scholarly journals A clinical case of successful treatment of a giant serous endometrial carcinoma imitating ovarian cancer

2021 ◽  
Vol 12 (4) ◽  
pp. 80-85
Author(s):  
Aleksander I. Berishvili ◽  
Yuri V. Ivanov ◽  
Dmitry P. Lebedev ◽  
Fedor G. Zabozlaev ◽  
Edward V. Kravchenko ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Umbilical Hernia ◽  
Clinical Case ◽  
Skin Flap ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Greater Omentum ◽  
Excess Skin

Background: Giant tumors of the abdominal cavity, as a rule, occur in elderly patients with characteristic features and represent a serious problem in terms of choosing a radical method of therapy. Of particular difficulty are cases of giant serous endometrial cancer, requiring a differential diagnosis with ovarian cancer. Clinical case description: A clinical case of giant serous endometrial cancer mimicking ovarian cancer in a 55-year-old woman is presented. The patient came to the oncology department with complaints of abdominal enlargement, difficulty breathing and bloody discharge from the genital tract. The examination revealed the following: a giant formation (4065 cm), occupying the entire pelvic and the entire abdominal cavities, ascites, lesions of the retroperitoneal lymph nodes, and the greater omentum, an umbilical hernia. A chest CT showed multiple contrast-accumulating circular shadows of 313 mm (metastases). By the decision of the council, after the preliminary chemoembolization of both the uterine and ovarian arteries, a supravaginal amputation of the uterus with appendages was performed, along with the resection of the greater omentum, removal of the umbilical hernia with positioning a plastic mesh implant and excision of an excess skin flap. The histological examination of the intraoperative material made it possible to verify the diagnosis of a serous endometrial carcinoma with subtotal tumor necrosis, the myometrium invasion of more than a half of its thickness, with the egress to the perimetrium, metastatic lesions of both ovaries, the greater omentum, anterior abdominal wall. Stage T3b (FIGO IIIB). In the postoperative period, 6 courses of Paclitaxel / Carboplatin (AUC4-5) chemotherapy were carried out with a pronounced clinical effect. The patient was discharged in a satisfactory condition. The control PET-CT scan after the 6th chemotherapy course showed no pathology in the thoracic cavity, and no process progress in the abdominal cavity. Currently, the remission of the disease is 9 months. Conclusion: An algorithm for the diagnostic measures aimed at making the correct diagnosis is presented, and the tactics of treating a patient with giant serous endometrial cancer is described.

The Accuracy of Endometrial Sampling in the Diagnosis of Patients With Endometrial Carcinoma and Hyperplasia

2021 ◽  
pp. 180-184
Author(s):  
Chelsea Chandler ◽  
Alexander Olawaiye
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Sensitivity And Specificity ◽  
Clinical Case ◽  
Meta Analysis ◽  
Atypical Hyperplasia ◽  
Endometrial Sampling ◽  
Landmark Study

This article provides a summary of a landmark study regarding the diagnosis of endometrial cancer. How accurate is endometrial sampling in women with endometrial carcinoma and hyperplasia? The article describes a meta-analysis in which the results of 39 studies using a variety of different endometrial sampling devices are compared by their sensitivity and specificity for diagnosis endometrial carcinoma and atypical hyperplasia of the endometrium. The article briefly reviews criticisms and limitations of the included studies, discusses implications, and concludes with a relevant clinical case.

Cytoreduction and intraperitoneal heated chemotherapy for the treatment of endometrial carcinoma recurrent within the peritoneal cavity

2007 ◽  
Vol 17 (1) ◽  
pp. 204-209 ◽  
Author(s):  
C. W. Helm ◽  
C. R. Toler ◽  
R. S. Martin ◽  
M. E. Gordinier ◽  
L. P. Parker ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Residual Disease ◽  
Abdominal Cavity ◽  
Retrospective Chart Review ◽  
Exploratory Laparotomy ◽  
Chemotherapy Agent ◽  
Postoperative Serum ◽  
Recurrent Endometrial Cancer ◽  
Lost To Follow Up

Our experience with hyperthermic intraperitoneal chemotherapy (IPHC) in conjunction with surgical resection for endometrial cancer recurrent within the abdominal cavity was reviewed. Eligible patients underwent exploratory laparotomy with the aim of resecting disease to ≤5 mm maximum dimension followed immediately by intraperitoneal perfusion of cisplatin (100 mg/m2) heated to 41–43°C (105.8–109.4°F) for 1.5 h. Data for analysis was extracted from retrospective chart review. Five patients underwent surgery and IPHC between September 2002 and January 2005 for abdomino-pelvic recurrence. Original stage and histology were 1A papillary serous (1), 1C endometrioid with clear cell features (1), and 1B endometrioid (3). Mean age was 61 (41–75) years, mean prior laparotomies were 1.4 (1–2), and mean chemotherapy agent exposure was 1.6 (0–4). Mean time from initial treatment to surgery and IPHC was 47 (29–66) months. Mean length of surgery was 9.8 (7–11) h after which three patients had no residual disease and two had ≤5 mm disease. The mean duration of hospital stay was 12.6 (6–20) days. Postoperative surgical complications included wound infection with septicemia in one patient. Mean maximum postoperative serum creatinine was 1.02 (0.6–1.70) mg/dL. There was no ototoxicity or neuropathy and no perioperative mortality. No patients have been lost to follow-up. Two are living disease free at 28 and 32 m and two are living with disease at 12 and 36 m. One patient died at 3 m without evidence of cancer. Two patients who had no residual macroscopic disease at the end of surgery are alive at 32 and 36 m. The combination of IPHC with surgery for recurrent endometrial carcinoma is relatively well tolerated. The unexpectedly long survival seen in this cohort supports a phase II trial of IPHC with cisplatin for recurrent endometrial cancer.

scholarly journals Modified Porro’s Operation in Ovarian Cancer: a Clinical Case

2021 ◽  
Vol 11 (1) ◽  
pp. 41-45
Author(s):  
A. G. Yashchuk ◽  
I. B. Fatkullina ◽  
I. R. Rahmatullina ◽  
I. I. Musin ◽  
A. R. Molokanova
Keyword(s):  
Ovarian Cancer ◽  
Surgical Technique ◽  
Cohort Studies ◽  
Clinical Case ◽  
De Novo ◽  
Greater Omentum ◽  
Rare Occurrence ◽  
Cancer In Pregnancy ◽  
Population Rate ◽  
In Pregnancy

Background. Ovarian cancer in pregnancy is quite rare having a top 5th incidence among other pregnancy-associated tumours [1]. Due to a low population rate in pregnant women, the lack of standardised management of such patients and the paucity of relevant randomised and cohort studies, analyses of individual clinical cases acquire particular importance.Materials and methods. This article presents a clinical case of de novo diagnosed ovarian cancer in pregnancy tackled with a modified Porro’s operation of peritonectomy, para-aortic and parametric lymphadenectomy and greater omentum resection at a gynaecology unit of the Kuvatov Republican Clinical Hospital of Ufa.Results and discussion. This clinical case is special in terms of a rare occurrence of ovarian cancer in pregnancy. The choice of this radical surgical technique is considered optimal for inspecting most plausible metastatic foci and ensuring a life-preserving prognosis.Conclusion. In the absence of standardised management protocols in pregnancy-associated ovarian cancer, further analyses and discussions of routine clinical case evidence are imperative.

Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma

2003 ◽  
Vol 13 (2) ◽  
pp. 223-227 ◽  
Author(s):  
L. Selvaggi ◽  
G. Cormio ◽  
O. Ceci ◽  
G. Loverro ◽  
A. Cazzolla ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Cancer Patients ◽  
Abdominal Cavity ◽  
Primary Diagnosis ◽  
Peritoneal Cytology ◽  
Clinicopathologic Characteristics ◽  
Diagnostic Modality ◽  
Tumor Dissemination ◽  
Positive Peritoneal Cytology

Fluid hysteroscopy has been suspected to cause tumor dissemination in the abdominal cavity in endometrial cancer patients. The aim of our study was to evaluate the incidence of microscopic extrauterine spread according to diagnostic modality (dilatation & curretage, D&C, hysteroscopy, or both) in patients with endometrial carcinoma. A retrospective study was conducted on 147 patients with histologically proven diagnosis of endometrial carcinoma without macroscopic extrauterine disease. Fluid hysteroscopy was performed by using saline solution irrigated at a final flow of 150 ml/min with a intrauterine pressure ranging between 25 and 50 mmHg. Microscopic intraperitoneal disease and positive peritoneal cytology were considered the primary end-points of this analysis. Fifty-two patients (35%) had diagnosis of endometrial cancer made only by D&C, 56 (39%) underwent D&C and then hysteroscopy, and 39 (26%) had only hysteroscopy. Distribution of the patients in this three groups was casual, and clinicopathologic characteristics of the patients in the three groups were similar. Peritoneal cytology was positive in nine patients, 13 had microscopic ovarian metastases, and eight had microscopic involvement of the pelvic peritoneum or of omentum. Neither the presence of positive peritoneal cytology nor the findings of microscopic intraperitoneal dissemination were significantly associated with the diagnostic procedure employed for primary diagnosis (D&C or D&C plus hysteroscopy or hysteroscopy alone). We conclude that fluid hysteroscopy does not increase the risk of microscopic intraperitoneal spread in endometrial cancer patients as compared to D&C.

Middle ear tuberculosis - clinical case

ORL ro ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 12-14
Author(s):  
A. Sandul ◽  
M. Buracovschi ◽  
N. Buracovschi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Human Population ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Tuberculous Otitis Media ◽  
Type V

Tuberculosis is one of the oldest pathologies that affect human population, being a significant cause of morbidity/mortality in several countries. Middleear tuberculosis is a rare pathology, often misdiagnosed because of an atipic evolution, as a result leading to severe complications. This paper presents a case of tuberculous otitis media complicated with facial nerveparalysis House Brackmann type V in a patient who underwent multiple middleear surgeries before correct diagnosis was established.  

scholarly journals CD133 Expression in the Nucleus Is Associated with Endometrial Carcinoma Staging and Tumor Angioinvasion

2021 ◽  
Vol 10 (10) ◽  
pp. 2144
Author(s):  
Milosz Pietrus ◽  
Kazimierz Pitynski ◽  
Marcin Waligora ◽  
Katarzyna Milian-Ciesielska ◽  
Monika Bialon ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Plasma Membrane ◽  
Tumor Progression ◽  
Endometrial Carcinoma ◽  
Molecular Level ◽  
Risk Group ◽  
High Risk Group ◽  
Cd133 Expression ◽  
Transmembrane Glycoprotein ◽  
The Impact

Background: (1) Endometrial cancer is one of the most common cancers affecting women, with a growing incidence. To better understand the different behaviors associated with endometrial cancer, it is necessary to understand the changes that occur at a molecular level. CD133 is one of the factors that regulate tumor progression, which is primarily known as the transmembrane glycoprotein associated with tumor progression or cancer stem cells. The aim of our study was to assess the impact of subcellular CD133 expression on the clinical course of endometrial cancer. (2) Methods: CD133 expression in the plasma membrane, nucleus, and cytoplasm was assessed by immunohistochemical staining in a group of 64 patients with endometrial cancer representing FIGO I-IV stages, grades 1–3 and accounting for tumor angioinvasion. (3) Results: Nuclear localization of CD133 expression was increased in FIGO IB-IV stages compared to FIGO IA. Furthermore, CD133 expression in the nucleus and plasma membrane is positively and negatively associated with a higher grade of endometrial cancer and angioinvasion, respectively. (4) Conclusions: Our findings suggest that positive nuclear CD133 expression in the tumor may be related to a less favorable prognosis of endometrial carcinoma patients and has emerged as a useful biomarker of a high-risk group.

scholarly journals Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature

2021 ◽  
Vol 07 (02) ◽  
pp. e116-e120
Author(s):  
Tatjana Braun ◽  
Amelie De Gregorio ◽  
Lisa Baumann ◽  
Jochen Steinacker ◽  
Wolfgang Janni ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Case Report ◽  
Diagnostic Imaging ◽  
Medical History ◽  
Rare Disease ◽  
Metastatic Cancer ◽  
Abdominal Cavity ◽  
Advanced Ovarian Cancer ◽  
Splenic Tissue ◽  
Tumor Spread

AbstractSplenosis is a rare disease, which is often discovered incidentally years after surgical procedures on the spleen or traumatic splenic lesions. Through injury of the splenic capsule, splenic cells are able to spread and autoimplant in a fashion similar to the process of metastatic cancer. Here we present the case of a 62-year-old female patient with a palpable tumor of the lower abdomen. Her medical history was unremarkable, except for splenectomy after traumatic splenic lesion in her childhood. Clinical examination and diagnostic imaging raised the suspicion of advanced ovarian cancer, which was further substantiated by the typical presentation of adnexal masses and disseminated peritoneal metastases during the following staging laparotomy. Surprisingly, we also found peritoneal implants macroscopically similar to splenic tissue. Microscopic examination of tissue specimens by intrasurgical frozen section confirmed the diagnosis of intra-abdominal splenosis. The patient then underwent cytoreductive surgery with complete resection of all cancer manifestations, sparing the remaining foci of splenosis to avoid further morbidity. This case demonstrates the rare coincidence of intra-abdominal carcinoma and splenosis, which could lead to intraoperative difficulties by misinterpreting benign splenic tissue. Therefore, splenosis should be considered in patients with medical history of splenic lesions and further diagnostic imaging like Tc-99m-tagged heat-damaged RBC scan could be used for presurgical distinguishing between tumor spread in the abdominal cavity and disseminated splenosis. The presented case report should not only raise awareness for the rare disease splenosis, but also emphasize the need to consider the possibility of simultaneous incidence of benign and malignant intra-abdominal lesions, as to our knowledge this is the first published case of simultaneous peritoneal carcinomatosis and splenosis.

Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

2019 ◽  
Vol 29 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Arnold-Jan Kruse ◽  
Henk G ter Brugge ◽  
Harm H de Haan ◽  
Hugo W Van Eyndhoven ◽  
Hans W Nijman
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Vaginal Hysterectomy ◽  
Cancer Survival ◽  
Survival Rates ◽  
Survival Outcomes ◽  
Ovarian Malignancy ◽  
Post Menopausal ◽  
Ovarian Cancer Survival ◽  
Overall Survival Rates

ObjectiveVaginal hysterectomy with bilateral salpingo-oophorectomy may be an alternative strategy for patients with low-risk endometrial cancer and medical co-morbidities precluding laparoscopic or abdominal procedures. The current study evaluates the prevalence of co-existent ovarian malignancy in patients with endometrial cancer and the influence of bilateral salpingo-oophorectomy on survival outcomes in these patients.MethodsMedline and EMBASE were searched for studies published between January 1, 2000 and November 20, 2017 that investigated (1) the prevalence of co-existing ovarian malignancy (either metastases or primary synchronous ovarian cancer in women with endometrial cancer, and (2) the influence of bilateral salpingo-oophorectomy on recurrence and/or survival rates.ResultsOf the pre-menopausal and post-menopausal patients (n=6059), 373 were identified with metastases and 106 were identified with primary synchronous ovarian cancer. Of the post-menopausal patients (n=6016), 362 were identified with metastases and 44 were identified with primary synchronous ovarian cancer. Survival outcomes did not differ for pre-menopausal patients with endometrial cancer with and without bilateral salpingo-oophorectomy (5-year overall survival rates were 89–94.5% and 86–97.8%, respectively).ConclusionBilateral salpingo-oophorectomy during vaginal hysterectomy seems to have a limited impact on disease outcome in patients with endometrial cancer. These results support the view that vaginal hysterectomy alone or with bilateral salpingo-oophorectomy may be an option for patients with endometrial cancer who are not ideal surgical candidates.

Phase II Trial of the Pegylated Liposomal Doxorubicin in Previously Treated Metastatic Endometrial Cancer: A Gynecologic Oncology Group Study

2002 ◽  
Vol 20 (9) ◽  
pp. 2360-2364 ◽  
Author(s):  
Franco M. Muggia ◽  
John A. Blessing ◽  
Joel Sorosky ◽  
Gary C. Reid
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Liposomal Doxorubicin ◽  
Gynecologic Oncology ◽  
Pegylated Liposomal Doxorubicin ◽  
Median Number ◽  
Gynecologic Oncology Group ◽  
Pretreated Patients ◽  
Central Pathology ◽  
Wbc Count

PURPOSE: To determine whether pegylated liposomal doxorubicin (PLD) has antitumor activity in pretreated patients with persistent or recurrent endometrial carcinoma and to define the nature and degree of toxicity of PLD. PATIENTS AND METHODS: Women with histologically documented recurrent or persistent measurable endometrial carcinoma and with failure of one prior treatment regardless of prior anthracycline therapy were enrolled. PLD was administered intravenously over a 1-hour period at a dose of 50 mg/m2 every 4 weeks; the dosage was modified in accordance with observed toxicity. RESULTS: Of 46 patients entered, 42 were assessable for response, as three were declared ineligible on central pathology review and one was not assessable for response. Forty had received prior chemotherapy, 11 hormonal therapy, and 29 radiation therapy. Doxorubicin had been given to 32 patients, carboplatin with paclitaxel to six, carboplatin to one, and fluorouracil to one. Four patients had partial responses lasting 1.1, 2.1, 3.3, and 5.4 months; the overall response rate was 9.5% (95% confidence interval, 2.7% to 22.6%). Three of these responses (in liver and in lymph node) occurred in patients who had progressed after doxorubicin with either paclitaxel or cisplatin. The median number of courses was 2.5 (range, one to 14). Toxicity was generally mild: only 25 patients experienced leukopenia, with a median WBC count of 2,900 (range, 800 to 3,900) at nadir. The only grade 4 toxicities were one episode each of esophagitis, hematuria, and vomiting. The median overall survival was 8.2 months. CONCLUSION: PLD has only limited activity in pretreated advanced, recurrent endometrial cancer, but further trials in anthracycline-naive patients and in previously untreated patients are ongoing. Its toxicity profile should permit its use in combination with myelosuppressive drugs.

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