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ZusammenfassungDie vorliegende Übersicht fasst die relevanten Aspekte der S2k-Leitlinie Endometriose zusammen. Die Empfehlungen umfassen die Aufarbeitung und Befunderhebung bei Biopsien und Resektaten, die bei der klinischen Diagnose einer Endometriose entnommen wurden. Die Leitlinie berücksichtigt neben praktischen Aspekten der Pathologie ebenso die klinischen Notwendigkeiten an die Histopathologie für eine optimale Diagnostik und Therapie der Patientinnen.Basierend auf der in der pathologischen Literatur gebräuchlichsten Definition der Endometriose des Corpus uteri (Adenomyosis uteri) wurde diese in der Leitlinie definiert als der Nachweis des Endometrioseherdes im Myometrium in einem Abstand zur endomyometranen Grenze von einem mittelgroßen Gesichtsfeld (100fache Vergrößerung), was metrisch rund 2,5 mm entspricht. Bei Darmresektaten soll zum Status der Resektionsränder Stellung genommen werden.Ebenso definiert werden Anforderungen im Kontext endometrioseassoziierter Karzinome (z. B. Hormonrezeptorbestimmungen, immunhistochemische Untersuchung auf Ausfall der DNA-Mismatch-Reparaturproteine).

The Red fox (Vulpes vulpes) is the largest of the true foxes and the most abundant wild member of the carnivora. This study aimed to determine the anatomical structure of the cervix uteri, corpus uteri and cornu uteri of the Red foxes. Animals that were taken to the Kafkas University Wildlife Rescue and Rehabilitation Center, Kars, Turkey, because of various reasons, such as traffic accidents and firearm injuries, were used. The uterus of four Red foxes of similar ages, which could not be rescued by the Center despite all interventions, were dissected. Measurements were taken from the cervix uteri, corpus uteri and right-left cornu uteri using digital calipers. The weights of each organ section were measured using a precision scale. The mean length of the cervix uteri 11.54 ± 1.56 mm, width was 4.46 ± 0.52 mm, thickness was 5.18 ± 0.08 mm, and weight was 1.18 ± 0.04 g. The mean length of the corpus uteri was 20.68 ± 3.06 mm, width was 2.88 ± 0.50 mm, thickness was 2.22 ± 0.19 mm, and weight was 0.90 ± 0.01 g. The mean length of the cornu uteri was 79.85 ± 0.86 mm, width was 4.85 ± 0.79 mm, thickness was 4.33 ± 0.18 mm, and weight was 2.33 ± 0.12 g. In conclusion, information about the uterus of the female genital track of the Red foxes, was given in this study. We believe that the findings of this study may be useful for surgical and gynecological operations to be performed in red foxes and studies to be conducted on this subject., Kızıl tilki, tilkilerin en büyüğü ve vahşi yaşamın bir üyesi olan carnivorların en çok görülenidir. Bu çalışma ile cervix uteri, corpus uteri ve cornu uteri’nin anatomik yapısını belirlemek amaçlandı. Kafkas Üniversitesi Yaban Hayatı Kurtarma ve Rehabilitasyon Merkezi'ne (Kars, Türkiye) trafik kazası, ateşli silah yaralanması gibi çeşitli nedenlerle getirilen hayvanlar kullanıldı. Tüm müdahalelere rağmen merkez tarafından kurtarılamayan benzer yaştaki dört Kızıl tilkinin uterus’u diseke edildi. Dijital kumpas kullanılarak cervix uteri, corpus uteri ve sağ-sol cornu uteri'den ölçümler alındı. Her organ bölümünün ağırlıkları, hassas terazi kullanılarak ölçüldü. Ortalama cervix uzunluğu 11.54 ± 1.56 mm, genişliği 4.46 ± 0.52 mm, kalınlığı 5.18 ± 0.08 mm ve ağırlığı 1.18 ± 0.04 gr idi. Corpus uteri uzunluğu ortalama 20.68 ± 3.06 mm, genişliği 2.88 ± 0.50 mm, kalınlığı 2.22 ± 0.19 mm ve ağırlığı 0.90 ± 0.01 g idi. Cornu uteri'nin ortalama uzunluğu 79.85 ± 0.86 mm, genişliği 4.85 ± 0.79 mm, kalınlığı 4.33 ± 0.18 mm ve ağırlığı 2.33 ± 0.12 g idi. Sonuç olarak Kızıl tilkilerde, dişi genital sistem organlarından uterus hakkında bilgi verildi. Bu çalışmanın bulgularının kızıl tilkilerde, yapılacak olan cerrahi ve jinekolojik operasyonlar ile bu konu ile ilgili yapılacak çalışmalarda faydalı olabileceğine inanıyoruz.

Objective: A straight resection of corpus uteri using the sacrouterine ligament as landmark is a common method during supracervical hysterectomy. Subsequent spotting rates of up to 25% suggest the existence of residual endometrial glands in the remaining cervical tissue, casting doubt on the landmark qualities of the sacrouterine ligament. Fifty-one females who underwent total laparoscopic hysterectomy for benign diseases were investigated. Material and Methods: Macroscopic uterine parameters were determined during operation. First appearance of endometrium cells, complete disappearance of endometrial cells in the cervix and others were measured microscopically with reference to the external cervical orifice. Associations were described using odds ratio with 95% confidence interval and p-value

Background and Aim: Ultrasonography (USG) is useful for non-invasively identifying changes that occur in soft tissue architecture. The objective of this research was to demonstrate postpartum (PP) uterine involution through the changes of perineal muscle intensity and thickness in Madura beef cow by ultrasonography. Materials and Methods: Madura's breed cows used in the research consist of eight non-pregnant (NP) cows and three PP cow. The transrectal and transperineal USG imaging of NP cows was performed on days 1, 33, and 65. USG imaging of PP cows was performed every day starting from day 1 (24 h after parturition) until day 21 PP. Transrectal USG of the reproductive tract was performed for the cervix, corpus uteri, and cornua uteri. USG was performed transcutaneously over the perineal area for coccygeus and levator ani muscles at the longitudinal and transverse angles. Reproductive tract diameter and perineal muscle intensity and thickness were measured with ultrasound imaging. Results: The analysis of the sonogram of PP cows showed that the diameter of the cervix, corpus uteri, and cornua uteri decreased within 21 days PP. The transverse view of the coccygeus muscle of PP cows showed decreased muscle intensity and thickness. On the other hand, the longitudinal view showed increased coccygeus muscle intensity and thickness. The transverse view of the coccygeus muscle of NP cows showed increased muscle intensity, while muscle thickness was reduced. Sonogram analysis of the levator ani muscle of PP cows showed decreased muscle intensity with increasing muscle thickness. However, imaging of the levator ani muscle of NP cows showed a decrease in both intensity and muscle thickness. There was a significant difference in the mean value intensity of the scanning view analysis results of the levator ani muscle of the PP cow (523.6 AU increased to 672.1 AU) and the NP cow (515.9 AU decreased to 465.4 AU). Furthermore, there was a significant difference (p

Thema: Einfluss des Füllzustandes der Blase auf deren Dosisbelastung bei der Bestrahlung des Corpus Uteri in der Brachytherapie. Problem: Im Zuge einer Strahlentherapie ist der Schutz des umliegenden Gewebes, vor allem der an das Planungszielvolumen enganliegenden Risikoorgane, von Bedeutung. Ein Risikoorgan, welches anatomisch betrachtet sehr nah am Uterus der Frau liegt, stellt die Harnblase dar. Fragestellung: Inwiefern hat das Blasenfüllvolumen einen Einfluss auf die Dosisbelastung der Blase bei der Bestrahlung des Corpus Uteri in der Brachytherapie? Methode: Anhand einer retrospektiven Datenauswertung von 12 Patientinnen, welche sich jeweils sechs intracavitären Brachytherapiebehandlungen am Univ. Klinikum Graz unterzogen haben, wurde der Einfluss der Blasenfüllung auf die Dosisbelastung der Harnblase untersucht. Für die Analyse wurden Klassifikationen für das Füllungsvolumen der Blase, die anatomischen Form der Blase, den Längenverlaufs der Blase neben dem Applikator sowie die Volumendosis (D2cc) generiert. Ergebnisse: Es zeigt sich, dass die Mehrheit der Patientinnen interfraktionell unterschiedliche Blasenfüllvolumina hatte, wobei ein geringerer Füllzustand der Harnblase und eine Hufeisen ähnliche Blasenform sich günstig auf die Dosisbelastung der Harnblase im Zuge einer vaginalen Brachytherapie bei einem Corpus Uteri Tumor auswirkten. Die Auswertungen, bezogen auf den Längenverlauf der Blase neben den Applikator, haben keine eindeutigen Ergebnisse bezüglich einer geringeren Dosisbelastung geliefert, da sich zeigte, dass ab einer Applikatorlänge >3,5 cm kein Unterschied ersichtlich ist. Diskussion: Ein geringes Blasenvolumen ist mit niedrigeren Volumendosiswerten assoziiert. Um bei der Brachytherapie von Corpus Uteri Tumoren reproduzierbarere Blasenvolumina und damit niedrige Blasendosiswerte zu erzielen, sollte vor der Brachytherapie darauf geachtet werden, die Blase zu entleeren bzw. die Brachytherapie mit annähernd identer Blasenfüllung durchzuführen. Schlussfolgerung: Um die Ergebnisse zu stützen, sollten weitere Untersuchungen mit Fokus auf reproduzierbare Blasenvolumina (≤200 ml) durchgeführt werden. Subject: The Impact of the bladder filling on its dose load during irradiation of the corpus uteri in brachytherapy. Problem: During a treatment with radioactive sources the protection of the surrounding tissue, especially these, which are placed near the planning target volume, is significant important. One organ at risk, which is placed anatomically close to the uterus of women, is the urinary bladder. Research Question: To what extent does the bladder filling volume influence the dose exposure of the bladder during irradiation of the corpus uteri in brachytherapy? Method: Based on a retrospective data analysis of 12 female patients, who underwent intracavitary brachytherapy treatment at the local university hospital, the influence of the bladder filling on the dose exposure of the urinary bladder was investigated. For the analysis classifications were generated according to the filling volume of the bladder, the anatomical shape of the bladder, the length courses of the bladder next to the applicator and volume dose referred to the 2ml bladder volume. All collected values of all six treatment sessions per patient were evaluated in respective classifications and compared. Results: The majority of patients in this study had different bladder filling volumes between the individual fractions, whereby a small filling state of the bladder and a horseshoe-like shape of the bladder, have a beneficial impact on the dose exposure of the urinary bladder during the vaginal brachytherapy treatment on the corpus uteri. The evaluation related to the length of the urinary bladder next to the applicator did not deliver any clear results regarding a lower dose exposure. Furthermore, it has shown that no difference can be noted above a length greater than 3.5 cm. Discussion: A small bladder volume is associated with lower volume dose values. To achieve more reproducible bladder volumes and with this to provide low bladder dose values during the brachytherapy of corpus uteri tumours, care should be taken to empty the bladder before brachytherapy or to carry out the brachytherapy with almost identical bladder filling. Conclusion: To support these results, further studies with a similar design and focus on reproducible bladder volumes (≤ 200 ml) are recommended. Viktoria Reisinger Abweichender Titel laut Übersetzung der Verfasserin/des Verfassers Bachelorarbeit FH JOANNEUM 2022

Endometrial cancer is the most common gynecological malignancy in high- and middle-income countries. Although the overall prognosis is relatively good, high-grade endometrial cancers have a tendency to recur. Recurrence needs to be prevented since the prognosis for recurrent endometrial cancer is dismal. Treatment tailored to tumor biology is the optimal strategy to balance treatment efficacy against toxicity. Since The Cancer Genome Atlas defined four molecular subgroups of endometrial cancers, the molecular factors are increasingly used to define prognosis and treatment. Standard treatment consists of hysterectomy and bilateral salpingo-oophorectomy. Lymphadenectomy (and increasingly sentinel node biopsy) enables identification of lymph node-positive patients who need adjuvant treatment, including radiotherapy and chemotherapy. Adjuvant therapy is used for Stage I-II patients with high-risk factors and Stage III patients; chemotherapy is especially used in non-endometrioid cancers and those in the copy-number high molecular group characterized by TP53 mutation. In advanced disease, a combination of surgery to no residual disease and chemotherapy with or without radiotherapy results in the best outcome. Surgery for recurrent disease is only advocated in patients with a good performance status with a relatively long disease-free interval. ispartof: INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS vol:155 issue:Suppl 1 pages:45-60 ispartof: location:United States status: published

Objective: to identify the threshold values of FoxP3, CD56, PGRMC1, and Galectin-1 expression, to analyze the survival rate of female patients based on the obtained threshold values, to determine the statistical differences in groups depending on the presence/absence of radiotherapy.Mаteriаl аnd methods. The group with radiotherapy (LT+) included 42 female patients, the group without radiotherapy (LT-) included 38. The ROC-analysis was performed to determine the threshold values. The analysis of the survival rate was performed using the logrank test. The groups were compared using the tables 2×2 (Fisher's twosided test), as well as the odds ratio (OR) was calculated. The differences were considered statistically significant at p < 0.05.Results. The study of the Galectin-1 parenchymatous expression showed that statistically significant differences (pConclusion. At a low relapsefree survival rate, a statistically significant increase above the threshold values of the parenchymatous (p < 0.0001) and stromal (p = 0.0002) Galectin-1 expression was observed most frequently.

Background: Hysterectomy is the most common surgery performed in gynaecological practice, sometimes considered a lifesaving procedure in women, which also improves the quality of life for women with certain uterine pathologies such as fibroids, endometriosis, uterine prolapse and various types of cancer. The diagnostic value of histopathological examination is well explained and enables determination of origin of a particular benign or malignant lesion and in the latter, where adjuvant treatment is dependent upon grade and extent of invasion of disease. Aims: To study the histomorphological spectrum of lesions of corpus uteri in hysterectomy specimens and their distribution in different age groups along with clinicopathological correlation. Materials and Methods: The present study comprised of 450 hysterectomy specimens with lesions in the corpus uteri, received in the Department of Pathology, Navodaya Medical College, Raichur, during 5 years from October 2012 to September 2017. All the specimens were subjected to histomorphological study and clinical correlation was made. Results: The commonest type of hysterectomy was abdominal hysterectomy (84%) with the peak age incidence in 5th decade (45.33%). Most common clinical diagnosis was fibroid uterus (45.55%) and pathological diagnosis was leiomyoma (59.33%) and malignancy being endometrial carcinoma (2.67%). Clinicopathological correlation was observed in 46% of cases, commonly among malignant lesions (87.5%), when compared to benign lesions of corpus uteri (65.16%). Conclusion: The study emphasizes on histomorphological evaluation of lesions in hysterectomy specimens and is mandatory as various benign and malignant conditions occur with increasing frequency and carries diagnostic and therapeutic significance and should be done in all cases for confirming the preoperative clinical diagnosis and thus ensuring a better postoperative outcome.

Insufficient physical activity is a known risk factor for various co-morbidities, including cancer. Globally, its prevalence has increased markedly over the past decades. The aim of this study was to estimate the proportion and number of cancers that were attributable to insufficient physical activity in France in 2015.Population attributable fractions (PAFs) and numbers of cancer cases attributable to insufficient physical activity (30 min daily of moderate-to-vigorous physical activity) were estimated by age, sex and cancer site. Assuming a 10-year lag-period, PAFs were calculated using physical activity prevalence from a cross-sectional French population survey and cancer-specific relative risks.About half of all French adults were found to be insufficiently physically active, with great variation by age and sex. In 2015, an estimated 2973 cancer cases diagnosed in French adults aged 30y+ were attributable to insufficient physical activity, corresponding to 0.8% of all cancer cases (0.2% in men and 1.6% in women). This comprised 3.8% of all postmenopausal breast cancers (1620 cases), 3.6% of all colon cancers (902 cases) and 6.0% of all cancers of the corpus uteri (450 cases). If at least half of the recommended physical activity level was achieved, 1095 cancer cases could have been avoided.Insufficient physical activity is associated to about 3000 cancer cases in France, a country with comparatively low but increasing prevalence of this risk factor. This result is important for setting priorities in cancer prevention programmes aiming to increase physical activity in France and Europe in general.

Aim. This study was designed to determine the relationship between pregnancy-associated protein A (PAPP-A), placenta localization and fetal birth weight (FBW).Materials and methods. First trimester PAPP-A levels, second trimester placental localization and birth weights of 1145 infants were obtained through a retrospective review of the patient follow up charts in Koru Hospital. Serum PAPP-A levels were recorded as the multiple of median (MоM) values, the FBW values of infants were recorded in grams, and the placental localization was recorded under seven different pre-defined categories: 1. placenta anterior; 2. placenta posterior; 3. placenta fundal; 4. placenta fundal-anterior; 5. placenta fundal-posterior; 6. placenta lateral-right; 7. placenta lateral-left. The data were analyzed using the Statistical Package for Social Sciences (SPSS) program (SPSS Inc., Chicago, IL, USA).Results.There was no significant difference between the FBW and PAPP-A levels. The comparison of seven placental localizations shows that the anterior and posterior localizations have an impact on FBW of the infants.Conclusion. The FBW was highest in the cases where the placenta was located in the corpus uteri. We believe this finding is consistent with the fact that the corpus uteri receives the largest blood supply.

Background: The corpus uteri and ovarian cancers burden in Lithuania has remained high. The aim of this study was to investigate time trends in mortality rates of corpus uteri and ovarian cancer in Lithuania across age groups and time periods over a 30-year time span. Materials and Methods: Data on numbers of deaths from corpus uteri cancer during the period 1987&ndash, 2016 and ovarian cancer during the period 1993&ndash, 2016 were obtained from the WHO mortality database. Trends in age-standardized mortality rates (ASR, world standard), and age-specific rates were analyzed by calculating annual percentage change using Joinpoint regression. In addition, age&ndash, period&ndash, cohort analysis was performed for each cancer type. Results: Mortality from corpus uteri cancer decreased by &minus, 1.2% (95% CI: &minus, 1.8, &minus, 0.7) annually from 1987 to 2016. Decrease was most pronounced in youngest age group of 40&ndash, 49 years, annual percentage change was &minus, 2.4 (95% CI: &minus, 4.0, 0.9). Mortality rates for ovarian cancers decreased by &minus, 1.6, 0.8) annually from 1993 to 2016. Corpus uteri and ovarian cancer ASRs in 2016 were 3.5/100,000 and 7.4/100,000, respectively. The age&ndash, cohort analysis suggests that temporal trends in corpus uteri cancer mortality rates could be attributed to period and cohort effects. Conclusion: A reduction in mortality rate was observed for corpus uteri and ovarian cancer over the entire study period. Similar decreasing pattern for corpus uteri and ovarian cancer mortality indicate effect of shared factors.

BackgroundExtraovarian Brenner tumors (EOBTs) are extremely rare and can be observed incidentally in both female and male patients, raising concerns regarding the origin of Brenner tumors.Case presentationA 53-year-old postmenopausal woman presented with a nodular lesion in the left side of the corpus uteri, which was found at a routine health check. Macroscopically, the lesion appeared as a solid nodule with a yellowish-gray cut surface, approximately 6 cm in greatest diameter. Microscopically, the lesion consisted of well-defined epithelial nests and spindled stromal cells. Parenchymal cells expressed CK7, GATA3, CK5/6, 34βE12, and p63. A single layer of cavity-lined cells with umbrella-like shape showed apical Uroplakin III positivity. Stromal cells were positive for SMA, ER, and PR. The final diagnosis was EOBT and the patient was followed for 2 months with no recurrence.ConclusionsWe report here the third case of EOBTs in the uterus. The combination of morphologic and immunohistochemical results supported the involvement of urothelial metaplasia in the development of EOBTs. The similarities between EOBTs and Walthard nests made Müllerian epithelium an attractive candidate as the cellular origin. Changes of tissue structure or sex hormones imbalance may lead to the translocation of Müllerian remnants to distant organs, explaining the pathogenesis of EOBTs.

Objective: To investigate treatment and survival over three decades. Methods: Clinical registry data from three major public hospitals analysed using Kaplan–Meier product-limit estimates and multivariate proportional hazard regression to determine disease-specific survival. Results: Five-year survival increased from 75% to 84%. The adjusted hazard ratio (HR, 95% CI) was 0.56 (0.41, 0.77) for 2010–2016 compared with 1984–1989 and was higher for: ages 80+ years; more advanced stages; poorly differentiated tumours; and complex mixed epithelial and mesenchymal tumours and sarcomas. Treatment was by surgery (92%), radiotherapy (33%), chemotherapy (12%) and hormone therapy (10%). Adjusted analyses showed radiotherapy and hormone therapy were less common from 1990 and chemotherapy more common for 2010–2016. Treatment likelihood was lower for ages ≥80 years, mixed epithelial and mesenchymal tumours receiving surgery and chemotherapy, but higher for radiotherapy. Advanced cancers (FIGO stage IV) had less surgery but more non-surgical treatments. Marginal evidence presented of more hormone therapy for high socio-economic areas. Conclusions: Survival was equivalent to national figures for Australia and the United States, but potentially higher than for England and Wales. Cases aged 80+ years had less care and poorer survival. Findings illustrate the complementary roles of hospital and population-based registries in local service evaluation Refereed/Peer-reviewed

The objective of this study was (1) to describe the US appearance and obtain reference values for the uterus and ovaries in nongravid and gravid queens with histologically confirmed reproductive tracts without disorders, (2) to provide US measurements of the reproductive tract compared to gross macroscopic and water-bath post-OVH US measurements in nongravid queens, and (3) to describe the sonographic appearance of the female reproductive tract during the different histopathologic phases of the reproductive cycle in nongravid and gravid queens. Ninety-three queens from a "trap, neuter, return" program were included in this study. Sonographic evaluation of the reproductive tract was performed in all queens, and measurements of the corpus uteri, uterine horns, and ovaries were recorded. Following OVH, macroscopic measurements were obtained, and a water-bath US evaluation of these tissues and measurements was recorded. Samples from the corpus uteri and both the uterine horns and ovaries were collected for histopathologic examination after all measurements had been recorded. Seventy-two reproductive tracts met the inclusion criteria by having a histopathologically confirmed normal reproductive tract. Sixty-three queens were nonpregnant and 9 were pregnant. The ovaries and uterus were sonographically visible in all queens regardless of reproductive status. The ovaries were ovoid in shape, and the uterus appeared as a tubular structure with distinct wall layers (serosa and indistinct myometrium and myometrium, or serosa, myometrium, and endometrium), with variable echogenicity of the inner layers. The layering of the uterine wall, observed during the second half of pregnancy, was described. Ovarian follicles were visible in 66/72 (92%) cats. However, the CL was only visible in 40/72 (55%) cats. The reference values of the left ovarian length, right ovarian length, uterine horn diameter, and uterine body are 7.1-13.9, 7.3-13.6, 1-5.8, and 1.5-5.3 mm, respectively, in a nongravid uterus. The uterine wall thickness during pregnancy varied from 2.4 to 6.8 mm. There was a significant positive correlation between US measurements obtained in vivo and those obtained macroscopically and in a water bath post-OVH. The body weight, follicular size, sonographic visibility of the uterine wall layering, the histopathologic luteal phase, and the active/inactive status on histopathology had a significant effect on the uterine measurements (p 0.05). It was not possible to describe the exact US features of the reproductive tract during the different histopathologic phases. In conclusion, ultrasonographic reference values for the normal female reproductive tract in cats were determined. The results of this study indicated that the ovaries and uterus were visible in cats regardless of reproductive status.

Objective : to identify correlative interrelations among the parameters of the tumor microenvironment of endometrioid adenocarcinoma and relative risk of its prognosis. Material and methods. Immunohistochemic and morphometric studies were performed on the histological material of 60 patients. Results. Correlative interrelations were revealed among the studied parameters in groups with favorable and unfavorable outcomes. Relative risks for progression of endometrioid adenocarcinoma of the corpus uteri were determined. Conclusion. The revealed differences in the interrelations among morphological and immunohistochemical parameters in female patients with endometrioid adenocarcinoma of the corpus uteri of different survival potential reflect biological features of the tumorous growth and the disease progression.

To evaluate trends in contemporary robotic surgery across multiple organ sites as they relate to robotic prostatectomy volume. We queried the National Cancer Database for patients who underwent surgery from 2010 to 2013 for prostate, kidney, bladder, corpus uteri, uterus, cervix, colon, sigmoid, rectum, lung and bronchus. The trend between volumes of robotic surgery for each organ site was analyzed using the Cochran–Armitage test. Multivariable models were then created to determine independent predictors of robotic surgery within each organ site by calculating the odds ratio with 95% CI. Among the 566,399 surgical cases analyzed, 35.1% were performed using robot assistance. Institutions whose robotic prostatectomy volume was in the top 75 percentile compared to the bottom 25 percentile performed a larger percentage of robotic surgery on the following sites: kidney 32.6 vs. 28.8%, bladder 23.6 vs. 18.6%, uterus 52.5 vs. 47.7%, cervix 43.5 vs. 39.2%, colon 3.2 vs. 2.9%, rectum 10.7 vs. 8.9%, and lung 7.3 vs. 6.8% (all p

OBJECTIVE:To estimate the prevalence of corpus uteri, cervix uteri, and ovarian malignancy in women undergoing hysterectomy or myomectomy for presumed benign indications.METHODS:We conducted a secondary analysis of data from the 2014–2015 American College of Surgeons National Surgical Quality Improv

Background Medical circumstances in Japanese patients with cancer of the corpus uteri have greatly changed since the late 1990s, including the introduction of concomitant therapy with taxane and platinum. We evaluated changes in survival rates for this cancer following these advances by analyzing data from population-based cancer registries in Japan. Methods Data were available for 8562 cases of cancer of the corpus uteri from six prefectural cancer registries. We defined the two periods of 1993-2000 (1st period) and 2001-2006 (2nd period). Relative survival (RS) in each period was calculated to assess changes using an excess mortality model, with adjustment for age group (15-54, 55-69, and 70-99 years), extent of disease (localized, regional, and distant), and histological subtype. Results Overall 5-year RS improved from 77.7% in the 1st period to 80.2% in the 2nd period, with an excess hazard ratio (EHR) of 0.785 (95% confidence interval [CI], 0.705-0.873). Five-year RS significantly improved in the group aged 55-69 years, in all groups by extent of disease, and in the endometrioid adenocarcinoma group. In particular, 5-year RS significantly improved in patients with endometrioid adenocarcinoma, from 84.5% to 89.7%, with an EHR of 0.698 (95% CI, 0.560-0.870). Conclusion Overall 5-year RS for cancer of the corpus uteri in Japan improved from the 1990s to early 2000s. These improvements might have been aided by the comprehensive medical development of management for this cancer, including the spread of concomitant therapy with taxane and platinum as a standard adjuvant chemotherapy in the early 2000s.

This experiment was performed to assess reliability of the cytobrush-cytology method (CCM) in diagnosis of subclinical endometritis (SCE) using the biopsy-histopathology method (BHM) as a reference in late lactating dairy cows. Reproductive organs were collected from 115 slaughtered multiparous crossbred cows culled due to infertility 398 ± 135 days subsequent to parturition. Samples were collected from the dorsal part of the corpus uteri for analyses. Inflammation status was graded histopathologically based on the cell percentages [(neutrophils, eosinophils, lymphocytes (LYM), macrophages (MAC), and plasma cells)]. Data were subjected to Friedman's test for group comparisons (method and diagnosis), concordance correlation and chi-square tests for consistency of results among methods, and the receiver operating characteristics curve analysis for reliability of the CCM. Percentages of LYM (2.67x) and MAC (3.00x) were greater when evaluated using BHM than with CCM (P 0.05 for both). The agreement (Cohen's κ value) of results among methods was 0.79 ± 0.06. The sensitivity (Se) and specificity (Sp) of the CCM for defining endometrial inflammation were 79.3% and 100%, respectively. Among inflammatory cells, proportions of LYM and MAC in the CCM had merit for evaluation of uterine inflammation, with an Se of 74.1 and 84.5 and an Sp of 93.0 and 75.4 at the cut-off 4 and 0, respectively. The results indicate the CCM may be used in the diagnosis of SCE when the LYM and MAC percentages are considered in chronically infertile cows in the later stages of the lactational period.

Uterine diffuse large B-cell lymphoma (DLBCL) is a rare clinical condition. Most studies for uterine DLBCL are derived from case reports and series. Our main objective was to present a new case while also investigating the demographic, clinical characteristics, and survival of women with primary uterine DLBCL as compared to non-uterine DLBCL using the Surveillance, Epidemiology, and End Results incidence database. We queried the Surveillance, Epidemiology, and End Results database for women aged 18 years or older with a diagnosis of primary DLBCL from 1975 to 2017. The most common site of primary uterine DLBCL is the cervix uteri not otherwise specified, followed by endometrium, uterus not otherwise specified, corpus uteri, myometrium and isthmus uteri. Non-uterine DLBCL cases tend to be older than uterine DLBCL cases. Uterine DLBCL is most common among women aged 40 to 64 years. Patients with uterine DLBCL showed greater survival than non-uterine DLBCL patients, and patients treated in the rituximab era also exhibited a survival benefit. Both the elderly and African American cohorts experienced worse overall survival.

This is the second well documented case of paraneoplastic Cushing’s syndrome arising from a small cell carcinoma of the endometrium described in English literature. This tumour has an aggressive biological behaviour and early detection provides the only opportunity for long-term survival. In that regard recognition of associated paraneo- plastic features might be helpful.

Objectives. Compliance of physicians with guidelines has emerged as an important indicator for quality of care. We evaluated compliance of physicians with adjuvant therapy guidelines for endometrial cancer patients in the Netherlands in a population-based cohort over a period of 10 years.Methods. Data from all patients diagnosed with endometrial cancer between 2005 and 2014, without residual tumor after surgical treatment, were extracted from the Netherlands Cancer Registry (N = 14,564). FIGO stage, grade, tumor type and age were used to stratify patients into risk groups. Possible changes in compliance over time and impact of compliance on survival were assessed.Results. Patients were stratified into low/low-intermediate (52%), high-intermediate (21%) and high (20%) risk groups. Overall compliance with adjuvant therapy guidelines was 85%. Compliance was highest in patients with low/low-intermediate risk (98%, no adjuvant therapy indicated). The lowest compliance was determined in patients with high risk (61%, external beam radiotherapy with/without chemotherapy indicated). Within this group compliance decreased from 64% in 2005-2009 to 57% in 2010-2014. In high risk patients with FIGO stage III serous disease compliance was 55% (chemotherapy with/without radiotherapy indicated) and increased from 41% in 2005-2009 to 66% in 2010-2014.Conclusion. While compliance of physicians with adjuvant therapy guidelines is excellent in patients with low and low-intermediate risk, there is room for improvement in high risk endometrial cancer patients. Eagerly awaited results of ongoing randomized clinical trials may provide more definitive guidance regarding adjuvant therapy for high risk endometrial cancer patients. (C) 2017 Elsevier Inc. All rights reserved.

To investigate the features of expression of extracellular matrix metalloproteinase inducer (EMMPRIN) and the matrix metalloproteinase MMP-1 in the cervix uteri and corpus uteri in cervical squamous cell carcinoma (CSCC).The investigation was conducted using the surgical material obtained after hysterectomy in patients diagnosed as having CSCC. RT-PCR, immunohistochemistry (IHC), and enzymatic assays were used.The high expression of EMMPRIN and MMP-1 in CSCC was found not only in cervical carcinoma, but also in the stroma and epithelium of the cervix uteri and corpus uteri outside the tumor, whereas the level of MMP-1 expression in the morphologically intact tissue was significantly lower than in the tumor, while that of EMMPRIN gene expression did not differ substantially.The expression of EMMPRIN and MMP-1 in CSCC occurs in both the tumor and the morphologically intact tissue, which may suggest that the invasive potential of tumor may increase and therefore have prognostic value.Цель исследования - изучить особенности экспрессии индуктора экспрессии ММП - EMMPRIN и матриксной металлопротеиназы - ММП-1 в шейке и теле матки при цервикальной плоскоклеточной карциноме. Материал и методы. Исследование проводили на операционном материале, полученном после экстирпации матки у пациенток с диагнозом: плоскоклеточный рак шейки матки (ПРШМ). Использованы метод ОТ-ПЦР, иммуногистохимический и энзиматический методы. Результаты. Установлено, что высокая экспрессия EMMPRIN и ММП-1 при ПРШМ обнаружена не только в карциноме шейки матки, но также в строме и эпителии шейки и тела матки вне опухоли, причем уровень экспрессии ММП-1 в морфологически нормальной ткани значимо ниже, чем в опухоли, в то время как уровень экспрессии генов EMMPRIN существенно не отличался. Заключение. Экспрессия EMMPRIN и ММП-1 при ПРШМ происходит как в опухоли, так и в морфологически нормальной ткани, что может свидетельствовать об усилении инвазивного потенциала опухоли и, следовательно, иметь прогностическое значение.

Background: The present study aims to assess the incidence and mortality rates of gynecological cancers and their changes from 1990 to 2016 at national and subnational levels in Iran. Methods: Annual estimates of incidence and mortality for gynecological cancers from 1990 to 2016 at national and subnational levels were generated as part of a larger project entitled National and Subnational Burden of Diseases, Injuries, and Risk Factors (NASBOD). After the precise processing of data extracted from the Iran Cancer Registry, annual age-standardized incidence and mortality rates were calculated for each cancer, province, year and age group during the period of the study. Results: In 2016, gynecological cancers constituted 8.0% of new cancer cases among women of all ages compared to 3.7% of new cases of cancer among women in 1990. The incidence rate of gynecological cancers has increased from 2.5 (0.9-5.6) per 100000 women in 1990 to 12.3 (9.3–15.7) per 100000 women in 2016, and the most common gynecological cancer has changed from cervical cancer in 1990 to corpus uteri cancer in 2016. Age-standardized incidence rates of ovarian, corpus uteri and vulvovaginal cancers increased from 1.3 (0.5–2.4), 1.7 (0.6–3.0), and 0.3 (0.0–0.7) in 1990 to 4.4 (3.6–5.2), 9.9 (6.8–13.4), and 0.6 (0.2–1.0) in 2016, respectively, showing a 3.3, 5.8 and 1.7-fold increase during this period. Age-standardized incidence rate of cervical cancer was 2.4 (1.7–3.3) cases per 100000 women in 2016 and did not differ significantly from the beginning of the study. An overall reduction was seen in national mortality to incidence ratios (MIR) from 2000 to 2015. Conclusion: The incidence rates of all gynecological cancers in different provinces have shown a converging trend that could indicate that attempts toward health equality have been effective. The declining trend of MIR could be interpreted as advancements in detection of cancer in its early stages and also improvements in treatments, in turn reflecting improvements in access to and quality of care.

Utilization of liquid biopsy in the management of cancerous diseases is becoming more attractive. This method can overcome typical limitations of tissue biopsies, especially invasiveness, no repeatability, and the inability to monitor responses to medication during treatment as well as condition during follow-up. Liquid biopsy also provides greater possibility of early prediction of cancer presence. Corpus uteri mesenchymal tumors are comprised of benign variants, which are mostly leiomyomas, but also a heterogenous group of malignant sarcomas. Pre-surgical differentiation between these tumors is very difficult and the final description of tumor characteristics usually requires excision and histological examination. The leiomyomas and malignant leiomyosarcomas are especially difficult to distinguish and can, therefore, be easily misdiagnosed. Because of the very aggressive character of sarcomas, liquid biopsy based on early diagnosis and differentiation of these tumors would be extremely helpful. Moreover, after excision of the tumor, liquid biopsy can contribute to an increased knowledge of sarcoma behavior at the molecular level, especially on the formation of metastases which is still not well understood. In this review, we summarize the most important knowledge of mesenchymal uterine tumors, the possibilities and benefits of liquid biopsy utilization, the types of molecules and cells that can be analyzed with this approach, and the possibility of their isolation and capture. Finally, we review the typical abnormalities of leiomyomas and sarcomas that can be searched and analyzed in liquid biopsy samples with the final aim to pre-surgically differentiate between benign and malignant mesenchymal tumors.

Mesenchymal tumours of the corpus uteri comprise common benign lesions - leiomyomas and very rare malignant variants - sarcomas. It can be difficult to distinguish between the particular types of mesenchymal tumours pre-surgically. Primarily, leiomyomas and the very aggressive leiomyosarcomas can be easily misdiagnosed when using only imaging devices. Therefore, a reliable non-invasive marker for these tumour types would provide greater certitude for patients that the lesion remains benign. Our collection comprises 76 native leiomyomas, an equal number of healthy myometrium samples and 49 FFPE samples of various types of sarcomas. The methylation level was assessed by MS-HRM method and we observed differences in the methylation level between healthy, benign and (semi)malignant tissues in the KLF4 and DLEC1 genes. The mean methylation levels of leiomyomas compared to myometrium and leiomyosarcomas were 70.7% vs. 6.5% vs. 39.6 % (KLF4) and 66.1% vs. 14.08% vs. 37.5% (DLEC1). The ATF3 gene was differentially methylated in leiomyomatous and myometrial tissues with 98.1% compared to 76.6%. The AUC values of the predictive logistic regression model for discrimination between leiomyomas and leiomyosarcomas based on methylation levels were 0.7829 (KLF4) and 0.7719 (DLEC1). Finally, our results suggest that there should be distinct models for the methylation events in benign leiomyomas and sarcomas, and that the KLF4 and DLEC1 genes can be considered potential methylation biomarkers for uterine leiomyomas.

Disorders of development, fusion, or resorption of paired müllerian ducts and urogenital sinus may cause various congenital malformations of the corpus uteri, cervix, vagina, and fallopian tubes. Classification systems have been developed to better characterize these anomalies, and each has advantages and disadvantages. Clinical correlation of classification of anomalies with pre- and postsurgical outcomes is needed to better direct treatment. Methods to evaluate these anomalies are primarily radiologic studies, with diagnostic surgery rarely used. Treatment of müllerian anomalies used to focus on relief of symptoms. Now, as diagnostic and surgical options have expanded, preservation or improvement of reproductive potential is a primary goal. As a consequence, controversies in surgical management have also developed. Future directions in this field include better-quality studies with the use of consistent diagnostic criteria to evaluate impacts of treatment on clinical outcomes.

Carcinosarcomas are rare and aggressive tumour consisting of both carcinomatous and sarcomatous elements within same tumour. These tumours are supposed to arise from monoclonal proliferation of epithelial component. Carcinosarcoma of the uterus account for 2-5% of all uterine malignancies. They typically present with abnormal vaginal bleeding and may present with bloody discharge, abdominal pain or abdominal mass. Hereby a case report of a 60-year-old post-menopausal female presenting with painless lump abdomen progressively increasing in size has been described. Ultrasonography revealed a large solid-cystic mass in left adnexa. Total hysterectomy with bilateral salpingo-oophorectomy was performed. Histological examination of specimen revealed carcinosarcoma of uterus with left adnexal metastasis and left ovarian endometriotic cyst.

The present study examines anatomy of Gayo mare reproductive organs. This study used three sample of Gayo mare reproductive organs (n= 3) for observation of morphology and morphometric of the mare reproductive organs. The ovarium was fixed in 4% paraformaldehyde solution then followed by histological method and stained using hematoxylin and eosin (HE) and Masson’s trichome (MT). Three mares were observed for diameter and changes overview of uterus during estrous cycle in real time using ultrasound. The results showed that, in general, the anatomy of Gayo mare’s reproductive organs was similar to other mares, but smaller in morphometry. The total length of the Gayo mare’s reproductive tract from labia to apex cornua was 48.00±1.00 cm. Weight of Gayo mare’s left ovary was 19.07±7.70 g and the right was 24.43±0.83 g. Histologically, there was no difference between Gayo mare’s structure and other mares. In cortex uteri there were some follicles surrounded by capillary, various development stages of follicles, healthy follicles, atretic follicle, and corpus albican; while in medulla there were a lot of connective tissues. Ultrasound of the uterus showed the change in diameter during estrous cycle with the largest diameter of corpus uteri was 4.43±0.10 cm in horses with estrous cycle of 21 days and 6.30±0.93 cm in horses with 24 days estrous cycle. In conclusion, the morphometry of Gayo mare reproductive organs are smaller than the other horses and there are differences in diameter of the uterus during the estrous cycle due to the changes of endometrium thickness.

Introduction The objective of this study was to examine the allowable warm ischemic time and pathological changes due to ischemia and reperfusion injury in the uterus of the cynomolgus monkey as a model for uterus transplantation. Material and methods Six female cynomolgus monkeys were used in the study. The uterus was resected from the vaginal canal and connected through the bilateral ovarian and uterine arteries and veins only. One animal was used as a control. In the other five animals, the bilateral uterine and ovarian vessels were clamped for 0.5, 1, 2, 4 and 8 h, respectively. Biopsy of the smooth muscle tissue of corpus uteri was performed after each ischemic time and after subsequent reperfusion for 3 h. Biopsy samples were observed by light and electron microscopy. Menstruation recovery was monitored. Results There were no particular findings in both light and electron microscopy after ischemia for up to 2 h and after subsequent reperfusion. There were no marked changes after ischemia for 4 h, but dilated nuclear pores and rough endoplasmic reticulum swelling were found after reperfusion. These changes also occurred, along with mitochondrial swelling and cristae loss after ischemia for 8 h, and plasma membrane loss, nuclear fragmentation and chromatin condensation were found after reperfusion. Periodical menstruation restarted in all animals with ischemia up to 4 h, but the animal with ischemia for 8 h had amenorrhea and uterine atrophy. Conclusions The uterus of the cynomolgus monkey tolerates warm ischemia for up to 4 h.

Context: Extra-nodal diffuse large B-cell lymphoma (DLBCL) affecting the uterus is a rare entity. Most of the epidemiology and prognosis for uterine DLBCL is derived from case reports and series. Objective: Our main objective was to investigate the demographics, clinical characteristics, and survival of women with primary uterine DLBCL using a multi-institutional database. Design: We retrospectively queried for women with DLBCL of the uterus from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database from 1975–2017. Setting: Public database. Patients or other participants: All women with diagnosis of DLBCL of uterus. Interventions: N/A Main outcome measures: Demographic, clinical characteristics, and survival of women with primary DLBCL of uterus. We also looked at survival difference in the rituximab era (before vs after 1997). Results: A total of 223 cases were identified in the database. The primary sites were cervix uteri NOS (56.1%), endometrium (17.9%), uterus NOS (17.0%), corpus uteri (6.3%), myometrium (1.8%), and isthmus uteri (1.9%). Most women were between 40–64 years (45.7%) and 35.4% were >65 years. Uterine DLBCL patients tended to be younger compared to non-uterine DLBCL cases (P Conclusions: Uterine DLBCL is a rare presentation of DLBCL. The most common site of uterine DLBCL is cervix uteri. Most women affected are between 40–64 years of age. Survival in patients with uterine DLBCL was superior in comparison to patients with non-uterine DLBCL cases.

To reveal the morphological characteristics of simultaneously diagnosed leiomyoma of the corpus uteri and vulva.The paper describes a case of multiple uterine leiomyomas concurrent with vulvar leiomyoma in a 39-year-old patient with progressive tumor nodule growth over 2 years. Vulvar tumor was biopsied simultaneously with extirpation of the uterus; vulvar leiomyoma was removed six months later. Histological and immunohistochemical studies: such as hematoxylin and eosin staining, the expression of smooth muscle actin, desmin, and progesterone and estrogen receptors, S100, CD10, and determination of Ki-67 proliferation index, were conducted.The largest (14-cm) multiple tumor nodule in the corpus uteri had the structure of leiomyoma of uncertain malignant potential; the large (8-cm) vulvar tumor was a leiomyoma with hyalinosis. The immunohistochemical profile of uterine and vulvar leiomyoma (smooth muscle actin+, desmin+, progesterone+, estrogen+ receptors, CD117-, and Ki-67) was the same (1-3%). The vulvar leiomyoma was assumed to be a tumor of metastatic origin.Vulvar leiomyoma is rare; it can arise from smooth muscle tissue of various anatomical structures of the skin and soft tissues. The pathogenesis of the so-called metastatic leiomyoma is unclear; there are concepts of a metaplastic transformation of subcelomic mesenchyme and multifocal smooth muscle proliferation. The presented case demonstrates the synchronous development of uterine and vulvar leiomyoma.Цель исследования - выявить морфологические особенности лейомиомы тела матки и лейомиомы вульвы, диагностированные одновременно. Материал и методы. Представлено наблюдение множественной лейомиомы тела матки в сочетании с лейомиомой вульвы у пациентки 39 лет с прогрессивным ростом опухолевых узлов в течение 2 лет. Биопсия опухолевого образования вульвы выполнена одновременно с экстирпацией матки, лейомиома вульвы удалена через полгода. Проведены гистологическое и иммуногистохимическое исследования: окраска гематоксилином и эозином, экспрессия гладкомышечного актина, десмина, рецепторов прогестерона и эстрогена, S100, CD10, а также определение индекса пролиферации Ki-67. Результаты. Наибольший из множественных опухолевых узлов тела матки (14 см) имел строение лейомиомы с неясным злокачественным потенциалом, опухоль вульвы больших размеров (8 см) - лейомиома с гиалинозом. Иммуногистохимический профиль лейомиомы тела матки и вульвы был одинаков: гладкомышечный актин+, десмин+, рецепторы к прогестерону+, эстрогену+, CD117-, Ki-67 1-3%. Предположено метастатическое происхождение лейомиомы вульвы. Заключение. Лейомиома вульвы встречается редко, может развиваться из гладкомышечной ткани различных анатомических структур кожи и мягких тканей. Патогенез так называемой метастатической лейомиомы неясен, существуют концепции метапластической трансформации субцеломической мезенхимы и мультифокальной гладкомышечной пролиферации. Представленное наблюдение демонстрирует синхронное развитие лейомиомы тела матки и вульвы.