WorldWideScience

Sample records for uterine myoma endometrial

  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

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

    Scientific Electronic Library Online (English)

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

    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 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

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

    Directory of Open Access Journals (Sweden)

    SNEZANA PEJIC

    2006-01-01

    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

  4. Uterine artery embolization as a treatment option for uterine myomas.

    Science.gov (United States)

    Marshburn, Paul B; Matthews, Michelle L; Hurst, Bradley S

    2006-03-01

    Information is still being collected on the long-term clinical responses and appropriate patient selection for UAE. Prospective RCTs have not been performed to compare the clinical results from UAE with more conventional therapies for symptomatic uterine leiomyomata. At least three attempts at conducting such RCTs have been unsuccessful because of poor patient accrual that related to differing patient expectation and desires, clinical bias, insurance coverage, and the tendency that patients who have exhausted other treatment options may be disposed more favorably to less invasive treatments. Other comparative studies have serious limitations. For example, the retrospective study that compared outcomes after abdominal myomectomy with UAE suggested that patients who received UAE were more likely to require further invasive treatment by 3 years than were recipients of myomectomy. Lack of randomization introduced a selection bias because women in the group that underwent UAEwere older and were more likely to have had previous surgeries. A prospective study of "contemporaneous cohorts," which excluded patients who had sub-mucosal and pedunculated subserosal myomas, sought to compare quality of life measures and adverse events in patients who underwent UAE or hysterectomy. The investigators concluded that both treatments resulted in marked improvement in symptoms and quality of life scores, but complications were higher in the group that underwent hysterectomy over 1 year. In this study,however, a greater proportion of patients who underwent hysterectomy had improved pelvic pain scores. Furthermore, hysterectomy eliminates uterine bleeding and the risk for recurrence of myomas. Despite the lack of controlled studies that compared UAE with conventional surgery, and despite limited extended outcome data, UAE has gained rapid acceptance, primarily because the procedure preserves the uterus, is less invasive, and has less short-term morbidity than do most surgical options. The cost of UAE varies by region, but is comparable to the charges for hysterectomy and is less expensive than abdominal myomectomy. The evaluation before UAE may entail additional fees for diagnostic testing, such as MRI, to assess the uterine size and screen for adenomyosis. Other centers have recommended pretreatment ultrasonography, laparoscopy, hysteroscopy, endometrial biopsy, and biopsy of large fibroids to evaluate sarcoma. Generally,after UAE the recovery time and time lost from work are less; however, the potential need for subsequent surgery may be greater when compared with abdominal myomectomy. Any center that offers UAE should adhere to published clinical guidelines,maintain ongoing assessment of quality improvements measures, and observe strict criteria for obtaining procedural privileges. After McLucas advocated that gynecologists learn the skill to perform UAE for managing symptomatic myomas, the Society of Interventional Radiology responded with a precautionary commentary on the level of technical proficiency that is necessary to maintain optimum results from UAE. The complexity of pelvic arterial anatomy, the skill that is required to master modern coaxial microcatheters, and the hazards of significant patient radiation exposure were cited as reasons why sound training and demonstration of expertise be obtained before clinicians are credentialed to perform UAE.A collaboration between the gynecologist and the interventional radiologist is necessary to optimize the safety and efficacy of UAE. The primary candidates for this procedure include women who have symptomatic uterine fibroids who no longer desire fertility, but wish to avoid surgery or are poor surgical risks. The gynecologist is likely to be the primary initial consultant to patients who present with complaints of symptomatic myomas. Therefore, they must be familiar with the indications, exclusions, outcome expectations, and complications of UAE in their particular center. When hysterectomy is the only option, UAE should be considered. Appropriate diagnostic testing should ai

  5. [The role of biogenic amines in the mechanism of uterine hemorrhage in uterine myoma].

    Science.gov (United States)

    Bel'skaia, G D

    1990-02-01

    Function of the adrenosympathetic system has been assessed in 103 patients with uterine myoma. Levels of biogenic amines (adrenaline, noradrenaline, histamin) were determined in uterine tissues using spectrofluorometry. It was found out that storage of vasoactive mediators in the uterine tissue represents a mechanism of uterine bleedings in patients with uterine myoma. Another determinant is stress experienced by patients with menometrorrhagia. PMID:2339756

  6. MRI evaluation for conservative treatment in endometriosis and uterine myoma

    International Nuclear Information System (INIS)

    Eighteen patients with endometriosis or uterine myoma underwent MRI before and after conservative treatment with Danazol (400 mg/day) or Buserelin (900 ?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.)

  7. Processes of apoptosis and cell proliferation in uterine myomas originating from reproductive and perimenopausal women

    OpenAIRE

    Karolina Sieron-Stoltny; Gra?yna Nowaczyk; Pawe? Madej; Danuta Plewka; Andrzej Plewka; Beata Jakubiec-Bartnik

    2011-01-01

    We studied uterine myomas originating from females of reproductive age and from females of perimenopausal age. Uterine myomas represent benign tumors of the myometrium, and they develop frequently in women of reproductive age. The frequency of uterine myomas increases with age until women reach the menopause. The study included patients with a myomatous uterus, in the reproductive age or peri-menopausal age, independently evaluating small and large myomas. Myometrial alterations in their dire...

  8. Histological and immunohistochemical evaluation of leiomyoma and endometrial tissue in patients with uterine leiomyoma and endometrial hyperplasia

    Directory of Open Access Journals (Sweden)

    Potapov V.A.

    2014-03-01

    Full Text Available Background. Uterine leiomyoma and endometrial hyperplasia are commonly found disorders because of quite similar pathogenic pathways associated with action of sex steroids such as estradiol and progesterone. The gold standard of treatment of combination of uterine leiomyoma and endometrial hyperplasia is myomectomy with further prescription of gestagens. Objective. Histological and immunohistochemical evaluation of leiomyoma and endometrial tissue in patients with uterine leiomyoma and endometrial hyperplasia. Methods. In this study histological and immunohistochemical analysis of leiomyoma and endometrium samples were conducted in 30 patients with uterine leiomyoma and endometrial hyperplasia. Further evaluation with transvaginal ultrasound end endometrial biopsy was conducted in 6 and 12 months after surgery. Results. In women with combined endometrial hyperplasia and uterine leiomyoma there is an increased risk of myoma relapse (23.3% and treatment failure of endometrial hyperplasia (36.7% after traditional treatment with gestagens. Among 7 patients with leiomyoma recurrence there was persistence of endometrial hyperplasia what was associated with increased proliferation, angiogenesis and decreased apoptosis. Conclusion. During a comprehensive immunohistochemical study of endometrial biopsies and uterine leiomyoma in women with histologically verified uterine leiomyoma and endometrial hyperplasia common immunohistochemical features had been identified such as increased expression of ki-67 and VEGF and bcl-2. It was proposed that traditional scheme using derivatives of progesterone should be avoided in such patients. In order to optimize treatment outcomes in women with such findings proposed treatment of choice should be drugs with severe suppressive action on proliferation, angiogenesis with simultaneous stimulating action on apoptosis. Drug of choice in such case should be GnRH agonist what should be assessed in future research. Citation: Potapov VA, Donskaya YuV, Medvedev MV. [Histological and immunohistochemical evaluation of leiomyoma and endometrial tissue in patients with uterine leiomyoma and endometrial hyperplasia]. Morphologia. 2014;8(1:80-4. Ukrainian.

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

    OpenAIRE

    Cheung, Wellman W; Bluth, Martin H.; Dorota Borawski

    2011-01-01

    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 sur...

  10. Deep venous thrombosis due to massive compression by uterine myoma

    Directory of Open Access Journals (Sweden)

    Aleksandra Brucka

    2010-10-01

    Full Text Available A 42-year-old woman, gravida 3, para 3 was admitted to hospital because of painful oedema of her right lower extremity. Initial physical examination revealed a gross, firm tumour filling the entire peritoneal cavity. Doppler ultrasound scan revealed a thrombus in the right common iliac vein, extending to the right femur and popliteal veins, and partially into the calf deep vein. Computed tomography confirmed the existence of an abdominal tumour probably deriving from the genital organs and the presence of a thrombus in the said veins.The patient underwent hysterectomy where a myomatous uterine was removed. She was put on subcutaneous enoxaparine and compressive therapy of the lower extremities. Such symptoms as pain and oedema receded. Control Doppler scan showed fibrinolysis, partial organization of the thrombus and final vein recanalisation. After exclusion of other risk factors of deep vein thrombosis apart from stasis, we conclude that the described pathology was the effect of compression of regional pelvic structures by a uterine myoma.

  11. Body weight gain during adulthood and uterine myomas: Pró-Saúde Study

    Science.gov (United States)

    Boclin, Karine de Lima Sírio; Torres, Fernanda Pelegrini; Faerstein, Eduardo

    2015-01-01

    ABSTRACT This study intended to investigate whether body weight gain during adulthood is associated with uterine myomas. 1,560 subjects were evaluated in a Pró-Saúde Study. Weight gain was evaluated in a continuous fashion and also in quintiles. Odds ratios and 95% confidence intervals were estimated through logistic regression models that were adjusted for education levels, color/race, body mass indices at age 20, age of menarche, parity, use of oral contraceptive methods, smoking, health insurance, and the Papanicolaou tests. No relevant differences were observed regarding the presence of uterine myomas among weight gain quintiles in that studied population. PMID:26558353

  12. Evaluation on the safety of transcatheter uterine artery embolization for uterine myoma

    International Nuclear Information System (INIS)

    Objective: To observe complications of transcatheter uterine artery embolization (TUAE) for uterine fibroids and to evaluate its long-term safety. Methods: One hundred and ninety-eight women with uterine fibroids were treated by TUAE. The bilateral TUAE were performed using lipiodol-pingyangmycineemulsion (LPE) and gelatin sponge particles in 186 women. Among them, 138 patients were followed up for 1 to 3 year and complications were observed. Results: Complications included ecchymosis and ulceration on buttock (n=1); ulcer of labia minora (n=1); urinary retention (n=12); urinary tract infection (n=1); expelling of necrotic fibroids via vagina (n=5); secondary infection of chocolate cyst of ovary (n=1); increasing in endometrial thickness and calcification (n=1) and amenorrhea (n=2). Conclusion: TUAE is a treatment with long-term safety, while severe complications or sequelae may occur to a few patients, so strict indication should be insisted in patient selection. (authors)

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

    OpenAIRE

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

    2013-01-01

    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...

  14. Actual management and its problem for uterine myoma using transcervical needle biopsy

    International Nuclear Information System (INIS)

    Recent clinical introductions of gonadotropin releasing hormore (GnRH) agonists and uterine artery embolization have meant that the patients with uterine myoma, who might have previously undergone surgery, are now often managed conservatively. In both of the above situations, there is an important common clinical problem; that is distinguishing uterine sarcomas from benign leiomyomas. However, clinical differential diagnosis between uterine sarcomas and benign leiomyomas is difficult even with magnetic resonance imaging (MRI). The most reliable preoperative diagnostic method is a biopsy of the tumor. We have evaluated the accuracy and the practical problem of needle biopsy for uterine myoma-like tumors, a procedure that has been infrequently performed. Transcervical needle biopsy was performed in 694 patients with uterine myoma-like tumors. The biopsy specimens were classified into 5 groups for degree of malignancy according to the histopathological criteria proposed by Bell et al. Immunohistochemical analysis (49 cases) using Ki67 (MIB1), P53 and hTERT, and telomerase activity measured using TRAP (62 cases) were also evaluated for differential diagnosis. Histopathological evaluation of surgical specimens and clinical outcome of 2 years of follow-up were used as the reference standards. Among 694 patients, 11 had uterine sarcomas. Six cases, judged as Group V, were diagnosed as 'sarcoma' by needle biopsy alone. No sarcoma cases were included in those patients with Group I, II, and III. The cutoff level combining the highest sensitivity and specificity with respect to distinguishing uterine leiomyosarcoma from uterine leiomyoma was obtained was Group VI; sensitivity, specificity, positive, and negative predictive values were 100%, 98.9%, 69%, and 100.0%, respectively. Of the 3 immunohistochemical analyses, the evaluation using Ki67 showed the highest accuracy. At cutoff values of 20 units, telomerase activity in needle biopsy sample showed the highest accuracy; sensitivity and specificity were 85% and 100%, respectively. Transcervical needle biopsy using histopathological grouping is a reliable diagnostic test for differential diagnosis between uterine sarcomas and leiomyomas. This diagnostic method, combined with MRI screening, could support the conservative management for patients with uterine myoma more safely. (author)

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

    Directory of Open Access Journals (Sweden)

    Farzaneh Goharzad

    2011-01-01

    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

  16. Treatment of uterine myomas by radiofrequency thermal ablation: a 10-year retrospective cohort study.

    Science.gov (United States)

    Yin, Geping; Chen, Ming; Yang, Shujun; Li, Juan; Zhu, Tongyu; Zhao, Xiaoli

    2015-05-01

    Patients' selection criteria, effectiveness, and safety of radiofrequency thermal ablation (RFTA) therapy for uterine myomas (UM) were assessed using a 10-year retrospective cohort study. From July 2001 to July 2011, a total of 1216 patients treated for UM were divided into 2 groups. Group A consisted of 476 premenopause patients, average age 36.5 ± 8.5 years, average number of myomas 1.7 ± 0.9, and average diameter of myomas 4.5 ± 1.5 cm, and group B consisted of 740 menopause patients, average age 48.5 ± 3.5 years, average number of myomas 2.6 ± 1.3, and average diameter of myomas 5.0 ± 2.5 cm. Average follow-up period was 36.5 ± 11.5 months. At 1, 3, 6, 12, and 24 months after RFTA, average diameters of myomas in group A were 3.8, 3.0, 2.7, 2.4, and 2.2 cm, respectively, and 47.7% (227 of 476) of patients had tumor trace at 12 months after RFTA. In group B, the results were 4.7, 3.7, 3.3, 2.3, and 2.3 cm, respectively, and 58.8% (435 of 740) of patients had tumor trace at 12 months after RFTA. Three months after treatment, myoma volumes were significantly reduced in both the groups (P < .01), and group B had higher rate of tumor trace at 12 months after RFTA than group A (P < .05). Clinical symptoms and health-related quality-of-life outcome (HRQL) were significantly improved after RFTA in both groups and the postoperative recurrence rate of UM was significantly higher in group A at 10.7% (51 of 476) than group B at 2.4% (18 of 740; P < .05). Radiofrequency thermal ablation is an excellent minimally invasive treatment for UM smaller than 5.0 cm in diameter. PMID:25355802

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

    Directory of Open Access Journals (Sweden)

    Arsenijevi? S.

    2013-01-01

    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

  18. Focused ultrasound for treatment of uterine myoma: From experimental model to clinical practice

    Directory of Open Access Journals (Sweden)

    Terzi? Milan

    2008-01-01

    Full Text Available It is well known that focused ultrasound has a biologic effect on tissue. High intensity focused ultrasound (HIFU on a small target area raises the temperature of the tissue enough to denaturate proteins and cause irreversible cell damage. The tight focus of the ultrasound energy allows delivery of the intended dose to a very precise location. The resulting coagulation necrosis is relatively painless. The application of this method in the human clinical setting has required pilot studies on an animal model. Although the treatment had a high success rate, there was a significant percentage of complications, mainly attributed to the technical drawbacks of the procedure. Therefore, this method has been modified for use in humans, and the HIFU is now guided, monitored and controlled by magnetic resonance imaging (MRI. In October 2004, Food and Drug Adiministration (FDA approved MRI guided focused ultrasound treatment of uterine fibroids in humans. Since then, successful treatment of uterine myomas by HIFU has been performed in thousands of women.

  19. Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) in Treatment of Symptomatic Uterine Myomas

    OpenAIRE

    Filipowska, Justyna; ?ozi?ski, Tomasz

    2014-01-01

    Magnetic Resonance-guided High-Intensity Focused Ultrasound (MR-HIFU) is a noninvasive technique for ablation therapy for uterine myomas, where focused ultrasound energy beam generates localized high temperature in the selected area and coagulates chosen tissue, leaving the skin and tissues in between unharmed. Magnetic resonance imaging enables accurate targeting for HIFU as well as temperature monitoring during treatment. MR guidance with 3D anatomical imaging provides reference data for tr...

  20. Management of dysfunctional uterine bleeding based on endometrial thickness

    Directory of Open Access Journals (Sweden)

    Ozgul Muneyyirci-Delale

    2010-09-01

    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

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

    Directory of Open Access Journals (Sweden)

    Carlos Antonio Sánchez Portela

    2012-10-01

    Full Text Available 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 través 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.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 having odd dimensions and uterine myoma, not frequently found in present times. Pathological studies proved a serous cystadenoma of the ovary.

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

    Scientific Electronic Library Online (English)

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

    2012-10-01

    Full Text Available 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.

  3. Endometrial Cancer: Hidden Pathology in a Patient with Abnormal Uterine Bleeding and Known Leiomyoma.

    Science.gov (United States)

    Sri, Trisha; Steren, Albert J; Stratton, Pamela

    2015-12-01

    Uterine leiomyomas and endometrial pathology are both associated with abnormal uterine bleeding. We report a case in which a nulliparous woman with heavy uterine bleeding and leiomyomas had undergone two prior hysteroscopic myomectomies for benign leiomyomas. She was evaluated, but was ineligible for a clinical trial of a novel Magnetic Resonance guided High Intensity Focused Ultrasound (MRgx200B;HIFU) device. The 8 cm, prolapsed submucosal leiomyoma hindered endometrial sampling and was inaccessible to HIFU treatment. Preoperatively, neither endometrial sampling nor saline sonohysterography was technically feasible. She underwent hysterectomy, and on histological examination of specimen, stage 1A grade 1 endometrial carcinoma was found on the endometrial side of the prolapsing fibroid. Endometrial pathology is an important consideration in the evaluation of abnormal uterine bleeding, even in women with large prolapsing leiomyoma. PMID:25634727

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

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Mayumi; Matsuzaki, Kenji; Yoshida, Shusaku; Nishitani, Hiromu [University of Tokushima, Department of Radiology, Tokushima (Japan); Uehara, Hisanori [University of Tokushima, Department of Molecular and Environmental Pathology, Tokushima (Japan); Shimazu, Hideki [Oe Kyoudo Hospital, Department of Radiology (Japan)

    2005-11-01

    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.)

  5. Endometrial cancer

    Science.gov (United States)

    ... cancer; Adenocarcinoma - endometrium; Adenocarcinoma - uterus; Cancer - uterine; Cancer - endometrial; Uterine corpus cancer ... Endometrial cancer is the most common type of uterine cancer. The exact cause of endometrial cancer is unknown. ...

  6. 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

    Scientific Electronic Library Online (English)

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

    Full Text Available CONTEXTO: Miomas uterinos são tumores benignos que ocorrem na idade reprodutiva das mulheres com uma freqüência que varia entre 20% a 25%. Quando presentes os sintomas, estes se caracterizam por aumento do fluxo menstrual, dor e sinais de compressão. Têm sido propostas novas formas de tratamento, de [...] stacando-se a embolização das artérias uterinas. OBJETIVO: Avaliar os efeitos do tratamento com embolização das artérias uterinas em mulheres portadoras de miomas sintomáticos e os volumes uterino e do mioma dominante, antes e após 12 semanas após o procedimento. TIPO DE ESTUDO: Ensaio clínico aberto. LOCAL: Hospital Leonor Mendes de Barros, São Paulo, Brasil. PARTICIPANTES: 32 mulheres com diagnóstico de mioma sintomático, único ou múltiplo, do corpo uterino, atendidas no Ambulatório de Ginecologia do Hospital Leonor Mendes de Barros, entre maio de 2000 e setembro de 2001. VARIÁVEIS ESTUDADAS: As mulheres foram submetidas a exame ginecológico seguido de ultra-sonografia abdominal, pélvica e endovaginal, repetidos 12 semanas após o procedimento. A embolização da artéria uterina com PVA (partículas de álcool polivinil de 355 a 700 µ) foi realizada através da cateterização da artéria femoral direita em 30 mulheres e, em duas mulheres, a cateterização foi bilateral. RESULTADOS: A média do volume uterino de 32 mulheres antes da embolização foi 455 cm³ e a média do volume do mioma dominante foi de 150 cm³ antes da embolização. Após 12 semanas de embolização, média do volume uterino e do mioma dominante foram 256 cm³ e 91 cm³ respectivamente. A redução dos volumes uterino e do mioma dominante foi estatisticamente significativa (p Abstract in english 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 evalu [...] ate 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 12 weeks later. TYPE OF STUDY: Open clinical trial. SETTING: A tertiary-care women's hospital. PARTICIPANTS: The study was conducted on 32 women with symptomatic single or multiple myomas of the uterine body, seen at the outpatient unit from May 2000 to September 2001. MAIN MEASUREMENTS: The patients were submitted to gynecological examination and abdominal and endovaginal pelvic ultrasonography, and the examinations were repeated 12 weeks after the first procedure. Uterine artery embolization using PVA (polyvinyl alcohol) particles of 355-700 µ was performed by catheterization of the right femoral artery in 30 women and by bilateral catheterization in two. RESULTS: Before embolization, the mean uterine volume of the 32 women was 455 cm³ and the mean volume of the dominant myoma was 150 cm³. Twelve weeks after embolization, the mean uterine volume was 256 cm³ and the mean volume of the dominant myoma was 91 cm³, with p

  7. An incidentally found inflamed uterine myoma causing low abdominal pain, using Tc-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging.

    Science.gov (United States)

    Zandieh, Shahin; Schütz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg

    2013-01-01

    We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging. PMID:24043983

  8. An incidentally found inflamed uterine myoma Causing low abdominal pain, using TC-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging

    International Nuclear Information System (INIS)

    We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.

  9. An incidentally found inflamed uterine myoma Causing low abdominal pain, using TC-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zandieh, Shahin; Schuetz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg [Hanusch-Hospital, Teaching Hospital of Medical University of Vienna, Vienna (Australia)

    2013-10-15

    We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.

  10. Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding

    OpenAIRE

    Fakhar Shazia; Saeed Gulshan; Khan Amir; Alam Ali

    2008-01-01

    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 ...

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

    Scientific Electronic Library Online (English)

    Jorge Luís, Hiralda Martínez.

    2013-09-01

    Full Text Available 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

  12. Clinical assessment of uterine endometrial cancer by magnetic resonance imaging

    International Nuclear Information System (INIS)

    A retrospective review of magnetic resonance (MR) images of 33 patients with surgically proved uterine endometrial cancer was done to define the essential sequence of MR imaging for the purpose of shortening of the scan time. Only T2 weighted sagittal image was studied for cancer staging. The relation between surgical staging and the ratio of tumor width to uterine width in the sagittal plane as well as direct image analysis was evaluated. The cervical involvement was diagnosed by continuity of tumor intensity into cervical canal, adnexal invasion by swelling of adnexa, myometrial invasion by blurring of tumor-myometrial interface. Accuracy of direct MR imaging analysis as for cervical involvement, adnexal invasion, and myometrial invasion were 83.3%, 77.8%, 73.3% respectively. The tumor volume ratio showed a statistically significant difference (p<0.05) between cases with superficial myometrial invasion and with deep invasion, while there was no difference between cases without myometrial invasion and those with superficial invasion. Thus we suggest that when tumor volume ratio was over 75% one must consider the possibility of deep myometrial invasion even if the tumor-myometrial interface was smooth. (author)

  13. Parasitic myoma after supracervical laparoscopic histerectomy

    Directory of Open Access Journals (Sweden)

    Maurício Paulo Angelo Mieli

    2013-06-01

    Full Text Available Parasitic myoma is a condition defined as a myoma of extrauterine nourishing. It may occur spontaneously or as a consequence of surgical iatrogeny, after myomectomy or videolaparoscopic supracervical hysterectomy, due to remaining residues of uterine tissue fragments in the pelvic cavity after morcellation. The authors describe two cases in which the patients were submitted to videolaparoscopic supracervical hysterectomy and uterine body removal through morcellation. The sites of development of the parasitic myomas were next to the cervix stump in Case 1, and next to the right round ligament in Case 2. These parasitic myomas were removed by videolaparoscopy. After myomectomies or videolaparoscopic supracervical hysterectomies followed by uterine fragments removal from the pelvic cavity through morcellation, meticulous searching for residues or fragments of uterine tissue is mandatory to prevent the occurrence of parasitic myomas.

  14. Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dreisler, E; Sorensen, S Stampe; Ibsen, P H; Lose, G

    2009-01-01

    OBJECTIVE: To assess the diagnostic value of transvaginal sonographic (TVS) measurement of endometrial thickness for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding (AUB). METHODS: A random selection from the Danish Civil Registration System was made: 1660 women aged 20-74 years were invited to participate and 686 women were eligible and accepted inclusion (429 pre- and 257 postmenopausal). The women underwent TVS measurement of endometrial thickness and saline...

  15. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  16. 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

    International Nuclear Information System (INIS)

    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.

  17. Effect of age and endometrial degenerative changes on uterine blood flow during early gestation in mares.

    Science.gov (United States)

    Ferreira, J C; Canesin, H S; Ignácio, F S; Rocha, N S; Pinto, C R; Meira, C

    2015-10-15

    The present experiment was divided into three studies to investigate the effect of age and endometrial degeneration on uterine blood flow of mares. In study 1, the influence of semen infusion and conception was evaluated using noninseminated (non-AI), inseminated nonpregnant (AI-NP), and inseminated pregnant (AI-P) mares (n = 7 mares/group). In study 2, the effect of age was investigated using young (?6 years), adult (from 8 to 12 years), and old (?15 years) pregnant mares (n = 7 mares/group). In study 3, uterine blood flow was also characterized in pregnant mares (n = 7 mares/group) with minimal, moderate, or severe endometrial degenerative changes (GI, GII, and GIII, respectively). Uterine vascular perfusion and pulsatility index from mesometrium attachment arteries were recorded daily from Day 0 (day of ovulation) to Day 12 and between Days 0 and 20 in nonpregnant and pregnant mares. Analysis according to the position of the embryo (uterine horn with embryo vs. opposite horn) was performed from Day 12 until Day 20. In study 1, increased uterine vascular perfusion and decreased pulsatility index were detected (P AI and AI-P mares, whereas the uterine vascular perfusion of AI-NP mares did not change (P > 0.05) throughout the experiment. In study 2, the vascular perfusion of the uterine horn with embryo was higher (P  0.1) vascular perfusion from Day 12. In study 3, vascular perfusion of both uterine horns was lower (P < 0.001) in GIII mares than in GI and GII mares. After Day 15, the scores for uterine vascular perfusion were consistently greater (P < 0.001) in the uterine horn with embryo than in the opposite horn in GI mares. Results showed, for the first time, the reduced blood flow of the gravid uterus during early gestation in older mares and in mares with significant endometrial degeneration. PMID:26194699

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

    Directory of Open Access Journals (Sweden)

    ?or?evi? Biljana

    2008-01-01

    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.

  19. Cabozantinib-S-Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer

    Science.gov (United States)

    2015-10-02

    Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Mixed Adenocarcinoma; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  20. Progesterone Action in Endometrial Cancer, Endometriosis, Uterine Fibroids, and Breast Cancer

    OpenAIRE

    Kim, J. Julie; Kurita, Takeshi; Bulun, Serdar E

    2013-01-01

    Progesterone receptor (PR) mediates the actions of the ovarian steroid progesterone, which together with estradiol regulates gonadotropin secretion, prepares the endometrium for implantation, maintains pregnancy, and differentiates breast tissue. Separation of estrogen and progesterone actions in hormone-responsive tissues remains a challenge. Pathologies of the uterus and breast, including endometrial cancer, endometriosis, uterine fibroids, and breast cancer, are highly associated with estr...

  1. Retained placenta accreta after a first-trimester abortion manifesting as an uterine mass

    OpenAIRE

    Lim, Soyi; Ha, Seung-Yeon; Lee, Kwang-Beom; Lee, Ji-Sung

    2013-01-01

    Placenta accreta during the first trimester of pregnancy is rare. Only a few cases of placenta accreta manifesting as a uterine mass have been published. Most patients with placenta accreta present with vaginal bleeding during or after pregnancy. This report describes a patient with placenta accreta that caused vaginal bleeding three years after a first trimester abortion. The patient had regular menstruation for three years after the abortion. Initially endometrial cancer or a uterine myoma ...

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

    International Nuclear Information System (INIS)

    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 (MVDFVIII) and CD105-positive angiogenesis (MVDCD105) at the indicated time points after UAE.ResultsQuantitative analysis revealed that MVDFVIII significantly decreased in the A1 (11.40 ± 2.76, p CD105-positive angiogenesis in the A1 group (9.33 ± 2.37, p 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

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

    OpenAIRE

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

    2008-01-01

    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...

  4. Analysis of 258 cases of uterine endometrial carcinoma in 18 years

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-12-01

    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)

  5. Atypical paracaval recurrence of uterine endometrial stromal sarcoma: a case report.

    Science.gov (United States)

    Bacalba?a, Nicolae; Balescu, Irina

    2015-06-01

    Endometrial stromal sarcomas are rare uterine malignancies with a high capacity for recurrence, even in cases diagnosed at an early stage of the disease. Recurrence is usually confined to the pelvic space but sometimes accelerated growth and extension into the upper abdomen can be found. In such cases, an aggressive surgical approach might be needed in order to provide complete resection of the recurrent tumor. We present the case of a 51-year-old patient who was diagnosed with an atypical spindle-shaped recurrence stretching from the pelvic floor to the right renal hilum along the inferior vena cava following total interadnexial hysterectomy for a presumed benign uterine tumor. An R0 resection of the recurrent tumor was performed and the histopathological study revealed the presence of a low-grade endometrial stromal sarcoma. PMID:26026102

  6. Correlation of bleeding pattern with endometrial histopathologic results in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Zehra Yilmaz

    2015-06-01

    Full Text Available Background: Abnormal Uterine Bleeding (AUB is referred as bleeding outside of normal menstruation pattern and it is the most common gynecological problem for women of all ages. This study was evaluated the correlation of menstrual bleeding patterns and endometrial histopathological findings in perimenopausal women. Methods: This study was done on perimenopausal aged women presented with AUB for the last 6 months at a gynecology clinic of a tertiary medical center. Only the patients with isolated endometrial causes of AUB were selected for study. A total of 313 cases were included in the study. Abnormal bleeding patterns of the patients were recorded and endometrial sampling was performed to all women. AUB was classified as menorrhagia, metrorrhagia, menometrorrhagia, polymenorrhea, intermenstrual bleeding, and histopathological findings were classified as Proliferative Endometrium (PE, Secretory Endometrium (SE, Disordered Proliferative Pattern (DPP, Endometrial Polyp (EP, Chronic Endometritis (CE, Endometrial Hyperplasia (EH, and Endometrial Adenocarcinoma (CA. Results: The most common bleeding pattern was menorrhagia (45.0% and the most common histopathological finding was PE+SE (52.0% in our study. PE+SE and endometrial hyperplasia without atypia were found more common in menorrhagia group. The most histopathological findings were found PE+SE in menometrorrhagia and polymenorrhea group (P 0.05. Conclusions: We concluded that although menometrorrhagia and polymenorrhea were significantly more associated with PE+SE, intermenstrual bleeding was significantly more associated with EP and CE. It is noteworthy that endometrial hyperplasia without atypia is significantly higher in patients with menorrhagia which is the most common abnormal bleeding pattern in perimenopausal aged women. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 547-550

  7. Low Grade Endometrial Stromal Sarcoma of Uterine: Review of 17 Cases

    Directory of Open Access Journals (Sweden)

    Nadereh Behtash

    2011-09-01

    Full Text Available "nEndometrial stromal sarcomas (ESS are the second most common uterine sarcomas. Endometrial stromal sarcomas account for 0.25% of all uterine malignancies. Uterine sarcomas most often affect postmenopausal women. The aim of this retrospective study was to review the experience in the treatment and clinical outcome of low grade malignant endometrial stromal sarcoma. Seventeen patients with histologically proven low grade ESS in department of Gynecologic Oncology of the Vali-e-Asr Hospital, Tehran-Iran, between 1999 and 2008 were included in the analysis. Demographics, pathology, treatment, time to recurrence, salvage therapy and survival information was collected. The median age of our patients was 45.35±6.8 (range 36-61. The median parity of the patients was 5 (range 0-8. Most patients were diagnosed at FIGO stage I. The mean survival for patients with stage I and II was 73.5±35.09 and 57.6±5.37 months, respectively, with mortality rate of 5.9% through a median follow-up time of 68.82±30 months. Of 17 patients, seven cases (35.29% were disease free at 6 years after hysterectomy. Radiotherapy was administered to four patients (23.53%. Only one patient recurred at 10th month after surgery. Surgeries not preserving ovarian function were helpful to decrease the risk of recurrence compared with those sparing ovarian function.

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

    Directory of Open Access Journals (Sweden)

    F Behnamfar

    2004-06-01

    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.

  9. Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Fakhar Shazia

    2008-01-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  11. Current approaches to the treatment of endometrial hyperplasia in women with uterine leiomyoma

    Directory of Open Access Journals (Sweden)

    Potapov V.A.

    2014-09-01

    Full Text Available The study involved 155 women, of which 30 healthy women were in the control group. 125 women with uterine leiomyomas and endometrial hyperplasia constituted the main groups. In all women with uterine leiomyoma myomectomy was performed. Further treatment included randomized study of a new regimen of GnRH agonists together with COCs after myomectomy using comparison techniques: monotherapy with a-GnRH, progestins (dydrogesterone or COCs. The treatment using different medication regimens of endometrial hyperplasia after myomectomy convincingly demonstrated significantly greater efficacy of GnRH-a and COCs com¬bination in reducing frequency of symptoms of these diseases, volume of menstrual blood loss and improvement quality of life through the entire observation period. Greater efficacy of COCs and a-GnRH combination, to our opinion, is associated with a greater degree of suppression of cell proliferation and angiogenesis as a result of local (COCs, and systemic effects (a-GnRH.Thus, the proposed method of adjuvant therapy after myomectomy for women with associated endometrial hyperplasia has significant clinical benefits with minimal impact on bone mineral density and other menopausal signs caused by a-GnRH monotherapy.

  12. Dasatinib, Paclitaxel, and Carboplatin in Treating Patients With Stage III-IV or Recurrent Endometrial Cancer

    Science.gov (United States)

    2015-10-28

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Mucinous Adenocarcinoma; Endometrial Serous Adenocarcinoma; Endometrial Undifferentiated Carcinoma; Endometrioid Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  13. Radiation Therapy With or Without Cisplatin in Treating Patients With Recurrent Endometrial Cancer

    Science.gov (United States)

    2015-07-13

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma

  14. Sunitinib Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer

    Science.gov (United States)

    2015-08-05

    Endometrial Adenocarcinoma; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage IVA Uterine Corpus Cancer; Stage IVA Uterine Sarcoma; Stage IVB Uterine Corpus Cancer; Stage IVB Uterine Sarcoma; Uterine Carcinosarcoma

  15. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years

    DEFF Research Database (Denmark)

    Dreisler, E; Stampe Sorensen, S; Ibsen, P H; Lose, G

    2009-01-01

    OBJECTIVE: To estimate the prevalence of endometrial polyps and to investigate associated abnormal uterine bleeding in a Danish population aged 20-74 years. METHODS: This was a study of a random selection of women from the Danish Civil Registration System: 1660 women were invited of whom 686 were included (429 pre- and 257 postmenopausal). AUB was assessed by a validated questionnaire. The women underwent transvaginal sonography (TVS) and saline contrast sonohysterography (SCSH). Hysteroscopic r...

  16. Pulmonary embolus arising from sloughed off myoma in late puerperium

    Directory of Open Access Journals (Sweden)

    Ahmet Mete Ergeno?lu

    2010-09-01

    Full Text Available Pulmonary embolus is a rare and serious complication of myoma uteri in the puerperium that resulted in late postpartum hysterectomyA 38-year-old, multiparous woman with a large myoma located on the left lateral wall of the uterus underwent emergency cesarean section due to fetal distres at 28 weeks. During the operation, a 15 cm sized intramural myoma was left without any intervention. On the 40th day postpartum the patient returned to the clinic with sepsis and pulmonary embolus because of obstruction of lochia drainage by the sloughed off myoma. The patient underwent hysterectomy and medical therapy for pulmonary embolus.We presented an unusual complication of uterine leiomyoma in the late postpartum period after cesarean section. Whatever the mode of sloughing off ofthe myoma, the results of the obstruction of lochia drainage may be devastating as in our case. To avoid these complications, clinicians must be aware of these symptoms and prompt intervention is essential.

  17. Pulmonary embolus arising from sloughed off myoma in late puerperium.

    Science.gov (United States)

    Ergeno?lu, Ahmet Mete; Yeniel, Ahmet Özgür; Uluku?, Murat; A?kar, Niyazi

    2010-01-01

    Pulmonary embolus is a rare and serious complication of myoma uteri in the puerperium that resulted in late postpartum hysterectomy A 38-year-old, multiparous woman with a large myoma located on the left lateral wall of the uterus underwent emergency cesarean section due to fetal distres at 28 weeks. During the operation, a 15 cm sized intramural myoma was left without any intervention. On the 40(th) day postpartum the patient returned to the clinic with sepsis and pulmonary embolus because of obstruction of lochia drainage by the sloughed off myoma. The patient underwent hysterectomy and medical therapy for pulmonary embolus. We presented an unusual complication of uterine leiomyoma in the late postpartum period after cesarean section. Whatever the mode of sloughing off of the myoma, the results of the obstruction of lochia drainage may be devastating as in our case. To avoid these complications, clinicians must be aware of these symptoms and prompt intervention is essential. PMID:24591925

  18. Cystic adenomyosis spreading into subserosal-peduncolated myoma: How to explain it?

    Directory of Open Access Journals (Sweden)

    Gloria Calagna

    2015-01-01

    Conclusions: In this case, the peculiar growth pattern of cystic adenomyosis in a myoma represents a singular condition rarely reported in the medical literature. We therefore support the pathogenetic theory that the disease might have been caused by direct proliferation of endometrial cells within a peduncolated- subserosal myoma.

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

    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.

  1. What Are the Key Statistics about Endometrial Cancer?

    Science.gov (United States)

    ... endometrial cancer? What are the key statistics about endometrial cancer? In the United States, cancer of the endometrium ... of the uterine body. These estimates include both endometrial cancers and uterine sarcomas. Up to 8% of uterine ...

  2. An Incidentally Found Inflamed Uterine Myoma Causing Low Abdominal Pain, Using Tc-99m-Tektrotyd Single Photon Emission Computed Tomography-CT Hybrid Imaging

    OpenAIRE

    Zandieh, Shahin; Schütz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg

    2013-01-01

    We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated ch...

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

    Directory of Open Access Journals (Sweden)

    Pajovi? Snežana B

    2009-12-01

    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.

  4. Endometrial blood flow measured by xenon 133 clearance in women with normal menstrual cycles and dysfunctional uterine bleeding

    International Nuclear Information System (INIS)

    Endometrial blood flow was measured through the menstrual cycle in nonpregnant women (28 studies of 17 women with normal menstrual cycles and 32 studies of 20 women with dysfunctional uterine bleeding) with use of a clearance technique in which 100 to 400 microCi of the gamma-emitting isotope, xenon 133 in saline solution was instilled into the uterine cavity. The mean (+/- SEM) endometrial blood flow in normal cycles was 27.7 +/- 2.6 ml/100 gm/min, with a significant elevation in the middle to late follicular phase, followed by a substantial fall and a secondary slow luteal phase rise that was maintained until the onset of menstruation. There was a significant correlation between plasma estradiol levels and endometrial blood flow in the follicular but not the luteal phase. Blood flow patterns in women with ovulatory dysfunctional bleeding were similar to normal, except for a significantly lower middle follicular rate. Women with anovulatory dysfunctional bleeding exhibited exceedingly variable flow rates

  5. Primary endometrial uterine Burkitt lymphoma in a 65-year-old woman.

    Science.gov (United States)

    Mackenzie, Elliot; Towns, Cindy; Tiong, Ing Soo; Petrich, Simone

    2015-08-01

    •Primary Burkitt lymphoma of the uterus is a rare disease.•Differential of postmenopausal bleeding and night sweats should include lymphoma.•Outpatient endometrial sampling expedites diagnosis of endometrial malignancy. PMID:26425716

  6. What Is Uterine Sarcoma?

    Science.gov (United States)

    ... key statistics about uterine sarcoma? What is uterine sarcoma? Uterine sarcoma is a cancer of the muscle ... type of cell they developed from: Endometrial stromal sarcomas develop in the supporting connective tissue ( stroma ) of ...

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

    Directory of Open Access Journals (Sweden)

    Biljana Djordjevic

    2008-04-01

    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.

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

    OpenAIRE

    F Behnamfar; T. Khamehchian; T. Mazoochi; T Fahiminejad

    2004-01-01

    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 postmenop...

  9. Hysteroscopic findings in postmenopausal patients with ultrasonographic diagnosis of endometrial thickening

    Directory of Open Access Journals (Sweden)

    Hosana Karinne de Marathaoan Souza Martins e Castello Branco

    2008-09-01

    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.

  10. Histological correlation of pipelle endometrial sampling with dilatation and curettage in abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Lavanya Rachamallu

    2015-10-01

    Conclusions: Hence pipelle aspiration biopsy is an alternative to traditional D and C in diagnosing endometrial pathology which is safer and quick. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1324-1329

  11. Temsirolimus With or Without Megestrol Acetate and Tamoxifen Citrate in Treating Patients With Advanced, Persistent, or Recurrent Endometrial Cancer

    Science.gov (United States)

    2015-07-28

    Endometrial Carcinoma; Recurrent Uterine Corpus Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC1 Uterine Corpus Cancer; Stage IIIC2 Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  12. Comparison of levonorgestrel-releasing intrauterine device with oral progestins in heavy menstrual bleeding (HMB) cases with uterine leiomyoma (LNG-IUD and oral progestin usage in myoma uteri)

    OpenAIRE

    Tosun, Ayse Kavasoglu; Tosun, Ismet; Suer, Necdet

    2014-01-01

    Objective: To compare the effectiveness and acceptability of LNG-IUD with oral progesterone (norethisterone acetate; NETA) in achieving a reduction in volume of the myomas, hemoglobin levels, satisfaction of the women.

  13. Uterine Cancer

    Science.gov (United States)

    ... is pregnant. There are different types of uterine cancer. The most common type starts in the endometrium, the lining of the uterus. This type of cancer is sometimes called endometrial cancer. The symptoms of ...

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

    Directory of Open Access Journals (Sweden)

    Suna Kabil Kucur

    2013-01-01

    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

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

    International Nuclear Information System (INIS)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  17. Impact of myomas on the results of transcervical resection of the endometrium

    DEFF Research Database (Denmark)

    Christoffersen, Christian P. V.; Kahr, Henriette StrØm

    2014-01-01

    STUDY OBJECTIVE: To investigate long-term hysterectomy rates after transcervical resection of the endometrium (TCRE) performed by experienced surgeons in the presence and absence of intracavitary myomas. DESIGN: Multicenter case-control study (Canadian Task Force classification II-2). PATIENTS: The study group comprised 456 women with myomas who met the inclusion criteria, and of these, 82 (17.98%) later underwent hysterectomy. The control group comprised 1438 women without myomas, and of these, 284 (19.75%) later underwent hysterectomy. METHODS: From 2001 to 2004, standardized results were extracted from Hyskobase on the basis of a total of 1894 women aged 23 to 59 years. The women were identified as having or not having myomas, and data from both groups were statistically analyzed. Detailed information on myoma size and intramural involvement (type 0, 1, and 2) was collected. MEASUREMENTS AND MAIN RESULTS: After TCRE, women with type 2 myomas, compared with those with type 0 myomas, were found to have asignificantly higher risk of undergoing hysterectomy (p = .04), and women, including controls, with myomas >3.6 cm in greatest diameter were found to have a significantly higher risk of undergoing hysterectomy than were those with smaller myomas (p = .01). There was no statistically significant difference in risk of hysterectomy between type 0 and type 1 myomas or between type 1 and type 2 myomas. When hysterectomy rates between the myoma and control groups were compared, there was an increased risk of hysterectomy in the control group (p = .008). Multiple-step multivariate regression analysis of uterine and procedural characteristics of TCRE demonstrated that factors that were positive predictors of hysterectomy within 66 months after resection were younger age, inaccessible uterine corners, enlarged uterus, and pretreatment using gonadotropin-releasing hormone agonists. CONCLUSION: When performing TCRE in women with intracavitary myomas, the chance of treatment success is worsened if they are of type 2 ortheir diameter is >3.5 cm. In addition, younger age increases the risk of hysterectomy and the need for pretreatment with gonadotropin-releasing hormone agonists, or if the uterus is enlarged or the uterine corners are difficult to access during the procedure.

  18. Paclitaxel, Carboplatin, and Bevacizumab or Paclitaxel, Carboplatin, and Temsirolimus or Ixabepilone, Carboplatin, and Bevacizumab in Treating Patients With Stage III, Stage IV, or Recurrent Endometrial Cancer

    Science.gov (United States)

    2015-11-26

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  19. Diffusion-weighted magnetic resonance imaging to detect synchronous uterine endometrial and endocervical adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Filomena Marino Carvalho

    2012-01-01

    Full Text Available Synchronous endometrial and cervical cancer is a very rare condition. This report describes a case of a 46-year-old woman who presented with a cervical mass that measured 5.6 cm along its longest diameter, whose biopsy analysis revealed an endocervical mucinous adenocarcinoma. She was classified as having an IB2 cervical carcinoma and treated with concurrent chemoradiation plus hysterectomy. Pathological and immunohistochemical analysis of the surgical specimens revealed a synchronous endometrioid grade 2 adenocarcinoma in the endometrium, and a well-differentiated mucinous adenocarcinoma in the cervix. Magnetic resonance imaging (MRI studies performed prior to treatment were reviewed and apparent diffusion coefficient (ADC maps were generated. The ADC values demonstrated distinct signal intensity differences between the endometrial and endocervical tumors. In conclusion, diffusion-weighted MRI and ADC maps can help to distinguish the site of origin of synchronous tumors.

  20. Office hysteroscopy, transvaginal ultrasound and endometrial histology: a comparison in infertile patients

    Directory of Open Access Journals (Sweden)

    Devleta Bali?

    2011-05-01

    Full Text Available Objective. To evaluate accuracy of transvaginal sonography (TVS and hysteroscopy in detection of intrauterine pathology in infertile women. Subjects and methods. This retrospective study was conducted in 56 infertile women with abnormal transvaginal ultrasound findings of the uterine cavity which was performed during the midfollicular phase as a part of routine infertility workup. Hysteroscopy was performed between 6th and 10th day of cycle. Results. The mean age of the subjects was 31.9±4.0. The most frequent ultrasound finding was endometrial polyp in 34 (60.7% patients, septate uterus in 8 (14.3% patients, submucosal myoma in 7 (12.5% patients, endometrial hyperplasia in 5 (8.9% patients and Syndroma Ascherman in 2 (3.6% patients. Hysteroscopy confirmed 20 (35.7% polyps, the same number of myomas, septate uterus and Syndroma Ascherman as detected by ultrasound, (7 (12.5%, 8 (14.3% and 2 (3.6%, respectively and 19 (33.9% endometrial hyperplasia. In 46 women with histological excamination, the sensitivity of TVS and hysteroscopy in the diagnosis of endometrial polyps were identical - 100%, while the specificity was higher in hysteroscopy than in TVS (92.3% versus 56.4%, p<0.001. The sensitivity of TVS in the diagnosis of endometrial hyperplasia was higher than that of hysteroscopy (86.4% versus 22.7%, p<0.001, while specificity was identical, of 100%. Accordance between hysteroscopy and histology was good (k=0.79, between ultrasound and histology was moderete (k=0.59. Conclusion. Hysteroscopy appeared to be more reliable in diagnosis than TVS. The use of a high frequency ultrasound probe leads us to a lack of diagnostic clarity between endometrial polyps and hyperplasia.

  1. 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.

  2. 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)

    Angélica Lemos Debs, Diniz; Elmar Gonzaga, Gonçalves.

    2000-06-01

    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 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.

  3. 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

    Directory of Open Access Journals (Sweden)

    Angélica Lemos Debs Diniz

    2000-06-01

    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.

  4. 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

  5. Progestins Upregulate FKBP51 Expression in Human Endometrial Stromal Cells to Induce Functional Progesterone and Glucocorticoid Withdrawal: Implications for Contraceptive- Associated Abnormal Uterine Bleeding

    Science.gov (United States)

    Guzeloglu Kayisli, Ozlem; Kayisli, Umit A.; Basar, Murat; Semerci, Nihan; Schatz, Frederick; Lockwood, Charles J.

    2015-01-01

    Use of long-acting progestin only contraceptives (LAPCs) offers a discrete and highly effective family planning method. Abnormal uterine bleeding (AUB) is the major side effect of, and cause for, discontinuation of LAPCs. The endometria of LAPC-treated women display abnormally enlarged, fragile blood vessels, decreased endometrial blood flow and oxidative stress. To understanding to mechanisms underlying AUB, we propose to identify LAPC-modulated unique gene cluster(s) in human endometrial stromal cells (HESCs). Protein and RNA isolated from cultured HESCs treated 7 days with estradiol (E2) or E2+ medroxyprogesterone acetate (MPA) or E2+ etonogestrel (ETO) or E2+ progesterone (P4) were analyzed by quantitative Real-time (q)-PCR and immunoblotting. HSCORES were determined for immunostained-paired endometria of pre-and 3 months post-Depot MPA (DMPA) treated women and ovariectomized guinea pigs (GPs) treated with placebo or E2 or MPA or E2+MPA for 21 days. In HESCs, whole genome analysis identified a 67 gene group regulated by all three progestins, whereas a 235 gene group was regulated by E2+ETO and E2+MPA, but not E2+P4. Ingenuity pathway analysis identified glucocorticoid receptor (GR) activation as one of upstream regulators of the 235 MPA and ETO-specific genes. Among these, microarray results demonstrated significant enhancement of FKBP51, a repressor of PR/GR transcriptional activity, by both MPA and ETO. q-PCR and immunoblot analysis confirmed the microarray results. In endometria of post-DMPA versus pre-DMPA administered women, FKBP51 expression was significantly increased in endometrial stromal and glandular cells. In GPs, E2+MPA or MPA significantly increased FKBP51 immunoreactivity in endometrial stromal and glandular cells versus placebo- and E2-administered groups. MPA or ETO administration activates GR signaling and increases endometrial FKBP51 expression, which could be one of the mechanisms causing AUB by inhibiting PR and GR-mediated transcription. The resultant PR and/or GR-mediated functional withdrawal may contribute to associated endometrial inflammation, aberrant angiogenesis, and bleeding. PMID:26436918

  6. [Uterine sarcoma. Case report].

    Science.gov (United States)

    Mortara Gómez, Agueda Sofía; González Blanco, Rafael; Arias Loza, Rosa; Sangines Martínez, Augusto; Moreno Lara, Héctor José Manuel; Zertuche Zuani, José Gerardo

    2012-03-01

    55 years female patient who is sent to the New Hospital Durango management fibroids and anemia, why not start the study protocol for hysterectomy, preoperative presenting within normal parameters, transvaginal ultrasound uterine fibroids and endometrial hyperplasia, biopsy endometrium with endometrial hyperplasia without atypia simple, and is scheduled for total abdominal hysterectomy with bilateral salpingo-oophorectomy. Surgical procedure is performed with the incident of tearing the uterine body on the right side with extension to the neck and externalization of endometrial tissue, the event is completed without complications. Histopathologic endometrial stromal sarcoma of high grade. Management in a row by the oncology department by 25 sessions of radio and brachytherapy. PMID:22812179

  7. Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer

    Science.gov (United States)

    2014-12-23

    Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer

  8. Role of transvaginal sonography and hysteroscopy in abnormal uterine bleeding: does the diagnostic yield increase by combining transvaginal sonography, hysteroscopy and biopsy?

    Directory of Open Access Journals (Sweden)

    Nivedita Krishnamoorthy

    2014-08-01

    Methods: This was a descriptive cross sectional study between January 2013 to June2014 in Sri Manakula Vinayagar medical college and hospital. After obtaining ethics committee approval, 100 consecutive patients with abnormal uterine bleeding between the age group of 35 and 55 years, who consented to participate in the study, were subjected to transvaginal sonography followed by diagnostic hysteroscopy combined with a directed biopsy. TVS and hysteroscopy was performed by two different investigators. The endometrial curettings and any intracavitary lesion were subjected to histopathological examination. Results tabulated and analysed using MS EXCEL and cross tabulation using Epi-info. Sensitivity, specificity, PPV, NPV for each pathology by TVS and hysteroscopy with HPE as the gold standard was calculated. Also the pathology causing abnormal uterine bleeding was computed by taking into account the endometrial characteristics and the associated lesions diagnosed by TVS, hysteroscopy and histopathological examination report. Results: 61 patients had only single lesions in the form of normal endometrium, atrophic endometrium, endometrial hyperplasia, endometrial polyp, malignancy and IU synechiae whereas 39 patients had lesions like intramural fibroids, adenomyosis, submucus myoma and polyps associated with different types of endometrium. The diagnostic accuracy of TVS and hysteroscopy were comparable for normal endometrium whereas hysteroscopy was found to be more accurate for endometrial polyps, endometrial hyperplasia and atrophic endometrium. Conclusions: The combination of transvaginal sonography, hysteroscopy and directed biopsy was found to increase the diagnostic yield in patients with abnormal uterine bleeding. As the diagnostic accuracy increased by combining the three modalities, an effective and appropriate management can be planned. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 919-923

  9. Cystic adenomyosis spreading into subserosal-peduncolated myoma: How to explain it?

    Science.gov (United States)

    Calagna, Gloria; Cucinella, Gaspare; Tonni, Gabriele; Gregorio, Roberto De; Triolo, Onofrio; Martorana, Anna; Perino, Antonino; Granese, Roberta

    2015-01-01

    Introduction Cystic adenomyosis is a rare variant of adenomyosis characterized by well- circumscribed cavitated endometrial gland and stroma located within the myometrium. The cysts usually measure ? 1 cm in diameter, contain a “chocolate-colored” fluid and do not open into the overlaying endometrium. Case presentation We present a case of a peduncolated-subserosal cystic adenomyoma, namely cystic adenomyosis, correlated with pelvic MR imaging, laparoscopic surgery technique and histopathology findings. Conclusions In this case, the peculiar growth pattern of cystic adenomyosis in a myoma represents a singular condition rarely reported in the medical literature. We therefore support the pathogenetic theory that the disease might have been caused by direct proliferation of endometrial cells within a peduncolated- subserosal myoma. PMID:25617727

  10. 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

    Directory of Open Access Journals (Sweden)

    Rabe T

    2013-01-01

    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.

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

    Scientific Electronic Library Online (English)

    Benito Pio Vitório, Ceccato Júnior; Victor Hugo de, Melo; José Benedito de, Lira Neto.

    2002-09-01

    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 uter [...] ina 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. Abstract in english 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 endova

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

    Directory of Open Access Journals (Sweden)

    Benito Pio Vitório Ceccato Júnior

    2002-09-01

    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

  13. Endometrial stromal sarcoma of uterus.

    Science.gov (United States)

    Xue, Wei-Cheng; Cheung, Annie N Y

    2011-12-01

    Endometrial stromal sarcomas are the second most common uterine sarcomas. Currently, they are classified into low-grade endometrial stromal sarcomas and undifferentiated endometrial sarcoma. Low-grade endometrial stromal sarcomas are biologically low-grade uterine sarcomas, and typically composed of uniform cells intimately associated with prominent arterioles, resembling the endometrial stroma in proliferative phase. There is usually little cytological atypia or pleomorphism, and mitoses are scanty. In contrast, undifferentiated endometrial sarcomas are frankly malignant, lack specific differentiation and any features of normal endometrial stroma. It is a highly aggressive neoplasm, often exhibiting myometrial invasion, haemorrhage and necrosis, as well as marked nuclear pleomorphism and high mitotic activity. The diagnosis of undifferentiated endometrial sarcoma is reached after excluding other uterine tumours with a sarcomatous component, such as adenosarcoma and malignant mixed Müllerian tumour. Histological variants of endometrial stromal sarcomas, including the so called 'high-grade endometrial stroma sarcomas' are addressed. The problems with histologic diagnosis and application of immunohistochemical studies and molecular pathology are highlighted. PMID:21820965

  14. Enzymes of the AKR1B and AKR1C subfamilies and uterine diseases

    Directory of Open Access Journals (Sweden)

    TeaLanisnik Rizner

    2012-03-01

    Full Text Available Endometrial and cervical cancers, uterine myoma, and endometriosis are very common uterine diseases. Worldwide, more than 800,000 women are affected annually by gynecological cancers, as a result of which, more than 360,000 die. During their reproductive age, about 70% of women develop uterine myomas, 10% to 15% suffer from endometriosis, and 35% to 50% from infertility associated with endometriosis. Uterine diseases are associated with aberrant inflammatory responses and concomitant increased production of prostaglandins (PG. They are also related to decreased differentiation, due to low levels of protective progesterone and retinoic acid, and to enhanced proliferation, due to high local concentrations of estrogens. The pathogenesis of these diseases can thus be attributed to disturbed PG, estrogen and retinoid metabolism and actions. Five human members of the aldo-keto reductase 1B (AKR1B and 1C (AKR1C superfamilies, i.e., AKR1B1, AKR1B10, AKR1C1, AKR1C2 and AKR1C3, have roles in these processes and can thus be implicated in uterine diseases. AKR1B1 and AKR1C3 catalyze the formation of PGF2alpha which stimulates cell proliferation. AKR1C3 converts PGD2 to 9alpha,11beta-PGF2, and thus counteracts the formation of 15deoxy-PGJ2, which can activate pro-apoptotic peroxisome-proliferator-activated receptor beta. AKR1B10 catalyzes the reduction of retinal to retinol, and in thus lessens the formation of retinoic acid, with potential pro-differentiating actions. The AKR1C1-AKR1C3 enzymes also act as 17-keto- and 20-ketosteroid reductases to varying extents, and are implicated in increased estradiol and decreased progesterone levels. This review comprises a short introduction to uterine diseases, followed by an overview of the current literature on the AKR1B and AKR1C expression in the uterus and in uterine diseases. The potential implications of the AKR1B and AKR1C enzymes and their pathophysiologies are then discussed, followed by conclusions and future perspectives.

  15. Non-puerperal uterine inversion: a case report

    Directory of Open Access Journals (Sweden)

    Anitha G.S.

    2015-08-01

    The aim was to highlight a rare condition of chronic non-puerperal uterine inversion following the extrusion of a benign fundally located submucous uterine myoma. A high index of suspicion is required to make a prompt diagnosis. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1223-1226

  16. 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)

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

    DEFF Research Database (Denmark)

    Dueholm, M; Forman, Axel

    2001-01-01

    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.

  18. Uterine neoplasms, version 1.2014.

    Science.gov (United States)

    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

    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

  19. [Stage I endometrial carcinoma].

    Science.gov (United States)

    Peignaux, K; Truc, G; Blanchard, N; Créhange, G; Maingon, P

    2008-11-01

    Most endometrial cancers are diagnosed at stage I (disease limited to the uterine corpus). The definitive treatment for endometrial carcinoma consists in total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy. The decision of adjuvant treatment depends on risk factors. Postoperative radiotherapy plays a major role in the management of stage I endometrial cancer but the respective place of external radiotherapy and vaginal brachytherapy remains controversial. Adjuvant external beam radiotherapy reduces locoregional recurrences, but carries a risk of toxicity without overall survival benefits. Recent data suggest that vaginal brachytherapy is effective in preventing vaginal recurrence with lower toxicity and should be the treatment of choice for intermediate risk endometrial cancer. PMID:18706845

  20. Miomatosis uterina e infertilidad: ¿qué evidencias tenemos como causa y como tratamiento? Uterine fibroids and infertility: what evidence do we have regarding cause and treatment?

    Directory of Open Access Journals (Sweden)

    Luis Ernesto Pérez

    2008-12-01

    Full Text Available Objetivos: revisar las evidencias actuales que determinen el impacto de la miomatosis uterina en la infertilidad, así como la seguridad y la eficacia de las diferentes formas de tratamiento quirúrgico conservador. Metodología: revisión sistemática cualitativa, consultando las fuentes de datos de Cochrane (Menstrual Disorders and subfertility, Medline (PubMed -MeSH, y de OVID (EBM; desde 1995 a 2008. Resultados: muchos estudios observacionales han sugerido que los miomas causantes de infertilidad son todos los submucosos, los intramurales mayores de 5 cm que alteren la cavidad uterina y también los subserosos cuya cantidad y tamaño distorsionen la fisiología reproductiva. Pero no hay estudios aleatorizados controlados (RCTs que soporten estas afirmaciones. En la actualidad, las miomectomías constituyen la mejor forma de tratamiento para pacientes infértiles. Por histeroscopia se deben resecar miomas submucosos menores de 5 cm, tipos 0 y I; por laparoscopia miomas intramurales o subserosos menores de 10 cm y no más de 5 miomas; finalmente, por laparotomía es posible resecar todo tipo de miomas, independientemente de su localización, tamaño y número. No hay RCTs que comparen la histeroscopia con otras técnicas de miomectomías; pero sí los hay mostrando que las indicaciones para laparotomía y laparoscopia son igualmente efectivas en resultados reproductivos. Conclusión: hay evidencias limitadas soportando la miomatosis como causante de infertilidad, y las miomectomías por histeroscopia respecto a otros tratamientos conservadores. Sin embargo, hay RCTs que muestran iguales resultados reproductivos al realizar miomatomías intramurales o subserosas por laparoscopia y por laparotomía en pacientes seleccionadas.Objectives: reviewing the evidence to determine the impact of fibroids on infertility and different types of conservative surgical treatment’s efficacy and safety. Methodology: the Cochrane Menstrual Disorders and Sub-fertility Review Group specialized register of controlled trials, MEDLINE (PUBMED-MeSH, and OVID (EBM were searched from 1995 to 2008 for carrying out a qualitative systematic review. Main results: many observational, retrospective studies have suggested that all infertility-producing myomas are submucosal, intramural myomas bigger than 5 cm thereby altering the endometrial cavity and subserosal myomas whose size distorts reproductive physiology; however, no randomised controlled trials (RCT were found to support such affirmations. Submucosal myomas must be removed by hysteroscopy (with the exception of myomas bigger than 5 cm or type II; however, no RCTs were found comparing hysteroscopic treatment with other types of treatment. Intramural and subserosal myomas must be removed by laparoscopy or laparotomy (depending on their localisation and size supported by RCTs showing that there are no outcome differences in terms of reproductive results. Conclusions: there is limited evidence for suggesting the impact of uterine myomas on infertility and the removal of submucosal myomas by hysteroscopy. Some RCTs show no differences in fertility efficacy outcome if intramural or subserosal myomas are removed via laparotomy or laparoscopy.

  1. Miomatosis uterina e infertilidad: ¿qué evidencias tenemos como causa y como tratamiento? / Uterine fibroids and infertility: what evidence do we have regarding cause and treatment?

    Scientific Electronic Library Online (English)

    Luis Ernesto, Pérez; Ivonne, Díaz; Luis, Ospina.

    2008-12-01

    Full Text Available Objetivos: revisar las evidencias actuales que determinen el impacto de la miomatosis uterina en la infertilidad, así como la seguridad y la eficacia de las diferentes formas de tratamiento quirúrgico conservador. Metodología: revisión sistemática cualitativa, consultando las fuentes de datos de Coc [...] hrane (Menstrual Disorders and subfertility), Medline (PubMed -MeSH), y de OVID (EBM); desde 1995 a 2008. Resultados: muchos estudios observacionales han sugerido que los miomas causantes de infertilidad son todos los submucosos, los intramurales mayores de 5 cm que alteren la cavidad uterina y también los subserosos cuya cantidad y tamaño distorsionen la fisiología reproductiva. Pero no hay estudios aleatorizados controlados (RCTs) que soporten estas afirmaciones. En la actualidad, las miomectomías constituyen la mejor forma de tratamiento para pacientes infértiles. Por histeroscopia se deben resecar miomas submucosos menores de 5 cm, tipos 0 y I; por laparoscopia miomas intramurales o subserosos menores de 10 cm y no más de 5 miomas; finalmente, por laparotomía es posible resecar todo tipo de miomas, independientemente de su localización, tamaño y número. No hay RCTs que comparen la histeroscopia con otras técnicas de miomectomías; pero sí los hay mostrando que las indicaciones para laparotomía y laparoscopia son igualmente efectivas en resultados reproductivos. Conclusión: hay evidencias limitadas soportando la miomatosis como causante de infertilidad, y las miomectomías por histeroscopia respecto a otros tratamientos conservadores. Sin embargo, hay RCTs que muestran iguales resultados reproductivos al realizar miomatomías intramurales o subserosas por laparoscopia y por laparotomía en pacientes seleccionadas. Abstract in english Objectives: reviewing the evidence to determine the impact of fibroids on infertility and different types of conservative surgical treatment’s efficacy and safety. Methodology: the Cochrane Menstrual Disorders and Sub-fertility Review Group specialized register of controlled trials, MEDLINE (PUBMED- [...] MeSH), and OVID (EBM) were searched from 1995 to 2008 for carrying out a qualitative systematic review. Main results: many observational, retrospective studies have suggested that all infertility-producing myomas are submucosal, intramural myomas bigger than 5 cm thereby altering the endometrial cavity and subserosal myomas whose size distorts reproductive physiology; however, no randomised controlled trials (RCT) were found to support such affirmations. Submucosal myomas must be removed by hysteroscopy (with the exception of myomas bigger than 5 cm or type II); however, no RCTs were found comparing hysteroscopic treatment with other types of treatment. Intramural and subserosal myomas must be removed by laparoscopy or laparotomy (depending on their localisation and size) supported by RCTs showing that there are no outcome differences in terms of reproductive results. Conclusions: there is limited evidence for suggesting the impact of uterine myomas on infertility and the removal of submucosal myomas by hysteroscopy. Some RCTs show no differences in fertility efficacy outcome if intramural or subserosal myomas are removed via laparotomy or laparoscopy.

  2. 21 CFR 884.1100 - Endometrial brush.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Endometrial brush. 884.1100 Section 884.1100 Food and Drugs FOOD AND DRUG ADMINISTRATION...Pregnancy, history of uterine perforation, or a recent cesarean section, and (3) Design and testing: (i) The...

  3. 21 CFR 884.1060 - Endometrial aspirator.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Endometrial aspirator. 884.1060 Section 884.1060 Food and Drugs FOOD AND DRUG ADMINISTRATION...Pregnancy, history of uterine perforation, or a recent cesarean section, and (3) The sampling component is covered...

  4. Role of emmprin in endometrial cancer

    Directory of Open Access Journals (Sweden)

    Nakamura Keiichiro

    2012-05-01

    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.

  5. Uterine tumor resembling ovarian sex cord tumors treated by resectoscopic surgery.

    Science.gov (United States)

    Garuti, Giancarlo; Gonfiantini, Cristina; Mirra, Maurizio; Galli, Carlo; Luerti, Massimo

    2009-01-01

    Uterine tumors resembling ovarian sex cord tumors (UTROSCTs) are rare neoplasms of uncertain malignancy, affecting either pre or menopausal women. Only 48 cases of UTROSCTs have been reported and in most patients the diagnosis was made incidentally, after a hysterectomy as a result of the assumption of a leiomyoma. Although no death from progressive disease was reported, locoregional spread or abdominal relapse was detected in some patients. Up until now, a treatment sparing the uterus was reported in only 2 patients with UTROSCTs. Both patients conceived after surgery and were free from recurrent disease after a mean follow-up of 16.5 months. We report a third case of a young patient affected by pure UTROSCTs and treated conservatively. A 29-year-old woman underwent resectoscopic hysteroscopy because of the assumption of a grade-1 submucous myoma measuring about 5 cm. To accomplish the removal of the endometrial mass, a 2-step hysteroscopic resection was required. Histology showed epithelioid cells arranged in nests, cords, tubules, and trabeculae infiltrating the myometrium; no sarcoma cell differentiation was detected. Immunohistochemistry resulted in positivity to CD99, inhibin, calretinin, cytokeratin, and estrogen receptor, whereas a negative staining to epithelial membrane antigen, actin, desmin, and human melanoma black 45 was obtained. Based on histologic pattern and immunohistochemical phenotype, a diagnosis of pure UTROSCTs was made; the staging of disease revealed neither locoregional spread nor distant metastases. Two months after surgery, reassessment by hysteroscopy and endometrial biopsy revealed no residual endometrial disease. The patient was free from disease 13 months after surgery. Because of the uncertain malignant potential of UTROSCTs and based on the poor data available from current literature, a fertility-sparing surgery in young patients appears safe. However, a close long-term follow-up is required and a quick completion of a patient's childbearing desire seems advisable. PMID:19249718

  6. Sarcoma del estroma endometrial de grado alto / High degree endometrial stromal sarcoma

    Scientific Electronic Library Online (English)

    Mariuska, Forteza Sáez; Maylin América, Ramos Alfonso; Migdalia, Pérez Trejo; Dulvis Amanda, Almeida Arias; Danay, Corrales Otero.

    2014-09-01

    Full Text Available El sarcoma del estroma endometrial es un tumor infrecuente, que comprende menos del 1 % de los tumores malignos ginecológicos. Presentamos el caso de una adolescente de 16 años con hemorragia uterina anormal a la que se le realizó histerectomía subtotal. Microscópicamente, la neoplasia estaba consti [...] tuida por una proliferación maligna de células estromales del endometrio. El estudio inmuno-histoquímico mostró positividad para vimentina, desmina, CD10, CD117. El CD10 es un marcador inmuno-histoquímico del estroma endometrial normal y de los tumores del estroma endometrial, y es útil para el diagnóstico diferencial entre el sarcoma del estroma endometrial y el leiomioma celular o el leiomiosarcoma uterino. Las mejores opciones de tratamiento se obtienen con un enfoque multidisciplinario y en centros especializados. Abstract in english Endometrial stromal sarcoma is a rare tumor comprising less than 1 % of gynecological malignancies. We report the case of a 16 year-old adolescent with abnormal uterine bleeding who underwent hysterectomy subtotal. At microscopy the neoplasm was composed of malignant proliferation of endometrial str [...] omal cells. Immunohistochemical studies were positive for vimentin, desmin, CD10 and CD117. CD10 is an immunohistochemical marker of normal endometrial stroma and of endometrial stromal neoplasms. This marker is useful in the differential diagnosis of endometrial stromal sarcoma versus uterine cellular leiomyoma or uterine leiomyosarcoma. The best treatment options are obtained with a focus multidisciplinary, in specialized centers.

  7. Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

    Directory of Open Access Journals (Sweden)

    Adriana Bittencourt Campaner

    2004-02-01

    Full Text Available OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19% recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2. Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%; endométrio atrófico, em 15 (12,4%; sinéquia senil, em 15 (12,4%; espessamento focal, em 13 (10,7%; lesão cerebróide, em 6 (5,0%; endométrio proliferativo, em 5 (4,1%; muco, em 5 (4,1%; mioma, em 4 (3,3%; endométrio secretor, em 3 (2,5%; hiperplasia endometrial, em 3 (2,5% e atrofia cística, em 1 (0,8%. Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina.PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2 was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%; atrophic endometrium in 15 patients (12.4%; senile synechia in 15 patients (12.4%, focal thickening in 13 patients (10.7%; cerebroid lesion in 6 patients (5.0%; proliferative endometrium in 5 patients (4.1%; mucus in 5 patients (4.1%; myoma in 4 patients (3.3%; secreting endometrium in 3 patients (2.5%; endometrial hyperplasia in 3 patients (2.5%; and cystic atrophy in 1 patient (0.8%. Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.

  8. Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal / Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

    Scientific Electronic Library Online (English)

    Adriana Bittencourt, Campaner; Sebastião, Piato; Paulo Ayrosa Galvão, Ribeiro; Tsutomo, Aoki; Ricardo da Fonseca, Nadais; Roberto Adelino de Almeida, Prado.

    2004-02-01

    Full Text Available OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por [...] ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19%) recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2). Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%); endométrio atrófico, em 15 (12,4%); sinéquia senil, em 15 (12,4%); espessamento focal, em 13 (10,7%); lesão cerebróide, em 6 (5,0%); endométrio proliferativo, em 5 (4,1%); muco, em 5 (4,1%); mioma, em 4 (3,3%); endométrio secretor, em 3 (2,5%); hiperplasia endometrial, em 3 (2,5%) e atrofia cística, em 1 (0,8%). Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina. Abstract in english PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonogra [...] phy. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2) was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%); atrophic endometrium in 15 patients (12.4%); senile synechia in 15 patients (12.4%), focal thickening in 13 patients (10.7%); cerebroid lesion in 6 patients (5.0%); proliferative endometrium in 5 patients (4.1%); mucus in 5 patients (4.1%); myoma in 4 patients (3.3%); secreting endometrium in 3 patients (2.5%); endometrial hyperplasia in 3 patients (2.5%); and cystic atrophy in 1 patient (0.8%). Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.

  9. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of); Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired.

  10. Comparative analysis between the cytobrush and low-volume uterine flush techniques for endometrial cytology in clinically normal postpartum crossbred dairy cowsComparação das técnicas de citologia endometrial escova citológica e lavado uterino de baixo volume no pós-parto de vacas leiteiras mestiças

    Directory of Open Access Journals (Sweden)

    João Paulo Elsen Saut

    2013-10-01

    Full Text Available This study compared two frequently employed techniques for the collection of endometrial and inflammatory cells and characterized postpartum endometrial cytology (EC of clinically normal postpartum crossbred dairy cows in dairy farming system in Southwestern Brazil. Thirty-four crossbred, clinically healthy dairy cows with normal delivery and puerperium, complete uterine involution and without any treatment were monitored until 42 days in milk (DIM. All cows were evaluated by complete clinical and gynecological examinations at days 0, 7, 14, 21, 28, and 42 DIM. The gynecological examinations were done by transrectal palpation, ultrasonography, vaginoscopy, evaluation of the vaginal mucus and EC by using the cytobrush (CB and low-volume uterine flush (LVF techniques. The agreement (Kappa statistic between the two technicians was good for CB (86% and LVF (80.3% for the counting of the percentage of neutrophils. The average number of neutrophils was significantly higher throughout the experiment for LVF, but a reduced percentage of neutrophils were observed during the postpartum period for both techniques. The amount of macrophages, lymphocytes, and eosinophils were not affected during postpartum and there was no significant difference relative to these cells when the two techniques were compared. There were significant differences in the percentage of cows with subclinical endometritis only at d28 by CB (22.2% and LVF (59.3%. Objetivou-se comparar duas técnicas frequentemente usadas na colheita de células endometriais e inflamatórias e caracterizar a citologia endometrial (CE de vacas leiteiras mestiças no pós-parto fisiológico, criadas em sistemas de fazendas leiteiras do sudoeste do Brasil. Foram utilizadas 34 vacas clinicamente sadias com parto e puerpério fisiológico, completa involução uterina e sem qualquer tratamento até os 42 dias pós-parto (dpp. Realizou-se o exame clínico e ginecológico no parto e aos 7, 14, 21, 28 e 42 dpp. O exame ginecológico foi executado pela palpação retal, ultrassonografia, vaginoscopia, avaliação de muco vaginal e CE realizada com escova citológica (CB ou por lavado uterino de baixo volume (LVF. A concordância (Kappa statistic entre os técnicos na contagem da porcentagem de neutrófilos foi boa para CB (86% e para LVF (80,3%. A média de neutrófilos foi maior em todos os momentos na técnica de LVF, porém a redução de neutrófilos foi observada durante o pós-parto nas duas técnicas de citologia. A contagem de macrófagos, linfócitos e eosinófilos não variou durante o pós-parto e não houve diferença entre as técnicas CB e LVF. Houve diferença apenas aos 28 dpp, na porcentagem de vacas com endometrite subclínica, entre as técnicas CB (22.2% e LVF (59.3%.

  11. Re-intervention after uterine leiomyoma embolisation is related to incomplete infarction and presence of submucous leiomyomas

    DEFF Research Database (Denmark)

    Dueholm, Margit; Langfeldt, Sten; Mafi, Hossain Mohit; Eriksen, Gitte; Marinovskij, Edward

    2014-01-01

    Objective To evaluate outcome of invasive gynecological re-interventions after uterine artery embolisation (UAE) in relation to leiomyoma characteristics. Design A cohort of 114 women with symptomatic myomas underwent UAE. Myoma characteristics were determined by contrast-enhanced magnetic resonance imaging (MRI) before and 6 months after treatment. The median follow-up time after UAE was 55.9 months; (range 20–116). Data on gynecological re-interventions were obtained for all patients and were ...

  12. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Directory of Open Access Journals (Sweden)

    Miller JD

    2015-01-01

    Full Text Available Jeffrey D Miller,1 Gregory M Lenhart,1 Machaon M Bonafede,1 Cindy M Basinski,2 Andrea S Lukes,3 Kathleen A Troeger4 1Truven Health Analytics, Cambridge, MA, 2Basinski, LLC, Newburgh, IN, 3Carolina Women’s Research and Wellness Center, Durham, NC, 4Hologic, Inc, Marlborough, MA, USA Objectives: Abnormal uterine bleeding (AUB interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods: A health state transition (semi-Markov model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results: Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial and $3,000 (Medicaid; cost savings versus hysterectomy were $6,500 (commercial and $8,900 (Medicaid. Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities, and 82%–91% fewer versus hysterectomy. Furthermore, NovaSure-treated patients had fewer days of work absence and short-term disability. Cost-effectiveness metrics showed NovaSure treatment as economically dominant over other GEA modalities in all circumstances. With few exceptions, similar results were shown for NovaSure treatment versus hysterectomy. Conclusion: Model results demonstrate strong financial favorability for NovaSure ablation versus other GEA modalities and hysterectomy from commercial and Medicaid payer perspectives. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. Keywords: NovaSure, abnormal uterine bleeding, menorrhagia, hysterectomy, global endometrial ablation, cost-effectiveness analysis

  13. Pulmonary embolus arising from sloughed off myoma in late puerperium

    OpenAIRE

    Ahmet Mete Ergeno?lu; Ahmet Özgür Yeniel; Murat Uluku?; Niyazi A?kar

    2010-01-01

    Pulmonary embolus is a rare and serious complication of myoma uteri in the puerperium that resulted in late postpartum hysterectomyA 38-year-old, multiparous woman with a large myoma located on the left lateral wall of the uterus underwent emergency cesarean section due to fetal distres at 28 weeks. During the operation, a 15 cm sized intramural myoma was left without any intervention. On the 40th day postpartum the patient returned to the clinic with sepsis and pulmonary embolus because o...

  14. Krüppel-Like Factor 13 Deficiency in Uterine Endometrial Cells Contributes to Defective Steroid Hormone Receptor Signaling but Not Lesion Establishment in a Mouse Model of Endometriosis.

    Science.gov (United States)

    Heard, Melissa E; Velarde, Michael C; Giudice, Linda C; Simmen, Frank A; Simmen, Rosalia C M

    2015-06-01

    Krüppel-like Factor (KLF) 13 and the closely related KLF9 are members of the Sp/KLF family of transcription factors that have collectively emerged as essential regulators of tissue development, differentiation, proliferation, and programmed cell death. Steroid hormone-responsive tissues express multiple KLFs that are linked to progesterone receptor (PGR) and estrogen receptor (ESR) actions either as integrators or as coregulators. Endometriosis is a chronic disease characterized by progesterone resistance and dysregulated estradiol signaling; nevertheless, distinct KLF members' contributions to endometriosis remain largely undefined. We previously demonstrated promotion of ectopic lesion establishment by Klf9 null endometrium in a mouse model of endometriosis. Here we evaluated whether KLF13 loss of expression in endometrial cells may equally contribute to lesion formation. KLF13 transcript levels were lower in the eutopic endometria of women with versus women without endometriosis at menstrual midsecretory phase. In wild-type (WT) mouse recipients intraperitoneally administered WT or Klf13 null endometrial fragments, lesion incidence did not differ with donor genotype. No differences were noted for lesion volume, number, proliferation status, and apoptotic index as well. Klf13 null lesions displayed reduced total PGR and ESR1 (RNA and immunoreactive protein) and altered expression of several PGR and ESR1 target genes, relative to WT lesions. Unlike for Klf9 null lesions, changes in transcript levels for PGR-A, ESR1, and Notch/Hedgehog-associated pathway components were not observed for Klf13 null lesions. Results demonstrate lack of a causative relationship between endometrial KLF13 deficiency and lesion establishment in mice, and they support the broader participation of multiple signaling pathways, besides those mediated by steroid receptors, in the pathology of endometriosis. PMID:25904015

  15. The treatment of uterine sarcomas.

    Science.gov (United States)

    Reichardt, P

    2012-09-01

    Uterine sarcomas are rare and comprise only 3% of all uterine cancers. Within the group of adult soft tissue sarcomas, they account for ?7% of new cases. They consist of several distinct histological subtypes like leiomyosarcoma, endometrial stromal tumors, undifferentiated sarcomas, pure heterologous sarcomas, and mixed epithelial and mesenchymal tumors. Standard treatment in localized disease is abdominal hysterectomy. Bilateral salpingo-oophorectomy and lymphadenectomy have no proven value in leiomyosarcomas and high-grade undifferentiated sarcomas. However, in endometrial stromal tumors, given the hormonal reponsiveness of most tumors, salpingo-oophorectomy is generally recommended. Carcinosarcomas are treated according to current recommendations for epithelial uterine cancers. In leiomyosarcomas, postoperative radiation does not improve both relapse-free and overall survival. adjuvant chemotherapy seems to improve survival in the context of uncontrolled phase II trials. However, it is currently not considered standard of care in the absence of data from randomized trials. In contrast, adjuvant chemotherapy does improve overall survival in carcinosarcomas and is therefore considered standard of care. Systemic therapy for advanced uterine leiomyosarcomas, undifferentiated uterine sarcomas, and heterologous sarcomas is generally following the recommendations for adult soft tissue sarcomas. Endometrial stromal sarcomas are usually hormonal receptor positive, which allows endocrine therapy in most cases. PMID:22987952

  16. Role of emmprin in endometrial cancer

    OpenAIRE

    Nakamura Keiichiro; Kodama Junichi; Hongo Atsushi; Hiramatsu Yuji

    2012-01-01

    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 imm...

  17. Endometrial stromal tumors: the new WHO classification.

    Science.gov (United States)

    Conklin, Christopher M J; Longacre, Teri A

    2014-11-01

    Endometrial stromal tumors are rare uterine mesenchymal neoplasms that have intrigued pathologists for years, not only because they commonly pose diagnostic dilemmas, but also because the classification and pathogenesis of these tumors has been widely debated. The current World Health Organization recognizes 4 categories of endometrial stromal tumor: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS). uterine sarcoma. These categories are defined by the presence of distinct translocations as well as tumor morphology and prognosis. Specifically, the JAZF1-SUZ12 (formerly JAZF1-JJAZ1) fusion identifies a large proportion of ESN and LG-ESSs, whereas the YWHAE-FAM22 translocation identifies HG-ESSs. The latter tumors appear to have a prognosis intermediate between LG-ESS and UUS, which exhibits no specific translocation pattern. This review (1) presents the clinicopathologic features of endometrial stromal tumors; (2) discusses their immunophenotype; and (3) highlights the recent advances in molecular genetics which explain their pathogenesis and lend support for a new classification system. PMID:25299308

  18. FDG PET/CT diagnostic criteria may need adjustment based on MRI to estimate the presurgical risk of extrapelvic infiltration in patients with uterine endometrial cancer

    International Nuclear Information System (INIS)

    The staging of endometrial cancer requires surgery which carries the risk of morbidity. FDG PET/CT combined with anatomical imaging may reduce the number of unnecessary lymphadenectomies by demonstrating the risk of extrapelvic infiltration. The purpose of this study was to optimize FDG PET/CT diagnostic criteria for risk assessment in endometrial cancer after first-line risk triage with MRI. The study population comprised 37 patients who underwent curative surgery for the treatment of endometrial cancer. First, the risk of extrapelvic infiltration was triaged using MRI. Second, multiple glucose metabolic profiles of the primary lesion were assessed with FDG PET/CT, and these were correlated with the histopathological risk of extrapelvic infiltration including lymphovascular space invasion (LVSI) and high-grade malignancy (grades 2 and 3). The results of histological correlation were used to adjust FDG PET/CT diagnostic criteria. Presurgical assessment using MRI was positive for deep (>50 %) myometrial invasion in 17 patients. The optimal FDG PET/CT diagnostic criteria vary depending on the results of MRI. Specifically, SUVmax (?16.0) was used to indicate LVSI risk with an overall diagnostic accuracy of 88.2 % in patients with MRI findings showing myometrial invasion. High-grade malignancy did not correlate with any of metabolic profiles in this patient group. In the remaining patients without myometrial invasion, lesion glycolysis (LG) or metabolic volume were better indicators of LVSI than SUVmax with the same diagnostic accuracy of 80.0 %. In addition, LG (?26.9) predicted high-grade malignancy with an accuracy of 72.2 %. Using the optimized cut-off criteria for LVSI, glucose metabolic profiling of primary lesions correctly predicted lymph node metastasis with an accuracy of 73.0 %, which was comparable with the accuracy of visual assessment for lymph node metastasis using MRI and FDG PET/CT. FDG PET/CT diagnostic criteria may need adjustment based on the anatomical information provided by MRI. The optimized criteria can predict the risk of pathology-proven LVSI correctly in 83.8 % of patients before surgery, and thus would improve presurgical treatment planning. (orig.)

  19. FDG PET/CT diagnostic criteria may need adjustment based on MRI to estimate the presurgical risk of extrapelvic infiltration in patients with uterine endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sudo, Satoko; Sakuragi, Noriaki [Hokkaido University Graduate School of Medicine, Department of Gynecology, Sapporo (Japan); Hattori, Naoya; Manabe, Osamu; Hirata, Kenji; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Kitaku, Sapporo (Japan); Kato, Fumi; Mimura, Rie; Magota, Keiichi; Sugimori, Hiroyuki [Hokkaido University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Sapporo (Japan)

    2015-04-01

    The staging of endometrial cancer requires surgery which carries the risk of morbidity. FDG PET/CT combined with anatomical imaging may reduce the number of unnecessary lymphadenectomies by demonstrating the risk of extrapelvic infiltration. The purpose of this study was to optimize FDG PET/CT diagnostic criteria for risk assessment in endometrial cancer after first-line risk triage with MRI. The study population comprised 37 patients who underwent curative surgery for the treatment of endometrial cancer. First, the risk of extrapelvic infiltration was triaged using MRI. Second, multiple glucose metabolic profiles of the primary lesion were assessed with FDG PET/CT, and these were correlated with the histopathological risk of extrapelvic infiltration including lymphovascular space invasion (LVSI) and high-grade malignancy (grades 2 and 3). The results of histological correlation were used to adjust FDG PET/CT diagnostic criteria. Presurgical assessment using MRI was positive for deep (>50 %) myometrial invasion in 17 patients. The optimal FDG PET/CT diagnostic criteria vary depending on the results of MRI. Specifically, SUVmax (?16.0) was used to indicate LVSI risk with an overall diagnostic accuracy of 88.2 % in patients with MRI findings showing myometrial invasion. High-grade malignancy did not correlate with any of metabolic profiles in this patient group. In the remaining patients without myometrial invasion, lesion glycolysis (LG) or metabolic volume were better indicators of LVSI than SUVmax with the same diagnostic accuracy of 80.0 %. In addition, LG (?26.9) predicted high-grade malignancy with an accuracy of 72.2 %. Using the optimized cut-off criteria for LVSI, glucose metabolic profiling of primary lesions correctly predicted lymph node metastasis with an accuracy of 73.0 %, which was comparable with the accuracy of visual assessment for lymph node metastasis using MRI and FDG PET/CT. FDG PET/CT diagnostic criteria may need adjustment based on the anatomical information provided by MRI. The optimized criteria can predict the risk of pathology-proven LVSI correctly in 83.8 % of patients before surgery, and thus would improve presurgical treatment planning. (orig.)

  20. Embolização das artérias uterinas com partículas de PVA-PVAC esférico como preparo para posterior ressecção cirúrgica de miomas / Uterine artery embolization with spherical pva-pvac particles as preparation for surgical resection of miyomas

    Scientific Electronic Library Online (English)

    Juraci, Ghiaroni; Gaudencio Espinosa, Lopez; Antonio Carlos, Coutinho Junior; Alberto, Schanaider.

    2013-10-01

    Full Text Available OBJETIVO: avaliar a utilização de uma nova partícula de polivinil álcool e polivinil acetato (PVA-PVAc) esférica, para embolização das artérias uterinas, em pacientes portadoras de mioma, com indicação cirúrgica. MÉTODOS: doze pacientes foram submetidas à embolização de miomas uterinos com partícula [...] s de PVA-PVAc. Três a nove meses depois, realizou-se uma laparotomia com miomectomia. Analisaram-se os seguintes parâmetros: volume do útero e do maior mioma; concentrações do hormônio folículo estimulante e de hemoglobina; sangramento menstrual (número de dias e de absorventes utilizados), sinais e sintomas antes do tratamento, após a embolização e após a miomectomia. RESULTADOS: a média de idade foi 37 anos e a média do volume uterino, previamente ao tratamento, de 939,3cc. Três anos após a embolização, observou-se diminuição do volume uterino (p=0,0005). Houve melhora na concentração de hemoglobina (p= 0,0004), com elevação após a embolização, sem variação subsequente à miomectomia. Não ocorreu variação significante do hormônio folículo estimulante, (p=0,17). Não foi constatado nenhum caso de falência ovariana, mas uma das pacientes apresentou atrofia de endométrio. Duas pacientes engravidaram, com bons indicadores obstétricos. Quanto aos sinais e sintomas, houve melhora após a embolização, que se manteve após a miomectomia. CONCLUSÃO: a embolização arterial com partículas de PVA-PVAc esférico mostrou-se promissora no preparo para uma intervenção cirúrgica com retirada dos miomas, pois, associou-se à redução do volume uterino, à diminuição do sangramento operatório e tornou possível a utilização de incisões menores, aumentando a chance de preservação do útero. Abstract in english OBJECTIVE: To evaluate the use of a new spherical particle of polyvinyl alcohol and polyvinyl acetate (PVA-PVAc) for uterine artery embolization in patients with myoma with surgical indication. METHODS: twelve patients underwent uterine myoma embolization with PVA-PVAc particles. Three to nine month [...] s later, they were submitted to laparotomy with myomectomy. We analyzed the following parameters: volume of the uterus and of the bigger myoma; concentrations of follicle stimulating hormone and hemoglobin; menstrual bleeding (number of days and used absorbents), signs and symptoms before treatment, after embolization and after myomectomy. RESULTS: The mean age was 37 years and mean uterine volume prior to treatment, 939.3 cc. Three years after embolization, there was reduction in uterine volume (p = 0.0005), increase in hemoglobin concentration after embolization (p = 0.0004), without variation after the myomectomy. There was no significant variation of the follicle stimulating hormone (p = 0.17). There was no case of ovarian failure, but one of the patients had endometrial atrophy. Two patients became pregnant, with good obstetric indicators. Signs and symptoms improved after embolization, and remained after myomectomy. CONCLUSION: Arterial embolization with spherical PVA-PVAc particles is promising in the preparation for myoma surgery, since it was associated with a reduction in uterine volume, decrease in intraoperative bleeding and made possible the use of smaller incisions, increasing the chance of preserving the uterus.

  1. 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

  2. 21 CFR 884.1185 - Endometrial washer.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Endometrial washer. 884.1185 Section 884.1185 Food and Drugs FOOD AND DRUG ADMINISTRATION...Pregnancy, history of uterine perforation, or a recent cesarean section, and (iii) Warning: Do not attach to a wall...

  3. Abnormal uterine bleeding: a clinicohistopathological analysis

    OpenAIRE

    Anupamasuresh Y; Suresh YV; Prachi Jain

    2014-01-01

    Background: Abnormal uterine bleeding (AUB) is one of the most common problem for the patients and the gynecologists. It adversely effects on the quality of life and psychology of women. It is of special concern in developing country as it adds to the causes of anemia. Management of Abnormal Uterine Bleeding (AUB) is not complete without tissue diagnosis especially in perimenopausal and post-menopausal women. Histological characteristics of endometrial biopsy material as assessed by light mic...

  4. What Is Endometrial Cancer?

    Science.gov (United States)

    ... the key statistics about endometrial cancer? What is endometrial cancer? Endometrial cancer starts in the endometrium, the inner ... grade cancers (grades 1 and 2). Type 1 endometrial cancers are thought to be caused by excess estrogen. ...

  5. Endometrial Cancer

    OpenAIRE

    AMANT, FRÉDÉRIC; Moerman, Philippe; Neven, Patrick; Timmerman, Dirk; van Limbergen, Erik; Vergote, Ignace

    2012-01-01

    Each year, endometrial cancer develops in about 142,000 women worldwide, and an estimated 42,000 women die from this cancer. The typical age-incidence curve for endometrial cancer shows that most cases are diagnosed after the menopause, with the highest incidence around the seventh decade of life. The appearance of symptoms early in the course explains why most women with endometrial cancer have early-stage disease at presentation. For all stages taken together, the overall 5-year survival is...

  6. Avaliação da cavidade uterina com hístero-sonografia em pacientes com falha de implantação após fertilização in vitro Evaluation of the uterine cavity by sonohysterography in patients with implantation failure after in vitro fertilization

    Directory of Open Access Journals (Sweden)

    Teiichi Ninomiya

    2003-08-01

    Full Text Available OBJETIVO: analisar a acurácia da hístero-sonografia (HSoG na avaliação da cavidade uterina nas pacientes que tiveram falha de implantação na primeira tentativa de fertilização in vitro. MÉTODOS: foram analisadas prospectivamente, em estudo duplo-cego, pacientes previamente submetidas à transferência de pelo menos um embrião e que apresentaram falha de implantação. As pacientes foram submetidas a HSoG e em seguida a histeroscopia diagnóstica, realizadas por equipes diferentes, não havendo troca de informações sobre os resultados das mesmas. Os resultados foram agrupados e interpretados somente após o término da pesquisa. A HSoG foi realizada após cateterização do colo uterino por sonda uretral nº 8 e injeção de soro fisiológico. A interface anecóica proporcionada pela solução salina permite determinar as anormalidades, tais como pólipos uterinos ou miomas submucosos. A histeroscopia diagnóstica foi realizada com equipamento Karl Storz, óptica rígida de 4 mm a 30°, e distensão da cavidade uterina com soro fisiológico. Não utilizou-se anestesia local nem houve a necessidade de realizar dilatação cervical. RESULTADOS: foram estudadas 28 pacientes das 33 inicialmente selecionadas para o presente estudo. A HSoG diagnosticou anormalidades em 8 pacientes, sendo que em cinco pacientes foram encontrados pólipos endometriais (62,5%, pólipos endocervicais em duas pacientes (25,0% e mioma submucoso em uma (12,5%. A histeroscopia (padrão-ouro diagnosticou alterações em 7 pacientes, sendo que em duas pacientes (28,6% foram encontrados pólipos endometriais, em outras duas pacientes (28,6% pólipos cervicais e em uma paciente, mioma submucoso (14,2%. A HSoG, quando comparada com a histeroscopia diagnóstica, apresentou sensibilidade de 71,4%, especificidade de 85,7%, valor preditivo positivo de 62,5% e valor preditivo negativo de 90%. CONCLUSÕES: por apresentar valor preditivo positivo baixo, todas as vezes que a HSoG for anormal, sugerimos confirmar o exame pela histeroscopia diagnóstica. Pelo fato de a HSoG apresentar boa especificidade e bom valor preditivo negativo, poderíamos sugerir que diante de HSoG normal não há necessidade de indicação de se avaliar a cavidade uterina pela histeroscopia diagnóstica antes de realizar a fertilização in vitro. Concluímos que a histero-sonografia é bom método para rastreamento de lesões polipóides da cavidade uterina que possam responder pela falha de implantação nas técnicas de fertilização in vitro.PURPOSE: to analyze the accuracy of sonohysterography for the evaluation of the uterine cavity in patients with an implantation failure, at the first attempt of an in vitro fertilization cycle. METHODS: in a prospective double blind study, the authors analyzed patients previously submitted to at least one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, carried out by different professionals each of whom was not aware of the results of the other. The results were recorded and only interpreted after the end of the trial. Sonohysterography was performed by the introduction of a urethral catheter 8 into the uterine cervix followed by infusion of physiological saline. The anechoic interface shown by the physiological saline can reveal abnormalities, like uterine polyps or submucosal myomas. Hysteroscopy was performed with a Karl Storz equipment, 4 mm 30º rigid telescope, and infusion of physiological saline for uterine cavity distention. RESULTS: twenty-eight of the 33 originally selected patients for this study were analyzed. Sonohysterography detected abnormalities in 8 patients, five with endometrial polyps (62.5%, two with endocervical polyps (25.0%, and one with submucosal myoma (12.5%. Hysteroscopy (gold standard detected abnormalities in 7 patients, two with endometrial polyps (28.6%, two with cervical polyps (28.6% and one with submucosal myoma (14.2%. Sonohysterography, when compared with diag

  7. Myomectomies by endo-uterine resection.

    Science.gov (United States)

    Hallez, J P

    1996-08-01

    Endo-uterine resection is a true surgical act, well defined and atraumatic. To perform elective and complete one-stage hysteroscopic myomectomies, sparing normal myometrium, is not easy. Endometrial ablations provoking synaechie and adenomyosis should not be added to myomectomies. Complications of hysteroscopic surgery may be threatening and must be prevented. PMID:8875035

  8. Uterine prolapse

    Science.gov (United States)

    Pelvic relaxation - uterine prolapse; Pelvic floor hernia; Prolapsed uterus ... Tightening the pelvic floor muscles using Kegel exercises helps to strengthen the muscles and reduces the risk of uterine prolapse. Estrogen therapy ...

  9. Re-intervention after uterine leiomyoma embolisation is related to incomplete infarction and presence of submucous leiomyomas.

    DEFF Research Database (Denmark)

    Dueholm, Margit; Langfeldt, Sten

    2014-01-01

    Objective To evaluate outcome of invasive gynecological re-interventions after uterine artery embolisation (UAE) in relation to leiomyoma characteristics. Design A cohort of 114 women with symptomatic myomas underwent UAE. Myoma characteristics were determined by contrast-enhanced magnetic resonance imaging (MRI) before and 6 months after treatment. The median follow-up time after UAE was 55.9 months; (range 20–116). Data on gynecological re-interventions were obtained for all patients and were analysed using the Kaplan–Meier method. Data were obtained on frequency of invasive re-interventions: major myoma procedures (hysterectomy, re-embolisation, laparoscopic or abdominal myomectomy) and outpatient hysteroscopic myoma procedures. Myoma characteristics with impact on outcome of re-interventions were determined by statistical analysis. Results Total re-intervention rate was 35.1%. Hysterectomy was performed due to myoma related symptoms in 6.1% of patients, but 23.7% of patients underwent additional uterineprocedures, mainly outpatient hysteroscopy (15%). Major myoma re-intervention correlated with the extent of the infarct at follow-up MRI (n = 107). Patients had undergone major re-intervention (3 years) as follows: infarct group C (<80%, n = 16) 44%, infarct group B (80–99%, n = 16) 19%, and infarct group A (100%, n = 75) 10.1% ((p < 0.01) for both A vs B + C and A + B vs C). Major re-interventions were not associated with the presence of submucous myomas; but the hazard ratio (CI 95%) for undergoing hysteroscopic re-intervention was 8.4 (2–29) (p = 0.001) in patients with submucous myomas, but 12.7 (5–35) (p < 0.0001) in patients with more than one submucous myomas. Conclusions Complete infarction after UAE reduces the need for major re-interventions. Assessment of complete infarction may be considered to improve quality in UAE procedures. Patients with more than one submucous myoma at UAE may often have hysteroscopic removal of residual myomas.

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

    Directory of Open Access Journals (Sweden)

    Snežana Peji?

    2008-09-01

    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.

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

    Scientific Electronic Library Online (English)

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

    2008-09-01

    Full Text Available 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.

  12. The Role of LEF1 in Endometrial Gland Formation and Carcinogenesis

    OpenAIRE

    Shelton, Dawne N; Fornalik, Hubert; Neff, Traci; Park, Soo Yeun; Bender, David; DeGeest, Koen; LIU, XIAOMING; Xie, Weiliang; Meyerholz, David K.; ENGELHARDT, JOHN F.; GOODHEART, MICHAEL J.

    2012-01-01

    Endometrial carcinoma is the most common gynecologic cancer, yet the mechanisms underlying this disease process are poorly understood. We hypothesized that Lef1 is required for endometrial gland formation within the uterus and is overexpressed in endometrial cancer. Using Lef1 knockout (KO) mice, we compared uterine gland development to wild-type (WT) controls, with respect to both morphology and expression of the Lef1 targets, cyclin D1 and MMP7. We characterized the dynamics of Lef1 protein...

  13. Expression of the epidermal growth factor system in endometrioid endometrial cancer

    DEFF Research Database (Denmark)

    Ejskjaer, Kirsten; Sørensen, Boe Sandahl; Poulsen, Steen Seier; Forman, Axel; Nexø, Ebba; Mogensen, Ole

    2007-01-01

    OBJECTIVE: The Epidermal Growth Factor (EGF) system is expressed in healthy premenopausal endometrium. We describe the expression of the four receptors, HER1, HER2, HER3, HER4 and the six ligands amphiregulin, transforming growth factor alpha (TGF-alpha), heparin binding EGF like growth factor (HB-EGF), betacellulin, epiregulin and EGF in endometrioid endometrial cancer. METHODS: We have uterine samples from 45 women with endometrioid endometrial cancer. As normal counterparts, endometrial sampl...

  14. Expression of the epidermal growth factor system in endometrioid endometrial cancer

    DEFF Research Database (Denmark)

    Ejskjaer, Kirsten; Sørensen, Boe Sandahl; Poulsen, Steen Seier; Forman, Axel; Nexø, Ebba; Mogensen, Ole

    2006-01-01

    OBJECTIVE: The Epidermal Growth Factor (EGF) system is expressed in healthy premenopausal endometrium. We describe the expression of the four receptors, HER1, HER2, HER3, HER4 and the six ligands amphiregulin, transforming growth factor alpha (TGF-alpha), heparin binding EGF like growth factor (HB-EGF), betacellulin, epiregulin and EGF in endometrioid endometrial cancer. METHODS: We have uterine samples from 45 women with endometrioid endometrial cancer. As normal counterparts, endometrial sampl...

  15. Ultrasound detection of endometrial fluid in postmenopausal women

    Directory of Open Access Journals (Sweden)

    ?ur?i? Aleksandar

    2009-01-01

    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.

  16. Endometrial coccidiosis

    OpenAIRE

    de Otazu, R D; García-Nieto, L; Izaguirre-Gondra, E; Mayayo, E.; Ciani, S; Nogales, F. F.

    2004-01-01

    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...

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

    Scientific Electronic Library Online (English)

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

    2014-05-20

    Full Text Available 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.

  18. Endometrial stromal sarcoma of the uterus presenting as pulmonary metastasis

    Science.gov (United States)

    Binesh, Fariba; Taghipour Zahir, Shokouh; Akhavan, Ali; Roshan Bovanlu, Taghi

    2013-01-01

    Endometrial stromal sarcoma (ESS) is a rare uterine sarcoma. Compared with other uterine malignancies, it occurs at an earlier age (42–58?years) and about 10–25% of the patients are premenopausal. The tumours have an indolent growth, with a tendency for late recurrence. Metastases are rarely detected before the diagnosis of the primary lesion. We report a case of ESS with pulmonary metastasis as a prodromal manifestation. PMID:23907964

  19. Uterine sarcomas: histology and its implications on therapy.

    Science.gov (United States)

    Hensley, Martee L

    2012-01-01

    Uterine sarcomas are rare cancers, they comprise only 5% of all uterine malignancies. There are about 2,000 cases of uterine sarcoma diagnosed annually in the United States. Uterine sarcomas may be categorized as either favorable-risk, low-grade malignancies with a relatively good prognosis or as poor-risk, high-grade cancers that carry a high risk for tumor recurrence and disease progression. Expert histologic review is critical for appropriate diagnosis and management. Uterine sarcoma histologies considered to carry a more favorable prognosis include low-grade endometrial stromal sarcomas and adenosarcomas. The high-grade sarcomas include high-grade leiomyosarcomas, high-grade undifferentiated endometrial sarcomas, and adenosarcomas with sarcomatous overgrowth. The favorable histology, low-grade uterine sarcomas may be cured with surgical resection of uterus-limited disease. These tumors are often hormone-sensitive, and treatment with hormonal therapies may be efficacious for patients with advanced, unresectable disease. High-grade uterine leiomyosarcomas and undifferentiated endometrial sarcomas carry a high risk for recurrence, even after complete resection of uterus-limited disease. No adjuvant intervention has been shown to improve survival outcomes. Advanced, metastatic disease is generally treated with systemic cytotoxic therapies, which may result in objective response but is not curative. Selected patients with isolated metastatic disease and a long disease-free interval may benefit from metastatectomy. PMID:24451763

  20. [Chemotherapy and hormone therapy for uterine sarcomas].

    Science.gov (United States)

    Yamashita, Hiroshi; Arai, Hiroharu; Aoki, Daisuke

    2012-05-01

    Uterine sarcomas are relatively rare mesenchymal malignant neoplasms with poor prognosis, accounting for 8%of all uterine malignant neoplasms. There are only a few moderately active cytotoxic agents for this entity, and therefore, chemotherapy for uterine sarcomas is palliative in most cases. According to traditional classification systems, uterine sarcomas encompass carcinosarcoma(CS), leiomyosarcoma(LMS), and endometrial stromal cell sarcoma(ESS). For carcinosarcoma, ifosfamide, cisplatin, and paclitaxel are reported to be moderately effective single agents. The combination of ifosfamide and cisplatin appeared to improve progression-free survival, but the severe toxicity it induced was not negligible. Paclitaxel and ifosfamide were the only chemotherapy regimen which slightly improved both progression-free and overall survival. For leiomyosarcoma and undifferentiated endometrial sarcoma(formerly named high-grade ESS), doxorubicin, ifosfamide, and gemcitabine are moderately effective single agents. There are several reports showing the effectiveness of gemcitabine plus docetaxel. For endometrial stromal sarcoma(formerly named low-grade ESS), progestins and aromatase inhibitors have been proven beneficial. PMID:22584323

  1. Anesthetic management of a parturient with placenta previa totalis undergoing preventive uterine artery embolization before placental expulsion during cesarean delivery: a case report

    OpenAIRE

    Lee, Jae woo; Song, In Ae; Ryu, Junghee; Park, Hee-Pyoung; Jeon, Young-Tae; Hwang, Jung-Won

    2014-01-01

    Placenta previa totalis can cause life-threatening massive postpartum hemorrhage, and careful anesthetic management is essential. Preventive uterine artery embolization (UAE) before placental expulsion was introduced to reduce postpartum bleeding in cases of placenta previa totalis. We describe the case of a 40-year-old woman (gravida 0, para 0) with placenta previa totalis and uterine myomas who underwent intraoperative UAE, which was preoperatively planned at the strong recommendation of th...

  2. Hysteroscopic diagnosis of a high-grade endometrial sarcoma in a 41-year-old woman.

    Science.gov (United States)

    Gonzalez-Bosquet, E; Suñol, M; Cortes, L; Murcia, N; Callejo, J; Lailla, J M

    2010-01-01

    Endometrial stromal sarcomas originate in the endometrial cavity. These tumors represent between 15-27.9% of uterine sarcomas. We present the case of a 41-year-old woman who underwent surgical hysteroscopy for metrorrhagia over a period of one month who had an intrauterine polypoid mass detected by ultrasonography. Histologic analysis of the polypoid mass removed by hysteroscopy was a high-grade endometrial stromal sarcoma of the uterus. The description of this case provides an opportunity to review the literature on uterine sarcomas diagnosed by surgical hysteroscopy. PMID:21061807

  3. Uterine Sarcoidosis: A Rare Extrapulmonary Site of Sarcoidosis

    OpenAIRE

    Marak, Creticus P; Narendrakumar Alappan; Amit Chopra; Olena Dorokhova; Sumita Sinha; Achuta K. Guddati

    2013-01-01

    Sarcoidosis is a multisystem disease which is most commonly manifested in the pulmonary system. However, extrapulmonary manifestations have also been frequently reported. Isolated occurrence of sarcoidosis in the genital system is rare and poses a diagnostic and therapeutic dilemma. Uterine sarcoidosis can present with cervical erosions, endometrial polypoid lesions, and recurrent serometra. In majority of cases, it is diagnosed by endometrial curettage, but it has also been detected by exami...

  4. Evaluation of endometrium in peri-menopausal abnormal uterine bleeding

    OpenAIRE

    Kotdawala, Parul; Kotdawala, Sonal; Nagar, Nidhi

    2013-01-01

    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...

  5. Uterine tumour resembling an ovarian sex cord tumour

    OpenAIRE

    Sutak, J; Lazic, D.; Cullimore, J E

    2005-01-01

    Endometrial stromal sarcomas account for 0.25% of all uterine malignancies. These tumours were originally divided into low grade and high grade stromal sarcomas, but the recent World Health Organisation classification (2003) recognises low grade stromal sarcoma and undifferentiated endometrial sarcoma. Low grade sarcomas may exhibit other forms of differentiation, including smooth muscle and sex cord differentiation. In the latter form, the tumour contains epithelial-like or sex cord-like ele...

  6. Diagnostic double guarded low-volume uterine lavage in mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Brandis, Louise; Samuelsson, Julia; Bojesen, Anders Miki; Troedsson, M.H.T.; Petersen, M. R.

    2014-01-01

    Endometritis constitutes a major problem in the management of broodmares; hence diagnostic tests with a high sensitivity and specificity are desired. We hypothesize that a double guarded uterine flush technique for bacterial culture and cytology is comparable to standard diagnostic tests, the endometrial biopsy and double guarded swab. Endometrial biopsies (n=199), swabs (n=199) and double guarded lavage samples (n=199) were obtained from 34 mares at six different time points in four estrous cyc...

  7. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-10-15

    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.

  9. Progesterone: the ultimate endometrial tumor suppressor

    OpenAIRE

    Yang, Shujie; Thiel, Kristina w.; Leslie, Kimberly K

    2011-01-01

    The uterine endometrium is exquisitely sensitive to steroid hormones that act through well-described nuclear receptors. Estrogen drives epithelial proliferation, and progesterone inhibits growth and causes cell differentiation. The importance of progesterone as a key inhibitor of carcinogenesis is reflected by the observation that women who ovulate and produce progesterone almost never get endometrial cancer. In this review we describe seminal research findings that define progesterone as the...

  10. Histopathological study of endometrium in cases of abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Saroj A. Bolde

    2014-08-01

    Full Text Available Background: Abnormal uterine bleeding is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. Aim of current study was to find out the histopathological pattern of endometrium in Abnormal Uterine Bleeding (AUB also to study organic causes of AUB. Methods: Specimens received as endometrial curettage and hysterectomy specimens were studied followed by correlation of histopathology with age and clinical presentation. Results: The patients were mainly from the age group of 30-49 years (74.24%. The most common menstrual disorder was menorrhagia (46.86%. In dysfunctional uterine bleeding the most common histological pattern of endometrium includes proliferative endometrium (22.8% followed by endometrial hyperplasia (19.40%, atrophic endometrium (7.16%, secretory endometrium (5.97%, irregular shedding [1.80%], irregular ripening (1.20% and anovulatory endometrium (0.59%. Organic lesions encountered in AUB cases were leiomyoma (17.92%, endometrial polyp (1.79%, endometrial carcinoma (1.50%, endometriosis (0.59% and choriocarcinoma (0.29%. Conclusion: It is important to know the histological pattern of the endometrium like proliferative endometrium, endometrial hyperplasia, atrophic endometrium, secretory endometrium, irregular ripening and shredding and organic lesions in patients diagnosed as AUB in different age groups since recognition of these conditions will help and will avoid further complications. [Int J Res Med Sci 2014; 2(4.000: 1378-1381

  11. Uterine morphology and peristalsis in women with polycystic ovary syndrome

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  12. Uterine morphology and peristalsis in women with polycystic ovary syndrome

    International Nuclear Information System (INIS)

    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

  13. Indices of differential endometrial: myometrial growth may be used to improve the reliability of detecting endometrial neoplasia in women on tamoxifen.

    Science.gov (United States)

    Pepper, J M; Oyesanya, O A; Dewart, P J; Howell, A; Seif, M W

    1996-12-01

    The aim of this study was to test the hypothesis that the use of indices of differential endometrial: myometrial growth may be a non-invasive method of improving the reliability of detecting endometrial neoplasia in women on tamoxifen. Thirty postmenopausal women were involved in this prospective study. Nineteen had been treated with tamoxifen for 2 years or more, and eleven were age- and ponderal index-matched controls who had never been exposed to tamoxifen and who were non-smokers. Transvaginal ultrasonography and color Doppler imaging were performed, to measure the length, anteroposterior diameter, uterine sagittal area, endometrial thickness and uterine blood flow (using the pulsatility index and the resistance index as measures of uterine blood flow impedance). The anteroposterior diameter: endometrial thickness ratio and product, and the saggital area: endometrial thickness ratio and product were used as indices of differential endometrial: myometrial growth. The predictive values (sensitivity, specificity, positive and negative predictive values) of each index were calculated using established criteria. For the purpose of analysis the women were allocated to three groups: controls (group 1); women on tamoxifen without endometrial neoplasia (group 2) and women on tamoxifen who developed endometrial neoplasia (group 3). The mean age was similar in the three groups as was the duration of tamoxifen treatment in groups 2 and 3. Analysis of the decision matrix based on increased endometrial thickness (> 5 mm) alone revealed good sensitivity (100%) and negative predictive value (100%) but poor specificity (46.15%) and positive predictive value (26.32%). However, when the indices of differential endometrial: myometrial growth were taken into consideration, the sensitivities and negative predictive values were similar but the specificities and positive predictive values were significantly improved, indicating an improvement in the reliability of predicting the development of endometrial neoplasia. PMID:9014281

  14. Endometrial Ablation

    OpenAIRE

    Budi R. Hadibroto

    1990-01-01

    Sekitar 9 – 30% wanita usia reproduksi mengalami ketidak-teraturan haid dan 25 – 50% dilakukan prosedur bedah ginekologi untuk penanganan disfungsi haid. Ablasi endometrium merupakan salah satu prosedur untuk penanganan perdarahan uterus yang abnormal. Dengan perkembangan alat-alat bedah untuk ablasi. DeCherney pertama sekali melakukan reseksi endometrial menggunakan kauterisasi monopolar. Saat ini dengan semakin berkembangnya histeroskopi, digunakan alat seperti rollerball ukuran 3 mm untuk ...

  15. Endometrial stromal tumours revisited: an update based on the 2014 WHO classification.

    Science.gov (United States)

    Ali, Rola H; Rouzbahman, Marjan

    2015-05-01

    Endometrial stromal tumours (EST) are rare tumours of endometrial stromal origin that account for less than 2% of all uterine tumours. Recent cytogenetic and molecular advances in this area have improved our understanding of ESTs and helped refine their classification into more meaningful categories. Accordingly, the newly released 2014 WHO classification system recognises four categories: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LGESS), high-grade endometrial stromal sarcoma (HGESS) and undifferentiated uterine sarcoma (UUS). At the molecular level, these tumours may demonstrate a relatively simple karyotype with a defining chromosomal rearrangement (as in the majority of ESNs, LGESSs and YWHAE-rearranged HGESS) or demonstrate complex cytogenetic aberrations lacking specific rearrangements (as in UUSs). Herein we provide an update on this topic aimed at the practicing pathologist. PMID:25595274

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

    LENUS (Irish Health Repository)

    McMenamin, Moya

    2012-09-01

    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.

  17. Pólipos endometriais / Endometrial polyps

    Scientific Electronic Library Online (English)

    Antonio Alberto, Nogueira.

    2005-05-01

    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 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.

  18. Uterine Cancer

    Science.gov (United States)

    ... and being physically active. • Taking progesterone (the other female hormone) if you are taking estrogen to replace hormones during menopause. Are there tests that can find uterine cancer early? The Pap test does not screen for ...

  19. Abnormal uterine bleeding: a clinicohistopathological analysis

    Directory of Open Access Journals (Sweden)

    Anupamasuresh Y

    2014-06-01

    Methods: In our prospective study of 359 Patients of the age between 46 and 73 years, clinical characteristics and the pattern of endometrial histopathology and their association in women, who present with abnormal uterine bleeding, are categorised into six groups. Results: In our study, a significant correlation of histopathology and BMI was observed with endometrial hyperplasia and malignancy in obese patient i.e. 37 out 96 and 13 out of 23 respectively. The incidence of malignancy has been increasing with the age being 1.6% in 46-50 years to 60% in 70-75 years. In our study 116 (32.3% had hypertension, 33 patients (9.2% had diabetes mellitus, 40 patients (11.1% had hypothyroidism. Conclusions: We found a maximum incidence of AUB in multiparous women. Clinicohistopathological analysis of AUB revealed endometrial hyperplasia in majority of patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 656-661

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

    Science.gov (United States)

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

    2014-04-01

    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 (Phigh 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  2. 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

  3. Endometrial Side Population Cells: Potential Adult Stem/Progenitor Cells in Endometrium.

    Science.gov (United States)

    Masuda, Hirotaka; Maruyama, Tetsuo; Gargett, Caroline E; Miyazaki, Kaoru; Matsuzaki, Yumi; Okano, Hideyuki; Tanaka, Mamoru

    2015-10-01

    Uterine endometrium is one of the most important organs for species preservation. However, the physiology of human endometrium remains poorly understood, because the human endometrium undergoes rapid and large changes during each menstrual cycle and it is very difficult to investigate human endometrium as one organ. This remarkable regenerative capacity of human endometrium strongly suggests the existence of adult stem cells, and physiology of endometrium cannot be explained without adult stem cells. Therefore, investigating endometrial stem/progenitor cells should lead to a breakthrough in understanding the normal endometrial physiology and the pathophysiology of endometrial neoplastic disorders, such as endometriosis and endometrial cancer. Several cell populations have been discovered as putative endometrial stem/progenitor cells. Emerging evidence reveals that the endometrial side population (SP) is one of the potential endometrial stem/progenitor populations. Of all the endometrial stem/progenitor cell candidates, the endometrial SP (ESP) is best investigated in vitro and in vivo, and has the largest number of references. In this review, we provide an overview of the accumulating evidence for the ESP cells, both directly from human endometria and from cultured endometrial cells. Furthermore, SP cells are compared to other potential stem/progenitor cells, and we discuss their stem cell properties. We also discuss the difficulties and unsolved issues in endometrial stem cell biology. PMID:26316062

  4. UTERINE ANGIOLEIOMYOMAS: A REPORT OF 2 CASES

    Directory of Open Access Journals (Sweden)

    Manimekhala

    2013-05-01

    Full Text Available Angioleiomyomas are relatively common neoplasms in s kin and superficial planes of extremities (89%, head (48% and trunk (14%. Thes e tumours are extremely rare in uterus with very few cases described in the literature. Th ese cases have been described with varied names like angiomyoma, angioleiomyoma, or vascular leiomyoma. There is no description of angioleiomyoma as an entity or as a variant of leio myoma in the latest WHO classification of uterine tumours. There is a mention of vascular lei omyoma as a differential diagnosis of hemangioma under rare mesenchymal tumors but no des cription provided. A proposal has been made by Glenn Mc Cluggage et.al that angioleiomyoma should be included among the b enign leiomyoma variants in the next WHO classification.

  5. Diagnosis and surgical therapy of uterine sarkoma

    Directory of Open Access Journals (Sweden)

    La?evi? N.N.

    2006-01-01

    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. .

  6. Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis.

    Science.gov (United States)

    Gargett, C E; Schwab, K E; Brosens, J J; Puttemans, P; Benagiano, G; Brosens, I

    2014-07-01

    The pathogenesis of early-onset endometriosis has recently been revisited, sparked by the discovery of endometrial stem/progenitor cells and their possible role in endometriosis, and because maternal pregnancy hormone withdrawal following delivery induces uterine bleeding in the neonate. The neonatal uterus has a large cervix to corpus ratio which is functionally blocked with mucous, supporting the concept of retrograde shedding of neonatal endometrium. Only 5% show overt bleeding. Furthermore, the presence of endometriosis in pre-menarcheal girls and even in severe stage in adolescents supports the theory that early-onset endometriosis may originate from retrograde uterine bleeding soon after birth. Endometrial stem/progenitor cells have been identified in menstrual blood suggesting that they may also be shed during neonatal uterine bleeding. Thus, we hypothesized that stem/progenitor cells present in shedding endometrium may have a role in the pathogenesis of early-onset endometriosis through retrograde neonatal uterine bleeding. During the neonatal and pre-pubertal period, shed endometrial stem/progenitor cells are postulated to survive in the pelvic cavity in the absence of circulating estrogens supported by niche cells also shed during neonatal uterine bleeding. According to this hypothesis, during thelarche, under the influence of rising estrogen levels, endometrial stem/progenitor cells proliferate and establish ectopic endometrial lesions characteristic of endometriosis. This New Research Horizon review builds on recent discussions on the pathogenesis of early-onset endometriosis and raises new avenues for research into this costly condition. PMID:24674992

  7. Significance of negative hysteroscopic view in abnormal uterine bleeding.

    OpenAIRE

    Parasnis H; Parulekar S

    1992-01-01

    Ninety six cases of abnormal uterine bleeding were evaluated by both panoramic hysteroscopy and dilatation and curettage. The indications for hysteroscopy included postmenopausal bleeding, infertility with abnormal bleeding, abnormal bleeding and suspected leiomyoma with bleeding. Twenty three patients had abnormal hysteroscopy findings. Hysteroscopy diagnosed endometrial polyp and submucus leiomyoma with 100% accuracy. In 17 cases, the results of hysteroscopy and curettage were in agr...

  8. The effect of glutathione S-transferase gene polymorphisms on susceptibility to uterine myoma

    Directory of Open Access Journals (Sweden)

    Salva Sadat Mostafavi Dehraisi

    2015-01-01

    Conclusion: The findings suggest that the GSTM1 and GSTT1 genetic polymorphisms are associated with the development of endometriosis in Iranian women which is in agreement with previous results obtained in other populations. However, the ethnic variations of polymorphisms should be evaluated in detail and differences should be incorporated into investigations of susceptibility variants for this disease.

  9. Endometrial Stromal Nodule : A Rarity and a Pathological Challenge

    DEFF Research Database (Denmark)

    Borg, Camilla Skovvang; Humaidan, Peter

    2015-01-01

    Endometrial stromal tumors are rare, and endometrial stromal nodule is the least common. In the region of Middle Jutland, Denmark, only two cases are reported since 1995. The nodules are benign; nevertheless, hysterectomy is the treatment of choice. Tumor margins are required for diagnosis and essential to differentiate it from an invasive stromal sarcoma whose prognosis is very different. We report a rare case of a 38-year-old woman, with presurgical diagnosis of a uterine tumor/polyp. She presented with nausea and changes in bleeding pattern and initially had a transcervical polyp resection performed. Histopathological examination showed the presence of an endometrial stromal tumor with unclear margins, and an invasive malignant endometrial sarcoma could not be excluded. Pathological examination revealed an endometrial stromal nodule with invasion, not exceeding three mm. Endometrial stromal tumors are interesting due to their rare existence and difficulties in establishing a histological diagnosis. Although endometrial stromal nodules are benign entities, they must be differentiated from the other invasive malignant stromal tumors, which may change the final prognosis. No preoperative diagnostic tools are at hand, and benign as well as malignant tumors are treated with hysterectomy.

  10. Endometrial Cancer Prevention

    Science.gov (United States)

    ... risk of endometrial cancer: Estrogen Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Estrogen can affect the growth of some cancers , including endometrial cancer . A woman's risk of developing ...

  11. Cystic endometrial hyperplasia and pyometra in three captive African hunting dogs (Lycaon pictus).

    Science.gov (United States)

    Jankowski, Gwen; Adkesson, Michael J; Langan, Jennifer N; Haskins, Samantha; Landolfi, Jamie

    2012-03-01

    Pyometra and cystic endometrial hyperplasia are common in domestic canids and are suspected to develop as a consequence of elevated progesterone levels. Reports of uterine pathology in exotic canids are limited, with some speculating of association with contraception. This report describes pyometra, cystic endometrial hyperplasia, and ovariohysterectomy in three African hunting dogs (Lycaon pictus). Ovarian corpora lutea were detected in two of the dogs, suggesting endogenous progesterone production. One dog had a uterine adenocarcinoma and two had ovarian granulosa cell tumors. Clinical signs included anorexia, lethargy, vulvar discharge, polyuria, polydipsia, and abdominal distention. Diagnosis was based on clinical signs, physical examination, bloodwork, radiography, and ultrasonography, with confirmation through histopathologic evaluation of tissues. Cystic endometrial hyperplasia, pyometra, and uterine neoplasia have rarely been diagnosed in exotic canids; however, they should be considered as differential diagnoses in intact bitches that present with suspected reproductive disease. PMID:22448515

  12. Application of saline infusion sonography in the diagnosis of endometrial polyps

    Directory of Open Access Journals (Sweden)

    K. Drljevi?

    2006-08-01

    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.

  13. Sildenafil Effect on Nitric Oxide Secretion by Normal Human Endometrial Epithelial Cells Cultured In vitro

    OpenAIRE

    Farzaneh Chobsaz; Rostam Ghorbani; Shiva Roshankhah; Mozafar Khazaei

    2011-01-01

    Background: Sildenafil is a selective inhibitor of cyclic-guanosine monphosphat-specificphosphodiesterase type 5. It increases intracellular nitric oxide (NO) production in some cells.There are reports on its positive effect on uterine circulation, endometrial thickness, and infertilityimprovement. Endometrial epithelial cells (EEC) play an important role in embryo attachment andimplantation. The present work investigates the effect of sildenafil on human EEC and their NOsecretion in vitro.Ma...

  14. MRI of endometrial cancer

    International Nuclear Information System (INIS)

    This study was performed to clarify the signal characteristics of endometrial cancer especially on enhanced MRI. Authors selected 21 ceses of endometrial cancer and 16 cases of noncancerous endometrium who had Gd-DTPA enhanced MRI. We compared preoperative MRI reports with postsurgical-histological proof and measured signal intensity of endometrial cancer, noncancerous endometrium and myometrium using region-of-interest. The accuracy of preoperative MRI in diagnosis of endometrial cancer was 97%. There were 6 cases suspected as endometrial cancer without preoperative proof. Three cases of them, who had endometrial cancer, were diagnosed correctly on MRI. The other 3 cases, one with endometrial hyperplasia, one with atypical hyperplasia and one with normal endometrium, were diagnosed as having noncancerous endometrium on MRI. These facts indicate that MRI including enhanced study has good accuracy. On unenhanced T1 weighted image, the signal intensity of endometrial cancer was not different from myometrium and normal endometrium. But on enhanced MRI, endometrial cancer showed lower signal intensity than myometrium and normal endometrium (p<0.01). Endometrial cancer was less enhanced than myometrium and normal endometrium after administration of Gd-DTPA (p<0.01). We have to pay attention to signal intensity and enhancement effect of endometrial region on enhanced MRI. The less enhanced endometrium suggests abnormal endometrium including cancer. (author)

  15. Endometrial carcinoma; Endometriumkarzinom

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-15

    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.)

  16. Analysis of amenorrhea after transcatheter uterine artery embolization for uterine fibroids

    International Nuclear Information System (INIS)

    Objective: To investigate the causes of amenorrhea after transcatheter uterine artery embolization (TUAE) for uterine fibroids. Methods: Two hundreds thirty-one cases of uterine fibroids with the range of age from 29 to 51 years (mean, 39.5 years) underwent TUAE between April 1999 and May 2004. TUAE was performed by injecting lipiodol-pingyangmycine emulsion (LPE) into bilateral uterine arteries, followed by administration of gelatin sponge particles in 186 of 231 patients. LPE was prepared with pingyangmycine 8-16 mg and ultra fluid lipiodol 6-20 ml. Results: Amenorrhea occurred in 2 of 231 (0.87%) patients respectively at 3 and 4 months after TUAE. Premature ovarian failure was proved to be etiology of amenorrhea in one patient because her serum estradiol (E2) became decreased and serum follicle-stimulating hormone (FSH) level increased. This woman had normal amenorrhea later after receiving estrogen-progestogen sepuential therapy for 12 months. Another patient's amenorrhea was proved to be associated with endometrial atrophy after TUAE by hysteroscope. Conclusion: Amenorrhea caused by premature ovarian failure and endometrial atrophy may occur in a tiny minority of women undergoing TUAE. (authors)

  17. PATHOLOGY OF ENDOMETRIUM AS «THE UTERINE FACTOR» OF INFERTILITY IS THE IMPORTANT MEDICAL AND SOCIAL PROBLEM IN RUSSIA

    Directory of Open Access Journals (Sweden)

    Olga Aleksandrovna Vitkina

    2015-01-01

    Full Text Available Infertility is the important medical and social problem which decreases the birth rates. Complex examination the women with infertility, including histological, and immunohistochemical study of endometrial biopsies revealed  high percentage of endometrial pathology: endometrial hyperplasia, chronic endometritis and their combination, as so called   «the uterine factor» of  infertility.  In chronic endometritis we observed:  the disturbance in expression of the sex steroids receptors , marker of cell proliferation Ki-67 and marker of apoptosis (p53  in the endometrium.?hat creates a pathological syndrome, leading to the development and progression of endometrial hyperplasia.

  18. How Is Endometrial Cancer Staged?

    Science.gov (United States)

    ... Survival by stage of endometrial cancer How is endometrial cancer staged? Staging is the process of looking at ... cancer may have spread. The stage of an endometrial cancer is the most important factor in choosing a ...

  19. Tranexamic Acid: A Potential Adjunct to Resectoscopic Endometrial Ablation

    OpenAIRE

    Ergun, Bulent; Bastu, Ercan; Ozsurmeli, Mehmet; Celik, Cem

    2012-01-01

    Abnormal uterine bleeding (AUB) is a substantial cause of ill health in women worldwide. In this study, our aim was to evaluate the effectiveness of endometrial ablation using a modified urologic resectoscope along with tranexamic acid in AUB. Sixty patients were enrolled in this study. All patients underwent resectoscopic surgery. Patients were randomly divided into two groups. Group 1 (n = 30) received 500 mg of tranexamic acid. Group 2 (n = 30) served as the control group and underwent sur...

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

    Scientific Electronic Library Online (English)

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

    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 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

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

    Directory of Open Access Journals (Sweden)

    M.L. Schulman

    1997-07-01

    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.

  2. Analysis of MDM2 Amplification in 43 Endometrial Stromal Tumors: A Potential Diagnostic Pitfall.

    Science.gov (United States)

    Schoolmeester, J Kenneth; Sciallis, Andrew P; Greipp, Patricia T; Hodge, Jennelle C; Dal Cin, Paola; Keeney, Gary L; Nucci, Marisa R

    2015-11-01

    MDM2 amplification is known to occur in a variety of neoplasms and its detection by fluorescence in situ hybridization is helpful in distinguishing well-differentiated and dedifferentated liposarcoma from classic lipoma. We recently evaluated a mesenteric mass initially diagnosed as dedifferentiated liposarcoma, largely due to the neoplasm's myxoid morphology and MDM2 expression by immunohistochemistry, from a 46-yr-old woman with a history of uterine low-grade endometrial stromal sarcoma (LG-ESS) with a JAZF1 rearrangement. Our workup of the mesenteric mass revealed a JAZF1 rearrangement and a revised diagnosis of metastatic LG-ESS with myxoid change was rendered. Retrospective testing of the mesenteric mass was negative for MDM2 amplification, an uncommon, but known diagnostic pitfall in MDM2 expression by immunohistochemistry. As MDM2 amplification is not specific for the diagnosis of liposarcoma, we investigated its occurrence in 43 cases of endometrial stromal tumors: 14 uterine LG-ESS, 11 metastatic or recurrent uterine LG-ESS, 8 undifferentiated uterine sarcomas, 5 endometrial stromal nodules, and 4 high-grade ESS with YHWAE rearrangement. In addition, 40 of the 43 cases had previously undergone fluorescence in situ hybridization analysis of JAZF1, PHF1, and YHWAE. Two of the 43 cases (5%) had MDM2 amplification: one was a uterine LG-ESS (JAZF1 rearrangement) and the other was a undifferentiated uterine sarcoma (polysomy intact JAZF1, PHF1, and YHWAE), both metastatic to the lung. Both cases positive for MDM2 amplification showed MDM2 expression by immunohistochemistry. At last follow-up, both patients had died of disease (19 and 60 mo). Our study is the first to demonstrate MDM2 amplification in endometrial stromal tumor. Awareness of MDM2 amplification in endometrial stromal tumor is critical; particularly in locations more common to liposarcoma, to avoid diagnostic errors. PMID:26444253

  3. Usefulness of sonohysterography in differentiating endometrial cancer from endometrial hyperplasia

    International Nuclear Information System (INIS)

    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.

  4. Usefulness of sonohysterography in differentiating endometrial cancer from endometrial hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-06-15

    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.

  5. Clinical evaluation of high-intensity focused ultrasound in treating uterus myomas

    International Nuclear Information System (INIS)

    Objective: To explore the safety and efficacy of high-intensity focused ultrasound (HIFU) for the treatment of uterus myomas. Methods: HIFU was performed in 47 patients with symptomatic hysteromyoma, who had a childbearing history and were 26-59 years old. Postoperative follow-up was carried out. Clinical symptoms and the tumor's size were observed before and after the HIFU treatment. The results were compared with each other. Results: After HIFU treatment, the symptoms such as dysmenorrhea and hypermenorrhea were markedly improved. Some patients developed hematuria or lower limb pain, which was relieved after symptomatic management. The average volume of myoma before the treatment was (47.6 ± 24.1) cm3 and it was reduced to (17.7 ± 13.1) cm3 at 6 months after the treatment, the difference was statistically significant (P < 0.05). Conclusion: HIFU is a safe and effective treatment for uterus myomas. (authors)

  6. Endometrial adenocarcinoma after endometrial ablation. A case report

    OpenAIRE

    Areia, AL; Branco, M.; Frutuoso, C; Oliveira, CF

    2006-01-01

    The authors present a case of endometrial adenocarcinoma after endometrial ablation, emphasizing the importance of close surveillance of these patients, patient selection and education. Even patients with none of the risk factors for endometrial cancer or contraindications to endometrial ablation should be checked carefully.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

    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.

  8. 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.

  9. Epithelial progesterone receptor exhibits pleiotropic roles in uterine development and function

    OpenAIRE

    Franco, Heather L.; Rubel, Cory A.; Large, Michael J.; Wetendorf, Margeaux; Fernandez-Valdivia, Rodrigo; Jeong, Jae-wook; Spencer, Thomas E.; Behringer, Richard R; Lydon, John P.; DeMayo, Francesco J

    2012-01-01

    The ovarian steroid progesterone, acting through the progesterone receptor (PR), coordinates endometrial epithelial-stromal cell communication, which is critical for its development and function. PR expression in these cellular compartments is under tight temporal and endocrine control. Although ex vivo studies demonstrated the importance of stromal PR expression, they failed to show a role for epithelial PR in uterine function. Here, the in vivo role of PR in the uterine epithelium is define...

  10. Successful Reduction of Acute Puerperal Uterine Inversion with the Use of a Bakri Postpartum Balloon

    OpenAIRE

    Ida, Akinori; Ito, Koichi; KUBOTA, YOKO; Nosaka, Maiko; Kato, Hiroshi; Tsuji, Yoshiyuki

    2015-01-01

    Uterine inversion is a state wherein the endometrial surface is inverted. Although this condition may be observed in nonpregnant women, it most commonly develops at the time of delivery. In the present case, a 37-year-old woman without any remarkable history developed acute puerperal uterine inversion after the successful induction of labor. Following the delivery, she complained twice of severe lower abdominal pain; subsequently, hemorrhage was noted at the site of partial detachment of the ...

  11. Isolated Uterine Metastasis of Invasive Ductal Carcinoma

    Science.gov (United States)

    Arslan, Deniz; Tural, Deniz; Tatl?, Ali Murat; Akar, Emre; Uysal, Mükremin; Erdo?an, Gülgün

    2013-01-01

    Introduction. Most common metastasis sites of breast cancer are the lungs, bones, liver, and brain, whereas uterine involvement by metastatic breast disease is rare. Metastatic carcinoma of the uterus usually originates from other genital sites, most commonly being from the ovaries. Invasive lobular carcinoma spreads to gynecologic organs more frequently than invasive ductal carcinoma. Case Report. A 57-year-old postmenopausal woman was diagnosed with breast carcinoma 2 years ago and modified radical mastectomy was performed. Pathological examination of tumor revealed invasive ductal carcinoma, stage IIIc. She presented with abdominal pain and distension. Diagnostic workup and gynecologic examination revealed lesions that caused diffuse thickening of the uterus wall. Endometrial sampling was performed for confirmation of the diagnosis. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Breast carcinoma metastases in endometrium and myometrium were confirmed histopathologically and immunohistochemically. Conclusion. We herein report the first case of isolated uterine patient who had invasive ductal carcinoma of breast. PMID:23573438

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

    Scientific Electronic Library Online (English)

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

    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/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.

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

    Directory of Open Access Journals (Sweden)

    Ernesto García Ayala

    2010-01-01

    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.

  14. 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.)

  15. Endometrial stromal sarcoma of uterus with metastasis to the lung and brain

    Science.gov (United States)

    Akhavan, Ali; Shishebor, Forozan; Moghimi, Mansour; Binesh, Fariba

    2012-01-01

    Endometrial stromal sarcomas are rare tumours of the uterus and account for 10% of uterine sarcomas. Most of such tumours are low grade, although even these types can spread to the extrauterine areas; however, brain metastasis is very uncommon. This case report presents a 43-year-old Iranian woman with synchronous lung and brain metastases. PMID:22987911

  16. Endometrial carcinoma in elderly women.

    Science.gov (United States)

    Hoffman, K; Nekhlyudov, L; Deligdisch, L

    1995-08-01

    Endometrial carcinoma remains the most common invasive gynecologic malignancy. Increased longevity is associated with an increased incidence of endometrial carcinoma (EC) in elderly women. While recent studies have looked at aging and its relation to ovarian, breast, and cervical cancer, few have focused on EC in the growing elderly population. This study analyzed 35 histologic specimens of EC in women 75-92 years of age. Findings revealed that only 23% of the tumors were Stage I, G1. The majority (77%) were deeply invasive or of advanced stage (IC-IV). These were G2, G3, or "virulent" types of nonendometrioid EC (undifferentiated, clear cell, uterine serous papillary, and squamous cell carcinoma). Fifty-seven percent of tumors were endometrioid, of which 9% were mixed, including a rare case of nongestational choriocarcinoma. The nonendometrioid tumors, compared to the endometrioid types, were more often high-stage tumors with vascular invasion. They were also more often associated with atrophic (vs hyperplastic) uninvolved endometrium. Clinical risk factors (nulliparity, obesity, estrogen replacement therapy) were assessed and correlated with the histologic findings. It was shown that tumors in the elderly were less likely to be estrogen-related. It was concluded that EC in this age group is more aggressive, histologically less differentiated, and often nonendometrioid compared with EC in the general population. The increased virulence of EC in the elderly may be related to the tumor's independence from hormonal factors, to the poorly understood but well-known diminished immunologic defense against cancer in general in elderly patients, and/or to the belated diagnosis of the disease in this population. PMID:7622105

  17. Ultrastructural assessment of leiomyoma tissue and different layers of myometrium in patients with uterine leiomyoma during hypo- and hyperestrogenic states after different schemes of gonadotroping relising hormone agonists use

    Directory of Open Access Journals (Sweden)

    Medvedev M.V.

    2011-01-01

    Full Text Available In study conducted ultrastructural analysis of cells and extracellular matrix of myoma tissue and different layers of myometrium in 35 patients with uterine leyomioma in long-term and short-term corre ction of hormonal status before surgery gosereline acetate. Study of ultrastructural characteristics we re performed on ultrathin sectio ns for transmission electron microscope. Studies have shown that the ultrastructural characteristics of uterine le yomioma were similar to those of unchanged myometrium. The most characteristic feature of uterine fibroids is excessive extracellular matrix elements, arranged randomly. Under the action of a-GnRH there were atrophic changes in myocytes, which in most cases do not lead to cell death and is reversible: reducing the size of myocytes in both myomatous tissue and in normal myometrium, two-fold reduction in myofilaments amount in unchanged myometrium and in uterine myoma. Under the influence of hyperestrogenemy, along with increasing size of the nucleus, endoplasmic reticulum elements and number of ribosom es the size of myocytes was likely to increase in both myoma tissue and myometrium; increased the ratio of condensed chromatin to uncondensed one (in simple fibroids – 1.7 times, in cellular fibroids – 2.1 times; increase in 1.5 times the number of myofilaments both in unchanged myometrium and in uterine myoma; increase in number of mitochondria and increase of their size in myomatous tissue only caused mainly by by intracellular edema. Elements of extracellu lar matrix do not depend on short-term action of hyperestrogeny and mid-term action of hypoestrogeny, bu t the synthesis of new fibers is reduc ed under action of artificial menopause.

  18. Brain Metastases from Endometrial Carcinoma

    OpenAIRE

    Ettie Piura; Benjamin Piura

    2012-01-01

    This paper will focus on knowledge related to brain metastases from endometrial carcinoma. To date, 115 cases were documented in the literature with an incidence of 0.6% among endometrial carcinoma patients. The endometrial carcinoma was usually an advanced-stage and high-grade tumor. In most patients (~90%), brain metastasis was detected after diagnosis of endometrial carcinoma with a median interval from diagnosis of endometrial carcinoma to diagnosis of brain metastases of 17 months. Brain...

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

    Directory of Open Access Journals (Sweden)

    Salete Yatabe

    2011-12-01

    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.

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

    Scientific Electronic Library Online (English)

    Juan Carlos, Carvajal V; Juan, Rodríguez C; Tamara, Briceño C; Julio, Veas P.

    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 trata [...] das 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 benigna Abstract in english Objective: 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

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

    Directory of Open Access Journals (Sweden)

    Juan Carlos Carvajal V

    2007-01-01

    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

  2. Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation

    Directory of Open Access Journals (Sweden)

    Khan Faryal

    2011-01-01

    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.

  3. Vulvar extrauterine endometrial stromal sarcoma: A case report and literature review.

    Science.gov (United States)

    Zaza, Khaled J; Arafah, Maria A; Al-Badawi, Ismail A

    2015-09-01

    Endometrial stromal sarcoma (ESS) is an extremely rare neoplasm accounting for only 0.2% of all uterine malignancies and for 15-26% of primary uterine sarcomas. The annual incidence of ESS is 1-2 per million women. Herein, to the best of our knowledge, we present the first reported case of ESS of the vulva in a 50-year-old female presenting with per vaginal spotting over a period of three months. Her past surgical history included a subtotal hysterectomy and left salpingo-oophorectomy for uterine fibroids ten years previously. On examination, a 3.5×3×2 cm cystic mass was found in the right labia majora. The mass was excised and the diagnosis of endometrial stromal sarcoma was made. Subsequent metastatic workup was negative and the patient was started on megestrol acetate. She has remained disease free with no signs or symptoms of recurrent or advanced disease for 28 months. PMID:25585306

  4. Uterine health and disorders.

    Science.gov (United States)

    Lewis, G S

    1997-05-01

    Nonspecific uterine infections reduce the reproductive efficiency of cows and the profit potential of dairy farms. Fortunately, most cows do not develop severe uterine infections. The term uterine infection indicates that the uterus is contaminated with pathogenic organisms. Actinomyces pyogenes, either alone or with other bacteria, is often associated with uterine infections. When A. pyogenes was isolated from uterine fluids after d 21 postpartum, cows developed severe endometritis and were infertile at first service. However, the exact causes of uterine infections are unknown but are associated with several factors. Cows with dystocia, retained placenta, twins or still-births, and various metabolic disorders are more likely to develop metritis than are other cows. Aberrant immune function before and after calving seems to predispose cows to severe uterine infections. Few cows die from uterine infections, but cows with uterine infections are more likely to be culled for poor reproductive performance. Also, uterine infections can reduce milk production, and some treatments contaminate milk. Because they are nonspecific, uterine infections are difficult to prevent; attention to sanitation and periparturient hygiene, especially during assisted calving, may be the best defense. Evidence that aberrant immuno function predisposes cows to uterine infections indicates that methods for regulating immune function in periparturient cows have the potential for preventing or treating uterine infections. PMID:9178140

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

    Directory of Open Access Journals (Sweden)

    Luis Paulo Galvao Wolff

    2010-01-01

    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.

  6. Physical Activity Behavioral Intervention in Obese Endometrial Cancer Survivors

    Science.gov (United States)

    2015-10-14

    Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  7. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... women with uterine fibroids is heavy bleeding. In fact, some of our patients have such heavy bleeding ... contrast. We want to make sure that, in fact, it is the uterine artery, that we're ...

  8. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... old. She has very symptomatic uterine fibroids, very heavy menstrual periods. Her periods last on the order ... we see in women with uterine fibroids is heavy bleeding. In fact, some of our patients have ...

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

    Scientific Electronic Library Online (English)

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

    Full Text Available 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.

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

    International Nuclear Information System (INIS)

    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).

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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).

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

    Science.gov (United States)

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

    2007-12-01

    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

  13. Pólipo endometrial, una causa infrecuente de sangrado genital anormal en la adolescencia

    Scientific Electronic Library Online (English)

    Constanza, Ralph T; Claudia, Zajer A; Valentina, De Petris V; Roger, Gejman E; Mauricio, Cuello F.

    Full Text Available Antecedentes: El sangrado genital anormal es una causa frecuente de consulta en la adolescencia. En este período, la principal causa de sangrado es la metrorragia asociada a ciclos anovulatorios producto de la inmadurez del eje hipotálamo-hipofisario-gonadal. Dentro de las causas infrecuentes de san [...] grado genital anormal en ese período está el pólipo endometrial. Caso clínico: Presentamos el caso de una niña de 13 años cuya causa de sangrado correspondió a un pólipo endometrial, sospechado por ultrasonografía, resecado mediante histeroscopia y confirmado mediante estudio histológico. Discusión: Pese a su baja incidencia, los pólipos endometriales deben ser considerados como parte del diagnóstico diferencial en adolescentes que consultan por trastorno menstrual, particularmente en aquellos casos sin respuesta a la terapia hormonal y donde la ultrasonografía muestra engrosamiento endometrial. Abstract in english Background: Abnormal genital bleeding is a common cause of medical consultation in patients during adolescence. In this period, the main cause of genital bleeding is metrorrhagia in relation to anovulatory cycles due to immaturity of hypothalamus- pituitary-gonadal axis. Among the uncommon causes of [...] bleeding at this age is the endometrial polyp. Case report: We report a 13 year old girl with abnormal uterine bleeding due to endometrial polyp, suspected during a pelvic ultrasound, removed by hysteroscopy, and confirmed by histological analysis. Discussion: Despite its low incidence, endometrial polyps should be included in the differential diagnosis of adolescents presenting menstrual disorders, particularly in those with no response to hormonal therapy and endometrial thickness in ultrasound.

  14. Molecular profiling of endometrial malignancies.

    Science.gov (United States)

    Samarnthai, Norasate; Hall, Kevin; Yeh, I-Tien

    2010-01-01

    Molecular profiling of endometrial neoplasms reveals genetic changes in endometrial carcinomas that support the dualistic model, in which type I carcinomas are estrogen-dependent, low grade lesions and type II carcinomas are nonestrogen dependent and high grade. The molecular changes in type I endometrial carcinomas include mutations in PTEN, PIK3CA, KRAS, and beta-catenin, along with microsatellite instability, whereas type II endometrial carcinomas are characterized by genetic alterations in p53, HER2/neu, p16, and E-cadherin. For endometrial neoplasms with a malignant mesenchymal component, C-MYC mutations and loss of heterozygosity are frequently seen in carcinosarcomas, and a fusion gene, JAZF1/JJAZ1, is distinctive for endometrial stromal sarcoma. In addition, p53 mutations may play an important role in tumorigenesis of undifferentiated endometrial sarcoma. These molecular changes can help in the diagnosis of endometrial neoplasms, as well as form the basis of molecular targeted therapy. PMID:20368795

  15. YWHAE-FAM22 endometrial stromal sarcoma: diagnosis by reverse transcription-polymerase chain reaction in formalin-fixed, paraffin-embedded tumor.

    Science.gov (United States)

    Isphording, Anna; Ali, Rola H; Irving, Julie; Goytain, Angela; Nelnyk, Nataliya; Hoang, Lien N; Gilks, C Blake; Huntsman, David G; Nielsen, Torsten O; Nucci, Marisa R; Lee, Cheng-Han

    2013-05-01

    A subset of endometrial stromal sarcoma harbors t(10;17)(q23;p13), which results in the genetic fusion between YWHAE and 1 of 2 highly homologous FAM22 family members-FAM22A or FAM22B. In contrast to classic low-grade endometrial stromal sarcoma with JAZF1-SUZ12 fusions, YWHAE-FAM22 endometrial stromal sarcoma displays high-grade histologic features and is associated with more aggressive disease course. Ancillary fluorescence in situ hybridization assay demonstrating the presence of YWHAE rearrangement can be used to support the diagnosis, but the detection of fusion transcript would be the most definitive test. We describe here an optimized reverse transcription-polymerase chain reaction assay for detection of YWHAE-FAM22 fusion transcript in formalin-fixed and paraffin-embedded tumor samples. We studied a series of 6 YWHAE-FAM22 endometrial stromal sarcomas, 7 JAZF-SUZ12 endometrial stromal sarcomas, 3 JAZF1-PHF1/EPC1-PHF1 endometrial stromal sarcomas, 6 undifferentiated endometrial sarcomas, 4 uterine leiomyosarcomas, and 4 uterine adenosarcomas. All 6 YWHAE-FAM22 endometrial stromal sarcomas were confirmed by fluorescence in situ hybridization assay, whereas all non-YWHAE-FAM22 tumors were confirmed to lack YWHAE rearrangement by fluorescence in situ hybridization assay. The reverse transcription-polymerase chain reaction assay optimized for formalin-fixed and paraffin-embedded samples detected YWHAE-FAM22 fusion transcripts in all 6 YWHAE-FAM22 endometrial stromal sarcomas and none of the 24 non-YWHAE-FAM22 uterine sarcomas. These findings show that this reverse transcription-polymerase chain reaction assay is sensitive and specific for detection of YWHAE-FAM22 fusion transcript and can serve as a useful adjunct diagnostic assay to confirm the diagnosis of YWHAE-FAM22 endometrial stromal sarcoma in formalin-fixed and paraffin-embedded tumor samples. PMID:23159154

  16. The prognostic relevance of histological type in uterine sarcomas: a Cooperation Task Force (CTF) multivariate analysis of 249 cases.

    OpenAIRE

    Zola, Paolo

    2002-01-01

    PURPOSE OF INVESTIGATION: The objective of this retrospective multicenter study was to assess the prognostic relevance of histologic type in uterine sarcomas. METHODS: The hospital reports of 249 patients with uterine sarcomas were reviewed. Surgery was the initial therapy for all patients. Histologic type was leiomyosarcoma in 95 cases, low-grade endometrial stromal sarcoma (ESS) in 19, high-grade ESS in 34, and carcinosarcoma in 101. Postoperative treatment was given without well-defined pr...

  17. Endometrial sampling and general practice.

    OpenAIRE

    Shapley, M; Redman, C. W.

    1997-01-01

    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....

  18. Molecular Profiling of Endometrial Malignancies

    OpenAIRE

    I-Tien Yeh; Kevin Hall; Norasate Samarnthai

    2010-01-01

    Molecular profiling of endometrial neoplasms reveals genetic changes in endometrial carcinomas that support the dualistic model, in which type I carcinomas are estrogen-dependent, low grade lesions and type II carcinomas are nonestrogen dependent and high grade. The molecular changes in type I endometrial carcinomas include mutations in PTEN, PIK3CA, KRAS, and ?-catenin, along with microsatellite instability, whereas type II endometrial carcinomas are characterized by genetic alterations in ...

  19. Diagnostic double guarded low-volume uterine lavage in mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Brandis, Louise

    2014-01-01

    Endometritis constitutes a major problem in the management of broodmares; hence diagnostic tests with a high sensitivity and specificity are desired. We hypothesize that a double guarded uterine flush technique for bacterial culture and cytology is comparable to standard diagnostic tests, the endometrial biopsy and double guarded swab. Endometrial biopsies (n=199), swabs (n=199) and double guarded lavage samples (n=199) were obtained from 34 mares at six different time points in four estrous cycles, and were evaluated cytologically and bacteriologically. Endometrial biopsies from the first cycle (n=34) were examined for the presence of polymorphonuclear neutrophils (PMNs) in the endometrial epithelium and was used as a gold standard for calculation of diagnostic sensitivity. E. coli was most frequently isolated (lavage: 31%, swab: 21%, biopsy: 12%) followed by ?-hemolytic streptococci (lavage: 11%, swab: 8%, biopsy: 7%) (positive bacterial growth > 4 Colony forming units (CFU)). Positive cytology was less likely to occur when E. coli was isolated from the diagnostic tests compared to the growth of ?-hemolytic streptococci. Isolation of pathogens from uterine samples was highly associated with the presence of PMNs on histology (p=0.003). Using the presence of PMNs in the endometrial tissue as the gold standard for diagnosing endometritis, the sensitivity of double guarded lavage culture was 0.75, and 0.33 and 0.5 for the swab and biopsy, respectively. In conclusion, the double guarded lavage technique was an accurate method for diagnosing mares with endometritis and the risk of false positive samples is considered to be minimal compared to other flushing techniques described. Key words: Endometritis, double guarded lavage, diagnostic test, E. coli, ?-hemolytic streptococci

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

    International Nuclear Information System (INIS)

    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 (? = 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

  1. Comparative clinicopathologic and immunohistochemical analysis of uterine sarcomas diagnosed using the World Health Organization classification system.

    Science.gov (United States)

    D'Angelo, Emanuela; Spagnoli, Luigi G; Prat, Jaime

    2009-11-01

    Uterine sarcomas are rare tumors that account for 3% to 7% of uterine cancers. Their histopathologic classification was revised by the World Health Organization (WHO) in 2003. The objectives of this study were to determine the frequency of different subtypes of uterine sarcoma applying the WHO criteria to a series of cases, compare the outcome of patients with different subtypes, and compare their immunoprofiles using a panel of immunomarkers. Thirty-four uterine sarcomas were identified for a 20-year period (1988-2008). Eighteen benign tumors of smooth muscle or endometrial stromal origin served as a comparison group. A tissue microarray was prepared and immunostaining performed for 10 selected oncoproteins involved in cell proliferation (Ki-67, P53, p16, and phosphatase and tensin homolog [PTEN]), cell differentiation (CD10, h-caldesmon, estrogen receptor, and progesterone receptor), and apoptosis (bcl-2 and Twist). Hierarchical clustering analysis of the immunohistochemical results was performed. The uterine sarcomas were classified as follows: 20 leiomyosarcomas, 9 endometrial stromal sarcomas, and 5 undifferentiated endometrial sarcomas. The outcome for patients with uterine sarcoma was poor, irrespective of histologic type, even for those with stage I tumors. Of the patients with follow-up available, 12 (67%) of 18 with leiomyosarcoma, 4 of 5 with undifferentiated sarcoma, and 4 of 7 with endometrial stromal sarcoma experienced recurrence and 8 patients with high-grade sarcomas died of tumor. In our series, most uterine sarcomas were leiomyosarcomas. Comparison was made between leiomyosarcomas that recurred and those with a favorable outcome and 3 patients with leiomyosarcoma without evidence of recurrence on long-term follow-up had tumors that were negative/low expressors of Ki-67, p53, p16, and Twist, with strong expression of bcl-2. A subset of undifferentiated endometrial sarcomas composed of cells with uniform nuclei may be a separate entity from those with nuclear anaplasia and may be related to low-grade endometrial stromal sarcomas. It may be possible to identify a subset of leiomyosarcomas with a favorable prognosis based on staining with a panel of immunomarkers for cell proliferation and apoptosis. PMID:19540555

  2. Regulated expression of matrix metalloproteinases, inflammatory mediators, and endometrial matrix remodeling by 17beta-estradiol in the immature rat uterus

    OpenAIRE

    Caruso Joseph A; Olenchock Benjamin A; Cavalcanto Todd D; Trivedi Shreya P; Peano Bryan J; Russo Louise A; Smolock Amanda R; Vishnevsky Oleg; Gardner Russell M

    2009-01-01

    Abstract Background Administration of a single physiological dose of 17beta-estradiol (E2:40 microg/kg) to the ovariectomized immature rat rapidly induces uterine growth and remodeling. The response is characterized by changes in endometrial stromal architecture during an inflammatory-like response that likely involves activated matrix-metalloproteinases (MMPs). While estrogen is known as an inducer of endometrial growth, its role in specific expression of MMP family members in vivo is poorly...

  3. 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)

  4. Uterine artery embolization to treat uterine fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Machan, L.; Martin, M. [Univ. of British Columbia Hospital, Dept. of Radiology, Vancouver, BC (Canada)

    2001-06-01

    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)

  5. Immunohistochemical survey of mismatch repair protein expression in uterine sarcomas and carcinosarcomas.

    Science.gov (United States)

    Hoang, Lien N; Ali, Rola H; Lau, Sherman; Gilks, C Blake; Lee, Cheng-Han

    2014-09-01

    Uterine sarcomas and carcinosarcomas are an aggressive group of uterine malignancies. The frequency of mismatch repair (MMR) protein loss by immunohistochemical evaluation has not been comprehensively characterized in this group of tumors; hence, the appropriateness of applying an immunohistochemical panel to screen for Lynch syndrome in these tumors remains unclear. We examined for the immunohistochemical loss of 4 MMR proteins (MLH1, MSH2, MSH6, and PMS2) in a series of 67 uterine carcinosarcomas and 51 uterine sarcomas (20 leiomyosarcomas, 11 adenosarcomas, 9 low-grade endometrial stromal sarcomas, 8 high-grade endometrial stromal sarcomas/undifferentiated endometrial sarcomas, and 3 rhabdomyosarcomas) at our institution. Four of the 67 (6.0%) carcinosarcomas demonstrated abnormal MMR protein expression. Two tumors showed concurrent loss of MLH1 and PMS2 in both the carcinomatous and sarcomatous components. One tumor showed the loss of only PMS2 in both components. The remaining tumor showed an isolated loss of MLH1 and PMS2 in only the small cell carcinoma component, whereas the non-small-cell carcinoma and sarcoma components demonstrated normal staining patterns for MMR proteins. Two of 20 leiomyosarcomas (10%) showed the loss of MMR proteins: one with loss of PMS2 and the other with loss of MSH2 and MSH6. All other uterine sarcoma types examined showed intact MMR protein expression. These observations provide a basis for MMR protein screening in uterine carcinosarcomas and leiomyosarcomas but not in other types of uterine mesenchymal or mixed epithelial/mesenchymal malignancies. PMID:25083964

  6. General Information About Uterine Sarcoma

    Science.gov (United States)

    ... Cancer Screening Research Uterine Sarcoma Treatment (PDQ®) General Information About Uterine Sarcoma Key Points Uterine sarcoma is ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  7. Oxytocin stimulated release of PGF2? and its inhibition by a cyclooxygenase inhibitor and an oxytocin receptor antagonist from equine endometrial cultures.

    Science.gov (United States)

    Penrod, Leah V; Allen, Ronald E; Rhoads, Michelle L; Limesand, Sean W; Arns, Mark J

    2013-06-01

    Uterine inflammation results in a poor uterine environment and early embryonic loss in the mare due to an inhibition of maternal recognition of pregnancy caused from increased prostaglandin F2? (PGF2?). Oxytocin binds to endometrial cell receptors to activate prostaglandin synthesis. An oxytocin receptor antagonist (Atosiban) and a cyclooxygenase inhibitor (indomethacin) both decrease PGF2? production. The aim of this study was to evaluate the in vitro effects of Atosiban and indomethacin on equine uterine prostaglandin secretion. Equine endometrial explants were harvested on day two of behavioral estrus. Endometrial explant cultures were challenged with oxytocin (250nM) and PGF2? concentrations were measured over time. Explants were also cultured with Atosiban and indomethacin for 6h to determine the influence on PGF2? secretion. When endometrial explants were challenged with oxytocin, PGF2? concentrations were greater (PAtosiban or indomethacin. These findings show equine endometrial explants can be stimulated with oxytocin to increase secretion of PGF2? and this secretion can be inhibited through an oxytocin receptor antagonist and a Cox inhibitor, suggesting that this response to oxytocin involves an oxytocin receptor mediated event that activates the prostaglandin synthesis cascade through cyclooxygenase. Furthermore, this data suggests a role for the use of these inhibitors in vivo to decrease uterine PGF2? secretion and prevent early luteal regression and embryonic loss. PMID:23664650

  8. Stages of Endometrial Cancer

    Science.gov (United States)

    ... summary on Uterine Sarcoma Treatment for more information. Obesity, high blood pressure, and diabetes mellitus may increase ... the way cancer will be treated in the future. Even when clinical trials do not lead to ...

  9. Metastatic endometrial stromal sarcoma: a case report

    Directory of Open Access Journals (Sweden)

    Shobha S. Pillai

    2014-06-01

    Full Text Available Endometrial Stromal Sarcoma (ESS is a rare slow growing tumour of mesodermal origin arising from the stroma of the endometrium and accounting for less than 1% of all uterine cancers. It is characterized by late recurrences and distant metastases. This report presents a case of ESS in a 40 year old nulliparous woman who had a myomectomy for a clinically suspected Leiomyoma uterus in a local hospital. The histopathological examination of the specimen revealed ESS and the patient was referred to our tertiary institute. Here after investigations including a CT scan which also revealed pulmonary metastases, patient underwent Modified Radical Hysterectomy with Bilateral Salpingo-oophorectomy with pelvic lymph node sampling. Histopathological Examination of the uterine specimen confirmed the diagnosis. The patient was given the option of referral to a thoracic surgeon for resection of the isolated lung metastasis, but she refused this and opted instead for hormone therapy which she is presently undergoing. ESS is a very rare tumour often presenting with clinical and examination findings suggestive of leiomyoma of the uterus and hence misdiagnosed. In cases of rapidly growing tumours and suspicious radiological features, suspect sarcoma and initiate timely diagnosis and proper treatment. Recommended long-term follow up in view of late recurrences. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 812-815

  10. Endometrial stromal sarcoma

    OpenAIRE

    Puliyath Geetha; Nair Rajasekharan; Singh Swetha

    2010-01-01

    Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. This is a case of low-grade ESS presenting as rapid enlargement of a fibroid uterus. Because of her secondary infertility, she was planned for myomectomy. However, due to the high degree of suspicion of a sarcomatous change in the fibroid, in view of rapid enlargement of uterus within the last 4 months, we planned for a preoperative endometrial aspiration. It showed low-g...

  11. Cine MR imaging of uterine peristalsis in patients with endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Aki; Togashi, Kaori; Koyama, Takashi; Fujimoto, Ryota [Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto (Japan); Nishino, Mizuki [Beth Israel Deaconess Medical Center, Department of Radiology, Kyoto (Japan); Miyake, Kanae; Hayakawa, Katsumi [Kyoto City Hospital, Department of Radiology, Kyoto (Japan); Iwasaku, Kazuhiro [Kyoto City Hospital, Department of Obstetrics and Gynecology, Kyoto (Japan); Fujii, Shingo [Kyoto University, Department of Gynecology and Obstetrics, Kyoto (Japan)

    2007-07-15

    Endometriosis is one of the most important causes of infertility; however the precise mechanism by which it affects female fertility is unclear. The objective of this study was to study the functional aspects of the uterus by evaluating uterine contractility in patients with endometrial cysts of the ovary. The study population was recruited from two institutes and consisted of 26 women (periovulatory (10), luteal (13), and menstrual phase (3); age range: 19-51 years) with untreated endometriosis; the control group consisted of 12 healthy women (age range: 22-41 years). Cine MR imaging obtained by a 1.5T magnet was visually evaluated at 12 x faster than real speed, focusing on the presence of uterine peristalsis, the direction and frequency of peristalsis, and the presence of sustained uterine contractions. Uterine peristalsis was identifiable in 3/10, 3/13, and 3/3 of the endometriosis patients in each menstrual cycle, respectively, and in 11/12, 3/12, and 5/12 of their control subjects. Peristaltic detection rate and frequency were significantly less for the endometriosis group than for the controls in the periovulatory phase only (p<0.05). Sustained contractions were recognized in 19/36 control subjects and in 13/26 endometriosis patients, but the difference was not significant. Uterine peristalsis appears to be suppressed during the periovulatory phase in patients with endometriosis, which may have an adverse effect on sperm transport. (orig.)

  12. Analysis of Stage-Specific Gene Expression Profiles in the Uterine Endometrium during Pregnancy in Pigs

    Science.gov (United States)

    Kim, Mingoo; Seo, Heewon; Choi, Yohan; Yoo, Inkyu; Seo, Minseok; Lee, Chang-Kyu; Kim, Heebal; Ka, Hakhyun

    2015-01-01

    The uterine endometrium plays a critical role in regulating the estrous cycle and the establishment and maintenance of pregnancy in mammalian species. Many studies have investigated the expression and function of genes in the uterine endometrium, but the global expression pattern of genes and relationships among genes differentially expressed in the uterine endometrium during gestation in pigs remain unclear. Thus, this study investigated global gene expression profiles using microarray in pigs. Diverse transcriptome analyses including clustering, network, and differentially expressed gene (DEG) analyses were performed to detect endometrial gene expression changes during the different gestation stages. In total, 6,991 genes were found to be differentially expressed by comparing genes expressed on day (D) 12 of pregnancy with those on D15, D30, D60, D90 and D114 of pregnancy, and clustering analysis of detected DEGs distinguished 8 clusters. Furthermore, several pregnancy-related hub genes such as ALPPL2, RANBP17, NF1B, SPP1, and CST6 were discovered through network analysis. Finally, detected hub genes were technically validated by quantitative RT-PCR. These results suggest the complex network characteristics involved in uterine endometrial gene expression during pregnancy and indicate that diverse patterns of stage-specific gene expression and network connections may play a critical role in endometrial remodeling and in placental and fetal development to establish and maintenance of pregnancy in pigs. PMID:26580069

  13. 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

  14. Endometrial Stromal Sarcoma Presented as an Incidental Lung Mass with Multiple Pulmonary Nodules

    OpenAIRE

    Kang, Dong Oh; Choi, Sue In; Oh, Jee Youn; Sim, Jae Kyeom; Choi, Jong Hyun; Choo, Ji Yung; Hwang, Jin Wook; Lee, Seung Heon; Lee, Ju-Han; Lee, Ki Yeol; Shin, Chol; Kim, Je Hyeong

    2014-01-01

    Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, sev...

  15. Can Endometrial Cancer Be Found Early?

    Science.gov (United States)

    ... Topic Signs and symptoms of endometrial cancer Can endometrial cancer be found early? In most cases, noticing any ... have symptoms of that disease. Women at average endometrial cancer risk At this time, there are no screening ...

  16. Cancer of the Uterus (Endometrial Cancer)

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Cancer of the Uterus (Endometrial Cancer) Home For Patients Search FAQs Cancer of the ... Uterus (Endometrial Cancer) FAQ097, May 2011 PDF Format Cancer of the Uterus (Endometrial Cancer) Gynecologic Problems What ...

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

    DEFF Research Database (Denmark)

    Ørtoft, Gitte; Dueholm, Margit

    2013-01-01

    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.

  18. Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

    Science.gov (United States)

    2015-11-16

    Adult Hepatocellular Carcinoma; Advanced Adult Hepatocellular Carcinoma; Endometrial Serous Adenocarcinoma; Localized Non-Resectable Adult Liver Carcinoma; Lung Carcinoid Tumor; Malignant Ovarian Mixed Epithelial Tumor; Malignant Pancreatic Gastrinoma; Malignant Pancreatic Glucagonoma; Malignant Pancreatic Insulinoma; Malignant Pancreatic Somatostatinoma; Metastatic Digestive System Neuroendocrine Tumor G1; Ovarian Carcinosarcoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Serous Surface Papillary Adenocarcinoma; Pancreatic Alpha Cell Adenoma; Pancreatic Beta Cell Adenoma; Pancreatic Delta Cell Adenoma; Pancreatic G-Cell Adenoma; Pancreatic Polypeptide Tumor; Recurrent Adult Liver Carcinoma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IIIC Uterine Corpus Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  19. THE INVESTIGATION OF COMPLEX ENDOMETRIAL HYPERPLASIA PREVALENCE BY DIAGNOSTIC CURETTAGE AND SOME OF RISKFACTORS AFFILIATED TO IT IN AHVAZ-RAZI HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ali Ghomeishi and Mahin Najafian*

    2014-12-01

    Full Text Available The endometrial hyperplasia indicates the wide spectrum of limit variation of endometrial hyperplasia which has changed from intensification of physiological status to carcinoma. The endometrial hyperplasia is the introduction of the endometrial cancer, which is the most common female genital tract malignancy. Studies suggest that abnormal uterine bleeding is the most common indication of the endometrial hyperplasia that is performed for diagnosis of diagnostic curettage. With regard to the mentioned issue of this study, in order to identify factors associated with endometrial hyperplasia have been performed. This cross-sectional study has been performed on one thousand diagnostic curettage specimen’s from 1390 to 1393 (During the last three years in RaziAhvaz hospital. The specimens based on the presence or absence of endometrial hyperplasia were divided into two groups. Then factors such as age, menstrual pattern, diabetes, hypertension, history of infertility, age over 45years, obesity, use of oral contraceptives were studied and compared. In this study of a thousand cases of diagnostic curettage, because of abnormal uterine bleeding in 160 patients(16% complex hyperplasia, with factors such as oligomenorrhea38% vs.8/5 % (P<0/0001 and diabetes (28% versus (P<0/001, hypertension 32% versus 12% (P<0/001, history of infertility, 19% vs. 5/5% (P<0/001, age over 45years, 32% versus 19% (P<0/001, obesity BMI> 30 46% versus 18% (P<0/001, nulliparity 9% versus 1% (P<0/001 had significant relationship with endometrial hyperplasia. But there was no significant relationship with use of oral contraceptive. According to this study, women who were obese and have history of hypertension, diabetes, infertility, menstrual disorders as oligomenorrhea are at high risk for developing endometrial hyperplasia which at last leads to endometrial cancer.

  20. Metastatic low-grade endometrial stromal sarcoma of the sigmoid colon three years after hysterectomy

    OpenAIRE

    Asada, Yuki; Isomoto*, Hajime; Akama, Fumitaka; Nomura, Noriko; Wen, Chun-Yang; Nakao, Haruhiko; Murata, Ikuo; TORIYAMA, KAN; Kohno, Shigeru

    2005-01-01

    A 49-year-old woman, who had undergone hysterectomy for low-grade endometrial stromal sarcoma (ESS) 3 years ago, presented with a 2-wk history of lower abdominal pain. Barium enema and sigmoidoscopy disclosed a polypoid submucosal tumor. Histopathologic features of biopsy specimens from the lesion were similar to those of the resected uterine ESS. Under the diagnosis of metastatic ESS of the sigmoid colon, sigmoidectomy was performed. Microscopic examination demonstrated dense proliferation o...

  1. Case Report of Undifferentiated Endometrial Sarcoma in Association with Osteoclast-Like Giant Cells

    OpenAIRE

    Elpidio Jimenez; Vadim Khachaturov; Patel Kirtesh; Svetoslav Bardarov

    2011-01-01

    We describe the clinical, gross and microscopic features of undifferentiated uterine stromal sarcoma associated with osteoclast-like giant cells. A case of low-grade endometrial stromal sarcoma is already described in association with osteoclast-like giant cells; however, the current case differs in that the tumor was a high grade and did not show any evidence of smooth muscle or epithelioid differentiation and was shown to be strongly positive for CD10 and focally for WT-1 and Inhibin suppor...

  2. 14-3-3 fusion oncogenes in high-grade endometrial stromal sarcoma

    OpenAIRE

    Lee, Cheng-Han; Ou, Wen-bin; Mariño-Enriquez, Adrian; Zhu, Meijun; Mayeda, Mark; Wang, Yuexiang; Guo, Xiangqian; Brunner, Alayne L.; AMANT, FRÉDÉRIC; French, Christopher A; West, Robert B.; McAlpine, Jessica N.; Gilks, C. Blake; Yaffe, Michael B.; Prentice, Leah M

    2011-01-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Asselin Eric

    2006-10-01

    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.

  4. Robotics in Endometrial Cancer Care

    OpenAIRE

    Joseph Ng

    2013-01-01

    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.

  5. BIOPSIA ENDOMETRIAL AMBULATORIA: EXPERIENCIA PRELIMINAR

    Scientific Electronic Library Online (English)

    Claudio, Domínguez C; Jessica, Zamora F; Sandra, Barrera P; Ximena, Tacla F.

    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 endomet [...] rial 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 endometrio Abstract in english Objective: 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%), 1 [...] 10 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

  6. Lower values of VEGF in endometrial secretion are a possible cause of subfertility in asthmatic patients

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis

    2014-01-01

    Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women (aged 28-44) underwent asthma and allergy testing, questionnaires, endometrial secretion and blood samples in the mid-secretory phase of the menstrual cycle (day 19-23) during assisted reproduction. Differences in cytokines and growth factors were analyzed. Results: Mean log-VEGF in uteri was lower in asthma patients compared with controls (2.29 vs. 2.70, p=0.028). This was mainly due to lower values of VEGF among women with non-atopic asthma compared with women with atopic asthma (1.86 vs. 2.72, p=0.009) and with healthy controls (1.86 vs. 2.70, p=0.01). Asthma treatment status had no effect on VEGF levels in uteri. Serum high sensitivity CRP was negatively correlated with VEGF in endometrial secretions. No other significant correlations were observed between peripheral blood values and markers found in utero. Conclusion: Asthma is associated with lower values of VEGF in uterine endometrial secretions, which might affect the receptiveness of the endometrium and thereby increase time to pregnancy. The effect appears to be associated with non-atopic asthma with general increased systemic inflammation.

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

    Directory of Open Access Journals (Sweden)

    Navid Esfandiari

    2008-01-01

    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.

  8. Assessment of leukemia inhibitory factor and glycoprotein 130 expression in endometrium and uterine flushing: a possible diagnostic tool for impaired fertility

    OpenAIRE

    Tawfeek Manal A; Eid Manal A; Hasan Azza M; Mostafa Manal; El-Serogy Hesham A

    2012-01-01

    Abstract Background Uterine receptivity and implantation are complex processes requiring coordinated expression of molecules by zygote and uterus. Our objective was to evaluate the role of the endometrial expression of leukemia inhibitory factor (LIF) and its glycoprotein 130 (gp130) receptor molecules and their secretion in uterine flushing during the window of implantation in cases of primary unexplained infertility Case presentation The study was conducted on 25 infertile women with unexpl...

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

    Science.gov (United States)

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

    2013-08-01

    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 NAC-treated mares (2.3 ± 0.2 PMN/field). At 72 h after treatment, the intensity of staining for COX2 was significantly higher after saline than after NAC treatment (p NAC-treated mares than in C-mares 72 h after treatment (p mucus in deep uterine glands differed significantly between groups at 24 h after treatment (p NAC does not adversely affect the endometrial function. Moreover, an anti-inflammatory effect on the equine endometrium was observed. PMID:23186260

  10. Comparison of MR imaging and CT in the evaluation of uterine tumors

    International Nuclear Information System (INIS)

    The authors compared the usefulness of MR imaging and CT in staging uterine tumors. Forty women with known cervical carcinoma, endometrial cancer, or leiomyosarcoma underwent CT and MR imaging within 1 week prior to surgery. MR imaging was better than CT for localizing tumors to the endometrium of myometrium and in the evaluation of lymph node involvement and extension to the cervix and parametria. MR imaging, with its superior ability to demonstrate pelvic anatomy and its lack of ionizing radiation and risk from iodinated contrast media, has an important place in the staging of uterine tumors

  11. Endometrial stromal sarcoma

    Directory of Open Access Journals (Sweden)

    Puliyath Geetha

    2010-03-01

    Full Text Available Endometrial stromal sarcoma (ESS is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. This is a case of low-grade ESS presenting as rapid enlargement of a fibroid uterus. Because of her secondary infertility, she was planned for myomectomy. However, due to the high degree of suspicion of a sarcomatous change in the fibroid, in view of rapid enlargement of uterus within the last 4 months, we planned for a preoperative endometrial aspiration. It showed low-grade ESS, which was later confirmed by histopathology examination of total hysterectomy specimen. As surgery was the main treatment for ESS, because of the proper preoperative diagnosis, we could plan the treatment accordingly. Despite the rarity of the tumor, one has to consider the possibility of ESS in cases with presentation of rapid enlargement of a fibroid uterus.

  12. Endometrial stromal sarcoma.

    Science.gov (United States)

    Puliyath, Geetha; Nair, V Rajasekharan; Singh, Swetha

    2010-01-01

    Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. This is a case of low-grade ESS presenting as rapid enlargement of a fibroid uterus. Because of her secondary infertility, she was planned for myomectomy. However, due to the high degree of suspicion of a sarcomatous change in the fibroid, in view of rapid enlargement of uterus within the last 4 months, we planned for a preoperative endometrial aspiration. It showed low-grade ESS, which was later confirmed by histopathology examination of total hysterectomy specimen. As surgery was the main treatment for ESS, because of the proper preoperative diagnosis, we could plan the treatment accordingly. Despite the rarity of the tumor, one has to consider the possibility of ESS in cases with presentation of rapid enlargement of a fibroid uterus. PMID:20931016

  13. Uterine Leiomyoma: Hysterosalpingographic Appearances

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2008-01-01

    Full Text Available Uterine leiomyoma is the most common benign tumor of genital tract. The etiology of myomasis unknown. Leiomyoma shows a broad spectrum of radiographic appearances depending on thenumber, size, and location of the tumor. The diagnostic method for uterine leiomyomas is basedprimarily on the clinical situation. Despite of the varied diagnostic options such as; transvaginalsonography, sonohysterography, hysteroscopy, laparoscopy and MRI; hysterosalpingography isstill one of the valuable imaging methods for identification of uterine leiomyoma.The various features of the proved leiomyoma are illustrated in this pictorial review. The incidence,risk factors and clinical features will also be discussed briefly.

  14. Tuberculosis Endometrial Polyp

    OpenAIRE

    Julien Seror; Erika Faivre; Sophie Prevot; Xavier Deffieux

    2013-01-01

    Tuberculosis can cause infertility when it infects the genital tract (e.g., endometritis). A 31-year-old woman (origin: Algeria) was referred to our academic gynecological institute for unexplained primary infertility. The patient presented with no complaint. Hysteroscopy showed a 10?mm sized endometrial polyp. The polyp was removed. Pathology showed lymphocytic and plasmacytic chronic inflammatory modification, granulomatous modification, and gigantocellular modification,which lead to the di...

  15. What's New in Endometrial Cancer Research and Treatment?

    Science.gov (United States)

    ... Additional resources for endometrial cancer What`s new in endometrial cancer research and treatment? Molecular pathology of endometrial cancer Recent research has improved our understanding of how ...

  16. Endometrial stromal sarcoma--the new genetic paradigm.

    Science.gov (United States)

    Lee, Cheng-Han; Nucci, Marisa R

    2015-07-01

    Endometrial stromal sarcoma (ESS) is a gynaecological sarcoma that is composed of cells that resemble those of proliferative-phase endometrial stroma. The 2014 World Health Organization tumour classification system separates ESS into low-grade and high-grade types, which are histologically, genetically and clinically distinct from undifferentiated uterine sarcoma (UUS). Low-grade ESSs frequently contain chromosomal rearrangements that result in JAZF1-SUZ12 fusion or equivalent genetic fusions. Although most low-grade ESSs show classic histological features that closely resemble those of proliferative-phase endometrial stroma, there are several histological variants that are associated with the same genetic fusions as seen in the classic type. High-grade ESS is defined by the presence of YWHAE-NUTM2A/B (YWHAE-FAM22A/B) fusions. High-grade ESSs are clinically more aggressive than low-grade ESSs, but are associated with a lower mortality rate than UUSs. The histological and immunophenotypic features of these different types of ESS, and their diagnostic considerations, are the subjects of this review. PMID:25355621

  17. Laparoscopic hysterectomy in the treatment of endometrial cancer: NCI experience

    International Nuclear Information System (INIS)

    The standard treatment for women with endometrial cancer is total abdominal hysterectomy and pelvic lymphadenectomy for surgical staging. Total laparoscopic radical hysterectomy (TLH) is an alternative approach providing surgical and patient related advantages to laparoscopy. Methods: Twenty female patients with early stage endometrial cancer were operated upon by TLH and pelvic lymphadenectomy, aiming to assess the safety and efficacy of TLH. Results: The mean operative time was 296.8 min conversion to laparotomy was done in one patient due to bleeding from the uterine vessels. The mean blood loss was 517.5 cc. The uterus was removed transvaginally in 18 patients (90%) and via a small Pfannenstiel incision in two patients (10%). The mean number of pelvic lymph nodes retrieval was 21.2. Postoperative bleeding occurred in one patient (5%) which necessitated exploration. One patient (5%) suffered a pulmonary embolism. Four patients (20%) developed pyrexia, and one patient (5%) suffered from a chest infection. One patient (5%) had wound infection. The mean hospital stay was 4.5 days (range 3-10). Conclusion: TLH with pelvic lymphadenectomy is a safe and effective approach in the treatment of early endometrial carcinoma.

  18. Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

    Directory of Open Access Journals (Sweden)

    Longwen Chen

    2014-01-01

    Full Text Available The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap interpretations of atypical endometrial cells (AEMs or AGC favor endometrial origin (AGC-EM. More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05% were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7. On follow-up histology, 27 (20.3% had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal, 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial lesions were identified in 20.3% of patients. Patients with Pap test interpretations of AEM or AGC-EM and the clinical presentation of abnormal vaginal bleeding should be followed closely.

  19. Somatic MED12 mutations in uterine leiomyosarcoma and colorectal cancer

    DEFF Research Database (Denmark)

    Kämpjärvi, K; Mäkinen, N

    2012-01-01

    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.

  20. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... 1,000 uterine fibroid embolizations. Fibroids are common, benign tumors in women. They can range in size ... make sure that we minimize the amount of radiation that's delivered in this procedure. And at this ...

  1. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... uterine fibroids, very heavy menstrual periods. Her periods last on the order of eight days, four of ... I can quickly go back, we have this last image in our mind, if you will, that ...

  2. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... parts of it can actually break off and fall into the cavity. And a small percentage of ... fibroid, instead of shrinking, may break off and fall into the uterine cavity, in which case we ...

  3. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... 000 uterine fibroid embolizations. Fibroids are common, benign tumors in women. They can range in size from ... come into this vessel and block off the tumor. It will then kill the tumor. So if ...

  4. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... OR Live bah 2777 show some short-term relief of her symptoms. Her symptoms have come back. ... We don't want to treat people with history of cervical cancer or uterine cancer. We have ...

  5. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... make sure that we're not going too fast, slowly inject, only going forward into the uterine ... blockage is relieved, we don't inject too fast. And so, typically it's a relatively low-pressure ...

  6. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... We don't want to treat people with history of cervical cancer or uterine cancer. We have ... bed. Tomorrow morning, she'll be home taking oral mediations to control her cramping. And within a ...

  7. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... that it's impacting her lifestyle. At her young age, she originally underwent a myomectomy, which Jim will ... want to treat people with history of cervical cancer or uterine cancer. We have to make sure ...

  8. Ultrasonographic evaluation of abnormal uterine bleeding in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Bindushree Kadakola

    2015-02-01

    Full Text Available Background: Objectives of current study were to diagnose causes of Abnormal Uterine Bleeding (AUB in postmenopausal women (PMW and to correlate it with curettage and histopathological findings, hysteroscopy and thereby minimizing unnecessary interventions in the form of operations and hysteroscopy where sonography depicts normal findings. Methods: After obtaining ethical clearance present prospective observational study was conducted from November 2010 to November 2012, to evaluate the endometrium in 50 postmenopausal women (PMW with bleeding per vagina referred to the department of Radio diagnosis by the department of gynaecology in Bangalore medical college and research institute. After applying inclusion and exclusion criterias the cases were evaluated with ultrasonography both transabdominal (TAS and transvaginal scan (TVS where ever necessary. Histopathological and hysteroscopic correlation was done in all cases. Results: 58% of the PMW with bleed were in the age group of 51-60 years. Most common cause of PMB was atrophic endometrium (44%, endometrial polyp (22%, followed by malignancy (14%, and hyperplastic endometrium (6%. At Endometrium thickness less than 4 mm there were nil chances of carcinoma. Conclusions: In women with AUB in postmenopausal age ultrasonography (USG can be considered as an initial imaging modality for diagnosing endometrial diseases. The sensitivity and specificity of USG for Atrophic endometrium is 100% and 84% respectively with accuracy of 100%, endometrial polyp the specificity is 100% with accuracy of 88%. For malignancy USG showed 100% specificity and accuracy of 100%. Hence USG is highly accurate for evaluating endometrial pathologies. Being noninvasive, less costly and good patient compliance USG should be considered as an initial imaging modality over invasive investigations like D and C, hysteroscopy in evaluating endometrial disorders. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 229-234

  9. Sarcoma del estroma endometrial de grado alto: presentación de un caso / High degree endometrial stromal sarcoma: case report

    Scientific Electronic Library Online (English)

    Ernesto, Molina-Loza; Carlos, Altez-Navarro.

    Full Text Available El sarcoma del estroma endometrial (SEE) es un tumor infrecuente, que comprende menos del 1% de los tumores malignos ginecológicos. Presentamos el caso de una mujer de 24 años con hemorragia uterina anormal a la que se le realizó histerectomía con anexectomía bilateral por tumor pélvico. Microscópic [...] amente, la neoplasia estaba constituida por una proliferación maligna de células estromales del endometrio. El estudio inmunohistoquimico mostró positividad para vimentina y desmina. Se presenta el estudio clínico patológico, la nueva clasificación de la OMS y las opciones terapéuticas. Abstract in english Endometrial stromal sarcoma (ESS) is a rare tumor comprising less than 1% of gynecological malignancies. We report the case of a 24 year old woman with abnormal uterine bleeding who underwent hysterectomy and bilateral oophorectomy for pelvic tumor. At microscopy the neoplasm was composed of maligna [...] nt proliferation of endometrial stromal cells. Immunohistochemical studies were positive for vimentin and desmin. Clinical and pathologic findings are presented, as well as a review of the new WHO classification and treatment options.

  10. Role of serum copper and ceruloplasmin level in patients with dysfunctional uterine bleeding

    OpenAIRE

    Ketki P. Khandhadiya; Yousef Rezaei Chianeh; Pragna Rao.

    2014-01-01

    Background: Objective of current study was to study serum copper and ceruloplasmin levels in abnormal endometrial angiogenesis observed in dysfunctional uterine bleeding patients. Methods: Design: The present cross sectional study was undertaken in the departments of biochemistry and department of OBG, Kasturba medical college, Manipal University, Manipal, India. Population: This study was done in 40 females age between 18-45 years with history of, bleeding excessively for more than 3 mont...

  11. Evaluation of abnormal uterine bleeding: role of diagnostic hysteroscopy and its correlation with histopathology

    Directory of Open Access Journals (Sweden)

    Rebecca Edwin

    2014-08-01

    Full Text Available Background: The objective was to assess the accuracy of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and to correlate hysteroscopic findings with histopathology reports. Methods: A prospective study was carried out at our institute from January 2010 to December 2013. Ninety cases were included in this study. Patients' age varied from 20 to 60. Those women with the history of abnormal uterine bleeding were admitted. In all cases diagnostic hysteroscopic examination and dilatation and curettage were carried out. Endometrium was sent for histopathology and correlation of hysteroscopic findings with histopathology reports was studied. Results: Various findings on hysteroscopy are as following: proliferative endometrium 36.66%, secretary endometrium 17.77% endometrial hyperplasia 24.44%, atrophic endometrium 5.55%, endometrial polyp 8.88%, submucous fibroid 4.44%, and endometrial carcinoma 2.22%. Conclusions: Hysteroscopy is an eye in uterus and it provides more accurate diagnosis than dilatation and curettage alone in patients with abnormal uterine bleeding. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1082-1086

  12. Association Between Single Nucleotide Polymorphism +276G > T (rs1501299) in ADIPOQ and Endometrial Cancer.

    Science.gov (United States)

    Bie?kiewicz, Jan; Smolarz, Beata; Malinowski, Andrzej

    2016-01-01

    Current literature gives evidence of an indisputable role adiponectin plays in adipose tissue metabolism and obesity-related diseases. Moreover, latest research efforts focus on linking genetic markers of this adipocytokine's gene (ADIPOQ) with cancer. Aim of this study was to determine the genotype distribution of single nucleotide polymorphism +276G > T (rs1501299) in ADIPOQ and an attempt to identify the impact this polymorphism exerts on endometrial cancer risk in obese females. The test group comprised 90 women treated surgically for endometrial cancer between 2000 and 2012 in the Department of Surgical & Endoscopic Gynecology and Gynecologic Oncology, Polish Mothers' Memorial Hospital - Research Institute, Lodz, Poland. 90 individuals treated in the parallel period for uterine fibroids constituted the control group. Patients within both groups were stratified according to BMI into: lean, overweight and obese subjects. Statistical analysis was performed between two major groups and, furthermore, within the abovementioned subgroups. The analysis revealed that allele G of the investigated polymorphism in obese women with endometrial cancer is significantly more frequent, and allele T is significantly less frequent than in lean controls. However, no significant correlation was observed between the polymorphism and endometrial cancer in lean and overweight females. Single nucleotide polymorphism +276G > T (rs1501299) in ADIPOQ may be considered to be a risk factor of endometrial cancer. Further research on SNP in EC is warranted to obtain more conclusive outcomes. PMID:26386690

  13. Annexin A2 Acts as an Adhesion Molecule on the Endometrial Epithelium during Implantation in Mice

    Science.gov (United States)

    Lee, Kai-Fai; Chiu, Philip C. N.; Pang, Ronald T. K.; Ng, Ernest H. Y.; Yeung, William S. B.

    2015-01-01

    To determine the function of Annexin A2 (Axna2) in mouse embryo implantation in vivo, experimental manipulation of Axna2 activities was performed in mouse endometrial tissue in vivo and in vitro. Histological examination of endometrial tissues was performed throughout the reproduction cycle and after steroid treatment. Embryo implantation was determined after blockage of the Axna2 activities by siRNA or anti-Axna2 antibody. The expression of Axna2 immunoreactivies in the endometrial luminal epithelium changed cyclically in the estrus cycle and was upregulated by estrogen. After nidatory estrogen surge, there was a concentration of Axna2 immunoreactivities at the interface between the implanting embryo and the luminal epithelium. The phenomenon was likely to be induced by the implanting embryos as no such concentration of signal was observed in the inter-implantation sites and in pseudopregnancy. Knockdown of Axna2 by siRNA reduced attachment of mouse blastocysts onto endometrial tissues in vitro. Consistently, the number of implantation sites was significantly reduced after infusion of anti-Axna2 antibody into the uterine cavity. Steroids and embryos modulate the expression of Axna2 in the endometrial epithelium. Axna2 may function as an adhesion molecule during embryo implantation in mice. PMID:26444699

  14. Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule.

    Science.gov (United States)

    Maruyama, Shunsuke; Sato, Yukiyasu; Satake, Yumiko; Mise, Hiroko; Kim, Tomoko

    2015-01-01

    Preoperative differentiation of benign endometrial stromal nodule (ESN) from malignant low-grade endometrial sarcoma (LGESS) is challenging, because it requires histological evaluation of the tumor-myometrium interface, which is difficult to obtain in conventional endometrial curettage. A 72-year-old postmenopausal woman presented with 5-year history of persistent vaginal bleeding. Histological examination of the endometrial curettage specimen revealed hyperplasia of apparently normal endometrial stromal cells. T2-weighted magnetic resonance imaging (T2W-MRI) showed polypoid tumor occupying the entire uterine cavity. The tumor exhibited high signal intensity in diffusion-weighted MRI (DW-MRI) and intense accumulation of (18)F-fluorodeoxyglucose (FDG) in positron emission tomography (PET). Intense FDG accumulation was also observed in the left internal iliac region. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed under the diagnosis of LGESS with lymph node metastasis. However, postoperative histological examination proved that the tumor was ESN without lymph node metastasis. Since mitotic figure is no longer included in the diagnostic criteria of ESN or LGESS, ESN could exhibit high cellularity and high proliferative activity as observed in this case. Therefore, DW-MRI or FDG-PET is not useful in the differentiation of ESN from LGESS. PMID:25694838

  15. Effect of Letrozole on Endometrial Histology in Patients with Disordered Proliferative Endometrium and Simple Hyperplasia

    Directory of Open Access Journals (Sweden)

    Parvin Mostafa Gharabaghi

    2014-01-01

    Full Text Available Objectives: This is a preliminary study investigating the efficacy of aromatase inhibitor letrozol on endometrial histology in patients with disordered proliferative endometrium or simple hyperplasia. Materials and Methods: In a randomized clinical trial, 92 patients with abnormal uterine bleeding who had disordered proliferative endometrium or simple hyperplasia in endometrial biopsy, were randomized into case and control groups. patients received 2.5 mg of letrozole daily in case group (n=46 and 40 mg of megestrol acetate daily in control group (n=46 for 3 months. Endometrial biopsy was performed 3 to 4 weeks after completion of therapy to assess response. Results: After intervention in letrozole group, response to treatment was seen in 93% cases (including endometrial atrophy in 58.7% cases and weakly proliferative endometrium in 34.78% cases and in megestrol group response to treatment was seen in 85% cases (including endometrial atrophy in 41.3% cases and weakly proliferative endometrium in 43.47% cases. The difference between two groups was not statistically significant (P=0.31. Conclusion: The results of this study show that pre and post menopausal women with disordered proliferative endometrium or simple hyperplasia can be successfully treated with letrozole alone. However, due to the lack of significant difference between the two groups, further studies with larger sample size is recommended for better clearance of the topic.

  16. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

  17. 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

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan; Kim, Bohyun; Park, Jong Min; Ryu, Jeong Ah [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology, Center for Imaging Science, Seoul (Korea); Kim, Mi Sung [Kwandong University College of Medicine, Department of Radiology, Myongji Hospital, Seoul (Korea); Bae, Duk Soo [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea); Ahn, Geung Hwan [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Pathology, Seoul (Korea)

    2006-07-15

    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.)

  18. Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

    Directory of Open Access Journals (Sweden)

    Trefoux Bourdet A

    2015-03-01

    Full Text Available Alice Trefoux Bourdet, Dominique Luton, Martin Koskas Department of Obstetrics and Gynecology, Bichat University Hospital, Paris Diderot University, Paris, France Abstract: Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA, an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s. Keywords: uterine fibroids, medical treatment, selective progesterone receptor modulator, ulipristal acetate, surgery

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

    Directory of Open Access Journals (Sweden)

    Gimpelson RJ

    2014-03-01

    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®

  20. Pregnancy after uterine arterial embolization

    OpenAIRE

    Cláudio E. Bonduki; Paulo C. Feldner, Jr.; Juliana da Silva; Rodrigo A. Castro; Marair G. F. Sartori; Girão, Manoel J. B. C.

    2011-01-01

    OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter). Pregnancies were identified using screening questionnaires and the study database. RESULT...

  1. The evaluation of the uterine cavity pathologies after abortion with hysteroscopy

    Directory of Open Access Journals (Sweden)

    Elçin Üzmez Telli

    2012-01-01

    Full Text Available Objective: To investigate the anatomy of uterine cavity in cases with history of spontaneous pregnancy loss. Material and Methods: This prospective cohort study was approved by Local Ethical Committee on 18th March 2009 with the application number of 179. 40 cases with at least two of them before 12 weeks of pregnancy or at least one miscarriage after 12 weeks of pregnancy and have no live birth are included in this study. The uterine cavity was evaluated with TVUSG after menstruation. Right after this examination hysteroscopy was performed to rule out uterine malformations. Results: A total of 40 patients with a median age of 28.70 years (range, 20-44 years were enrolled in the current study. The number of miscarriages ranged between one and six while the median is 2.92. Uterine malformation is observed in 13 (32.5% of cases. 25% of this uterine anomalies were congenital (uterus septus, uterus subseptus, uterus bicornis while 7.5% were acquired pathologies (submucous leiomyoma, endometrial polyp, adhesion. When we compared early abortion cases with late abortions, there was no statistical significance with respect to the rate of uterine malformations. There was no significant difference in uterine malformations among cases with two consecutive abortions and three or more consecutive abortions. It was observed that the use of transvaginal ultrasonography in screening uterine malformations is not adequate because of low sensitivity. Conclusion: Hysteroscopy is the gold standart in the evaluation of uterine cavity in spontaneous pregnancy loss. TVUSG is not adequate in evaluation because of its low sensitivity. Cases admitting with two consecutive abortions who seek for the etiology, hysteroscopy is a feasible method.

  2. Cervical Myomas

    Science.gov (United States)

    ... and Gallbladder Disorders Lung and Airway Disorders Men's Health Issues Mental Health Disorders Mouth and Dental Disorders Older People’s Health ... and Gallbladder Disorders Lung and Airway Disorders Men's Health Issues Mental Health Disorders Mouth and Dental Disorders Older People’s ...

  3. Uterine mesenchymal tumors

    Directory of Open Access Journals (Sweden)

    Nikhil A Sangle

    2011-01-01

    Full Text Available Uterine mesenchymal tumors are a heterogeneous group of neoplasms that can frequently be diagnostically challenging. Differentiation between the benign and malignant counterparts of mesenchymal tumors is significant due to differences in clinical outcome, and the role of the surgical pathologist in making this distinction (especially in the difficult cases cannot be underestimated. Although immunohistochemical stains are supportive toward establishing a final diagnosis, the morphologic features trump all the other ancillary techniques for this group of neoplasms. This review therefore emphasizes the key morphologic features required to diagnose and distinguish uterine mesenchymal tumors from their mimics, with a brief description of the relevant immunohistochemical features.

  4. Cytoplasmic estrogen receptors in carcinoma of the uterine cervix.

    Science.gov (United States)

    Yajima, A; Yamauchi, R; Wada, Y; Furuhashi, N; Toki, T; Tase, T; Oikawa, N; Sato, S; Takabayashi, T; Ozawa, N

    1985-01-01

    The concentration of cytoplasmic estrogen receptors (ER) in cancer of the uterine cervix was measured in 30 cases (28 squamous cell carcinomas and 2 adenocarcinomas). The mean ER concentration in squamous cell carcinoma was 19.3 +/- 26.0 fmol/mg cytosol protein; for pre- and postmenopausal women 6.82 +/- 9.86 and 28.6 +/- 30.1 fmol/mg protein, respectively, were found, the latter being significantly higher. When 'ER-positive' was defined as concentrations greater than 10 fmol/mg protein, 12 of the 28 cases (43%) were found to be ER-positive. There were no significant differences between the ER concentrations of clinical stage I and II squamous cell carcinomas (19.2 +/- 24.2 and 20.9 +/- 27.2 fmol/mg, respectively). ER were detectable in the cervical tissue from all of the control cases of myoma of the uterus. There were, however, no differences in the ER content between the proliferative and secretory phases, but the concentration in premenopausal women was significantly lower than that in postmenopausal women. In comparison with the controls, the mean ER level in both pre- and postmenopausal women with squamous cell carcinoma was significantly lower, due to the fact that ER were not detectable in 57% of these cases. Both cases of cervical adenocarcinoma were ER-positive. PMID:4054727

  5. 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.

  6. Derivation of Insulin Producing Cells From Human Endometrial Stromal Stem Cells and Use in the Treatment of Murine Diabetes

    OpenAIRE

    Santamaria, Xavier; Massasa, Efi E.; Feng, Yuzhe; Wolff, Erin; Hugh S. Taylor

    2011-01-01

    Pancreatic islet cell transplantation is an effective approach to treat type 1 diabetes, however the shortage of cadaveric donors and limitations due to rejection require alternative solutions. Multipotent cells derived from the uterine endometrium have the ability to differentiate into mesodermal and ectodermal cellular lineages, suggesting the existence of mesenchymal stem cells in this tissue. We differentiated human endometrial stromal stem cells (ESSC) into insulin secreting cells using ...

  7. Cyclin D1 as a diagnostic immunomarker for endometrial stromal sarcoma with YWHAE-FAM22 rearrangement

    OpenAIRE

    Lee, Cheng-Han; Rola H. Ali; Rouzbahman, Marjan; Marino-Enriquez, Adrian; Zhu, Meijun; Guo, Xiangqian; Brunner, Alayne L.; Chiang, Sarah; Leung, Samuel; Nelnyk, Nataliya; Huntsman, David G.; Gilks, C. Blake; Nielsen, Torsten O; Cin, Paola Dal; Rijn, Matt van de

    2012-01-01

    Endometrial stromal sarcoma (ESS) characterized by YWHAE-FAM22 genetic fusion is histologically higher-grade and clinically more aggressive than ESS with JAZF1-SUZ12 or equivalent genetic rearrangements, hence it is clinically important to recognize this subset of ESS. To identify diagnostic immunomarkers for this biologically-defined ESS subset, we compared gene expression profiles from YWHAE-FAM22 ESS, JAZF1-rearranged ESS and uterine leiomyosarcomas. These studies showed consistent upregul...

  8. The prevalence of endometrial hyperplasia and endometrial cancer in women with polycystic ovary syndrome or hyperandrogenism

    DEFF Research Database (Denmark)

    Holm, Nina Sofie Lillegaard; Glintborg, Dorte; Andersen, Marianne Skovsager; Schledermann, Doris; Ravn, Pernille

    2012-01-01

    Polycystic ovary syndrome may be associated with an increased risk of endometrial hyperplasia and endometrial cancer, but substantial evidence for this remains to be established. We investigated the prevalence of endometrial hyperplasia and endometrial cancer in a well characterized group of women with polycystic ovary syndrome and/or clinical/biochemical hyperandrogenism.

  9. Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma-Relationship with local invasiveness

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Kun, E-mail: kun-cao@hotmail.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Gao, Min, E-mail: gaominmin202@163.com [Department of Gynecology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Sun, Ying-Shi, E-mail: sunysabc@163.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Li, Yan-Ling, E-mail: yanlingli1982@gmail.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Sun, Yu, E-mail: sunyu_bch@163.com [Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Gao, Yu-Nong, E-mail: gaoyunong@vip.sina.com [Department of Gynecology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Zhang, Xiao-Peng, E-mail: zxp@bjcancer.org [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China)

    2012-08-15

    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/mm{sup 2}). 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 < 0.001), with the lowest in junctional zone [(1.126 {+-} 0.190) Multiplication-Sign 10{sup -3} mm{sup 2}/s] and highest in outer myometrium [(1.496 {+-} 0.196) Multiplication-Sign 10{sup -3} mm{sup 2}/s]. Mean ADC value of endometrial carcinomas [(1.011 {+-} 0.121) Multiplication-Sign 10{sup -3} mm{sup 2}/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.

  10. Lower values of VEGF in endometrial secretion are a possible cause of subfertility in non-atopic asthmatic patients

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis

    2014-01-01

    Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women (aged 28-44) underwent asthma and allergy testing, questionnaires, endometrial secretion and blood samples in the mid-secretory phase of the menstrual cycle (day 19-23) during assisted reproduction. Differences in cytokines and growth factors were analyzed. Results: Mean log-VEGF in uteri was lower in asthma patients compared with controls (2.29 versus 2.70, p?=?0.028). This was mainly due to lower values of VEGF among women with non-atopic asthma compared with women with atopic asthma (1.86 versus 2.72, p?=?0.009) and with healthy controls (1.86 versus 2.70, p?=?0.01). Asthma treatment status had no effect on VEGF levels in uteri. Serum high sensitivity CRP was negatively correlated with VEGF in endometrial secretions. No other significant correlations were observed between peripheral blood values and markers found in utero. Conclusion: Asthma is associated with lower values of VEGF in uterine endometrial secretions, which might affect the receptiveness of the endometrium and thereby increase time to pregnancy. The effect appears to be associated with non-atopic asthma with general increased systemic inflammation.

  11. Novel genetic targets in endometrial cancer

    OpenAIRE

    Bell, Daphne W

    2014-01-01

    Worldwide, ~74,000 women die from endometrial cancer each year. Understanding the somatic genomic alterations that drive endometrial tumorigenesis may provide new opportunities to identify targeted therapies for specific subsets of patients.

  12. Uterine sarcomas-Recent progress and future challenges

    Energy Technology Data Exchange (ETDEWEB)

    Seddon, Beatrice M., E-mail: beatrice.seddon@uclh.nhs.uk [London Sarcoma Service, Department of Oncology, University College Hospital, 1st Floor Central, 250 Euston Road, London, NW1 2PG (United Kingdom); Davda, Reena [London Sarcoma Service, Department of Oncology, University College Hospital, 1st Floor Central, 250 Euston Road, London, NW1 2PG (United Kingdom)

    2011-04-15

    Uterine sarcomas are a group of rare tumours that provide considerable challenges in their treatment. Radiological diagnosis prior to hysterectomy is difficult, with the diagnosis frequently made post-operatively. Current staging systems have been unsatisfactory, although a new FIGO staging system specifically for uterine sarcomas has now been introduced, and may allow better grouping of patients according to expected prognosis. While the mainstay of treatment of early disease is a total abdominal hysterectomy, it is less clear whether routine oophorectomy or lymphadenectomy is necessary. Adjuvant pelvic radiotherapy may improve local tumour control in high risk patients, but is not associated with an overall survival benefit. Similarly there is no good evidence for the routine use of adjuvant chemotherapy. For advanced leiomyosarcoma, newer chemotherapy agents including gemcitabine and docetaxel, and trabectedin, offer some promise, while hormonal therapies appear to be more useful in endometrial stromal sarcoma. Novel targeted agents are now being introduced for sarcomas, and uterine sarcomas, and show some indications of activity. Non-pharmacological treatments, including surgical metastatectomy, radiofrequency ablation, and CyberKnife radiotherapy, are important additions to systemic therapy for advanced metastatic disease.

  13. Outcome analysis in patients with uterine sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Yu, To Sol; Kim, Hak Jae; Wu, Hong Gyun; Ha, Sung Whan; Song, Yong Sang; Park, Noh Hyun; Kim, Jae Won [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-03-15

    To analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery. We retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months). The 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure. The most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.

  14. Equine Endometrial Gland Density and Endometrial Thickness Vary among Sampling Sites in Thoroughbred Mares

    OpenAIRE

    HANADA, Michiko; MAEDA, Yousuke; OIKAWA, Masa-aki

    2012-01-01

    The secretions of the equine endometrial glands are essential for the survival, growth, and development of the conceptus in early pregnancy, and endometrial gland density is directly related to successful pregnancy outcome. Endometrial biopsy is routinely used to assess the reproductive potential of broodmares. Some previous studies have shown that equine endometrial glands are uniformly distributed throughout the uterus; however, other work has shown variation of the endometri...

  15. Infectious endometritis is associated with endometrial expression of lactoferrin in broodmares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; MØller Nielsen, Jesper

    For decades, infectious endometritis has been a major cause of infertility in mares and an inflammatory response secondary to uterine infection appears to be a major contributor to a suboptimal uterine environment. The aim of the present study was to characterize the endometrial gene expression of the glycoprotein lactoferrin in brood mares and to evaluate if the expression was associated with infectious endometritis. Endometrial biopsies were obtained from broodmares at a Danish AI-center during the 2014 breeding season by the use of a guarded approach as described by Nielsen (Nielsen, 2005). Mares with clinical signs of endometritis and/or a history of previous un-successful breeding were selected for the study. Two biopsies were obtained from each mare. One biopsy was used for bacterial culture and cytology and one biopsy was used for RNA extraction. Relative gene-expression analyses were performed by quantitative reverse transcriptase PCR (qRT-PCR) using validated primers and SYBR green detection. Infectious endometritis was diagnosed in 49% of the mares (29/59) with S. zooepidemicus isolated most frequently (45%). Data was analysed using the non-parametric Kruskal-Wallis test. Expression of lactoferrin was significantly increased in mares with infectious endometritis compared to mares with no growth of uterine pathogens. Lactoferrin expression was also associated with positive cytology (>0.5% PMNs) (Nielsen, 2005). The results indicate that lactoferrin plays a role in the innate immune response and emphasizes its ability to function as a bacteristatic and bactericidal agent.

  16. Concurrent endometrial hyperplasia with carcinoma of the corpus uteri.

    Science.gov (United States)

    Yajima, A; Sakahira, H; Wada, Y; Sato, S; Yamauchi, R; Ozawa, N; Toki, T; Tase, T; Oikawa, N; Uehara, S

    1985-01-01

    Using 117 uteri which were extirpated in cases of carcinoma of the corpus uteri, a study was made to investigate the relationship between the site of the cancer and the site of associated endometrial hyperplasia. It was found that 75% of the cases had carcinomas of the upper portion of the uterus primarily of the uterine fundus. About 50% of the cancers were associated with adenomatous or atypical hyperplasia, and these two types of hyperplasia were frequently found in the fundus or upper portion of the uterus. In contrast, there was no site of particular prevalence in cases with concurrent cystic hyperplasia. About 70% of the cases had adenomatous or atypical hyperplasia on one or both of the histological blocks adjacent to the cancer. PMID:3983954

  17. Dysplastic Ichthyosis Uteri-like changes of the entire endometrium associated with a squamous cell carcinoma of the uterine cervix

    OpenAIRE

    Fadare Oluwole

    2006-01-01

    Abstract Ichthyosis uteri is an exceedingly rare condition in which the entire surface of the endometrium is replaced by stratified squamous epithelium. Originally described as an endometrial response to iatrogenically-introduced caustic substances, similar changes have since been described in association with a variety of inflammatory conditions of the endometrium. We describe herein a heretofore undescribed example of a moderately differentiated squamous cell carcinoma of the uterine cervix...

  18. Dietary glycemic index and load in relation to risk of uterine leiomyomata in the Black Women's Health Study123

    OpenAIRE

    Radin, Rose G.; Palmer, Julie R; Rosenberg, Lynn; Kumanyika, Shiriki K; Wise, Lauren A.

    2010-01-01

    Background: High dietary glycemic index (GI) and glycemic load (GL) may promote tumorigenesis by increasing endogenous concentrations of insulin-like growth factor I (IGF-I) or the bioavailability of estradiol. In vitro studies have shown that uterine leiomyoma (UL) cells proliferate in response to IGF-I and display increased IGF-I gene expression and protein synthesis. Previous epidemiologic studies suggest that a high GL is a risk factor for endometrial and ovarian cancers, which, like UL, ...

  19. Persistence of uterine bacterial infection, and its associations with endometritis and ovarian function in postpartum dairy cows

    OpenAIRE

    GHANEM, Mohamed Elshabrawy; TEZUKA, Erisa; DEVKOTA, Bhuminand; Izaike, Yoshiaki; OSAWA, Takeshi

    2014-01-01

    We investigated the relationship between the persistence of uterine bacterial infections with cytologically determined endometritis and ovarian function in 65 postpartum Holstein cows. Vaginal mucus discharges were collected, and endometrial smear samples (n = 130) were collected for cytological and bacteriological examinations from the cows at weeks 5 and 7 postpartum (pp). Blood samples were collected at weeks 3, 5 and 7 pp to determine plasma progesterone concentrations to monitor ovarian ...

  20. Uterine fibroid vascularization and clinical relevance to uterine fibroid embolization.

    Science.gov (United States)

    Pelage, Jean-Pierre; Cazejust, Julien; Pluot, Etienne; Le Dref, Olivier; Laurent, Alexandre; Spies, James B; Chagnon, Sophie; Lacombe, Pascal

    2005-10-01

    Embolization has become a first-line treatment for symptomatic uterine fibroid tumors. Selective catheterization and embolization of both uterine arteries, which are the predominant source of blood flow to fibroid tumors in most cases, is the cornerstone of treatment. Although embolization for treatment of uterine fibroid tumors is widely accepted, great familiarity with the normal and variant pelvic arterial anatomy is needed to ensure the safety and success of the procedure. The uterine artery classically arises as a first or second branch of the anterior division of the internal iliac artery and is usually dilated in the presence of a uterine fibroid tumor. Angiography is used for comprehensive pretreatment assessment of the pelvic arterial anatomy; for noninvasive evaluation, Doppler ultrasonography, contrast material-enhanced magnetic resonance (MR) imaging, and MR angiography also may be used. After the uterine artery is identified, selective catheterization should be performed distal to its cervicovaginal branch. For targeted embolization of the perifibroid arterial plexus, injection of particles with diameters larger than 500 mum is generally recommended. Excessive embolization may injure normal myometrium, ovaries, or fallopian tubes and lead to uterine necrosis or infection or to ovarian failure. Incomplete treatment or additional blood supply to the tumor (eg, via an ovarian artery) may result in clinical failure. The common postembolization angiographic end point is occlusion of the uterine arterial branches to the fibroid tumor while antegrade flow is maintained in the main uterine artery. PMID:16227501

  1. Endometrial stromal sarcoma: clinicopathological and immunophenotype study of 18 cases.

    Science.gov (United States)

    Vera, Adrián Antonio López; Guadarrama, Mónica Belinda Romero

    2011-10-01

    Malignant tumors of the uterine corpus are uncommon. They originate from the endometrial stroma, smooth muscle, blood vessels, or from a mixture of them. The objective of this article was to know the frequency and the clinical, morphologic, and immunophenotype characteristics of the endometrial stromal sarcoma (ESS). We reviewed the cases of ESS observed from 2002 to 2008 at the Pathology Unit of the General Hospital of Mexico. The following data were analyzed: age, clinical stage, degree of differentiation, and immunophenotype. We found 18 cases, and the average age of patients was 48.6 years; 66% were in clinical stages 1 and 2. Fifteen cases (83.3%) were classified as low-grade sarcomas and 3 (16.6%) as high-grade or undifferentiated sarcomas. We determined immunohistochemical markers in 17 cases; receptors to estrogens were positive in 5 (29.4%) and to progesterone in 9 (52.9%). CD10 was expressed in 10 (58.8%) and p53 in 11 cases (64.7%). Two cases were associated to primary tumors of the ovary (papillary cystadenocarcinoma). In conclusion, ESS was present at 0.6% in our institution; and most were low grade. Expression of markers, such as p53, CD10, and hormonal receptors, was positive. PMID:21652246

  2. Rac1 Regulates Endometrial Secretory Function to Control Placental Development.

    Science.gov (United States)

    Davila, Juanmahel; Laws, Mary J; Kannan, Athilakshmi; Li, Quanxi; Taylor, Robert N; Bagchi, Milan K; Bagchi, Indrani C

    2015-08-01

    During placenta development, a succession of complex molecular and cellular interactions between the maternal endometrium and the developing embryo ensures reproductive success. The precise mechanisms regulating this maternal-fetal crosstalk remain unknown. Our study revealed that the expression of Rac1, a member of the Rho family of GTPases, is markedly elevated in mouse decidua on days 7 and 8 of gestation. To investigate its function in the uterus, we created mice bearing a conditional deletion of the Rac1 gene in uterine stromal cells. Ablation of Rac1 did not affect the formation of the decidua but led to fetal loss in mid gestation accompanied by extensive hemorrhage. To gain insights into the molecular pathways affected by the loss of Rac1, we performed gene expression profiling which revealed that Rac1 signaling regulates the expression of Rab27b, another GTPase that plays a key role in targeting vesicular trafficking. Consequently, the Rac1-null decidual cells failed to secrete vascular endothelial growth factor A, which is a critical regulator of decidual angiogenesis, and insulin-like growth factor binding protein 4, which regulates the bioavailability of insulin-like growth factors that promote proliferation and differentiation of trophoblast cell lineages in the ectoplacental cone. The lack of secretion of these key factors by Rac1-null decidua gave rise to impaired angiogenesis and dysregulated proliferation of trophoblast cells, which in turn results in overexpansion of the trophoblast giant cell lineage and disorganized placenta development. Further experiments revealed that RAC1, the human ortholog of Rac1, regulates the secretory activity of human endometrial stromal cells during decidualization, supporting the concept that this signaling G protein plays a central and conserved role in controlling endometrial secretory function. This study provides unique insights into the molecular mechanisms regulating endometrial secretions that mediate stromal-endothelial and stromal-trophoblast crosstalk critical for placenta development and establishment of pregnancy. PMID:26305333

  3. Randomized comparative trial of cervical block protocols for pain management during hysteroscopic removal of polyps and myomas

    Science.gov (United States)

    Lukes, Andrea S; Roy, Kelly H; Presthus, James B; Diamond, Michael P; Berman, Jay M; Konsker, Kenneth A

    2015-01-01

    Purpose To evaluate the efficacy of two cervical block protocols for pain management during hysteroscopic removal of intrauterine polyps and myomas using the MyoSure® device. Patients and methods This was a randomized, comparative treatment trial conducted by five private Obstetrics and Gynecology practices in the USA. Forty premenopausal women aged 18 years and older were randomized to receive either a combination para/intracervical block protocol of 37 cc local anesthetic administered at six injections sites in association with the application of topic 1% lidocaine gel, or an intracervical block protocol of 22 cc local anesthetic administered at three injections sites without topical anesthetic, for pain management during hysteroscopic removal of intrauterine polyps and/or a single type 0 or type 1 submucosal myoma ?3 cm. The main outcomes were a composite measure of procedure-related pain and pain during the postoperative recovery period, assessed by the Wong-Baker Faces Rating Scale (0= no pain to 10= maximum pain). The lesion characteristics, procedure time, and adverse events were summarized. Results A total of 17 polyps and eight myomas were removed in the para/intracervical block group, with diameters of 1.3±0.5 cm and 1.8±0.8 cm, respectively. In the intracervical block group, 25 polyps with a mean diameter of 1.2±0.7 cm and 7 myomas with a mean diameter of 1.9±0.9 cm were removed. The mean tissue resection time was 1.2±2.0 minutes and 1.2±1.4 minutes for the para/intracervical and intracervical block groups, respectively. The mean composite procedure-related pain score was low for both cervical block protocols, 1.3±1.4 in the para/intracervical block group vs 2.1±1.5 in the intracervical block group. During the postoperative recovery period, the mean pain scores were 0.3±0.7 vs 1.2±1.7 for the para/intracervical and intracervical block groups, respectively. There were no serious adverse events. Conclusion The MyoSure procedure for removal of polyps and myomas was well tolerated, with low pain scores reported for both the para/intracervical and intracervical block protocols. PMID:26543383

  4. YWHAE rearrangement identified by FISH and RT-PCR in endometrial stromal sarcomas: genetic and pathological correlations.

    Science.gov (United States)

    Croce, Sabrina; Hostein, Isabelle; Ribeiro, Agnes; Garbay, Delphine; Velasco, Valérie; Stoeckle, Eberhardt; Guyon, Frederic; Floquet, Anne; Neuville, Agnes; Coindre, Jean-Michel; MacGrogan, Gaëtan; Chibon, Frederic

    2013-10-01

    Endometrial stromal sarcomas represent the second most common mesenchymal uterine tumor. The 2003 WHO classification distinguishes low-grade and undifferentiated endometrial stromal sarcomas with different prognoses. Endometrial stromal sarcomas are a genetically heterogeneous group of sarcomas harboring different cytogenetic anomalies. Recently, a fusion between the YWHAE and FAM22A/B genes subsequent to a t(10;17) (q22;p13) has been described in endometrial sarcomas with high-grade histology. We examined YWHAE rearrangements by FISH break-apart and RT-PCR in a series of 27 undifferentiated uterine stromal sarcoma without JAZF1 rearrangements. Immunohistochemistry (IHC) was carried out with a panel of antibodies (estrogen (ER) and progesterone (PR) receptors, CD10, Cyclin D1, ?-catenin, p53, and Ki-67). We identified a subgroup of endometrial sarcomas with high-grade histology and uniform morphology harboring YWHAE rearrangements. FISH break-apart was interpretable in 20 cases (74%). Twelve cases (60%) showed 20%. RT-PCR was tested on 24/27 cases (88%) and 19 cases were interpretable (79%). Five cases (26%) showed a specific fusion transcript YWHAE-FAM22A/B sequence. The best concordance rate between FISH and RT-PCR (94%) was obtained with the threshold of 20% of cells with a YWHAE rearrangement. The YWHAE-rearranged cases showed high-grade morphology with uniform appearance, spindle or round epithelioid cells, low ER and PR, CD10 expression, and a high and diffuse positivity for Cyclin D1, p53, and nuclear ?-catenin negativity. Cyclin D1 was the most sensitive marker for high-grade endometrial sarcomas with YWHAE rearrangement. All undifferentiated uterine sarcomas with pleomorphic appearances did not harbor any YWHAE rearrangements, except for one case. Overall, for endometrial sarcoma cases with high-grade morphology we recommend to test for YWHAE rearrangements by FISH break-apart, a cost- and time-efficient method, and to complete the investigation by RT-PCR in borderline cases. PMID:23599159

  5. Successful Reduction of Acute Puerperal Uterine Inversion with the Use of a Bakri Postpartum Balloon

    Science.gov (United States)

    Ida, Akinori; Ito, Koichi; Kubota, Yoko; Nosaka, Maiko; Kato, Hiroshi; Tsuji, Yoshiyuki

    2015-01-01

    Uterine inversion is a state wherein the endometrial surface is inverted. Although this condition may be observed in nonpregnant women, it most commonly develops at the time of delivery. In the present case, a 37-year-old woman without any remarkable history developed acute puerperal uterine inversion after the successful induction of labor. Following the delivery, she complained twice of severe lower abdominal pain; subsequently, hemorrhage was noted at the site of partial detachment of the placenta. These findings led to a diagnosis of placenta accreta, and the patient developed a state of shock. A Bakri postpartum balloon was inserted into the uterine cavity under ultrasonographic guidance and was filled with physiological saline for treatment of this condition. With this procedure, the uterine inversion was completely reduced and the hemorrhage was stopped. Moreover, no reinversion was observed in the postoperative period. These findings suggest that a Bakri postpartum balloon can be used to noninvasively reduce uterine inversion and prevent its recurrence. PMID:25954560

  6. Diagnostic Features and Therapeutic Consequences of Hysteroscopy in Women with Abnormal Uterine Bleeding and Abortion

    Directory of Open Access Journals (Sweden)

    Sedigheh A. Fard

    2012-01-01

    Full Text Available Problem statement: Hysteroscopy is a procedure in which the endometrial cavity is observable and subject of manipulation via transcervical route. Hysteroscopy is a minimally invasive process in diagnosis and treatment of many intrauterine and endocervical conditions. Polypectomy, myomectomy and endometrial ablation could be easily manageable by this procedure. According to safety and high efficiency of hysteroscopy, this method is changing to a widespread procedure in dealing with many gynecologic and obstetrical conditions. This study aimed at evaluating the diagnostic and therapeutical efficiency of hysteroscopy in managing of common conditions including abnormal uterine bleeding and abortion. Approach: In a descriptive cross-sectional setting, 243 women underwent hysteroscopy were evaluated in two groups: with uterine bleeding 236 cases and with recurrent abortions 7 cases. This study was conducted in Tabriz Alzahra Educational Center during a 15-month period. The main causes of the complaints were determined in each group. Six months after treatment, the overall success rate was recorded. Results: Hysteroscopy was the sole diagnostic procedure in 16.5 and 14.3% of the patients in groups with abnormal uterine bleeding and abortion, respectively. In the group with abnormal uterine bleeding, curettage, myomectomy, polypectomy, hysterectomy, laparoscopy and laparotomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending order. In the group with recurrent abortion, laparoscopy, curettage and myomectomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending. There was not any major complication. The diagnostic-therapeutical measures accompanying with the laparoscopy were successful in 73.5% of the bleeding group in follow-up period. Conclusion: Based on our results, hysteroscopy is a safe, accurate and highly-efficient procedure in managing women with abnormal uterine bleeding and recurrent abortion.

  7. A PROSPECTIVE STUDY ON ROLE OF HYSTEROSCOPY VS. TRANSVAGINAL SONOGRAPHY IN DIAGNOSIS OF ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Padma

    2014-07-01

    Full Text Available AIMS AND OBJECTIVES: To study the demographic pattern of the patients and to evaluate causes of abnormal uterine bleeding in different menstrual phases using transvaginal sonography and diagnostic hysteroscopy. Evaluation of the validity of transvaginal sonography and hysteroscopy in various menstrual abnormalities and intrauterine pathologies. MATERIAL AND METHODS: Total 60 patients were selected with complaint of abnormal uterine bleeding who were in reproductive, premenopausal and postmenopausal phase of life and were grouped similarly. All patients were subjected for transvaginal sonography followed by hysteroscopy. RESULTS: Analysis of 60 cases were done, 21 (35% cases were normal and 39 (65% were having different uterine pathologies according to transvaginal sonography whereas 13 (21.66% were normal and 47 (78.34% were having uterine pathology as per hysteroscopy. In this study hysteroscopy was superior to TVS in detecting endometrial polyp and hyperplasia with sensitivity (100%, specificity (97.8%, positive predictive value (92.8% and negative predictive value (100% for polyp and 100%, 98.04%, 90% and 100% respectively for hyperplasia. Hysteroscopy shows 100% validity for submucous fibroid. TVS has better sensitivity (100%, specificity (98.2% and NPV (100% than hysteroscopy for detecting adenomyosis. TVS is superior to hysteroscopy in investigating endometrial carcinoma with 100%. Sensitivity, Specificity, PPV and NPV against hysteroscopic value of 66.6%, 100%, 100% and 98.2% respectively. Hysteroscopy has higher sensitivity (92.0% NPV (69.2% whereas TVS has higher specificity (100%, PPV (100% in diagnosis of AUB. CONCLUSION: Diagnostic hysteroscopy and transvaginal sonography are complimentary to each other in management of patients with abnormal uterine bleeding.

  8. General Information About Endometrial Cancer

    Science.gov (United States)

    ... summary on Uterine Sarcoma Treatment for more information. Obesity, high blood pressure, and diabetes mellitus may increase ... the way cancer will be treated in the future. Even when clinical trials do not lead to ...

  9. Treatment Option Overview (Endometrial Cancer)

    Science.gov (United States)

    ... summary on Uterine Sarcoma Treatment for more information. Obesity, high blood pressure, and diabetes mellitus may increase ... the way cancer will be treated in the future. Even when clinical trials do not lead to ...

  10. Effect of immunomodulatory therapy on the endometrial inflammatory response to induced infectious endometritis in susceptible mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Woodward, E. M.

    2012-01-01

    The objective of the present study was to evaluate the effect of immunomodulatory therapy (glucocorticoids (GC) and mycobacterium cell wall extract (MCWE)) on the endometrial gene expression of inflammatory cytokines in susceptible mares with induced infectious endometritis. Endometrial gene expression of pro- and anti-inflammatory cytokines; interleukin (IL)-1ß, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-a, IL-1 receptor antagonist (ra), acute phase protein (APP) serum amyloid A (SAA) and clinical parameters were evaluated. Five mares were classified as susceptible to persistent endometritis based on their endometrial histopathology and ability to clear an induced uterine inflammation. To investigate the effect of immunomodulatory therapy, the mares were inoculated with 10(5) colony forming units (CFU) Escherichia coli in three consecutive estrus cycles in a modified cross-over study design. Thus, each mare served as its own control and the treatment type was performed in randomized order. The effect of treatment with MCWE (1.5 mg Settle IV), dexamethasone (0.1 mg per kg IV) or no treatment was investigated. All mares were free from uterine inflammation before each E. coli inoculation. Endometrial biopsies were recovered 3, 24 and 72 h post inoculation. Relative gene-expression analyses were performed by quantitative reverse transcriptase PCR (qRT-PCR). Endometrial gene expression of inflammatory cytokines was modulated by administration of GC. Expression of proinflammatory cytokines (IL-1ß, IL-6, IL-8) and SAA was significantly lower in the GC treated group late in the study period (72 h) compared to "no treatment" and MCWE treatment. Increased expression of the anti-inflammatory cytokine IL-10 was observed 3 and 24 h after E. coli infusion and GC treatment. A significant decrease of SAA expression was observed after MCWE treatment compared to "no treatment". MCWE and GC treatment had a significant effect on the clearance of uterine pathogens and number of mares retaining fluid after E. coli infusion. The results of the current investigation suggest that GC is capable of effectively modulating the innate immune response to induced infectious endometritis in susceptible mares.

  11. CORRELACIÓN DE LA HISTEROSCOPIA Y BIOPSIA DIRIGIDA EN EL ESTUDIO DEL ENGROSAMIENTO ENDOMETRIAL PATOLÓGICO POR ULTRASONIDO

    Directory of Open Access Journals (Sweden)

    Macarena Socías T

    2007-01-01

    Full Text Available Objetivo: Correlacionar la histeroscopia con la biopsia dirigida en pacientes pre y postmenopáusicas con engrosamiento endometrial patológico al ultrasonido. Método: Estudio retrospectivo de 265 pacientes derivadas por engrosamiento endometrial patológico en la ecografía transvaginal y evaluadas mediante histeroscopia con biopsia dirigida. Resultados: 68,7% de las pacientes presentaron un aspecto histeroscópico benigno, 15,1% normal, 10,6% potencialmente maligno y 5,6% maligno. Los diagnósticos anátomo patológicos más frecuentes fueron: pólipo endometrial (n=92; 34,7%, endometrio proliferativo/secretor (n=84; 31,7% y mioma submucoso (n=38; 14,3%. Todos los cánceres endometriales (n=9 se presentaron en mujeres postmenopáusicas sin TRH y con endometrio 11 mm. La correlación entre histeroscopia y anatomía patológica para diagnóstico de patología benigna tuvo una sensibilidad y especificidad de 90,7% (95% IC 85,2 - 94,3 y 65,4% (95% IC 55,8 - 73,8; valor predictivo positivo y negativo fue de 80,2% (95% IC 73,8 - 85,4 y 82% (95% IC 72,3 - 88,7. Para diagnóstico de hiperplasia endometrial la sensibilidad y especificidad fue 60% (95% IC 31,3 - 83,2 y 91,4% (95% IC 87,3 - 94,2; el valor predictivo positivo y negativo fue de 21,4% (95% IC 10,7 - 39,5 y 98,3% (95% IC 95,7 - 99,3. Para diagnóstico de cáncer endometrial la sensibilidad y especificidad fue de 95% (95% IC 65,5 - 99,5 y 97,9% (95% IC 95,2 - 99; el valor predictivo positivo y negativo fue de 63,3% (95% IC 38,7 - 82,5 y 99,7% (95% IC 98,1 - 99,8. Conclusión: El 85% de las pacientes con engrosamiento endometrial presentaron una histeroscopia alterada (benigna, potencialmente maligna o maligna, confirmada en 80% de los casos por anatomía patológica. En un centro con experiencia la histeroscopia normal puede hacer innecesaria la biopsia. El aspecto potencialmente maligno a la histeroscopia puede ser un sobrediagnóstico, por lo que la anatomía patológica es imprescindible. Todos los cánceres endometriales fueron diagnosticados a la histeroscopiaObjective: Comparison of hysteroscopy with biopsy in pre- and post -menopausic patients with endometrial thickening on ultrasound. Methods: Retrospective study of 265 patients with pathologic endometrial thickening on transvaginal ultrasound and evaluated with hysteroscopy and biopsy. Results: 68.7% of the patients had benign hysteroscopy results, 15.1% were normal, 10.6% were potentially malignant, and 5.6% were malignant. The most frequent biopsy results were: endometrial polyp (n= 92, 34.7%, proliferate / secretor endometrium (n= 84, 31.7%, and submucosal myoma (n=38, 14.3%. All of the endometrial cancers (n= 9 were in post- menopausic women, with no history of hormone replacement therapy and with endometrial thickening 11mm. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing benign pathology were 90.7% (95% CI 85.2 - 94.3 and 65.4% (95% CI 55.8 - 73.8, and the positive and negative predictive values were 80.2% (95% CI 73.8 - 85.4 and 81.9% (95% CI 72.3 - 88.7. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial hyperplasia were 60% (95% CI 31.3 - 83.2 and 91.4% (95% CI 87.3 - 94.2, the positive and negative predictive values were 21.4% (95% CI 10.7 - 39.5 and 98.3% (95% CI 95.7 - 99.3. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial cancer were 95% (95% CI 65.5 - 99.5 and 97.9% (95% CI 95.2 - 99, positive and negative predictive values were 63.3% (95% CI 38.7 - 82.5 and 99.7% (95% CI 98.1 - 99.8. Conclusion: 85% of the patients with endometrial thickening had an abnormal hysteroscopy result, which latter were confirmed in 80% of the cases with biopsy. In a center with experience, a normal hysteroscopy result can make biopsy unnecessary. Potentially malignant hysteroscopys tend to be over diagnosed, making biopsy fundamental. All endometrial cancers were detected by hysteroscopy in our study

  12. CORRELACIÓN DE LA HISTEROSCOPIA Y BIOPSIA DIRIGIDA EN EL ESTUDIO DEL ENGROSAMIENTO ENDOMETRIAL PATOLÓGICO POR ULTRASONIDO

    Scientific Electronic Library Online (English)

    Macarena, Socías T; Renato, Vargas S; Alberto, Costoya A; Bárbara, Monje R; María Teresa, Haye M.

    Full Text Available Objetivo: Correlacionar la histeroscopia con la biopsia dirigida en pacientes pre y postmenopáusicas con engrosamiento endometrial patológico al ultrasonido. Método: Estudio retrospectivo de 265 pacientes derivadas por engrosamiento endometrial patológico en la ecografía transvaginal y evaluadas med [...] iante histeroscopia con biopsia dirigida. Resultados: 68,7% de las pacientes presentaron un aspecto histeroscópico benigno, 15,1% normal, 10,6% potencialmente maligno y 5,6% maligno. Los diagnósticos anátomo patológicos más frecuentes fueron: pólipo endometrial (n=92; 34,7%), endometrio proliferativo/secretor (n=84; 31,7%) y mioma submucoso (n=38; 14,3%). Todos los cánceres endometriales (n=9) se presentaron en mujeres postmenopáusicas sin TRH y con endometrio 11 mm. La correlación entre histeroscopia y anatomía patológica para diagnóstico de patología benigna tuvo una sensibilidad y especificidad de 90,7% (95% IC 85,2 - 94,3) y 65,4% (95% IC 55,8 - 73,8); valor predictivo positivo y negativo fue de 80,2% (95% IC 73,8 - 85,4) y 82% (95% IC 72,3 - 88,7). Para diagnóstico de hiperplasia endometrial la sensibilidad y especificidad fue 60% (95% IC 31,3 - 83,2) y 91,4% (95% IC 87,3 - 94,2); el valor predictivo positivo y negativo fue de 21,4% (95% IC 10,7 - 39,5) y 98,3% (95% IC 95,7 - 99,3). Para diagnóstico de cáncer endometrial la sensibilidad y especificidad fue de 95% (95% IC 65,5 - 99,5) y 97,9% (95% IC 95,2 - 99); el valor predictivo positivo y negativo fue de 63,3% (95% IC 38,7 - 82,5) y 99,7% (95% IC 98,1 - 99,8). Conclusión: El 85% de las pacientes con engrosamiento endometrial presentaron una histeroscopia alterada (benigna, potencialmente maligna o maligna), confirmada en 80% de los casos por anatomía patológica. En un centro con experiencia la histeroscopia normal puede hacer innecesaria la biopsia. El aspecto potencialmente maligno a la histeroscopia puede ser un sobrediagnóstico, por lo que la anatomía patológica es imprescindible. Todos los cánceres endometriales fueron diagnosticados a la histeroscopia Abstract in english Objective: Comparison of hysteroscopy with biopsy in pre- and post -menopausic patients with endometrial thickening on ultrasound. Methods: Retrospective study of 265 patients with pathologic endometrial thickening on transvaginal ultrasound and evaluated with hysteroscopy and biopsy. Results: 68.7% [...] of the patients had benign hysteroscopy results, 15.1% were normal, 10.6% were potentially malignant, and 5.6% were malignant. The most frequent biopsy results were: endometrial polyp (n= 92, 34.7%), proliferate / secretor endometrium (n= 84, 31.7%), and submucosal myoma (n=38, 14.3%). All of the endometrial cancers (n= 9) were in post- menopausic women, with no history of hormone replacement therapy and with endometrial thickening 11mm. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing benign pathology were 90.7% (95% CI 85.2 - 94.3) and 65.4% (95% CI 55.8 - 73.8), and the positive and negative predictive values were 80.2% (95% CI 73.8 - 85.4) and 81.9% (95% CI 72.3 - 88.7). Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial hyperplasia were 60% (95% CI 31.3 - 83.2) and 91.4% (95% CI 87.3 - 94.2), the positive and negative predictive values were 21.4% (95% CI 10.7 - 39.5) and 98.3% (95% CI 95.7 - 99.3). Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial cancer were 95% (95% CI 65.5 - 99.5) and 97.9% (95% CI 95.2 - 99), positive and negative predictive values were 63.3% (95% CI 38.7 - 82.5) and 99.7% (95% CI 98.1 - 99.8). Conclusion: 85% of the patients with endometrial thickening had an abnormal hysteroscopy result, which latter were confirmed in 80% of the cases with biopsy. In a center with experience, a normal hysteroscopy result can make biopsy unnecessary. Potentially malignant hysteroscopys tend to be over diagnosed, making biopsy fundamental. All endometrial cancers were detected by hysteroscopy in our study

  13. Menstrual cycle distribution of uterine natural killer cells is altered in heavy menstrual bleeding.

    Science.gov (United States)

    Biswas Shivhare, Sourima; Bulmer, Judith N; Innes, Barbara A; Hapangama, Dharani K; Lash, Gendie E

    2015-11-01

    Heavy menstrual bleeding (HMB) affects 30% of women of reproductive age and significantly interferes with quality of life. Altered endometrial vascular maturation has been reported in HMB and recurrent miscarriage, the latter associated with increased uterine natural killer (uNK) cell numbers. This study compared endometrial leukocyte populations in controls and women with HMB. Formalin-fixed paraffin-embedded endometrial biopsies from controls (without endometrial pathology) and HMB were immunostained for CD14 (macrophages), CD56 (uNK cells), CD83 (dendritic cells), FOXP3 (regulatory T cells/Tregs), CD3 and CD8 (T cells). Leukocyte numbers were analysed as a percentage of total stromal cells in five randomly selected fields of view in the stratum functionalis of each sample. In control women across the menstrual cycle, 2-8% of total stromal cells were CD3(+) cells, 2-4% were CD8(+) T cells and 6-8% were CD14(+) macrophages. Compared with controls, CD3(+) cells were reduced during the mid-secretory phase (4%, Pmenstrual cycle in both groups. In controls, 2% of stromal cells in proliferative endometrium were CD56(+) uNK cells, increasing to 17% during the late secretory phase. In HMB, CD56(+) uNK cells were increased in the proliferative (5%, P<0.01) and early secretory (4%, P<0.02) phases, but reduced (10%, P<0.01) in the late secretory phase. This study demonstrates dysregulation of uNK cells in HMB, the functional consequence of which may have an impact on endometrial vascular development and/or endometrial preparation for menstruation. PMID:26398782

  14. Microarray Analysis on Gene Regulation by Estrogen, Progesterone and Tamoxifen in Human Endometrial Stromal Cells

    Directory of Open Access Journals (Sweden)

    Chun-E Ren

    2015-03-01

    Full Text Available Epithelial stromal cells represent a major cellular component of human uterine endometrium that is subject to tight hormonal regulation. Through cell-cell contacts and/or paracrine mechanisms, stromal cells play a significant role in the malignant transformation of epithelial cells. We isolated stromal cells from normal human endometrium and investigated the morphological and transcriptional changes induced by estrogen, progesterone and tamoxifen. We demonstrated that stromal cells express appreciable levels of estrogen and progesterone receptors and undergo different morphological changes upon hormonal stimulation. Microarray analysis indicated that both estrogen and progesterone induced dramatic alterations in a variety of genes associated with cell structure, transcription, cell cycle, and signaling. However, divergent patterns of changes, and in some genes opposite effects, were observed for the two hormones. A large number of genes are identified as novel targets for hormonal regulation. These hormone-responsive genes may be involved in normal uterine function and the development of endometrial malignancies.

  15. Ablación endometrial histeroscópica como tratamiento definitivo para el sangrado uterino anormal

    Scientific Electronic Library Online (English)

    Verónica, Chamy P; Javiera, Berhó F; Benjamín, Tudela S; Anibal, Scarella C.

    Full Text Available Introducción: El sangrado uterino anormal (SUA) afecta a un 19% de las mujeres. Su tratamiento definitivo consiste en la histerectomía, sin embargo la ablación endometrial histeroscópica surge como un tratamiento menos invasivo, menos riesgoso y más rápido. Objetivo: Evaluar la efectividad de la abl [...] ación endometrial histeroscópica como tratamiento definitivo para el SUA. Método: Estudio de cohorte retrospectivo obtenido de base de datos de protocolos operatorios específicos del total de histeroscopías quirúrgicas realizadas en el Servicio de Ginecología del Hospital Naval Almirante Nef de Viña del Mar, entre enero de 2002 y diciembre de 2010. Resultados: De las 507 histeroscopías quirúrgicas realizadas, 230 fueron por SUA. Del total de pacientes sometidas a ablación endometrial histeroscópica, 27 (11,7%) necesitaron un segundo procedimiento, de las cuales sólo 15 (6,5%) fueron por persistencia de SUA. No se encontró asociación entre la necesidad de un segundo procedimiento por SUA con características propias de la paciente ni del procedimiento quirúrgico. Conclusión: La ablación endometrial histeroscópica es una opción terapéutica efectiva y segura para el tratamiento del SUA, con baja necesidad de segundo procedimiento por persistencia de éste y bajo riesgo de complicaciones. La necesidad de un segundo procedimiento por SUA no se asocia con características propias de la paciente ni del procedimiento quirúrgico. Abstract in english Introduction: Abnormal uterine bleeding (AUB) affects 19% of women. Definitive treatment is hysterectomy, however hysteroscopic endometrial ablation is emerging as a less invasive, less risky and faster treatment. Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation as defi [...] nitive treatment for AUB. Method: Retrospective cohort study database obtained from specific surgical protocols of all surgical hysteroscopies performed in the Gynecology Department of Hospital Naval Almirante Nef de Vina del Mar, between January 2002 and December 2010. Results: Of the 507 surgical hysteroscopies performed, 230 were because of AUB. Of all patients undergoing hysteroscopic endometrial ablation, 27 (11.7%) required a second procedure, of which only 15 (6.5%) were due to persistence of AUB. No association was found between the need for a second procedure because of AUB with patient characteristics or the surgical procedure itself. Conclusion: Hysteroscopic endometrial ablation is a safe and effective therapeutic option for AUB treatment, with a low need for a second procedure due to its persistence and with low risk of complications. The need of a second procedure because of AUB is not associated with patient characteristics or the surgical procedure itself.

  16. Uterine RAC1 via Pak1-ERM signaling directs normal luminal epithelial integrity conducive to on-time embryo implantation in mice.

    Science.gov (United States)

    Tu, Z; Wang, Q; Cui, T; Wang, J; Ran, H; Bao, H; Lu, J; Wang, B; Lydon, J P; DeMayo, F; Zhang, S; Kong, S; Wu, X; Wang, H

    2016-01-01

    Successful embryo implantation requires functional luminal epithelia to establish uterine receptivity and blastocyst-uterine adhesion. During the configuration of uterine receptivity from prereceptive phase, the luminal epithelium undergoes dynamic membrane reorganization and depolarization. This timely regulated epithelial membrane maturation and precisely maintained epithelial integrity are critical for embryo implantation in both humans and mice. However, it remained largely unexplored with respect to potential signaling cascades governing this functional epithelial transformation prior to implantation. Using multiple genetic and cellular approaches combined with uterine conditional Rac1 deletion mouse model, we demonstrated herein that Rac1, a small GTPase, is spatiotemporally expressed in the periimplantation uterus, and uterine depletion of Rac1 induces premature decrease of epithelial apical-basal polarity and defective junction remodeling, leading to disrupted uterine receptivity and implantation failure. Further investigations identified Pak1-ERM as a downstream signaling cascade upon Rac1 activation in the luminal epithelium necessary for uterine receptivity. In addition, we also demonstrated that Rac1 via P38 MAPK signaling ensures timely epithelial apoptotic death at postimplantation. Besides uncovering a potentially important molecule machinery governing uterine luminal integrity for embryo implantation, our finding has high clinical relevance, because Rac1 is essential for normal endometrial functions in women. PMID:26184908

  17. Relationships between intrauterine infusion of N-acetylcysteine, equine endometrial pathology, neutrophil function, post-breeding therapy, and reproductive performance.

    Science.gov (United States)

    Gores-Lindholm, Alicia R; LeBlanc, Michelle M; Causey, Robert; Hitchborn, Anna; Fayrer-Hosken, Richard A; Kruger, Marius; Vandenplas, Michel L; Flores, Paty; Ahlschwede, Scott

    2013-08-01

    Persistent endometritis in the mare is associated with hypersecretion of mucus by endometrial epithelium and migration of neutrophils into the uterine lumen. This study examines the relationships between N-acetylcysteine (NAC), a mucolytic agent with anti-inflammatory properties, and endometrial architecture, serum neutrophil function, post-breeding therapy, and reproductive performance of NAC-treated mares in a clinical setting. In study 1, endometrial biopsies from mares receiving intrauterine saline (fertile-control, n = 6) or 3.3% NAC (fertile-treatment, n = 6; barren-treatment, n = 10) were evaluated by histology and image analysis. In study 2, phagocytic activity of serum-derived neutrophils was measured after adding 0.5% or 3% NAC. In study 3, pregnancy rates of repeat breeders (n = 44) receiving an intrauterine infusion of 3.3% NAC 24-36 hours before mating (group 1) was recorded, as was first cycle of the season pregnancy rates of reproductively normal mares (group 2, n = 85), and mares treated for bacterial endometritis the cycle before mating (group 3, n = 25). Intrauterine NAC did not adversely affect endometrial histology. Extracellular mucus thickness and staining intensity were reduced in fertile-treatment mares (P NAC solution, but not by 0.5% NAC (P NAC was not irritating and inhibited the oxidative burst of neutrophils. Repeat breeder mares, with evidence of mucus hypersecretion, but no uterine pathogens, when treated with NAC followed by post-mating uterine lavage and oxytocin (and in some cases intrauterine antibiotics), achieved a pregnancy rate of 77%. PMID:23623166

  18. Histeroscopia cirúrgica com ressectoscópio para polipectomia endometrial: eficácia e segurança / Operative hysteroscopy with resectoscope for endometrial polypectomy: efficacy and safety

    Scientific Electronic Library Online (English)

    Hélio de Lima Ferreira Fernandes, Costa; Arinaldo Vasconcelos de, Alencar; Maria do Socorro Alves, Carvalho; Silvana Rocha, Menelau; Laura Olinda Bregieiro Fernandes, Costa.

    2001-07-01

    Full Text Available Objetivos: avaliar os resultados das primeiras 104 polipectomias histeroscópicas em nossa instituição de ensino. Métodos: estudo retrospectivo descritivo. Foram revistos os registros das primeiras 136 histeroscopias cirúrgicas realizadas no serviço, sendo 104 polipectomias. Foram avaliadas caracterí [...] sticas das pacientes operadas como idade, paridade, fase da vida reprodutiva e sintomatologia; número e tamanho dos pólipos e os resultados em relação às complicações e remissão dos sintomas. Resultados: as pacientes tinham em média 52,7 anos, sendo três quartos delas multíparas. Encontravam-se na pós-menopausa 60 pacientes (57,7% do grupo). Cerca de metade das pacientes apresentavam sintomas atribuíveis aos pólipos, sendo o sangramento anormal o mais comum (47,1%). Em 16,3% dos casos havia mais de um pólipo, sendo que 84% deles mediam mais de 1 cm. A única complicação imediata de importância foi uma perfuração uterina, sendo que as complicações tardias foram raras e sem gravidade. O tempo médio de seguimento foi de 9 meses. Em 82% das pacientes houve remissão das queixas. Apenas 8,2% das pacientes necessitaram de histerectomia complementar, todas com outras doenças uterinas, como mioma, adenomiose ou hiperplasia endometrial atípica, a qual foi encontrada em apenas 1 paciente. Conclusões: a polipectomia histeroscópica mostrou-se método simples, seguro e eficaz no tratamento dos pólipos endometriais. A seleção das pacientes deve ser rigorosa para evitar procedimentos cirúrgicos complementares. Abstract in english Purpose: to evaluate the results of the first 104 hysteroscopic polypectomies in a teaching hospital. Methods: a retrospective descriptive study was designed. Medical records of the first 136 operative hysteroscopies - 104 of which polypectomies - were reviewed. Patient characteristics such as age, [...] parity, period of reproductive function and symptoms; number and size of polyps and results concerning complications and symptom relief were evaluated. Results: the average age of patients was 52.7 years. Three quarters of them were multiparous. Fifty-seven percent of the patients were menopaused. About half of the patients had symptoms related to polyps. Abnormal bleeding was the most frequent symptom (47.1%). In 16.3% of the patients more than 1 polyp were detected and 84% of the polyps were larger than 1 cm. The only immediate complication was a uterine perforation. Late complications were rare and mild. The follow-up period was 9 months on average. In 82% of teh patients the symptoms were controlled. Hysterectomy was necessary in 8.2% of the patients, all of them with other uterine diseases such as leiomyomas, adenomyosis and atypical endometrial hyperplasia in one patient). Conclusion: hysteroscopic polypectomy is a simple, safe and effective method for the treatment of endometrial polyps. Selection of patients must be rigorous to avoid further operative procedures.

  19. Histeroscopia cirúrgica com ressectoscópio para polipectomia endometrial: eficácia e segurança Operative hysteroscopy with resectoscope for endometrial polypectomy: efficacy and safety

    Directory of Open Access Journals (Sweden)

    Hélio de Lima Ferreira Fernandes Costa

    2001-07-01

    Full Text Available Objetivos: avaliar os resultados das primeiras 104 polipectomias histeroscópicas em nossa instituição de ensino. Métodos: estudo retrospectivo descritivo. Foram revistos os registros das primeiras 136 histeroscopias cirúrgicas realizadas no serviço, sendo 104 polipectomias. Foram avaliadas características das pacientes operadas como idade, paridade, fase da vida reprodutiva e sintomatologia; número e tamanho dos pólipos e os resultados em relação às complicações e remissão dos sintomas. Resultados: as pacientes tinham em média 52,7 anos, sendo três quartos delas multíparas. Encontravam-se na pós-menopausa 60 pacientes (57,7% do grupo. Cerca de metade das pacientes apresentavam sintomas atribuíveis aos pólipos, sendo o sangramento anormal o mais comum (47,1%. Em 16,3% dos casos havia mais de um pólipo, sendo que 84% deles mediam mais de 1 cm. A única complicação imediata de importância foi uma perfuração uterina, sendo que as complicações tardias foram raras e sem gravidade. O tempo médio de seguimento foi de 9 meses. Em 82% das pacientes houve remissão das queixas. Apenas 8,2% das pacientes necessitaram de histerectomia complementar, todas com outras doenças uterinas, como mioma, adenomiose ou hiperplasia endometrial atípica, a qual foi encontrada em apenas 1 paciente. Conclusões: a polipectomia histeroscópica mostrou-se método simples, seguro e eficaz no tratamento dos pólipos endometriais. A seleção das pacientes deve ser rigorosa para evitar procedimentos cirúrgicos complementares.Purpose: to evaluate the results of the first 104 hysteroscopic polypectomies in a teaching hospital. Methods: a retrospective descriptive study was designed. Medical records of the first 136 operative hysteroscopies - 104 of which polypectomies - were reviewed. Patient characteristics such as age, parity, period of reproductive function and symptoms; number and size of polyps and results concerning complications and symptom relief were evaluated. Results: the average age of patients was 52.7 years. Three quarters of them were multiparous. Fifty-seven percent of the patients were menopaused. About half of the patients had symptoms related to polyps. Abnormal bleeding was the most frequent symptom (47.1%. In 16.3% of the patients more than 1 polyp were detected and 84% of the polyps were larger than 1 cm. The only immediate complication was a uterine perforation. Late complications were rare and mild. The follow-up period was 9 months on average. In 82% of teh patients the symptoms were controlled. Hysterectomy was necessary in 8.2% of the patients, all of them with other uterine diseases such as leiomyomas, adenomyosis and atypical endometrial hyperplasia in one patient. Conclusion: hysteroscopic polypectomy is a simple, safe and effective method for the treatment of endometrial polyps. Selection of patients must be rigorous to avoid further operative procedures.

  20. Significance of negative hysteroscopic view in abnormal uterine bleeding.

    Directory of Open Access Journals (Sweden)

    Parasnis H

    1992-04-01

    Full Text Available Ninety six cases of abnormal uterine bleeding were evaluated by both panoramic hysteroscopy and dilatation and curettage. The indications for hysteroscopy included postmenopausal bleeding, infertility with abnormal bleeding, abnormal bleeding and suspected leiomyoma with bleeding. Twenty three patients had abnormal hysteroscopy findings. Hysteroscopy diagnosed endometrial polyp and submucus leiomyoma with 100% accuracy. In 17 cases, the results of hysteroscopy and curettage were in agreement and hysteroscopy revealed more information than curettage in 6 cases. Among the remaining 73 cases with ?negative? hysteroscopic view, an abnormality was detected by tissue sampling in only 2 patients. The specificity and positive predictive value of hysteroscopy is 100%. The sensitivity of hysteroscopy was greater (92% than that of curettage (76% and the negative predictive value of hysteroscopy was 2.8%. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of intrauterine pathology.

  1. Significance of negative hysteroscopic view in abnormal uterine bleeding.

    Science.gov (United States)

    Parasnis, H B; Parulekar, S V

    1992-01-01

    Ninety six cases of abnormal uterine bleeding were evaluated by both panoramic hysteroscopy and dilatation and curettage. The indications for hysteroscopy included postmenopausal bleeding, infertility with abnormal bleeding, abnormal bleeding and suspected leiomyoma with bleeding. Twenty three patients had abnormal hysteroscopy findings. Hysteroscopy diagnosed endometrial polyp and submucus leiomyoma with 100% accuracy. In 17 cases, the results of hysteroscopy and curettage were in agreement and hysteroscopy revealed more information than curettage in 6 cases. Among the remaining 73 cases with 'negative' hysteroscopic view, an abnormality was detected by tissue sampling in only 2 patients. The specificity and positive predictive value of hysteroscopy is 100%. The sensitivity of hysteroscopy was greater (92%) than that of curettage (76%) and the negative predictive value of hysteroscopy was 2.8%. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of intrauterine pathology. PMID:1432829

  2. Effects of Interceed on endometrial receptivity in rabbits with intrauterine adhesion

    Directory of Open Access Journals (Sweden)

    Hui-juan LI

    2015-06-01

    Full Text Available Objective?To observe the effect of anti-adhesion membrane made of oxidized regenerated cellulose (Interceed on endometrial receptivity in New Zealand white rabbits with intrauterine adhesion (IUA. Methods?Forty-eight female rabbits were randomly divided into 4 groups (12 each: normal control group (group A, Interceed control group (group B, untreated model group (group C, and Inte rceed therapy group (group D. Rabbits in group A received sham operation and underwent no modeling. The Interceed was placed into the normal rabbits' uteruses in group B. The IUA rabbit models were reproduced in group C and group D by both mechanical injury and infection. Rabbits in group C were not treated, and in group D Interceed was put into their uteruses 7 days after modeling. Four rabbits in each group were sacrificed on the 28th day, the uterine tissues were collected. The endometrial glands count was performed after HE staining, and the degree of endometrial fibrosis was assessed after Masson staining. For the remaining animals in each group, ovulation was induced by stimulating the vagina in estrus, and they were sacrificed and the uterine tissue was collected on the 7th day after pseudopregnancy. The expression of pinopodes in endometrium was observed by scanning electron microscopy, and that of integrin ?v?3 protein was determined by immunohistochemistry. Results?The expression of glands and the degree of fibrosis in endometrium was obviously improved in group D as compared with that of group C (P<0.05, but no significant difference was found among the groups A, B and D. In group A, and developed pinopodes were abundantly expressed in endometrial surface, and similar changes were found in group B. The expression of pinopodes in group C was scarce, and the development was not synchronized. More pinopodes, with irregular shape and synchronized development, were expressed in group D than in group C. The expression of integrin ?v?3 protein was significantly lower in group C than in group A and group D (P<0.05. Conclusion?Interceed may alleviate the endometrial pathological changes, increase the expression of integrin ?V?3 protein, ameliorate the expression and development of pinopodes, thus improve the endometrial receptivity. DOI: 10.11855/j.issn.0577-7402.2015.05.02

  3. Magnetic resonance imaging of cancer of uterine cervix and body. Preliminary study in 9 cases of body cancer and 20 of cervical cancer

    International Nuclear Information System (INIS)

    We studied nine cases of endometrial carcinoma and twenty of cervix carcinoma. Correlation with histology is made after curietherapy in 8 cases of endometrial carcinoma. Tumor is not always seen and particularly when there is no mass effect on macroscopic examination. Myometral invasion is not seen with accuracy: the interruption of junctional zone is not a good sign. The cervix tumors are well seen on T2 sequences before any treatment. There extra uterine extension is difficult to appreciate. The best results of RMI were in the follow-up after radiotherapy. Therefore it appears actually to us the best indication of RMI

  4. Molecular characterisation of the uterine microbiome of dairy cows suffering from endometritis, metritis, and pyometra

    DEFF Research Database (Denmark)

    Knudsen, Lif RØdtness Vesterby

    2014-01-01

    Postpartum uterine disease is a problem in dairy herds. Approximately 90% of dairy cows experience postpartum bacterial contamination of the uterus. Most of the cows are able to clear the infection within 8 weeks in the process of involution, but up to 20% of the cows develop metritis, which is infection throughout the uterine wall; and in some herds, 30-50% of cows develop endometritis, which is infection in the inner lining of the uterus. Pyometra is a related postpartum uterine disease, which is thought to occur when a cow with endometritis ovulates, and the cervix closes. The diseases are negatively correlated to reproductive performance, and in combination with the high incidence rate, they are costly for the farmers. Traditional culturebased studies are biased towards bacteria that thrive in a laboratory environment. In this project the bacterial flora were investigated by molecular microbiology methods, primarily 16S rRNA PCR and next generation sequencing. The study included uterine flush samples from the lumen as well as endometrial samples, to evaluate the correlation between the uterine flush samples, which are commonly used sample type in the area, and the bacteria found adhering to the mucosal layer of the uterus, the endometrium. It was hypothesised that pathogenic bacteria in the uterus initially adhere to the endometrium to cause disease, and that the chance of identifying pathogens is higher in examinations of endometrial biopsies than in uterine flush samples. In order to investigate the expression patterns of the bacteria in the endometritic uterus, a metatransgenomic study was performed. This method is based on mRNA sequencing, and provides a snapshot of the expression profile of the bacteria at the time of sampling. Previous studies of virulence factors have been performed with quantitative PCR, which requires prior knowledge of gene sequence. It was found that there was an association between the Fusobacteriaceae and Porphyromonadaceae families and metritis in week 1 postpartum. For endometritis in weeks 4 and 7, there was not a bacterial family consistently associated with the disease across time points and sample types. There were large differences between the uterine flush samples and the endometrial biopsies, and although the sample types were correlated, the diversity of the microbiota in the biopsy samples was higher than the diversity of the microbiota of the uterine flush samples. Furthermore, the bacterial families that made out the majority of the population were the same over time. The most abundant family observed in cows with pyometra was the Fusobacteriaceae family, which contain F. necrophorum, a pathogen previously known to be associated with pyometra, whereas evidence of the association of T. pyogenes with pyometra was less convincing. The previously unidentified Gram-negative bacteria observed in other studies of pyometra are likely to belong to the Porphyromonadaceae, Pasteurellaceae, and Mycoplasmataceae families identified. It was found that the 50 most up-regulated transcripts of the microbiota from the uterus of cows with metritis and endometritis were primarily involved in DNA replication, transcription, translation, and metabolic processes. This indicates an active multiplication phase in the infection, and an adaption to the host environment. Furthermore, an up-regulation was observed of genes potentially involved in the synthesis of LPS, lipid A, haemagglutinin, and several genes that code for proteases. These genes are putative virulence genes. The majority of the most differentially expressed transcripts mapped most closely to proteins from the F. necrophorum and P. levii species. This indicates that these species were the most metabolically active in the uterus of the cows with uterine disease, and that these may be the primary pathogens of uterine disease. Transcripts from other species were also observed to be highly expressed in the uterus of cows with uterine disease, among others from M. bovigenitalium. The results in this thesis underline the high number of bacter

  5. 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian Past Issues / Spring 2007 ... of this page please turn Javascript on. Gynecologic Cancers Cervical, Endometrial, and Ovarian NCI estimates that endometrial, ...

  6. Lajjalu treatment of uterine prolapse

    OpenAIRE

    Shivanandaiah, T. M.; Indudhar, T. M.

    2010-01-01

    Mimosa pudica was found useful in cases of uterine prolapse with bleeding, consistent with my experience of working with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has been avoided up to this date, and is not now expected to be recommended.

  7. Malignant transformation of uterine leiomyoma

    OpenAIRE

    Al Ansari, Afaf A.; Al Hail, Fatima A.; Abboud, Emad

    2013-01-01

    A rare case of malignant transformation of uterine leiomyoma is reported. A 54 year old lady, nulliparous and 2 years postmenopausal presented to gynecology clinic with a pelvi – abdominal mass and ultrasound scan suggestive of multiple uterine fibroid. Total abdominal hysterectomy performed. Histopathology report showed leiomyosarcomative changes from benign leiomyoma within the huge mass.

  8. PET in uterine malignancies

    OpenAIRE

    Valeria Pirro; Andrea Skanjeti; Ettore Pelosi

    2010-01-01

    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 18FF...

  9. An estrogen-induced endometrial hyperplasia mouse model recapitulating human disease progression and genetic aberrations

    International Nuclear Information System (INIS)

    Endometrial hyperplasia (EH) is a condition originating from uterine endometrial glands undergoing disordered proliferation including the risk to progress to endometrial adenocarcinoma. In recent years, a steady increase in EH cases among younger women of reproductive age accentuates the demand of therapeutic alternatives, which emphasizes that an improved disease model for therapeutic agents evaluation is concurrently desired. Here, a new hormone-induced EH mouse model was developed using a subcutaneous estradiol (E2)-sustained releasing pellet, which elevates the serum E2 level in mice, closely mimicking the effect known as estrogen dominance with underlying, pathological E2 levels in patients. The onset and progression of EH generated within this model recapitulate a clinically relevant, pathological transformation, beginning with disordered proliferation developing to simple EH, advancing to atypical EH, and then progressing to precancerous stages, all following a chronologic manner. Although a general increase in nuclear progesterone receptor (PR) expression occurred after E2 expression, a total loss in PR was noted in some endometrial glands as disease advanced to simple EH. Furthermore, estrogen receptor (ER) expression in the nucleus of endometrial cells was reduced in disordered proliferation and increased when EH progressed to atypical EH and precancerous stages. This EH model also resembles other pathological patterns found in human disease such as leukocytic infiltration, genetic aberrations in ?-catenin, and joint phosphatase and tensin homolog/paired box gene 2 (PTEN/PAX2) silencing. In summary, this new and comprehensively characterized EH model is cost-effective, easily reproducible, and may serve as a tool for preclinical testing of therapeutic agents and facilitate further investigation of EH

  10. Chorionic gonadotropin and uterine dialogue in the primate

    Directory of Open Access Journals (Sweden)

    Strakova Zuzana

    2004-07-01

    Full Text Available Abstract Implantation is a complex spatio-temporal interaction between the growing embryo and the mother, where both players need to be highly synchronized to be able to establish an effective communication to ensure a successful pregnancy. Using our in vivo baboon model we have shown that Chorionic Gonadotropin (CG, as the major trophoblast derived signal, not only rescues the corpus luteum but also modulates the uterine environment in preparation for implantation. This response is characterized by an alteration in both the morphological and biochemical activity in the three major cell types: luminal and glandular epithelium and stromal fibroblasts. Furthermore, CG and factors from the ovary have a synergistic effect on the receptive endometrium. Novel local effects of CG which influence the immune system to permit the survival of the fetal allograft and prevent endometrial cell death are also discussed in this review. An alternate extracellular signal-regulated kinase (ERK activation pathway observed in epithelial endometrial cells and the possibility of differential expression of the CG/LH-R isoforms during gestation, open many questions regarding the mechanism of action of CG and its signal transduction pathway within the primate endometrium.

  11. Gene Tests May Improve Therapy for Endometrial Cancer

    Science.gov (United States)

    ... External link, please review our exit disclaimer . Subscribe Gene Tests May Improve Therapy for Endometrial Cancer By analyzing genes in hundreds of endometrial tumors, scientists identified details ...

  12. Ultrasonographic findings of uterine polypoid adenomyomas

    International Nuclear Information System (INIS)

    To characterize the ultrasonographic findings of polypoid adenomyoma of the uterus. Ultrasonographic findings of twenty seven patients with histologically confirmed polypoid adenomyoma were retrospectively reviewed. Ultrasonography (US) was performed in all patients while sonohysterography (SH) in fifteen patients and color Doppler sonography (CDS) in thirteen patients were additionally performed. Location, size, growth pattern, surface, margin from the endometrim and underlying myometrium, echogenecity and echotexture, presence and patterns of cystic areas, hemorrhage, and posterior shadowing of the endometrial or submucosal mass on US and SH were evaluated. The presence of blood flow and resistive index (RI) on CDS were also evaluated. On US and SH, the tumor location was the corpus in sixteen cases, fundus in eight, and isthmus in three cases, and the tumor size ranged from 0.5 to 6 cm (mean 3.5 cm). The tumors were polypoid in eighteen cases, sessile in four cases, and pedunculated in five cases, and three of them protruded into endocervical canal while two cases prolapsed through externals os. The surface was smooth in twenty six cases, lobulated in four and irregular in one. Nineteen cases had ill defined margin while eight cases, a well circumscribed margin. The mass was inhomogeneously isoechoic in twelve cases, homogeneously isoechoic in seven cases, homogeneously and inhomogeneously hyperechoic in four cases each, respectively. Cystic areas were seen in twenty cases, and there were three patterns of cystic areas: all solid mass (pattern 1, n=7), solid mass with cystic areas (pattern 2, n=18) and predominantly cystic mass (pattern 3, n=2). Eight cases had hemorrhage and seven had posterior shadowing. CDS showed a blood flow with range of RI from 0.19 to 0.74 (mean 0.47). Other findings included adenomyosis in sixteen cases, leiomyoma in three, and endometrial thickening and mass in one each, respectively. Polypoid adenomyoma can be characterized as a heterogeneously isoechoic polypoid or pedunculated mass with multiple small cysts, hemorrhage, posterior shadowing and associated adenomyosis on US and SH. US could be useful in differentiating polypoid adenomyoma from other uterine polypoid tumors.

  13. Uterine adenosarcomas overgrown by sex-cord-like tumour: report of two cases.

    Science.gov (United States)

    Stolnicu, S; Balachandran, K; Aleykutty, M A; Loghin, A; Preda, O; Goez, E; Nogales, F F

    2009-10-01

    Müllerian adenosarcomas are tumours of low malignant potential with proliferation of benign glands and low grade endometrial stromal sarcoma (LGESS). Unusually, the latter may include foci of uterine tumours resembling ovarian sex-cord tumours (UTROSCT). Two cases of uterine adenosarcomas massively overgrown by UTROSCT are reported, for the first time. The patients, aged 71 and 64, one receiving tamoxifen, presented with intracavitary polypoid adenosarcomas; each was overgrown by an immunopathologically characteristic UTROSCT that constituted more than 75% of its volume. Periglandular CD10+LGESS represented less than 25%. Both are alive and well after 5 and 3 years, respectively. Compared to the poor prognosis of adenosarcomas overgrown by high grade sarcomata, the cases reported here had a benign behaviour. Quantitative assessment of volume percentage of the potentially aggressive LGESS, CD10+ areas should be considered as a relevant prognostic histological parameter in these tumours. PMID:19783725

  14. Established, emerging and future applications of FDG-PET/CT in the uterine cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, K., E-mail: kitajima@med.kobe-u.ac.j [PET Diagnosis, Institute of Biomedical Research and Innovation, Kobe (Japan); Murakami, K. [Division of Nuclear Medicine, Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo (Japan); Kaji, Y. [Radiology, Dokkyo University School of Medicine, Mibu (Japan); Sakamoto, S. [PET center, Dokkyo Medical University Hospital, Mibu (Japan); Sugimura, K. [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2011-04-15

    Integrated positron emission tomography/computed tomography (PET/CT) with 2-[{sup 18}F]fluoro-2-deoxy-D-glucose (FDG) is a useful technique to acquire both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session and has opened a new field in clinical oncologic imaging. FDG-PET/CT has been used successfully for the staging, optimization of treatment, re-staging, therapy monitoring, and prognostic prediction of uterine cervical cancer and endometrial cancer as well as various malignant tumours. The present review discusses the current role of FDG-PET/CT in the management of uterine cancer, discussing its usefulness and limitations in the imaging of these patients.

  15. Accessory Cavitated Uterine Mass: A Rare Cause of Severe Dysmenorrhea in Young Women.

    Science.gov (United States)

    Paul, P G; Chopade, Gaurav; Das, Tanuka; Dhivya, N; Patil, Saurabh; Thomas, Manju

    2015-01-01

    We present 3 case reports of a rare Müllerian anomaly called accessory and cavitated uterine mass (ACUM), which is found in young women >30 years of age. They presented with severe dysmenorrhea refractory to medical treatment. The patients were 17, 19, and 25 years old. The patients had the classic Müllerian anomalies. The hysteroscopic examination was normal in all 3 cases, and laparoscopic examination showed a 3- to 4-cm ill-defined mass on the right half of the uterus, without any communication to the uterine cavity. The chocolate-colored material was drained in all of the cases, during excision of the mass. The myometrial defect was sutured laparoscopically. On histological examination, the mass was found to be a cystic cavity, lined by endometrial glands and stroma, which confirmed the diagnosis of ACUM. PMID:26093186

  16. Hysteroscopy as a standard procedure for assessing endometrial lesions among postmenopausal women / Histeroscopia como procedimento padrão para avaliação de lesões endometriais em mulheres na pós-menopausa

    Scientific Electronic Library Online (English)

    Camila Toffoli, Ribeiro; Júlio César, Rosa-e-Silva; Marcos Felipe, Silva-de-Sá; Ana Carolina Japur de Sá, Rosa-e-Silva; Omero Benedicto, Poli Neto; Francisco José Candido dos, Reis; Antonio Alberto, Nogueira.

    2007-11-01

    Full Text Available CONTEXTO E OBJETIVO: O câncer endometrial é o tipo mais prevalente de neoplasia maligna do trato genital. Os objetivos deste estudo foram: calcular a sensibilidade, especifi cidade e acurácia, bem como valor preditivo positivo e negativo das histeroscopias diagnósticas em comparação com a análise hi [...] stopatológica de todas as lesões da cavidade endometrial. DESENHO E LOCAL: Estudo retrospectivo e descritivo no setor de endoscopia ginecológica do hospital universitário, terciário e público da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. MÉTODOS: A histeroscopia diagnóstica foi indicada nas seguintes situações: espessura endometrial > 4 mm em pacientes assintomáticas, sangramento na pós-menopausa, endométrio irregular ou endométrio de difícil avaliação pelo ultra-som, com ou sem sangramento vaginal. A avaliação ultra-sonográfi ca foi realizada não mais que três meses antes da histeroscopia. RESULTADOS: A idade média das pacientes foi 61,1 ± 2,0 anos, e a duração média do período pós-menopausa foi de 12,7 ± 2,5 anos. Das 510 pacientes, 293 (57,5%) foram submetidas à biópsia endometrial, no estudo histopatológico, 18 pacientes apresentavam carcinoma endometrial, hiperplasia típica ou atípica e nenhuma delas apresentava espessura endometrial maior que 8 mm. Nenhuma diferença signifi cativa foi encontrada entre as espessuras medianas das várias lesões benignas (p > 0,05). A sensibilidade (94,4%), especifi cidade (97%), acurácia (96,8%) e valores preditivos positivo e negativo (68% e 99,6% respectivamente) foram altos em nosso estudo. CONCLUSÃO: Nossos resultados sugerem que a histeroscopia diagnóstica apresenta boa validade como ferramenta diagnóstica para lesões malignas e hiperplasias, bem como para lesões benignas, com exceção dos leiomiomas submucosos, para o qual a sensibilidade foi de somente 52,6%. Abstract in english CONTEXT AND OBJECTIVES: Endometrial cancer is the most prevalent type of malignant neoplasia of the genital tract. The objective of this study was to calculate the sensitivity, specificity, accuracy and positive and negative predictive values for diagnostic hysteroscopy, in comparison with histopath [...] ological tests, for all lesions of the endometrial cavity. DESIGN AND SETTING: Retrospective descriptive study at the public tertiary-level university hospital of Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Diagnostic hysteroscopy was indicated in the following instances: endometrial thickness > 4 mm in asymptomatic patients; postmenopausal bleeding; and irregular endometrium or endometrium difficult to assess from ultrasound, with or without vaginal bleeding. Ultrasound evaluations were carried out no more than three months prior to hysteroscopy. RESULTS: There were 510 patients, with a mean age of 61.1 ± 2.0 years and mean time elapsed since the menopause of 12.7 ± 2.5 years. Endometrial biopsies were performed on 293 patients (57.5%). Histopathological analysis showed that 18 patients presented endometrial carcinoma or typical or atypical hyperplasia, and none of them presented endometrial thickness of less than 8 mm. No significant differences were found between the median thicknesses of the various benign lesions (p > 0.05). In our data, the sensitivity, specificity, accuracy and positive and negative predictive values for cancer or hyperplasia were 94.4%, 97.0%, 96.8%, 68% and 99.6%, respectively. CONCLUSIONS: Our results suggest that hysteroscopy is valuable as a diagnostic tool for malignant/hyperplastic and benign lesions, except for submucous myomas, for which the sensitivity was only 52.6%.

  17. Thermotolerance of human myometrium: implications for minimally invasive uterine therapies

    Science.gov (United States)

    Thomas, Aaron C.; Grisez, Brian T.; McMillan, Kathleen; Chill, Nicholas; Harclerode, Tyler P.; Radabaugh, Rebecca; Jones, Ryan M.; Coad, James E.

    2013-02-01

    Endometrial ablation has gained significant clinical acceptance over the last decade as a minimally invasive treatment for abnormal uterine bleeding. To improve upon current thermal injury modeling, it is important to better characterize the myometrium's thermotolerance. The extent of myometrial thermal injury was determined across a spectrum of thermal histories/doses (time-temperature combinations). Fresh extirpated human myometrium was obtained from 13 subjects who underwent a previous scheduled benign hysterectomy. Within two hours of hysterectomy, the unfixed myometrium was treated in a stabilized saline bath with temperatures ranging from 45-70 °C and time intervals from 30- 150 seconds. The time-temperature combinations were selected to simulate treatment times under 2.5 minutes. A total of six such thermal matrices, each comprised of 45 time-temperature combinations, were prepared for evaluation. The treated myometrium was cryosectioned for nitro blue tetrazolium (NBT) staining to assess for thermal respiratory enzyme inactivation. Image analysis was subsequently used to quantitatively assess the stained myometrium's capacity to metabolize the tetrazolium at each time-temperature combination. This colorimetric data was then used as marker of cellular viability and determine survival parameters with implications for developing minimally invasive uterine therapies.

  18. Staging of carcinoma of the uterine cervix and endometrium

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Takashi; Tamai, Ken; Togashi, Kaori [Kyoto University, Department of Diagnostic Radiology, Graduate School of Medicine, Kyoto (Japan)

    2007-08-15

    Carcinoma of the uterine cervix and endometrium are common gynecologic malignancies. Both carcinomas are staged and managed by means of the International Federation of Gynecology and Obstetrics (FIGO) staging system. In uterine cervical cancer, the FIGO staging system is determined preoperatively by limited conventional procedures. Although this system is effective for early stage disease, it has inherent inaccuracies in advanced stage diseases and does not address nodal involvement. CT and MR imaging are widely used as comprehensive imaging modalities to evaluate tumor size and extent, and nodal involvement. MR imaging is an excellent modality for depicting invasive cervical carcinoma and can provide objective measurement of tumor volume, and provides high negative predictive value for parametrial invasion and stage IVA disease. In contrast, endometrial cancer is surgically staged. Beside recognition of the important prognostic factors, including histologic subtype and grade, accurate assessment of the tumor extent on preoperative MR imaging is expected to greatly optimize surgical procedure and therapeutic strategy. Contrast-enhanced MR imaging can offer ''one stop'' examination for evaluating the depth of myometrial invasion cervical invasion and nodal metastases. Evaluation of myometrial invasion on MR imaging may be an alternative to gross inspection of the uterus during the surgery. (orig.)

  19. A new case of primary signet-ring cell carcinoma of the cervix with prominent endometrial and myometrial involvement: Immunohistochemical and molecular studies and review of the literature

    Directory of Open Access Journals (Sweden)

    Giordano Giovanna

    2012-01-01

    Full Text Available Abstract Background As a rule, endocervical tumours with signet-ring cell are classed as metastatic extra-genital neoplasms. In a patient aged 45 years, we describe primary cervical signet-ring cell carcinoma (PCSRCC characterized by prominent endometrial and myometrial involvement, simulating primary endometrial adenocarcinoma with cervical extension. In addition, a review was made of the literature to identify the clinical and pathological features of this rare malignancy. Case presentation A 45-year-old woman was referred to our Gynaecology Department due to persistent abnormal vaginal bleeding. Transvaginal ultrasonography showed slight endometrial irregularities in the whole uterine cavity suggestive of endometrial neoplasms. Pelvic magnetic resonance imaging revealed diffuse enlargement of the cervix, which had been replaced by a mass. Induration extended to the parametria and sigmoid colon fat. Histological examination of endometrial curettage and a cervical biopsy revealed a neoplasm characterized by neoplastic signet-ring cells and trabecular structures. Immunohistochemical analysis and molecular studies showed certain findings consistent with a cervical neoplasm, such as positivity to CEA, keratin 7, Ca-125 and p16 and the presence of HPV (Human Papilloma Virus DNA 18. On examination of the hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the lesion replacing the cervix, endometrium and myometrium, revealed the same immunohistochemical findings observed on endometrial curettage and cervical biopsy specimens. Metastases were found in an ovarian cystic lesion and the lymph nodes. Conclusion With this report the authors have demonstrated that the spread of cervical adenocarcinoma to the uterine corpus, although rare, may be observed, and that in this instance immunohistochemical and molecular studies can provide sufficient information for accurate diagnosis even on small biopsy specimens.

  20. Neutrophil-lymphocyte and platelet-lymphocyte ratios in endometrial hyperplasia

    Science.gov (United States)

    Gulucu, Selim; Aliyev, Nurlan; Ozsoy, Zeki; Nacar, Mehmet; Koseoglu, Dogan

    2015-01-01

    Objective The purpose of present study was to evaluate association between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) and endometrial hyperplasia (EH). Methods One hundred and ten women with abnormal uterine bleeding were included into the study. Blood samples were drawn from all patients to obtain complete blood cell counts, neutrophil-leukocyte ratio and platelet-leukocyte ratio before endometrial curettage procedure initiated. The patients were divided into three groups due to their pathological results: group 1, patients with EH without atypia (n=40); group 2, patients with EH with atypia (n=15); and group 3, patients with neither hyperplasia nor cancer as control group (n=55). Blood cell counts, NLRs and PLRs were compared among these groups. Results Based on hemoglobin and platelet counts, there was no significant difference among these groups (P>0.05). Leukocyte and neutrophil counts were higher in group 2 (EH with atypia) than group 1 and group 3 (P<0.01). NLR of group 2 was significantly elevated when compared to group 1 and group 3 (P=0.004). PLR was higher in group 1 and group 2 than control group (P=0.024). Conclusion Non-specific inflammatory markers such as NLR and PLR were elevated in women with atypical EH. These markers may be used as a predictor of atypical EH in patients with abnormal uterine bleeding. PMID:25798430

  1. Postoperative radiotherapy of endometrial cancer

    International Nuclear Information System (INIS)

    A retrospective study was made of the influence of such factors as the stage, morphological structure, degree of tumor differentiation, time and volume of irradiation in the postoperative period on therapeutic efficacy. Combined therapy was provided to 118 patients with endometrial cancer. The morphological diagnosis of adenocarcinoma was made in 117 of them. By the operative findings in 77.9% the tumor infiltrated the endometrium, in 5.1% it affected the cervical canal and in 6.8% the ovaries. A decrease in tumor differentiation was worse for prognolis. The combination of contact and ?-beam therapy after panhysterectomy for endometrial cancer proves effective, radiation reactions are infrequent (cystitis in 5.1%, rectitis in 6.8% of the patient,). Of the 31 patients, 24 have been alive for 6-11 yrs., of the 18 patients, 13 for 5 yrs

  2. Excessive uterine bleeding.

    Science.gov (United States)

    Talib, Hina J; Coupey, Susan M

    2012-04-01

    Menstrual bleeding that falls outside the range of normal in adolescents is often a cause of great concern for both girls and their families. Often, much of this anxiety can be alleviated with proper anticipatory guidance about menarche and early menstrual bleeding patterns. Eliciting a menstrual history from an adolescent girl is challenging, and the use of concrete methods to chart their patterns and flow, such as menstrual calendars and pictorial bleeding assessment calendar (PBAC) tools, may be helpful. The importance of obtaining a confidential history from the adolescent girl cannot be overestimated. A confidential sexual history is essential so that pregnancy and infectious causes of bleeding are addressed. Not all menstrual bleeding in young girls is attributable to immaturity of the HPO axis. Anovulation and DUB from other clinically relevant conditions in adolescent girls must also be considered. Chief among these is PCOS, which should always be ruled out when a girl presents with excessive bleeding associated with clinical signs of hyperandrogenism, obesity, or insulin resistance. Attention must also be paid to signs or a family history of a bleeding disorder, as vWD is commonly associated with excessive uterine bleeding. Importantly, the laboratory testing for both PCOS and vWD is affected by therapies for the excessive bleeding, and it should be performed before hormonal interventions or blood products are administered or during the placebo phase if treatment has begun. Management goals for excessive uterine bleeding include stabilizing the endometrium and stopping further blood loss, as well as preventing future uncontrolled blood loss. Hormonal stabilization of the endometrium is often helpful regardless of the cause of bleeding and especially in those with hormonally mediated anovulation. New antifibrinolytics, such as tranexamic acid, may also be helpful in the emergent setting and in adolescents with bleeding disorders. PMID:22764555

  3. DNA methylation in endometrial cancer

    OpenAIRE

    Tao, Meng Hua; Freudenheim, Jo L.

    2010-01-01

    Endometrial cancer is the most commonly diagnosed gynecological cancer, and it has been shown to be a complex disease driven by abnormal genetic and epigenetic alterations, as well as environmental factors. Epigenetic changes resulting in aberrant gene expression are dynamic and modifiable features of many cancer types. A significant epigenetic change is aberrant DNA methylation. In this review, we review evidence on the role of aberrant DNA methylation, examining changes in relation to endom...

  4. Pregnancy recognition in cattle: effects of conceptus products on uterine prostaglandin production

    International Nuclear Information System (INIS)

    In cattle, continued progesterone (P4) production by the corpus luteum (CL) is required if pregnancy is to persist. Identification of putative conceptus-derived signals and evaluation of their biological roles relative to CL maintenance during early pregnancy were goals of this research endeavor. Using various chromatography systems, bovine conceptuses (days 19 to 23) exhibited extensive metabolism of tritiated P4 (90-98%), in vitro. A majority of conceptus metabolites were 5?-reduced pregnanes. A major conceptus metabolite was 5?-pregnan-3?-ol-20-one (5?-P). Conversely, endometrial explant cultures metabolized 40 to 50% of P4 substrate to primarily 5?-reduced steroid products. An in vivo test system to evaluate uterine PGF/sub 2?/ production capacity was characterized in experiment two. Exogenous estradiol-17? (E2; 3 mg I.V.) stimulated uterine blood flow, and PGF/sub 2?/ production and metabolism. In experiment three, CL function, interestrous interval, and spontaneous uterine PGF/sub 2?/ production were evaluated in cyclic cows following intrauterine administration of 5?-P, conceptus secretory proteins (CSP) or homologous serum proteins (Control). Results support a role for CSP in suppression of uterine PGF/sub 2?/ production during early pregnancy in cattle

  5. Utility of the broccoli sign in the distinction of prolapsed uterine tumor from cervical tumor

    Energy Technology Data Exchange (ETDEWEB)

    Jha, Priyanka; Chang, Stephanie T. [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Rabban, Joseph T. [Department of Anatomic Pathology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Chen, Lee-may [Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Yeh, Benjamin M. [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Coakley, Fergus V., E-mail: Fergus.Coakley@radiology.ucsf.edu [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States)

    2012-08-15

    Objective: To describe the utility, histopathological basis, and clinical correlates of the broccoli sign. Methods: The committee on human research approved this HIPAA compliant study and waived written informed consent. Based on the records of the senior author and our multidisciplinary Gynecologic Oncology Tumor Board, we retrospectively identified thirteen women (mean age of 48.8 years; range, 34-74) with a cervical mass seen at MR imaging (n = 13) or CT (n = 5) that demonstrated the previously reported broccoli sign (i.e., a soft tissue stalk connecting the cervical mass to the uterine cavity) on one or other modality. All available clinical, imaging, and histopathological records were reviewed, with particular emphasis on initially suspected diagnosis, final proven diagnosis, and outcome. Results: Cervical cancer was the initial clinically suspected diagnosis in 6 of 13 patients. Surgical resection demonstrated prolapsed uterine tumor in all patients, consisting of endometrioid adenocarcinoma (n = 7), carcinosarcoma (n = 2), adenosarcoma (n = 1), and leiomyoma (n = 3). Excluding the three patients with leiomyomas, currently, 7 patients with malignant tumors are disease free after a mean interval of 15 months (range, 3-45) and 3 patients have been lost to follow-up. Conclusion: A stalk connecting an apparent cervical mass seen at CT or MR imaging to the endometrial cavity ('broccoli sign') favors the diagnosis of a prolapsed uterine tumor; these prolapsed uterine tumors can often be malignant but appear to have a good prognosis.

  6. The Ultrasound and MRI Findings of Uterine Adenofibroma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jung; Rha, Sung Eun; Byun, Jae Young; Lee, Ah Won [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-09-15

    Adenofibroma is an extremely rare benign m'ullerian mixed tumor composed of epithelium and mesenchymal cells. Most uterine adenofibromas occur in the endometrium, but they rarely protrude into the vagina. To date, only a few such cases with the imaging findings have been reported. Therefore, we report here on the sonographic and magnetic resonance (MR) imaging findings of a case of endometrial adenofibroma protruding into the vaginal cavity in a 28-year-old woman. The uterine adenofibroma appeared as a large intracavitary echogenic mass containing multiple small internal cysts, and it was distending the vaginal cavity on transrectal sonography. T2- weighted MR images showed a large intracavitary mass with heterogeneous high signal intensity protruding into the vaginal cavity. On gadolinium-enhanced T1-weighted MR images, heterogeneous septa-like enhancement was noted in the mass. Although uterine adenofibroma is extremely rare, adenofibroma can be suggested as a possible diagnosis when an intracavitary uterine mass, with multiple internal small cystic components and enhancing septa-like structures, is protruding into the vaginal cavity on imaging

  7. Utility of the broccoli sign in the distinction of prolapsed uterine tumor from cervical tumor

    International Nuclear Information System (INIS)

    Objective: To describe the utility, histopathological basis, and clinical correlates of the broccoli sign. Methods: The committee on human research approved this HIPAA compliant study and waived written informed consent. Based on the records of the senior author and our multidisciplinary Gynecologic Oncology Tumor Board, we retrospectively identified thirteen women (mean age of 48.8 years; range, 34–74) with a cervical mass seen at MR imaging (n = 13) or CT (n = 5) that demonstrated the previously reported broccoli sign (i.e., a soft tissue stalk connecting the cervical mass to the uterine cavity) on one or other modality. All available clinical, imaging, and histopathological records were reviewed, with particular emphasis on initially suspected diagnosis, final proven diagnosis, and outcome. Results: Cervical cancer was the initial clinically suspected diagnosis in 6 of 13 patients. Surgical resection demonstrated prolapsed uterine tumor in all patients, consisting of endometrioid adenocarcinoma (n = 7), carcinosarcoma (n = 2), adenosarcoma (n = 1), and leiomyoma (n = 3). Excluding the three patients with leiomyomas, currently, 7 patients with malignant tumors are disease free after a mean interval of 15 months (range, 3–45) and 3 patients have been lost to follow-up. Conclusion: A stalk connecting an apparent cervical mass seen at CT or MR imaging to the endometrial cavity (“broccoli sign”) favors the diagnosis of a prolapsed uterine tumor; these prolapsed uterine tumors can often be malignant but appear to have a good prognosis.

  8. Endometrial cancer arising from atypical complex hyperplasia: The significance in an endometrial biopsy and a diagnostic challenge

    Science.gov (United States)

    Byun, Jung Mi; Jeong, Dae Hoon; Kim, Young Nam; Cho, En Bee; Cha, Ju Eun; Sung, Moon Su; Lee, Kyung Bok

    2015-01-01

    Objective We investigated the features of endometrial hyperplasia with concurrent endometrial cancer that had been diagnosed by endometrial sampling. Further, we attempted to identify an accurate differential diagnostic method. Methods We retrospectively studied 125 patients who underwent a diagnostic endometrial biopsy or were diagnosed after the surgical treatment of other gynecological lesions, such as leiomyoma or polyps. Patients were diagnosed between January 2005 and December 2013 at Busan Paik Hospital. Clinical and histopathological characteristics were compared in patients who had atypical endometrial hyperplasia with and without concurrent endometrial cancer. Results The patients were grouped based on the final pathology reports. One hundred seventeen patients were diagnosed with endometrial hyperplasia and eight patients were diagnosed with endometrioid adenocarcinoma arising from atypical hyperplasia. Of the 26 patients who had been diagnosed with atypical endometrial hyperplasia by office-based endometrial biopsy, eight (30.8%) were subsequently diagnosed with endometrial cancer after they had undergone hysterectomy. The patients with endometrial cancer arising from endometrial hyperplasia were younger (39.1 vs. 47.2 years, P=0.0104) and more obese (body mass index 26.1±9.6 vs. 23.8±2.8 kg/m2, P=0.3560) than the patients with endometrial hyperplasia. The correlation rate between the pathology of the endometrial samples and the final diagnosis of endometrial hyperplasia was 67.3%. Conclusion In patients with atypical endometrial hyperplasia, the detection of endometrial cancer before hysterectomy can decrease the risk of suboptimal treatment. The accuracy of endometrial sampling for the diagnosis of concurrent endometrial carcinoma was much lower than that for atypical endometrial hyperplasia. Therefore, concurrent endometrial carcinoma should be suspected and surgical intervention should be considered in young or obese patients who present with atypical endometrial hyperplasia.

  9. Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinkel, K. [Geneva University Hospital and Institut de Radiologie, Clinique des Grangettes, Chene-Bougeries/Geneva (Switzerland); Clinique des Grangettes, Institut de radiologie, Chene-Bougerie/Geneva (Switzerland); Forstner, R. [LandesklinikenSalzburg, Zentralroentgeninstitut, Salzburg (Austria); Danza, F.M. [Universita Cattolica del S. Cuore, Dipartimento di Bioimmagini e scienze radiologiche, Rome (Italy); Oleaga, L. [Hospital Clinic, Radiology Department, Barcelona (Spain); Cunha, T.M. [Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Department of Radiology, Lisboa Codex (Portugal); Bergman, A. [Uppsala University Hospital, Department of Radiology, Uppsala (Sweden); Barentsz, J.O. [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands); Balleyguier, C. [Institut de Cancerologie Gustave Roussy, Department of Radiology, Villejuif Cedex (France); Brkljacic, B. [University Hospital ' ' Dubrava' ' , Department of Diagnostic and Interventional Radiology, Zagreb (Croatia); University of Zagreb, Medical School, Zagreb (Croatia); Spencer, J.A. [St James' s Institute of Oncology, Department of Clinical Radiology, Leeds (United Kingdom)

    2009-07-15

    The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution post-contrast images acquired at 2 min {+-} 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph node-specific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cancer. (orig.)

  10. Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging

    International Nuclear Information System (INIS)

    The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution post-contrast images acquired at 2 min ± 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph node-specific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cancer. (orig.)

  11. Definition of Compartment Based Radical Surgery in Uterine Cancer—Part I: Therapeutic Pelvic and Periaortic Lymphadenectomy by Michael Höckel Translated to Robotic Surgery

    OpenAIRE

    Rainer Kimmig; Antonella Iannaccone; Paul Buderath; Bahriye Aktas; Pauline Wimberger; Martin Heubner

    2013-01-01

    Objective. To define compartment based therapeutic pelvic and periaortic lymphadenectomy in cervical and endometrial cancer. Compartment based oncologic surgery appears to be favorable for patients in terms of radicality as well as complication rates, and the same appears to be true for robotic surgery. We describe a method of robotically assisted compartment based lymphadenectomy step by step in uterine cancer and demonstrate feasibility data from 35 patients. Methods. Patients with the diag...

  12. Carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    There are few reports on uterine cancer in relation to radiation. This chapter discusses uterine cancer in A-bomb survivors, with special reference to the mortality rate, in a review of the literature. The Atomic Bomb Casualty Commission has first discovered 28 cases of uterine cancer among A-bomb survivors during the period 1953-1957. Since 1970, mortality rate from uterine cancer has been investigated statistically according to the T65D system. The Radiation Effect Research Foundation (RERF) has revealed 282 death cases from uterine cancer during the period 1950-1974. The RERF's data up to 1982 has revealed no radiation-dependent mortality from uterine cancer. More recent data (1950-1985) has revealed that mortality rate was increased by 22% in A-bomb survivors exposed to 1 Gy or more. When mortality of uterine cancer was investigated statistically using the 1968-1982 data for the population of the Research Institute for Nuclear Medicine and Biology, Hiroshima University, it was 1.2 times higher in the entire exposed group and 1.4 times higher in the group of proximally exposed A-bomb survivors (within 2 km from the hypocenter) than the non-exposed group, with statistically significant difference. It tended to be high in the group of distally exposed A-bomb survivors (who entered the city within 3 days after A-bombing) than the non-exposed group. When comparing the group of Hiroshima City with the group of Hiroshima Prefecture, mortality from uterine cancer was 1.3 times higher in the municipal group for proximally exposed A-bomb survivors and 1.3 times higher in the prefectural group for distally exposed A-bomb survivors and the others. Mortality rate was highest within one year after the acquisition of health handbook in the exposed group. (N.K.)

  13. Radical radiotherapy for endometrial cancer and clinical evaluation of radiation dose for reference points

    International Nuclear Information System (INIS)

    Fifteen patients with endometrial cancer (Stage I [5], Stage II [4], Stage III [4], Stage IVa [2]) were treated by radiation therapy alone at Tokyo Women's Medical College during the 23-year period from 1969 to 1991. All patients were considered medically inoperable due to advanced age, hypertension, cardiovascular disease, diabetes mellitus, etc. Patient ages ranged from 46 to 82 years with a mean of 63 years (62.5±12.0). An external beam with a 10 MeV linear accelerator and low dose-rate intracavitary radiotherapy using a TAO applicator were administered to the patients with a total dose of 87.2±19.5 Gy at point A for cervical cancer. The complete response rate was 66.7% by clinical examination after treatment. Intrapelvic recurrence was seen in 1 patient and distant metastasis in 3. The 5-year cumulative survival rate for all patients was 59.3% and 100% for Stage I and II, respectively. Rectal complications were found in 4 cases, bladder in 2. In order to standardize the dose value for radiotherapy for endometrial cancer, we established three reference points (point I: fundus of the uterus, point II: bilateral uterotubal ostium, point III: bilateral mid portion of the lateral wall of the uterine body). These points were determined by measuring myometrial thickness of the uterine body by CT image at the time of treatment planning in each case. We make practical application of these points in radiation treatment and have found them to be useful for standardization and dose specification of intracavitary radiotherapy for endometrial cancer. (author)

  14. Polipectomia endometrial histeroscópica: tratamento ambulatorial versus convencional / Hysteroscopic endometrial polypectomy: outpatient versus conventional treatment

    Scientific Electronic Library Online (English)

    Angela Mendes, Bergamo; Daniella de Batista, Depes; Ana Maria Gomes, Pereira; Taciana Cristina Duarte de, Santana; Umberto Gazi, Lippi; Reginaldo Guedes Coelho, Lopes.

    2012-09-01

    Full Text Available OBJETIVO: Comparar resultados da polipectomia histeroscópica endometrial efetuada ambulatorialmente, sem anestesia, com polipectomia histeroscópica convencional sob anestesia, em centro cirúrgico, avaliando taxa de sucesso, tempo de procedimento e complicações. Mensurar dor aferida pela paciente nos [...] dois grupos. MÉTODOS: Estudo transversal observacional de 60 pacientes com diagnóstico histeroscópico de pólipo endometrial divididas em dois grupos: Grupo Ambulatorial, composto por pacientes submetidas à polipectomia histeroscópica ambulatorial, utilizando-se pinça endoscópica em histeroscópio operatório ambulatorial de fluxo contínuo, por meio de vaginoscopia sem anestesia, e Grupo Convencional com pacientes submetidas à polipectomia histeroscópica em centro cirúrgico, utilizando-se ressectoscópio monopolar sob anestesia. RESULTADOS: Os grupos foram similares quanto a idade, paridade, tipo de parto e presença ou não de menopausa. Ambos os grupos apresentaram 100% de eficácia na exérese dos pólipos. O tempo médio de procedimento foi de 7 minutos no Grupo Ambulatorial e 35,16 minutos no Grupo Convencional. No Grupo Ambulatorial, as pacientes após a menopausa (p=0,04) e aquelas com pólipos >1cm (p=0,01) apresentaram tempo de procedimento maior. Durante o procedimento,a média de dor referida pelas pacientes, segundo a Escala Analógica Verbal de Dor, no Grupo Ambulatorial, foi de 2,93 e, após efeito anestésico do procedimento no Grupo Convencional, foi de 1,42 pontos. Não houve complicações no Grupo Ambulatorial. No Grupo Convencional, registraram-se um caso de perfuração uterina e um de falso trajeto. CONCLUSÃO: A polipectomia histeroscópica realizada em regime ambulatorial, sem anestesia, é um procedimento bem tolerado. Quando comparada ao tratamento convencional, apresenta a mesma eficácia, porém com menor tempo gasto no procedimento e menor índice de complicações. Abstract in english OBJECTIVE: To compare results of hysteroscopic polypectomy of the endometrium performed in an outpatient clinic, under no anesthesia, to conventional hysteroscopic polypectomy under anesthesia in the operating theatre, assessing success rate, procedure time and complications; and to measure pain ref [...] erred by patients in both groups. METHODS: An observational cross-sectional study of 60 patients with hysteroscopic diagnosis of endometrial polyps, divided into two groups: the Outpatient Group, comprising patients submitted to outpatient´s hysteroscopic polypectomy by continuous flow vaginoscopy using endoscopic forceps under no anesthesia, and the Conventional Group with patients submitted to hysteroscopic polypectomy in the operating theater, using a monopolar resectoscope under anesthesia. RESULTS: The groups were similar as to age, parity, mode of delivery and menopausal status. Both groups presented 100% efficacy in exeresis of polyps. The mean time of procedure was 7 minutes in the Outpatient Group and 35.16 minutes in the Conventional Group. In the Outpatient Group, menopausal patients (p=0.04) and those with polyps >1cm (p=0.01) had longer procedures. Using the Verbal Analog Scale of Pain, the mean score of pain referred by patients during the procedure was 2.93 in the Outpatient Group and, after anesthetic effect, 1.42 in the Conventional Group. There were no complications in the Outpatient Group. There was one case of uterine perforation and one case of false passage in the Conventional Group. CONCLUSION: Hysteroscopic polypectomy performed in an outpatient setting under no anesthesia is a well-tolerated procedure. As compared to conventional treatment, it displays the same efficacy, but the procedure time is shorter and the complication rate is lower.

  15. Divergent endometrial inflammatory cytokine expression at peri-implantation period and after the stimulation by copper intrauterine device.

    Science.gov (United States)

    Chou, Chia-Hung; Chen, Shee-Uan; Shun, Chia-Tung; Tsao, Po-Nien; Yang, Yu-Shih; Yang, Jehn-Hsiahn

    2015-01-01

    Endometrial inflammation has contradictory effects. The one occurring at peri-implantation period is favourable for embryo implantation, whereas the other occurring after the stimulation by copper intrauterine device (Cu-IUD) prevents from embryo implantation. In this study, 8 week female ICR mice were used to investigate the endometrial inflammation, in which they were at proestrus stage (Group 1), at peri-implantation period (Group 2), and had a copper wire implanted into right uterine horn (Group 3). Cytokine array revealed that two cytokines were highly expressed in Group 2 and Group 3 as compared with Group 1, and seven cytokines, including tumour necrosis factor ? (TNF-?), had selectively strong expression in Group 3. Immunohistochemistry demonstrated prominent TNF-? staining on the endometrium after Cu-IUD stimulation, and in vitro culture of human endometrial glandular cells with Cu induced TNF-? secretion. The increased TNF-? concentration enhanced in vitro THP-1 cells chemotaxis, and reduced embryo implantation rates. These results suggest that inflammatory cytokine profiles of endometrium are different between those at peri-implantation period and after Cu-IUD stimulation, and TNF-? is the one with selectively strong expression in the latter. It might account for the contradictory biological effects of endometrial inflammation. PMID:26469146

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

    Directory of Open Access Journals (Sweden)

    Ghaemmaghami F

    1999-06-01

    Full Text Available 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 before operation and the results were compared. 96% of total patients (67 and 91% of patients with post menopause age had tolerance of undergoing out-patient PIPELLE biopsy of endometrium. 79% of these individuals complained of mild pain and 21% of moderate pain. Endometrium biopsy by PIPELLE in 77% of patients had similar accurate diagnostic results as compared to D&C. PIPELLE in 34% of patients (24 could not be conducted with the same accuracy of D&C patients, although in 14 (20% of them, notissue samples could be collected by D&C. In none of these methods endometrial hyperplasia or endometrial cancer were detected. This study showed that in 77% of the total patients, the extra cost and general anesthetical risk of D&C could have been eliminated, by utilization of out-patient biopsy with PIPELLE

  17. Proteomics of the human endometrial glandular epithelium and stroma from the proliferative and secretory phases of the menstrual cycle.

    Science.gov (United States)

    Hood, Brian L; Liu, Baoquan; Alkhas, Addie; Shoji, Yutaka; Challa, Rusheeswar; Wang, Guisong; Ferguson, Susan; Oliver, Julie; Mitchell, Dave; Bateman, Nicholas W; Zahn, Christopher M; Hamilton, Chad A; Payson, Mark; Lessey, Bruce; Fazleabas, Asgerally T; Maxwell, G Larry; Conrads, Thomas P; Risinger, John I

    2015-04-01

    Despite its importance in reproductive biology and women's health, a detailed molecular-level understanding of the human endometrium is lacking. Indeed, no comprehensive studies have been undertaken to elucidate the important protein expression differences between the endometrial glandular epithelium and surrounding stroma during the proliferative and midsecretory phases of the menstrual cycle. We utilized laser microdissection to harvest epithelial cells and stromal compartments from proliferative and secretory premenopausal endometrial tissue and performed a global, quantitative mass spectrometry-based proteomics analysis. This analysis identified 1224 total proteins from epithelial cells, among which 318 were differentially abundant between the proliferative and secretory phases (q tenascin C, neprilysin, and ectonucleotide pyrophosphatase/phosphodiesterase family member 3 (ENPP3). ENPP3, which was elevated in epithelial glandular cells in the secretory phase, was confirmed to be elevated in midsecretory-phase baboon uterine lavage samples and also observed to have an N-linked glycosylated form that was not observed in the proliferative phase. This study provides a detailed view into the global proteomic alterations of the epithelial cells and stromal compartments of the cycling premenopausal endometrium. These proteomic alterations during endometrial remodeling provide a basis for numerous follow-up investigations on the function of these differentially regulated proteins and their role in reproductive biology and endometrial pathologies. PMID:25695723

  18. Hormonal and molecular aspects of endometrioid endometrial cancer

    OpenAIRE

    Jongen, Vincentius Hubertus Willibrordus Maria,

    2008-01-01

    This thesis concerns the expression and prognostic value of various hormones and molecular markers playing a role n endometrioid endometrial cancer. Especially we were interested in the enzyme aromatase, its expression and (prognostic) role in endometrioid endometrial cancer. Endometrial cancer is the most common genital tract malignancy in women. Two major histological types can be distinguished; endometrioid endometrial cancer, and nonendometrioid endometrial cancer including high-grade mal...

  19. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: Experience in a tertiary referral centre

    Energy Technology Data Exchange (ETDEWEB)

    Busard, M.P.H., E-mail: m.busard@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Mijatovic, V., E-mail: Mijatovic@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Lüchinger, A.B., E-mail: ab.luchinger@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Bleeker, M.C.G., E-mail: MCG.Bleeker@vumc.nl [VU University Medical Centre, Department of Pathology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Pieters-van den Bos, I.C., E-mail: i.pieters@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Schats, R., E-mail: r.schats@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Kuijk, C. van, E-mail: C.vanKuijk@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Hompes, P.G.A., E-mail: p.hompes@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Waesberghe, J.H.T.M. van, E-mail: JHTM.vanwaesberghe@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands)

    2012-09-15

    Objective: Both the intraperitoneal seeding and the uterine-vesical extension theory have been proposed to explain the pathogenesis of bladder endometriosis. The aim of this study was to describe MR imaging findings of bladder endometriosis and involvement of the anterior uterine wall in a tertiary referral centre for endometriosis in a effort to improve diagnosis and help clarify the pathogenesis. Methods: In a single-centre, retrospective study (2004–2009), 463 consecutive patients analysed for deep infiltrating endometriosis (DIE) were studied independently by two experienced readers for the presence of bladder endometriosis. MR studies revealing bladder endometriosis were then analysed in consensus for: location, size, signal intensity characteristics, uterine involvement, continuity with adenomyosis and presence of cysts. There was histopathologic correlation in 9 patients who had undergone partial bladder resection. Results: Bladder endometriosis was diagnosed in 32 patients on MR imaging (k = 0.85). Most lesions showed heterogeneous isointensity compared to that of muscle on T2-weighed imaging, containing foci of high signal intensity, suggesting cystic ectopic endometrial glands. On T1-weighted imaging lesions showed heterogeneous isointensity with foci or small cysts, demonstrating high signal intensity, indicating hemorrhage, was observed. Uterine involvement was found in 94% of the lesions, with either “continuous” or “hourglass” configurations. Presence of contiguous adenomyosis was found in only 4 lesions. Conclusions: With MR imaging, uterine involvement in bladder endometriosis is frequently found and in most cases located subserosally, suggesting extensive DIE, favouring the intraperitoneal seeding theory.

  20. Cyclin D1 as a diagnostic immunomarker for endometrial stromal sarcoma with YWHAE-FAM22 rearrangement.

    Science.gov (United States)

    Lee, Cheng-Han; Ali, Rola H; Rouzbahman, Marjan; Marino-Enriquez, Adrian; Zhu, Meijun; Guo, Xiangqian; Brunner, Alayne L; Chiang, Sarah; Leung, Samuel; Nelnyk, Nataliya; Huntsman, David G; Blake Gilks, C; Nielsen, Torsten O; Dal Cin, Paola; van de Rijn, Matt; Oliva, Esther; Fletcher, Jonathan A; Nucci, Marisa R

    2012-10-01

    Endometrial stromal sarcoma (ESS) characterized by YWHAE-FAM22 genetic fusion is histologically higher grade and clinically more aggressive than ESS with JAZF1-SUZ12 or equivalent genetic rearrangements, hence it is clinically important to recognize this subset of ESS. To identify diagnostic immunomarkers for this biologically defined ESS subset, we compared gene expression profiles between YWHAE-FAM22 ESS and JAZF1-rearranged ESS. These studies showed consistent upregulation of cyclin D1 in YWHAE-FAM22 ESS compared with JAZF1-SUZ12 ESS. Immunohistochemically, the high-grade round cell component of all 12 YWHAE-FAM22 ESS demonstrated diffuse (?70%) moderate to strong nuclear cyclin D1 staining, and this diffuse positivity was not seen in 34 ESSs with JAZF1 and equivalent genetic rearrangements or in 21 low-grade ESS with no demonstrable genetic rearrangements. In a series of 243 non-ESS pure uterine mesenchymal and mixed epithelial-mesenchymal tumors, only 2 of 8 undifferentiated endometrial sarcomas with nuclear uniformity and 1 of 80 uterine leiomyosarcomas demonstrate diffuse cyclin D1 immunoreactivity. Both cyclin D1-positive undifferentiated endometrial sarcomas showed diffuse strong CD10 staining, which is consistently absent in the high-grade round cell component of YWHAE-FAM22 ESS. The low-grade spindle cell component of YWHAE-FAM22 ESS showed a spatially heterogenous cyclin D1 staining pattern that was weaker and less diffuse overall. Our findings indicate that cyclin D1 is a sensitive and specific diagnostic immunomarker for YWHAE-FAM22 ESS. When evaluating high-grade uterine sarcomas, cyclin D1 can be included in the immunohistochemical panel as an indicator of YWHAE-FAM22 ESS. PMID:22982899

  1. Ablação Histeroscópica do Endométrio no Tratamento da Menorragia: Seguimento de 200 Casos / Hysteroscopic Endometrial Ablation for the Treatment of Menorrhagia: Follow-up of 200 Cases

    Scientific Electronic Library Online (English)

    Francesco, Viscomi; João Alfredo, Martins; Marilice Dall' Aglio, Pastore.

    2001-04-01

    Full Text Available Objetivo: avaliar a eficácia da ablação histeroscópica do endométrio no tratamento cirúrgico da menorragia. Métodos: foram realizadas 200 ablações histeroscópicas do endométrio no período de abril de 1991 a abril de 1999 em pacientes de clínica privada dos autores. Todas as pacientes apresentavam sa [...] ngramento uterino anormal de causa benigna rebelde ao tratamento clínico. O procedimento foi realizado em ambiente hospitalar sob anestesia de bloqueio (raqui ou peridural). Nos primeiros quatro anos utilizou-se a glicina 1,5% como meio de distensão da cavidade uterina e nos últimos quatro anos o manitol 3%. O seguimento variou de 8 meses a 8 anos. Resultados: das 200 pacientes, 180 (90%) mostraram-se satisfeitas com o procedimento, relatando diminuição acentuada do fluxo menstrual. A análise histológica do endométrio após ressecção histeroscópica revelou atividade proliferativa em 104 pacientes (52%), e secretora em 34 (17%). A hiperplasia endometrial esteve presente em 20 pacientes (10%). As pacientes que se submeteram à ressecção apresentaram a cavidade uterina diminuída e formação de sinéquias fibrosas, ao passo que nas pacientes que foram submetidas à destruição endometrial a cavidade mostrou-se diminuída porém sem formação de sinéquias. Duas pacientes apresentaram quadro de hipervolemia moderada durante o procedimento, que respondeu bem ao tratamento clínico. Ocorreu um episódio de perfuração uterina durante a fase de dilatação e cinco casos de hematômetra foram registrados. Conclusões: A ablação histeroscópica do endométrio é um procedimento seguro e eficaz em pacientes selecionadas no tratamento da menorragia de causa benigna rebelde a tratamento clínico. Abstract in english Purpose: the aim of the present study was to evaluate the role of hysteroscopic endometrial ablation in the treatment of menorrhagia. Methods: two hundred patients were submitted to hysteroscopic endometrial ablation between April 1991 and April 1999. The surgery was performed in a private hospital [...] under spinal anesthesia. In the first four years we used 1.5% glycine as a distension medium and in the last four years we used mannitol 3%. The follow-up ranged from 8 months to 8 years. Results: relief of the symptomatology was achieved in 180 (90%) patients. One episode of uterine perfuration, two cases of moderate liquid overload and five of hematometra were recorded. The histologic evaluation of the resected endometrium showed proliferative activity in 104 patients (52%) and secretory activity in 34 (17%). Endometrial hyperplasia was found in 20 patients (10%). The patients submitted to resection showed a smaller uterine cavity and fibrous synechia, whereas in patients submitted to endometrial destruction the uterine cavity was small but without synechia. Two patients had moderade hypervolemia during the procedure, for which clinical treatment was successful. Conclusions: Hysteroscopic endometrial ablation showed to be a safe and effective procedure as treatment of menorrhagia.

  2. Rabdomiosarcoma Embrionario Uterino: Aspectos Morfológicos e Inmunohistoquímicos Embryonal Rhabdomyosarcoma of the Corpus Uterine: Morphological and Immunohistochemical Characteristics

    Directory of Open Access Journals (Sweden)

    Oscar Tapia E

    2011-12-01

    Full Text Available Los sarcomas uterinos son relativamente raros. El tipo histológico más frecuente es el leiomiosarcoma, seguido por el sarcoma del estroma endometrial. Los rabdomiosarcomas (RMS son neoplasias malignas con diferenciación muscular esquelética. El rabdomiosarcoma embrionario (RMSE tipo botrioide es el sarcoma más común de la infancia; con escasos reportes en adultos, afectando la región de cabeza y cuello, tracto genitourinario y extremidades más frecuentemente. En el tracto genitourinario, la vagina es la localización mas frecuente, comprometiendo en raras ocasiones el cuello o fondo uterino. Se presentan las características clínicas y morfológicas de un caso de RMSE uterino tipo botrioide diagnosticado en una paciente de 58 años en la Unidad de Anatomía Patológica del Hospital Hernán Henríquez Aravena de Temuco.Uterine sarcomas are relatively rare. The most common histological type is leiomyosarcoma, followed by endometrial stromal sarcoma. The rhabdomyosarcoma (RMS are malignant neoplasms with skeletal muscle differentiation. Embryonal rhabdomyosarcoma (RMSE type botryoides is the most common in childhood, with few reports in adults, affecting the head and neck region, genitourinary tract and extremities more frequently. In the genitourinary tract, the vagina is the most common location, rarely involving cervix and fundus uterine. Clinical and morphological characteristics are presented of a case of uterine RMSE diagnosed in a 58 year-old woman in the Pathology Unit of the Hernán Henríquez Aravena Hospital in Temuco.

  3. Rabdomiosarcoma Embrionario Uterino: Aspectos Morfológicos e Inmunohistoquímicos / Embryonal Rhabdomyosarcoma of the Corpus Uterine: Morphological and Immunohistochemical Characteristics

    Scientific Electronic Library Online (English)

    Oscar, Tapia E.

    2011-12-01

    Full Text Available Los sarcomas uterinos son relativamente raros. El tipo histológico más frecuente es el leiomiosarcoma, seguido por el sarcoma del estroma endometrial. Los rabdomiosarcomas (RMS) son neoplasias malignas con diferenciación muscular esquelética. El rabdomiosarcoma embrionario (RMSE) tipo botrioide es e [...] l sarcoma más común de la infancia; con escasos reportes en adultos, afectando la región de cabeza y cuello, tracto genitourinario y extremidades más frecuentemente. En el tracto genitourinario, la vagina es la localización mas frecuente, comprometiendo en raras ocasiones el cuello o fondo uterino. Se presentan las características clínicas y morfológicas de un caso de RMSE uterino tipo botrioide diagnosticado en una paciente de 58 años en la Unidad de Anatomía Patológica del Hospital Hernán Henríquez Aravena de Temuco. Abstract in english Uterine sarcomas are relatively rare. The most common histological type is leiomyosarcoma, followed by endometrial stromal sarcoma. The rhabdomyosarcoma (RMS) are malignant neoplasms with skeletal muscle differentiation. Embryonal rhabdomyosarcoma (RMSE) type botryoides is the most common in childho [...] od, with few reports in adults, affecting the head and neck region, genitourinary tract and extremities more frequently. In the genitourinary tract, the vagina is the most common location, rarely involving cervix and fundus uterine. Clinical and morphological characteristics are presented of a case of uterine RMSE diagnosed in a 58 year-old woman in the Pathology Unit of the Hernán Henríquez Aravena Hospital in Temuco.

  4. Correlation between Endometrial Parameters in Doppler Sonography and Success Rate of Implantation in Assisted Reproductive Programs

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2007-01-01

    Full Text Available Background: A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. Evaluating the role of endometrial and sub-endometrial blood flows detected by color Doppler sonography at the day of embryo transfer, as a predictor of pregnancy rate during IVF/ICSI programs was our main goal in this study.Materials and Methods: Seventy three infertile patients aged <38 years with basal serum FSH level<12 mIU/ml who had less than two failed attempts of ART cycles were prospectively evaluated. The cases with more than two failed IVF cycle and uterine disorders were excluded. All procedures were performed by one expert and two good quality embryos were transferred. Vaginal power color Doppler sonography was performed at the day of embryo transfer and endometrial characteristics including endometrial vascularization, area of vascularization distribution and pulsatility index were registered. Then pregnant and non-pregnant groups were compared for ultrasonographic parameters of endometrium.Results: Pregnancy occurred in 28 patients. Mean age, duration and etiology of infertility, baseline mean FSH and estradiol level at the day of Human chorionic gonadotropin (HCG injection, amount of drug administered, number of retrieved oocytes and embryos, also number and quality of transferred embryos in the pregnant and non-pregnant groups showed no statistically significant difference .On the other hand, none of the sonographic parameters reported in two groups indicated a statistically significant difference.Conclusion: Doppler ultrasonographic indices at the day of embryo transfer are not considered appropriate criteria for prediction of success rate or failure of embryo implantation.

  5. Prediction of lymph node metastasis in patients with apparent early endometrial cancer

    Science.gov (United States)

    Son, Joo-Hyuk; Kong, Tae-Wook; Kim, Su Hyun; Paek, Jiheum; Lee, Eun Ju; Ryu, Hee-Sug

    2015-01-01

    Objective The purpose of this study is to investigate the incidence of lymph node metastasis in early endometrial cancer patients and to evaluate preoperative clinicopathological factors predicting lymph node metastasis. Methods We identified 142 patients with endometrial cancer between January 2000 and February 2013. All patients demonstrated endometrioid adenocarcinoma with grade 1 or 2 on preoperative endometrial biopsy. Preoperative magnetic resonance imaging showed that tumors were confined to the uterine corpus with superficial myometrial invasion (less than 50%), and there were no lymph nodes enlargements. All patients had complete staging procedures and were surgically staged according to the 2009 FIGO (International Federation of Gynecology and Obstetrics) staging system. Clinical and pathological data were obtained from medical records and statistically analyzed. Results Of the 142 patients, 127 patients (89.4%) presented with stage 1A, 8 (5.6%) with stage IB, 3 (2.1%) with stage II, and 4 (2.8%) with stage III disease. Three patients (2.1%) had lymph node metastasis-2 IIIC1 and 1 IIIC2 disease. Age, preoperative tumor grade, and myometrial invasion less than 50% on preoperative MRI were not associated with lymph node metastasis. A high preoperative serum CA-125 level (>35 IU/mL) was a statistically significant factor for predicting lymph node metastasis on univariate and multivariate analyses. Lymph node metastasis was only found in patients with preoperative grade 2 tumors or a high serum CA-125 level. Conclusion Preoperative tumor grade and serum CA-125 level can predict lymph node metastasis in apparent early endometrial cancer patients. PMID:26430663

  6. Genistein promotes DNA demethylation of the steroidogenic factor 1 (SF-1) promoter in endometrial stromal cells

    Energy Technology Data Exchange (ETDEWEB)

    Matsukura, Hiroshi, E-mail: hmatsukura.epi@mri.tmd.ac.jp [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Aisaki, Ken-ichi; Igarashi, Katsuhide; Matsushima, Yuko; Kanno, Jun [Division of Cellular and Molecular Toxicology, National Institute of Health Sciences, 1-18-1 Kamiyoga, Setagaya-ku, Tokyo 158-8501 (Japan); Muramatsu, Masaaki [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Sudo, Katsuko [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Animal Research Center, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402 (Japan); Sato, Noriko, E-mail: nsato.epi@tmd.ac.jp [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan)

    2011-08-26

    Highlights: {yields} Genistein (GEN) is a phytoestrogen found in soy products. {yields} GEN demethylated/unsilenced the steroidogenic factor 1 gene in endometrial tissue. {yields} GEN thus altered mRNA expression in uteri of ovariectomized (OVX) mice. {yields} A high-resolution melting assay was used to screen for epigenetic change. {yields} We isolated an endometrial cell clone that was epigenetically modulated by GEN. -- Abstract: It has recently been demonstrated that genistein (GEN), a phytoestrogen in soy products, is an epigenetic modulator in various types of cells; but its effect on endometrium has not yet been determined. We investigated the effects of GEN on mouse uterine cells, in vivo and in vitro. Oral administration of GEN for 1 week induced mild proliferation of the endometrium in ovariectomized (OVX) mice, which was accompanied by the induction of steroidogenic factor 1 (SF-1) gene expression. GEN administration induced demethylation of multiple CpG sites in the SF-1 promoter; these sites are extensively methylated and thus silenced in normal endometrium. The GEN-mediated promoter demethylation occurred predominantly on the luminal side, as opposed to myometrium side, indicating that the epigenetic change was mainly shown in regenerated cells. Primary cultures of endometrial stromal cell colonies were screened for GEN-mediated alterations of DNA methylation by a high-resolution melting (HRM) method. One out of 20 colony-forming cell clones showed GEN-induced demethylation of SF-1. This clone exhibited a high proliferation capacity with continuous colony formation activity through multiple serial clonings. We propose that only a portion of endometrial cells are capable of receiving epigenetic modulation by GEN.

  7. Genistein promotes DNA demethylation of the steroidogenic factor 1 (SF-1) promoter in endometrial stromal cells

    International Nuclear Information System (INIS)

    Highlights: ? Genistein (GEN) is a phytoestrogen found in soy products. ? GEN demethylated/unsilenced the steroidogenic factor 1 gene in endometrial tissue. ? GEN thus altered mRNA expression in uteri of ovariectomized (OVX) mice. ? A high-resolution melting assay was used to screen for epigenetic change. ? We isolated an endometrial cell clone that was epigenetically modulated by GEN. -- Abstract: It has recently been demonstrated that genistein (GEN), a phytoestrogen in soy products, is an epigenetic modulator in various types of cells; but its effect on endometrium has not yet been determined. We investigated the effects of GEN on mouse uterine cells, in vivo and in vitro. Oral administration of GEN for 1 week induced mild proliferation of the endometrium in ovariectomized (OVX) mice, which was accompanied by the induction of steroidogenic factor 1 (SF-1) gene expression. GEN administration induced demethylation of multiple CpG sites in the SF-1 promoter; these sites are extensively methylated and thus silenced in normal endometrium. The GEN-mediated promoter demethylation occurred predominantly on the luminal side, as opposed to myometrium side, indicating that the epigenetic change was mainly shown in regenerated cells. Primary cultures of endometrial stromal cell colonies were screened for GEN-mediated alterations of DNA methylation by a high-resolution melting (HRM) method. One out of 20 colony-forming cell clones showed GEN-induced demethylation of SF-1. This clone exhibited a high proliferation capacity with continuous colony formation activity through multiple serial clonings. We propose that only a portion of endometrial cells are capable of receiving epigenetic modulation by GEN.

  8. Abnormal uterine bleeding: a study of menstrual patterns and histopathological patterns in perimenopausal females

    Directory of Open Access Journals (Sweden)

    Mahima Jain

    2015-02-01

    Full Text Available Background: In gynecology out-patient department there is a large group of patients especially in perimenopausal age group who present with various menstrual disorders. These can be as such caused due to various etiologies, which need to be investigated as line of management is thereupon decided. This study is undertaken to know the various abnormal uterine bleeding in perimenopausal women, and their histopathological pattern. Methods: This study is done at PDU medical college hospital, Rajkot, Gujarat which is a tertiary care centre. A retrospective analysis of 268 cases clinically presenting with abnormal uterine bleeding is done. They are further posted for dilatation and curettage after thorough investigation to rule out other pathologies. The endometrial samplings from the D and C material are collected and sent for histopathological assessment. The data is recorded and further analysed. Women between 40-55 years age group are included in this study. Women with diagnosed pelvic pathology, endocrinal cause and bleeding tendencies are excluded from the study. Results: In our study almost all menstrual disorders are found, commonest being menorrhagia in 42.16%. Other patterns reported are metrorrhagia in 3.35%, oligomenorrhea in 14.80%, polymenorrhea and polymenorrhagia in 5.22% and 5.59% cases. Post-menopausal bleeding is found in one case. The histopathological diagnoses reported in this study are proliferative and secretory phase in 26.49% and 19.77% respectively. Other endometrial hyperplasias reported are Swiss cheese in 1.86%, simple cystic hyperplasia in 12.31%, complex hyperplasia with or without atypia in 7% and 4.10% respectively. Malignancy is found in 2 cases. Conclusions: From this study it is well established that endometrial sampling from D and C material still remains the gold standard in diagnosis of various endometrial pathologies in low resource set-up. Thereby the further line of management can also be decided for a rational approach in the treatment of perimenopausal women with abnormal uterine bleeding. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 109-112

  9. Pregnancy after uterine arterial embolization

    Directory of Open Access Journals (Sweden)

    Cláudio E. Bonduki

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  10. Pregnancy after uterine arterial embolization

    Scientific Electronic Library Online (English)

    Cláudio E., Bonduki; Paulo C., Feldner, Jr.; Juliana da, Silva; Rodrigo A., Castro; Marair G. F., Sartori; Manoel J. B. C., Girão.

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was perform [...] ed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter). Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2), and 87.5% were successful live births (n = 14). The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54). One of the pregnancies resulted in twins. The newborn weights (n = 14) ranged from 2.260 to 3.605 kg (mean, 3.072 kg). One (7.1%) was considered to have a low birth weight (2.260 kg). There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%]), one case of premature rupture of the membranes (PRM) (6.3%), and one case of preeclampsia (6.3%). All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  11. Innovative Oral Treatments of Uterine Leiomyoma

    OpenAIRE

    Mohamed Sabry; Ayman Al-Hendy

    2012-01-01

    Uterine fibroids (leiomyoma), the benign tumors of the uterine wall, are very common cause of morbidity in reproductive age women usually in the form of excessive vaginal bleeding, chronic pelvic pain, miscarriage and infertility. These tumors are the leading indication for hysterectomy in the United States. Uterine fibroids are about 4 times higher in blacks compared to whites and constitute a major health disparity challenge. The estimated cost of uterine fibroids is up to $34.4 billion ann...

  12. Frequency of endometrial tuberculosis in female infertility

    International Nuclear Information System (INIS)

    Objective: To determine the frequency of endometrial tuberculosis in infertility patients. Design: an observational analytical study. Place and Duration of Study: Military Hospital Rawalpindi and Armed Forces Institute of Pathology, Rawalpindi from August 1998 to April 1999. Subjects and Methods: Endometrial biopsies were taken from 50 cases of infertility and subjected to culture on BACTEC 460 TB instrument. Results: Tuberculous endometritis was found in 10 % (n=5) of cases. Conclusion: It was concluded that endometrial tuberculosis is not an infrequent cause of infertility in our setup. (author)

  13. Uterine and ovarian disorders in old cats: A study by ultrasonography and radiography

    International Nuclear Information System (INIS)

    Aim of this study was to examine disorders of ovaries and uteri in old domestic cats, using ultrasonography and radiography. Six intact female domestic cats, 6-9 years old that had never received any hormonal contraception were used in the study. Serum samples were taken on days 2, 4 and 6 of oestrus and analysed for oestradiol-17 beta and progesterone concentrations. On day 4 of oestrus, ovarian and uterine appearance and diameters was determined, using ultrasonography. Hysterography was performed using an infusion of a contrast medium into the cranial vagina. The measurement of uterine diameter was done using the ultrasound and the hysterogram. Cystic endometrial hyperplasia (CEH) and cystic ovaries were common abnormal features. Ultrasound showed an ovarian diameter of 1.24+-0.48 cm and a follicle diameter of 0.3-0.4 cm at mid-oestrus. Cysts in the ovaries were observed with a diameter of 0.98-2.04 (3/6). Multiple cystic structures of 0.1-0.2 cm were found in the hyperplastic endometrium (5/6). Hysterography provided an overview of the uterine appearance, hyperplasia and the cystic changes in the endometrium. The diameter of the uterine horns, measured using the ultrasound and hysterogram, was 0.66+-0.22 and 0.68+-0.18 cm, respectively (p LT 0.05). The increase and the decline of oestradiol-17 beta, and the basal level of progesterone concentration, during oestrus, indicated that the cystic ovaries did not produce these hormones. The study demonstrated the abnormal changes in the ovaries and uteri of old cats, which is likely to be the cause infertility which is particularly important in endangered wild felids. It is valuable that ultrasound and hysterogram can now be used for diagnosing the pathology of ovaries and uterine disease in cats

  14. Primary Extrauterine Endometrial Stromal Sarcoma in the Sigmoid Colon

    Science.gov (United States)

    Kim, Joo-Heon; Kang, Dong-Wook; Lee, Hye-Kyung; Park, Mee-Ja; Lee, Seung Yun

    2015-01-01

    An endometrial stromal sarcoma (ESS) is an uncommon uterine neoplasm, and its primary occurrence in the intestine as an extrauterine ESS (EESS) is exceedingly rare. We hereby report a primary EESS arising in the sigmoid colon with a review of the literature. A 52-year-old woman presented with bloody stool and underwent a colon fiberscopy, which revealed a fungating mass obstructing the lumen at the distal sigmoid. A laparoscopic low anterior resection was performed, and an umbilicated polypoid mass was identified; on section, it had infiltrated the mesocolic fat and measured 3.8 cm × 2.5 cm. The tumor showed geographic sheets or nests composed of relatively monotonous stromal cells, expansion or infiltration to the proper muscle and mesocolic fat, and extensive lymphovascular invasion and metastasis to regional lymph nodes and the pelvic peritoneum. The tumor cells were strongly and diffusely immunoreactive for CD10, but negative for c-kit, CD34, and Dog1. Two months later, a hysterectomy with a bilateral salpingo-oophorectomy was performed, and no evidence of an ESS was found in the uterus. PMID:25960975

  15. DNA damage and apoptosis of endometrial cells cause loss of the early embryo in mice exposed to carbon disulfide

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Bingzhen [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China); Shen, Chunzi [Centers for Disease Control and Prevention, Zibo (China); Yang, Liu; Li, Chunhui; Yi, Anji [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China); Wang, Zhiping, E-mail: zhipingw@sdu.edu.cn [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China)

    2013-12-01

    Carbon disulfide (CS{sub 2}) may lead to spontaneous abortion and very early pregnancy loss in women exposed in the workplace, but the mechanism remains unclear. We designed an animal model in which gestating Kunming strain mice were exposed to CS{sub 2} via i.p. on gestational day 4 (GD4). We found that the number of implanted blastocysts on GD8 was significantly reduced by each dose of 0.1 LD{sub 50} (157.85 mg/kg), 0.2 LD{sub 50} (315.7 mg/kg) and 0.4 LD{sub 50} (631.4 mg/kg). In addition, both the level of DNA damage and apoptosis rates of endometrial cells on GD4.5 were increased, showed definite dose–response relationships, and inversely related to the number of implanted blastocysts. The expressions of mRNA and protein for the Bax and caspase-3 genes in the uterine tissues on GD4.5 were up-regulated, while the expressions of mRNA and protein for the Bcl-2 gene were dose-dependently down-regulated. Our results indicated that DNA damage and apoptosis of endometrial cells were important reasons for the loss of implanted blastocysts induced by CS{sub 2}. - Highlights: • We built an animal model of CS2 exposure during blastocyst implantation. • Endometrial cells were used in the comet assay to detect DNA damage. • CS2 exposure caused DNA damage and endometrial cell apoptosis. • DNA damage and endometrial cell apoptosis were responsible for embryo loss.

  16. DNA damage and apoptosis of endometrial cells cause loss of the early embryo in mice exposed to carbon disulfide

    International Nuclear Information System (INIS)

    Carbon disulfide (CS2) may lead to spontaneous abortion and very early pregnancy loss in women exposed in the workplace, but the mechanism remains unclear. We designed an animal model in which gestating Kunming strain mice were exposed to CS2 via i.p. on gestational day 4 (GD4). We found that the number of implanted blastocysts on GD8 was significantly reduced by each dose of 0.1 LD50 (157.85 mg/kg), 0.2 LD50 (315.7 mg/kg) and 0.4 LD50 (631.4 mg/kg). In addition, both the level of DNA damage and apoptosis rates of endometrial cells on GD4.5 were increased, showed definite dose–response relationships, and inversely related to the number of implanted blastocysts. The expressions of mRNA and protein for the Bax and caspase-3 genes in the uterine tissues on GD4.5 were up-regulated, while the expressions of mRNA and protein for the Bcl-2 gene were dose-dependently down-regulated. Our results indicated that DNA damage and apoptosis of endometrial cells were important reasons for the loss of implanted blastocysts induced by CS2. - Highlights: • We built an animal model of CS2 exposure during blastocyst implantation. • Endometrial cells were used in the comet assay to detect DNA damage. • CS2 exposure caused DNA damage and endometrial cell apoptosis. • DNA damage and endometrial cell apoptosis were responsible for embryo loss

  17. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... disease, severe chronic obstructive pulmonary disease, or severe reactive airway disease, just because the positioning of the ... some questions from how robotics has changed referral patterns. And I think, potentially, I think endometrial cancer ...

  18. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... lymphectomy, and hysterectomy. Just to put it in perspective, endometrial cancer will affect about 40,000 women ... we’re doing in essence is microsurgery. For perspective for the viewers, the scissors that we’re ...

  19. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... pelvic, periaortic lymphectomy, and hysterectomy. Just to put it in perspective, endometrial cancer will affect about 40, ... women in the United States every year, making it the most common gynecologic malignancy. A significant portion ...

  20. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... here while we’re watching the dissection regarding complications of the robotic endometrial cancer stage, he says, ... laparoscopic cases to open. With regards to other complications such as blood transfusions, we’ve had none. ...

  1. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... to put it in perspective, endometrial cancer will affect about 40,000 women in the United States ... patients to start decreasing their intake of solid food, you know, at least a day, sometimes two ...

  2. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... treatments, then I think that that’s a real benefit that we’re able to get that information ... complete lymph adenectomy may actually provide a therapeutic benefit in patients with endometrial cancer, so theoretically, the ...

  3. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... to put it in perspective, endometrial cancer will affect about 40,000 women in the United States ... permanent on the anterior thigh. It’s a side effect of a lymph adenectomy that we wish didn’ ...

  4. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... improved access to reach the deep pelvis. These advantages can be particularly helpful in staging endometrial cancer ... blood loss. And that’s one of the major advantages that we’ve found with this system, because ...

  5. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... EEA cisers. But as this patient has a clinical stage one endometrial cancer, there is no concern regarding the use of the Koh ring for this case. And you can see just a visualization as ...

  6. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Science.gov (United States)

    ... the expandibility. There has been introduced a new vision system for the S that is in high-definition. And ... a little over 70 endometrial stagings with the robotic system and we’ve never had to open a ...

  7. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... with improved access to reach the deep pelvis. These advantages can be particularly helpful in staging endometrial ... in women who has significant hypertensive disease where these vessels are very ectatic, meaning that they take ...

  8. Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Butori, Noemie [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Tixier, Herve; Filipuzzi, Laurence; Mutamba, William [Department of Gynecology and Obstetrics, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Guiu, Boris; Cercueil, Jean-Pierre [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Douvier, Serge; Sagot, Paul [Department of Gynecology and Obstetrics, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Krause, Denis [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Loffroy, Romaric, E-mail: romaric.loffroy@chu-dijon.fr [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France)

    2011-07-15

    Purpose: To evaluate the efficacy of pre-myomectomy uterine artery embolization with gelatin sponge particles to reduce operative blood loss and facilitate removal of fibroids. Materials and methods: This retrospective study included 33 women (mean age, 36 years; range, 24-45 years), of whom at least 18 wished to preserve fertility. They presented with at least one large myoma (mean diameter, 90 mm; range, 50-150 mm) and had undergone preoperative uterine artery embolization with resorbable gelatin sponge by unilateral femoral approach between December 2001 and November 2008. Clinical, radiological and surgical data were available for all patients. Mean haemoglobin levels before and after surgery were compared with Student's t-test. Results: No complication or technical failure of embolization occurred. The myomectomies were performed during laparotomy (25 cases) or laparoscopy (8 cases). Dissection of fibroids was easier (mean, 3 per patient; range, 1-11), with a mean operating time of 108 {+-} 50 min (range, 30-260 min). Bloodless surgery was the rule with a mean estimated peroperative blood loss of 147 {+-} 249 mL (range, 0-800 mL). Mean pre-(12.9 {+-} 1.3 g/dL) and post-therapeutic (11.4 {+-} 1.2 g/dL) haemoglobin levels were not statistically different (p > 0.05). There was no need for blood transfusion. None of the patients required hysterectomy. The mean duration of hospital stay was 7.5 {+-} 1.3 days (range, 3-12 days). Conclusion: Preoperative uterine artery embolization is effective in reducing intraoperative blood loss and improves the chances of performing conservative surgery. It should be considered a useful adjunct to myomectomy in women at high hemorrhagic risk or who refuse blood transfusion.

  9. Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of pre-myomectomy uterine artery embolization with gelatin sponge particles to reduce operative blood loss and facilitate removal of fibroids. Materials and methods: This retrospective study included 33 women (mean age, 36 years; range, 24-45 years), of whom at least 18 wished to preserve fertility. They presented with at least one large myoma (mean diameter, 90 mm; range, 50-150 mm) and had undergone preoperative uterine artery embolization with resorbable gelatin sponge by unilateral femoral approach between December 2001 and November 2008. Clinical, radiological and surgical data were available for all patients. Mean haemoglobin levels before and after surgery were compared with Student's t-test. Results: No complication or technical failure of embolization occurred. The myomectomies were performed during laparotomy (25 cases) or laparoscopy (8 cases). Dissection of fibroids was easier (mean, 3 per patient; range, 1-11), with a mean operating time of 108 ± 50 min (range, 30-260 min). Bloodless surgery was the rule with a mean estimated peroperative blood loss of 147 ± 249 mL (range, 0-800 mL). Mean pre-(12.9 ± 1.3 g/dL) and post-therapeutic (11.4 ± 1.2 g/dL) haemoglobin levels were not statistically different (p > 0.05). There was no need for blood transfusion. None of the patients required hysterectomy. The mean duration of hospital stay was 7.5 ± 1.3 days (range, 3-12 days). Conclusion: Preoperative uterine artery embolization is effective in reducing intraoperative blood loss and improves the chances of performing conservative surgery. It should be considered a useful adjunct to myomectomy in women at high hemorrhagic risk or who refuse blood transfusion.

  10. Systemic Therapy in Endometrial Cancer: Recent Advances.

    OpenAIRE

    Guru Prasad B; Rajshekhar Kundargi; Samit Purohit; Rohan Bhise; Rachan Shetty; Lakshmaiah KC

    2013-01-01

    Endometrial cancer is a chemosensitive disease. Studies have established a clear benefit of chemotherapy in advanced stages and trials are ongoing to define its role in early stages as well. As more molecular pathways are being elucidated there is increasing role for targeted agents and future looks quite promising. We did an extensive search both online and offline for all the relevant articles including chemotherapy and targeted therapy for endometrial cancer.

  11. Sterility of the uterine cavity.

    DEFF Research Database (Denmark)

    MØller, B R; Kristiansen, F V

    1995-01-01

    In a prospective open study the sterility of the uterine cavity was evaluated in 99 women admitted for hysterectomy. The indications for hysterectomy were in most cases persistent irregular vaginal bleeding and fibromyomas of the uterus. Samples for both aerobic and anaerobic bacteria, Chlamydia trachomatis, yeasts and viruses were taken preoperatively from the apex of the vagina and cervical os. Immediately after hysterectomy the uterus was opened under sterile conditions and samples obtained from the isthmus and fundus of the uterine cavity for microbiological examination. Wet smears were taken from the same sites. Nearly a quarter of all the patients harbored one or more microorganisms in the uterus, mostly Gardnerella vaginalis, Enterobacter and Streptococcus agalactiae. We found that in a significant number of cases, the uterine cavity is colonized with potentially pathogenic organisms which may play a causative role in endometritis. The results indicate that inflammation of the uterine cavity should be evaluated by hysteroscopic examination before hysterectomy is undertaken in patients with persistent irregular vaginal bleeding. Udgivelsesdato: 1995-Mar

  12. Bovine endometrial stromal cells display osteogenic properties

    Directory of Open Access Journals (Sweden)

    Cavirani Sandro

    2008-12-01

    Full Text Available Abstract The endometrium is central to mammalian fertility. The endometrial stromal cells are very dynamic, growing and differentiating throughout the estrous cycle and pregnancy. In humans, stromal cells appear to have progenitor or stem cell capabilities and the cells can even differentiate into bone. It is not clear whether bovine endometrial stromal cells exhibit a similar phenotypic plasticity. So, the present study tested the hypothesis that bovine endometrial stromal cells could be differentiated along an osteogenic lineage. Pure populations of bovine stromal cells were isolated from the endometrium. The endometrial stromal cell phenotype was confirmed by morphology, prostaglandin secretion, and susceptibility to viral infection. However, cultivation of the cells in standard endometrial cell culture medium lead to a mesenchymal phenotype similar to that of bovine bone marrow cells. Furthermore, the endometrial stromal cells developed signs of osteogenesis, such as alizarin positive nodules. When the stromal cells were cultured in a specific osteogenic medium the cells rapidly developed the characteristics of mineralized bone. In conclusion, the present study has identified that stromal cells from the bovine endometrium show a capability for phenotype plasticity similar to mesenchymal progenitor cells. These observations pave the way for further investigation of the mechanisms of stroma cell differentiation in the bovine reproductive tract.

  13. COMPARACIÓN ENTRE EL SISTEMA INTRAUTERINO DE LIBERACIÓN DE LEVONORGESTREL Y LA ABLACIÓN ENDOMETRIAL EN EL TRATAMIENTO DE LA HEMORRAGIA UTERINA DISFUNCIONAL

    Directory of Open Access Journals (Sweden)

    Laura Melado V

    2008-01-01

    Full Text Available Objetivo: Comparación entre el sistema intrauterino de liberación de levonorgestrel (SIL-LNG y las técnicas de ablación endometrial (AR-E en el tratamiento de la hemorragia uterina disfuncional (HUD. Método: Estudio retrospectivo de 170 pacientes con HUD distribuidas de la siguiente forma: 51 de ellas en el grupo AR-E y 119 en el grupo SIL-LNG. Se estudió el ciclo menstrual, la hemoglobina y el hematocrito, los efectos adversos y la satisfacción de las usuarias. Resultados: En ambos grupos se observó un incremento de los niveles de hemoglobina y hematocrito. El patrón de sangrado más frecuente fue el de amenorrea, hipomenorrea y ciclos normales tras los tratamientos. El grado de satisfacción fue muy elevado en ambos grupos. Conclusión: Ambos tratamientos son efectivos para mejorar la HUD. La paciente debe conocer los beneficios y riesgos de cada uno y elegir el más conveniente.Objective: To compare the efficacy of levonorgestrel intrauterine system and endometrial resection in the treatment of dysfunctional uterine bleeding. Methods: Retrospective study with 170 women, 51 of them in endometrial resection group and 119 in the levonorgestrel intrauterine system group. Hemoglobin levéis, menstrual bleeding patterns, adverse effects and degree of satisfaction were evaluated. Results: Hemoglobin levéis increased in both groups. The most frequent bleeding patterns were amenorrhea, hypomenorrhea and normal pattern. The most of the patients in both groups were satisfied with the treatment. Conclusión: Both treatments were effective in reducing dysfunctional uterine bleeding. The woman must know risks and benefits from each one.

  14. Evaluation of Uterine Biophysical Profile and to Assess its Role in Predicting Conception among Unexplained Primary Infertility Patients

    Directory of Open Access Journals (Sweden)

    Pooja Gupta

    2014-12-01

    Full Text Available Introduction: Infertility is a devastating disease which affects its victims at a very basic level the ability to reproduce. This can be divisive to the couples involved, their relatives and friends. The influence of infertility can be immense. There are a lot of medical and social consequences of infertility and the psychological sequelae are one of them. Affected patients and their families suffer from loss of esteem, disappointment and depression. Considering the immense effect of infertility on the life of not only the affected couples but also on their families and relatives the present study was conducted with following objective. Objective: To evaluate the Uterine Biophysical Profile and to assess its role in predicting the conception outcome in spontaneous cycles in patients with unexplained primary infertility. Material &Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, U.P. Rural Institute of Medical Sciences & Research, Saifaion 55 women with unexplained primary infertility after standard diagnostic work up. Ultrasound (TVS measurement of all patients was performed in their midcycle of spontaneous cycle. The Uterine Biophysical Profile (UBP i.e. certain sonographic qualities of the uterus were noted during the normal mid-cycle of these patients. These included 7 parameters: Endometrial thickness in greatest AP dimension of 7 mm or greater (full-thickness measurement, a layered ("5 line" appearance to the endometrium, myometrial contractions causing a wave like motion of the endometrium, homogeneous myometrial echogenicity, uterine artery blood flow (as measured by PI, less than 3.0, blood flow within zone 3 using color doppler technique, myometrial blood flow seen on gray-scale examination. The Uterine Scoring System for Reproduction ("USSR" was used to evaluate the total score. Results: Among 55 unexplained primary infertility patients 24 i.e. 43.63% conceived by serial ultrasonographic monitoring of spontaneous menstrual cycle and timed intercourse. According to USSR, with a ‘perfect score’ of 20, there was 80% conception rate. While 9 /15 patients (i.e 60% conceived with a score of 17-19.  With a score of 14-16, 10/23 patients conceived i.e. 43.37%.  Only 8.33% conception rate was seen with a low score of < or = 13.  Highest pregnancy rate (60% was seen with an endometrial thickness of 7-9mm while zone IV endometrial blood flow gave maximum conception rate of 66.66%. Conclusion: UBP can prove to be a simple, reliable, reproducible, rapid and non-invasive tool to predict uterine environment and hence conception outcome.

  15. Ablação histeroscópica do endométrio: resultados após seguimento clínico de 5 anos / Results of hysteroscopic endometrial ablation after five-year follow-up

    Scientific Electronic Library Online (English)

    Winny Hirome, Takahashi; Reginaldo Guedes Coelho, Lopes; Daniella de Batista, Depes; Hosana Karinne de Marathaoan Souza Martins e, Castello Branco.

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos, após seguimento mínimo de 5 anos, de pacientes com sangramento uterino anormal de etiologia benigna que realizaram ablação endometrial, analisando a taxa de sucesso do tratamento em relação ao método, compreendida como satisfação da paciente e melhora do san [...] gramento uterino anormal, bem como complicações tardias, fatores associados e recorrência dos sintomas. MÉTODOS: Estudo transversal conduzido após período mínimo de 5 anos de cirurgia em pacientes submetidas ao procedimento entre 1999 e 2004. Foram analisados os seguintes dados: faixa etária quando da realização da cirurgia, complicações imediatas e tardias, e fatores associados. Foi utilizado o modelo de regressão logística com cálculo da respectiva Odds Ratio (OR) para se observarem as possíveis associações existentes entre a taxa de sucesso da cirurgia e as variáveis analisadas. RESULTADOS: Cento e quatorze pacientes foram submetidas à ablação endometrial no período de Março de 1999 a Abril de 2004. O tempo mediano de seguimento foi de 82 meses. O modelo de regressão logística permitiu a predição correta do sucesso da ablação endometrial em 80,6%. A idade relacionou-se diretamente com o sucesso do procedimento (OR=1,2; p=0,003) e a ligadura tubária pregressa mostrou relação inversa com o sucesso da ablação endometrial (OR=0,3; p=0,049). Dentre as pacientes com falha terapêutica, 21 (72,4%) foram tratadas com histerectomia. Em uma das pacientes submetidas à histerectomia foi confirmada a presença de hidro-hematossalpinge ao exame anatomopatológico, caracterizando a síndrome da ligadura tubária pós-ablação. CONCLUSÃO: A ablação endometrial tem se mostrado uma opção de tratamento vantajosa, mantendo altos índices de satisfação das pacientes, mesmo em seguimentos a longo prazo A idade quando da ablação endometrial influenciou no sucesso terapêutico e mais estudos são necessários para avaliar os fatores que poderão futuramente influenciar na indicação do procedimento em casos selecionados. Abstract in english PURPOSE: To evaluate the clinical outcomes after a minimum period of 5 years of follow-up of patients with abnormal uterine bleeding of benign etiology who underwent endometrial ablation, analyzing the success rate of treatment defined as patient satisfaction and improvement in uterine abnormal blee [...] ding, as well as late complications and factors associated with recurrence of symptoms. METHODS: A cross-sectional survey was conducted after a minimum period of 5 years after surgery in patients who underwent the procedure between 1999 and 2004. We analyzed the following data: age at the time of surgery, immediate and late complications and associated factors. Logistic regression with Odds Ratio (OR) calculation was performed to evaluate possible associations between the success rate of surgery and the analyzed variables. RESULTS: A total of 114 patients underwent endometrial ablation between March 1999 and April 2004. The median follow-up was 82 months. The logistic regression model allowed the correct prediction of the success of endometrial ablation in 80.6% of cases. Age was directly related to the success of the procedure (OR=1.2; p=0.003) and previous tubal ligation showed a negative association with the success of endometrial ablation (OR=0.3; p=0.049). Among the patients with treatment failure, 21 (72.4%) underwent hysterectomy. In one of the hysterectomy cases, hydro/hematosalpinx was confirmed by the anatomopathological exam, characterizing the postablation-tubal sterilization syndrome. CONCLUSION: Endometrial ablation has proven to be a worthwhile treatment option, maintaining high rates of patient satisfaction, even over long-term follow-up. The age at endometrial ablation influenced the therapeutic success. Further studies are needed to evaluate the factors that may influence the future indication for the procedure in selected cases.

  16. Ablação histeroscópica do endométrio: resultados após seguimento clínico de 5 anos Results of hysteroscopic endometrial ablation after five-year follow-up

    Directory of Open Access Journals (Sweden)

    Winny Hirome Takahashi

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos, após seguimento mínimo de 5 anos, de pacientes com sangramento uterino anormal de etiologia benigna que realizaram ablação endometrial, analisando a taxa de sucesso do tratamento em relação ao método, compreendida como satisfação da paciente e melhora do sangramento uterino anormal, bem como complicações tardias, fatores associados e recorrência dos sintomas. MÉTODOS: Estudo transversal conduzido após período mínimo de 5 anos de cirurgia em pacientes submetidas ao procedimento entre 1999 e 2004. Foram analisados os seguintes dados: faixa etária quando da realização da cirurgia, complicações imediatas e tardias, e fatores associados. Foi utilizado o modelo de regressão logística com cálculo da respectiva Odds Ratio (OR para se observarem as possíveis associações existentes entre a taxa de sucesso da cirurgia e as variáveis analisadas. RESULTADOS: Cento e quatorze pacientes foram submetidas à ablação endometrial no período de Março de 1999 a Abril de 2004. O tempo mediano de seguimento foi de 82 meses. O modelo de regressão logística permitiu a predição correta do sucesso da ablação endometrial em 80,6%. A idade relacionou-se diretamente com o sucesso do procedimento (OR=1,2; p=0,003 e a ligadura tubária pregressa mostrou relação inversa com o sucesso da ablação endometrial (OR=0,3; p=0,049. Dentre as pacientes com falha terapêutica, 21 (72,4% foram tratadas com histerectomia. Em uma das pacientes submetidas à histerectomia foi confirmada a presença de hidro-hematossalpinge ao exame anatomopatológico, caracterizando a síndrome da ligadura tubária pós-ablação. CONCLUSÃO: A ablação endometrial tem se mostrado uma opção de tratamento vantajosa, mantendo altos índices de satisfação das pacientes, mesmo em seguimentos a longo prazo A idade quando da ablação endometrial influenciou no sucesso terapêutico e mais estudos são necessários para avaliar os fatores que poderão futuramente influenciar na indicação do procedimento em casos selecionados.PURPOSE: To evaluate the clinical outcomes after a minimum period of 5 years of follow-up of patients with abnormal uterine bleeding of benign etiology who underwent endometrial ablation, analyzing the success rate of treatment defined as patient satisfaction and improvement in uterine abnormal bleeding, as well as late complications and factors associated with recurrence of symptoms. METHODS: A cross-sectional survey was conducted after a minimum period of 5 years after surgery in patients who underwent the procedure between 1999 and 2004. We analyzed the following data: age at the time of surgery, immediate and late complications and associated factors. Logistic regression with Odds Ratio (OR calculation was performed to evaluate possible associations between the success rate of surgery and the analyzed variables. RESULTS: A total of 114 patients underwent endometrial ablation between March 1999 and April 2004. The median follow-up was 82 months. The logistic regression model allowed the correct prediction of the success of endometrial ablation in 80.6% of cases. Age was directly related to the success of the procedure (OR=1.2; p=0.003 and previous tubal ligation showed a negative association with the success of endometrial ablation (OR=0.3; p=0.049. Among the patients with treatment failure, 21 (72.4% underwent hysterectomy. In one of the hysterectomy cases, hydro/hematosalpinx was confirmed by the anatomopathological exam, characterizing the postablation-tubal sterilization syndrome. CONCLUSION: Endometrial ablation has proven to be a worthwhile treatment option, maintaining high rates of patient satisfaction, even over long-term follow-up. The age at endometrial ablation influenced the therapeutic success. Further studies are needed to evaluate the factors that may influence the future indication for the procedure in selected cases.

  17. Postoperative radiotherapy for endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Eun Cheol; Kim, Jin Hee; Kim, Ok Bae; Byun, Sang Jun; Park, Seung Gyu; Kwon, Sang Hoon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2012-09-15

    To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. Sixty four patients with stage I?III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended fi eld. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.

  18. What Should You Ask Your Doctor about Endometrial Cancer?

    Science.gov (United States)

    ... cancer? What should you ask your doctor about endometrial cancer? As you cope with cancer, you need to ... want to ask: What type and grade of endometrial cancer do I have? Has my cancer spread outside ...

  19. Leucemia mieloide extramedular con compromiso endometrial: reporte de un caso y revisión de la literatura / Extramedullary myelogenous leukemia with endometrial involvement: a case report and literature review

    Scientific Electronic Library Online (English)

    Germán, García-Soto; Juan de Jesús, Pachón-Rincón; Jorge A, Castaño; José Domingo, Torres; Elvia Inés, Gómez.

    2007-09-01

    Full Text Available La leucemia mieloide extramedular (LME), también conocida como sarcoma granulocítico, es una manifestación extramedular de la leucemia mieloide aguda. Puede presentarse virtualmente en todos los sitios del organismo y en cualquier momento de la evolución de la enfermedad primaria. Se define como una [...] lesión tumoral compuesta de células mieloides inmaduras que se localiza en cualquier sitio extramedular. Se reporta el caso de una paciente de 39 años de edad quien se presentó con compromiso uterino que simuló un carcinoma endometrial y en quien finalmente se diagnosticó LME con compromiso uterino, en el contexto de una leucemia mieloide aguda (LMA). Se presenta una revisión de la literatura y se resaltan los aspectos más importantes de la enfermedad. Metodología: con el fin de conocer los aspectos más relevantes de esta enfermedad como frecuencia, manifestaciones clínicas y diagnóstico histopatológico, tratamiento y pronóstico, reportados en la literatura, se utilizaron las bases de datos Medline y Ovid y se hizo la búsqueda con las palabras clave granulocytic sarcoma, extramedullary leukemia, myeloid sarcoma, female genital tract, uterus, uterine cervix, endometrium. Resultados: dos revisores evaluaron la pertinencia de los artículos y seleccionaron aquellos que trataban los aspectos relevantes del tema o hacían referencia al tracto genital femenino y específicamente al útero (uterus, uterine cervix). Se realizó nueva búsqueda con base en las referencias de algunos artículos. La búsqueda arrojó en total 123 artículos que se referían a diversos aspectos de la enfermedad y las diferentes partes del cuerpo involucradas. Se seleccionaron 14 artículos pertinentes, incluyendo uno de revisión sobre leucemia mieloide extramedular en general. La mayoría de los artículos son reporte de casos, reportes breves y revisión de algunos aspectos de la enfermedad, en series pequeñas de pacientes. Ningún artículo se refiere específicamente al compromiso del endometrio. Conclusiones: el compromiso del útero por LME es raro y la información disponible en la literatura acerca de esta entidad es escasa, y consiste básicamente de informes de casos y de análisis por agrupamiento de los temas publicados. Hay consenso en la dificultad del diagnóstico inicial de esta enfermedad, en su mal pronóstico y en su tratamiento, aunque la experiencia es limitada. Abstract in english Extramedullary myelogenous leukemia (also known as granulocytic sarcoma) is an extramedullary manifestation of acute myelogenous leukaemia. It can appear virtually at every body site and during any moment during primary disease evolution. Extramedullary myelogenous leukaemia is defined as being a tu [...] moural lesion composed of immature myeloid cells localised at any extramedullar site. The case of a 39-year old female is reported; she had uterine involvement for this disease. The lesion initially had a clinical appearance of endometrial carcinoma; however, extramedullary myelogenous leukemia with uterine involvement was finally diagnosed in this woman, within an acute myelogenous leukaemia context. Methodology: Ovid and Medline databases were searched using the following key words: granulocytic sarcoma, extramedullary leukaemia, myeloid sarcoma, female genital tract, uterus, uterine cervix, endometrium. The search was carried out to learn more about this disease, such as frequency, clinical features and diagnosis, treatment and prognosis, according to current medical literature. Results: two independent reviewers evaluated the papers’ relevancy and chose articles dealing with granulocytic sarcoma or mentioning the female genital tract, specifically the uterus (uterus, uterine cervix). A new search was made using references from some papers so found. 123 articles were found referring to different aspects of the disease and the anatomical parts so affected. 14 pertinent papers were chosen, including a review article about extramedullary myeloid leukaemia. Most papers were case reports, brief reports and rev

  20. Risk factors for lower limb lymphedema after lymph node dissection in patients with ovarian and uterine carcinoma

    International Nuclear Information System (INIS)

    Lymph node dissection has proven prognostic benefits for patients with ovarian or uterine carcinoma; however, one of the complications associated with this procedure is lymphedema. We aimed to identify the factors that are associated with the occurrence of lymphedema after lymph node dissection for the treatment of ovarian or uterine carcinoma. A total of 694 patients with histologically confirmed ovarian (135 patients) or uterine cancer (258 with cervical cancer, 301 with endometrial cancer) who underwent lymph node dissection were studied retrospectively. Logistic regression analyses were used to identify the risk factors associated with occurrence of lymphedema. Among ovarian and uterine cancer patients who underwent pelvic lymph node dissection, post-operative radiotherapy (odds ratio: 1.79; 95% confidence interval: 1.20–2.67; p = 0.006) was statistically significantly associated with occurrence of lymphedema. There was no relationship between any surgical procedure and occurrence of lymphedema among patients undergoing pelvic lymphadenectomy. Our findings are supported by a sound biological rationale because they suggest that limb lymphedema is caused by pelvic lymph node dissection

  1. Risk factors for lower limb lymphedema after lymph node dissection in patients with ovarian and uterine carcinoma

    Directory of Open Access Journals (Sweden)

    Fukushima Masanori

    2009-02-01

    Full Text Available Abstract Background Lymph node dissection has proven prognostic benefits for patients with ovarian or uterine carcinoma; however, one of the complications associated with this procedure is lymphedema. We aimed to identify the factors that are associated with the occurrence of lymphedema after lymph node dissection for the treatment of ovarian or uterine carcinoma. Methods A total of 694 patients with histologically confirmed ovarian (135 patients or uterine cancer (258 with cervical cancer, 301 with endometrial cancer who underwent lymph node dissection were studied retrospectively. Logistic regression analyses were used to identify the risk factors associated with occurrence of lymphedema. Results Among ovarian and uterine cancer patients who underwent pelvic lymph node dissection, post-operative radiotherapy (odds ratio: 1.79; 95% confidence interval: 1.20–2.67; p = 0.006 was statistically significantly associated with occurrence of lymphedema. Conclusion There was no relationship between any surgical procedure and occurrence of lymphedema among patients undergoing pelvic lymphadenectomy. Our findings are supported by a sound biological rationale because they suggest that limb lymphedema is caused by pelvic lymph node dissection.

  2. Endometrial cancer: Diagnostic methods in postmenopausal vaginal bleeding

    OpenAIRE

    Mandi? Aljoša; Vujkov Tamara

    2003-01-01

    Postmenopausal vaginal bleeding (PMB) is the leading symptom of endometrial cancer. More than 70% of patients with endometrial cancer are postmenopausal. Despite PMB as a leading symptom in diagnosis of endometrial cancer, PMB could be caused by some benign processes in endometrium such as hyperplasia and focal endometrial disease, such as a polyp. The golden standard for histological evaluation of the endometrium is curettage. Transvaginal ultrasound (TVS) and measurement of endometrium thic...

  3. Endometrial Sampling Performed by Gynecological Residents in Training

    OpenAIRE

    Osama Sadkeak Bajouh; Ohoud Al-Shamrany; Ahmad H. Abduljabbar; Hassan S. O. Abduljabbar

    2014-01-01

    Objectives: Endometrial sampling became the first choice in screening endometrial pathology. The technique is accurate and simple. The aim is to evaluate the use of endometrial sample in outpatients’ clinic as a routine by LEVEL of gynecological resident in training. Methods: A retrospective study of 463 patients seen by the residents at KAUH. A detailed history was obtained from medical records file. Reasons for endometrial sampling were divided into 6 categories, including screening, P...

  4. Personalized therapy in endometrial cancer: Challenges and opportunities

    OpenAIRE

    Westin, Shannon N; Russell R. Broaddus

    2012-01-01

    Early stage endometrial cancer is generally curable. However, progress in the treatment of advanced and recurrent endometrial cancer has been limited. This has led to a shift from the use of traditional chemotherapeutic agents and radiotherapy regimens to the promising area of targeted therapy, given the large number of druggable molecular alterations found in endometrial cancer. To maximize the effects of directed targeted therapy, careful molecular characterization of the endometrial tumor ...

  5. The morbidity of treatment for patients with stage I endometrial cancer: results from a randomized trial

    International Nuclear Information System (INIS)

    Purpose: To compare the treatment complications for patients with Stage I endometrial cancer treated with surgery and pelvic radiotherapy (RT) or surgery alone in a multicenter randomized trial. Methods and Materials: The Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial included patients with endometrial cancer confined to the uterine corpus, either Grade 1 or 2 with more than 50% myometrial invasion, or Grade 2 or 3 with less than 50% myometrial invasion. Surgery consisted of an abdominal hysterectomy and oophorectomy, without lymphadenectomy. After surgery, patients were randomized to receive pelvic RT (46 Gy), or no further treatment. A total of 715 patients were randomized. Treatment complications were graded using the French-Italian glossary. Results: The analysis was done at a median follow-up duration of 60 months. 691 patients were evaluable. Five-year actuarial rates of late complications (Grades 1-4) were 26% in the RT group and 4% in the control group (p<0.0001). Most were Grade 1 complications, with 5-year rates of 17% in the RT group and 4% in the control group. All severe (Grade 3-4) complications were observed in the RT group (3%). Most complications were of the gastrointestinal tract. The symptoms resolved after some years in 50% of the patients. Grade 1-2 genitourinary complications occurred in 8% of the RT patients, and 4% of the controls. Bone complications occurred in 4 RT patients (1%). Seven patients (2%) discontinued their RT due to acute RT-related symptoms. Patients with acute morbidity had an increased risk of late RT complications (p=0.001). The 4-field box technique was associated with a lower risk of late complications (p=0.06). Conclusion: Pelvic RT increases the morbidity of treatment in Stage I endometrial cancer. In the PORTEC trial, severe complications occurred in 3% of treated patients, and over 20% experienced mild (mostly Grade 1) symptoms. Patients with acute RT-related morbidity had an increased risk of late complications. As pelvic RT in Stage I endometrial carcinoma was shown to significantly reduce the rate of locoregional recurrence, but without a survival benefit, its use in the adjuvant setting requires careful patient selection (treating those at increased risk of relapse), and the use of treatment schemes with the lowest risk of morbidity

  6. Endometrial caspase 1 and interleukin-18 expression during the estrous cycle and peri-implantation period of porcine pregnancy and response to early exogenous estrogen administration

    Directory of Open Access Journals (Sweden)

    Stein Daniel R

    2010-04-01

    Full Text Available Abstract Background The role for endometrial secretion of cytokines during the establishment of pregnancy in a number of mammals is well established. The current study determined endometrial expression of caspase 1 (CASP1 and interleukin-18 (IL18 during the estrous cycle and early pregnancy, and following early estrogen administration, which induces conceptus loss during early development in pigs. Methods Gilts were hysterectomized on either D 0, 5, 10, 12, 15 and 18 of the estrous cycle, or D 10, 12, 15 or 18 of pregnancy. The abundance of endometrial CASP1 mRNA was unaffected by day of the estrous cycle, however there was a 6 and 10-fold increase in expression on D 15 and 18 of pregnancy. Endometrial expression of IL18 mRNA increased 5-fold between D 10 to 18 in cyclic and pregnant gilts. Total recoverable IL18 in uterine flushings was greater in pregnant compared to cyclic gilts on D 15 and 18. In the second experiment, mated gilts were treated with either corn oil (CO or estrogen (E on D 9 and 10 and hysterectomized on either D 10, 12, 13, 15 or 17 of pregnancy. The current study localizes the presence of CASP1 to the epithelial layer of the endometrium for the first time. Further, a day × treatment interaction was detected for endometrial CASP1 mRNA and protein abundance as E stimulated an earlier increase on D 13 compared to CO gilts. Although IL18 mRNA expression remained unaltered from the E treatment, protein abundance was significantly attenuated on D 15 and 18 in response to E treatment. Conclusions Endometrial expression of CASP1 and IL18 is associated with establishment of pregnancy in pigs. Alteration of CASP1 and IL18 following premature exposure of the uterus to estrogen during early pregnancy may contribute to conceptus loss between Days 15 to 18 of pregnancy.

  7. Alterações endometriais após embolização de leiomiomas uterinos avaliadas por ressonância magnética de alto campo (3 Tesla) / Endometrium evaluation with high-field (3-Tesla) magnetic resonance imaging in patients submitted to uterine leiomyoma embolization

    Scientific Electronic Library Online (English)

    Monica Amadio Piazza, Jacobs; Felipe, Nasser; Eduardo, Zlotnik; Marcos de Lorenzo, Messina; Ronaldo Hueb, Baroni.

    2013-03-01

    Full Text Available OBJETIVO: Avaliar alterações endometriais relacionadas à embolização de artérias uterinas para tratamento da leiomiomatose uterina sintomática (dor pélvica e/ou sangramento uterino), por meio de ressonância magnética de alto campo (3 Tesla). MÉTODOS: Estudo longitudinal e prospectivo, no qual foram [...] incluídas 94 pacientes com diagnóstico clínico e por imagem de leiomiomatose uterina sintomática, todas tratadas por meio de procedimento de embolização das artérias uterinas. As pacientes foram submetidas a avaliações por ressonância magnética de alto campo da pelve antes e 6 meses após o procedimento. Foram realizadas avaliações específicas do endométrio nas sequências ponderadas em T2 e nas sequências ponderadas em T1, antes e após a infusão endovenosa dinâmica do meio de contraste paramagnético. Diante dos resultados dessas medidas, foram realizadas análises estatísticas por meio de teste t de Student para comparação dos resultados obtidos antes e após o procedimento. RESULTADOS: Observou-se um aumento médio de 20,9% no sinal endometrial nas imagens ponderadas em T2 obtidas após o procedimento de embolização das artérias uterinas, quando comparadas com a avaliação pré-procedimento (p=0,0004). Nas imagens obtidas com a infusão endovenosa do meio de contraste paramagnético, foi observado um aumento médio de 18,7% na intensidade de sinal endometrial pós-embolização de artérias uterinas, quando comparadas com a medida pré-embolização (p Abstract in english OBJECTIVE: To evaluate the endometrial alterations related to embolization of uterine arteries for the treatment of symptomatic uterine leiomyomatosis (pelvic pain and/or uterine bleeding) by means of high-field (3-Tesla) magnetic resonance. METHODS: This is a longitudinal and prospective study that [...] included 94 patients with a clinical and imaging diagnosis of symptomatic uterine leiomyomatosis, all of them treated by embolization of the uterine arteries. The patients were submitted to evaluations by high-field magnetic resonance of the pelvis before and 6 months after the procedure. Specific evaluations were made of the endometrium on the T2-weighted sequences, and on the T1-weighted sequences before and after the intravenous dynamic infusion of the paramagnetic contrast. In face of these measures, statistical analyses were performed using Student's t test for comparison of the results obtained before and after the procedure. RESULTS: An average increase of 20.9% was noted in the endometrial signal on T2-weighted images obtained after the uterine artery embolization procedure when compared to the pre-procedure evaluation (p=0.0004). In the images obtained with the intravenous infusion of paramagnetic contrast, an average increase of 18.7% was noted in the post-embolization intensity of the endometrial signal, compared to the pre-embolization measure (p

  8. What Are the Risk Factors for Endometrial Cancer?

    Science.gov (United States)

    ... know what causes endometrial cancer? What are the risk factors for endometrial cancer? A risk factor is anything that changes (raises or lowers) ... to obesity, which is a well-known endometrial cancer risk factor. Many scientists think this is the main way ...

  9. Spontaneous uterine rupture at 32 weeks of gestation after previous uterine artery embolization.

    Science.gov (United States)

    Takeda, Jun; Makino, Shintaro; Ota, Atsuyuki; Tawada, Tetsuo; Mitsuhashi, Naoki; Takeda, Satoru

    2014-01-01

    Uterine artery embolization (UAE) is a common treatment for post-partum hemorrhage and uterine fibroids. However, the effects of UAE on subsequent pregnancies have not been established. Here, we present a case of spontaneous uterine rupture after previous UAE. A 31-year-old woman underwent UAE for a cervical ectopic pregnancy. Contrast-enhanced magnetic resonance imaging (MRI) at days 5 and 25 post-UAE suggested a regionally decreased blood supply in the mid-posterior wall of the uterine fundus. During a subsequent pregnancy at age 35 years, she underwent an emergency cesarean delivery due to spontaneous uterine rupture at the mid-posterior wall of the uterus at 32 weeks of gestation. Obstetricians should be attentive to the possibility of spontaneous uterine rupture in pregnant women who have previously undergone UAE. Detection of ischemic uterine muscle on MRI may predict potential for uterine rupture in a subsequent pregnancy. PMID:23945024

  10. Claudin7 and moesin in endometrial Adenocarcinoma; a retrospective study of 265 patients

    Directory of Open Access Journals (Sweden)

    Mhawech-Fauceglia Paulette

    2012-01-01

    Full Text Available Abstract Background Metastasis is the main cause of death in cancer and is a multistep process. Moesin (MSN, a member of the ezrin-rdixin-moesin family and Claudin7 (CLDN7, a tight junction protein, both play a role in tumor cell metastasis. Previously, we found an over-expression of MSN and under-expression of CLDN7 at the mRNA level in uterine serous carcinoma in comparison to uterine endometrioid adenocarcinoma. The purpose of this study is to determine the protein expression of MSN and CLDN7 in endometrial cancer (EC and to evaluate their prognostic value. Two hundred sixty-five patients with EC were retrieved from the archives. MSN and CLDN7 immunostaining were performed on the tissue paraffin sections. The expression of each antibody was reported and then correlated with clinicopathological prognostic factors including age, tumor grade, tumor stage, lympho-vascular involvement, depth of myometrial invasion, overall survival (OS, disease free survival (DFS and death of disease (DOD. Results MSN and CLDN were expressed in 46% and 52% of overall cases. We observed an association between MSN+ staining and tumor grade, and serous and clear cell carcinoma subtypes (p + staining and low tumor grade and endometrioid adenocarcinoma subtype (p Conclusion A significant prognostic value of MSN and CLDN7 in predicting disease outcomes in patients with EC was not demonstrated. Nevertheless, the high percentage of EC cases with MSN and CLDN7 immunoexpression, and their association with tumor grade and subtypes, suggests that these proteins might play a role in tumorigenesis of endometrial adenocarcinomas. Future studies are needed to shed light on their mechanistic properties in EC cells.

  11. A Risk-Scoring Model for the Prediction of Endometrial Cancer among Symptomatic Postmenopausal Women with Endometrial Thickness > 4?mm

    OpenAIRE

    Luca Giannella; Kabala Mfuta; Tiziano Setti; Lillo Bruno Cerami; Ezio Bergamini; Fausto Boselli

    2014-01-01

    Objective. To develop and test a risk-scoring model for the prediction of endometrial cancer among symptomatic postmenopausal women at risk of intrauterine malignancy. Methods. We prospectively studied 624 postmenopausal women with vaginal bleeding and endometrial thickness > 4?mm undergoing diagnostic hysteroscopy. Patient characteristics and endometrial assessment of women with or without endometrial cancer were compared. Then, a risk-scoring model, including the best predictors of endometr...

  12. Use of an Intubating Stylet as a Guide to Complete Uterine Curettage Complicated by Uterine Perforation

    OpenAIRE

    Baum, Jonathan D; Douglas J. Sherlock; Atkinson, Andrew L.

    2013-01-01

    Completion of uterine curettage may be challenging following uterine perforation even under sonographic and laparoscopic monitoring. This report illustrates the use of a flexible intubating stylet as a guide to place the suction curette into the uterine cavity when sonography and laparoscopy alone are not successful. Use of a malleable instrument such as an intubating stylet as a guide should be considered an option when insertion of the suction curette into the uterine cavity is complicated ...

  13. Long-term progestin contraceptives (LTPOC induce aberrant angiogenesis, oxidative stress and apoptosis in the guinea pig uterus: A model for abnormal uterine bleeding in humans

    Directory of Open Access Journals (Sweden)

    Buchwalder Lynn

    2010-04-01

    Full Text Available Abstract Background Irregular uterine bleeding is the major side effect of, and cause for, discontinuation of long-term progestin-only contraceptives (LTPOCs. The endometria of LTPOC-treated women display abnormally enlarged, fragile blood vessels (BV, decreased endometrial blood flow and oxidative stress. However, obtaining sufficient, good quality tissues have precluded elucidation of the mechanisms underlying these morphological and functional vascular changes. Methods The current study assessed the suitability of the guinea pig (GP as a model for evaluating the uterine effects of LTPOC administration. Thus GPs were treated with a transdermal pellet for 21 days and examined for endometrial histology, angiogenic markers as well as markers of oxidative stress and apoptosis. Results and Discussion We now demonstrate that GP uteri were enlarged by both estradiol (E2 and medroxyprogesterone acetate (MPA (p Conclusions LTPOC exposure alters endometrial vascular and tissue morphology consistent with oxidative stress and apoptosis in a complex interplay with endogenous estrogens. These findings are remarkably similar to in vivo change observed in the human uterus following LTPOC administration. Hence, the GP is an excellent model for the study of LTPOC effects on the uterus and will be extremely useful in determining the mechanistic pathways involved in this process which cannot be conducted on humans.

  14. Adenocarcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    A retrospective analysis was performed to evaluate the prognosis significance of histologic type (epidermoid carcinoma versus adenocarcinoma) on local control of disease and on the development of distant metastatic disease in 1239 patients with carcinoma of the uterine cervix treated with radiation therapy alone or surgery and irradiation at the Radiation Oncology Center, Mallinckrodt Institute of Radiology (MIR), Washington University Medical Center, between 1959 and 1982. The data indicate that adenocarcinoma of the uterine cervix does not confer a worse prognosis than does epidermod carcinoma when all other factors are equal. Those factors most significant for survival are size of the primary lesion, dose at point A, and the presence of positive lymph nodes

  15. Second-Trimester Uterine Rupture: Lessons Learnt

    OpenAIRE

    F. ABDULWAHAB, Dalia; ISMAIL, Hamizah; NUSEE, Zalina

    2014-01-01

    Uterine rupture is a rare life-threatening complication. It mainly occurs in the third trimester of pregnancy and is rarely seen during the first or second trimesters. Our centre experienced three important cases of uterine rupture. First case: spontaneous uterine rupture at 14 weeks of pregnancy, which was diagnosed at autopsy. It was misled by the ultrasound finding of an intrauterine pregnancy, and searching for other non-gynaecological causes delayed the urgent obstetric surgical manageme...

  16. Predictive Value of Endometrial Thickness in Detecting Endometrial Malignancy in Patients with Postmenopausal Bleeding

    Directory of Open Access Journals (Sweden)

    Onur Kaya

    2014-09-01

    Full Text Available Aim: The aim of this study was to investigate the place of endometrial thickness in detecting endometrial malignancy in patients with postmenopausal vaginal bleeding. Methods: In this study, we retrospectively evaluated hospital records of 380 patients who had undergone endometrial biopsy with the diagnosis of postmenopausal bleeding in the Department of Obstetrics and Gynecology at Haseki Training and Research Hospital between January 2008 and January 2012. Results: Analysis of the biopsy specimens revealed benign or premalignant endometrium in 355 of the 380 patients who were histopathologically diagnosed with postmenopausal bleeding. The mean endometrial thickness in 25 patient with malign endometrium was 11.6±8.2 mm. In our study, when a endometrial thickness cut-off value of 10.8 mm was taken, the sensitivity, specificity, and negative predictive value was found to be 84%, 52%, and 96%, respectively. Conclusion: In our study, almost all patients (96% with endometrial thickness of less than 10.8 mm, were free from endometrial malignancy. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52:164-7

  17. Potassium channels and uterine function

    OpenAIRE

    Brainard, Adam M.; Korovkina, Victoria P.; England, Sarah K

    2007-01-01

    Ion channels are effector proteins that mediate uterine excitability throughout gestation. This review will focus primarily on the role of potassium channels in regulating myometrial tone in pregnancy and labor contractions. During gestation, potassium channels maintain the uterus in a state of quiescence by contributing to the resting membrane potential and counteracting contractile stimuli. This review summarizes the current knowledge about the significance of the potassium channels in main...

  18. Case report of undifferentiated endometrial sarcoma in association with osteoclast-like giant cells.

    Science.gov (United States)

    Bardarov, Svetoslav; Khachaturov, Vadim; Kirtesh, Patel; Jimenez, Elpidio

    2011-01-01

    We describe the clinical, gross and microscopic features of undifferentiated uterine stromal sarcoma associated with osteoclast-like giant cells. A case of low-grade endometrial stromal sarcoma is already described in association with osteoclast-like giant cells; however, the current case differs in that the tumor was a high grade and did not show any evidence of smooth muscle or epithelioid differentiation and was shown to be strongly positive for CD10 and focally for WT-1 and Inhibin supporting an endometrial stromal origin. The associated osteoclast-like giant cells were abundant, evenly distributed within the tumor and showed strong positivity for CD68. Interestingly, rare (less than 2%) giant cells also showed weak cytoplasmic positivity for b-hCG. The tumor infiltrated deep into the myometrium and had marked lymphovascular invasion. Although the regional lymph nodes and peritoneal washings were negative, the lesion showed a highly aggressive clinical course. Despite treatment, the tumor disseminated within the abdominal cavity and lungs and ultimately led to the patient's demise within 9 months of the diagnosis. PMID:21559205

  19. Sildenafil Effect on Nitric Oxide Secretion by Normal Human Endometrial Epithelial Cells Cultured In vitro

    Directory of Open Access Journals (Sweden)

    Farzaneh Chobsaz

    2011-01-01

    Full Text Available Background: Sildenafil is a selective inhibitor of cyclic-guanosine monphosphat-specificphosphodiesterase type 5. It increases intracellular nitric oxide (NO production in some cells.There are reports on its positive effect on uterine circulation, endometrial thickness, and infertilityimprovement. Endometrial epithelial cells (EEC play an important role in embryo attachment andimplantation. The present work investigates the effect of sildenafil on human EEC and their NOsecretion in vitro.Materials and Methods: In this experimental in vitro study, endometrial biopsies (n=10 werewashed in a phosphate buffered solution (PBS and digested with collagenase I (2 mg/ml in DMEM/F12 medium at 37°C for 90 minutes. Epithelial glands were collected by sequential filtrationthrough nylon meshes (70 and 40 ?m pores, respectively. Epithelial glands were then treated withtrypsin to obtain individual cells. The cells were counted and divided into four groups: control and1, 10, and 20 ?M sildenafil concentrations. Cells were cultured for 15 days at 37ºC and 5% CO2; themedia were changed every 3 days, and their supernatants were collected for the NO assay. NO wasmeasured by standard Greiss methods. Data were analyzed by one way ANOVA.Results: There was no significant difference between groups in cell count and NO secretion, but thelevel of NO increased slightly in the experimental groups. The 10 ?M dose showed the highest cellcount. EEC morphology changed into long spindle cells in the case groups.Conclusion: Sildenafil (1, 10, and 20 ?M showed a mild proliferative effect on human EECnumbers, but no significant change was seen in NO production.

  20. [Uterine rupture: report of 41 cases].

    Science.gov (United States)

    Chennoufi, Mohamed Badis; Ben Temime, Riadh; Chelli, Dalenda; Ben Romdhane, Boutheina; Khemiri, Bechir; Maghrebi, Hayen; Sfar, Ezzeddine; Chelli, Hela

    2002-01-01

    To establish the epidemiological profile, of patients who presented a uterine rupture, as well as the obstetrical follow up, the neonatal outcome and the prognosis factors. A retrospective study of 41 cases of uterine rupture treated in the maternity center of Tunis during a 5-year period. The frequency of uterine rupture was 1.38%@1000 of births. Rupture in scarred uterus was found in 58.5% of the cases against 41.5% in sain uterus. Three risk factors were statistically significant in our series: cesarian section, multiparity and high fetal weight. Uterine rupture is a medico-surgical emergency causing materno-fetal morbidity and mortality. PMID:12071046

  1. Large cell neuroendocrine carcinoma originating from the uterine endometrium: a report on magnetic resonance features of 2 cases with very rare and aggressive tumor

    Directory of Open Access Journals (Sweden)

    Natsuko Makihara

    2012-06-01

    Full Text Available Neuroendocrine carcinomas (NEC of the female genital tract are aggressive and uncommon tumors, which usually involve the uterine cervix and ovary, and are seen very rarely in the endometrium. Only less than 10 cases of large cell NEC (LCNEC of the endometrium have been reported in the literature and their radiological findings are not well described. We report here two cases of pathologically proven LCNEC of the uterine endometrium. In both cases, the uterine body was enlarged and the tumor occupied part of the uterine cavity. Endometrial mass exhibited heterogeneous high intensity on T2-weighted magnetic resonance (MR images, and diffusion-weighted MR images revealed high intensity throughout the tumor, consistent with malignancy. LCNEC is a highly malignant neoplasm without particular findings in terms of diagnostic imaging and pathology, so its preoperative definitive diagnosis is very difficult. However, when laboratory test, pathologic diagnosis and MR imaging suggest a poorly differentiated uterine malignancy, positron emission tomography-computed tomography scan should be performed as a general assessment to help with diagnosis.

  2. Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy

    Directory of Open Access Journals (Sweden)

    Sharma J

    2009-06-01

    Full Text Available Background : Office hysteroscopy with endometrial biopsy is usually the first investigation for abnormal uterine bleeding and other uterine diseases. Aims: To evaluate the effect of oral drotaverine with mefenamic acid on pain perception during hysteroscopy and endometrial biopsy and to compare it with that of paracervical block using 1% lignocaine and with that of intravenous sedation using diazepam with pentazocine. Settings and Design : Outpatient gynecological department and open randomized trial. Materials and Methods : One hundred twenty women undergoing hysteroscopy and endometrial biopsy were randomized into 3 groups. Group I received tablet containing drotaverine hydrochloride (80 mg + mefenamic acid (250 mg, group II received lignocaine paracervically and group III received intravenous diazepam. The intensity of pain during the procedure, 30 and 60 minutes later on visual analog scale (VAS was assessed. Statistical Analysis : Statistical analysis was performed using Kruskal-Wallis test, with the Bonferroni correction, the t test, and the ?2 test. Results: Groups were similar in age, parity, vaginal birth or relevant medical history. A statistically significant difference in pain scores was noted among the 3 groups during the procedure (group I, 4.13± 1.28; group II, 5.93± 1.26; group III, 5.58± 1.51, (P< 0.001; as well as 30 minutes later (group I, 1.78± 0.89; group II, 2.53± 0.81; group III, 2.23± 0.94, (P< 0.001 and 60 minutes later (group I, 1.2± 0.46; group II, 1.98± 0.83; group III, 1.68± 0.75, (P< 0.001. VAS at different time intervals among the groups was also statistically significant. No adverse effects were observed. Conclusions : Oral drotaverine with mefenamic acid is effective in women undergoing hysteroscopy and endometrial biopsy.

  3. The Danish endometrial cancer study (DEMCA)

    International Nuclear Information System (INIS)

    In an attempt to create uniform nation-wide guidelines for the management of all stages of endometrial cancer, and to limit the use of adjuvant irradiation in stage I disease to high-risk patients only, a protocol was developed by the Danish Endometrial Cancer (DEMCA) group. As histologic grading and degree of myometrial invasion are useful indicators of high risk, it was decided not to deliver preoperative irradiation. In order to evaluate the effect of sequential endocrine treatment with anti-estrogen and progestin in stage IV endometrial cancer and recurrences a phase II protocol was developed. From September 1986, the great majority of women in Denmark with newly diagnosed cancer of the endometrium have been treated according to these protocols. The DEMCA protocols are described, and preliminary data from the first year of the study are presented. Mean follow-up time is still short and does not permit analysis in respect to treatment results. (orig.)

  4. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... could be theoretic concerns of exfoliation of cancer cells with uterine manipulation at the time of the ... can expose the psoas muscle here. The one structure that we really want to watch for and ...

  5. Treatment Options by Stage (Endometrial Cancer)

    Science.gov (United States)

    ... summary on Uterine Sarcoma Treatment for more information. Obesity, high blood pressure, and diabetes mellitus may increase ... the way cancer will be treated in the future. Even when clinical trials do not lead to ...

  6. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... uterine manipulation at the time of the zumi [sp?] placement. And Dr. Boggess, it would be great ... very little thermal spread, which is a very safe -- very safe for the patient as well. 01: ...

  7. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... could be theoretic concerns of exfoliation of cancer cells with uterine manipulation at the time of the ... going to work our way down the side wall here. She just has some retroperitoneal fibrosis. You ...

  8. The Receptive Endometrial Transcriptomic Signature Indicates an Earlier Shift from Proliferation to Metabolism at Early Diestrus in the Cow.

    Science.gov (United States)

    Mesquita, F S; Ramos, R S; Pugliesi, G; Andrade, S C S; Van Hoeck, V; Langbeen, A; Oliveira, M L; Gonella-Diaza, A M; Gasparin, G; Fukumasu, H; Pulz, L H; Membrive, C M; Coutinho, L L; Binelli, M

    2015-08-01

    This study aimed to characterize the endometrial transcriptome and functional pathways overrepresented in the endometrium of cows treated to ovulate larger (?13 mm) versus smaller (?12 mm) follicles. Nelore cows were presynchronized prior to receiving cloprostenol (large follicle [LF] group) or not (small follicle [SF] group), along with a progesterone (P4) device on Day (D) -10. Devices were withdrawn and cloprostenol administered 42-60 h (LF) or 30-36 h (SF) before GnRH agonist treatment (D0). Tissues were collected on D4 (experiment [Exp.] 1; n = 24) or D7 (Exp. 2; n = 60). Endometrial transcriptome was obtained by RNA-Seq, whereas proliferation and apoptosis were assessed by immunohistochemistry. Overall, LF cows developed larger follicles and corpora lutea, and produced greater amounts of estradiol (D-1, Exp. 1, SF: 0.7 ± 0.2; LF: 2.4 ± 0.2 pg/ml; D-1, Exp. 2, SF: 0.5 ± 0.1; LF: 2.3 ± 0.6 pg/ml) and P4 (D4, Exp. 1, SF: 0.8 ± 0.1; LF: 1.4 ± 0.2 ng/ml; D7, Exp. 2, SF: 2.5 ± 0.4; LF: 3.7 ± 0.4 ng/ml). Functional enrichment indicated that biosynthetic and metabolic processes were enriched in LF endometrium, whereas SF endometrium transcriptome was biased toward cell proliferation. Data also suggested reorganization of the extracellular matrix toward a proliferation-permissive phenotype in SF endometrium. LF endometrium showed an earlier onset of proliferative activity, whereas SF endometrium expressed a delayed increase in glandular epithelium proliferation. In conclusion, the periovulatory endocrine milieu regulates bovine endometrial transcriptome and seems to determine the transition from a proliferation-permissive to a biosynthetic and metabolically active endometrial phenotype, which may be associated with the preparation of an optimally receptive uterine environment. PMID:26178716

  9. Endometrioid adenocarcinoma associated with endometrial stromal sarcoma: A rare, often unrecognized collision tumor.

    Science.gov (United States)

    Kim, Grace; Pham, Huyen Q; Ramzan, Amin; Elishaev, Esther; Mhawech-Fauceglia, Paulette

    2015-08-01

    We are reporting 3 cases of the uterine corpus with collision of endometrioid adenocarcinoma (EAC) with endometrial stromal sarcoma (ESS). The patients' ages ranged from 36 to 59 years old. The major clinical presentation was abnormal uterine bleeding. Microscopically, all 3 cases presented with 2 separate components, EAC Grade 1 and ESS (one low grade and two high grades). The EAC component ranged from 10% to 70%, and the ESS component ranged from 30% to 70% of total tumor volume. The EAC component was stage 1A in two cases and stage II in one case. The ESS component was stages IA, IIB, and IIIB. Adjuvant hormonal therapy was administrated to one patient while a second patient was treated with chemo/radiation therapy. Two patients were still alive with no evidence of disease at 4 years post-therapy. One patient was lost for follow-up. Collision tumor should be distinguished from carcinosarcoma due to its different treatment modality, outcome and, prognosis. PMID:26425710

  10. Endometrioid adenocarcinoma associated with endometrial stromal sarcoma: A rare, often unrecognized collision tumor

    Directory of Open Access Journals (Sweden)

    Grace Kim

    2015-08-01

    Full Text Available We are reporting 3 cases of the uterine corpus with collision of endometrioid adenocarcinoma (EAC with endometrial stromal sarcoma (ESS. The patients' ages ranged from 36 to 59 years old. The major clinical presentation was abnormal uterine bleeding. Microscopically, all 3 cases presented with 2 separate components, EAC Grade 1 and ESS (one low grade and two high grades. The EAC component ranged from 10% to 70%, and the ESS component ranged from 30% to 70% of total tumor volume. The EAC component was stage 1A in two cases and stage II in one case. The ESS component was stages IA, IIB, and IIIB. Adjuvant hormonal therapy was administrated to one patient while a second patient was treated with chemo/radiation therapy. Two patients were still alive with no evidence of disease at 4 years post-therapy. One patient was lost for follow-up. Collision tumor should be distinguished from carcinosarcoma due to its different treatment modality, outcome and, prognosis.

  11. Uterine sarcoma incidental in infertile women: experience in a tropical hospital

    International Nuclear Information System (INIS)

    Uterine sarcoma is an uncommon gynaecological malignancy. Diagnosis in its early stage and management is challenging especially in a resource poor setting. The objective of the study is to evaluate the clinico-pathologic presentation of uterine sarcoma in 9 subfertile patients that underwent surgery for seemingly benign uterine diseases. Nine consecutive infertile women with intra-operative diagnosis of uterine sarcoma were reviewed over a period of 5.5 years. The nine patients were pre-operatively misdiagnosed with uterine fibroid in 7 (77.8%) patients and adenomyosis uteri in 2 (22.2%) patients. The patients mean age was 39.2 years with a range of 36 to 47 years. Parity ranged from para 0 to para 3. Of the nine patients, 7 (77.8%) presented with secondary infertility and two (22.2%) patients with primary infertility. Clinical presentations were mainly abdomino - pelvic mass (100%), pelvic pain (77.8%) and abnormal uterine bleeding in (77.8%) of patients. Three (33.3%) of the 9 patients had history of myomectomy. Pre-operative hysterosalpingogram revealed that six (66.7%) patients had bilateral tubal blockage, two (22.2%) patients had unilateral tubal blockage and one (11.1%) patient had bilateral patent fallopian tubes. Six (66.7%) patients had hydrosalpinges. Clinical staging of malignancy was stage Ic in seven patients, stage IIa and IIb in the remaining two patients. Histologic classifications were leiomyosarcoma in six patients and endometrial stromal sarcoma in three patients. Treatments offered were surgery alone in six (66.7%) patients, surgery with adjuvant chemotherapy for 2 (22.2%) patients and one (11.1%) patient had surgery with adjuvant radiotherapy. Case fatality was 77.8% with a year of diagnosis. In a resource constrained setting, due to limitations in making diagnosis in the early stage of the disease, a high index of suspicion is needed in all elderly infertile women presenting with seemingly benign abdomino pelvic mass. (author)

  12. Evaluation of radiotherapy as a method of treating inoperable cases of uterine corpus carcinoma

    International Nuclear Information System (INIS)

    The results of treatment and factors influencing them were studied in the group of 590 patients with uterine corpus carcinoma who had not been qualified for surgical treatment and were treated by radical palliative radiotherapy. The 5-year survival rate in this group was 44.1%, that is 52.4% in the stage 1, 48.2% in the stage 2 and 34.6% in 3 deg. Complications connected with the treatment developed in 28.3% of patients, including 2.2% of lethal complications and 2.0% of fistula. It was found that the following factors had an adverse effect on the results of radiotherapy: anaemia, uterus enlargement, low grade of carcinoma maturation, incomplete treatment. The age of the patient, obesity, features of the so called ''typical endometrial cancer individual'', and coexistence of other diseases had no significant effect on the results of radiotherapy. (author)

  13. Relative morbidity of preoperative and postoperative radiation therapy for uterine cancer

    International Nuclear Information System (INIS)

    This paper compares factors responsible for the difference in morbidity of preoperative and postoperative radiation therapy for endometrial cancer. From 1970 through 1986, 219 women received postoperative and 167 received preoperative pelvic external-beam therapy and vaginal radium or cesium for uterine cancer. Prescribed doses ranged from 38 to 51 Gy of pelvic external beam, 70 to 119 Gy to the vaginal surface postoperatively, and 4,000-5,000 mg-h preoperatively. The postoperative severe enteric morbidity rate of 8.7% was significantly greater than the preoperative incidence of 3.0%. Postoperatively, multiple logistic analysis demonstrated total bowel complications to occur more frequently in patients with pelvic lymph node, sampling at hysterectomy, abdominal surgery prior to hysterectomy, and greater vaginal surface boost dose, while small bowel complications occurred more commonly in patients with pelvic lymph node sampling, previous abdominal surgery, and thin physique, the factors most associated with complications

  14. Multiple brain metastases in a patient with uterine papillary serous adenocarcinoma: Treatment options for this rarely seen metastatic brain tumor

    Science.gov (United States)

    Gulsen, Salih; Terzi, Aysen

    2013-01-01

    Background: Uterine papillary serous adenocarcinoma (UPSAC) occurs 10-fold less frequently than endometrial carcinoma, and is referred to type 2 endometrial adenocarcinoma. The prognosis of UPSAC is worse than that of type I endometrial carcinoma. Herein we report what is only the second case of UPSAC, but it should prove to be more informative than the first reported case. Case Description: A 71-year-old female had three different metastases in the brain; two of the metastases were located in the posterior fossa within the cerebellar parenchyma with perilesional edema, but no mass effect, and the third metastasis was located in the right frontal lobe, and caused hemispheric edema and subfalcine herniation. The lesion that caused mass effect was completely extirpated without any surgical complications. The patient's recovery was excellent. She is able to walk independently, and use her left hand and left arm. Her Karnofsky performance score 5 months postsurgery was 80/100. Conclusion: Based on the outcome in the presented case, we think that in any UPSAC patient with a metastatic brain tumor causing mass effect the symptomatic metastatic tumor must be removed, regardless of disease grade, to ensure optimal quality of life. PMID:24032086

  15. Genomic landscape of endometrial stromal sarcoma of uterus.

    Science.gov (United States)

    Choi, Youn Jin; Jung, Seung-Hyun; Kim, Min Sung; Baek, In-Pyo; Rhee, Jae-Keun; Lee, Sung Hak; Hur, Soo Young; Kim, Tae-Min; Chung, Yeun-Jun; Lee, Sug Hyung

    2015-10-20

    Although recurrent gene fusions such as JAZF1-JJAZ1 are considered driver events for endometrial stromal sarcoma (ESS) development, other genomic alterations remain largely unknown. In this study, we performed whole-exome sequencing, transcriptome sequencing and copy number profiling for five ESSs (three low-grade ESS (LG-ESS) and two undifferentiated uterine sarcomas (UUSs)). All three LG-ESSs exhibited either one of JAZF1-SUZ12, JAZF1-PHF1 and MEAF6-PHF1 fusions, whereas the two UUSs did not. All ESSs except one LG-ESS exhibited copy number alterations (CNAs), many of which encompassed cancer-related genes. In UUSs, five CNAs encompassing cancer-related genes (EZR, CDH1, RB1, TP53 and PRKAR1A) accompanied their expressional changes, suggesting that they might stimulate UUS development. We found 81 non-silent mutations (35 from LG-ESSs and 46 from UUSs) that included 15 putative cancer genes catalogued in cancer-related databases, including PPARG and IRF4 mutations. However, they were non-recurrent and did not include any well-known mutations, indicating that point mutations may not be a major driver for ESS development. Our data show that gene fusions and CNAs are the principal drivers for LG-ESS and USS, respectively, but both may require additional genomic alterations including point mutations. These differences may explain the different biologic behaviors between LG-ESS and UUS. Our findings suggest that ESS development requires point mutations and CNAs as well as the gene fusions. PMID:26429873

  16. Endometrial biopsy with uretral plastic No. 12 sonde

    Scientific Electronic Library Online (English)

    Ismael Dale Cotrim, Guerreiro; Paulo Roberto de Oliveira Lima, Castanho; Fausto Farah, Baracat.

    1995-02-01

    Full Text Available INTRODUÇÃO : Os autores demonstram a técnica de obtenção de fragmentos endometriais em 25 pacientes encaminhadas ao Serviço de Prevenção do Câncer Ginecológico do Instituto do Câncer Arnaldo Vieira de Carvalho por quadro de sangramento uterino anormal no período de setembro de 1991 a janeiro de 1992 [...] . MATERIAL E MÉTODOS: A técnica consistiu na vácuo aspiração do endométrio com auxílio de sonda uretral n° 12 de orifício lateral único. RESULTADOS: A correlação com curetagem foi positiva em 88% dos casos; a biópsia com sonda não mostrou confirmação em apenas três pacientes. Não foram observadas complicações de qualquer espécie (infecção, hemorragia ou perfuração uterina). CONCLUSÃO: Os autores concluem que o método está adequado a uma correta abordagem diagnóstica, trata-se de procedimento de baixo custo, pouco doloroso, de fácil execução e que possibilitou material suficiente para o diagnóstico histopatológico em 88% dos casos estudados Abstract in english The authors demonstrate technique for obtaining endometrial fragments in 25 patients sent to Gynecological Cancer Preventive Service of the Arnaldo Vieira de Carvalho Cancer Institute, during the period of September 1991 through January 1992, presenting abnormal uterine hemorrhage. Technique consist [...] s in vacuum aspiration with the support of a No. 12 uretral sonde , provided with one lateral opening only. Correlation with curettage was positive in 88% of the patients; biopsy with sonde did not result in confirmation in three patients only. No complications at all were observed (infection, hemorrhage or uterus perforation). Authors understand that this method is in conformity with a correct diagnostic performance, being a low cost procedure, almost painless, easy to be done and furnishing sufficient material for the histopathologic diagnosis, in 88% of the cases studied.

  17. Immunohistological demonstration of intermediate trophoblast in the diagnosis of uterine versus ectopic pregnancy : a retrospective survey and results of a prospective trial

    DEFF Research Database (Denmark)

    SØrensen, Flemming Brandt; Marcussen, N

    1991-01-01

    Immunohistological demonstration of human placental lactogen (hPL) in non-villous, mononuclear intermediate trophoblastic cells may be of routine diagnostic value, when chorionic villi are absent in endometrial curettings from patients suspected of miscarriage of an intrauterine pregnancy. The histological presence and distribution of hPL was investigated in endometrial curettings from 90 patients studied retrospectively (47 had ectopic pregnancies, 14 miscarriages, and 29 legal abortions), and a consecutive, prospective series of 50 patients (40 had miscarriages and 10 had ectopic pregnancies) without chorionic villi in their endometrial curettings. Non-specific background staining was not a problem. The retrospective survey disclosed that hPL was a highly sensitive marker of intrauterine pregnancy (sensitivity = 0.98). In the prospective series, the predictive value of positive staining for hPL for intrauterine pregnancy was 1.00, and the sensitivity of hPL, as an indicator of uterine gestation, was 0.62. In absence of specific hPL-staining, the risk of ectopic pregnancy was about 50%. The immunohistochemical demonstration of hPL is a useful tool for identifying patients who are suspected of having had a miscarriage, but for whom evidence in the form of chorionic villi in endometrial curettings is lacking.

  18. High-grade endometrial stromal sarcomas: a clinicopathologic study of a group of tumors with heterogenous morphologic and genetic features.

    Science.gov (United States)

    Sciallis, Andrew P; Bedroske, Patrick P; Schoolmeester, John K; Sukov, William R; Keeney, Gary L; Hodge, Jennelle C; Bell, Debra A

    2014-09-01

    The existence of a "high-grade endometrial stromal sarcoma" category of tumors has been a controversial subject owing to, among other things, the difficulty in establishing consistent diagnostic criteria. Currently, the recommended classification for such tumors is undifferentiated uterine/endometrial sarcoma. Interest in this subject has recently increased markedly with the identification of recurrent molecular genetic abnormalities. At Mayo Clinic, a group of neoplasms has been observed that morphologically resemble, either cytologically or architecturally, classic "low-grade" endometrial stromal sarcoma but feature obvious deviations, specifically, 17 tumors with unequivocally high-grade morphology. These high-grade tumors displayed 3 morphologic themes: (1) tumors with a component that is identical to low-grade ESS that transitions abruptly into an obviously higher-grade component; (2) tumors composed exclusively of high-grade cells with uniform nuclear features but with a permeative pattern of infiltration; (3) tumors similar to the second group but with a different, yet characteristic, cytomorphology featuring enlarged round to ovoid cells (larger than those found in low-grade ESS) with smooth nuclear membranes and distinct chromatin clearing but lacking prominent nucleoli. We collected clinicopathologic data, applied immunohistochemical studies, and also tested tumors by fluorescence in situ hybridization for abnormalities in JAZF1, PHF1, YWHAE, and CCND1. Tumors from these 3 groups were found to be immunohistochemically and genetically distinct from one another. Most notable was the fact that category 3 contained all the cases that tested positive for YWHAE rearrangement, did not show any classic translocations for JAZF1, PHF1, or CCND1, often presented at a high stage, and behaved aggressively. This study demonstrates the morphologic, immunophenotypic, and molecular genetic heterogeneity that exists within "undifferentiated endometrial sarcomas" as currently defined and lends credence to the effort of subclassifying some tumors as truly "high-grade endometrial stromal sarcomas." Our study also shows that, in the context of undifferentiated endometrial sarcomas, recognition of cytomorphologic features on routine hematoxylin and eosin-stained sections may be used to select tumors with specific molecular genetic changes-that is, translocations involving YWHAE. Our conclusions will help further efforts towards proper sub-classification of these tumors which will aid in diagnosis and potentially affect clinical management. PMID:25133706

  19. Expression of leptin receptor in endometrial biopsies of endometrial and ovarian cancer patients

    OpenAIRE

    MÉNDEZ-LÓPEZ, LUIS FERNANDO; DÁVILA-RODRÍGUEZ, MARTHA IMELDA; ZAVALA-POMPA, ANGEL; Torres-López, Ernesto; GONZÁLEZ-MARTÍNEZ, BLANCA EDELIA; LÓPEZ-CABANILLAS-LOMELÍ, MANUEL

    2013-01-01

    The adipokine leptin plays a critical role in the regulation of reproductive function and there has been growing interest in its potential role in the development of cancers in which obesity is an established risk factor. Serum leptin levels were found to be higher in patients diagnosed with endometrial and ovarian cancer compared to those observed in healthy individuals. This study was conducted to determine the expression of the leptin receptor (Ob-R) in endometrial biopsies of patients dia...

  20. Breast cancer susceptibility polymorphisms and endometrial cancer risk: a Collaborative Endometrial Cancer Study.

    OpenAIRE

    2011-01-01

    Recent large--scale association studies, both of genome-wide and candidate gene design, have revealed several single-nucleotide polymorphisms (SNPs) which are significantly associated with risk of developing breast cancer. As both breast and endometrial cancers are considered to be hormonally driven and share multiple risk factors, we investigated whether breast cancer risk alleles are also associated with endometrial cancer risk. We genotyped nine breast cancer risk SNPs in up to 4188 endome...

  1. Uterine prolapse in 2 dromedary camels.

    OpenAIRE

    Gutierrez, C; Corbera, J. A.; Morales, I; M Morales; Navarro, R

    2001-01-01

    Two cases of uterine prolapse in dromedary camels in a herd with concomitant cases of white muscle disease are described. Serum selenium and glutathione peroxidase in whole blood were investigated in both patients and showed statistical difference compared with a control group. Results suggest that selenium deficiency could promote uterine prolapse in dromedary camels.

  2. Uterine prolapse in 2 dromedary camels.

    Science.gov (United States)

    Gutierrez, C; Corbera, J A; Morales, I; Morales, M; Navarro, R

    2001-10-01

    Two cases of uterine prolapse in dromedary camels in a herd with concomitant cases of white muscle disease are described. Serum selenium and glutathione peroxidase in whole blood were investigated in both patients and showed statistical difference compared with a control group. Results suggest that selenium deficiency could promote uterine prolapse in dromedary camels. PMID:11665430

  3. Postoperative cerebral oedema after transcervical endometrial resection and uterine irrigation with 1.5% glycine

    DEFF Research Database (Denmark)

    Istre, O; Bjoennes, J

    1994-01-01

    Absorption of irrigating solution during transcervical resection of endometrium can cause dilutional hyponatraemia, nausea, and cerebral oedema. We studied 6 patients who absorbed more than 1500 mL of 1.5% glycine, and 14 patients who absorbed less. Cerebral oedema was diagnosed by blinded, paired comparison of computed tomography (CT) scans 3-6 hours and 3-6 days after operation. The absorbed volume of irrigating glycine solution was correlated with peroperative decrease in serum sodium. 10 patients who absorbed 500 mL of glycine or more had postoperative nausea, with cerebral oedema suspected in 9. None of the 10 patients who absorbed less than 500 mL had nausea; changes on CT scan suggestive of cerebral odema were found in 1. 8 patients who absorbed 1000 mL or more had a decrease in serum sodium of 10 mmol/L or more, nausea, and cerebral oedema on CT scan. Cerebral oedema may contribute to the development of postoperative nausea in patients undergoing transcervical surgery who absorb more than 500 mL of 1.5% glycine irrigating solution.

  4. Effects of adipocyte-secreted factors on decidualized endometrial cells: modulation of endometrial receptivity in vitro.

    Science.gov (United States)

    Gamundi-Segura, Silvia; Serna, Jose; Oehninger, Sergio; Horcajadas, Jose A; Arbones-Mainar, Jose M

    2015-09-01

    Obesity is defined as an excessive accumulation of adipose tissue that may lead to health complications. Mounting evidence indicates that obesity has a negative impact on fertility. Yet, the link between adipose tissue biology and infertility remains unclear. We aimed to investigate the communication between the adipose tissue and the reproductive system and the importance of this cross talk for the development of a receptive endometrium. To that end, we generated an in vitro model with endometrial and adipocyte cell lines. Sexual hormones, progesterone and estradiol, were used to decidualize endometrial cells and sensitize adipocytes. Decidualization produced a simultaneous increase of adipokine receptors in endometrial cells paralleling changes in their receptivity status. Furthermore, sensitization of 3T3-L1 adipocytes increased mRNA levels of leptin and resistin and decreased the expression of adiponectin and chemerin levels. This was accompanied by increased isoproterenol-induced lipolysis and reduced insulin-stimulated glucose uptake. Lastly, conditioned culture medium of those sensitized adipocytes was used to feed endometrial cells. This treatment resulted in (i) upregulation of genes previously identified as positive regulators of endometrial receptivity, such as leukemia inhibitory factor and glutathione peroxidase 3, and (ii) downregulation of interleukin-15 and mucin1, both genes negatively related with endometrial receptivity. Our results indicate that the endocrine communication between adipose tissue and the reproductive system is bidirectional and stress the importance of the adipose tissue to modulate the reproductive fitness. PMID:25686566

  5. Leiomyosarcoma: a rare complication of uterine fibroid

    Directory of Open Access Journals (Sweden)

    Shazia Parveen

    2014-04-01

    Full Text Available Uterine sarcomas are rare tumours of mesodermal origin. Malignant change occurring in uterine fibroid is termed as leiomyosarcoma. They constitute around 2-6 % uterine malignancies and 25-36% of uterine sarcomas1. The tumour is common in women between the age group 40-50 years. It has an aggressive course and usually metastasis goes to the lungs. The prognosis for women with uterine sarcoma primarily depends on the extent of disease at the time of diagnosis and mitotic index3. Women with tumor size >5 cm in maximum diameter have poor prognosis. These tumours should be diagnosed and managed with no delay and must be followed vigilantly as the rate of recurrence and metastasis is very high. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 486-487

  6. Aerobes and Levels of Estradiol and Progesterone in Cystic Endometrial Hyperplasia-Pyometra Complex Bitches

    Directory of Open Access Journals (Sweden)

    Xiuli Peng

    2011-01-01

    Full Text Available To determine which aerobic bacteria exert a marked effect on Cystic Endometrial Hyperplasia-Pyometra complex (CEH-P and to determine from where these bacteria originate. About 48 privately owned bitches were diagnosed with CEH-P. Healthy vagina and uterine samples were obtained with cotton pledgets and cumulative uterine fluids from CEH-P cysts were collected with a syringe in utero to isolate and identify aerobic bacterial. A total of 99 isolates were identified and the primary aerobe in the CEH-P bitches was found to be Escherichia coli (33/99. The levels of estrode in bitches with endometritis and in bitches with pyometra and estrus were higher than the levels in diestrus bitches (p<0.01. When ranked according to the levels of progesterone in a descending order (i.e., from high to low levels, the ranking was bitches with pyometra, bitches with endometritis, bitches in estrus and bitches in diestrus. These results suggest that in addition to common pathogenic bacteria differential in every area, casual bacterial contamination invariably occurred in bitches with CEH-P and the primary infection ascended from the vagina when the cervix was open. The researchers also inferred that both estrode and progesterone levels in CEH-P bitches were increased relative to the levels in healthy bitches and were even higher than that of the levels observed in estrus bitches. Estrode and progesterone pretreatment and uterine mucosa damage were interpreted as the preconditions for bacterial infection. The hormone levels in CEH-P bitches were similar to the endocrinal characteristics of peripartum bitches.

  7. Long-term results of symptomatic fibroids treated with uterine artery embolization: In conjunction with MR evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of)], E-mail: mdkim@cha.ac.kr; Lee, Hyun Seok [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Lee, Mee Hwa [Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Kim, Hee Jin [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Cho, Jin Ho; Cha, Sun Hee [Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of)

    2010-02-15

    Objective: The aim of the present study is to determine long-term clinical efficacy of uterine fibroid embolization (UFE) for symptomatic fibroids in conjunction with MR evaluation. Materials and methods: Sixteen patients with a follow-up period of 4 years or longer were analyzed retrospectively. Ages ranged from 27 to 45 (mean 39.5) years. Mean follow-up periods were 5.8 years (range: 4.1-6.9 years). The symptom changes, in terms of menorrhagia and dysmenorrhea and bulk-related symptoms, were assessed. The primary embolic agent was polyvinyl alcohol particle (250-710 {mu}m). All patients underwent preprocedural and long-term follow up MR imaging. Uterine volumes were calculated using MRI. Results: Symptom improvements were reported for menorrhagia (8/9, 88.9%), dysmenorrhea (5/5, 100%), and bulk-related symptoms (7/9, 77.8%) at long-term follow up. Two patients (12.5%) had symptom recurrences at long-term follow-up. Tumor regrowth from incomplete infarction was a cause of recurrence in one patient and newly developed leiomyomas in the other one. One patient underwent hysterectomy because endometriosis developed 4 years after UFE. Of the 14 necrotic myomas on short-term follow up MR after UFE, eight (57.1%) demonstrated maintaining necrosis with further shrinkage and six (42.9%) were no longer visualized on long-term follow up MR images. Overall, the mean volume reduction rates of the predominant fibroid and uterus were 80.5%, 36.7% at long-term follow up, respectively. Conclusion: UFE is an effective treatment for symptomatic fibroids with an acceptable long-term success rate. Long-term MR imaging after UFE revealed persistent necrotic fibroid, non-visualization of fibroids and tumor regrowth when incompletely infarcted.

  8. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... We are going to treat a woman in her 50s today who has a grade-2 endometrial carcinoma, so we are – it is important ... surgery. She’s had a laparotomy as well as two laparoscopic procedures ... If you’ll pull up towards her head more, Aaron. For some reason the fundus ...

  9. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... of the system and how it’s applied to treatment of ovarian cancer. Dr. Gehrig will review in a short while – ... that complete lymph adenectomy may actually provide a therapeutic benefit in patients with endometrial cancer, so theoretically, the more nodes we’re able ...

  10. Prevalence of Human Papillomavirus in endometrial cancer

    DEFF Research Database (Denmark)

    Olesen, Tina Bech; Svahn, Malene Frøsig; Faber, Mette Tuxen; Duun-Henriksen, Anne Katrine; Junge, Jette; Norrild, Bodil; Kjaer, Susanne K

    2014-01-01

    HPV is a common sexually transmitted infection and is considered to be a necessary cause of cervical cancer. The anatomical proximity to the cervix has led researchers to investigate whether Human Papillomavirus (HPV) has a role in the etiology of endometrial cancer.

  11. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... abdomen, combined with improved access to reach the deep pelvis. These advantages can be particularly helpful in staging endometrial cancer since the surgeon can readily access the periaortic lymph nodes for staging and the deep pelvis to perform the hysterectomy, as well as ...

  12. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... much experience as we do with endometrial and cervical cancer. 00:51:15 PAOLA A. GEHRIG, MD: So ... MD: Yeah, we weren’t traditionally treating any cervical cancers, for instance, in a minimally invasive approach because ...

  13. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... will review some data for you from our clinical experience using daVinci for endometrial staging -- That’s perfect, ... able to learn early on. Our first-year clinical fellows at this point have so far been ...

  14. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... review some data for you from our clinical experience using daVinci for endometrial staging -- That’s perfect, Aaron, ... a level of precision that you don’t experience with laparoscopy. When we’re doing the surgery ...

  15. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... the expandibility. There has been introduced a new vision system for the S that is in high-definition. And ... a little over 70 endometrial stagings with the robotic system and we’ve never had to open a ...

  16. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... put it in perspective, endometrial cancer will affect about 40,000 women in the United States every ... we’re using – the tips of them are about 4mm in length, so what you’re looking ...

  17. A Successful Live Twin Birth by In Vitro Fertilization after Conservative Treatment of Recurrent Endometrial Cancer

    OpenAIRE

    Yung-Kuei Soong; Hsin-Shih Wang; Hong-Yuan Huang; Chyong-Huey Lai; Hsien-Ming Wu

    2008-01-01

    Endometrial cancer is predominately a postmenopausal disease. Endometrial cancer inwomen of childbearing age is relatively unusual. Endometrial cancer is typically treated withhysterectomy. After the development of endometrial cancer, successful pregnancy is rare.We present a case of recurrent stage I endometrial adenocarcinoma in a 35-year-old woman.Magnetic resonance imaging (MRI) revealed endometrial lesions without myometrium invasionand no pelvic lymph node enlargement. The patient refus...

  18. Frequent expression of KIT in endometrial stromal sarcoma with YWHAE genetic rearrangement.

    Science.gov (United States)

    Lee, Cheng-Han; Hoang, Lien N; Yip, Stephen; Reyes, Carolina; Marino-Enriquez, Adrian; Eilers, Grant; Tao, Derrick; Chiang, Sarah; Fletcher, Jonathan A; Soslow, Robert A; Nucci, Marisa R; Oliva, Esther

    2014-05-01

    Endometrial stromal sarcomas with the YWHAE-NUTM2A/B genetic fusion characteristically contain high-grade round to epithelioid cell component that is strongly and diffusely cyclin D1-positive and it may or may not show an associated low-grade fibroblastic/myxoid cell component. They are clinically more aggressive than endometrial stromal sarcomas with the JAZF1-SUZ12 genetic fusion and frequently demonstrate extrauterine extension at initial clinical presentation. In this setting, the tumor may be misdiagnosed as gastrointestinal stromal tumor. This study examines the expression of KIT and ANO1 in 14 YWHAE-NUTM2A/B tumors by immunohistochemistry. Staining localization was determined as membranous and/or cytoplasmic, and the staining intensity was assessed (negative, weak, moderate and strong). Of the 14 tumors, 6 contained only a high-grade round cell component, 2 only a low-grade fibroblastic component and 6 had both components in the slides evaluated. The high-grade round cell component displayed moderate to strong membranous/cytoplasmic KIT staining in all tumors (12 of 12). The low-grade fibroblastic cell component showed only weak cytoplasmic KIT staining in 3 of 8 tumors. In contrast, ANO1 was negative in all 14 neoplasms, irrespective of the component evaluated. Sanger sequencing analysis (exons 9, 11, 13 and 17) and Ampliseq Cancer Panel mutation screen (Ion Torrent) demonstrated no KIT mutations in three KIT-positive YWHAE-NUTM2A/B tumors. This study shows that the high-grade round cell component of YWHAE-NUTM2A/B endometrial stromal sarcoma consistently expresses KIT but lacks KIT hotspot mutations. KIT expression may represent a potential diagnostic pitfall in the evaluation of YWHAE-NUTM2A/B endometrial stromal sarcoma presenting with pelvic/abdominal mass, particularly in situations where its uterine origin is not definitive, and thus a panel of antibodies that includes ANO1 and cyclin D1 is necessary. PMID:24186140

  19. Oral contraception and risk of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Mueck AO

    2011-10-01

    Full Text Available Alfred O Mueck1, Harald Seeger1, Xiangyan Ruan2 1Department of Endocrinology and Menopause, University Women's Hospital of Tuebingen, Tuebingen, Germany; 2Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China Abstract: No placebo-controlled studies concerning hormonal contraception in general have been published, and only investigations on biological mechanisms and observational clinical studies are available. Thus, associations can be described but not their causality. Experimental studies strongly suggest protective effects of the progestagen component of hormonal contraception against development of estrogen-related (type 1 endometrial cancer. In light of this research, it seems biologically plausible that, in more than 20 published studies, a reduction in endometrial cancer risk was achieved in up to 50% of users of combined oral contraceptives (COC, compared with nonusers. Few data exist for progestin-only oral preparations. However, in view of the mechanisms involved, a reduction in cancer risk should also be expected. Whereas hormonal dose-dependency has been investigated in only a few studies, which showed a stronger risk reduction with increasing progestagenic potency, a decreased risk dependent on duration of use has been clearly demonstrated, and after stopping COC this effect has persisted for up to 20 years. Possible confounders, including family history, parity, and smoking, have been investigated in a few studies, with only a minor impact on hormonal effect of endometrial cancer risk, with the exception of obesity, which was a strong risk factor in most but not all studies. There are obvious differences in the incidence of endometrial cancer in women using COC when evaluated in absolute numbers for Western and Asian countries, being about 3–5-fold higher in the US than in Asia. Further research should include the noncontraceptive benefit of COC, especially in patients with a high risk of cancer, as in polycystic ovary disease, and should also include new contraceptive drugs using natural estradiol instead of ethinyl estradiol. Of importance is the question of the potency of hormonal intrauterine devices to protect against endometrial cancer. It can be concluded on the basis of biological plausibility and observational data that COC can strongly decrease the risk of estrogen-related endometrial cancer, with an effect persisting after withdrawal of the hormones, and a causal relationship for this protection against cancer seems reasonable. Keywords: hormonal contraceptives, endometrial cancer

  20. Effects of oral treatment with N-acetylcysteine on the viscosity of intrauterine mucus and endometrial function in estrous mares.

    Science.gov (United States)

    Witte, T S; Melkus, E; Walter, I; Senge, B; Schwab, S; Aurich, C; Heuwieser, W

    2012-10-01

    Persistent breeding-induced endometritis is ranked as the third most common medical problem in the adult mare and leads to enormous economic loss in horse breeding. In mares suffering from persistent breeding-induced endometritis, increased amounts of intrauterine (i.u.) fluid or viscous mucus in estrus or after breeding may act as a barrier for sperm and can contribute to low fertility. Current therapies of these mares aim to eliminate i.u. fluid and mucus by uterine lavage and/or administration of ecbolic drugs. Recently, i.u. administration of N-acetylcysteine (NAC) has been shown to support therapy in mares with endometritis. It was the objective of the present study to investigate effects of an oral administration of NAC on the viscosity of i.u. fluid in estrous mares. It was hypothesized that oral treatment with NAC reduces the viscosity of i.u. fluid and has a positive effect on the inflammatory response of the endometrium. Mares (n = 12) were included in the study as soon as estrus was detected (ovarian follicle >3.0 cm and endometrial edema), which was defined as Day 1. They were randomly assigned to a treatment (10 mg/kg NAC on Days 1-4) or a control group (no treatment). On days 1 and 5 i.u. mucus was collected and its rheologic properties were accessed. On Day 5, endometrial biopsies were obtained and 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). In the treatment group, viscosity of i.u. mucus increased significantly between Days 1 and 5 (P NAC treatment the mean number of PMN in endometrial biopsies was significantly lower compared to mares of the control group (1.9 ± 0.3 vs. 4.8 ± 0.4; P NAC treatment compared to control mares (P mucus in deep uterine glands differed significantly between groups (both P NAC treatment does not reduce viscosity of uterine mucus but has an antiinflammatory effect on the equine endometrium. PMID:22819282

  1. Association Between Genetic Variants of Akt1 and Endometrial Cancer.

    Science.gov (United States)

    Fallah, Soudabeh; Korani, Mohsen; Hajimirza, Milad; Seifi, Morteza

    2015-12-01

    Akt isoforms have critical roles in the cause and regulation of cancer cells invasive, migration, and metastatic dissemination. In the present study, the association between Akt1 polymorphisms and endometrial cancer was investigated in patients with endometrial cancer and controls. Thirty premenopaused patients diagnosed with endometrial cancer and 30 premenopaused women with no clinically documented abnormalities of the endometrium undergoing hysterectomy were included in this study. Genotypes were determined by polymerase chain reaction and restriction fragment length polymorphism. There was no significant difference between Akt1 gene polymorphisms of patients (SNP1, SNP2 and SNP3) with endometrial cancer and controls (p > 0.05). Difference between alleles frequency of SNP1, SNP2, SNP3 of patients with endometrial cancer and controls was not significant (p > 0.05). SNPs (rs72715985), (rs2494750), and (rs74090038) of Akt1 gene are not associated with endometrial cancer in Iranian subjects. PMID:26296520

  2. Ancient Transposable Elements Transformed the Uterine Regulatory Landscape and Transcriptome during the Evolution of Mammalian Pregnancy

    Directory of Open Access Journals (Sweden)

    Vincent J. Lynch

    2015-02-01

    Full Text Available A major challenge in biology is determining how evolutionarily novel characters originate; however, mechanistic explanations for the origin of new characters are almost completely unknown. The evolution of pregnancy is an excellent system in which to study the origin of novelties because mammals preserve stages in the transition from egg laying to live birth. To determine the molecular bases of this transition, we characterized the pregnant/gravid uterine transcriptome from tetrapods to trace the evolutionary history of uterine gene expression. We show that thousands of genes evolved endometrial expression during the origins of mammalian pregnancy, including genes that mediate maternal-fetal communication and immunotolerance. Furthermore, thousands of cis-regulatory elements that mediate decidualization and cell-type identity in decidualized stromal cells are derived from ancient mammalian transposable elements (TEs. Our results indicate that one of the defining mammalian novelties evolved from DNA sequences derived from ancient mammalian TEs co-opted into hormone-responsive regulatory elements distributed throughout the genome.

  3. Effects of 13- cis-retinoic acid on the tamoxifen induced uterine histological changes in the rabbit

    International Nuclear Information System (INIS)

    Objective: To study the effects of 13-cis-retinoic acid on the tamoxifen induced uterine histological changes in the rabbit. Study Design: Experimental - randomized controlled trial. Place and Duration of study: The study was conducted for 4 months at the department of Anatomy, Army Medical College and National Institute of Health in 2007. Material and Methods: The animals were randomly divided into three groups, a control group A, and two experimental groups B and C, consisting of thirty rabbits each. The experimental groups were treated with tamoxifen only and tamoxifen plus retinoic acid, respectively. The animals were sacrificed after three months. The uteri were then processed for paraffin embedding. Sections were then assessed for the luminal epithelial height, endometrial area and percentage of mitotic figures. Results: The results obtained were suggestive of uterine proliferation by tamoxifen. The adjuvant administration of 13-cis-retinoic acid produced a statistically significant (p = 0.002) inhibitory effect on the tamoxifen induced increase in the area of endometrium, whereas no significant suppressive effect of this drug has been observed on the other parameters when compared with Group B. Conclusion: 13-cis Retinoic acid has not shown a significant role in the reversal of tamoxifen induced changes in the uterine tissue after a short term administration of three months. (author)

  4. Intravascular interventional therapy for uterine cervical adenocarcinoma

    International Nuclear Information System (INIS)

    Adenocarcinoma of the uterine cervix shows an upward trend in younger patients with poorer prognosis in comparing with squamous carcinoma. The traditional radiotherapy and intravenous route chemo- therapy are all difficult in treating uterine cervical adenocarcinoma due to different biomolecular characterization with that of the squamous cell carcinoma. Because of long term growth for primary lesion and infiltration with limitation inside the pelvis, provides a reliable clinico-pathologic basis for intra-vascular interventional treatment. This article presents a comprehensive statement of clinico-pathologic, biomolecular investigation and intravascular intervention for uterine cervical carcinoma. (authors)

  5. Diffuse uterine leiomyomatosis in a child

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Deepa; Coletti, Monette C.; Ladino-Torres, Maria; Caoili, Elaine [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Elkins, Matthew [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States)

    2012-01-15

    Leiomyomas are the most common benign uterine tumor; however, this entity is relatively uncommon in the pediatric population. Although leiomyomas most commonly present as solitary uterine masses, unusual patterns of growth have been described including diffuse leiomyomatosis. In this condition, the myometrium of the uterus is symmetrically expanded by innumerable confluent leiomyomas; this pattern of growth is quite uncommon and has never been reported in a pediatric patient. This case report illustrates the imaging appearance of diffuse uterine leiomyomatosis in an otherwise healthy 16-year-old girl. (orig.)

  6. The association between polycystic ovary syndrome and endometrial cancer.

    OpenAIRE

    Chedumbarum Pillay, O. D.

    2010-01-01

    HYPOTHESIS: Women suffering from polycystic ovary syndrome have an increased risk of developing endometrial carcinoma. AIM: To determine whether people with polycystic ovary syndrome have an increased risk of developing endometrial carcinoma. BACKGROUND: Endometrial cancer is one of the commonest cancers to occur in women in the Western World and unopposed oestrogen stimulation of the uterus is amongst one of the aetiologies postulated for this condition. It is generally assumed that ...

  7. Molecular mechanisms of tamoxifen-associated endometrial cancer (Review)

    OpenAIRE

    Hu, Rong; Hilakivi-Clarke, Leena; CLARKE, ROBERT

    2015-01-01

    Tamoxifen has been prescribed to millions of females for breast cancer prevention or treatment. However, tamoxifen is known to significantly enhance the risk of developing endometrial lesions, including hyperplasia, polyps, carcinomas, and sarcoma. Notably, tamoxifen-associated endometrial cancer often has a poor clinical outcome. Understanding the molecular mechanism of tamoxifen-induced endometrial cancer is essential for developing strategies that minimize tamoxifen’s effects on the endome...

  8. A Prospective Investigation of Coffee Drinking and Endometrial Cancer Incidence

    OpenAIRE

    Gunter, Marc J.; Schaub, Jennifer A.; XUE, Xiaonan; Freedman, Neal D.; Gaudet, Mia M; Rohan, Thomas E.; Hollenbeck, Albert R.; Sinha, Rashmi

    2011-01-01

    Coffee drinking may be associated with reduced risk of endometrial cancer; however, prospective data are limited. Further, it is not clear whether any association between coffee and endometrial cancer differs according to coffee caffeine content. The association of coffee drinking with incidence of endometrial cancer was evaluated among 226,732 women, aged 50–71, enrolled in the NIH-AARP Diet and Health Study who completed a baseline epidemiologic questionnaire. Following a mean 9.3 years of ...

  9. Obesity and endometrial cancer survival: a systematic review

    OpenAIRE

    Arem, H; Irwin, ML

    2012-01-01

    Although it is known that obesity increases the risk of endometrial cancer and is linked to higher mortality rates in the general population, the association between obesity and mortality among endometrial cancer survivors is unclear. We performed a medline search using exploded Mesh keywords ‘endometrial neoplasms/’ and (‘body mass index/’ or ‘obesity/’) and (‘survival analysis/’ or ‘mortality/’ or (survivor* or survival*).mp.). We also inspected bibliographies of relevant papers to identify...

  10. Primary brachytherapy as a radical treatment for endometrial carcinoma

    OpenAIRE

    der Steen-Banasik, Elzbieta Van

    2014-01-01

    Surgery is the primary treatment for endometrial cancer, with radiation therapy having an established place in the adjuvant treatment setting. However, there is a population of patients with endometrial cancer who may not be suitable for surgery and primary radiation therapy as a treatment option. This article describes the place of radiotherapy in the management of endometrial cancer and describes the author's own experiences with primary brachytherapy in those patients who are unsuitable fo...

  11. Expression and clinical significance of FXYD3 in endometrial cancer

    OpenAIRE

    LI, YIFEI; Zhang, Xia; Xu, Shuwen; Ge, Jing; Liu, Jing; LI, Lin; FANG, GUIYING; MENG, YALI; ZHANG, HONGZHEN; SUN, XIAOFENG

    2014-01-01

    FXYD3 expression is upregulated in numerous cancer cell types. The present study compared the FXDY3 expression in normal endometrium, premalignant lesion and endometrial cancer tissue samples, and investigated the correlation between FXDY3 expression and clinicopathological features. FXYD3 expression was analyzed by streptavidin-peroxidase immunohistochemistry in 21 normal endometrial tissue samples, 18 atypical endometrial hyperplasia samples and 50 tissues obtained from patients diagnosed w...

  12. ESMO-ESGO-ESTRO consensus conference on endometrial cancer

    DEFF Research Database (Denmark)

    Colombo, Nicoletta; Creutzberg, Carien; Amant, Frederic; Bosse, Tjalling; González-Martín, Antonio; Ledermann, Jonathan; Marth, Christian; Nout, Remi; Querleu, Denis; Mirza, Mansoor Raza; Sessa, Cristiana

    2015-01-01

    The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically-relevant questions about endometrial cancer relating to the following...

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

    DEFF Research Database (Denmark)

    Ørtoft, Gitte; Dueholm, Margit; Mathiesen, Ole; Hansen, Estrid S; Lundorf, Erik; Møller, Charlotte; Marinovskij, Edvard; Petersen, Lone K

    2013-01-01

    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 ut...

  14. Clinical significance of three-dimensional sonohysterography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Hye; Lee, Mi Hwa; Lee, Chan; Kim, Jong Wook; Shin, Myung Choel [Pochon Cha University College of Medicine, Pochon (Korea, Republic of)

    1999-12-15

    To evaluate the usefulness of three dimensional sonohysterography (3D SHG) in the evaluation of uterine endometrial and submucosal lesions in comparison with conventional two-dimensional sonohysterography (2D SHG). Our series consisted of 26 patients (mean aged 41 years) who complained of uterine bleeding, menorrhagia, or dysmenorrhea. 2D SHG was performed, and then 3D SHG was done after the volume mode was switched on. Simultaneous display of three perpendicular two-dimensional planes and surface rendering of findings on particular section were obtained. We analyzed whether the endometrium was thickened or not, and the location, size, shape, echogenicity, posterior shadowing, and echogenic rim of the focal lesion. The results were compared with the pathologic findings or MRI. There were submucosal myomas (n=12), intramural myomas (n=2), endometrial polyps (n=7), placental polyp (n=1), and normal endometrial cavities (n=4) on SHG. Nineteen cases were confirmed by pathologic findings or MRI. The results were correlated in 89% (17/19) of the cases. We misdiagnosed 2 cases: focal endometrial hyperplasia and choriocarcinoma were misdiagnosed as endometrial polyp and placental polyp, respectively. Imaging diagnoses were same in the techniques. Comparing with 2D SHG, 3D SHG provided a subjective display of pathologic findings and an additional information about spatial relationship between focal lesion and surroundings.

  15. Osteoporosis is less frequent in endometrial cancer survivors with hypertriglyceridemia.

    Science.gov (United States)

    Hirasawa, Akira; Makita, Kazuya; Akahane, Tomoko; Yamagami, Wataru; Makabe, Takeshi; Yokota, Megumi; Horiba, Yuko; Ogawa, Mariko; Yanamoto, Shigehisa; Deshimaru, Rhota; Tominaga, Eiichiro; Banno, Kouji; Susumu, Nobuyuki; Aoki, Daisuke

    2015-01-01

    We previously reported an association between dyslipidemia and endometrial cancers. Osteoporosis is also reported to relate with some cancers. A common etiologic event has been proposed between dyslipidemia and osteoporosis. However, the pattern of interrelationships among dyslipidemia, osteoporosis and endometrial cancer is not well understood. To improve the quality of life of endometrial cancer survivors, these relationships should be determined. This study included 179 Japanese menopausal women who underwent bilateral salpingo-oophorectomy, including 114 women with incident endometrial cancer and 65 without endometrial cancer. The women were categorized according to dyslipidemia status. Bone mineral density was measured and compared between groups. Osteoporosis was statistically more frequent in women with hypertriglyceridemia who did not have endometrial cancer. In contrast, osteoporosis was statistically less frequent in women with hypertriglyceridemia who had endometrial cancer. In this cross-sectional study in a Japanese population, osteoporosis was associated with hypertriglyceridemia in post-menopausal women without endometrial cancer, but was less frequent in endometrial cancer survivors with hypertriglyceridemia. PMID:25324478

  16. Endometrial Cancer: Comparison of Patients with Synchronous Primary Carcinoma of the Endometrium and Ovary vs. Endometrial Carcinoma with Ovarian Metastases

    OpenAIRE

    Juhasz-Böss, I.; Fehm, T.; Becker, S.; Rothmund, R.; Krämer, B; Staebler, A.; Wallwiener, D; Solomayer, E. F.

    2012-01-01

    Purpose: The aim of our study was to investigate the rate of secondary carcinomas in patients with endometrial carcinoma (EC). In particular, we wanted to describe the subset of patients with endometrial and simultaneous ovarian carcinoma (OC), including outcomes. The study also compared patients with EC and ovarian metastasis with patients with EC and simultaneous OC. Patients and Methods: Data from 251 patients with primary endometrial carcinoma who underwent surgery in the years 2005–2009 ...

  17. Uterine Healing after Therapeutic Intrauterine Administration of TachoSil (Hemostatic Fleece) in Cesarean Section with Postpartum Hemorrhage Caused by Placenta Previa

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Dueholm, Margit

    2012-01-01

    Background. Application of hemostatic fleece (TachoSil) directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa. Methods. Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing. Results. Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects. Conclusion. TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.