Population-based survey on menopausal symptoms and treatment use.

OBJECTIVE: This article aimed to study the use of menopausal hormone therapy (MHT) among Spanish perimenopausal and postmenopausal women, the presence of menopausal symptoms and the sources of information. METHODS: The epidemiological study using a survey included Spanish perimenopausal or postmenopausal women aged between 40 and 70 years in August 2021. RESULTS: A total of 1254 women were included. In the postmenopausal group, 86% reported one or more menopausal symptoms; the most frequent was vulvovaginal dryness (57%). Among the symptomatic women, 15.2% used some treatment. Vasomotor symptoms (p = 0.001), vulvovaginal atrophy (p < 0.001) and symptoms related to sexuality (p < 0.001) were associated with greater use of treatments; 2.5% of postmenopausal women used MHT. In the perimenopausal group, 75.1% were symptomatic, hot flashes being the most frequent. Only insomnia was related to greater use of some treatment (p = 0.021); 1.6% of perimenopausal women used MHT. The most common reason for women's rejection of MHT was the fear of side effects, especially cancer. The gynecologist was the most frequently used source of information. CONCLUSIONS: Although there is a high prevalence of symptoms, the use of MHT in Spanish perimenopausal and postmenopausal women is very low.

Factores de riesgo para carcinoma de endometrio de alto grado / Risk factors for high-grade endometrial carcinoma

El carcinoma de endometrio (CE) ha sido dividido de forma clásica en 2grupos: el tipo I, considerado de buen pronóstico y estrógeno dependiente y el tipo II, de peor pronóstico y estrógeno independiente. Esta subdivisión etiopatogénica no está tan clara cuando se habla de CE de alto grado. El objetivo del estudio es analizar los factores de riesgo asociados al CE de alto grado. Material y métodos: Estudio retrospectivo de cohortes multicéntrico en 3hospitales españoles de tercer nivel, Hospital Universitario Miguel Servet en Zaragoza, Hospital Clínico San Carlos en Madrid y Hospital Virgen del Rocío en Sevilla, en el que se estudió la presencia de los factores de riesgo asociados al CE de alto grado histológico: endometrioide G3 (CEG3), carcinoma seroso (CS), carcinoma de células claras (CCC) y carcinosarcoma uterino o tumor mülleriano mixto maligno (TMMM). Se analizaron las posibles diferencias entre los subtipos y atendiendo a si se trataba de CE tipo I/II. Se incluyeron 373 CE de alto grado, de ellos, 135 fueron CEG3 o de tipo I y 238 de tipo II: 96 CS, 64 CCC y 78 TMMM. Resultados: La diabetes, obesidad, nuliparidad y utilización de tratamiento hormonal de reemplazo no mostraron diferencias significativas entre los subtipos. El TMMM fue el que con menor frecuencia se asoció a HTA y, por el contrario, el que mostró mayor asociación a la utilización de tamoxifeno. Conclusiones: Los factores de riesgo asociados a CE de alto grado son similares en el tipo I y II

Endometrial carcinoma (EC) has traditionally been divided into 2groups: type I, considered to have a good prognosis and to be oestrogen-dependent and type II, with a poorer prognosis and oestrogen-independent. The aim of the study is to analyse the risk factors associated with high-grade EC. Material and Methods: Retrospective multicentre cohort study in 3Spanish reference hospitals: Hospital Universitario Miguel Servet in Zaragoza, Hospital Clínico San Carlos in Madrid and Hospital Virgen del Rocío in Seville. We studied the presence of risk factors associated with high grade EC: G3 endometrioid (G3EC), serous carcinoma (SC), clear cell carcinoma (CCC) and malignant mixed mesodermal tumours (MMMT). Differences between subtypes were analysed depending on whether the EC was type I or II. A total of 373 cases of high-grade EC were included, of which 135 were G3EC or type I and 238 were type II (96 SC, 64 CCC and 78 MMMT). Results: Diabetes, obesity, nulliparity and use of hormonal replacement therapy showed no significant difference between subtypes. MMMT was less frequently associated with hypertension and conversely it showed greater association with the use of tamoxifen. Conclusions: Risk factors associated with high-grade EC are similar in type I and II

Cancer sincronico de endometrio y trompa / Synchronous primary endometrial and tube fallopian cancers

Los tumores sincrónicos del tracto genital femenino son un entidad infrecuente que plantea un reto en el diagnóstico diferencial con la enfermedad metastásica. La mayoría de ellos son cánceres de endometrio y ovario, siendo los tumores sincrónicos de endometrio (CE) y trompa (CT) una asociación excepcional. Presentamos el caso de una paciente de 54 años con un diagnóstico preoperatorio de CE en la en la pieza quirúrgica se desveló la existencia de un tumor sincrónico de trompa izquierda. A propósito de este caso se realiza una revisión del tema haciendo hincapié en cómo llegar a un correcto diagnóstico de los tumores independientes descartando la extensión tumoral y la enfermedad metastásica.

Synchronous primary cancers of gynecological tract are uncommon and a challenge in the differential diagnosis with metastatic disease. Most of them are endometrial and ovarian cancers. Synchronous primary endometrial (EC) and tube fallopian cancers (TC) are a very rare association. We report the case of a patient of 54 years with EC preoperative diagnosis with synchronous left TC postoperative diagnosis. We review the topic emphasizing how to reach a correct diagnosis of tumors independent refusing the tumor invasion and metastatic disease.