1/4. Endometrial adenocarcinoma in pregnancy.OBJECTIVE: The coexistence of endometrial adenocarcinoma and pregnancy is rare. Most cases are discovered in the first trimester due to irregular bleeding or spontaneous abortion. CASE: A 44-year-old woman, gravida 3, para 2, was admitted due to abnormal vaginal bleeding. After complete history, physical examination, and laboratory evaluation, she was diagnosed with spontaneous abortion and underwent a suction curettage. Pathological examination of the tissue included chorionic villi and an area of atypical hyperplasia and endometrial cancer. CONCLUSION: Recent association between first-trimester spontaneous abortions and subsequent endometrial cancer makes these rare cases of concurrent endometrial cancer and first trimester of pregnancy attractive in that they may disclose insights into the pathophysiology of hormone-dependent cancers.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/4. Laparoscopically assisted vaginal hysterectomy with bilateral salpingo-oophorectomy due to endometrial cancer in a heart transplant recipient. A case report.INTRODUCTION: Transplant recipients have a higher incidence of cancer compared with the general population. This increased risk is related to the intensity and chronicity of immunosuppression that these patients receive. In this report, we present a case of a heart transplant woman with endometrial cancer who was diagnosed six months after transplantation. CASE REPORT: A 49-year-old woman who had undergone a heart transplant was referred to our department in May 2002 for final treatment. The diagnosis of endometrial cancer was established on the basis of the histopathology findings of the fractional curettage. Her heart transplant had occurred six months before, as a result of idiopathic restrictive cardiomyopathy. The patient received triple immunosuppression with cyclosporin, azathioprine and prednisone and she displayed no signs of acute graft rejection features. Laparoscopically assisted vaginal hysterectomy with adnexa was performed without any complications. Duration of surgery was 85 minutes. The patient was operated on under general anesthesia and intraabdominal pressure was automatically maintained at 10 mmHg with a carbon dioxide insufflator (AESCULAP, germany). Immunosuppressive therapy was continued without modification. The postoperative course was uncomplicated in our patient. No significant changes in heart rate or blood pressure were observed. The patient was discharged from the hospital on the 11th postoperative day. Microscopic appearance revealed Stage I endometrial cancer. The patient is in good physical condition with normal heart performance and without disease recurrence. CONCLUSION: In our opinion LAVH was a justifiable form of surgical management in the treatment of a heart transplant recipient with an early-stage endometrial cancer.- - - - - - - - - - ranking = 0.067165670797956keywords = physical (Clic here for more details about this article) |
3/4. Primary low-grade endometrial B-cell lymphoma.We describe three cases of primary low-grade B-cell lymphoma of the endometrium and contrast the histological, immunohistochemical, and molecular features with two examples of benign endometrial lymphoid infiltrates. The first case was an incidental finding in a curettage specimen, confirmed on a subsequent hysterectomy. The other two cases of lymphoma were incidental findings on hysterectomy procedures performed for prolapse and cervical dysplasia, respectively. All three lymphomas occurred in patients in their sixties; none formed gross tumors. Histologic examination revealed lymphoid nodules adjacent to endometrial glands. The lymphoid cells showed mild nuclear enlargement and slight irregularities of the nuclear contour. None of the three patients had evidence of disease outside the endometrium by physical examination, bone marrow biopsy, or sampling of pelvic lymph nodes. immunohistochemistry demonstrated a B-cell phenotype of the lymphoid cells (CD20 positive, CD79a positive) with aberrant coexpression of the T-cell-associated marker CD43. polymerase chain reaction (PCR) amplification of the VDJ region of the immunoglobulin heavy-chain was performed on dna isolated from paraffin sections. These studies demonstrated a clonal proliferation of b-lymphocytes in two cases. In the third case, a faint band was found superimposed on a background smear, suggesting the presence of a B-cell clone. In contrast, the two examples of histologically benign lymphoid aggregates of the endometrium consisted predominantly of T cells with rare b-lymphocytes; there was no evidence of coexpression of CD43 by B-cells. The PCR amplification from the benign lymphoid aggregates did not support a clonal process. Primary lymphoid neoplasms of the endometrium are rare, and all cases described so far have been high-stage, high-grade neoplasms. To our knowledge, this is the first report of primary low-grade B-cell lymphoma of the endometrium, presumably arising from endometrial lymphoid tissue.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/4. An interesting unusual case of endometrial stromal sarcoma.An interesting case with an unusual presentation of endometrial sarcoma is described. This patient presented with a history of continuous vaginal bleeding 3 months following a full term caesarean section and perception of an enlarging abdominal mass. The physical examination revealed an enlarged uterus with a leiomyoma though there was no evidence of the same at the time of the caesarean section. A laparotomy was undertaken and the patient was found to have a large tumor with multiple polypoidal growths invading the myometrium through to the serosa. This was proven to be an endometrial stromal sarcoma on histopathology.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |