ABSTRACT
@#Dysgerminoma comprises 3%–5% among ovarian malignancies, mostly seen in adolescent and early adult women. The recurrence rate is approximately 10%–20%, occurring within 2 years of diagnosis, and has been reported that more than 75% occur in the 1st year. A 19‑year‑old nulligravid initially presented with severe abdominal pain, who underwent emergency exploratory laparotomy and left salpingo‑oophorectomy, whose histopathologic result revealed dysgerminoma, Stage IC2. Recurrence of dysgerminoma was noted on the contralateral ovary 10 months after for which she had undergone another surgery for wedge resection of the right ovarian mass and complete surgical staging. She received adjuvant chemotherapy without complications. Despite two consecutive surgeries and chemotherapy, she had conceived naturally and her pregnancy was carried to term with no complications and delivered to a live baby girl by normal spontaneous delivery. This case is a proof of how fertility‑sparing surgeries and chemotherapy in dysgerminoma can successfully preserve reproductive functions for future conceptions.
Subject(s)
Pregnancy , Chemotherapy, Adjuvant , Dysgerminoma , RecurrenceABSTRACT
@#Carcinosarcoma, formerly known as malignant mixed Mullerian tumors (MMMTs) are highly aggressive tumors that include both malignant epithelial and mesenchymal or stromal elements. The most common site of carcinosarcomas in a female reproductive organ is the endometrium with an incidence of 2/100,000 females, whereas carcinosarcomas arising from the paratubal mass are extremely rare malignancies accounting for fewer than 0.1% of MMMTs. Carcinosarcomas of the Fallopian tube usually occur in the fifth to sixth decades in postmenopausal women with the most common presenting symptom of abdominal pain, followed by vaginal bleeding and abdominal distention. There have been limited published cases worldwide, that is, it has been a thing of interest to be analyzed in today’s era. A rare case of paratubal carcinosarcoma is highlighted in this paper as it discourses its clinicopathological characteristics and assesses the prognostic factors associated with treatment outcome and survival.
Subject(s)
CarcinosarcomaABSTRACT
Background and Objective@#Radical hysterectomy remains to be the first surgery for early‑stage cervical and selected stage 2 endometrial carcinoma. Functional disorders of the lower urinary tract are the foremost common complications following radical surgery necessitating catheterization. This study was undertaken to determine the number of postoperative days (POD) of the removal of urinary catheters after hysterectomy and assess the practicability of earlier removal of the catheter without compromising the bladder function@*Methodology@#A descriptive observational study of patients who underwent Type 2 or 3 hysterectomy for cervical or endometrial carcinoma. Clinical, intraoperative, and anesthesia records and results of the histopathologic reports of every patient were reviewed. Demographic, clinical, and histopathologic data needed during this review were recorded. Descriptive statistics were used.@*Results@#Between January 2016 and December 2019, a complete 45 patients underwent radical hysterectomy (43 patients for cervical cancer and a pair for endometrial carcinoma), with a median age of 50 years. The mean operative time is 2.5 h and also the average blood loss is 500 ml. The mean size of the cervical tumor was 2.2 cm, the mean length of the vagina was 2.5 cm, and the mean lateral width of parametria was 3.6 cm. Catheters were removed between the 3rd and 20th (mean = 6 days) POD. All patients had adequate spontaneous void within 6 h after removal. Five patients had their catheters removed beyond 7 days, 3 patients between POD 8 and POD 14, and 2 patients between days POD 15 and POD 20. All patients were able to return to bladder function within 3 weeks of catheterization.@*Conclusion@#The outcome showed that earlier removal of catheter seems to be a practical and safe option compared to long‑term catheterization for patients who underwent radical hysterectomy without causing morbidities
Subject(s)
Uterine Cervical Neoplasms , Endometrial NeoplasmsABSTRACT
Objective@#Studies on Sexual dysfunctions among gynecologic cancer after treatment are sparse in the Philippines and data on sexual dysfunction varies greatly within the gynecologic oncology literature. This study aims to determine the sexual dysfunction among patients with endometrial cancer managed at a tertiary training public institution.@*Method@#This research was a cross-sectional study, which utilized a self-administered, validated Filipino version of the Female Sexual Function Index (FSFI) questionnaire in assessing the different domains such as desire, arousal, lubrication, orgasm, satisfaction and pain. Descriptive statistics such as frequency and percentages were used in determining the prevalence of sexual dysfunction in patients with endometrial carcinoma while Kruskal Wallis test and Spearman Rank Correlations were used to determine the association of sexual dysfunction with age, body mass index (BMI), duration and stage of endometrial cancer, presence of comorbidities and mode of treatment.@*Results@#Between May 2020 and January 2021, there were 53 women who participated in this study. Forty-one (77.36%) have sexual dysfunction. Majority of the respondents either reached up to high school level (22.6%) or are college graduates (22.6%). Most of them are also self-employed (58.1%). Fifty eight percent have only 1–3 child/children. Analysis showed no significant correlation of presence of sexual dysfunction to stage of cancer, BMI, presence of comorbidities, period of diagnosis and type of treatment received by the patients. @*Conclusion@#The study showed that there was high prevalence of sexual dysfunction among endometrial cancer patients in this study institution. Furthermore, presence of sexual dysfunction is irregardless of BMI, presence of comorbidities, stage of diagnosis, length of diagnosis and type of treatment. Hence, proper screening, diagnosis and counselling should be done to all patients upon diagnosis to promote better quality of life.
Subject(s)
Endometrial Neoplasms , Quality of LifeABSTRACT
Objective@#This study aimed to determine the accuracy, sensitivity and specificity of frozen section (FS) in the diagnosis of uterine neoplasm in a tertiary government training hospital.@*Methodology@#This is a retrospective validation study from 2004-2015 involving cases of uterine lesions from gynecologic surgeries. All histopathologic results of frozen and paraffin sections were retrieved and reviewed. Chi square test with 2x2 Fischer Exact test adjustment was used to check for associations. Accuracy indices of FS tool were estimated such as sensitivity, specificity, likelihood ratios, negative and positive predictive values, and overall accuracy. A p-value of < 0.05 alpha is considered significant.@*Results@#A total of 143 uterine specimens were submitted for frozen section analysis. The utilization rate of FS is 1% per year. The FS results were correlated with the final histopathologic diagnosis with 96% agreement rate. Utilizing a median number of 3 sections per specimen provides an overall accuracy rate of 97%. The accuracy rate of FS is equal between combined benign-premalignant and malignant cases at 96%. The accuracy rate is not statistically affected by the procedure by which the specimen was taken, as well as the source and gross morphology of the specimen. Moreover, a minimum of 11 sections per specimen is needed to obtain an accuracy rate of 99-100%. The accuracy rate particularly for endometrial lesions is between 94 and 100%.@*Conclusion@#Accuracy rates of frozen section on uterine lesions are high regardless of the sampling procedure and source of the specimen. Increasing the number of sections during FS parallels that of the final histopathologic diagnosis. FS for uterine lesions is a vital and cost-effective intraoperative decision tool to maximize care of patients.
Subject(s)
Frozen SectionsABSTRACT
@#<p>Majority of cervical cancer are squamous cell carcinoma and adenocarcinoma. The co-existence of two histologic types is rare. This article presents three cases of collision tumors of the cervix within a 10-year review. All underwent radical hysterectomy for an early stage disease. Likewise, it aims to review clinicopathologic features, management, response to treatment and prognosis of these types of tumor in the light of recent literature.</p>