Hipertensión pulmonar y leiomiomas uterinos, ¿existe relación causal? Serie de casos y revisión fisiopatológica / Pulmonary Hypertension and Uterine Leiomyomas, Is there a Causal Relationship? Case Series and Pathophysiological Review

Introducción: Los leiomiomas uterinos son un tipo de neoplasia benigna de frecuente aparición en mujeres de edad reproductiva, relacionados con enfermedad tromboem- bólica venosa. Este vínculo surge del efecto producido por la compresión de fibromas que genera estasis venosa en la región pelviana. Sin embargo, este pareciera no ser el único factor que lo relaciona con el desarrollo posterior de hipertensión pulmonar, sino que su presencia es gatillo de una serie de fenómenos que influyen sobre la vasculatu - ra pulmonar y también a nivel sistémico. Método: Revisión de una serie de casos (seis) atendidos en nuestra unidad, seguido de una revisión sobre la relación entre leiomio- mas y distintas formas de hipertensión pulmonar con una revisión desde la fisiopatología. Resultado y conclusiones: Encontramos sustento bibliográfico en los múltiples caminos fisiopatológicos que relacionan los mediadores vasculares comunes, que parecieran ser el punto clave en la relación entre estas dos patologías.

Introduction: Uterine leiomyomas are a type of benign neoplasm that frequently appears in women of reproductive age, related to venous thromboembolic disease. This link arises from the effect produced by the compression of fibroids, which generates venous stasis in the pelvic region. However, this seems not to be the only factor that re- lates it to the subsequent development of pulmonary hypertension, but rather its presence is a trigger for a series of phenomena that influence the pulmonary vasculature and also at a systemic level. Method: Review of a series of cases (six) cared for in our unit, followed by a review on the relationship between leiomyomas and different forms of pulmonary hypertension with a review from the pathophysiology. Result and conclusions: We found bibliographic support in the multiple pathophysiological paths that relate the common vascular mediators, which appear to be the key point in the relationship between these two pathologies.

Mapa de evidências efetividade clínica das Medicinas Tradicionais, Complementares e Integrativas para Câncer do Útero: informe executivo / Map of evidence clinical effectiveness of Traditional, Complementary and Integrative Medicines for Uterine Cancer: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos clínicos das terapias complementares e integrativas para o câncer do útero e do colo do útero. A partir da caracterização de centenas de estudos na série de mapas de evidências das Medicinas Tradicionais, Complementares e Integrativas (MTCI/PICS), foram selecionados e incluídos 26 estudos de revisão (18 revisões sistemáticas, 7 revisões sistemáticas e metanálises, e 1 metanálise). As revisões avaliaram o efeito de 28 tipos de intervenções distribuídos em 3 grupos ­ Fitoterapia e Plantas Medicinais; Terapias não-Farmacológicas; Suplementos / Produtos Naturais ­ e associadas a 33 desfechos de saúde distribuídos em 5 grupos: Curso da doença; Sintomas relacionados ao Câncer; Indicadores Metabólicos e Fisiológicos; Bem-Estar, Vitalidade e Qualidade de Vida; Saúde Mental.

MRI Findings of the Uterine Tumors Resembling Ovarian Sex Cord Tumors:Report of Two Cases / 中国医学科学院学报

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.

Tumor de músculo liso uterino de potencial maligno incierto (STUMP): reporte de caso y revisión de la literatura / Uterine smooth muscle tumor of uncertain malignant potential (STUMP): case report and literature review

Myometrial smooth muscle neoplasms are the most common gynecologic tumors with a prevalence of 70-80% at age 50. Among women undergoing hysterectomy or myomectomy for a suspected diagnosis of leiomyoma, 0.01% receive a diagnosis of STUMP. Clinically, the average age of presentation is between 41-48 years. Tumors ranging from 3 to 30 cm have been described. Signs and symptoms are similar to leiomyomas, such as abnormal uterine bleeding, anemia, dysmenorrhea, pelvic pain, pelvic mass, infertility or other types of pain secondary to compression of adjacent organs. Due to the limited literature available, there is no definite management consensus, and treatment and follow-up options are limited to observational studies. The standard treatment is total hysterectomy with or without bilateral salpingo-oophorectomy; if fertility has already been completed, there is no role for adjuvant hormonal therapy or chemotherapy. The overall 5-year survival is 92-100%. A case of a 31-year-old woman with STUMP is presented.

Tumor de células epitelioides perivasculares (PEComa) uterino en una paciente pediátrica: reporte de caso / Uterine perivascular epithelioid cell tumor (PEComa) in a pediatric patient: case report

El PEComa es un tumor de células epitelioides, perivascular, de origen mesenquimatoso. Estos tumores corresponden a un grupo raro de neoplasias. Hay cerca de 100 casos reportados de los que solo el 30% son de origen ginecológico y el cuerpo uterino es el sitio más frecuente. Debido a su baja frecuencia de aparición no hay una conducta médica y tratamiento establecidos, por lo cual es un reto el manejo de esta entidad. La presentación en población pediátrica es extremadamente rara, con datos limitados de su frecuencia de presentación en este grupo etario. Presentamos el caso de una paciente de 13 años que consultó por dolor pélvico; se realizaron imágenes diagnósticas que documentaron una masa paraanexial derecha sólida; es llevada a cirugía obteniendo como hallazgo un tumor dependiente del cuerpo uterino cuya histología correspondía a un PEComa con características de comportamiento maligno

PEComa is a perivascular epithelioid cell tumor of mesenchymal origin. These tumors correspond to a rare group of neoplasms. About 100 cases have been reported, of which only 30% are of gynecological origin, and the uterine body is the most frequent site. Due to its low frequency of appearance, there is no established medical conduct and treatment, which is why the management of this entity is a challenge. Presentation in the pediatric population is extremely rare, with limited data on its frequency in this age group. We present the case of a 13-year-old patient who consulted for pelvic pain. Diagnostic images were performed that documented a solid right para-adnexal mass. She was taken to surgery, which evidenced a tumor dependent on the uterine body with histology corresponding to a PEComa with characteristics of malignant behavior

Sarcoma uterino de topografía cervical / Sarcoma of the uterus of cervical topography / Sarcoma de colo de utero

Introducción: Los sarcomas uterinos son tumores poco frecuentes. Se originan en el tejido uterino de origen mesodérmico (músculo, tejido conjuntivo o estroma), siendo los más frecuentes los leiomiosarcomas, seguidos de los sarcomas del estroma endometrial. La expresión clínica de la enfermedad puede ser con sangrados genital, distensión abdominal y/o síntomas compresivos. Muchas veces se diagnostican en pacientes que son hatadas quirúrgicamente con diagnóstico de miomatosis uterina y, lo más frecuente es el diagnostico anatomopatológico posto peratorio de la pieza quirúrgica. El rol de la cirugía (histerectomía y anexectomía) es fundamental en el tratamiento. Descripción: El video presenta la evaluación diagnóstica y el abordaje quirúrgico de una paciente en la que se diagnosticó un leiomiosarcoma uterino de topografía cervical. Conclusiones: Se trata de una patología poco frecuente, con la particularidad de la ubicación, generando dificultades diagnósticas (clínica y paraclínicas) así como de abordaje quirúrgico. Ver video en https://www.youtube.com/watch?v=9rr8R2L7CWs

Summary: Introduction: Sarcoma of uterus are rather unusual tumors. They ori ginate in the mesodermal tissue of the uterus (muscle, connective tissue or stroma), the most frequent ones being leiomyosarcoma, followed by endometrial stromal sarcomas. The clinical presentation of the disease may include genital bleeding, abdominal distention or compressive symptoms. They are often diagnosed in patients who are surgically treated with a diagnosis of uterine myoma, upon the postoperative pathological study of the surgical piece. The role of surgical treatment (hysterectomy and anexectomy) is of the essence. Description: The video presents the diagnostic assessment and sur gical approach of a patient who was diagnosed with leiomyosarcoma of the uterus with cervical topography. Conclusions: It it rather an unusual condition with a special loca tion. which results in diagnostic difficulties (both clini cal and paraclinical) as well as hi the surgical approach. Watch video at https://www.youtube.com/watch?v=9rr8R2L7CWs

Introdução: Os sarcomas uterinos sào tumores raros. Originam-se no tecido uterino de origem mesodérmica (músculo, tecido conjuntivo ou estróina), sendo os leiomiossarco- mas os mais frequentes, seguidos dos sarcomas estro- mais endometriais. A expressão clínica da doença pode ser com sangramento genital, distensão abdominal e/ou sintomas compressivos. São frequentemente diagnosticados em pacientes tratadas cirurgicamente com diagnóstico de miomatose uterina e, mais frequentemente, com diagnóstico da anatomia patológica pós-operatória da peça cirúrgica. O papel da cirurgia (histerectomia e anexectomia) é essencial no tratamento. Descrição: O vídeo apresenta a avaliação diagnóstica e abordagem cirúrgica de uma paciente diagnosticada com leiomiossarcoma de colo de útero. Conclusões: É uma patologia pouco frequente, pela particularidade da sua localização, gerando dificuldades de diagnóstico (clínico e complementar) bem como de abordagem cirúrgica. Veja o vídeo em https://www.youtube.com/watch?v=9rr8R2L7CWs

Profile of gynecological cancers in a tertiary hospital, Eastern Nigeria

Introduction: there is a great diversity in the profile of cancers in the world. This study set out to analyze the profile of gynecological cancer in Federal University Teaching Hospital, Owerri, [FUTHO] (former Federal Medical Centre, Owerri, Imo state, Nigeria). Methods: this was a retrospective cross sectional descriptive study of the records of women admitted in the gynecological ward in FUTHO from January 2020 to November 2022. It was analyzed using SPSS version 23.0 and reported in simple percentages for categorical variables and measures of central tendency for quantitative variables. Results: a total of 1,378 gynecological patients were admitted into the Gynaecological ward of the hospital, out of which 242 (17.6%) were cancer cases. The most common cancer over the three years in review, was ovarian, 81(33.5%), followed by cervical, 66 (27.3 %), endometrial, 65 (26.8 %), choriocarcinoma, 22 (9.1%), vulvar, 6 (2.5%) and vagina, 2(0.8%). The most common gynecological cancers in this study is very different from previous reports from Nigeria and other African countries. The pattern looks like that seen in the developed countries where endometrial and ovarian cancers top the list. Conclusion: this report shows a possible change in lifestyle and improved access to cervical cancer prevention strategies. It is also assumed that all the facilities who have recorded cervical cancer as the most common cancer can actually have a similar result as ours if a more current review is done.

Les cancers gynécologiques en pratique oncologique à Lomé / Gynecological cancer in oncology practice in Lomé

Introduction. Les cancers gynécologiques constituent un problème majeur de santé publique dans le monde. L'objectif de cette étude était de déterminer la fréquence des cancers gynécologiques en pratique oncologique à Lomé et d'en étudier les aspects épidémiologiques et histo-cliniques. Méthodes. Il s'agitd'une étude rétrospective et descriptive portant sur tous les cancers gynécologiques reçus en oncologie entre le 1erJanvier 2016 et le 31 Décembre 2021. Résultats. Au total 202 cas de cancers gynécologiques ont été enregistrés. L'âge moyen des patientes était de 54 ans avec des extrêmes de 20 et 88 ans. Les cancers les plus fréquents étaient le cancer du col utérin (n=88; 43,6%), du corps utérin (n= 57; 28,3%) et de l'ovaire (n= 35; 17,4%). Le carcinome épidermoïde était le type histologique le plus fréquent dans le cancer du col (n= 86; 97,7%) tandis que les cancers du corps de l'utérus étaient majoritairement des adénocarcinomes (n=46 ; 80,7 %). Tous les cancers de la vulve et du vagin étaient des carcinomes épidermoïdes et la majorité des cancers de l'ovaire était des tumeurs épithéliales (n=29 ; 82,9%). Les deux-tiers des patients o été diagnostiqué à un stade avancé (stade III et IV) (n=134 ; 66,3%). Conclusion. Les cancers gynécologiques sont fréquents dans notre pratique et majoritairement diagnostiqués à un stade tardif. Cette étude souligne la nécessité d'une détection précoce de ces affections afin d'améliorer le pronostic des patientes.

Introduction. Gynecological cancers are an important public health problem worldwide. The objective of this study was to describe the epidemiological, clinical, and histopathological features of gynecological cancer in clinical oncology practice in Lomé. Methods. This was a retrospective study of histopathological confirmed gynecological malignancies conducted in the department of oncology from January 2016 to December 2021. Results. A total of 202 cases were identified. The mean age of patients was 54years [range20-88years]. The most common gynecological malignancy was cervical cancer (n=88 ; 43.6%), followed by uterine corpus cancer (n= 57 ; 28.3%) and ovarian cancer (n= 35 ; 17.4%). The most common histopathological diagnosis of cervical cancer was squamous cell carcinoma (n= 86 ; 97.7%) while most corpus uterine cancers were endometrioid adenocarcinoma (n= 46 ; 80.7 %). Vulval and vagina cancers were squamous cell carcinoma and the majority of ovarian cancers were epithelial tumours (n= 29 ; 82.9%). Two-thirds of patients were diagnosed at the advanced stage (stage III et IV) (n= 134 ; 66.3%). Conclusion. Gynecologic cancers are common in our practice. This study emphasizes the necessity of early detection of these diseases to improve prognostic and patient survival

Fumarate hydratase deficient uterine leiomyoma: a clinicopathological and molecular analysis of 80 cases / 中华病理学杂志

Objective: To investigate the clinicopathologic and molecular characteristics of fumarate hydratase (FH) deficient uterine leiomyoma. Methods: Eighty cases of FH deficient uterine leiomyoma were diagnosed from April 2018 to September 2022 in Department of Pathology, Peking University Third Hospital. Sanger sequencing of FH gene exons (exon 1-10) were performed on tumor tissues and matched non-tumor tissues/peripheral blood for all cases. FH immunohistochemistry were performed in 74 cases; S-(2-succino)-cysteine (2SC) were also detected by immunohistochemistry in five cases. Results: Patients' age ranged from 18 to 54 (36.0±7.5) years, with more than 60% exhibiting clinical symptoms of multiple and large leiomyomas (the median diameter was 70 mm). More than four histologic features, including staghorn vasculature, alveolar-pattern edema, bizarre nuclei, oval nuclei arranged in chains, prominent eosinophilic nucleoli with perinucleolar haloes and eosinophilic intracytoplasmic globules were observed in 98.5% (67/68) patients. The immunohistochemical sensitivity of FH and 2SC were 97.3% and 100%, respectively. Based on the Sanger sequencing results, the cases were divided into germline variant group (31 cases), somatic variant group (29 cases) and no variant group (20 cases). Sixty-nine percent (20/29) of the patients with FH germline variation had clear family history. Conclusions: Clinical features, histological morphology, FH and 2SC immunohistochemistry and Sanger sequencing have their own significance and limitations in differential diagnosis of FH deficient uterine leiomyoma. In clinical practice, the above information should be fully integrated and studied for accurate pathologic diagnosis and selection of patients with FH germline variation.

Leiomioma submucoso de gran tamaño: una presentación inusual. Reporte de Caso / Large submucosal leiomyoma: an unusual presentation

Se ha postulado que más del 70 % de las mujeres antes de la menopausia son diagnosticadas de leiomiomas; de estas un 25 % presentan sintomatología grave. La ecografía es la modalidad de imagen de primera elección para su estudio. Se tiene registros de progresión de leiomiomas a leiomiosarcomas, que conllevan a un mal pronóstico y son responsables de una cuarta parte de las muertes por neoplasias uterinas, con una sobrevida a 5 años que van desde 46-53 %, lo cual incentiva el diagnóstico precoz y eficaz de masas uterinas. El caso reportado es una presentación inusual de un leiomioma de gran tamaño, que por los hallazgos de imagen se reportó como una neoplasia maligna, su aspecto macroscópico totalmente atípico reforzaba la sospecha imagenológica. Solo se pudo determinar el diagnóstico definitivo mediante estudio histopatológico posterior a histerectomía. Las evaluaciones ginecológicas de rutina deben incluir exámenes especializados de imagen pélvica, la ausencia de presentación típica o síntomas característicos de una patología no debe ser motivo para obviar exámenes complementarios que permitan un diagnóstico oportuno y tratamiento eficiente de leiomiomas, incluso en casos de presentaciones inusuales y desafiantes para el diagnóstico, como el que se ha reportado en esta obra.

It has been postulated that more than 70% of premenopausal women are diagnosed with leiomyomas; Of these, 25% have severe symptoms. Ultrasound is the imaging modality of choice for its study. There are reports of progression from leiomyomas to leiomyosarcomas, which leads to a poor prognosis, and is responsible for a quarter of deaths from uterine neoplasms, with a 5-year survival ranging from 46-53%; this should encourage early and effective diagnosis of uterine masses. The reported case is an unusual presentation of a large leiomyoma, which due to its imaging characteristics, was reported as a malignant neoplasm. Its completely atypical macroscopic appearance reinforced the imaging diagnosis suspicion. The definitive diagnosis could only be determined by histopathological study after hysterectomy. Routine gynecological evaluations should include specialized pelvic imaging exams, the absence of a typical presentation or characteristic symptoms of a pathology should not be a reason to obviate ancillary testing that would allow a timely diagnosis and effective treatment of leiomyomas, even in unusual and challenging presentations, such as with the patient in this case report.

Cuando el cuerpo no puede / When the Body can't

En el presente trabajo nos proponemos visibilizar el padecimiento psíquico de las mujeres que atraviesan un cáncer ginecológico y que, además, deben hacer frente a la imposibilidad de gestar como consecuencia de la enfermedad. Y también reflexionar sobre el trabajo del psicólogo en este ámbito. Para cumplir con nuestro objetivo nos valdremos del episodio cinco de la segunda temporada de la serie televisiva estadounidense "New Amsterdam" (S2, E 5), estrenada en el año 2018 en Netflix, la plataforma de streaming estadounidense

In this paper we intend to make visible the psychological suffering of women who go through a gynecological cancer and who, in addition, must face the impossibility of gestating as a result of the disease. And also reflect on the work of the psychologist in this area. To meet our goal, we will use episode five of the second season of the American television series "New Amsterdam" (S2, E 5), premiered in 2018 on Netflix, the American streaming platform

Embarazo con miomatosis uterina complicado con isquemia intestinal: reporte de un caso / Pregnancy with uterine myomatosis complicated by intestinal ischemia: case report

Resumen Los miomas uterinos, también conocidos como fibromas o leiomiomas, son los tumores uterinos benignos más prevalentes. Afectan a las mujeres principalmente durante sus años reproductivos y se diagnostican hasta en un 70% de las mujeres blancas y en más del 80% de las mujeres de ascendencia africana durante su vida, con una prevalencia durante el embarazo del 2% al 10%. Pueden ser asintomáticos hasta en un 70% de las pacientes, y se estima que pueden ocurrir complicaciones en aproximadamente una de cada 10 mujeres embarazadas. Se han asociado a complicaciones y resultados adversos del embarazo, según su tamaño y ubicación en el útero, y pueden manifestarse de diferentes formas. Presentamos el caso de una mujer de 30 años, con embarazo en el tercer trimestre, quien consultó por dolor abdominal, con ecografías obstétricas durante su control prenatal que reportaban miomatosis uterina, quien presentó isquemia intestinal por un vólvulo de intestino delgado versus compresión extrínseca.

Abstract Uterine fibroids, also known as fibroids or leiomyomas, are the most prevalent benign uterine tumors, affecting women mainly during their reproductive years and are diagnosed in up to 70% of white women and more than 80% of women of African descent during their lifetime, with a prevalence during pregnancy of 2% to 10%; they may be asymptomatic in up to 70% of patients, and it is estimated that complications may occur in approximately one in 10 pregnant women. They have been associated with complications and adverse pregnancy outcomes, depending on their size and location in the uterus, they can manifest in different ways. We present the case of a 30-year-old woman, pregnant in the third trimester, who consulted for abdominal pain, with obstetric ultrasound scans during her prenatal check-up reporting uterine myomatosis, who presented intestinal ischemia due to small bowel volvulus versus extrinsic compression.

Analysis of phenotype and FH gene variation in a pedigree affected with hereditary leiomyomatosis and renal cell carcinoma syndrome / 中华医学遗传学杂志

OBJECTIVE@#To analyze clinical phenotype and genetic variants in a Chinese pedigree of hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome.@*METHODS@#Whole exome sequencing was carried out for the proband from the pedigree. Suspected FH gene variants were validated by Sanger sequencing. Clinical manifestation and histopathological examination were used to analyze the pedigree comprehensively.@*RESULTS@#The pedigree met the clinical diagnostic criteria for HLRCC syndrome. The whole exome sequencing showed that the FH gene of the proband had a heterozygous missense variant of c.1490T>C (p.F497S), which was consistent with the Sanger sequencing. The mother, daughter and son of the proband all had the heterozygous missense variant of c.1490T>C (p.F497S). According to the American Society of Medical Genetics and Genomics Classification Standards and Guidelines for Genetic Variations, c.1490T>C (p.F497S) (PM2+PP1-M+PP3+PP4) was a possible pathogenic variant. Based on our literature search, this variant was a new variant that had not been reported.@*CONCLUSION@#The FH gene missense variant of c.1490T>C (p.F497S) may be the cause of the HLRCC syndrome pedigree, which provides a basis for the genetic diagnosis and genetic counseling of the HLRCC syndrome.

MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report / 中国医学科学杂志(英文版)

Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case, a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand, there was no obvious particularity in imaging features and clinical features, especially for uncomfortably identifying endometrial cancer. On the other hand, APA has a pedicle, attaching to any part of the uterine cavity, which can cause pseudocoel between the mass with the uterine cavity wall. So, when it comes to getting the pathological tissue in the absence of hysteroscopy, it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore, preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime, pathological tissue of APA can be obtained by hysteroscopy in visual conditions.

Metastasizing leiomyoma during pregnancy

Uterine leiomyoma is a benign tumor of myometrial tissue which affects women of reproductive age. Its prevalence increases with age and has a peak incidence at the age of forty. The term "metastasizing leiomyoma" refers to a tumor of dense connective tissue and smooth myometrial muscle cells located outside the uterus. This group of tumors can metastasize to different organs, the lung being its main focus. We present the case report of a 33-year-old female gravida 3, para 1, abortus 1, at 11 weeks of pregnancy, with pelvic masses. The diagnosis was metastasizing leiomyoma during pregnancy.

Pulmonary Benign Metastasizing Leiomyoma: Case Report of Late Occurrence in Postmenopausal Patient / Leiomiomatose Benigna Metastatizante Pulmonar: Relato de um Caso com Ocorrência Tardia em Paciente Pós-menopausa / Leiomiomatosis Benigna Metastatizante Pulmonar: Reporte de un Caso con Ocurrencia Tardía en Paciente Posmenopáusica

Introduction: Pulmonary benign metastasizing leiomyoma (PBML) is a rare condition that occurs most commonly in young women of reproductive age some years after hysterectomy. The aim of this study was to report a PBML case which occurred 33 years after hysterectomy in a postmenopausal patient. Case report: A 59-year-old female diabetic patient, G2P2A0, with dyslipidemia, a non-smoker and ex-alcoholic (quit in the 90s), with pulmonary symptoms was referred to the health service. A chest computed tomography (CT) revealed multiple pulmonary nodules. A previous history of hysterectomy at 26 years of age led to a diagnostic hypothesis of PBML. The patient underwent segmentectomy of the largest nodule (measuring 1.2 x 0.9 cm) located in the left lung. Histopathology and immunohistochemistry studies confirmed the diagnosis of PBML. Conclusion: The patient is currently in good physical condition (regression of previous pulmonary symptoms) and scheduled for clinical follow-up. A new chest CT will be performed in 6 months

Introdução: A leiomiomatose benigna metastatizante pulmonar (LBMP) é uma doença rara, ocorrendo mais comumente em mulheres jovens em idade reprodutiva alguns anos após a realização de histerectomia. O objetivo deste estudo foi relatar um caso de LBMP de ocorrência tardia, 33 anos após a realização de histerectomia, em uma paciente pós-menopausa. Relato do caso: Paciente do gênero feminino, 59 anos, G2P2A0, diabética, dislipidêmica, não tabagista e ex-etilista (parou na década de 1990), foi encaminhada ao serviço médico com sintomas pulmonares, sendo realizada tomografia computadorizada (TC) de tórax que revelou múltiplos nódulos pulmonares. Havia história prévia de histerectomia aos 26 anos de idade, sendo levantada a hipótese diagnóstica de LBMP. Paciente realizou segmentectomia do maior nódulo (medindo 1,2 x 0,9 cm) localizado no pulmão esquerdo. Exame anatomopatológico e imuno-histoquímica confirmaram o diagnóstico de LBMP. Conclusão: Atualmente, a paciente se encontra em seguimento clínico e em bom estado geral (sem os sintomas pulmonares apresentados inicialmente). Será realizada uma nova TC de tórax em seis meses

Introducción: La leiomiomatosis benigna metastatizante pulmonar (LBMP) es una enfermedad rara, que ocurre con mayor frecuencia en mujeres jóvenes en edad reproductiva pocos años después de la histerectomía. El objetivo de este estudio fue reportar un caso de LBMP de inicio tardío, 33 años después de la histerectomía, en una paciente posmenopáusica. Reporte del caso: Paciente de género femenino, 59 años, G2P2A0, diabética, dislipidémica, no fumadora y exalcohólica (parado en los 90), fue remitida al servicio por cuadro pulmonar, siendo sometida a tomografía computarizada (TC) de tórax, que reveló múltiples nódulos pulmonares. Existía antecedente de histerectomía a los 26 años, planteando la hipótesis diagnóstica de LBMP. Paciente fue sometida a segmentectomía del nódulo de mayor tamaño (de 1,2 x 0,9 cm) localizado en el pulmón izquierdo. El examen patológico y la inmunohistoquímica confirmaron el diagnóstico de LBMP. Conclusión: Actualmente la paciente se encuentra en seguimiento clínico y en buen estado general (sin los síntomas pulmonares presentados inicialmente). Se realizará una nueva TC de tórax en seis meses

Nódulo del estroma endometrial: Reporte de un caso infrecuente / Endometrial stromal nodule: A rare case report

Introducción: Los tumores del estroma endometrial representan menos del 2% de los tumores uterinos, estando dentro de las neoplasias menos comunes del cuerpo uterino. Se pueden dividir en cuatro categorías principales: nódulo del estroma endometrial, sarcoma del estroma endometrial de bajo grado, sarcoma del estroma endometrial de alto grado y sarcoma uterino indiferenciado. En el presente trabajo se describe el caso de un paciente con diagnóstico de nódulo del estroma endometrial. Caso clínico : Paciente femenino de 50 años de edad, quien refiere inicio de enfermedad en marzo de 2022, caracterizado por presentar sangrado uterino anormal anemizante y aumento de volumen abdominal, por lo que acude a facultativo foráneo, donde indican paraclínicos. Para el día 12 de julio de 2022, presentó dolor abdominal de aparición brusca de moderada a severa intensidad. Motivo por el cual acudió a nuestro centro. Se determina anemia y leucocitosis. Estudios de imagen reportan masa voluminosa, densidad mixta, bien delimitada. Otra lesión hiperecogénica, que corresponde a quiste unicameral de ovario derecho. Se decide resolución quirúrgica, mediante la realización de laparotomía exploradora más protocolo de endometrio, con evolución satisfactoria de la paciente. Conclusión : La histerectomía es el tratamiento de elección. El estudio anatomopatológico es fundamental para su diagnóstico final y diferenciación de los sarcomas estromales, ya que su pronóstico, tratamiento y seguimiento es diferente(AU)

Introduction: Endometrial stromal tumors represent less than 2% of uterine tumors, being among the least common neoplasms of the uterine body. They can be divided into four main categories: endometrial stromal nodule, low-grade endometrial stromal sarcoma, high-grade endometrial stromal sarcoma and undifferentiated uterine sarcoma. This paper describes the case of a patient with a diagnosis of endometrial stromal nodule.Clinical case : A 50-year-old female patient, who reported the onset of the disease in March 2022, characterized by abnormal uterine bleeding with anemia and increased abdominal volume, for which she went to a foreign physician, where they indicated paraclinical tests. On July 12, 2022, he presented abdominal pain of sudden onset of moderate to severe intensity. Which is why she came to our center. Anemia and leukocytosis are determined. Imaging studies report a voluminous mass, mixed density, well delimited. Another hyperechoic lesion, which corresponds to a unicameral cyst of the right ovary. Surgical resolution was decided by performing an exploratory laparotomy and endometrial protocol, with satisfactory evolution of the patient.Conclusion : Hysterectomy is the treatment of choice. The anatomopathological study is fundamental for its final diagnosis and differentiation of stromal sarcomas, since its prognosis, treatment and follow-up are different(AU)

Cervical cancer in the Hauts-Bassins region of Burkina Faso: Results of a screening campaign by visual inspection with acetic acid (VIA screening in Burkina Faso)

This study was conducted to describe the distribution of precancerous and cancerous lesions of the cervix uteri, enumerated during a mass screening in Burkina Faso. We conducted a cross-sectional study involving 577 women aged 18 to 60 years, carried out from November 23 to December 19, 2013, in the city of Bobo-Dioulasso and in the rural commune of Bama. Regarding the screening results, 89 participants (15.4%) were positive for pre-malignant cervical lesions. Chi-square testing and logistic regression analyses were conducted to identify the likelihood of cervical pre-cancer lesion in the women. Participants less than 29 years old were approximately 3 times more likely to have cervical lesions than participants >39 years. Participants who were parous (1-3 deliveries) and multiparous (four or more deliveries) were approximately 4 times more likely to present with cervical lesions than nulliparous women. Access to screening services is low in the Bobo-Dioulasso region. Further research should be conducted to understand the incidence and distribution of cervical precancerous and cancerous lesions in Burkina Faso. (Afr J Reprod Health 2022; 26[6]:97-103).

Gran mioma uterino: manejo prequirúrgico con uso de agonistas de gnrh: reporte de un caso / Large uterine myoma: presurgical management with the use of gnrh agonists: case report

Introducción: Los leiomiomas uterinos son los tumores pélvicos benignos más comunes entre las mujeres. Se estima que 60% de las mujeres llegan a tener miomatosis a lo largo de la vida (1). La necesidad de tratamiento médico y/o quirúrgico es muy importante de evaluar, ya que los fibromas son una fuente importante de morbilidad ginecológica. Objetivos: Describir el caso de un gran mioma uterino con manejo prequirúrgico de análogos de GnRH, analizando los hallazgos obtenidos en el caso según la evidencia actual. Discusión: Se reporta el caso de una mujer de 29 años sin antecedentes mórbidos conocidos, con presencia de una gran masa abdominal, motivo por el cual se realizó una ecotomografía abdominal que evidenció una masa sugerente de un gran mioma uterino subseroso. Se realizó miomectomía vía laparotomía previo tratamiento médico con análogos de GnRH. Actualmente la frecuencia de miomas de gran tamaño es poco frecuente, por lo que se busca discutir el impacto del tratamiento médico previo a la cirugía en mujeres jóvenes. Conclusiones: La experiencia con el uso prequirúrgico de agonistas de GnRH indica una ventaja en el trabajo bien definida y su uso como tratamiento coadyuvante a la cirugía está bien establecido. Sin embargo, se debe tener en cuenta la posibilidad de recurrencia de los miomas

Introduction: Uterine leiomyomas are the most common benign pelvic tumors in women. It is estimated that 60% of women develop myomatosis throughout life (1). The need for medical and / or surgical treatment is very important to assess, since fibroids are an important source of gynecological morbidity. Objectives: To describe the case of a large uterine myoma with presurgical management of GnRH analogues and to summarize updated evidence on their use. Discussion: The case of a 29-year-old woman with no known morbid history is reported, with the presence of a large abdominal mass, which is why an abdominal ultrasound scan was performed, which revealed a mass suggestive of a large subserous uterine myoma. Myomectomy was performed via laparotomy after medical treatment with GnRH analogues. Currently, the frequency of large fibroids is rare, so we seek to discuss the impact of medical treatment prior to surgery in young women. Conclusions: Experience with the presurgical use of GnRH agonists indicates a well-defined treatment advantage and its use as adjunctive treatment to surgery is well established. However, the possibility of recurrence of fibroids should be taken into account