Castleman disease is a lymphoid disease characterized by herpes virus infection associated hyperplasia of lymphatic tissue. Castleman disease is generally localized in the mediastinum (70%) and the ...regions that it may be seen outside of the thorax are neck, axilla, pelvis and retroperitoneum. Castleman disease may present unicentrically or multicentrically. Fifty-six year old postmenopausal woman was detected to have a right adnexial mass in her routine gynecological examination. This adnexial mass was also observed in the pelvic ultrasonography and pelvic magnetic resonance imaging (MRI). A retroperitoneal mass was detected in the right hemipelvis. Pathological evaluation revealed Castleman disease, hyaline vascular type. Any lymphadenopathy other than this wasn’t observed in the systemic imaging of the patient. Therefore, she was considered to have unicentric disease and was told to come to follow-up visits. Castleman disease is a rare condition. Since symptoms and imaging findings aren’t specific to the disease, preoperative diagnosis is quite difficult. Castleman disease located in the pelvic retroperitoneum may mimic adnexial masses. It is genearlly related to pelvic walls and iliac vessels. Surgical removal of unicentric Castleman disease is curative. While Castleman disease is observed rarely in gynecological practice, it should be kept in mind in the differential diagnosis of adnexial masses.
The aim of this study was to evaluate the prognostic factors of recurrence in uterine tumors resembling ovarian sex-cord tumors (UTROSCT) and to determine clinical-pathological characteristics, ...treatment options and outcome.
An electronic literature search was conducted from 1976 to 2018. After the comprehensive evaluation and conjunction with our case, the study included 79 cases.
The median age at initial diagnosis was 49 years (range; 16-86 years). The age was under 40 years in 21 (26.6%) patients. Whereas 68 patients underwent at least hysterectomy, 9 patients had organ sparing surgery. There was necrosis in 4 (5.1%) patients, atypia in 16 (20.3%) patients, and infiltrative tumor border in 34 (43%) patients. At least one mitosis per 10 high power fields was determined in 36 (45.5%) patients. The tumor involved at least part of the myometrium in 54 (68.3%) patients. Median follow-up time was 30 months (range; 3-296 months). Recurrence was determined in 5 (6.3%) patients. The disease free survival (DFS) was significantly related only to surgery type. None of the pathologic features were associated with DFS. The 5-year DFS was 86% and 96% in patients who underwent organ sparing surgery or not, respectively (p=0.038).
The accurate pathologic diagnosis of UTROSCT has great value in shaping surgical management and management during the follow-up period. Organ sparing surgery was related to poor DFS. Although recurrence is rare, it should be kept in mind for patients with UTROSCT.
There has been limited literature about treatment and follow-up strategies of uterine adenosarcomas because of their rare nature. For this study we retrospectively investigated the medical database ...of the two major womens' health hospitals in Turkey. A total of 15 patients were identified from the hospital's database. Median follow-up was 86.43 months for all patients. Seven out of 15 patients had recurrences during their follow-up. Among these 7 patients, 4 of them had stage IA disease. Median Disease Free Survival (DFS) and Overall Survival (OS) were calculated as 41.47 and 57.21 months, respectively. According to our study, polypoid tumours confined to the uterus with superficial myometrial invasion can be treated without comprehensive surgical staging. We believe that, publishing all the data in an organised manner even though they are small in size, gives us an opportunity to design meta-analysis for the development of more appropriate treatment strategies.
Bu makalede iki ovarian leiomyosarkom olgusu sunuldu. Optimal sitoredüksiyon yapılan ve takiben adjuvan kemoterapi verilen hastalardan biri evre IA olup 34, diğeri evre IIIC olup 61 yaşındaydı. ...Postoperatif dönemde sırasıyla biri 13 ay, diğeri 48 ay takip edildi. Takip süreci içinde rekürrens saptanmadı. Ovarian leiomyosarkom nadir görülen ve kötü prognoza sahip oldukça agresif bir tümördür. Bu makalede sunulan olgular erken rekürrens saptanmaması
nedeniyle özellik göstermektedir. (Gazi Med J 2012; 23: 73-4)
Abstract Objective To evaluate retrospectively the prevalence of cervical cytological abnormalities in patient records obtained from healthcare centers in Turkey. Method Demographic characteristics ...and data on cervical cytological abnormalities were evaluated from patients who underwent Pap tests in healthcare centers in 2007. Results Data were collected from 33 healthcare centers totaling 140 334 patients. Overall, the prevalence of cervical cytological abnormalities was 1.8%; the prevalence of ASCUS, ASC-H, LSIL, HSIL, and AGC was 1.07%, 0.07%, 0.3%, 0.17%, and 0.08%, respectively. The prevalence of preinvasive cervical neoplasia was 1.7% and the prevalence of cytologically diagnosed invasive neoplasia was 0.06%. Conclusion The abnormal cervical cytological prevalence rate in Turkey is lower than in Europe and North America. This might be due to sociocultural differences, lack of population-based screening programs, or a lower HPV prevalence rate in Turkey.
OBJECTIVE: Primary papillary serous carcinoma of the peritoneum (PPSCP) is an uncommon tumor. The aim of this study was to review of the patients with PPSCP. STUDY DESIGN: 18 women with PPSCP in ...gynecologic oncology clinic between 1995 and 2005 were retrospectively reviewed. RESULTS: At diagnose, one patient (5.5 %) had stage IV and other patients (94.5 %) were IIIC. Six patients received neoadjuvant chemotherapy (paclitaxel/platinum in 5 patients and cyclophosphamide/platinum in the other). Initial or interval optimal/suboptimal debulking surgery was performed in all patients. After surgery, all of the patients received adjuvant chemotherapy including paclitaxel/platinum (n=16) and cyclophosphamide/platinum (n=2). In 6 months after adjuvant chemotherapy, persistent, progressive or recurrence disease was detected in 8 patients (44.4%). In 9 patients (50%) recurrence was detected after 6 months. Clinical complete response to chemotherapy was 55.5%. Survival rate was 90%. CONCLUSION: PPSPC are frequently indistinguishable from advanced serous papillary carcinoma of the ovary. The treatment choice is optimal cytoreductive surgery with adjuvant chemotherapy, but although the radical treatment is used the survival rate is poor.
Leiomyomatosis peritonealis disseminata is a benign disease of women of reproductive age. Female gonadal steroids play the major role in pathogenesis, but reported cases in postmenopausal women ...suggests other factors. A few cases in the literature with coexisting endometriosis confirm the hypothesis that both originate in submesothelial multipotential mesenchymal cells. The clinical behavior can be life threatening due to extension through the pelvic veins.
A 46-year-old woman with endometriosis diagnosed at laparotomy 3 years earlier presented with a huge pelvic mass. Postoperative histologic examination of the peritoneal nodules confirmed the diagnosis. Magnetic resonance angiography performed postoperatively revealed intravenous leiomyomatosis. Surgical castration was satisfactory after 2 years of follow-up.
Although malignant transformation of the disease is known, intravascular extension of the tumor increases the risk of mortality. Close follow-up by clinical examination and radiologic evaluations is required.
Splenosis Mimicking Pelvic Mass Tasci, Yasemin; Kayikcioglu, Fulya; Cavusoglu, Deniz ...
Obstetrics and gynecology (New York. 1953),
2005-November, Letnik:
106, Številka:
5, Part 2
Journal Article
Recenzirano
BACKGROUND:Splenosis is a rare complication after splenectomy and generally does not cause clinical symptoms.
CASE:A 34-year-old woman who had splenectomy in childhood after trauma presented with a ...pelvic mass. Ultrasound examination demonstrated a right adnexal mass and a myomatous uterus. Exploratory laparotomy revealed multiple splenic implants along the small and large bowel and in the ileocecal region, including the appendix. Total hysterectomy, right salphengectomy, and appendectomy were performed.
CONCLUSION:After splenectomy, splenic implants may mimic benign or malignant tumors of the pelvis and may require surgical exploration.
Amaç: Uterin leiomyom ön tanısıyla opere edilen hastalarda uterin sarkom sıklığının ve sarkom açısından riskli olan grubu tanımlayabilecek klinik özellik ve laboratuar testlerinin belirlenmesi.
Gereç ...ve Yöntemler: Hastanemiz Jinekoloji kliniğinde 1.Ocak.2002 ile 31.Aralık.2002 tarihleri arasında, myoma uteri tanısı ile yapılan 679 total abdominal histerektomi ve myomektomi olgusu retrospektif olarak incelendi. Hastaların yaşları, başvuru semptomları, preoperatif laboratuar tetkik sonuçları ve intraoperatif bulguları kaydedildi. Postoperatif kesin patoloji sonuçlarına göre leiomyosarkom, endometrial stromal sarkom, mikst mezodermal tümör sıklığı hesaplandı.
Bulgular: Hastaların yaşları 18-69 arasında idi (ortalama; 43). Leiomyoma ön tanısı ile opere edilen 679 olgunun 5'inde uterin sarkom saptandı. Olguların üç tanesinde leiomyosarkom (%0.44), bir tanesinde endometrial stromal sarkom (%0,15) ve bir tanesinde de karsinosarkom (%0.15) rapor edildi. Toplam sarkom sıklığı %0.74 olarak belirlendi. Hastaların uterin sarkom sıklığının yaşla beraber artış gösterdiği görüldü. İntraoperatif üç vakada sarkomu düşündüren bulgular mevcuttu.
Sonuç: Leiomyom ile belirti benzerliği nedeniyle sarkomun preoperatif tanısı zordur. Ultrasonografik görüntüleme ve endometrial örneklemenin tanıda değeri sınırlıdır. Özellikle postmenopozal hasta grubunda, leiomyom ön tanısı ile konservatif tedavi planlanan hastalarda, preoperatif değerlendirme detaylı yapılmalı, sarkom olasılığı akılda tutulmalı ve postoperatif patoloji sonucu yakından takip edilmelidir.
Objective: To determine the incidence of uterine sarcoma in patients operated for uterine leiomyoma and to determine the clinical features and laboratory analyses for defining the risk group for uterine sarcoma.
Material and Methods: Between January 01.2002 and December 31.2002, a total of 679 patients who had had hysterectomy or myomectomy for presumed uterine leiomyoma, were reviewed retrospectively. The age, initial symptoms, preoperative laboratory tests, operative and histopathological findings of patients were analyzed. The incidence of leiomyosarcoma, endometrial stromal sarcoma and mixed mesodermal tumor was calculated.
Results: The age of the patients were between 18-69 (mean; 43). Five of the 679 patients operated for presumed leiomyoma was found as uterine sarcoma. Three of them (0.44%) had leiomyosarcoma, one had endometrial stromal sarcoma (0.15%) and another one had mixed mesodermal tumor (0.15%). The total incidence of uterine sarcoma was determined as 0.74%. The incidence of uterine sarcoma was seen to increase with age. Intraoperatively, uterine sarcoma was suspected in three of them.
Conclusion: The diagnosis of uterine sarcoma is generally difficult because the signs and symptoms are similar to the uterine leiomyomas. Histological examination of endometrium and ultrasonographic imaging has limitations in detecting of the disease. Especially, in the postmenopausal patients, conservative approaches could delay the diagnosis and definitive treatment of uterine sarcoma.
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