INTRODUCTION: Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period. MATERIAL AND METHOD: Recommendations based on the consensus conference ...model. RESULTS: In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies. CONCLUSION: During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus.
Placental chorioangioma is a benign vascular tumor. Lesions larger than 4cm may cause fetal and maternal complications. Its association with disseminated neonatal hemangiomatosis is rarely described. ...We report a case of a large chorioangioma associated with an hydrops foetalis and disseminated neonatal hemangiomatosis. The relationship between placental chorioangioma and hemangioma is briefly discussed.
Terminal chromosome 1q deletion is rarely reported but causes typical malformations that have been well described
in childhood.
Clinical features include facial dysmorphy, growth and/or psychomotor ...retardation, brain agenesis or hypoplasia
of the corpus callosum, epilepsy and occasional urogenital or cardiac malformations.
The diagnosis of this condition is usually made at birth. The rare cases of antenatal diagnosis were based on
microcephaly and growth retardation. In the present case, the foetus presented with an hypoplasia of the corpus
callosum, a dysmorphic profile and a single umbilical artery. The foetal echocardiography suggested a noncompaction
of the left ventricular myocardium. No microcephaly or growth retardation were noted.
We compare our antenatal findings to those described in the literature with the aim to better define the antenatal
phenotype of the terminal chromosome 1 deletion syndrome.
Recent studies have identified a putative cell of origin for cervical intraepithelial neoplasia (CIN) and cervical cancer at the squamo-columnar junction (SCJ) and suggest that these cells may not ...regenerate following excision (LEEP). This study addressed the impact of SCJ excision on the temporal dynamics, histologic and viral (HPV) characteristics of recurrent CIN. One hundred thirty one consecutive patients treated by excision and attending follow-up visits were enrolled. We compared recurrent and initial CIN with attention to excision margins, timing of recurrence, CIN grade, HPV types, p16 immunophenotype, and SCJ immunophenotype. During the follow-up period (up to four years), sixteen (12.2%) recurrences were identified. Four (25%) were identified at the first follow-up visit, closely resembled the initial CIN 2/3 in grade and HPV type, and were typically SCJ marker positive SCJ(+), suggesting non-excised (residual) disease. Twelve (75%) manifested after the first postoperative visit and all were in the ectocervix or in mature metaplastic epithelium. All of the 12 delayed recurrences were classified as CIN 1 and were SCJ (-). Nine of 11 SCJ (-) recurrences (82%) followed regressed spontaneously. Taken together, these results show that new lesions developing from any HPV infection are delayed and occur within the ectocervix or metaplastic epithelium. This dramatically lower risk of CIN 2/3 following successful SCJ excision suggests that removal of the SCJ could be a critical variable in reducing the risk of subsequent CIN 2/3 and cervical cancer. (c) 2014 Wiley Periodicals, Inc.
RU-486 is a synthetic steroid analogue that can inhibit adrenal steroid synthesis in the rat and rhesus monkey. We measured the activities of five testicular and two ovarian microsomal steroidogenic ...enzymes to assess the potential effect of RU-486 on rat gonadal steroidogenesis. Hypophysectomized, gonadotropin-replaced rats received RU-486 or a vehicle solution twice daily for seven days. The animals were sacrificed and their gonads were resected, weighed, and microsomal enzyme activities were measured according to RU-486 treatment. Testicular 17-hydroxylase and aromatase activity decreased in RU-486 treated animals whereas 17,20-desmolase, 3 beta-hydroxysteroid dehydrogenase and 17-ketosteroid reductase activities were unaffected. Ovarian 17-hydroxylase but not 3 beta-hydroxysteroid dehydrogenase activity was decreased in the animals receiving the drug. We conclude that RU-486 inhibits both testicular and ovarian steroidogenesis in the rat.
Aims: To identify a DNA methylation signature of endometrioid carcinoma of the endometrium (EEC) in the early stages of endometrial carcinogenesis.
Methods and results: Archival biopsy specimens of ...39 EECs, 14 cases of atypical hyperplasia (AH), 11 histologically normal endometrial tissues adjacent to EECs and 24 normal control endometrial samples were retrieved. The cases were tested by quantitative methylation-specific polymerase chain reaction with primers hybridizing in the promoter regions of five genes frequently methylated in human cancer (RASSF1A, RARb2, P16, MGMT and GSTPi). Twenty-nine of 39 (74%) EECs and 7/14 (50%) AHs were methylated for the RASSF1A gene, whereas 17/39 (44%) EECs and 6/14 (43%) AHs were positive for the methylation of the RARb2 gene. No significant results were obtained for the other genes (P16, MGMT and GSTPi). Interestingly, 4/11 (36%) and 6/11 (55%) histologically normal endometrial tissues adjacent to EEC showed, respectively, RASSF1A and RARb2 gene methylation. Furthermore, these 11 specimens were microsatellite stable and showed similar proliferative, cell cycle and apoptotic mean labelling indices as the normal endometrial control tissues.
Conclusions: Promoter region methylation of RASSF1A and RARb2 genes is an early event in endometrial carcinogenesis.
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