ABSTRACT
The purpose of this study was to conduct a clinical and pathologic review of endometrial cancers diagnosed in women aged younger than 45 years to better identify the prognostic factors for this subgroup of women. We retrospectively evaluated the clinical history, treatment, and follow-up of patients with histologically confirmed endometrial cancer treated in Faculty Hospital Nitra, Slovakia from 1993 to 2003. Data were abstracted regarding tumor histology, grade, age, parity, stage, diabetes, use of oral contraceptives, body mass index (BMI), and survival. One hundred seventy-three patients with endometrioid histology were divided into two groups: younger group (age
Subject(s)
Adenocarcinoma/pathology , Endometrial Neoplasms/pathology , Adenocarcinoma/therapy , Adult , Age Factors , Endometrial Neoplasms/therapy , Female , Humans , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Prognosis , Retrospective StudiesABSTRACT
BACKGROUND: Patients with endometriosis rarely have a serum CA 125 concentration >100 IU/mL. A raised plasma level of D-dimer indicates active fibrinolysis, either secondary to clot formation or primarily activated. This condition is seldom diagnosed in patients with endometriosis. CASE REPORT: A 53-year-old woman was referred to our institution for acute abdominal pain. Laparoscopic surgery revealed a large ovarian cyst with rupture on the left side. Preoperative laboratory tests detected high serum CA 125 and D-dimer levels. Adnexectomy was performed, resulting in a sharp decrease in serum CA 125 and D-dimer concentration. We describe the clinical course of the patient. CONCLUSION: Rupture of a large ovarian endometrioma can lead to a high serum concentration of CA 125, a condition which, in addition to the detected pelvic mass, may mimic a malignant process. The increased D-dimer plasma level indicated that a ruptured endometriotic cyst can induce coagulation reactions.
Subject(s)
CA-125 Antigen/blood , Endometriosis/blood , Fibrin Fibrinogen Degradation Products/metabolism , Ovarian Cysts/blood , Diagnosis, Differential , Endometriosis/complications , Endometriosis/diagnosis , Endometriosis/etiology , Endometriosis/pathology , Endometriosis/surgery , Female , Gynecologic Surgical Procedures , Humans , Laparoscopy , Middle Aged , Ovarian Cysts/complications , Ovarian Cysts/pathology , Ovarian Cysts/surgery , Rupture, Spontaneous/blood , Rupture, Spontaneous/complicationsABSTRACT
AIM: To evaluate the routine surgical treatment of endometrial cancer in Slovak Republic in relation to current international recommendations. METHODS: A retrospective study based on a questionnaire was undertaken. Data on surgical and post-operative adjuvant therapy of endometrial cancer patients in Slovakia in 2001 were collected, assessed and validated for good clinical practice. RESULTS: We presented data of 298 cases of endometrial adenocarcinoma from 48 of 66 Slovak gynecologic departments. Laparotomy with hysterectomy and bilateral salpingo-oophorectomy was performed in 280/298 patients. Peritoneal washings were examined in 41/298 cases. Lymphadenectomy (pelvic and/or para-aortic) was performed in 52/298 of the women. Malignancy remained undiagnosed in 29/298 of the cases until it was detected by histological investigation of extirpated uterus. CONCLUSION: The study demonstrates that surgical management of endometrial cancer is far from optimal. It seems necessary to restrict treatment to the centres with gynecologic oncologists trained in pelvic surgery.