ABSTRACT
Objective@#In this video, we present our technique for ureter assessment during pelvic ultrasound examination. @*Methods@#We used a general electric Voluson E10 (General electric, Wauwatosa, WI, USA) to perform transvaginal ultrasonography. These images were shared after thorough counselling, and obtaining informed consent from the patient. This video was edited using FinalCut ProX® (Apple Inc, Cupertino, CA, USA). @*Results@#We systematized this routine after assessing the cervix, uterus, and adnexa. The vaginal probe was slightly removed to focus on the urethra. Next, we approached the hand on the contralateral thigh to the ureter. At this point, the probe was directed to the lateral pelvic wall where the ureteric orifice was found. Then, we raised our hands and perform an internal rotation movement to ascend the ureteral segments until it is related to the iliac vessels. @*Conclusion@#The urinary tract may be involved in gynecological pathologies. Transvaginal ultrasound is an easy, reproducible, and well-tolerated examination that can be used to evaluate the ureters below the pelvic brim.
ABSTRACT
OBJECTIVE: Patients with endometriosis are at increased risk of ovarian cancer. It has been suggested that atypical endometriosis is a precursor lesion of endometriosis-associated ovarian cancer (EAOC). The aim of this study is to evaluate if cytologic (cellular) atypia and architectural atypia (hyperplasia), histologic findings described as atypical endometriosis, play a different role in patients with EAOC. METHODS: A prospective study was conducted between January 2014 and April 2017 at our institution with patients undergoing surgery with a histologic diagnosis of endometriosis, ovarian cancer, or EAOC. The prevalence and immunohistologic study (Ki-67, BAF250a, COX-2) of cases of cellular and architectural atypia in endometriosis were analyzed. RESULTS: Two hundred and sixty-six patients were included: the diagnosis was endometriosis alone in 159 cases, ovarian cancer in 81, and EAOC in 26. Atypical endometriosis was reported in 23 cases (12.43%), 39.13% of them found in patients with EAOC. Endometriosis with cellular atypia was found mainly in patients without neoplasm (71.4%), and endometriosis with architectural atypia was seen in patients with ovarian cancer (88.9%) (p=0.009). Ki-67 was significantly higher in endometriosis patients with architectural atypia than those with cellular atypia. CONCLUSION: The diagnosis of endometriosis with architectural atypia is important because it may be a precursor lesion of ovarian cancer; therefore, pathologists finding endometriosis should carefully examine the surgical specimen to identify any patients with hyperplasia-type endometriosis, as they may be at higher risk of developing EAOC.