Multicentric disease of the lower genital tract,challenge to the colposcopist

Enfermedad multicéntrica del tracto genital inferior, reto al colposcopistaMulticentric disease of the lower genital tract,challenge to the colposcopis

Laparoscopic surgery in morbidly obese patients with endometrial cancer

Introduction: surgery in morbidly obese patients as a treatment for gynecologic cancer is a challenge for surgeons and anesthesiologists, since it is associated with the processes of increasing intraoperative and postoperative complications. Objective: to describe the main results gained with the use of laparoscopic surgery in patients with morbid obesity and endometrial adenocarcinoma treated at the Instituto Nacional de Oncología y Radiobiología (INOR) of Havana, Cuba, from January 2019 to March 2020. Method: a descriptive, observational, cross-sectional study was carried out in 22 patients, with body mass index more than 40 kg/m2 and diagnosis of endometrial adenocarcinoma, who underwent laparoscopic surgery. The primary data was obtained from the medical records, which were used to create a database in a Microsoft Excel spreadsheet to synthesize all the information. Results: the predominant age group was between 61 and 70 years old. Endometrial adenocarcinoma was the most frequent cancer (77.27%). The degree of differentiation was well differentiated, infiltrating less than 50 % of the myometrium. The predominant surgical staging was IA (72.72%). Transoperative bleeding was 78.9 ± 5.7 ml (range between 10 and 200 ml), mean operative time was 82 min (range 75-132 min), and hospital stay was less than 24 hours (90.90%). Surgical conversion was performed in 4.54% of cases. Conclusions: morbidly obese patients may benefit from the laparoscopic approach for the treatment and laparoscopic surgical staging of endometrial carcinoma, which decreases morbidity and hospital stay

Tumor de Células de Sertoli del ovario: Reporte de un caso

Introduction: Sertoli cell tumors are a rare entity with an incidence of ovarian cancer of 0,2-0,5 %. The initial diagnosis of this type of tumors is difficult to make due to the histological varieties and its differentiation.Objective: To demonstrate the value of immunochemical techniques in the completion of the diagnostic process of ovarian tumors aimed at identifying a rare variant such as Sertoli cell tumor.Case presentation: A 43-year old woman with a primitive Sertoli cell tumor of the ovary is presented. The patient had personal history of hypothyroidism. She underwent surgery at “Dr. Agostinho Neto” General Teaching Hospital because she had been diagnosed with a solid tumor of the right ovary. During the intraoperative period, a giant tumor with a malignant appearance was found. The pathological result reported a typical carcinoid tumor. The patient was referred to the National Institute of Oncology and Radiobiology where the immunohistochemistry of the biopsy reported a Sertoli cell tumor. Currently, the patient is asymptomatic.Conclusions: The accurate pathological diagnosis and the correct immunohistochemistry are very important for the management and treatment of this type of tumor.Introducción: Los tumores de Células de Sertoli son una entidad rara, con una frecuencia de 0,2-0,5 % del cáncer de ovario. El diagnóstico inicial de este tipo de tumores es difícil, debido a las variedades histológicas que presenta y a su diferenciación.Objetivo: Demostrar el valor del completamiento del proceso diagnóstico con técnicas de inmunohistoquímica en tumores ováricos para identificar una variante rara como el tumor de Células de Sertoli.Presentación del caso: Se presenta un caso de un tumor de ovario primitivo de Células de Sertoli en una paciente de 43 años de edad, con antecedentes personales de hipotiroidismo, intervenida quirúrgicamente por un tumor sólido del ovario derecho en el Hospital General Docente “Dr. Agostino Neto”. En el intraoperatorio, se encontró un tumor gigante de aspecto maligno. El resultado anatomopatológico informó un tumor carcinoide típico. La paciente fue remitida al Instituto Nacional de Oncología y Radiobiología, donde la inmunohistoquímica de la biopsia informó un tumor de Células de Sertoli. Actualmente la paciente se encuentra asintomática.Conclusiones: El diagnóstico anatomopatológico preciso y la inmunohistoquímica correcta son muy importantes para el manejo y tratamiento de este tipo de tumor

Could metabolic risk factors contribute to the development of cervical cancer?

The role of human papillomavirus infection as etiological factor for cervical squamous intraepithelial lesions and cervical cancer is well established. However, the presence of this virus is not sufficient condition for developing of cervical cancer. Currently, the contribution of other viral, environmental and host cofactors in triggering of this neoplasm is being investigated. Some metabolic risk factors have been associated with the development of several gynecological cancers such as endometrium, ovary and cervix. However, the mechanisms through which these factors contribute to carcinogenesis are complex and not fully elucidated. Few interventions regarding host metabolic factors have been performed on women at risk of developing cervical cancer. Some specific treatments and or changes in lifestyles could be carried out to avoid or delay progression to this kind of cancer. This paper aims to enlarge and update this topic based on the article ¨Association between components of the metabolic syndrome and degree of cervical squamous intraepithelial lesions in Cuban women¨, with emphasis on possible mechanisms that explain the link between central adiposity, insulin resistance and dyslipidemia with risk of premalignant lesions and cervical cancer.&nbsp