Search

Rapidly increase of medical diagnosis and assiduous depiction of imaging findings led to proper therapeutic mapping among clinical entities. In most of cases, especially in surgical controversial issues, use of endoscopic expertise increase potential therapeutic strategy. Neoplasms of the ampulla of Vater are uncommon, with a reported prevalence of 0.04% to 0.12%. Advances in endoscopy during the last 30 years have rendered endoscopic papillectomy (EP) a safe and less invasive therapeutic modality for small, benign periampullary tumors. Aim of our study, consists depiction of our surgical implementation in 5 cases (4 males and 1 female patients) of papillary adenomas accompanied with proper diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Molar pregnancy, also known as hydatidiform mole, represents a figuration of noncancerous (benign) tumor, originating from uterus. After the fertilization instead of a viable and well-growing pregnancy, there is an increasing and pathologic production of placental cysts. According to the completion of the cysts, molar pregnancy can be divided into a complete and an incomplete (partial) form. Molar pregnancy can be located inside the uterine cavity or can be invasive with malignant complications. A small percentage can be malignant transformed, undergoing gestational trophoblastic neoplasias (GNT). GNT are classified histologically into three distinct sub-groubs: choriocarcinoma destruens (invasive mole), choriocarcinoma(CC), and the very rare placental site trophoblastic tumor (PSTT). The authors present a case of a 27 year-old female patient in the 2nd trimester of gestation successfully diagnosed and treated as invasive molar pregnancy. [ABSTRACT FROM AUTHOR]

Ovarian fibroma represents the commonest benign tumor of the ovarian stroma. The cellular fibroma is a tumor of uncertain malignant potential that may recur or be associated with peritoneal implants. Usually these are solid tumors, sometimes with small areas of cystic degeneration. The authors present a case of a 70-year-old female patient with an enormous cellular ovarian fibroma located at the region of the right adnexa. The aim of this study consists of the presentation, dissection, and proper management of this rare histologic subtype of ovarian tumor. [ABSTRACT FROM AUTHOR]

Within the last decades, the percentage of diagnosed cervical cancer in women of reproductive age has increased. The possibility of diagnosing small cervical tumors (≤ twocm) in childbearing age, can be explained due to the fact that many women, are aware of the benefits of Pap smear or colposcopy examination. Many demand a more conservative policy to handle such lesions in order to have an uneventful pregnancy in the near future. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate the effect of tamoxifen on the endometrium of 45 postmenopausal women with breast cancer, as evidenced by hysteroscopic, ultrasound, histological methods, and by immunohistochemical investigation of the expression of Bel-2 and Ki67. Materials and Methods: Forty-five postmenopausal women with breast cancer (ER and/or PgR positive) undergoing tamoxifen therapy for six to 48 months, were selected from the files of the 2nd Department of Obstetrics and Gynecology, University of Athens Aretaieion Hospital, among a total of 120 patients treated from 2004-2009. Results: The ultrasound findings during the follow-up period revealed 18 cases of thickened endometrium, 14 cases of suspected polyps, one case with accumulation of endometrial fluid, and 12 cases of heterogeneous endometrial echo texture. The patients had undergone hysteroscopy because of thickened endometrium (18/45 patients), postmenopausal bleeding (14/45 patients), and polyps (13/45 patients). The endometrial tissue samples were examined in the Pathology Department of Aretaieion Hospital and showed in 23 cases with adenomatous endometrial polyps, 15 cases with endometrial cystic atrophy, two cases with adenomatous hyperplasia, and five cases with mucosal endometrial adhesions. Immunohistochemical investigation of Bel-2 and KJ67 expression was undertaken on paraffin blocks and showed elevated expression in the cases with endometrial polyps and hyperplasia, in contrast to atrophic endometria. Conclusion: Long-term tamoxifen therapy of postmenopausal women with breast cancer is associated with uterine pathology. Ultrasonography alone is useful in asymptomatic patients selecting cases with increased endometrial thickness for further investigation. Hysteroscopy is an accurate method for diagnosing endometrial disease because it provides a direct view of the uterine cavity, reveals focal lesions, and enables targeted biopsies to be performed at the same time. Pathological findings show elevated expression of Ki67 and Bcl-2 in hyperplastic endometria and adenomatous polyps, consistent with an elevated glandular cell proliferation due to tamoxifen effect. [ABSTRACT FROM AUTHOR]

Debate is heating up whether or not to require girls to be vaccinated against the human papillomavirus (HPV), a leading cause of cervical cancer (CC). Prolepsis against this plague is mainly focused on early detection with Pap test (screening) and recently with administrating HPV vaccines in youths. Objective: To discuss the increased bioethical role of contemporary gynecologist in the young population, with the aim to contribute to the decrease of this malignancy. Materials and Methods: The authors searched the web (data-warehouse: articles, forums, etc., and data-mining: sequence analysis and classification) for HPV vaccination and related bioethical issues. Results: HPV vaccines have already caused debates on whether they must be mandatory and on whether they cause a pseudo-safeness mental state, making youths "forget" necessary annual Pap tests or even worse, urging them in promiscuity, resulting in an increased occurrence of CC. Conclusions: Greece, in order to appropriately apply the Constitutional Law 5§5 (All persons have the right to the protection of their health...), needs to train contemporary gynecologists in adequate youth consultation and proper family approaches regarding HPV vaccination issues. Enhancing the gynecologist's role, vaccination's effectiveness (sensitivity and specificity) will be increased and on the other hand, a rule of social law will be established in the country. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to compare transvaginal sonographically thickened endometrium with hispathologic and hysteroscopic findings in asyptomatic postmenopausal women. The study performed a retropective analysis on 202 postmenopausal women with thickened endometrium, from January 2000 to December 2008, and underwent fractionated and hysteroscopic dilatation and curettage (D&C). The study recommends gynecological transvaginal sonography (TVS) on women with thickened endometrium.

Primary melanomas of the vulva are extremely rare, creating obstacles in the differential diagnosis of other epithelial and non-epithelial malignancies. Due to their rarity, there are only approximately 250 cases reported in the current literature. Vulvar melanomas tend to relapse locally, as well as develop locoregional and distant metastasis through lymph node and haematic dissemination. The authors describe a case of an 84-year-old Caucasian female patient, presenting with postmenopausal bleeding, consistent with primary vulvar melanoma cause, which was successfully diagnosed and treated accordingly. [ABSTRACT FROM AUTHOR]

Ovarian cancer is the second most common gynecologic malignancy and is one of the leading causes of death among women. The disease course and the accurate diagnosis are correlated with the early detection of the lesion. About 5% of ovarian cancers are poorly differentiated and difficult to be classified, and are referred to as undifferentiated carcinomas. They are usually large, solid with haemorrhage and necrosis, bilateral, and very difficult to be histologically classified. Generally, cases with undifferentiated components are very rare. The authors present a case of a young female patient with a rapidly progressive undifferentiated ovarian carcinoma and a final unfortunate clinical result. [ABSTRACT FROM AUTHOR]

Skin metastases secondary to vulvar carcinoma is an infrequent clinical entity. The authors describe a case of squamous vulvar carcinoma, which presented with cutaneous involvement as a part of distant spread. After a radical vulvectomy, bilateral inguino-femoral lymphadenectomy, and adjuvant radiotherapy, the patient developed multiple cutaneous metastases in lower extremities. This case was unique in presentation, with skin metastases secondary from vulvar carcinoma, and indicated advance disease and poor prognosis. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 29-year-old nulliparous woman who was diagnosed with enodmetrial stromal sarcomas (ESS). It is noted that the patient has a history of abnormal uterine bleeding and a surgical removal of a uterine leiomyoma. She received three cycles of gonadotrophin releasing hormone and underwent surgical excision of a uterine tumor. The management of the patient is described as well as the hysteroscopic features of uterine sarcoma.

The article presents a retrospective study on the comparison of radio wave cone biopsy and large loop excision of the transformation zone (LLETZ) method in patients with high-grade squamous intraepithelial lesions (HGSIL). It notes the diagnosis of 186 patients with HGSIL who underwent cone biopsy either with the LLETZ method or with the radio wave method. It cites the advantages of 4.0 mega hertz (MHz) radio wave surgery in the treatment of HGSIL including decreased tissue damage.

Background: The most common sites of visceral metastases in ovarian cancer are the liver and lungs, whereas the most frequent sites of lymph nodal involvement are abdominal, para-aortic, mediastinal, and pelvic nodes. Peripheral isolated lymph node metastasis is extremely rare. Case Report: This case represents an ovarian cancer with large metastasis to the right axillary mass. A 79-year-old female presented with a palpable and visibly enlarged mass. A neck lymph nodal mass was found on the CT scan with biopsy showing metastatic carcinoma with morphology and immunophenotype of ovarian primary tumor. Conclusions: Axillary metastasis secondary to ovarian carcinoma is an infrequent clinical entity. [ABSTRACT FROM AUTHOR]

In medicine, Meigs' syndrome is the triad of ascites, pleural effusion, and benign ovarian tumor (fibroma, Brenner tumour, and occasionally granulosa cell tumour). It resolves after the resection of the tumor. Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The etiologies of the ascites and pleural effusion are poorly understood. Atypical Meigs' syndrome, characterized by a benign pelvic mass with right-sided pleural effusion but without ascites, can also occur. As in Meigs syndrome, pleural effusion resolves after removal of the pelvic mass. The authors would like to share their own experience of a case of Meigs' syndrome associated with an enormous ovarian fibroma and elevated Ca-125. [ABSTRACT FROM AUTHOR]

Primary fallopian tube carcinoma (PFTC) is an uncommon gynecologic tumor, responsible for 0.14% to 1.8% of genital malignancies, with a mean incidence of 3.6 per million women per annum. The factors that contribute to its appearance are not well-known. Overall survival percentages for patients with PFTC are generally low. Although the preoperative diagnosis rarely occurs and it is usually first confirmed by the pathologist, an earlier diagnosis occurs with early clinical manifestation and prompt investigation leading to better prognosis. Both PFTC and epithelial ovarian cancer (EOC) are treated with similar surgical and chemotherapy methods. The authors report a case of a patient with bilateral high grade serous carcinoma of the fallopian tube, whose initial presentation was bilateral cystic adnexal masses and serosanguinous discharge, with no other pelvic involvement. This article also reviews in brief and presents updates of this rare gynecological malignancy. [ABSTRACT FROM AUTHOR]