Etiopathogenesis, diagnosis and treatment of patients with HSIL of the cervix

Introduction. HSIL is a precancerous layer of the cervix associated with HPV. It presents 3 morphopathological features CIN 2, CIN 3 and cancer in situ. The spectrum of abnormalities and mode of treatment was first subdivided in 1968 by Richart who also laid the basis for today's CIN classification. Aim of study. The assessment of treatment aspects of the patients with different degrees of high-grade squamous epithelial dysplasia. Methods and materials. The study was conducted on 46 patients with HSIL at the Oncologic Institute of the Republic of Moldova during 2020-2021. It is a prospective and retrospective analysis of the original documentation. The patients included in the study were divided according to the histological type in CIN 2 (18 patients), CIN 3 (20 patients) and cancer in situs (8 patients), age (48 years) and type of treatment (LLETZ - large loop excision of the transformation zone, total hysterectomy with bilateral adnexectomy). All the patients underwent primary surgical treatment within the Public Medical and Sanitary Institution – Oncological Institute. Results. From 46 patients included in this study within 25 and 72 years old, 18(39,13%) patients had CIN 2, aged <35 years and were underwent LLETZ, 20 (43,47%) patients had CIN 3, of which 17(36,95%) were aged 48 years and were underwent total hysterectomy with bilateral adnexectomy, 8(17,39%) patients had cancer in situs , of which 2(4,34%) had age 48 years and were underwent total hysterectomy with bilateral adnexectomy. All the patients after surgery had a positive outcome and were discharged from hospital. Conclusion. Patients with HSIL in childbearing age (<35 years) can undergo a less radical operation like LLETZ with subsequent observation of health status. Patients older than 48 years are more likely to develop malignant cancer from HSIL and are recommended a total hysterectomy with bilateral adnexectomy

The metachronic affectation – two malignant process. Clinical case

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Cancerul mamar reprezintă al doilea cel mai frecvent tip de cancer întâlnit atât la nivel mondial, cât și în Republica Moldova. Pacienții cu cancer mamar au un risc de circa 20 de ori mai mare de afectare a sânului contralateral, cât și de apariție a altor tumori maligne la distanță de focarul primar. Scopul lucrării. Prezentarea unui caz clinic a unei paciente cu 2 procese maligne metacrone: cancer mamar și limfomul Hodgkin, morfologic confirmat, ce a fost tratată în cadrul secției de Mamologie și Hematologie a Institutului Oncologic. Material și metode. Datele anamnestice, clinice, paraclinice și de tratament au fost prelevate din fișa medicală. Pacientă, 58 de ani, la evidență la Institutul Oncologic din anul 2020 cu diagnosticul de Cancer mamar pe dreapta T1cN0M0, st. Ic. Stare după operație organomenajantă pe dreapta, radioterapie postoperatorie și hormonoterapie. În anul 2021, pe fon de hormonoterapie a fost confirmat diagnosticul de limfom Hodgkin. Rezultate. Diagnosticul de limfom Hodgkin a fost stabilit prin examen ultrasonografic, radiologic și imunohistochimic prin biopsia cu ac gros a ganglionilor limfatici axilari pe stânga, cu reacție pozitivă la: CD20, CD45, CD15, caracteristic pentru Limfomul Hodgkin clasic sclerozant nodular. Tratamentul standard cu polichimioterapie a fost cu o evoluție favorabilă, cu ameliorare clinică și biologică. Concluzii. Pacienții cu cancer primar diagnosticat și tratat, au o probabilitate mai mare de a dezvolta un alt tip de tumori maligne comparativ cu populația generală. Tratamentul standard polichimioterapic pentru cancerele metacrone a demonstrat eficiența scontată.Background. Breast cancer represents the second most common type of cancer worldwide, as well as in the Republic of Moldova. Patients with breast cancer have a risk approximately 20 times higher for contralateral breast involvement and the development of other distant malignant tumors apart from the primary focus. Objective of the study. Presentation of a clinical case of a patient with two metachronous malignant processes: breast cancer and Hodgkin’s lymphoma, morphologically confirmed, who was treated within the Department of Mamology and Hematology of the Institute of Oncology. Material and methods. Anamnestic, clinical, paraclinical, and treatment data were extracted from the medical record. A 58-year-old woman, has been under observation at the Institute of Oncology since 2020 with a diagnosis of right breast cancer, T1cN0M0 stage Ic. She underwent organ-conserving surgery on the right side, followed by postoperative radiotherapy and hormone therapy. In 2021, while on hormone therapy, the diagnosis of Hodgkin’s lymphoma was confirmed. Results. The diagnosis of Hodgkin’s lymphoma was established through ultrasound, radiological, and immunohistochemical examination of a thick needle biopsy of the left axillary lymph nodes, showing positive reactions to CD20, CD45, and CD15, which are characteristic for classical nodular sclerosing Hodgkin’s lymphoma. Standard treatment with chemotherapy had a favorable outcome, with clinical and biological improvement. Conclusion. Patients with a primary cancer diagnosis and treatment have a higher probability of developing another type of malignant tumor compared to the general population. Standard polychemotherapy treatment for metachronous cancers has demonstrated the expected effectiveness