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Background and Clinical Significance: Retrorectal cystic hamartomas ("Tailgut cysts") are rare developmental cysts that appear in the retrorectal space, arising from aberrant remnants of the post-anal primitive gut in case of an incomplete embryogenetic involution. Case Presentation: We present the case of a 30-year-old woman with a history of chronic lower abdominal pain. Other digestive symptoms, like rectal fullness, constipation, pain on defecation, rectal bleeding or genitourinary obstruction symptoms, were not associated. During a period of 3 years, she underwent several surgical procedures for ovarian cysts, without relieving the symptomatology. A computed tomography (CT) scan showed a presacral tumor with a right pararectal development. A surgical resection of the lesion using an anterior approach was performed, with the final pathological diagnosis of a retrorectal cystic hamartoma ("tailgut cyst"). Conclusions: This case underlines the fact that retrorectal masses can be challenging to diagnose, and tailgut cysts must be taken into consideration in cases of perirectal tumors in patients with a history of multiple failed procedures and surgeries. [ABSTRACT FROM AUTHOR]

Endometriosis, a chronic hormone-dependent condition affecting 10% of women globally, impacts pelvic organs and occasionally distant sites, causing pain, infertility, and sexual dysfunction. Biomarkers such as IL-8, IL-10, and BDNF influence inflammation, nerve sensitization, and pain. This study investigates their relationship with sexual quality of life, focusing on dyspareunia and related dysfunctions, as assessed using the Female Sexual Function Index (FSFI). Dyspareunia, a prominent symptom of endometriosis, is linked to lower FSFI scores in domains such as desire (mean 3.38), satisfaction (mean 3.28), and pain (mean 3.07). Elevated IL-8 tissue levels negatively correlated with desire (r = −0.649, p < 0.05) and satisfaction (r = −0.813, p < 0.01). Similarly, higher BDNF tissue levels were associated with increased pain (r = −0.435, p < 0.01) and reduced satisfaction (r = −0.252, p < 0.05). Patient factors such as higher endometriosis severity scores (mean 26.3, p < 0.05) and surgical history correlated with lower desire and satisfaction. Conversely, physical activity improved pain scores (p < 0.01) and enhanced desire and lubrication (p < 0.05), likely through reduced inflammation and better circulation. These findings highlight the complex interplay between biomarkers, individual factors, and sexual dysfunction in endometriosis, underscoring the need for personalized therapeutic approaches. [ABSTRACT FROM AUTHOR]

Parvovirus B19 (B19V) infection is the cause of erythema infectiosum, or the "fifth disease", a widespread infection, potentially affecting 1–5% of pregnant women, in most cases without significant damage to the pregnancy or fetus. It follows a seasonal variation, with a higher prevalence in temperate climates, mainly in late winter and early spring. Women at increased risk include mothers of preschool and school-age children, and those working in nurseries, kindergartens, and schools. Vertical transmission occurs in 33% to 51% of cases of maternal infection. Parvovirus infection is an important cause of fetal perinatal infection resulting in increased morbidity through the development of fetal anemia, heart failure, and non-immune hydrops. A comprehensive literature review was conducted using PubMed, Cochrane Library, and Google Scholar, focusing on publications from the last 10 years and prioritizing studies related to parvovirus B19 infection in pregnancy. We summarized the existing data in the literature on the effects of parvovirus B19 infection during pregnancy and weighed if there is a need for screening in pregnant patients. Routine screening for parvovirus B19 infection can be considered in communities where infection is common, there is occupational exposure, or during endemic periods, with the reason being that accurate identification and treatment of fetuses affected by congenital B19V infection have been shown to improve perinatal outcomes. [ABSTRACT FROM AUTHOR]

Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) is a rare uterine tumor primarily affecting perimenopausal and postmenopausal women, typically aged between 45 and 55 years. Characterized by ambiguous histological features, STUMPs present diagnostic challenges as they cannot be definitively classified as benign or malignant based on morphology alone. This systematic review aims to elucidate the clinical, pathological, immunohistochemical, and treatment-related characteristics of STUMPs through an analysis of the literature from the past 20 years. The study follows PRISMA guidelines, utilizing comprehensive searches of PubMed and Scopus databases, yielding 32 studies that meet the inclusion criteria. From the analysis of these studies, it was revealed that the clinical presentations vary from common symptoms such as abnormal uterine bleeding and pelvic pain to incidental detection of uterine mass. Histologically, STUMPs demonstrate features overlapping with both leiomyomas and leiomyosarcomas, including mild nuclear atypia, low mitotic indices, and focal necrosis. Immunohistochemical markers such as p16 and p53 have been investigated for prognostic significance. Elevated p16 expression, often associated with aggressive behavior, was observed in a subset of STUMPs. Surgical management, typically involving hysterectomy or tumorectomy, is the primary treatment, though the extent of resection is variable. Adjuvant therapies are not routinely recommended, but long-term surveillance is advised, especially for high-risk patients. Recurrence rates for STUMPs are approximately 12%, with factors such as high mitotic counts and coagulative necrosis indicating higher risk. This review highlights the complexity of STUMP diagnosis and management, emphasizing the need for more precise diagnostic criteria and individualized treatment strategies. Understanding the morphological, immunohistochemical, and clinical behavior of STUMPs can improve patient outcomes and guide future research in this diagnostically challenging area. [ABSTRACT FROM AUTHOR]

Endometriosis is known to be a chronic, debilitating disease. The pathophysiological mechanisms of endometriosis development include local chronic inflammation and a certain degree of local immune deficit. We investigated the relationship between the endometriosis severity, IL-8, IL-10, BDNF, VEGF-A serum and tissue levels, patient-related pain, and physical activity in a cohort of 46 patients diagnosed with endometriosis who underwent surgery. The same panel of biomarkers was investigated in a control group of 44 reproductive-aged patients with non-endometriotic gynecological pathology who underwent surgical intervention. Our data show a high statistical significance between tissue expression of IL-8, IL-10, patient-related pain, and the severity of endometriosis. No relationship was identified between serum or tissue levels of VEGF-A and BDNF and the severity of endometriosis. These results validate the presence of local chronic inflammation and immune deficit, thereby creating, alongside other studies in the field, an opportunity for the development of innovative and personalized treatment approaches in endometriosis. [ABSTRACT FROM AUTHOR]

Disseminated peritoneal leiomyomatosis (DPL) is a rare condition marked by multiple leiomyomas in the peritoneal cavity, predominantly affecting women of reproductive age. Although typically benign, DPL can present significant diagnostic challenges and, in rare cases, may progress to malignancy. A primary contributing factor to DPL is iatrogenic, particularly due to surgical interventions such as morcellation during myomectomy. This scoping review explores the pathogenesis, epidemiology, diagnosis, and management of DPL, highlighting the crucial role of hormonal influences and iatrogenic factors. Diagnostic methods include computed tomography, ultrasound, magnetic resonance imaging, and histopathological evaluation, which are essential for assessing disease extent and guiding treatment. Management strategies encompass surgical intervention—with a focus on minimizing iatrogenic risks—conservative approaches for asymptomatic patients, and advancements in hormonal treatments. Emphasis is placed on preventing iatrogenic dissemination through refined surgical techniques and patient education. Despite its rarity, with fewer than 200 cases reported globally, understanding DPL's clinical presentation and iatrogenic origins is vital for optimal patient outcomes. This review underscores the importance of early diagnosis, personalized treatment plans, and ongoing research to address the challenges associated with DPL. [ABSTRACT FROM AUTHOR]

Purpose: Endometriosis has an incidence reaching up to 50% in infertile women. Cytokine-mediated immune responses seem to play an important role in endometriosis pathogenesis, but still the etiology and pathophysiology remain unclear. In the current study we tried to investigate whether there is a relationship between IL-10 genetic polymorphism, serum levels of IL-10 and the presence of advanced endometriosis.Methods: The presence of IL-10 592C/A, 819T/C, 1082G/A promoter polymorphisms and IL-10 serum levels were investigated in advanced endometriosis patients compared to healthy controls. Genomic DNA was extracted from peripheral blood leukocytes and further analyzed by PCR.Results: IL-10 serum levels were higher in endometriosis group compared to controls (1.48, 0.68, p < 0.001). We have observed an association between IL-10 592C/C and 819C/C genotypes, presence of C alleles and an increased risk of endometriosis. No difference was observed in IL-10 serum levels corresponding to different alleles or genotypes.Conclusion: Our results suggest that IL-10 592A/C and 819T/C promoter polymorphisms confer susceptibility to advanced endometriosis. No associations were found between the IL-10 1082A/G polymorphism and susceptibility to advanced endometriosis. [ABSTRACT FROM AUTHOR]

Background and aims. Endometriosis is a commonly encountered disorder in women of reproductive age, consisting of the presence of active ectopic endometrial tissue outside the endometrial cavity. Surgical scar endometriosis is a rare condition representing about 2% of all endometriosis cases. The purpose of this study was to assess the main characteristics, diagnostic tools and therapeutic options in abdominal wall endometriosis (AWE). Methods. We have reviewed a series of fourteen cases with histopathological confirmation of AWE that were managed in our institution. Results. The main characteristic of AWE were emphasized, showing that 78.57% of the patients had at least one previous caesarian section and that in only 57.14% of all cases an accurate diagnosis of AWE was established preoperatively. Conclusion. A direct relationship between gynecological and obstetrical surgery and AWE is well established and as the caesarian section rates increase constantly, the awareness regarding AWE should also be increased. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to assess the histological changes occurring in the vagina and vulva in ovariectomised female rats, as well as the response to the administration of injectable oestrogens.Material and Methods: We used 30 female Wistar white rats, distributed as follows: group 1 - the control group, group 2 - the operated but untreated rats, and groups 3, 4 and 5 - operated rats, to which oestrogenic treatment was administered (Estradiol, Estradurin, Sintofolin) at a dosage of 0.2 mg/rat/day. After 14 days of treatment, all animals were sacrificed and vaginal and vulvar biopsies were taken from all groups.Results: In group 2, we encountered structural changes of the vaginal mucosa, with severe atrophy and alterations in the thickness of the vagina and vulva. In groups 3, 4 and 5 we found marked hyperplasia of the vaginal and vulvar epithelium, eosinophilic and mast cell infiltration in the chorion.Conclusions: Our study proves that the histopathological changes during anoestrus after administration of oestrogens are cell hyperplasia, thickening of the superficial mucosal layer, eosinophilic and mast cells infiltrations, and chorionic congestion. Furthermore, we demonstrated that Estradiol therapy induces the most evident histological changes when compared to synthetic oestrogens such as Estradurin or Sintofolin. [ABSTRACT FROM AUTHOR]

Embryonic demise is the most common event in the lives of women during theirs reproductive time with a rate of about 25%. The aim of this review is to outline the most important paraclinic and biological prognostic parameters. English language articles containing keywords like "embryonic demise", "predictive factors" which were searched using Medline and Pubmed. Systematic reviews, retrospective and prospective studies, clinical trials focused on this subject were selected. Informative value of the references of selected articles was used as base for further relevant headlines. Among the most significant reported predictive factors are the distance between the yolk sac (YS) and embryo, also known as the yalk stalk sign, the progesterone and β human chorionic gonadotropine levels. Low levels of biomarkers and abnormal appearance of gestational sac, crown-rump length and YS are considered worst prognostic factors and may lead to a poor outcome. [ABSTRACT FROM AUTHOR]

Aims. To characterize the vascularity of endometriotic cysts using color Doppler ultrasound and to differentiate more accurately between endometriotic cysts and other pelvic cyst masses. Methods. Two prospective studies were initiated: the first included 50 patients diagnosed with ovarian endometriotic cysts and 50 patients without gynecological pathology, in whom the resistance index (RI) of the uterine artery, ovarian artery and endometrial arcuate arteries in the early secretory phase was determined by endovaginal Doppler ultrasound; the second study included 50 patients diagnosed with ovarian endometriotic cysts, in whom the RI of the uterine artery, ovarian artery and cyst wall arteries in the late proliferative phase and in the late secretory phase was determined. Results. In the early secretory phase, the vascular flow through the uterine artery was significantly higher in patients with ovarian endometrioma. These patients had increased endometrial vascularity in the early secretory phase compared to the control group. In the late secretory phase, the vascular flow through the ovarian artery was higher compared to the late proliferative phase in patients with ovarian endometrioma. The vascularization of the ovarian endometrioma wall was significantly increased in the late secretory phase compared to the late proliferative phase. Conclusions. Vascularization, described through the arrangement of vessels, vascular density and vascular resistance, is an important factor in the evaluation of ovarian endometrioma. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the serum pro-inflammatory cytokine profile in patients with diagnosed endometriosis. Material and methods: The study included 160 women, who were divided in two study groups (Group I - endometriosis; Group 2 - healthy). We evaluated the serum levels of interleukin (IL)-lß, lL-5, IL-6, IL-7, and IL-12, and of tumour necrosis factor a (TNF-a) with the use of Human Multiplex Cytokine Panels. Conclusions: Women with endometriosis have elevated levels of key pro-inflammatory cytokines, i.e. IL-1β, IL-6, and TNF-a. At the same time, IL-1ß and IL-6 could be used as predictors for endometriosis. [ABSTRACT FROM AUTHOR]

Twin reversed arterial perfusion (TRAP) sequence is a rare (1/35.000 pregnancies) and severe complication specific to monochorionic twin pregnancies, involving the presence of an acardiac twin and a structurally normal co-twin (pump twin). The normal twin has a high mortality rate (50- 70%), especially due to congestive heart failure. We report on the case of a IIG IIIP 33 year-old patient who was referred to our institution form another service with the initial diagnosis of multiple pregnancy with one dead twin. Ultrasound revealed 24 gestational weeks intrauterine biamniotic monochorionic twin pregnancy with TRAP sequence and polyhydramnios. Therapeutic amniocentesis was performed for polyhydramnios, evacuating 500 ml of amniotic fluid. A fetoscopic intervention was decided, with the occlusion of the umbilical cord of the acardiac twin, followed by the evacuation of another 700 ml amniotic fluid. The patient was readmitted to our institution at 34 gestational weeks for preterm premature rupture of membranes and vaginal bleeding. Ultrasound revealed intrauterine growth restriction of the living twin, corresponding to 30 gestational weeks and retroplacentar hematoma, reaching 8,5/5 cm. The patient gave birth through cesarean section to a living female fetus, weighing 1480 g, Apgar score 6, 7, 8 at 1, 2 and respectively 5 minutes. In conclusion, TRAP sequence is a rare entity, requiring early diagnosis and careful ultrasound monitoring, in order to select the best management option for the pump twin. To the best of our knowledge, this is the first case reporting a twin pregnancy with TRAP sequence complicated with retroplacentar hematoma. [ABSTRACT FROM AUTHOR]

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Objective The study aims to evaluate the presence of a correlation between visceral fat assessed by ultrasonography and the plasmatic level of lipocalin in patients diagnosed with endometrial cancer. Material and Method The study is a case-control analysis including 2 groups of patients: group I - 44 patients diagnosed with endometrial cancer, group II - 44 patients without gynecological pathology or inflammatory disorders. After the clinical examination and anthropometric measurements, these patients underwent ultrasonography (US) examination, in view of determining the visceral fat. At the patients included in this study, we also determined the plasmatic levels for lipocalin. Results At the patients diagnosed with endometrial cancer, the intraabdominal fat area evaluated by US and the plasmatic level of lipocalin is significantly larger (p<0.0001) compared to the control group. A correlation was also found between the intraperitoneal fat area evaluated by US and the plasmatic level of lipocalin. Conclusions The measurement of the intraperitoneal fat by US in correlation with the plasmatic level of lipocalin can be a screening method for endometrial cancer in obese patients. [ABSTRACT FROM AUTHOR]

Background: Transvaginal and transabdominal ultrasonography has become a widely used investigative method in the diagnostic workup of endometriosis, as well as for the postoperative follow-up. The variety of lesions, the distorted anatomy caused by adhesions and the fibrosis process represent the main challenges of the ultrasound evaluation. Regarding the recurrence of endometriosis, the diagnostic criteria are being imprecise, being adjusted according to the development of ultrasound techniques., Objective and Methods: To this study, extensive research has been performed interrogating PubMed, Embase and Web of Science databases to identify published research including patients with endometriosis who underwent surgery. Included patients had postoperative ultrasound investigations to detect evidence of endometriosis recurrence. The selected timeframe was 5 years. We conducted a literature review on ultrasound markers of endometriosis recurrence., Results: In this analysis, 2023 patients from 9 studies were included. The recurrence rate detected was 17.26%. The postoperative treatment was different in the selected studies and they include the administration of progesterone, oral combined contraceptives, GnRh antagonists, aromatase inhibitors and intrauterine devices with prolonged release of progesterone., Discussion: The recurrence rate is different in the selected studies as a result of the recurrence definition used by each author and the minimum dimension of the lesions, in case of the cystic pattern. Innovative techniques of differential diagnosis by ultrasound are proposed, one of them being the textural analysis performed by computer-aided diagnosis – CAD. In order to standardize the recommendations regarding imaging techniques, we propose an algorithm for following up with patients in the postoperative period., Conclusion: The transabdominal or endovaginal ultrasound performed regularly represents a key factor to determine the recurrence of endometriosis in the postoperative period and the imaging reassessment is recommended to be performed at a 6-month interval., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: The association of obesity with endometrial cancer is supported by the presence of endoplasmic reticulum (ER) stress in the adipocyte. Glucose-regulated protein 78 (GRP78) is a marker for ER stress. This protein is a central regulator of ER stress due to its major anti-apoptotic role. It plays an important role in tumor development, progression and chemoresistance., Aim: To look for an association between android and gynoid obesity, plasma GRP78 levels and endometrial cancer., Material and Methods: Forty four patients with endometrial cancer aged 72 ± 6 years and 44 healthy women aged 55 ± 9 years were studied. Android and gynoid fat distribution were determined by dual X-ray absorptiometry and plasma GRP78 levels were measured., Results: GRP78 plasma levels were significantly higher in patients with endometrial cancer as compared to the control group. Android fat distribution had a positive correlation with plasma GRP78 levels (p<0.01). Gynoid fat had a negative correlation with plasma GRP78 levels (p<0.01)., Conclusions: GRP78 levels are associated with the distribution of adipose tissue and are higher in patients with endometrial cancer.