The impact of metabolic syndrome on the clinical profile and tumor characteristics of endometrial carcinoma

Background: The objective is to study the influence of different components of metabolic syndrome on clinical behavior and tumor characteristics of endometrial cancer cases and to evaluate if metformin usage affects the stage and grade of endometrial cancer.Methods: 60 women attending the gynecological oncology clinic at El Shatby Maternity University Hospital, after being diagnosed as endometrial carcinoma, were recruited in the study. Serum samples were collected to detect insulin level and lipid profile, and then allocated into two groups according to metabolic syndrome existence. After the recommended surgery, and the routine histopathological diagnosis followed by histopathological chemilumeniscence technique to detect staining intensity, percentage of estrogen receptors ER, and score out of 8 according to Allred score.Results: Endometrial cancer EC patients with metabolic syndrome had a significantly higher age, higher FIGO stages, and higher grade compared to EC without metabolic syndrome (p˂0.05). There was no statically significant difference between both groups in estrogen receptors scoring. HDL was an important factor affecting grade of EC patients, as when HDL decreased by one mg/dl, the grade increased by 0.033% (P=0.030, OR=0.899, OR adjusted=0.826), Insulin level was found to be an important factor affecting stage as when insulin level increased by one Uiu/ml, the stage increased by1.091% (p=<0.001, OR=1.064, OR adjusted=1.091).Conclusions: Hyperinsulinemia was the most important factor affecting aggressiveness of the tumor as regards stage and risk group classification. Metformin failed to show a protective effect against endometrial cancer progression

Degenerated huge retroperitoneal leiomyoma presenting with sonographic features mimicking a large uterine leiomyoma in an infertile woman with a history of myomectomy: a case report

Abstract Introduction Retroperitoneal leiomyomata are rare. They are either mistaken preoperatively for malignant retroperitoneal tumors or dealt with as cases of subserous leiomyomata that turn out intraoperatively to be huge retroperitoneal masses of unknown nature. Case presentation We report the case of a 46-year-old nulligravid female patient of Middle Eastern ethnicity who presented to our university hospital with lower abdominal as well as pelvic pain along with a bloated sensation. She also reported noticing an unusual increase in her abdominal girth. These symptoms developed over the previous two months. Preoperative investigation by means of an ultrasound suggested a degenerated subserous huge uterine leiomyoma. An abdominal hysterectomy was planned. Intraoperatively, a normal sized uterus was found, the surface of which was studded with multiple variable sized pedunculated subserous leiomyomata. Another huge retroperitoneal soft to firm mass was found extending from her left pelvic wall to the level of her spleen, with no connections to her uterus. The mass was excised and a histopathological examination revealed a degenerated leiomyoma. Conclusion Some unusually located extra-uterine leiomyomata have been reported; retroperitoneal leiomyoma being among them. The origin of such tumors is still obscure; a parasitic origin as well as Müllerian cell rests or smooth muscle cells in the retroperitoneal vessels wall have been suggested. An 'iatrogenic' origin for such growths is also a possible theory. The origin of uncommonly located leiomyomata is an unexplored issue that merits more investigation.</p

The impact of metabolic syndrome on the clinical profile and tumor characteristics of endometrial carcinoma

Background: The objective is to study the influence of different components of metabolic syndrome on clinical behavior and tumor characteristics of endometrial cancer cases and to evaluate if metformin usage affects the stage and grade of endometrial cancer.Methods: 60 women attending the gynecological oncology clinic at El Shatby Maternity University Hospital, after being diagnosed as endometrial carcinoma, were recruited in the study. Serum samples were collected to detect insulin level and lipid profile, and then allocated into two groups according to metabolic syndrome existence. After the recommended surgery, and the routine histopathological diagnosis followed by histopathological chemilumeniscence technique to detect staining intensity, percentage of estrogen receptors ER, and score out of 8 according to Allred score.Results: Endometrial cancer EC patients with metabolic syndrome had a significantly higher age, higher FIGO stages, and higher grade compared to EC without metabolic syndrome (p˂0.05). There was no statically significant difference between both groups in estrogen receptors scoring. HDL was an important factor affecting grade of EC patients, as when HDL decreased by one mg/dl, the grade increased by 0.033% (P=0.030, OR=0.899, OR adjusted=0.826), Insulin level was found to be an important factor affecting stage as when insulin level increased by one Uiu/ml, the stage increased by1.091% (p=&lt;0.001, OR=1.064, OR adjusted=1.091).Conclusions: Hyperinsulinemia was the most important factor affecting aggressiveness of the tumor as regards stage and risk group classification. Metformin failed to show a protective effect against endometrial cancer progression