Longstanding survival without cancer progression in a patient affected by endometrial carcinoma treated primarily with leuprolide.

We report here a case of a patient affected by endometrial cancer and treated primarily with leuprolide, the surgical approach being unfeasible due to her compromised conditions. The therapy was continued for more than 6 years, and no progression of the disease was observed. During this period, some histological and immunohistochemical evaluations of the tumour (morphology, grading, proliferation and apoptotic index, E-cadherin expression) were performed. Furthermore, the expression of m-RNA for luteinizing-hormone releasing hormone (LHRH) receptors was determined. The results showed a discrepancy between some biological parameters of the tumour and its clinical characteristics. In fact, despite features suggestive of a progression of the cancer (such as the increase of both tumour grading and proliferating capacity (MIB-1), and a fall in the reparative process (appearance of mutated p53, reduced expression of both bcl-2 and c-erb-2) being detected, neither local invasion nor metastatic lesions were clinically observed. This discrepancy might be due to the maintenance of high levels of E-cadhezin. Moreover, since this tumour was shown to express mRNA for LHRH receptors, new evidence is provided about the favourable impact of LHRH analogue treatment in patients affected by endometrial cancer.

[Zinc blood levels in 73 puerperal women. Correlation with obstetric and neonatal complications]. / Livelli ematici di zinco in 73 puerpere. Correlazione con complicanze ostetriche e neonatali.

BACKGROUND: Low plasma zinc concentrations in pregnant women have been associated with certain obstetric and foetal complications. However, there is no agreement in previous studies and mediterranean populations have not been extensively studied. METHODS: The plasmatic zinc was tested in 73 mothers, within 24 hours post-partum, in order to evaluate an association between plasmatic zinc and various obstetric and fetal complications. The women were all from the Florence province and were admitted for delivery at the II Maternity Ward of the University of Florence (Third level Center); mothers of twins and foreign mothers were excluded. Subjects were consecutively included in the study. The values pointed out in a control group (n = 28) were compared with the hematic zinc of a) women who delivered by cesarean section (CS) for acute fetal distress or by operative delivery with vacuum extractor (n = 9), b,c) mothers whose children weighted over the 90th (LGA: n = 11) or under the 10th percentile (SGA: n = 13), and d) mothers who delivered prematurely (n = 12). The subjects included in two or more groups, were not considered. RESULTS: The plasmatic zinc of the control group has been significantly higher than that of mothers who delivered by vacuum extractor or by urgent CS (p < 0.0001) and than that of mothers whose newborns were LGA (p < 0.0024). The hematic zinc of the control group is not higher than that of mothers with SGA or premature children. CONCLUSIONS: The conclusions is drawn that even a relative zinc deficiency may negatively potentiate certain obstetric abnormalities in fetal development or in delivering.

[Use of a GnRH analogue in the treatment of certain forms of endometrial hyperplasia associated with menometrorrhagia]. / Impiego di un analogo del GnRH nel trattamento di alcune forme di patologia iperplastica endometriale associate a menometrorragia.

Hyperestrogenism is a powerful factor inducing the development of endometrial hyperplasia that in its turn may represent the first step in the natural history of endometrial carcinoma. During menopause it is possible to have a condition to relative hyperestrogenism induced by a residual hormonal activity and by aromatisation of androgens in the adipose tissue. Therapeutical approach in this pathology aims to control hyperplastic development of the endometrial mucosa and to exclude menometrorrhagia. This study has been performed according to an open uncontrolled design in 14 women (4 menopausal women) with abnormal uterine bleeding and hysteroscopic endometrial cystic or adenomatous hyperplasia. At the beginning and at the end of treatment all patients underwent routine biohumoral blood-tests, hysteroscopy and diagnostic curretage. The GnRH analogue (tryptorelin) 3.75 mg 1 ampoule i.m. every 28 days was administered during a 6-month treatment cycle. At the end of therapy bleeding had disappeared in all menopausal women; in the premenopausal group 8 patients have shown a normal menstrual cycle while 2 are still amenorrhoic. The final hysteroscopic evaluation displayed atrophic endometrium in 9 patients and simple proliferative endometrium in 5 cases. Safety was excellent: 3 cases of slight increase of systolic blood pressure and 1 case of slight increase of weight took place. Our results demonstrate therapeutic efficacy of GnRH analogues in the treatment of endometrial hyperplasia with menometrorrhagia either in premenopausal or menopausal women.