[Malignancy of uterine sarcoma in comparison with suspect leiomyoma. An anatomo-clinical study of 16 cases]. / La malignité du sarcome utérin, par comparaison avec les léiomyomes suspects. Etude anatomo-clinique sur seize cas.

Sarcoma of the uterus accounts for less than 1 per cent of uterine neoplasms but is responsible for more than 15 per cent of deaths. However, histological or clinical malignancy features are poorly understood, in particular those which differentiate sarcomas from leiomyomas. This study involved 16 cases, seen during 8 years in two gynecology clinics in Iasi (Rumania) and chosen according to histological diagnosis. Ten leiomyomas were also chosen for comparison of symptomatology. The malignancy criteria studied--vascular invasion, cellular density, number of mitoses and histological type (most often leiomyosarcoma: 8 out of 16)--were used to compare sarcomas with suspect leiomyomas. The mean age was 50, 7 cases being diagnosed after the menopause. The commonest symptom was metromenorrhagia (11 cases out of 16), but pain was more frequent in leiomyomas (9 out of 10). Treatment was above all surgical, total hysterectomy having the best prognosis (3 deaths out of 8 patients operated upon). Other methods (in particular radiotherapy) not being used immediately after surgery, they could not be studied. In terms of its difficult diagnosis and its high degree of malignancy (9 deaths out of 16), sarcoma must remain an argument in favour of total hysterectomy.

Meigs' syndrome. A case report and review of literature.

A 31-year-old woman, with primary infertility associated with cervico-vaginal defect, presented with intermittent breathlessness often correlated by the patient with menses, cough and chest pain. The symptoms had lasted for 6 months, and were attributed to a pleurisy, which was confirmed at roentgenology and treated by frequent thoracentesis, evacuating in all over 15 liters of fluid. Several aetiologies were excluded, such as: viral, TB, L.E., neoplasia, liver disfunction. A gynecological ultrasonography finally diagnosed a solid extensive ovarian tumour. Right oophorectomy has completely stopped pleural effusion relapse. We consider this case representative for the importance of a serious consideration of Meigs' syndrome in any recurrent pleurisy. We also believe our case to support the hypothesis of a hormone implication in Meigs' syndrome cause, as the symptoms correlated with menses, and especially as the morphopathological diagnosis was ovarian fibroma with myxoid areas, which could be incriminated for the patient's primary infertility, but it was not properly investigated.