoscopic hysterectomy (TLH) and patients in whom suturing was done after cornual pedicles. Using a prospective study (Canadian Task Force classification II-2) at a dedicated high-volume gynecologic laparoscopy center, a total of 350 women who underwent TLH from January 2005 through January 2007 were assigned into 2 groups. The indications for TLH were predominantly myomas and menorrhagia. In group A, TLH was done by suturing both uterine arteries at the beginning of the procedure. In group B, the uterine arteries were sutured after the cornual pedicles as done conventionally. All the other pedicles were desiccated and cut either with harmonic ultracision or bipolar diathermy. The uterus with cervix was removed either vaginally or by morcellation. The median age of patients in group A was 46 years and in group B was 44 years. Mean uterine size, weight, estimated blood loss, total operating time, need for blood transfusion, and complications were analyzed. In group A the total duration of surgery was 60 minutes (range 20-210). In group B, the total duration of surgery was 70 minutes (range 30-190). In group A, the median total blood loss was 50 mL (range 10-2000). In group B the total blood loss was 60 mL (range 10-2500). The comparison between the 2 groups revealed a statistically significant difference (p uterus weight > 1000 g) and required 4 units of packed cell transfusion in each. One patient in group B with previous cesarean section had a bladder wall rent and this was sutured laparoscopically using 3-0 delayed absorbable sutures. Uterine artery ligation at the beginning of TLH as done in group A is a technically feasible procedure. It reduces the total blood loss and decreases the time taken for the procedure. PMID:18439511

Sinha, Rakesh; Sundaram, Meenakshi; Nikam, Yogesh A; Hegde, Aparna; Mahajan, Chaitali

2008-01-01

276

Ultrasound-guided reoperative hysteroscopy: managing endometrial ablation failures.  

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Endometrial ablation and hysteroscopic myomectomy and polypectomy are having an increasing impact on the care of women with abnormal uterine bleeding (AUB). The complications of these procedures include the late onset of recurrent vaginal bleeding, cyclic lower abdominal pain, hematometra and the inability to adequately sample the endometrium in women with postmenopausal bleeding. According to the 2007 ACOG Practice Bulletin, approximately 24% of women treated with endometrial ablation will undergo hysterectomy within 4 years. By employing careful cervical dilation, a wide variety of gynecologic resectoscopes, and continuous sonographic guidance it is possible to explore the entire uterine cavity in order to locate areas of sequestered endometrium, adenomyosis, and occult hematometra. Sonographically guided reoperative hysteroscopy offers a minimally invasive technique to avoid hysterectomy in over 60% to 88% of women who experience endometrial ablation failures. The procedure is adaptable to an office-based setting and offers a very low incidence of operative complications and morbidity. In addition, the technique provides a histologic specimen, which is essential in adequately evaluating the endometrium in postmenopausal women or women at high risk for the development of adenocarcinoma of the endometrium. PMID:23292675

Wortman, Morris

2012-12-01

277

Relaxation time of magnetic resonance imaging on the uterine diseases  

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Magnetic Resonance Imaging (MRI) has been developed by use of the theory based on MR-phenomena. In the present paper, diagnostic analysis was performed on the various disorders of the uterus by use of MRI. 30 selected patients were subjected, they are one case of diagnosed hydatidiform mole, 11 cases of myoma uteri, 1 case of adenomyosis, 3 cases of ca. corporis uteri, and 14 cases of ca. colli uteri. MRI facility used was Magnetom M5, Siemens Co. with 0.5 Tesla superconducting magnet. As for tissue parameter of these lesions, both T{sub 1} and T{sub 2} values were measured. The features of hydatidiform mole showed dense granular pattern according to small cystic vesicles. Myoma nodule without degeneration showed low intensity, clear image of nodule and the shortest T{sub 1} and T{sub 2} values (T{sub 1}/T{sub 2} values:635.2/43.9 msec). In case of their degeneration, increased intensity and larger T{sub 1} and T{sub 2} values (T{sub 1}/T{sub 2} values:1219.3/112.7 msec) were shown. Adenomyosis showed widely, diffuse low intensity area within high intensity spots (T{sub 1}/T{sub 2} values:561.7/51.6 msec). Both malignant lesions of uterine body and cervix showed as high intensity on the T{sub 2} weighed SE image and similar T{sub 1} and T{sub 2} value (T{sub 1}/T{sub 2} values:774.4/72.8 and 789.4/74.4 msec) respectively. But their values were lower than normal tissue. It is suggested that MRI has good advantage for differential diagnosis of the uterine diseases. (author).

Yasuzawa, Michio (Kanazawa Medical Univ., Uchinada, Ishikawa (Japan))

1990-02-01

278

Relaxation time of magnetic resonance imaging on the uterine diseases  

International Nuclear Information System (INIS)

Magnetic Resonance Imaging (MRI) has been developed by use of the theory based on MR-phenomena. In the present paper, diagnostic analysis was performed on the various disorders of the uterus by use of MRI. 30 selected patients were subjected, they are one case of diagnosed hydatidiform mole, 11 cases of myoma uteri, 1 case of adenomyosis, 3 cases of ca. corporis uteri, and 14 cases of ca. colli uteri. MRI facility used was Magnetom M5, Siemens Co. with 0.5 Tesla superconducting magnet. As for tissue parameter of these lesions, both T1 and T2 values were measured. The features of hydatidiform mole showed dense granular pattern according to small cystic vesicles. Myoma nodule without degeneration showed low intensity, clear image of nodule and the shortest T1 and T2 values (T1/T2 values:635.2/43.9 msec). In case of their degeneration, increased intensity and larger T1 and T2 values (T1/T2 values:1219.3/112.7 msec) were shown. Adenomyosis showed widely, diffuse low intensity area within high intensity spots (T1/T2 values:561.7/51.6 msec). Both malignant lesions of uterine body and cervix showed as high intensity on the T2 weighed SE image and similar T1 and T2 value (T1/T2 values:774.4/72.8 and 789.4/74.4 msec) respectively. But their values were lower than normal tissue. It is suggested that MRI has good advantage for differential diagnosis of the uterine diseases. (author)

1990-01-01

279

Lymph Node Mapping in Patients With Newly Diagnosed Endometrial Cancer Undergoing Surgery  

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Stage IA Endometrial Carcinoma; Stage IB Endometrial Carcinoma; Stage II Endometrial Carcinoma; Stage IIIA Endometrial Carcinoma; Stage IIIB Endometrial Carcinoma; Stage IIIC Endometrial Carcinoma; Stage IVA Endometrial Carcinoma; Stage IVB Endometrial Carcinoma

2014-03-06

280

Intraperitoneal Paclitaxel, Doxorubicin Hydrochloride, and Cisplatin in Treating Patients With Stage III-IV Endometrial Cancer  

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Endometrial Adenosquamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Recurrent Endometrial Carcinoma; Stage IIIA Endometrial Carcinoma; Stage IIIC Endometrial Carcinoma; Stage IVA Endometrial Carcinoma; Stage IVB Endometrial Carcinoma

2014-03-25

 
 
 
 
281

Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial  

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Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

2012-10-01

282

Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial  

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Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

Mara, Michal; Kubinova, Kristyna, E-mail: kristyna.kubinova@gmail.com [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Maskova, Jana [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Horak, Petr [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Belsan, Tomas [Central Military Hospital, Department of Radiology (Czech Republic); Kuzel, David [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic)

2012-10-15

283

Atypical uterine bleeding-Histopathological audit of endometrium A study of 638 cases  

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Full Text Available Background: AUB is one of the most common problems in women of all ages especially those in the peri-menopausal age group. The abnormal bleeding can be caused by a wide variety of disorders and it is one of the commonest complaints leading to endometrial sampling. Objectives: Our study aimed at determining the types and frequencies of endometrial pathologies in patients presenting with abnormal uterine bleeding at our hospital which caters largely to women of low socioeconomic status. Material and Methods: The present study was conducted at the Hakeem Abdul Hameed Centenary Hospital, New Delhi. This was a retrospective age specific comparative analysis of 638 women presenting with abnormal uterine bleeding, who underwent endometrial sampling at our hospital. The pattern of endometrial histopathological changes were identified and classified. Results: Age of the patients ranged from 15 to 70 years, maximum patients (35.89 % in the age group 41-50 years. The most common clinical presentation was represented by menorrhagia (41% Various patterns on histopathology were secretory endometrium(28.99%the commonest, followed by proliferative endometrium (24.92%. Incidence of malignancy was low in the present study. Conclusion: Endometrial curetting and biopsy is an important diagnostic procedure in evaluation of AUB.. Endometrial causes of AUB are age related, therefore it is specially recommended in women of the perimenopausal age presenting with AUB, to rule out preneoplasia and malignancy.

Zeeba S. Jairajpuri

284

Endometrial sampling and general practice.  

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Endometrial sampling is an 'office' technique that has gained widespread acceptance in the United States (US). It is as accurate as dilatation and curettage (D&C) in the diagnosis of endometrial atypia and carcinoma. It appears to be the most suitable method of endometrial assessment for general practice. It has the potential for the earlier detection of endometrial abnormality and for increasing the number of women with abnormal vaginal bleeding who can be wholly managed within primary care....

Shapley, M.; Redman, C. W.

1997-01-01

285

Surgical and medical management of a uterine spindle cell tumor in an African hedgehog (Atelerix albiventris).  

Science.gov (United States)

A 5-yr-old female African hedgehog (Ateleris albiventris) presented with hematuria. Vulvar culture results revealed a 4+ growth of Enterococcus sp. and gamma-Streptococcus sp. susceptible to trimethoprim sulfa and enrofloxacin. Ultrasound evaluation of the abdomen revealed an unidentifiable tubular structure in the region of the reproductive tract. An exploratory laparotomy and ovariohysterectomy were performed. Pathologic studies of the uterus showed a uterine spindle cell tumor, uterine endometrial polyp, uterine adenomyosis, and a possible acute infarct resulting in uterine wall necrosis. Hematuria did not reoccur, and the hedgehog lived for another 19 mo until she died from an oral squamous cell carcinoma. To date, this is the first report of a uterine spindle cell tumor in an African hedgehog. PMID:18229871

Done, Lisa B; Deem, Sharon L; Fiorello, Christine V

2007-12-01

286

Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions  

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Full Text Available Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB or intrauterine lesions causing uterine bleeding. Methods: This study prospectively enrolled 100 patients who underwent operative hysteroscopy in tertiary referral university center because of uterine bleeding due to endometrial polyps or uterine submucosal leiomyomas diagnosed by transvaginal ultrasonogram. Indications for the operative hysteroscopies included abnormal uterine bleeding (AUB, ultrasound findings indicative of intrauterine lesions, and DUB. After operative hysteroscopic management, we inserted anti-adhesive solution, sodium hyaluronate and carboxymethyl cellulose into the uterine cavity. Results: Operative hysteroscopy was a successful procedure in 100 of 100 cases (100% but it needed to be repeated in three cases with large uterine submucosal leiomyoma and after two endometrial polypectomy. Mean duration of the procedure was 23.2 minutes (range 5 - 67 and postoperative hospital stay was 7 hours (range 3 - 48. Most common indication was DUB (39%, submucosal leiomyoma was 21%, and endometrial polyp was 17%. There were five cases with postoperative uterine bleeding and none with fluid overload syndrome. During postoperative follow-up (3 - 28 months the majority of patients (90/100, 90% were free of symptoms. Conclusion: Hysteroscopic procedure is an effective and safe method for the management of benign intracavitary pathology or the treatment of dysfunctional uterine bleeding. Although sodium hyaluronate and carboxymethyl cellulose seems to be effective in the prevention of adhesion in uterine cavity, further study will be needed to prove the effectiveness of anti-adhesive solution.

Junsik Park

2013-05-01

287

MR imaging of endometrial cancer that occurs after radiation therapy for cervix cancer  

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We wanted to describe the MR imaging findings of endometrial cancer in patients with a history of prior radiation therapy for cervical cancer (ECRT) and we compare them to the MR imaging findings of patients with spontaneously occurring endometrial cancer (SEC). Twenty-two patients with endometrial cancer that was diagnosed by operation or endometrial biopsy were included in the study. The patients were divided into two groups according to the presence of past RT for cervical cancer: ECRT (n = 4) and SEC (n = 18). The MR images were retrospectively analyzed by consensus of two experienced radiologists. The MR imaging findings were analyzed by the size, shape and signal intensity of the mass, distension of the uterine cavity, the presence of cervical stenosis and the nature of the fluid collection. For the mass shape, all the ECRT lesions were polypoid masses. However, the SEC patients had 5 polypoid masses and 13 wall thickenings. The maximal diameter, signal intensity and enhancement pattern of the masses were not different between the ECRT and SEC patients. The width of the endometrial cavity varied between 3.9 cm in the ECRT patients and 0.4 cm in the SEC patients ({rho} = 0.002). All the ECRT patients had cervical stenosis. However, none of the SEC patients had cervical stenosis. MR imaging of ECRT patients demonstrated prominent distension of their uterine cavity and cervical stenosis, which may be the result of radiation fibrosis in the uterus.

Kim, Youn Jeong [Inha University Hospital, Incheon (Korea, Republic of); Jeong, Yong Yeon; Lim, Nam Yeol [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Ko, Seok Wan [Kwangju Christian Hospital, Kwangju (Korea, Republic of); Kim, Bo Hyun [Mayo Clinic College of Medicine, Rochester, Minnesota (United States)

2007-05-15

288

Role of Hysteroscopy and Laparoscopy in Evaluation of Abnormal Uterine Bleeding.  

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Full Text Available Abnormal uterine bleeding poses a real challenge for the gynecologists Dilatation and curettagehas been the gold standard for differentiating benign from malignant endometrium. Hysteroscopyand laparoscopy are the recent addition to the armamentarium of investigations for abnormaluterine bleeding. This study was done to evaluate the role of hysteroscopy and laparoscopy in75 women with abnormal uterine bleeding. Hysteroscopy findings were compared withhistopathology in the diagnosis and etiology of abnormal uterine bleeding. Majority of the patientspresented with menorrhagia (40% and metrorrhagia (20%. Hysteroscopy showed abnormalitydetection rate of 66% as compared to 26.6% with traditional curettage. Diagnostic accuracy ofhysteroscopy was higher in patients with polyps and myoma. Hysteroscopy allows the exclusionof intra uterine pathology with greater precision. Hysteroscopy is superior to curettage, thoughnot a substitute for tissue diagnosis. Laparoscopy was performed in 50 cases including 16 of coexistentinfertility, 25 cases with normal hysteroscopy findings and in 9 patients symptoms andsigns indicative of pelvic inflammatory diseases were present. An abnormaliity was detected in40% of these cases in the form of adhesions, leiomyomas, ovarian cysts, misplaced IUCDs andendometriosis. Thus laparoscopy can be complimentary to hysteroscopy in evaluation andmanagement of patients with abnormal uterine bleeding.

Jyotsana, Kamlesh Manhas, Sudha Sharma.

2004-01-01

289

Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma—Relationship with local invasiveness  

International Nuclear Information System (INIS)

Objective: To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma. Methods and materials: The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b = 0 and b = 1000 s/mm2). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed. Results: ADC values were different in three zones of uterine body (P ?3 mm2/s] and highest in outer myometrium [(1.496 ± 0.196) × 10?3 mm2/s]. Mean ADC value of endometrial carcinomas [(1.011 ± 0.121) × 10?3 mm2/s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P < 0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased. Conclusion: Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative indicator to complement routine sequences.

2012-08-01

290

Magnetic resonance imaging of endometrial and cervical cancer.  

Science.gov (United States)

In this article we review the current and developing roles of magnetic resonance imaging (MRI) in endometrial and cervical cancer. In endometrial cancer, the purpose of MRI is to stage the primary tumor and in particular to identify myometrial and cervical invasion and extra-uterine disease, thereby informing preoperative surgical planning. MRI is also used to safely select young patients suitable for fertility-preserving medical management. In cervical cancer, MRI has an established role in local staging and in assessing proximal extension of tumors in young women for feasibility of fertility-preserving surgery. It is used to plan radiotherapy for primary tumors in cervical cancer and particularly for conformal radiotherapy to deliver optimal doses to the tumor sites, while limiting unwanted exposure of bowel and other pelvic organs. In both cancers, MRI is used for diagnosing nodal disease, surveillance, detection of recurrence, and evaluation of complications secondary to treatment. PMID:18837902

Sahdev, Anju; Reznek, Rodney H

2008-09-01

291

A new afterloading applicator for primary brachytherapy of endometrial cancer  

Energy Technology Data Exchange (ETDEWEB)

The authors describe and have used a new afterloading applicator in six patients for primary radiation therapy of endometrial cancer. The first introduction of the applicator was done under general anaesthesia. Dilating the cervical canal to Heger 9 made insertion easier. Prior to application it is advisable to probe the lumen of the uterine cavity with a tube or curette to estimate how far the applicator must be spread open. For brachytherapy it is advantageous to remove necrotic tumour portions. This requires experienced hands to avoid perforation of the uterus. The new afterloading applicator is easy to use, and permits direct contact between the six tubes and the tumour. In conjunction with careful planning with the help of MRI, it provides an optimal system for the treatment of endometrial cancer. (Author).

Bauer, M.; Schulz-Wendtland, R. (Freiburg Univ. (Germany). Dept. of Gynaecological Radiology)

1993-03-01

292

Effect of Isopropanolic Cimicifuga racemosa Extract on Uterine Fibroids in Comparison with Tibolone among Patients of a Recent Randomized, Double Blind, Parallel-Controlled Study in Chinese Women with Menopausal Symptoms.  

Science.gov (United States)

Objective. Effect of isopropanolic Cimicifuga racemosa extract (iCR) on uterine fibroid size compared with tibolone. Method. The randomized, double-blind, controlled study in China enrolled 244 patients aged 40-60 years with menopausal symptoms (Kupperman Menopause Index ? 15). The participants were treated with either iCR of 40 mg crude drug/day (N = 122) or tibolone 2.5?mg/day (N = 122) orally for 3 months in 2004. Now, we investigated the subset of all women (N = 62) with at least one uterine fibroid at onset of treatment for the effect of iCR (N = 34) on fibroid size compared with tibolone (N = 28) by transvaginal ultrasonography. Results. The median myoma volume decreased upon iCR by as much as -30% (P = 0.016) but increased upon tibolone by +4.7%. The percentage of volume change, mean diameter change and geometric mean diameter change of the iCR group compared to tibolone were statistically significant (P = 0.016, 0.021, 0.016 respectively). Conclusion. Our results suggest that iCR (Remifemin) is a valid herbal medicinal product in patients with uterine myomas as it provides adequate relief from menopausal symptoms and inhibits growth of the myomas in contrast to tibolone. PMID:24719645

Xi, Sisi; Liske, Eckehard; Wang, Shuyu; Liu, Jianli; Zhang, Zhonglan; Geng, Li; Hu, Lina; Jiao, Chunfeng; Zheng, Shurong; Zepelin, Hans-Heinrich Henneicke-von; Bai, Wenpei

2014-01-01

293

Transcriptional Regulation of Aldehyde Dehydrogenase 1A1 Gene by Alternative Spliced Forms of Nuclear Factor Y in Tumorigenic Population of Endometrial Adenocarcinoma  

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High activity of aldehyde dehydrogenase (ALDH) is characteristic of normal and cancerous stem cells. Recently, high ALDH expression was shown to be associated with poor prognosis in uterine endometrial adenocarcinoma. The population with high ALDH activity (ALDH-hi) was more invasive, anti-apoptotic, and tumorigenic than that with low activity (ALDH-lo). Here, the transcriptional regulation of ALDH1A1 gene, which is responsible for ALDH activity, was examined in endometrial adenocarcinoma. Th...

Mamat, Suhana; Ikeda, Jun-ichiro; Tian, Tian; Wang, Yi; Luo, Wenjuan; Aozasa, Katsuyuki; Morii, Eiichi

2011-01-01

294

HER2 gene amplification and EGFR expression in a large cohort of surgically staged patients with nonendometrioid (type II) endometrial cancer  

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Type II endometrial cancers (uterine serous papillary and clear cell histologies) represent rare but highly aggressive variants of endometrial cancer (EC). HER2 and EGFR may be differentially expressed in type II EC. Here, we evaluate the clinical role of HER2 and EGFR in a large cohort of surgically staged patients with type II (nonendometrioid) EC and compare the findings with those seen in a representative cohort of type I (endometrioid) EC. In this study HER2 gene amplification was studie...

2009-01-01

295

Concomitance of primary insular carcinoid developing in mature cystic teratoma of the ovary and endometrial papillary serous carcinoma  

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Full Text Available The primary ovarian carcinoid tumor is rare and must be differentiated from metastatic carcinoid tumors. Uterine serous papillary carcinoma is a highly aggressive type of endometrial carcinoma. A 70 year old patient referred to the clinic with the complaint of postmenapousal bleeding. Endometrial biopsy was performed and papillary serous carcinoma was diagnosed. Total hysterectomy and bilateral salpingoopherectomy was performed. Beside the tumor in the uterine cavity, the left ovary was 6x4,5x4 cm in size and had a multiloculated cystic appearance with a mural nodule 1,5 cm in diameter. With histopathologic examination, concomitance of insular carcinoid tumor developing in ovarian mature cystic teratoma and endometrial papillary serous carcinoma was found to be interesting and presented.

Ayten L?VAO?LU

2006-09-01

296

Clinical and cytological definition of endometrial cancer during radiotherapy  

Energy Technology Data Exchange (ETDEWEB)

The state of primary tumor in 45 patients with adenocarcinoma of the endometrium, stage 1-3, during concomitant radical radio-and hormonotherapy according to the data of hysterocervicography, hysterometry and cytohistology have been studied. Contact irradiation was performed in single fractions of 9.5-10.0 Gy per week. The time course of primary uterine tumor regression was observed with regard to various radiation dose levels in accordance with cytological data. The cytological method is regarded as an important quantitative criterion in the evaluation of radio- and hormonotherapeutic efficacy of inoperable endometrial cancer.

Titova, V.A.; Titova, N.P. (Akademiya Meditsinskikh Nauk SSSR, Moscow. Onkologicheskij Nauchnyj Tsentr)

1981-05-01

297

The Effect of Different Local Anesthesia Methods on Pain Relief in Outpatient Endometrial Biopsy: Randomized Clinical Trial  

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Full Text Available Introduction: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Methods: In this randomized clinical trial, 160 multiparous 40-55 years old women with AUB, candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3- intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy. Results: Pain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups. Conclusion: Intrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect.

Elaheh Olad-Saheb-Madarek

2013-08-01

298

Cesarean scar defects: an underrecognized cause of abnormal uterine bleeding and other gynecologic complications.  

Science.gov (United States)

The gynecologic sequelae due to deficient uterine scar healing after cesarean section are only recently being identified and described. These include conditions such as abnormal bleeding, pelvic pain, infertility, and cesarean scar ectopic pregnancy, as well as a potentially higher risk of complications and difficulties during gynecologic procedures such as uterine evacuation, hysterectomy, endometrial ablation, and insertion of an intrauterine device. The proposed mechanism of abnormal uterine bleeding is a pouch or "isthmocele" in the lower uterine segment that causes delayed menstrual bleeding. The prevalence of symptomatic or clinically relevant cesarean scar defects (CSDs) ranges from 19.4% to 88%. Possible risk factors for CSD include number of cesarean sections, uterine position, labor before cesarean section, and surgical technique used to close the uterine incision. There are no accepted guidelines for the diagnostic criteria of CSD. We propose that a CSD be defined on transvaginal ultrasound or saline infusion sonohysterography as a triangular hypoechoic defect in the myometrium at the site of the previous hysterotomy. We also propose a classification system to aid in standardized classification for future research. Surgical techniques for repair of CSD include laparoscopic excision, resectoscopic treatment, vaginal revision, and endometrial ablation. PMID:23680518

Tower, Amanda M; Frishman, Gary N

2013-01-01

299

Uterine artery embolization to treat uterine fibroids  

International Nuclear Information System (INIS)

The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

2001-06-01

300

Endometrial Cancer Screening  

Science.gov (United States)

... women who have or are at risk for hereditary non-polyposis colon cancer , experts suggest yearly screening with transvaginal ultrasound, beginning as early as age 25. The use of tamoxifen to treat or prevent breast cancer increases the risk of endometrial cancer. TVU ...

 
 
 
 
301

Intracavitary irradiation of endometrial carcinoma using a high-density sup 60 Co afterloading method  

Energy Technology Data Exchange (ETDEWEB)

Intracavitary irradiation of endometrial carcinoma with an afterloading technique, employing Cathetron equipment, was used preoperatively and in patients with inoperable disease as a single therapy or together with external pelvic irradiation. In clinical stages I and II, the survival rates of patients treated preoperatively with afterloading techniques and with the manual Heyman method were quite similar, and the radiation induced complications were less frequent with the afterloading technique. In cases with a large uterine cavity, the one-source tandem method was replaced with a specific two-phase intracavitary irradiation technique. In this method the treatment catheter was positioned against one lateral uterine wall in the first phase, and against the opposite lateral uterine wall in the second phase of irradiation. In experimental studies the shape of the dose distribution curves resembled the uterine shape, and the measured doses were quite similar to those calculated from the radiograms. The treatment results of 32 patients irradiated by this method confirmed its clinical usefulness. Our results show that the afterloading technique is a practical alternative to the manual packing method in the preoperative irradiation of endometrial cancer. With specific instrument modifications the new technique is also useful in cases with a large uterine cavity, whereas the details in the treatment strategies using remote intracavitary irradiation alone or in combinations with external radiotherapy need further development. (orig.).

Sipilae, P.; Kauppila, A. (Oulu Univ. (Finland). Dept. of Obstetrics and Gynaecology)

1989-01-01

302

Dysfunctional uterine bleeding.  

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Abnormal uterine bleeding is a common, debilitating condition. Dysfunctional uterine bleeding (DUB) is the diagnosis given to women with abnormal uterine bleeding in whom no clear etiology can be identified. DUB has been observed in both ovulatory and anovulatory cycles. Medical treatments include nonsteroidal anti-inflammatory drugs, oral contraceptive pills, progestins, danazol (a synthetic androgen), GnRH agonists, and antifibrinolytic drugs. The drawback to medical therapy, in addition to...

Chen, B. H.; Giudice, L. C.

1998-01-01

303

BIOPSIA ENDOMETRIAL AMBULATORIA: EXPERIENCIA PRELIMINAR  

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Full Text Available Objetivo: Presentar la experiencia inicial en el diagnóstico histológico con biopsia endometrial ambulatoria obtenida con pipelle de Cornier. Material y método: Se efectuó biopsia endometrial ambulatoria con pipelle de Cornier en 144 pacientes con sospecha clínica y/o ecográfica de patología endometrial difusa. Resultados: Se logró realizar el procedimiento a 131 pacientes (91%, obteniéndose diagnóstico histológico satisfactorio en 110 casos (76,4%. De las 110 muestras analizadas, se diagnosticó cáncer de endometrio en 3 pacientes (2,7% e hiperplasia con atipias en 1 paciente (0,9%. Conclusiones: La biopsia endometrial ambulatoria es un procedimiento sensible, específico, eficiente, seguro y económico, que permite aumentar la cobertura del diagnóstico precoz del cáncer de endometrioObjective: To present our initial experience with the ambulatory endometrial biopsy obtained with Cornier pipelle. Material and method: We used the device to obtain the endometrial sampling in 144 women with suspicious pathology of endometrium. Results: We obtained 131 endometrial specimens (91%, 110 were appropriate for histological diagnosis (76.4%. We met 3 women with endometrial carcinoma (2.7% and 1 with hyperplastic atypia. Conclusion: Endometrial ambulatory biopsy is a sensitive, specific, efficient, safe and cheap procedure. This method improves the early diagnosis of endometrial carcinoma

Claudio Domínguez C

2006-01-01

304

Analysis of TSG101 tumour susceptibility gene transcripts in cervical and endometrial cancers  

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Carcinoma of the uterine cervix is a common malignancy among women that has been found to show loss of heterozygosity in the chromosome 11p. Recent studies have localized the TSG101 gene in this region, and also demonstrated a high frequency of abnormalities of this gene in human breast cancer. To determine the role of the TSG101 gene in the carcinogenesis of cervical and uterine carcinoma, 19 cases of cervical carcinoma and five cases of endometrial carcinoma, as well as nearby non-cancerous...

Chang, J-g; Su, T-h; Wei, H-j; Wang, J-c; Chen, Y-j; Chang, C-p; Jeng, C-j

1999-01-01

305

Cervical carcinoma vs endometrial carcinoma, involving both corpus and cervix : comparison of growing pattern with MR imaging  

International Nuclear Information System (INIS)

To evaluate the growth pattern depicted by MR imaging and used to differentiate between uterine cervical and endometrial carcinoma where the mass involves both the uterine corpus and cervix. The tumor growth pattern observed on MR images obtained between November 1989 and January in 1999 in 37 of 784 cervical carcinomas and 9 of 47 endometrial carcinomas in which the tumor involved both the uterine corpus and cervix was analysed. The histologic type was squamous (n=29), adenocarcinomatous (n=6) or adenosquamous (n=2) in cervical carcinoma, and carcinomatous (n=8) or adenosquamous (n=1) in endometrial carcinoma. A 1.5-T (Magnetom Vision, Siemens, Germany) and a 2.0-T unit (Spectro-20000, Goldstar, Korea) were used to obtain T1-and T2-weighted axial, T2-weighted sagittal and Gd-enhanced images. Tumor involvement of the uterine cervix was classified as Cp-n, Cp-x, or Cp-b according to involvement of the endocervix, exocervix or both. Tumors of the uterine corpus were classified as involving the mucosa(U-mu), myometrium(U-my) or serosa(U-se). In 37 cases of cervical carcinoma, all three involving the endocervix(Cp-n) invaded the endometrium(U-mu), three involving both the endo- and exocervix(Cp-b) invaded the endometrium(U-mu, 1 case), myometrium(U-my, 1 case), or serosa(U-se, 1 case), and 31 involving the full-thickness of the uterine cervix(Ct) invaded the endometrium (U-mu, 6 cases) or serosa(U-se, 25 cases). In nine cases of endometrial carcinoma, three involving the endometrium(U-mu) and five involving the myometrium(U-my) invaded the endocervix(Cp-n), and one involving the serosa(U-se) invaded the full-thickness of the uterine cervix(Ct). Cervical carcinoma tended to involve the entire cervix and the full thickness of the uterine corpus, but endometrial carcinoma tended to involve the endometrium or myometrium of the uterine corpus and endocervix

2001-10-01

306

Diagnostic immunohistochemistry in uterine sarcomas: a study of 397 cases.  

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The purpose of this study was to evaluate the use of a broad panel of antibodies used as diagnostic markers for abdominal mesenchymal tumors in uterine sarcomas. The expression of vimentin, AE1/AE3, smooth muscle actin (SMA), desmin , h-caldesmon, actin, Myf4, CD10, CD31, CD68, CD117, factor VIII, HMB-45, and S-100 protein was studied in 397 uterine sarcomas. SMA was positive in 90% of the ordinary leiomyosarcomas and when combined with desmin or h-caldesmon, a positivity of 96% and 92%, respectively, was achieved. Actin and Myf4 were positive in 4 of 5 rhabdomyosarcomas. Endometrial stromal sarcomas reacted positive with CD10 in 62 of 84 tumors and negative with h-caldesmon in 75 of 84 tumors. CD10 was the most frequent positive marker in adenosarcoma. Most tumor markers stained negative in undifferentiated uterine sarcoma, but 12 of 21 tumors reacted positive for SMA. A few focally HMB-45-positive cells were found within all tumor groups, except in rhabdomyosarcomas and giant cell tumors. Endothelial markers, S-100 protein, and CD117 do not seem to be of any diagnostic value in uterine sarcomas. In conclusion, when immunohistochemistry is used diagnostically in uterine sarcomas, a broad panel of markers provides better information than reliance on a single antibody. PMID:21464730

Abeler, Vera M; Nenodovic, Maja

2011-05-01

307

Treatment of early uterine sarcomas: disentangling adjuvant modalities  

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Full Text Available Abstract Uterine sarcomas are a rare group of neoplasms with aggressive clinical course and poor prognosis. They are classified into four main histological subtypes in order of decreasing incidence: carcinosarcomas, leiomyosarcomas, endometrial stromal sarcomas and "other" sarcomas. The pathological subtype demands a tailored approach. Surgical resection is regarded as the mainstay of treatment. Total abdominal hysterectomy and bilateral salpingo-oophorectomy represents the standard treatment of uterine sarcomas. Pelvic and para-aortic lymph node dissection in carcinosarcomas is recommended, given their high incidence of lymph node metastases, and may have a role in endometrial stromal sarcomas. Adjuvant radiation therapy has historically been of little survival value, but it appears to improve local control and may delay recurrence. Regarding adjuvant chemotherapy, there is little evidence in the literature supporting its use except for carcinosarcomas. However, more trials are needed to address these issues, especially, their sequential application. Patients with uterine sarcomas should be referred to large academic centers for participation in clinical trials.

Kouloulias Vassilios

2009-04-01

308

POSSIBILITIES OF PHARMACALOGIC THERAPY APPLIED IN ABNORMAL UTERINE BLEEDING  

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Full Text Available The range of alternatives to hysterectomy includes ‘expanded’ oral medical regimens, the levonorgestrel-releasing intrauterine system (LNG-IUS, a wide range of endometrial ablative techniques, and where fibroids are the primary pathology—myomectomy and uterine artery embolization. Since the research has shown that hysterectomy is a highly effective treatment, these alternatives must be assessed against the recognized high satisfactory rates and improved quality of life reported following hysterectomy. Additional issues that would also need to be addressed include complication rates, side-effects, and cost-effectiveness. For women with prolonged abnormal uterine bleeding, recent research suggests that hysterectomy is significantly superior to an expanded medical treatment regimen for health-related quality-of-life measures. Satisfaction with the treatment, and health-related quality of life and psychosocial well-being, are reportedly similar between hysterectomy and the LNG-IUS, but the latter has the advantage of reduced cost. Endometrial ablation reduces menstrual blood flow, but its benefits relative to hysterectomy lessen over time. No large-scale studies have adequately compared uterine artery embolization or myomectomy to hysterectomy. Perhaps, the most telling finding from recent research with respect to the place of alternative therapies to hysterectomy is that the existence or advent of these alternatives has not reduced hysterectomy rates, but merely increased treatment options and interventions for excessive menstrual loss.

Valentina Nikolic

2006-07-01

309

Preoperative staging of endometrial cancer using TVS, MRI, and hysteroscopy  

DEFF Research Database (Denmark)

OBJECTIVES: To evaluate the accuracy of different preoperative modalities for staging of endometrial cancer to restrict extensive surgery to patients at high risk of metastatic disease. SETTING: Aarhus University Hospital. POPULATION: 156 women referred in 2006-2011 because of atypical endometrial hyperplasia (G0) or endometrial cancer. METHODS: Patients were offered preoperative transvaginal ultrasonography (TVS), magnetic resonance imaging (MRI), and hysteroscopic-directed biopsies from the uterine tumor and cervix. Final pathology of the removed uterus was the reference standard. Patients were divided into low risk (<50% myometrial invasion, and grades 0, 1, 2, and no cervical invasion) or high risk (all others). MAIN OUTCOME MEASURES: Accuracy, sensitivity, specificity, positive/negative predictive value. RESULTS: Patients were aged 32-88 years, with a mean body mass index of 29. At final pathology 81% had cancer and 19% G0 or no residual tumor; 54% were high risk. Hysteroscopy-directed biopsies had a higher accuracy (92%) than endometrial biopsy (58%) for differentiating G0 from cancer (p < 0.001); grade 3 tumor identification had similar accuracy (93 vs. 92%). Deep myometrial invasion was estimated with higher accuracy by MRI (82%) than TVS (74%) (p < 0.02). For cervical involvement, hysteroscopy-directed biopsies had higher accuracy (94%) than MRI (84%,) and TVS (80%) (p < 0.02). Accuracy for identifying high-risk women was highest (83%) using a combination of MRI and hysteroscopic-directed biopsies, compared with TVS and endometrial biopsy (72%) (p < 0.05). CONCLUSION: Preoperative staging with MRI and hysteroscopy-directed biopsy can identify eight of 10 women with high risk of lymph node metastases and spare eight of 10 low-risk women extended surgery.

Ã?rtoft, Gitte; Dueholm, Margit

2013-01-01

310

Carcinoma of the Lower Uterine Segment (LUS): Clinicopathological Characteristics and Association with Lynch Syndrome  

Science.gov (United States)

Endometrial cancer arises from the uterine body and fundus in many cases, but can also originate from the lower region of the uterine body through the upper region of the cervix. Such tumors are referred to as carcinoma of the lower uterine segment (LUS) or isthmus, and account for 3-6.3% of all cases of endometrial cancer. This relatively low incidence has permitted performance of only small-scale studies, but the clinical and pathological characteristics of carcinoma of the LUS in all these reports have differed from those of other endometrial cancers. Generally, endometrial cancer is classified into estrogen-dependent endometrioid adenocarcinoma (designated as type I), and non-endometrioid types that are less associated with estrogen and include poorly differentiated adenocarcinoma (type II). In some reports, carcinoma of the LUS has been found to have type II characteristics. Carcinoma of the LUS has also been associated with Lynch syndrome, a hereditary disease with frequent development of colorectal, endometrial, and ovarian cancers. Lynch syndrome is thought to be induced by mismatch repair gene mutation. The frequency of Lynch syndrome in cases of general endometrial cancer is 1-2%. In contrast, the frequency in patients with carcinoma of the LUS is much higher, with up to 29% of cases diagnosable with Lynch syndrome and a high frequency of hMSH2 mutation found in one study. This suggests that further investigation of the clinical and pathological characteristics of carcinoma of the LUS and the association with Lynch syndrome is required through performance of a large-scale survey.

Masuda, Kenta; Banno, Kouji; Yanokura, Megumi; Kobayashi, Yusuke; Kisu, Iori; Ueki, Arisa; Ono, Asuka; Nomura, Hiroyuki; Hirasawa, Akira; Susumu, Nobuyuki; Aoki, Daisuke

2011-01-01

311

The postpartum endometrial inflammatory response: a normal physiological event with potential implications for bovine fertility.  

Science.gov (United States)

After calving, the bovine endometrium undergoes marked morphological and functional changes that are necessary for subsequent re-breeding. Regulation and integration of these key events are largely uncharacterised. Here, endometrial swabs and biopsies were taken at 15, 30 and 60 days postpartum (DPP) from 13 healthy primiparous cows, 10 of which subsequently conceived, with a view to characterising innate and inflammatory gene expression profiles. Endometrial biopsies exhibited severe inflammation (>75 leukocytes per high-power field) at 15 DPP, which had begun to resolve by 30 DPP and had completely resolved by 60 DPP. The severe inflammation at 15 DPP coincided with uterine infection in all cows and a significant increase (P uterine involution. PMID:22948010

Chapwanya, Aspinas; Meade, Kieran G; Foley, Cathriona; Narciandi, Fernando; Evans, Alexander C O; Doherty, Michael L; Callanan, John J; O'Farrelly, Cliona

2012-01-01

312

The CADO-E I type endometrial applicator for RALS therapy  

International Nuclear Information System (INIS)

A dual stainless steel applicator (CADO-E I type) was developed for intracavitary radiotherapy of endometrial carcinoma using remotely controlled afterloader (RALS). An inverted pear-shaped isodose curve was obtained by means of this metallic applicator and Co-60 source with a stepwise movement. Reference point X was defined as 2 cm below the fundus and 2 cm lateral to the center line of the uterus to specify the dose absorbed to the uterine corpus with our endometrial applicator. Since cancer residua resulting from cold spots in dose distribution were recognized at the uterine fundus by histopathological investigation of serial sections in the hysterectomy specimens, we intend to develop an applicator with three metallic tubes (CADO-E II type). (author)

1986-01-01

313

Urokinase-like plasminogen activator as a marker of endometrial neoplasia.  

Science.gov (United States)

Urokinase-like plasminogen activator (ULPA) was determined with a radioimmunoassay in uterine aspirates from 67 patients prior to curettage. In women with normal endometrial histology the mean concentration of ULPA was 5.4 +/- 2.5 microgram per liter. Only one of this aspirates contained more than 8 microgram per liter. In cases with malignant histology ULPA was above this level in 10 of 11 with a mean concentration of 31.2 +/- 31.4 microgram per liter. In cases with glandular cystic hyperplasia and/or adenomatous hyperplasia 6 of 15 had values above 8 microgram per liter with a mean of 10.3 +/- 6.1 microgram per liter. In addition to other parameters of malignancy such as cytology, detection of ULPA in uterine fluid might prove useful in screening examinations for endometrial neoplasia. PMID:7196798

Niklasson, O; Svanberg, L; Thorell, J; Lecander, I; Astedt, B

1981-09-15

314

Pregnancy Following Uterine Artery Embolization with Polyvinyl Alcohol Particles for Patients with Uterine Fibroid or Adenomyosis  

International Nuclear Information System (INIS)

Purpose:To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.Methods:Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 ?m.Results:Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively.Conclusion:Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure

2005-06-01

315

HIPERPLASIA ENDOMETRIAL: ANÁLISIS DE SERIE DE CASOS DIAGNOSTICADOS EN BIOPSIA ENDOMETRIAL  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15% de legrados/bi [...] opsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en legrado/biopsia endometrial en pacientes de un hospital público de tercer nivel. Métodos: Se revisaron 22.048 procedimientos realizados en el Hospital Universitario de Santander, procesados en el Departamento de Patología de la Universidad Industrial de Santander, en el periodo comprendido entre 1 de enero de 2005 y 31 de diciembre 2008, de los cuales 1.750 correspondieron a legrados/biopsias de endometrio y en 168 de estos se realizó el diagnóstico histopatológico de hiperplasia endometrial. Resultados: Se encontró que el promedio de edad de presentación de está entidad fue de 44,8 años y que el mayor porcentaje de pacientes (68,5%) estuvieron en el grupo de la hiperplasia simple sin atipia. En el 19,7% de los casos hubo evidencia de atipia. Conclusiones: El promedio de edad encontrado y los porcentajes por subgrupos de hiperplasia estuvieron en relación a otros estudios. Se destaca una menor proporción de casos con atipia. Abstract in english Background: Endometrial hyperplasia is an entity in which there is a proliferation of endometrial glands of irregular size and shape, with the highest proportion of glands on the stroma, resulting from excessive exposure to estrogen. Approximately 15% of curettages/endometrial biopsies of postmenopa [...] usal women with clinical symptoms of abnormal uterine bleeding is diagnosed this entity. Objective: To describe the incidence and pathological findings in curettage/endometrial biopsy in patients of a tertiary public hospital. Methods: A retrospective review of 22,048 surgical procedures performed in the University Hospital of Santander, processed in the Pathology Department of Industrial University of Santander in the period from 1 January 2005 and 31 December 2008, of which 1,750 corresponded to curettage/biopsy of the endometrium and in 168 of these histopathological diagnosis was made of endometrial hyperplasia. Results: We found that the average age of presentation in this institution was 44.8 years and that the greater percentage of patients (68.5%) were in the group of simple hyperplasia without atypia. In 19.7% of the cases had evidence of atypia. Conclusions: The mean age and percentages found by hyperplasia subgroups were relatively within limits with regard to other studies, although broadly outlined in a lower proportion of cases with atypia.

García Ayala, Ernesto; Cárdenas Mastrascusa, Laura; Sandoval Martínez, Diana; Mayorga Anaya, Henry.

316

Robotics in Endometrial Cancer Care  

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Full Text Available Endometrial cancer is the most common gynecological cancer in women in most of the developed world. The majority of these women with endometrial cancer will be unaffected by their disease. The challenge therefore is for surgical treatment not to be worse than the disease. Robotics has changed the way that we care for women living with endometrial cancer by making low-impact surgical treatment available to more women than was previously possible.

Joseph Ng

2013-11-01

317

Testosterone metabolism in endometrial cancer.  

Science.gov (United States)

Plasma testosterone (PCT), metabolic clearance (MCRT), and production rates (PRT) of testosterone and conversion ratio of testosterone to androstenedione (CRppTA) were performed on 11 patients with endometrial cancer and on a control group of five postmenopausal women. The PCT, MCRT, and PRT of patients with endometrial cancer are in the normal postmenopausal range. The conversion of testosterone to androstenedione in patients with endometrial cancer was significantly decreased. PMID:1244748

Calanog, A; Sall, S; Gordon, G G; Olivo, J; Southren, A L

1976-01-01

318

Endometrial spiral artery Doppler parameters in unexplained infertility patients: is endometrial perfusion an important factor in the etiopathogenesis?  

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Full Text Available Objective: Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal- peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls. Material and Methods: Forty-two consecutive patients admitted to Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetric and Gynecology with the diagnosis of unexplained infertility after standard diagnostic work up constituted the study group and they were compared with a fertile control group admitted to hospital with non specific gynecological complaints or for check-up in the same period. Mid luteal transvaginal color Doppler ultrasonography was applied to each patient by the same radiologist who was blind to the diagnosis of the particular patient and, RI (resistance index and PI (pulsatility index values were calculated. Results: There were no significant differences between the two groups, in respect to age, body mass index, basal hormonal and mid luteal progesterone levels (p>0.05. For the fertile control group, mid luteal-peri-implantation phase endometrial spiral artery mean RI values were calculated as 0.48±0.08 SD and mean PI values as 0.65±0.18 SD. For the study group, mean RI values were calculated as 0.54±0.07 SD, PI values were calculated as 0.80±0.16 SD. The differences for RI (p=0.009 and PI (p=0.004 were statistically significant. Conclusion: According to Doppler parameters, unexplained infertility patients have high impedance blood flow in spiral arteries which means that peri-implantation blood flow in these patient is lower than fertile controls. These findings suggest that endometrial perfusion may have an important contribution to etiopathogenesis of unexplained infertility.

Selda Uysal

2012-09-01

319

14-3-3 fusion oncogenes in high-grade endometrial stromal sarcoma  

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14-3-3 proteins are ubiquitously expressed regulators of various cellular functions, including proliferation, metabolism, and differentiation, and altered 14-3-3 expression is associated with development and progression of cancer. We report a transforming 14-3-3 oncoprotein, which we identified through conventional cytogenetics and whole-transcriptome sequencing analysis as a highly recurrent genetic mechanism in a clinically aggressive form of uterine sarcoma: high-grade endometrial stromal ...

Lee, Cheng-han; Ou, Wen-bin; Marin?o-enriquez, Adrian; Zhu, Meijun; Mayeda, Mark; Wang, Yuexiang; Guo, Xiangqian; Brunner, Alayne L.; Amant, Fre?de?ric; French, Christopher A.; West, Robert B.; Mcalpine, Jessica N.; Gilks, C. Blake; Yaffe, Michael B.; Prentice, Leah M.

2012-01-01

320

Uterine Fibroid Embolization (UFE)  

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... relief of their symptoms. Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered ... would be a concern. The question of whether uterine fibroid embolization impacts fertility has not yet been answered, although a number ...

 
 
 
 
321

Neonatal uterine bleeding as antecedent of pelvic endometriosis.  

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We elaborate on a new theory to explain pelvic endometriosis, including endometriosis in premenarcheal girls, based on the finding that the neonatal endometrium can display secretory activity immediately after birth and, in some cases, changes analogous to those seen at menstruation in adults. The neonatal uterus is therefore capable of shedding its endometrium. Indeed, occult vaginal bleeding occurs in a majority of neonates, although overt bleeding is estimated to occur in only 5% of neonates. This may be due to functional plugging of the endocervical canal in the neonate, which in turn would promote retrograde flux of endometrial cells contained in menstrual debris. Ectopic endometrial implantation in a newborn with hydrometrocolpos has been documented. These data, coupled with the observation of a significantly increased risk of endometriosis in adolescents with cervical outflow obstruction and patent Fallopian tubes, indicate that endometriosis, especially in children and young adolescents, may originate from retrograde uterine bleeding soon after birth. PMID:24048011

Brosens, Ivo; Brosens, Jan; Benagiano, Giuseppe

2013-11-01

322

Angiogenesis Following Three-Dimensional Culture of Isolated Human Endometrial Stromal Cells  

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Full Text Available Background: Endometriosis is the presence of endometrial tissue outside of the uterine cavity andis the most common gynecologic disorder in women of reproductive age. We have preliminaryevidence that in the presence of a 3-dimensional (3-D fibrin matrix, human endometrial glands,stroma, and neovascularization can develop in vitro, mimicking the earliest stages of endometriosis.The aim of the present study was to determine if angiogenesis can be developed in a 3-D culture ofhuman stromal cells in vitro.Materials and Methods: This was an in vitro study of human endometrial biopsies in 3-D cultureof fibrin matrix and conducted at a university affiliated infertility center. Biopsies were taken fromten normal ovulating women undergoing infertility treatment. The samples obtained from fundusof the uterine cavity were minced, stromal cells isolated and placed in a 3-D fibrin matrix culturesystem. Degree of proliferation of stromal cells, invasion of the fibrin matrix, gland formation, vesselsprouting and immunohistochemical characterization of cellular components were recorded.Results: Three-dimensional culture of human stromal cells formed sheets of cells in the fibrinmatrix. By 3-4 weeks, endothelial cell branching was observed and rudimentary capillary-likestructures formed and endothelial cells confirmed by CD31 immunostaining.Conclusion: These data show that stromal cells from endometrial explants can proliferate andinvade a fibrin matrix in vitro generating new vessels. This procedure represents a controlled,quantifiable model for the study of angiogenesis during the menstrual cycle, and in conditions suchas endometriosis and cancer.

Navid Esfandiari

2008-01-01

323

Unusual Patterns of Endometrial Carcinoma Including MELF and its Relation to Epithelial Mesenchymal Transition.  

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Although most of Dr Scully's research addressed diseases of the ovary, about 10% of his published manuscripts focused on endometrial lesions, most often consisting of observations about unusual types or deceptive patterns of endometrial carcinoma that had not previously been described, or lesions for which the behavior had been unknown. He characterized and clarified the entity of clear cell carcinoma of the endometrium, and wrote about endometrial carcinomas with argyrophil, oxyphil, and giant cells, and those simulating microglandular hyperplasia of the cervix, as well as uterine papillary serous, squamous cell, and small cell carcinoma,. He provided a useful classification of precancers of the endometrium and also emphasized the relationship between estrogens and the development of some forms of uterine carcinoma. This article addresses the importance of his careful observations, focusing primarily on the potential relationship of 1 pattern of endometrial carcinoma that he described which has areas of microcystic, elongated, fragmented glands (MELF), frequently accompanied by a fibromyxoid or inflammatory stroma, to the recently described concept of epithelial mesenchymal transition. Endometrioid carcinomas with MELF frequently display a variety of immunohistochemical changes including reduced expression of E-cadherin, B-catenin, estrogen and progesterone receptors, Ki67, and overexpression of fascin, galactin-3, cyclin D1, and p16, as might be expected with epithelial mesenchymal transition. Additional studies will be needed to explain the significance of epithelial mesenchymal transition that occurs in carcinomas with regions of MELF. PMID:24901395

Zaino, Richard J

2014-07-01

324

Treatment of endometrial cancer. Radiotherapy and endometrial cancer  

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The current status of radiotherapy of endometrial cancer was discussed based on the literature, and the radiotherapeutic technique performed at the authors' institution and its results were presented. The treatment of endometrial cancer is predicted to become increasingly important, since this cancer tends to gradually increase in number, particularly among the aged.

Noguchi, H. (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

1981-10-01

325

Resveratrol interferes with AKT activity and triggers apoptosis in human uterine cancer cells  

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Full Text Available Abstract Background Endometrial cancer is the fourth most prominent cancer among all feminine cancers in the Western world. Resveratrol, a natural anti-oxidant found in red wine emerging as a novel anticancer agent, exerts antiproliferative and pro-apoptotic activity in various cancer cell types, but its effect on uterine cancer cells is poorly understood. At the molecular level, resveratrol has been reported to inhibit cyclooxygenase (COX expression and/or activity; in endometrial cancer cells, COX-2 is overexpressed and confers cellular resistance to apoptosis. The aim of the present study was to determine if resveratrol could exert anti-proliferative and pro-apoptotic activity over uterine cancer cells upon inhibition of COX-2 expression and/or activity. Six different human uterine cancer cell lines were used as a model (HeLa, Hec-1A, KLE, RL95-2, Ishikawa and EN-1078D. Results and discussion High-dose of resveratrol triggered apoptosis in five out of six uterine cancer cell lines, as judged from Hoechst nuclear staining and effector caspase cleavage. In accordance, uterine cancer cell proliferation was decreased. Resveratrol also reduced cellular levels of the phosphorylated/active form of anti-apoptotic kinase AKT. Endogenous COX-2 protein levels were decreased, concomitant with a decrease in production of COX metabolites PGE2 and PGF2?, in each uterine cancer cell line expressing detectable levels of COX-1 and/or COX-2 in presence of resveratrol. Although COX expression was identified as a target of resveratrol in uterine cancer cells, inhibition of COX activity or exogenously added PGE2 did not modulate the effect of resveratrol on cellular proliferation. Conclusion High-dose of resveratrol exerts tumoricidal activity over uterine cancer cells and regulates COX expression. In these cells, resveratrol would not directly target COX activity, but possibly other enzymes involved in prostaglandin synthesis that act downstream of the COXs.

Asselin Eric

2006-10-01

326

COUP-TFII regulates human endometrial stromal genes involved in inflammation.  

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Chicken ovalbumin upstream promoter-transcription factor II (COUP-TFII; NR2F2) is an orphan nuclear receptor involved in cell-fate specification, organogenesis, angiogenesis, and metabolism. Ablation of COUP-TFII in the mouse uterus causes infertility due to defects in embryo attachment and impaired uterine stromal cell decidualization. Although the function of COUP-TFII in uterine decidualization has been described in mice, its role in the human uterus remains unknown. We observed that, as in mice, COUP-TFII is robustly expressed in the endometrial stroma of healthy women, and its expression is reduced in the ectopic lesions of women with endometriosis. To interrogate the role of COUP-TFII in human endometrial function, we used a small interfering RNA-mediated loss of function approach in primary human endometrial stromal cells. Attenuation of COUP-TFII expression did not completely block decidualization; rather it had a selective effect on gene expression. To better elucidate the role of COUP-TFII in endometrial stroma cell biology, the COUP-TFII transcriptome was defined by pairing microarray comparison with chromatin immunoprecipitation followed by deep sequencing. Gene ontology analysis demonstrates that COUP-TFII regulates a subset of genes in endometrial stroma cell decidualization such as those involved in cell adhesion, angiogenesis, and inflammation. Importantly this analysis shows that COUP-TFII plays a role in controlling the expression of inflammatory cytokines. The determination that COUP-TFII plays a role in inflammation may add insight into the role of COUP-TFII in embryo implantation and in endometrial diseases such as endometriosis. PMID:24176914

Li, Xilong; Large, Michael J; Creighton, Chad J; Lanz, Rainer B; Jeong, Jae-Wook; Young, Steven L; Lessey, Bruce A; Palomino, Wilder A; Tsai, Sophia Y; Demayo, Francesco J

2013-12-01

327

Investigations on the endometrial response to intrauterine administration of N-acetylcysteine in oestrous mares.  

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In mares, mating-induced persistent endometritis contributes to low fertility. The condition is in part related to delayed clearance of mucus accumulated within the uterine lumen. The objective of this study was to investigate the endometrial response of healthy mares to intrauterine (i.u.) treatment with N-acetylcysteine (NAC). Oestrous mares (n = 12) were randomly assigned to a treatment (TM) or control (C) group and received an i.u. infusion of 5% NAC and saline (total volume 140 ml), respectively. Endometrial biopsies were collected in five of the mares 24 h after treatment, in the remaining seven mares 72 h after treatment. Endometrial biopsies were evaluated for integrity of the luminal epithelium, number of polymorphonuclear neutrophils (PMN), staining for cyclooxygenase 2 (COX2), staining with Kiel 67 antigen (Ki-67), lectins and periodic acid-Schiff (PAS). The integrity of endometrial epithelial cells was not affected by treatment (no statistical differences between groups or times). At 24 h after treatment, the mean number of PMN in endometrial biopsies from NAC- and C-mares did not differ, but at 72 h after treatment, number of PMN was significantly higher (p WGA) was slightly higher in NAC-treated mares than in C-mares 72 h after treatment (p < 0.05). Score for PAS staining of mucus in deep uterine glands differed significantly between groups at 24 h after treatment (p < 0.05). The present study demonstrates that NAC does not adversely affect the endometrial function. Moreover, an anti-inflammatory effect on the equine endometrium was observed. PMID:23186260

Melkus, E; Witte, T; Walter, I; Heuwieser, W; Aurich, C

2013-08-01

328

Laparoscopic treatment of unicornuate uterus with noncommunicating rudimentary uterine horn  

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Full Text Available Congenital anomalies of the Mullerian system, which are associated with fertility problems, are common uterine malformations. Unicornuate uteri with rudimentary horn containing an endometrial cavity is a rare Mullerian malformation. A 36-years-old woman with primary infertility presented with dysmenorrhonea which had been present since 1995; her symptoms had been relieved with medical management since then. During the routine work-up, unicornuate uterus, associated with the rudimentary horn, and haematosalpinx and endometrioma were found, and laparoscopic management was performed. The case was presented and the relevant literature reviewed.

Çetin ARIK

2002-09-01

329

Uterine fibroids: current perspectives.  

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Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause). There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman's menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy). The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs) and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE) has now been well-recognized as a uterine-sparing (fertility-preserving) method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS) or radiofrequency (VizAblate™ and Acessa™) for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge. PMID:24511243

Khan, Aamir T; Shehmar, Manjeet; Gupta, Janesh K

2014-01-01

330

Uterine Fibroid Embolization  

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Full Text Available Uterine fibroids are commonly asymptomatic. They often cause pelvic pain, abnormal and increased vaginal bleeding, etc. Traditional treatment of symptomatic uterine fibroids was trans-abdominal hysterectomy. Nowadays, uterine artery embolization (UAE, also called uterine fibroid embolization, is considered as a safe and highly-effective nonsurgical treatment for women with symptomatic uterine fibroid tumors. Advantages of UAE over conventional hormonal suppression and surgical procedures include avoidance of the side effects of drug therapy and surgery-related physical and psychological trauma. These patients commonly resume their normal activities within a week after the procedure; weeks earlier than that for trans-abdominal hysterectomy. Over the past 30 years, interventional radiologists have done UAE for treatment of emergency uterine bleeding. Since 1995, interventional radiologists have turned their attention to treatment of uterine fibroids with a similar procedure. The first fibroid embolization in Iran was done approximately three years ago. So far, more than 100 cases have been treated by this method and it is going to be quickly accepted as a safe alternate for surgery.

"R. Malek

2003-06-01

331

A case of metastatic uterine adenocarcinoma in a southern white rhinoceros (Ceratotherium simum simum).  

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A 39-yr-old, acyclic, uniparous, female white rhinoceros with a history of recurrent vaginal bleeding was euthanized following a period of respiratory distress and ill-thrift. The rhinoceros' uterus had previously been evaluated by ultrasound and diffuse endometrial hyperplasia and two benign uterine leiomyomas had been diagnosed. At necropsy examination, a large, infiltrative, metastatic uterine adenocarcinoma was found multifocally throughout the uterus, scattered within the peritoneal cavity, on the diaphragm, the splenic capsule, the pleural surface of the lung and mesenteric lymph nodes. A large volume (100 L) of ascites fluid was present in the abdominal and pleural cavities. PMID:20722262

Wilson, Margaret; Hermes, Robert; Bainbridge, John; Bassett, Hugh

2010-03-01

332

Long-term efficiency and safety of trans-catheter uterine artery embolization by lipiodol-pingyingmycin emulsion for uterine fibroids  

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Objective: To investigate the long-term efficiency and safety of trans-catheter uterine artery embolization using lipiodol-pingyingmycin emulsion (LPE-TUAE) for uterine fibroids. Methods: Two hundred and forty-three patients with uterine fibroids were treated by LPE-TUAE. Fourteen of them underwent hysterectomy or myomectomy 3 days to 6 months after LPE-TUAE. The specimens were studied pathologically. Another 229 patients were followed up for 1 to 4 years to observe the long-term outcomes. Results: Menorrhagia became normal or improved markedly in 96.0% (193/201). Lumbago and lower abdominal pain disappeared or relieved markedly in 949% (94/99). Bulk-related symptoms disappeared or lessened markedly in 96.0% (48/50). Ultrasound revealed that the average decreased rate in the largest fibroid volume were 60.7% at 1 year, 63.3% at 2 year, 65.6% at 3 year and 67.4% at 4 year after embolization, and the average decreased rate in the largest uterine volume were 49.6% at 1 year, 54.3% at 2 year, 55.2% at 3 year and 57.1% at 4 year after embolization. Reoccurrence rate of myoma was 10.8% 3-4 year after embolization. No significant difference was found in hormone level between pre- and post-embolization. Pathological studies of specimens showed that lipiodol was only accumulated in fibroids and was not seen in myometrium. Spotty necrosis 2 weeks after embolization and extensive patchy necrosis 3 weeks after embolization were occurred in fibroids. Necrosis was not showed in myometrium. No serious complications occurred. Conclusion: LPE-TUAE possesses a good long-term effectiveness for uterine fibroids, which doesn't cause the damage on ovarian function and normal myometrium or serious complications. (authors)

2009-02-01

333

CDB-2914 for Uterine Leiomyomata Treatment  

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OBJECTIVE To evaluate whether 3-month administration of CDB-2914, a selective progesterone receptor modulator, reduces leiomyoma size and symptoms. METHODS Premenopausal women with symptomatic uterine leiomyomata were randomly assigned to CDB-2914 at 10 mg (T1) or 20 mg (T2) daily or to placebo (PLC) for 3 cycles or 90–102 days if no menses occurred. The primary outcome was leiomyoma volume change determined by magnetic resonance imaging at study entry and within 2 weeks of hysterectomy. Secondary outcomes included the proportion of amenorrhea, change in hemoglobin and hematocrit, ovulation inhibition, and quality-of-life assessment. RESULTS Twenty-two patients were allocated, and 18 completed the trial. Age and body mass index were similar among groups. Leiomyoma volume was significantly reduced with CDB-2914 administration (PLC 6%; CDB-2914 ?29%; P=.01), decreasing 36% and 21% in the T1 and T2 groups, respectively. During treatment, hemoglobin was unchanged, and the median estradiol was greater than 50 pg/mL in all groups. CDB-2914 eliminated menstrual bleeding and inhibited ovulation (% ovulatory cycles: CDB-2914, 20%; PLC, 83%; P=.001). CDB-2914 improved the concern scores of the uterine leiomyoma symptom quality-of-life subscale (P=.04). One CDB-2914 woman developed endometrial cystic hyperplasia without evidence of atypia. No serious adverse events were reported. CONCLUSION Compared with PLC, CDB-2914 significantly reduced leiomyoma volume after three cycles, or 90–102 days. CDB-2914 treatment resulted in improvements in the concern subscale of the Uterine Fibroid Symptom Quality of Life assessment. In this small study, CDB-2914 was well-tolerated without serious adverse events. Thus, there may be a role for CDB-2914 in the treatment of leiomyomata.

Levens, Eric D.; Potlog-Nahari, Clariss; Armstrong, Alicia Y.; Wesley, Robert; Premkumar, Ahalya; Blithe, Diana L.; Blocker, Wendy; Nieman, Lynnette K.

2009-01-01

334

Somatic MED12 mutations in uterine leiomyosarcoma and colorectal cancer  

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Background:Mediator complex participates in transcriptional regulation by connecting regulatory DNA sequences to the RNA polymerase II initiation complex. Recently, we discovered through exome sequencing that as many as 70% of uterine leiomyomas harbour specific mutations in exon 2 of mediator complex subunit 12 (MED12). In this work, we examined the role of MED12 exon 2 mutations in other tumour types.Methods:The frequency of MED12 exon 2 mutations was analysed in altogether 1158 tumours by direct sequencing. The tumour spectrum included mesenchymal tumours (extrauterine leiomyomas, endometrial polyps, lipomas, uterine leiomyosarcomas, other sarcomas, gastro-intestinal stromal tumours), hormone-dependent tumours (breast and ovarian cancers), haematological malignancies (acute myeloid leukaemias, acute lymphoid leukaemias, myeloproliferative neoplasms), and tumours associated with abnormal Wnt-signalling (colorectal cancers (CRC)).Results:Five somatic alterations were observed: three in uterine leiomyosarcomas (3/41, 7%; Gly44Ser, Ala38_Leu39ins7, Glu35_Leu36delinsVal), and two in CRC (2/392, 0.5%; Gly44Cys, Ala67Val).Conclusion:Somatic MED12 exon 2 mutations were observed in uterine leiomyosarcomas, suggesting that a subgroup of these malignant tumours may develop from a leiomyoma precursor. Mutations in CRC samples indicate that MED12 may, albeit rarely, contribute to CRC tumorigenesis.

Kämpjärvi, K; Mäkinen, N

2012-01-01

335

Uterine Fibroid Embolization  

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Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the Baptist Cardiac and Vascular Institute here in Miami, Florida. ...

336

Symptoms of Uterine Cancer  

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... Announcements Radio Public Service Announcements Print Materials Campaign Research Doctors Who Use Social Media Poster Presentation Buttons and Badges Related Resources Gynecologic Cancer Symptoms Diary [PDF-503KB] Uterine Cancer fact sheet [PDF-622KB] ...

337

Uterine Fibroid Embolization  

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Full Text Available ... surgery in the United States. And the commonest reason that that surgery occurs is for uterine fibroids. ... the hospital overnight for the recovery. And the reason we do that is because after the procedure ...

338

Uterine Fibroid Embolization  

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Full Text Available ... we have been part of a number of clinical research trials to investigate how safe this is ... and fall into the uterine cavity, in which case we would refer you back to your gynecologist ...

339

Uterine Fibroid Embolization  

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Full Text Available ... has very symptomatic uterine fibroids, very heavy menstrual periods. Her periods last on the order of eight days, four ... painful intercourse, and very heavy and crampy menstrual periods. If we can come to our diagram here, ...

340

Uterine Fibroid Embolization  

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Full Text Available ... got just to where that artery starts to branch off. And then, using that special small micro- ... in that main uterine artery, but the little branches no longer have flow. So that's our first ...

 
 
 
 
341

Pure uterine lipoma.  

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Pure uterine lipoma is a very rare benign mesenchymal neoplasm, and only a few cases have been reported in the literature. This is in contrast to leiomyoma, which is not only the most common neoplasm of the uterus but also one of the most common tumours in women, estimated to occur in 20-40% of women beyond the age of 30 years (AFIP) and more frequently affect postmenopausal women. We report the case of a 70-year-old woman who presented with pelvic pain and postmenopausal uterine bleeding. Pure uterine lipoma was diagnosed preoperatively by CT scan with and without contrast and confirmed postoperatively by pathological examination. Clinical and histological diagnosis of pure uterine lipoma with immunohistochemical findings are described,and the efficacy of CT in diagnosing this tumour is discussed. PMID:23858948

Imenpour, H; Petrogalli, F; Anselmi, L

2013-02-01

342

Uterine Fibroid Embolization  

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Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the Baptist Cardiac and Vascular Institute here in Miami, Florida. I'm ...

343

Uterine Fibroid Embolization  

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Full Text Available ... as it shrinks parts of it can actually break off and fall into the cavity. And a ... some of this fibroid, instead of shrinking, may break off and fall into the uterine cavity, in ...

344

Uterine Fibroid Embolization  

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Full Text Available ... a young woman. She's 31 years old. She has very symptomatic uterine fibroids, very heavy menstrual periods. ... is a catheter, very similar to what he has in the vessel. And if I show you, ...

345

Uterine Fibroid Embolization  

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Full Text Available ... is a very abnormal uterine artery, the very rich blood supply. And that is typical of a ... tumor. But as a tumor, it has that rich blood supply. And, of course, that's what causes ...

346

Uterine fibroids: current perspectives  

Directory of Open Access Journals (Sweden)

Full Text Available Aamir T Khan,1 Manjeet Shehmar,1 Janesh K Gupta21Birmingham Women's Hospital, Edgbaston, Birmingham, UK; 2Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham, UKAbstract: Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause. There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman's menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy. The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE has now been well-recognized as a uterine-sparing (fertility-preserving method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS or radiofrequency (VizAblate™ and Acessa™ for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge.Keywords: leiomyoma, menorrhagia, ultrasonography, selective progesterone receptor modulators, uterine artery embolization, myomectomy

Khan AT

2014-01-01

347

Resveratrol interferes with AKT activity and triggers apoptosis in human uterine cancer cells  

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Abstract Background Endometrial cancer is the fourth most prominent cancer among all feminine cancers in the Western world. Resveratrol, a natural anti-oxidant found in red wine emerging as a novel anticancer agent, exerts antiproliferative and pro-apoptotic activity in various cancer cell types, but its effect on uterine cancer cells is poorly understood. At the molecular level, resveratrol has been reported to inhibit cyclooxygenase (COX) expression and/or activity; in endo...

Sexton Émilie; Van Themsche Céline; Leblanc Kim; Parent Sophie; Lemoine Pascal; Asselin Eric

2006-01-01

348

Comparison of DWI and PET/CT in evaluation of lymph node metastasis in uterine cancer  

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AIM: To investigate diffusion-weighted imaging (DWI) and positron emission tomography and computed tomography (PET/CT) with IV contrast for the preoperative evaluation of pelvic lymph node (LN) metastasis in uterine cancer. METHODS: Twenty-five patients with endometrial or cervical cancer who underwent both DWI and PET/CT before pelvic lymphadenectomy were included in this study. For area specific analysis, LNs were divided into eight regions: both common iliac, external iliac, internal iliac...

2012-01-01

349

Uterine expression of leukemia inhibitory factor coincides with the onset of blastocyst implantation.  

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We have analyzed the expression of the cytokine leukemia inhibitory factor (LIF) during embryogenesis and in tissues of neonatal and adult mice. The site of the most abundant LIF expression is the uterine endometrial glands, specifically on day 4 of pregnancy. Analysis of LIF expression in pseudopregnant mice and in females undergoing delayed implantation showed that it is under maternal control and that its expression coincides with blastocyst formation and always precedes implantation. Thes...

Bhatt, H.; Brunet, L. J.; Stewart, C. L.

1991-01-01

350

Limitations of CT and ultrasound diagnoses in the evaluation of uterine cancer involvement  

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The concordance rates between preoperative diagnostic imagings and postoperative pathologic findings were examined in a total of 36 patients with resectable uterine cancer (19 with cervical cancer and 27 with endometrial cancer). The accuracy of CT was 47 % in the evaluation of cervical cancer involvement to the parametrium; and was 83 % in the evaluation of wall involvement of endometrial cancer. The concordance rate was 74 % in the evaluation of stage-grouping in endometrial cancer. Out of 8 patients with resectable stage II cervical cancer, four (50 %) were found to have had involvement to the parametrium by transrectal echography. The results indicate that CT scanning and transrectal echography have limitations in the diagnosis of cervical cancer involvement to the parametrium. (Namekawa, K.).

Sato, Yasumi; Maki, Masahiro; Seki, Haruo; Saito, Yoshiharu.

1988-07-01

351

Hormone-regulated expression and distribution of versican in mouse uterine tissues  

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Full Text Available Abstract Background Remodeling of the extracellular matrix is one of the most striking features observed in the uterus during the estrous cycle and after hormone replacement. Versican (VER is a hyaluronan-binding proteoglycan that undergoes RNA alternative splicing, generating four distinct isoforms. This study analyzed the synthesis and distribution of VER in mouse uterine tissues during the estrous cycle, in ovariectomized (OVX animals and after 17beta-estradiol (E2 and medroxyprogesterone (MPA treatments, either alone or in combination. Methods Uteri from mice in all phases of the estrous cycle, and animals subjected to ovariectomy and hormone replacement were collected for immunoperoxidase staining for versican, as well as PCR and quantitative Real Time PCR. Results In diestrus and proestrus, VER was exclusively expressed in the endometrial stroma. In estrus and metaestrus, VER was present in both endometrial stroma and myometrium. In OVX mice, VER immunoreaction was abolished in all uterine tissues. VER expression was restored by E2, MPA and E2+MPA treatments. Real Time PCR analysis showed that VER expression increases considerably in the MPA-treated group. Analysis of mRNA identified isoforms V0, V1 and V3 in the mouse uterus. Conclusion These results show that the expression of versican in uterine tissues is modulated by ovarian steroid hormones, in a tissue-specific manner. VER is induced in the myometrium exclusively by E2, whereas MPA induces VER deposition only in the endometrial stroma.

Aplin John D

2009-06-01

352

Ten-year literature review of global endometrial ablation with the NovaSure® device  

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Full Text Available Richard J Gimpelson Mercy Clinic, Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Mercy Hospital St Louis, St Louis, MO, USA Abstract: This review examines the peer-reviewed literature describing prospective studies that report amenorrhea rates, patient satisfaction, and surgical reintervention rates following the NovaSure® endometrial ablation procedure. A search of the English-language literature published from 2000 to 2011 was conducted using PubMed. Ten prospective studies, six single-arm NovaSure trials, and four randomized controlled trials comparing the NovaSure procedure with other global endometrial ablation modalities met the inclusion criteria and were reviewed. The follow-up periods ranged from 6 to 60 months. Amenorrhea rates for the NovaSure procedure ranged from 30.0% to 75.0%. Patients who reported being satisfied with the NovaSure procedure ranged from 85.0% to 94.0%. In randomized controlled trials with other global endometrial ablation modalities, amenorrhea rates at 12 months with the NovaSure procedure ranged from 43.0% to 56.0%, while other modalities ranged from 8% to 24%. In addition, this manuscript reviews the following: the NovaSure technology; use of the NovaSure procedure in the office setting; intraoperative and postoperative pain; effects on premenstrual syndrome (PMS; dysmenorrhea; special circumstances, including presence of uterine disease, history of cesarean delivery, coagulopathy, or use of anticoagulant medication; post-procedure uterine cavity assessment and cancer risk; contraception and pregnancy; and safety. Keywords: abnormal uterine bleeding, menorrhagia, endometrial ablation, NovaSure®

Gimpelson RJ

2014-03-01

353

Sensitivities of Uterine Adenocarcinoma, Mixed Mullerian Tumor (MMT) and Sarcoma Cell Lines to Chemotherapeutic Agents and a Flex-Het Drug.  

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The administration and combination of a variety of chemotherapeutic agents for treatment of advanced or recurrent uterine cancer of different histologies is under current debate. Mixed Mullerian Tumors (MMTs), which contain both adenocarcinoma and sarcoma components, are the most rate histologic type and it is therefore difficult to conduct clinical trials to determine if they should be treated like endometrial adenocarinomas or like sarcomas. Flexible Heteroarotionoids (Flex-Hets) are a promising class of anti-cancer drugs with low toxicity that have demonstrated activity against a wide variety of cancer types, but their efficacy in uterine cancers is unknown. The objective of this study was to determine if cell lines established from endometrial carcinoma (HEC-1-A), uterine sarcoma (SK-UT-1) and MMT (MES-SA) cancers exhibit differential sensitivities to cisplatin, carboplatin, paclitaxel, docetaxel, doxorubicin and SHetA2, if SHetA2 can enhance sensitivity to the chemotherapeutic drugs and if SHetA2 exhibits a differential effect on uterine cancer cells in comparison to normal endometrial cells using a cytotoxicity assay. These cell lines did not differ in their sensitivities to platinum or taxel drugs. Doxorubicin was active against the sarcoma but not the adenocarcinoma or MMT cell lines. SHetA2 decreased the survival of all three cell lines, but did not enhance their sensitivities to the chemotherapeutic agents. Two of the three uterine cancer cell lines were more sensitive to SHetA2 in comparison to normal endometrial cells. In conclusion, doxorubicin appears to have a greater effect against sarcoma than other uterine histology types. SHetA2 is affective against uterine cancer cell lines, but does not enhance their sensitivities to chemotherapeutic agents. PMID:19890461

Hyde, Johnny; Benbrook, Doris M

2006-01-01

354

Differentiation of the various lesions causing an abnormality of the endometrial cavity using MR imaging: emphasis on enhancement patterns on dynamic studies and late contrast-enhanced T1-weighted images  

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The objectives of this study were to determine the usefulness of magnetic resonance (MR) imaging in the differentiation of various lesions causing an abnormality of the endometrial cavity by evaluating the imaging features on dynamic contrast-enhanced study and late contrast-enhanced T1-weighted images (T1WI). Contrast-enhanced MR imaging of 59 pathologically proven lesions that showed an abnormality of the endometrial cavity, including 32 endometrial cancers, five sarcomas, nine hyperplastic polyps, nine submucosal myomas, three hyperplasia, and one adenomyoma, were retrospectively reviewed. The enhancement degree and patterns on dynamic contrast-enhanced study and late contrast-enhanced T1WI were compared among different pathologies. On dynamic contrast-enhanced study, 72% (23/32) of endometrial cancers showed early peak enhancement to be reached within 1 min following intravenous administration of contrast material. On late-contrast-enhanced T1WI, lesions showed weak enhancement with gradual washout. Ninety-five percent (21/22) of benign lesions and 100% (5/5) of sarcomas showed late peak enhancement to be reached in 2-3 min following intravenous administration of contrast material. On late contrast-enhanced T1WI, both of these lesions showed persistent strong enhancement. Different enhancement patterns on dynamic contrast-enhanced MR imaging and late contrast-enhanced T1WI can provide a useful clue in the differentiation of various lesions causing an abnormality of the endometrial cavity. (orig.)

2006-07-01

355

[Metastatic lung tumor from uterine leiomyosarcoma; report of a case].  

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Endometrial leimyosarcoma is rare neoplasm of all the uterine malignancies. We herein present a case of metastatic pulmonary tumor derived from endometrial leiomyosarcoma She had undergone hysterectomy for leiomyosarcoma. About 10 years after the hysterectomy, metastatic hepatic tumors and peritoneal dissemination were pointed out. Following chemotherapy of cisplatin, ifomide and pirarubicine, right hepatectomy was performed. About 12 years after the hysterectomy, a metastatic lesion appeared in the right lower lung field and right S6 segmentectomy was performed. About 15 months after the pulmonary resection, another metastatic lesion appeared in the remaining right lower lobe. The mass grew so rapidly with involvement to adjacent organs that pericardial resection was necessary with completion right lower lobectomy. Postoperative chemotherapy was performed with the same regimen as previously performed. About 10 months after the second pulmonary resection, she died due to dissemination in the right haemithorax and malignant pericardial effusion. Careful follow up after the surgery for the uterine leiomyosarcoma is recommended because metastatic leiomyosarcoma possibly appears even after a long interval, and its progress can be so intensive that adjuvant chemotherapy is necessary if it can not be treated surgically alone. PMID:18616110

Takahashi, T; Sakamoto, J; Kosaka, S

2008-07-01

356

Studies on the diagnosis of uterine body cancer using "2"0"1Tl-chloride  

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"2"0"1Tl scintigraphy was performed in 18 patients with cancer of uterine body, and the results were compared with histopathological findings. With six patients, "2"0"1Tl distribution in the pelvic cavity was registered in the minicomputer, and the time activity curve was plotted. Analysis of "2"0"1Tl distribution using ROI revealed that the radioactivity in the uterus was approximately 1.47 times as high as that in background. In the removed uterus, the radioactivity in the cancer was calculated to be approximately 1.9 times as high as that in the myometrium. In all 13 patients with Stage Ib or higher cancer, obvious activity in the uterus coinciding with the lesion was obtained shortly after the intravenous administration of "2"0"1Tl-Cl. Though accumulation of activity in the uterus was obtained in three of five patients with Stage Ia cancer, it was interpreted as false-positive, because myoma or adenomyosis was present in addition to cancer in these three patients, and such a complication seemed responsible for the positive result. The sensitivity, specificity and accuracy of "2"0"1Tl scintigraphy in diagnosing cancer of the uterine body were 86.7, 0 and 72.2%, respectively. These results suggest that "2"0"1Tl scintigraphy is a promising diagnostic aid for cancer of the uterine body. (author)

1985-01-01

357

Studies on the diagnosis of uterine body cancer using S Tl-chloride  

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S Tl scintigraphy was performed in 18 patients with cancer of uterine body, and the results were compared with histopathological findings. With six patients, S Tl distribution in the pelvic cavity was registered in the minicomputer, and the time activity curve was plotted. Analysis of S Tl distribution using ROI revealed that the radioactivity in the uterus was approximately 1.47 times as high as that in background. In the removed uterus, the radioactivity in the cancer was calculated to be approximately 1.9 times as high as that in the myometrium. In all 13 patients with Stage Ib or higher cancer, obvious activity in the uterus coinciding with the lesion was obtained shortly after the intravenous administration of S Tl-Cl. Though accumulation of activity in the uterus was obtained in three of five patients with Stage Ia cancer, it was interpreted as false-positive, because myoma or adenomyosis was present in addition to cancer in these three patients, and such a complication seemed responsible for the positive result. The sensitivity, specificity and accuracy of S Tl scintigraphy in diagnosing cancer of the uterine body were 86.7, 0 and 72.2%, respectively. These results suggest that S Tl scintigraphy is a promising diagnostic aid for cancer of the uterine body.

Watanabe, Hiraku

1985-03-01

358

Strong family history of uterine leiomyomatosis warrants fumarate hydratase mutation screening.  

Science.gov (United States)

Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a tumor predisposition syndrome characterized by cutaneous and uterine leiomyomas and renal cell cancer. HLRCC is caused by heterozygous germline mutations in the fumarate hydratase (FH) gene. A Finnish family with nine closely related women with uterine leiomyomas was detected by an alert gynecologist. No cutaneous or renal cell tumors were reported in the family when it was referred to genetic analyses. Samples were available from seven patients, and a novel germline FH mutation was detected in five of them. Mutation carriers were symptomatic, had multiple tumors and were diagnosed at an early age. This study emphasizes the importance of considering FH mutation screening when gynecologists encounter families with multiple severe uterine leiomyoma cases. Due to possibility of phenocopies more than one patient should be tested. Early mutation detection allows regular screening of the mutation carriers and enables early detection of possible highly aggressive renal tumors. It may also affect family planning as multiple myomas at early age may significantly reduce fertility. PMID:22473397

Tolvanen, Jaana; Uimari, Outi; Ryynänen, Markku; Aaltonen, Lauri A; Vahteristo, Pia

2012-06-01

359

False contouring effect of the uterine wall during hysteroscopy a lesson from immediate hydrosonography  

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Full Text Available A 42 years old woman suffering from repeated events of intensive vaginal bleeding during the week off birth control pills was referred for diagnostic hysteroscopy. The patient underwent hysterohy drosonoscopy, a 3-step procedure, including a transvaginal ultrasound scan, a diagnostic hysteroscopy and immediate hydrosonography. A3 cmintramural myoma was detected by the ultrasound scan without impinging onto the uterine cavity as visualized by diagnostic hysteroscopy. However, continuous hydrosonographic evaluation of the uterus, performed immediately afterwards, unveiled a fibroid with a significant intracavitary portion. A falsely normal cavity could be appreciated by high pressured hysteroscopy, while during the gradual fall of the intracavitary pressure a significant lesion could be revealed encroaching into the lumen. In the absence of an agreed distention pressure range during hysteroscopy, an immediate hydrosonography may serve as an auxiliary tool to follow the uterine wall contour as distention pressure declines during the eventual escape of the distention fluid from the lumen. Uterine wall contour is heavily dependent on the distension pressure and guidelines for intrcavitary pressure during hysteroscopy are evidently needed.

Ronit Haimov-Kochman

2013-07-01

360

Drugs Approved for Endometrial Cancer  

Science.gov (United States)

This page lists cancer drugs approved by the Food and Drug Administration (FDA) for endometrial cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

 
 
 
 
361

How Is Endometrial Cancer Diagnosed?  

Science.gov (United States)

... a local anesthesia (numbing medicine). Dilation and curettage (D&C) If the endometrial biopsy sample doesn't provide ... suggests cancer but the results are uncertain, a D&C must be done. In this outpatient procedure, the ...

362

[Estrogen substitution and endometrial carcinoma].  

Science.gov (United States)

Perimenopausal and postmenopausal substitutive estrogen treatment is valuable if prescribed according to proper indications and in the proper manner. Studies have shown a correlation between menopausal estrogen treatment and endometrial cancer. Siiteri hypothesized that estrone was the estrogen with a specific carcinogenic effect. A study undertaken in California indicates, however, that conjugated estrogens are associated with a lower risk of endometrial cancer. There is also strong indications that certain factors predispose a woman to endometrial cancer during menopausal estrogen treatment: obesity, the Stein-Leventhal syndrone, the Turner syndrome, hirsuitism caused by increased androgen activity, and family history of endometrial cancer. Menopausal estrogen treatment is prescribed in cases of menstrual disturbances, neurovegetative or vaso-motor disturbances, psychological disturbances, atrophy of the urogenital tract, or cases of calcium or fat metabolism disturbances which could lead to osteoporosis or arteriosclerosis. PMID:216933

Kruyver, G P

1979-03-10

363

Acute puerperal uterine inversion  

International Nuclear Information System (INIS)

Objective: To determine the frequency, causes, clinical presentations, management and maternal mortality associated with acute puerperal inversion of the uterus. Materials and Methods: All the patients who developed acute puerperal inversion of the uterus either in or outside the JPMC were included in the study. Patients of chronic uterine inversion were not included in the present study. Abdominal and vaginal examination was done to confirm and classify inversion into first, second or third degrees. Results: 57036 deliveries and 36 acute uterine inversions occurred during the study period, so the frequency of uterine inversion was 1 in 1584 deliveries. Mismanagement of third stage of labour was responsible for uterine inversion in 75% of patients. Majority of the patients presented with shock, either hypovolemic (69%) or neurogenic (13%) in origin. Manual replacement of the uterus under general anaesthesia with 2% halothane was successfully done in 35 patients (97.5%). Abdominal hysterectomy was done in only one patient. There were three maternal deaths due to inversion. Conclusion: Proper education and training regarding placental delivery, diagnosis and management of uterine inversion must be imparted to the maternity care providers especially to traditional birth attendants and family physicians to prevent this potentially life-threatening condition. (author)

2004-04-01

364

[Risk factors of endometrial carcinoma].  

Science.gov (United States)

The authors base their experience on 12 women affected by endometrial carcinoma. Problems have been diagnosed in the post-menopausal and climacterium period, considering the clinical, hormonal and lipidic profile and some tumoral markers. The most risk factors for the endometrial adenocarcinoma have been collected in the adiposity with hypertension and hyperglycemia, above all in nullipara women with late menopause and dyslipidemia. PMID:8414144

Giannone, R; Bernorio, R; Poli, M

1993-01-01

365

MR staging of endometrial carcinoma  

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Endometrial cancer is the second most common gynaecological malignancy. The usual presentation with post-menopausal bleeding results in an early diagnosis in most cases and thus there is opportunity for cure. Magnetic resonance (MR) imaging is pivotal in the decision-making process regarding treatment options. We present a review of the magnetic resonance (MR) findings to illustrate its role in the staging of endometrial cancer.

Messiou, C. [St James' s University Hospital, Leeds, West Yorkshire (United Kingdom)]. E-mail: c_messiou@hotmail.com; Spencer, J.A. [St James' s University Hospital, Leeds, West Yorkshire (United Kingdom); Swift, S.E. [St James' s University Hospital, Leeds, West Yorkshire (United Kingdom)

2006-10-15

366

Residual carcinoma after intracavitary irradiation of endometrial carcinoma, stage I. A study of whole-organ sections  

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Surgical specimens from 87 patients with endometrial carcinoma, stage I, preoperatively treated by intracavitary irradiation were investigated by a whole-organ sectioning technique. Re-examination of the curettage material showed cancer stage 0 in 8 (9 percent) and carcinoma stage I in 79 cases (91 percent). In the stage I cases 57 percent showed residual carcinoma localized mainly to the myometrium of the uterine body and cornuae. Histological changes in the carcinoma were unevenly distributed, but tumors growing close to the external uterine surface were well preserved. In 40.5 percent, no carcinoma was present, and in 2.5 percent the changes found could not be classified. Correlated to disparity in irradiation technique, no significant difference could be demonstrated in the incidence or localization of residual carcinoma. The findings indicate that it is unlikely that endometrial carcinoma stage I with myometrial invasion will be eradicated by intracavitary irradiation.

Groentoft, O.; Risberg, B.; Stenson, S.; Westholm, B. (Linkoepings Universitet, Linkoeping (Sweden). Institutionen foer Medicinsk Mikrobiologi och Patologi)

1982-01-01