ABSTRACT
Uterine tumors resembling ovarian sex cord tumors are rarely reported with limited imaging findings.The current study reported two case of uterine tumors resembling ovarian sex cord tumors and described the detailed MRI findings,which would provide valuable imaging evidence for the diagnosis of such tumors.
Subject(s)
Female , Humans , Uterine Neoplasms/diagnostic imaging , Ovarian Neoplasms/pathology , Sex Cord-Gonadal Stromal Tumors/pathology , Magnetic Resonance ImagingABSTRACT
Rarely diagnosed in authors department, uterine smooth muscle tumor of uncertain malignant potential (STUMP) is one of the histologic types of uterine sarcoma. Among women undergoing hysterectomy or myomectomy for a presumed diagnosis of leiomyoma, 0.01% receive a diagnosis of STUMP. Authors report a case occurring to a patient aged of 55 which was diagnosed, managed successfully and followed-up in authors department.
ABSTRACT
Uterine tumors resembling ovarian sex-cord tumors (UTROSCT) are very rare tumors that occur mainly in the uterine fundus of women in reproductive age. These tumors can be classified into group 1 and group 2 by histological results. In group 1, epithelial-like differentiation is partially observed in the tumors. In group 2, sex-cord elements are predominant in uterine mural mass. We experienced UTROSCT group 1 in a 29-year-old woman who complained of severe abdominal pain that started one week after delivery and UTROSCT group 2 case in a 49-year-old woman who complained of dysfunctional uterine bleeding. We report two different types of UTROSCT cases that we experienced.
Subject(s)
Adult , Female , Humans , Middle Aged , Abdominal Pain , Metrorrhagia , Sex Cord-Gonadal Stromal Tumors , Uterine Diseases , Uterine NeoplasmsABSTRACT
The lipomatous tumors are very rare benign neoplasms of the uterus. Lipoleiomyoma is a benign tumor which is variant of leiomyoma. It has similar clinical course and presentation like uterine leiomyoma and is typically found in postmenopausal women. Authors report a case of 45 years female presented with a complaint of increased frequency of menstrual cycles and generalized weakness since 5- 6 months. On ultrasonography abdomen - pelvis a single large lobulated hyperechoic mass was noted in the fundal myometrium measuring 5 x 4.6 cm. The finding was suggestive of fibroid uterus. On histopathological examination showed variable proportions of lobules of mature adipocytes and interlacing bundles of benign smooth muscle cells which was diagnostic of lipoleiomyoma. Authors are presenting this case for its rarity, clinical presentation, imaging and histopathological finding with differential diagnosis.
ABSTRACT
Abstract Objective Intraoperative frozen section (IFS) is a valuable resource, and its use in gynecological pathology has not been sufficiently emphasized. The main goal of the present study is to evaluate the reliability and agreement rates between IFS and the final paraffin section (PS) and determine how reliable IFS is. Methods A retrospective study of all IFSs performed on uterine tumors and suspicious adnexal masses between January 2012 and December 2016 (excluding metastases) at the department of obstetrics and gynecology of the Centro Hospitalar Tondela Viseu. Frozen versus permanent section diagnosis were compared regarding the histologic type of the tumor, and the depth of myometrial invasion. Results A total of 286 cases were eligible for the present study, including 102 (35.7%) IFSs of uterine tumors, and 184 (64.3%) IFSs of ovarian tumors. The overall rate of deferred cases was 5.2% (15/286). The accuracy of the diagnosis in cases of endometrial carcinoma was 96.25% (77/80). Among the ovarian tumors, misdiagnoses occurred in 2 cases (1.1%), corresponding to a borderline tumor (serous type) and a clear cell intracystic adenocarcinoma. Conclusion The IFS analysis plays an important role in selected situations and is associated to a high sensitivity and specificity in cases of ovarian and endometrial tumors. Its high accuracy is almost universally associated with the possibility of obtaining an optimal surgical treatment at the time of the first surgical approach.
Resumo Objetivo O diagnóstico intraoperatório por congelação é umrecurso importante cujo uso empatologia ginecológica não tem sido suficientemente enfatizado. O objetivo do presente estudo foi avaliar as taxas de concordância entre o diagnóstico intraoperatório por congelação e o estudo anatomopatológico definitivo e determinar o quanto o diagnóstico intraoperatório por congelação é um método confiável. Métodos Um estudo retrospectivo de todos os diagnósticos intraoperatórios por congelação realizados em tumores uterinos e massas anexiais suspeitas entre janeiro e 2012 e dezembro de 2016 (excluindo metástases) no serviço de ginecologia e obstetrícia do Centro Hospitalar Tondela Viseu. Comparação do diagnóstico intraoperatório por congelação com o resultado do estudo definitivo em relação ao tipo histológico do tumor e profundidade de invasão miometrial. Resultados Um total de 286 casos foram elegíveis para o estudo, incluindo 102 (35.7%) tumores uterinos e 184 (64.3%) tumores ovarianos. A taxa global de casos deferidos foi de 5.2% (15/286). Entre os tumores uterinos, a acuidade de diagnóstico nos casos de carcinoma endometrial foi de 96.25% (77/80). Entre os tumores ovarianos, não se verificou concordância em 2 casos (1.1%), correspondendo a um tumor borderline do tipo seroso e a um adenocarcinoma de células claras intracístico. Conclusão O diagnóstico intraoperatório por congelação apresenta-se com um importante papel em situações selecionadas, sendo acompanhado de elevada taxa de sensibilidade e especificidade para tumores endometriais e ovarianos. A sua elevada acuidade diagnóstica encontra-se associada à possibilidade de obter um tratamento cirúrgico adequado na primeira abordagem cirúrgica
Subject(s)
Humans , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Ovarian Neoplasms/pathology , Uterine Neoplasms/pathology , Frozen Sections , Intraoperative Care , Ovarian Neoplasms/surgery , Uterine Neoplasms/surgery , Reproducibility of Results , Retrospective Studies , Tertiary Care Centers , Middle AgedABSTRACT
Uterine tumors resembling ovarian sex cord tumors are rare neoplasms with varied histological and immunophenotypic profile, uncertain histiogenesis and biological behavior. A critical evaluation of histological features is essential for diagnosis and management of these cases.
ABSTRACT
El cáncer de cuello uterino es un problema de salud pública en países subdesarrollados, a pesar de contar con un método eficaz para la detección precoz como la citología, que sigue siendo la prueba más eficiente para el cribado de lesiones precursoras. Los países que han logrado disminuir la morbimortalidad, fundamentalmente ha sido por la cobertura del Programa de Prevención de la patología. En Venezuela y particularmente en el estado Aragua se reactiva el programa desde 1995, aumentando paulatinamente su cobertura para el año 2000 hasta 58,7%; sin embargo, el Municipio Girardot alcanza 37,7%; esto motivó a realizar un estudio en 10 comunidades para determinar los factores que puedan estar incidiendo en este nivel de cobertura. Se ejecutó un estudio de corte transversal a través de puestos centinelas; para ello se diseño una encuesta a los fines de recabar información sobre: toma de citologías, intervalos entre las muestras y centros de salud donde se realizan las mismas. Dicha encuesta se aplicó en 887 hogares a 689 mujeres con edades comprendidas, entre 25 y 64 años. Los resultados reportaron que 95,2% se practicaron el estudio alguna vez, de estas 90% se lo habían hecho en los últimos tres años. La cobertura de citología encontrada fue de 85,7%, de las cuales 48,1% fueron realizadas en establecimientos públicos; las mujeres con bajo nivel socioeconómico son las que mayormente se realizaron el estudio en los últimos tres años. La cobertura de citología en el grupo estudiado es mayor que la reportada por el sistema de salud para el mismo año.
Uterine cervix cancer is an important issue in Public Health of underdeveloped countries in spite of the avvailabity of cytology as an available method for its precocious detection and sifting of precursor lesions. In those countries where morbidity and mortality has declined, this has been achieved through the implementation of a preventive program. In Venezuela, and particularly in Aragua state, the program was reactivated in 1995 and coverage was increased as to achieve 58.7% by 2000. Meanwhile, in Girardot Municipality, the achievement was around 37.7%. This figure acted as motivating factor to performed a study in 10 communities as to assess the factors determining such variations. A cross sectional study was performed, and information was collected in sentinel, through a survey aimed to determine periodicity of cytology, and the Health Centers in which the samples were taken. The survey was applied in 887 houses with a sample of 689 women in ages between 25 and 64 years. Results demostrated that 95.2% have had at least one citology and 90% during the last there years. Assessed coverage was 85.7% of which 48.1% were performed in Public Health Services, mainly in women from the lower socio-economic strata. Cytology coverage in surveyed group is higher that the figures reported by the Health System during the same period.
ABSTRACT
OBJECTIVE: Frozen-section evaluation of gynecologic tumors has historically been used to establish a histopatholgic diagnosis and to guide surgeons in appropriate surgical procedure. this study is to assess the clinical appropriation and accuracy of frozen-section biopsy in gynecologic tumors. METHODS: This is a retrospective quality assurance study all of frozen-section biopsy done at Chungnam National University Hospital during a three year period (1995 to 1997). There were 125 cases out of 2310 surgical specimens for gynecologic tumors, and the results were compared with final diagnoses based on fixed tissue specimens. RESULTS: Frozen section biopsy was accurate in 95.2% of all cases, in 96.3% (104/108) of ovarian tumor cases, and in 88.2% (15/17) of uterine tumor cases. Analysis of 6 inaccuracy cases revealed that most cases were sampling errors and occurred in mucinous tumor, belonging to all cases of ovarian tumors. Sensitivity, specificity, positive predictive value, and negative predictive value of frozen-section biopsy in ovarian tumors were 0.94, 1.00, 1, 00, 0.97. CONCLUSION: Frozen section biopsy is an appropriate method as a basic guideline during operations of gynecologic tumors and this method can obtains the highest accuracy when there is cooperation between experienced surgeons and reliable and careful pathologists. The accuracy of frozen section diagnosis has important implications regarding the type and extent of the primary surgery for gynecologic tumors.