Prognostic importance of atypical endometriosis with architectural hyperplasia versus cytologic atypia in endometriosis-associated ovarian cancer.

OBJECTIVE: Patients with endometriosis are at increased risk of ovarian cancer. It has been suggested that atypical endometriosis is a precursor lesion of endometriosis-associated ovarian cancer (EAOC). The aim of this study is to evaluate if cytologic (cellular) atypia and architectural atypia (hyperplasia), histologic findings described as atypical endometriosis, play a different role in patients with EAOC. METHODS: A prospective study was conducted between January 2014 and April 2017 at our institution with patients undergoing surgery with a histologic diagnosis of endometriosis, ovarian cancer, or EAOC. The prevalence and immunohistologic study (Ki-67, BAF250a, COX-2) of cases of cellular and architectural atypia in endometriosis were analyzed. RESULTS: Two hundred and sixty-six patients were included: the diagnosis was endometriosis alone in 159 cases, ovarian cancer in 81, and EAOC in 26. Atypical endometriosis was reported in 23 cases (12.43%), 39.13% of them found in patients with EAOC. Endometriosis with cellular atypia was found mainly in patients without neoplasm (71.4%), and endometriosis with architectural atypia was seen in patients with ovarian cancer (88.9%) (p=0.009). Ki-67 was significantly higher in endometriosis patients with architectural atypia than those with cellular atypia. CONCLUSION: The diagnosis of endometriosis with architectural atypia is important because it may be a precursor lesion of ovarian cancer; therefore, pathologists finding endometriosis should carefully examine the surgical specimen to identify any patients with hyperplasia-type endometriosis, as they may be at higher risk of developing EAOC.

Neurocisticercosis y gestación / Neurocysticercosis and pregnancy

Describimos el caso de una gestante de 29semanas que ingresó tras presentar una crisis comicial generalizada tónico-clónica, sin antecedentes de epilepsia. Se descartó en un primer momento, por la clínica y la analítica, el cuadro de eclampsia y se contactó con neurología, que tras el estudio exhaustivo de la paciente la diagnosticó de neurocisticercosis cerebral. El tratamiento etiológico permitió llevar la gestación a término con normalidad, evitando así la gran morbimortalidad que hubiera supuesto finalizar la gestación prematuramente de no haber realizado un correcto diagnóstico diferencial. Mostramos también la necesidad de descartar enfermedades parasitarias no endémicas en nuestro medio en población inmigrante (AU)

We describe the case of a 29 weeks pregnant woman admitted after suffering her first generalised tonic-clonic seizure. Eclampsia was first ruled out by means of clinical history and analytical findings. The neurology department, after an exhaustive study, diagnosed the patient with cerebral neuro cysticercosis. She received aetiological treatment which enabled her to have a normal pregnancy and delivery, thus avoiding a pre-term delivery, which is associated with high foetal morbidity and mortality. We also show the need to rule out non-endemic parasitic infection in our immigrant population (AU)