Residual Disease after Operative Hysteroscopy in Patients with Endometrioid Endometrial Cancer Associated with Polyps

Conclusion Patients with endometrioid EC associated with polyps may have the tumor completely removed during hysteroscopy, but the variables shown in the present study could not safely predict which patient w ould have no residual disease.Resumo Objetivo Avaliar a presen ça de doença residual no exame anatomopatológico definitivo de pacientes com câncer de endométrio endometrioide após polipectomia ou biópsia de pólipo histeroscópica. Métodos Analisamos 104 pacientes (92 casos do Hospital AC Camargo e 12 casos do Hospital do Servidor Público Estadual de São Paulo) com pólipos diagnosticados durante histeroscopia e cuja biópsia histeroscópica ou exame patológico final do útero acusaram câncer de endométrio endometrioide. As pacientes foram submetidas a cirurgia para câncer de endométrio de janeiro de 2002 a janeiro de 2017. Os dados clín icos e anatomopatológicos de cada paciente foram retirados dos prontuários médicos Resultados Em 78 casos (75%), o pólipo continha a neoplasia, e em 40 (38.5%), ela estava restrita ao tecido do pólipo, sem envolvimento endometrial adjacente. O estadio final foi IA em 96 casos (92.3%) e em 90 (86.5%) tratava-se de grau 1 ou 2. Em 18 casos (17.3%), não havia doença residual no espécime uterino, mas emapenas 9 deles a histeroscopia sugeriu doe...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research

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é R, Jakab A Abstract Endometrial cancer is the most common gynecological malignancy with a relatively good overall prognosis. It traditionally has two subtypes: type 1 (endometrioid carcinoma) and type 2 (non-endometrioid carcinoma). The prognosis is excellent for stage I endometrioid cancer, with a 5-year survival rate of 96%. However, the prognosis is much worse for women with high-risk endometrial cancer. Effective preoperative staging is important in order to tailor treatment and achieve optimal long-term survival. The majority of asymptomatic polyps detected by ultrasound are treated surgically. Conve...
Source: Climacteric - Category: Geriatrics Authors: Tags: Climacteric Source Type: research
CONCLUSION: The incidence of endometrial carcinoma in the surrounding endometrium after complete resection of a polyp with atypical hyperplasia is 30.8% in this study. This supports the current advice to perform a hysterectomy and bilateral salpingo-oophorectomy. No prognostic factor for (pre-)malignant changes in a polyp were established. PMID: 32133762 [PubMed - as supplied by publisher]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
Rationale: Uterine adenosarcoma (UA) with sarcomatous overgrowth (ASSO) is a rare and aggressive disease. Herein, wereported the case of a young patient with advanced uterine ASSO. Patients concerns: A 29-year-old woman with the diagnoses of endometrial polyp and adenomyosis underwent hysteroscopic endometrial polypectomy for the giant endometrial polyp. Postoperative regular ultrasound scan indicated thickened endometriumand an ill-defined mass with continuous enlargement in the myometrium of the posterior wall of the uterus, which was considered as an adenomyoma. Two years after hysteroscopy, she was re-admitted due...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We report a case of misdiagnosed endometrial cancer by D&C, but with a positive cytopathological finding. Following that, a meta-analysis including 4,179 patients of endometrial diseases with cyto-histopathological results was performed to assess the value of the endometrial cytological method in endometrial cancer diagnosis. The pooled sensitivity and specificity of the cytological method in detecting endometrial atypical hyperplasia or cancer was 0.91[95% confidence interval (CI) 0.74–0.97] and 0.96 (95% CI 0.90–0.99), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 25.4 (...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 15 April 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Anna Uglietti, Laura Buggio, Marilena Farella, Francesca Chiaffarino, Dhouha Dridi, Paolo Vercellini, Fabio ParazziniAbstractBackgroundEndometrial polyps are a common condition. The risk of malignancy has often led to an overtreatment with high health care costs and huge psychological distress.ObjectiveWe conducted a systematic review and a meta-analysis in order to estimate the prevalence of premalignant and malignant lesions in women undergoing hysteroscopic polypectomy.Data sourceWe d...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionIn our study, we detected an prevalence of endometrial cancer among 9% of geriatric women with endometrial polyps. Hence, it is important to conduct a pathological evaluation of endometrial polyps in such patients.
Source: International Journal of Gerontology - Category: Geriatrics Source Type: research
CONCLUSION: The prevalence of hyperplasia and cancer in benign-looking polyps is high. The independent predictors are body mass index and endometrial thickness. Removal of polyps may be warranted until hysteroscopic morphological criteria that can reliably predict the outcome are established in future research. PMID: 29219004 [PubMed - as supplied by publisher]
Source: Climacteric - Category: Geriatrics Authors: Tags: Climacteric Source Type: research
Conclusion Our results indicate that hysteroscopic evaluation of the uterine cavity and polyp resection are not enough for the eradication of pre-malignant and malignant endometrial lesions. This alternative should be reserved for well-selected cases such as for fertility preservation and for patient with surgical risk factors that after the hysteroscopic polypectomy will receive further medical treatment.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionLarge mass size, longer time after last menstrual period, and older age are risk factors for abnormal histologies of uterine masses resected via hysteroscopy. Clinicians should take particular care when contemplating hysteroscopic removal for women younger than 40 years, and those with masses of
Source: Journal of Obstetrics and Gynaecology Research - Category: OBGYN Authors: Tags: Original Article Source Type: research
Conclusion The risk of a malignant lesion appears to be high (12%) in menopausal patients aged over 59 presenting an endometrial polyp detected when there is pre-existing AUB. In this situation, hysteroscopic resection of endometrial polyps should therefore be routinely proposed. For other patients, the risk of a malignant lesion is low but not insignificant, standing at about 3%. Each patient record should therefore be discussed on an individual case basis, taking into consideration the patient’s pre-existing conditions, after providing clear and appropriate information.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
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