Feasibility of Sentinel Lymph Node Sampling in Early-Stage Carcinoma Endometrium: Single-Institution Experience.

Introduction: Accurate surgical staging is an essential component in the management of carcinoma endometrium to assess the stage of disease and to tailor adjuvant treatment. Sentinel node technique was introduced as an alternative for extensive lymphadenectomy in early stages to avoid complications associated with lymphadenectomy. Aims and Objectives: To assess the detection rate and diagnostic accuracy of SLN mapping in patients with early-stage carcinoma endometrium. Materials and Methods: Prospective validation study involving 30 patients diagnosed to have early-stage carcinoma endometrium. Sentinel nodes were detected by combined methods of radio colloid dye and isosulphan blue dye injection. Results: Sentinel lymph node was detected in 19 patients (63.4%). 11 patients had no sentinel nodes. Total number of sentinel nodes isolated was 68 with a mean of 2.26 per patient (range 0-4). Ten (33.33%) patients had single sentinel node location, while 9 (30%) had more than 1 sentinel lymph nodes. Twelve patients had bilateral sentinel nodes, and the most frequent location of sentinel node was obturator, 19 (63.3%) especially on right hemi-pelvis. One patient had a hot para-aortic node, while none had blue para-aortic sentinel node. Average number of lymph nodes obtained by lymphadenectomy was 13 per patient (range 7-22). All patients with sentinel node had negative frozen report as well as in histopathology. Two patients in whom no sentinel nodes were detected by either techniques had metastatic nodes in histopathology report. Conclusion: Detection rate was maximum with radiocolloid dye, and it is better to utilize the technique for less graded tumours and endometrioid variants.

Hypothyroidism Presenting as Ovarian Cysts-a Case Series.

Ovarian cysts can be caused by endocrine disorders. Hypothyroidism causing ovarian cysts is an uncommon entity, but rarely does it cause an ovarian cyst which can mimic malignancy. We report three cases of ovarian masses which were referred to our institute suspecting malignancy. These patients on further evaluation were found to have severe hypothyroidism and started on thyroxine supplementation. There was dramatic symptomatic relief as well as resolution of the ovarian masses on subsequent imaging. Hypothyroidism should be considered in the differential diagnosis of bilateral multicystic adnexal masses to avoid inadvertent surgery.