ABSTRACT
OBJECTIVE: To follow a population at high risk for endometrial carcinoma after endometrial ablation, to determine if ablation alters the incidence or detection of endometrial pathology. STUDY DESIGN: The animal model included 33 New Zealand white rabbits. Of this cohort, 17 underwent surgical ablation of the endometrium via laparotomy, while 16 served as controls. Vaginal bleeding was assessed with monthly cotton swab examinations as well as daily observation of the subjects. All animals received unopposed estrogen for 18 months prior to necropsy. RESULTS: No animal in either arm of the study demonstrated vaginal bleeding. Two rabbits from the ablation group and three controls showed histologic evidence of atypical endometrial hyperplasia or adenocarcinoma (P > .20). One additional animal from each group had hyperplasia without atypia. CONCLUSION: This animal model suggests that endometrial ablation does not decrease the risk of endometrial carcinoma in patients at high risk of developing endometrial pathology. Detection of hyperplasia or carcinoma in such a population may prove difficult due to the absence of traditional signs of endometrial abnormalities.
Subject(s)
Adenocarcinoma/chemically induced , Catheter Ablation , Endometrial Neoplasms/chemically induced , Endometrium/surgery , Estradiol/adverse effects , Adenocarcinoma/epidemiology , Adenocarcinoma/veterinary , Animals , Endometrial Hyperplasia , Endometrial Neoplasms/epidemiology , Endometrial Neoplasms/veterinary , Endometrium/pathology , Estradiol/administration & dosage , Female , Incidence , Rabbits , Risk Factors , Uterine HemorrhageABSTRACT
Breast cancer metastatic to the cervix and uterus in the absence of extrapelvic foci is a rare finding in the medical literature. Signet ring breast carcinoma is also an unusual neoplasm. We present an asymptomatic 71-year-old woman 2 years status-post modified radical mastectomy for signet ring carcinoma who was found to have metastatic lesions to the cervix and endometrium at the time of a routine gynecological examination. Bone scan as well as computerized tomography of the chest, abdomen, and pelvis failed to locate other metastatic sites. We believe this to be the only reported case of signet ring breast carcinoma metastatic solely to the uterus and cervix. The patient's lack of recent pelvic examination highlights the need for continued gynecological evaluation in patients with breast cancer.
