ABSTRACT
The presence of the giant abdominal-pelvic tumours is more and more rare because of the precocious methods of diagnosis. Sometimes the rare cases of giant uterine fibroma are met in medical practice and they need the use of atypical surgical techniques that are not entirely risk-free. In the present case, the giant uterine fibroma that was diagnosed (23/21/20 cm) was investigated clinically, and with imaging and pathologic techniques, then it underwent a surgical procedure in two stages, with major difficulties, because the entire anatomical structure of the pelvis was totally modified.
Subject(s)
Hysterectomy , Leiomyoma , Uterine Neoplasms , Female , Humans , Leiomyoma/diagnosis , Leiomyoma/surgery , Middle Aged , Treatment Outcome , Uterine Neoplasms/diagnosis , Uterine Neoplasms/surgeryABSTRACT
UNLABELLED: Almost all types of endometrial pathology in perimenopause have the same clinical features. That's why the paraclinical methods are the most useful for diagnosis. OBJECTIVE: To find which of the following: Pap smear, sonography, hysterography or hysteroscopy is more appropriate for the diagnosis. MATERIAL AND METHOD: We investigated 218 cases of endometrial hyperplasias and 57 of endometrial cancer between 45-74 years old. The final diagnosis was settled by pathological exam. RESULTS: For both of them the Pap smears has no significance; hysterography is not specific and old fashioned; the sonography may diagnose the disease but the hysteroscopy put the diagnosis in 87% cases of endometrial hyperplasias. In endometrial cancer the sonography separate the normal cases from the suspects and the hysteroscopy put the diagnosis in all cases but can not appreciate the myometrial invasion. CONCLUSION: There is no paraclinical method to be used alone for a correct diagnosis. Sonography can choose, hysteroscopy and biopsy put the diagnosis and treat.
Subject(s)
Endometrial Hyperplasia/diagnosis , Endometrial Neoplasms/diagnosis , Perimenopause , Aged , Biopsy , Female , Humans , Hysteroscopy/methods , Middle Aged , Papanicolaou Test , Postmenopause , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Ultrasonography , Uterine Neoplasms/diagnosis , Vaginal SmearsABSTRACT
UNLABELLED: The endometrium has a few possibilities to express the underlying pathology, even if there may be a potential dangerous one. This study is searching for a relationship between the ultrasound images of endometrial hyperplasias and the respective pathologic exams. MATERIAL AND METHOD: We analyzed 385 cases of endometrial hyperplasias hospitalized in the "Elena Doamna" Maternity from Iasi, Romania during the period 2000-2005. RESULTS: For all the cases included, the endometrium had a width from 2 mm to 20 mm, with a median of 9mm. The hyperplasias were: 70.18% simple hyperplasias without atypia, 18.52% complex hyperplasias without atypia, 7.1% complex hyperplasias with atypia and 4.17% secretory hyperplasias. There were no differences between the aspects or thickness of the endometrium in regard with any of the types of hyperplasias. CONCLUSIONS: Ultrasounds exams have a limited role to diagnose endometrial hyperplasias. They only selects patients for mandatory other investigations. Key words:
Subject(s)
Endometrial Hyperplasia/diagnostic imaging , Endometrial Hyperplasia/pathology , Endometrial Hyperplasia/diagnosis , Endometrium/diagnostic imaging , Endometrium/pathology , Female , Humans , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Ultrasonography, Doppler, Color/methodsABSTRACT
UNLABELLED: We have retrospectively evaluated the role of hysteroscopy for the diagnostic of the peri-menopausal metrorrhagia. METHODS: The cases included represented patients of more than 45 years, with persistent bleeding, from 2 gynecological hospitals (one public and one private), during one year, that were submitted to hysteroscopy for clarifying the diagnostic. The hysteroscopic endometrium descriptions were categorized as: atrophy, normal, simple or suspect hypertrophy, polyp, and adenocarcinoma, and they were compared to the pathological exam results. RESULTS: The descriptions were distributed among the categories: atrophy (8 cases), simple hypertrophy (17), suspect hypertrophy (3), polypoid (5), endometrial cancer (2) or normal (4). The correlation to pathological results was good, with only 14% of hysteroscopic underestimation of lesions. The sensitivity according to type of pathology, was 50 to 100%, specificity between 84% - 100%. CONCLUSION: Hysteroscopy is better than "blind" curettage in clarifying perimenopausal hemorrhagic endometrial pathology.
