Effect of letrozole on endometrial histology in patients with disordered proliferative endometrium and simple hyperplasia

This is a preliminary study investigating the efficacy of aromatase inhibitor letrozol on endometrial histology in patients with disordered proliferative endometrium or simple hyperplasia. In a randomized clinical trial, 92 patients with abnormal uterine bleeding who had disordered proliferative endometrium or simple hyperplasia in endometrial biopsy, were randomized into case and control groups. patients received 2.5 mg of letrozole daily in case group [n=46] and 40 mg of megestrol acetate daily in control group [n=46] for 3 months. Endometrial biopsy was performed 3 to 4 weeks after completion of therapy to assess response. After intervention in letrozole group, response to treatment was seen in 93% cases [including endometrial atrophy in 58.7% cases and weakly proliferative endometrium in 34.78% cases] and in megestrol group response to treatment was seen in 85% cases [including endometrial atrophy in 41.3% cases and weakly proliferative endometrium in 43.47% cases]. The difference between two groups was not statistically significant [P=0.31]. The results of this study show that pre and post menopausal women with disordered proliferative endometrium or simple hyperplasia can be successfully treated with letrozole alone. However, due to the lack of significant difference between the two groups, further studies with larger sample size is recommended for better clearance of the topic

Primary retroperitoneal mucinous tumor; report of two cases and review of literature

Primary retroperitoneal mucinous tumors are rare neoplasms and almost exclusively seen in women. In this case report we present two cases of this entity with their clinicopathologic features. The first patient was a 32 years old unmarried woman presented with abdominal pain. Ultrasound imaging demonstrated a solid and thick walled ovarian mass m. 105* 70*80 mm. At laparotomy a large retroperitoneal mass with extention to pelvis, dome of urinary bladder and upper abdomen was found and omentum was involved by the tumor. Histopathological examination revealed a mucinous adenocarcinoma with mural nodule contained high-grade anaplastic carcinoma in retroperitoneal space. The second case was a 36 years old woman with retroperitoneal mucinous cystadenoma. The first case died of disease at first month of her diagnosis. Primary retroperitoneal mucinous tumors that containing anaplastic carcinoma or sarcomas are highly aggressive tumors with poor prognosis showing metastasis by high-grade component

Comparison of the effect of gonadotropin-releasing hormone agonist and dopamine receptor agonist on uterine myoma growth. Histologic, sonographic, and intra-operative changes

To investigate the effect of 2 medications; Diphereline and Cabergoline, on uterine leiomyoma growth, and its histologic, sonographic, and intra-operative changes. In an effort to treat large uterine leiomyoma in symptomatic patients in the Gynecology Clinics of the Alzahra Teaching Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, from September 2007 to November 2008, 60 candidates randomized to receive Diphereline 3.75 mg, 4 times every 28 days [group I], and Cabergoline 0.5 mg, once a week for 6 weeks [group II], were included in this study. Clinical symptoms, feasibility of intra-operative dissection, intraoperative complications, sonographic, and pathologic characteristics of the tumor were evaluated. Thirteen patients from group I, and 10 patients from group II underwent surgery. There was a significant difference between the groups in the rate of lymphocyte infiltration [p=0.003], but not in other pathologic features. In both groups, the mitotic index was between 0-10. While there was no significant difference between the groups in the number [p=0.30], and volume of leiomyomas [p=0.65], however, changes in the uterine artery circulation was significant [p=0.001 [group I], p=0.026 [group II]]. In addition, there was a significant difference between the groups for intra-operative hemorrhage and adhesion of leiomyomas to the uterine wall. This study found that Cabergoline is as effective as Diphereline in the shrinkage of myomas, accompanied by improvement in the sonographic, clinical, and intra-operative outcomes without any adverse pathological changes, and could be a good medical regimen as an adjunct to surgical management