Incidence of occult uterine sarcoma and other unexpected pathologies in patients having surgery for presumed myomas: A retrospective observational study.

OBJECTIVE: To determine the incidence of occult uterine sarcomas and other unexpected pathologies in patients undergoing hysterectomies or myomectomies with a pre-operative diagnosis of uterine leiomyomas. STUDY DESIGN: Retrospective study. SETTING: Tertiary hospital in Santiago, Chile. POPULATION: 921 women who underwent surgery for presumed myomas. Database analysis of surgical and pathological notes, from January 2007 to December 2017 with a preoperative diagnosis of uterine leiomyoma. MAIN OUTCOME MEASURES: number of patients with uterine sarcoma confirmed on histology. RESULTS: During this period, a total of 921 gynecological surgeries were performed for benign uterine fibroids of which 787 were hysterectomies and 134 were myomectomies. We found four cases of malignant neoplasms (0,43 %). Two were uterine leiomyosarcoma (LMS), one mixed epithelial and mesenchymal tumor, and one case of incidental cervical cancer. This gives an LMS incidence of 1 in 460 and 1 in 921 of mixed epithelial and mesenchymal tumor. There were seven cases of unexpected benign pathology. This included six atypical myomas and one leiomyoblastoma epithelioid myoma. If we combine the malignant and benign cases, we would have an incidence of 1.2 % of unexpected pathology. CONCLUSION: In our series of patients undergoing myomectomies or hysterectomies for presumed myomas the incidence of LMS was 1 in 460. The incidence of any unexpected pathology including benign ones in presumed myomas was 1 in 83 (six atypical myomas, one leiomyoblastoma epithelioid myoma, two LMS, one mixed epithelial and mesenchymal tumor, one incidental cervical cancer).

Introduction of non-B subtypes among Spaniards newly diagnosed with HIV type 1 in the Canary Islands.

The Spanish Canary Islands face the northwest coast of Africa, being one gate of entrance of African immigrants into Europe and of HIV-1 non-B strains, prevalent in most African regions. The presence and nature of HIV-1 non-B subtypes were examined in Spanish natives newly diagnosed with HIV-1 infection from 1998 to 2004 in a reference hospital located in one of the largest islands of the archipelago. Subtyping of HIV-1 pol genes was performed in 139 out of 429 individuals found to be HIV-1 positive during that period. Non-B strains infected 40 (28.8%) subjects, 12 (13.7%) out of 87 native Spaniards and 28 (53.8%) out of 52 immigrants (75% Africans) (p < 0.01). HIV-1 non-B subtypes, mostly recombinant forms, were present in Spaniards at least since 1998. HIV-1 non-B subtypes are frequently recognized in HIV+ Africans arriving in the Canary islands and continuously introduced into the newly diagnosed HIV-1+ native population living in the archipelago.

Tratamiento quirúrgico por laparoscopia del embarazo tubario / Surgical treatment by laparoscopy of tubal pregnancy

Se presentan los 5 primeros casos de salpingectomía laparoscópica efectuados en nuestro servicio, describiendo los hallazgos clínicos, anatomopatológico y la técnica quirúrgica efectuada en cada caso. Además se discute los artículos más relevantes que aparecen en la literatura