ABSTRACT
La tasa de recurrencia del carcinoma endometrial después de la cirugía más radioterapia es baja y la mayoría de los casos ocurren dentro de los primeros 3 años. La cúpula vaginal es el sitio más común de recurrencia. La recurrencia del cáncer endometrial al colon es muy rara. Se presenta el caso de una mujer de 69 años que presentaba dolor en fosa ilíaca izquierda, anorexia y pérdida de peso de 5 meses de evolución, con antecedentes de histerectomía abdominal total y ooforosalpingectomía bilateral por carcinoma endometrial estadio IA hacía 7 años. La colonoscopia reveló constricción circunferencial en el tercio medio del colon transverso, sospechosa de compresión extrínseca. La tomografía computada no reveló si la tumoración se originaba en el colon sigmoides o lo rodeaba. Durante la laparotomía, se observó enfermedad macroscópica que afectaba colon transverso y mesenterio del intestino delgado, con estenosis vascular. Se realizó la resección intestinal de las porciones afectadas y omentectomía total, sin dejar enfermedad residual macroscópica durante el procedimiento. El análisis inmunohistoquímico reveló adenocarcinoma endometrial pobremente diferenciado. La paciente se recuperó sin complicaciones y fue tratada con quimioterapia adyuvante.
The recurrence rate of endometrial carcinoma after surgery plus radiotherapy is low and, in most cases, it occurs within the first 3 years of treatment. The vaginal vault is the most common site of recurrence. Recurrence of endometrial cancer to the colon is very rare. We report a 69-year-old woman who presented with right iliac fossa pain, anorexia and weight loss for five months. She had a history of total abdominal hysterectomy and bilateral oophorosalpingectomy for stage IA endometrial carcinoma 7 years ago. Colonoscopy revealed a mid-sigmoid colon stricture suspicious of external compression. A CT scan did not reveal if the tumor was arising from the sigmoid colon or abutting it. During laparotomy, we found macroscopic disease involving transverse colon and small bowel mesentery with an ischemic stricture was found. Bowel resection and total omentectomy were performed leaving no residual macroscopic disease. Immunohistochemistry analysis revealed a poorly-differentiated endometrial adenocarcinoma. Patient recovered without complications and was treated with chemotherapy.
ABSTRACT
Objective To investigate the expression of S100A4 and hypoxia-induced factor 1α (HIF-1α) protein in type Ⅰ endometrial carcinoma,and to analyze their relationship.Methods The expressions of S100A4 and HIF-1α protein were detected in 65 cases of type Ⅰ endometrial carcinoma and 40 normal endometrial tissues.Results The positive rate of S100A4 in endometrial carcinoma was 47.7 ％ (31/65),the normal tissues was 0 (0/40),and there was significant difference (x2 =27.069,P =0.001).The positive rate of HIF-lα was significantly higher in endometrial carcinoma [63.1％ (41/65)] than that in the normal tissues [7.5 ％ (3/40)] (x2 =31.417,P =0.001).The expressions of S100A4 and HIF-1α were positively related with FIGO staging,pathological grades,myometrial invasion and lymphatic metastasis (all P ＜ 0.05).The expressions of S100A4 and HIF-1α were positively correlated in type Ⅰ endometrial carcinoma (r =0.348,P =0.005).Conclusion The expression levels of S100A4 and HIF-1α are closely related with the oncogenesis and progression of type Ⅰ endometrial carcinoma,and their co-detection may be useful in prognosis assessment.
ABSTRACT
Conocer los factores de riesgo epidemiológico en pacientes atendidas por cáncer de endometrio y evaluar su incidencia. Estudio retrospectivo, descriptivo, epidemiológico de 44 pacientes con carcinoma endometrial atendidas entre 1999 y 2007. Servicios de Cirugía y Obstetricia del Hospital Central de Maracay. Las pacientes tenían edades entre 50-59 años en 31,8 por ciento. En índice de masa corporal el 24,9 por ciento tuvo obesidad. De las mujeres en posmenopausia 32,4 por ciento tenían edades entre 51 y 55 años. Paridad 36,4 por ciento tenía 5 gestas y más. La histogénesis resultó en 88,8 por ciento adenocarcinoma endometrioide. La estadiación clínico-patológica (FIGO 1988) reportó en 16 por ciento estadío 1b (G 1, 2, 3). Las mujeres con mayor riesgo para carcinoma endometrial tienen más de 50 años, son obesas, pos menopáusicas
To know risk factors related to the endometrial cancer and to evaluate the incidence. Analytical, epidemiological and retrospective study, of 44 cases of patients with endometrial cancer happened between 1999 and 2007. Hospital Central de Maracay. Patients were 31.8 percent between 50-59 years of age. Body mass index 24.9 percent was obese. Postmenopausal were 32.4 percent between 51-55 years of age. Parity between 5 or more: 36.4 percent. Histologic type 88.8 percent was adenocarcinoma. FIGO staging was 1b: 16 percent. Women with more risk for endometrial cancer are advanced age, obese, and postmenopausal