ABSTRACT
Aproximadamente un 25% de las mujeres en edad reproductiva tiene miomas, de estas el 50% tiene síntomas relevantes. El sangrado menstrual anómalo, el dolor o presión, la infertilidad y los abortos de repetición están asociados frecuentemente con miomas. Aunque la cirugía y las terapias radiológicas se usan frecuentemente para el manejo de estas tumoraciones, las terapias médicas se consideran como de primera línea en el tratamiento de los miomas. El objetivo de este artículo es que sirva de guía en la toma de decisiones en el manejo de los miomas (AU)
Approximately 25% of reproductive age females have fibroids; of these 50% have relevant symptoms. Abnormal menstrual bleeding, pain, pressure, infertility and repeated miscarriages are frequently associated with fibroids. Although surgery and radiological therapies are frequently used to manage these tumors, medical therapies are considered the first-line treatment for fibroids. The objective of this article is to serve as a guide for decision-making in the management of fibroids (AU)
Subject(s)
Female , Humans , Leiomyoma/therapy , Uterine Neoplasms/therapy , Uterus/surgery , Antineoplastic Agents, Hormonal/therapeutic use , High-Intensity Focused Ultrasound Ablation , Hysterectomy , Uterine Artery Embolization , Watchful WaitingABSTRACT
PURPOSE: To correlate clinical outcomes after uterine artery embolization (UAE) performed to treat uterine fibroids with the presence of varying types of utero-ovarian anastomoses (UOA). MATERIALS AND METHODS: A retrospective analysis was performed of all uterine angiograms from 202 patients (mean age 42 y, range 28-54 y) who underwent UAE because of heavy menstrual bleeding, dysmenorrhea, or anemia or a combination of these symptoms. UOA were classified as absent or present, unilateral or bilateral. The effects of UOA on long-term outcomes (clinical endpoints such as control of bleeding and pain) and complications (amenorrhea) were assessed statistically using Kaplan-Meier curves and χ(2) and log-rank tests. RESULTS: Of the UOA in 104 women, 38 anastomoses were bilateral, and 66 were unilateral. Type III was the most common type of anastomosis (66 cases) followed by type Ia (22 cases) and type Ib (18 cases); there were no type II anastomoses. Amenorrhea was reported in 27 (14%) women at 5-year follow-up after UAE (only 3% in women < 45 y old). There were 10 cases of clinical failure with a median follow-up of > 4 years. Bilateral or unilateral presence of UOA had no statistically significant effect on outcomes or on complications. CONCLUSIONS: Recurrence rates, clinical failure, and amenorrhea after UAE do not seem to be influenced by the presence or absence of UOA. However, further studies are needed to confirm these findings.
Subject(s)
Leiomyoma/therapy , Ovary/blood supply , Uterine Artery Embolization , Uterine Artery , Uterine Neoplasms/therapy , Adult , Amenorrhea/etiology , Chi-Square Distribution , Collateral Circulation , Female , Humans , Kaplan-Meier Estimate , Leiomyoma/blood supply , Leiomyoma/complications , Leiomyoma/diagnostic imaging , Middle Aged , Odds Ratio , Pain/etiology , Radiography , Recurrence , Regional Blood Flow , Retrospective Studies , Risk Assessment , Risk Factors , Spain , Time Factors , Treatment Outcome , Uterine Artery/diagnostic imaging , Uterine Artery/physiopathology , Uterine Artery Embolization/adverse effects , Uterine Hemorrhage/etiology , Uterine Neoplasms/blood supply , Uterine Neoplasms/complications , Uterine Neoplasms/diagnostic imagingABSTRACT
Presentamos un caso de sarcoma epitelioide de vulva en una mujer de 30 años de edad, tratada con escisión amplia de la lesión. Se revisa la literatura científica disponible al respecto
We report a case of vulvar epithelioid sarcoma in a 30 year old woman treated by extensive local excision. The literature on this subject is reviewed
