Early Diagnosis of Congenital Uterine Anomalies: Is the Three Dimensional Ultrasound Approach the Suitable Choice? 3D in Uterine Anomalies

Purposes: Congenital uterine anomalies (CUA) are benign conditions associated with relatively serious complications affecting the reproductive life. Due to their infrequency CUA are often misdiagnosed, exposing the patient to possible future complications. Case description: We report the cases of three women affected by an unknown CUA, which underwent three different diagnostic and surgical approaches. Conclusions: A correct and early diagnosis of CUA is mandatory to allow a correct clinical and therapeutic management. In our opinion we might avoid the use of MRI considered as the second line technique after 2D-US, keeping in mind that in CUA the diagnostic value of 3D-US has the same accuracy as MRI

Uterine undifferentiated sarcoma associated with primary adenocarcinoid of ileum: an unusual second primary malignancy with therapeutic implications

Purpose Uterine sarcomas and small bowel neuroendocrine tumours are both uncommon neoplasms. We report the case of a patient affected by an undifferentiated uterine sarcoma and synchronous adenocarcinoid of the ileum, in which surgery played a key role.Methods A 57-year-old postmenopausal woman presented with a 6-month history of pelvic pain and uterine bleeding. Examination revealed a polypoid mass of 15 mm in diameter protruding from external os. Abdomino-pelvic MRI identified another solid nodule of 20 mm in diameter in the ileal wall.Results Histology demonstrated an undifferentiated uterine sarcoma. However, the ileal nodule proved to be an adenocarcinoid and not a metastatic deposit of the uterine malignancy.Conclusions Histological evaluation of uncertain lesions may help in providing appropriate treatment and hence, a better survival

Therapeutic vaccines and immune checkpoints inhibition options for gynecological cancers

Treatments for gynecological cancer include surgery, chemotherapy, and radiation. However, overall survival is not improved, and novel approaches are needed. Immunotherapy has been proven efficacious in various types of cancers and multiple approaches have been recently developed. Since numerous gynecological cancers are associated to human papilloma virus (HPV) infections, therapeutic vaccines, targeting HPV epitopes, have been developed. The advancing understanding of the immune system, regulatory pathways and tumor microenvironment have produced a major interest in immune checkpoint blockade, Indeed, immune checkpoint molecules are important clinical targets in a wide variety of tumors, including gynecological. In this review, we will describe the immunotherapeutic targets and modalities available and review the most recent immunotherapeutic clinical trials in the context of gynecological cancers. The synergic results obtained from the combination of HPV therapeutic vaccines with radiotherapy, chemotherapy, or immune checkpoint inhibitors, may underlie the potential for a novel therapeutic scenario for these tumors

Prevention of recurrent lower urinary tract infections in postmenopausal women with genitourinary syndrome. outcome after 6 months of treatment with ospemifene

Aim of this study was to evaluate the efficacy of ospemifene in the prevention of recurrent lower urinary tract infections in postmenopausal women with vulvovaginal atrophy. The study have a retrospective design. Thirty-nine patients were enrolled. Patients underwent clinical examination and urine culture. The urinary symptoms and the quality of life were evaluated with UTISA score, PUF and SF-36 questionnaires before and after treatment. All 39 patients received ospemifene 60mg one tablet/daily for 6months. Adverse effects and complications were assessed. Thirty-nine patients were enrolled in the study. Two patients experienced one new UTI episode and the mean number of positive urine culture decreased significantly after 6months (3.652.12 vs 0.25 +/- 0.17, p<.0001). The mean number of urinary infection symptoms decreased significantly after treatment; dysuria reduced (4.76 +/- 2.45 vs 0.89 +/- 1.12). PUF score and SF-36 showed a statistically significant change (22.43 +/- 5.89 vs 12.14 +/- 3.21) and (52.86 +/- 9.21 vs 83.43 +/- 10.76). No adverse effects were reported and the total success rate was the 92.3% after 6months at PGI-I. Ospemifene is a valid alternative with excellent tolerability for the UTIS prevention in postmenopausal patients.